EM workforce swelling by 1500 doctors a year... will oversupply soon hit?

[TooMuchResearch]

So the median wait times published in Canadian media are not factual?

I wouldn't know.

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[GeneralVeers]

I wouldn't know.

You seemed to refute the published data with anecdotal evidence, so I wondered if you have a different take.

 

[TooMuchResearch]

You seemed to refute the published data with anecdotal evidence, so I wondered if you have a different take.

I don't know anything about Canada. I wasn't talking about Canada, maybe I stepped into a discussion on Canada by mistake.

 

[KeikoTanaka]

Just curious, I'm very uneducated in the field of Doctor business - but I get that undersupply = more money to each physician, however, in a field that is run no differently than a 24/7 Walmart, won't more EM docs make the lives of current EM docs way easier? Less nights, less weekends, etc? Sure, it might be a pay cut, but is it worth it to work less wonky hours?

 

[TooMuchResearch]

Just curious, I'm very uneducated in the field of Doctor business - but I get that undersupply = more money to each physician, however, in a field that is run no differently than a 24/7 Walmart, won't more EM docs make the lives of current EM docs way easier? Less nights, less weekends, etc? Sure, it might be a pay cut, but is it worth it to work less wonky hours?

Our group hires additional people as needed, the current supply of people looking to work for a fair SDG is more than sufficient for us.

 

[TooMuchResearch]

Also, the CMGs give zero sh*ts about making our schedules better, even if they have more bodies to fill the calendar.

 

[gro2001]

Just curious, I'm very uneducated in the field of Doctor business - but I get that undersupply = more money to each physician, however, in a field that is run no differently than a 24/7 Walmart, won't more EM docs make the lives of current EM docs way easier? Less nights, less weekends, etc? Sure, it might be a pay cut, but is it worth it to work less wonky hours?

I think it's a little bit more complicated than that. I think the demand for board certified EM physicians may be at least somewhat elastic. In fact there may be a threshold at which if there is too much of a scarcity then alternatives become more acceptable.

 

[KeikoTanaka]

I think it's a little bit more complicated than that. I think the demand for board certified EM physicians may be at least somewhat elastic. In fact there may be a threshold at which if there is too much of a scarcity then alternatives become more acceptable.

But, then, isn't it a good thing that more EM docs are entering the workforce? This would result in potentially less hospitals be willing to staff their EDs with PAs and NPs? I see this happening a lot in Primary Care. Out of necessity using NPs and PAs to handle most things. But if more docs were available, they wouldn't even have thought about transitioning away from them?

 

[gro2001]

But, then, isn't it a good thing that more EM docs are entering the workforce? This would result in potentially less hospitals be willing to staff their EDs with PAs and NPs? I see this happening a lot in Primary Care. Out of necessity using NPs and PAs to handle most things. But if more docs were available, they wouldn't even have thought about transitioning away from them?

That's the argument I made, perhaps not as clearly as you, earlier in this thread and similar threads in the past.

 

[alpinism]

But, then, isn't it a good thing that more EM docs are entering the workforce? This would result in potentially less hospitals be willing to staff their EDs with PAs and NPs? I see this happening a lot in Primary Care. Out of necessity using NPs and PAs to handle most things. But if more docs were available, they wouldn't even have thought about transitioning away from them?

The problem is that when community hospitals are given the choice between hiring an extra physician for 300K or an extra midlevel for 100K they'll choose the midlevel.

There's no federal regulations that require ERs to be staffed with BC/BE EM physicians so many places are moving towards a supervision model where you have a few physicians supervising a bunch of midlevels to increase profits. As a result there will actually be less jobs available to all these new grads over the coming years.

 

[Vandalia]

That is the way a Free Market is supposed to work. High prices (salaries) increases production, that drives prices (salaries) down at which point production decreases until an equilibrium solution is reached.

Now there is an easy solution to this if you want a socialist, centrally planned, economy.

 

[GeneralVeers]

That is the way a Free Market is supposed to work. High prices (salaries) increases production, that drives prices (salaries) down at which point production decreases until an equilibrium solution is reached.

Now there is an easy solution to this if you want a socialist, centrally planned, economy.

Right. Capitalism also says the producers (us) will lower production to increase or maintain a profit margin. We are too stupid to realize this and are doing the opposite.

 

[turkeyjerky]

Right. Capitalism also says the producers (us) will lower production to increase or maintain a profit margin. We are too stupid to realize this and are doing the opposite.

Wow it almost sounds like capitalism doesn't work well in medicine...

 

[GeneralVeers]

Wow it almost sounds like capitalism doesn't work well in medicine...

I agree. Let's go Single Payer and fix ALL the problems. The people will love their new glorious health care!

 

[namethatsmell]

That is the way a Free Market is supposed to work. High prices (salaries) increases production, that drives prices (salaries) down at which point production decreases until an equilibrium solution is reached.

Now there is an easy solution to this if you want a socialist, centrally planned, economy.

The thing is, we don't have a free market when it comes to EM thanks to the unfunded government mandate of EMTALA. While on the one hand this certainly protects patients, it also acts like an unbalanced healthcare tax and allows an irksome amount of patients to abuse the system. Apparently the fed thinks EMTALA is such a great idea that the VA, the government's largest health system, isn't required to comply with it (though the VA currently chooses to).

There are merits to free market healthcare and there are merits to socialized medicine.
Regardless, the system we currently have is doing a great job of continuing to shed its merits at an impressive pace.

And to the point of this thread...it's some of the worst aspects of our current health system (greedy for-profit HC systems and CMGs) that are causing all this increased production of EM residencies at hospitals that shouldn't have them. Yet, in spite of this, EM is better insulated from the risks of too high a supply of docs compared to most other fields of medicine. In part it's due to factors that continue to increase ED visits like the aging and increasingly chronically sick population along with the fluctuating insurance status of 10s of millions. And then there's the reality that working in any given ED can go from being an A-OK job one month to more like toiling away in a delightful hellscape the next month due to the most nonsensical and unexpected of reasons. And that the work is hard, the stressors are many, and the hours can be painful. Discussions of burnout, staffing issues, and EM docs leaving the field early aren't going away anytime soon. Until the day-to-day experience of working in many EDs become meaningfully different than exploring the inside of a meat grinder I don't think overproduction will be the biggest danger to our field.