if compensation drops too much...

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And this is exactly what some people want. Slash your pay to 'reasonable'. Thousands of foreign docs are lined up waiting for a chance to work for $60-70,000 per year. Less than an RN? Who cares! They work for a living, doctors just think. Nobody feels sorry for a starving physician, since we all make too much anyways.
 
Here's my take. We're entering a period of prolonged recession. Our "liabilities" (i.e. unfunded social programs) like SS and Medicaid are at staggering levels. It's been "acceptable" to turn a blind eye on these issues under non-recessionary times. But, a prolonged recession will change this.

I'm talking a BAD, prolonged recession. This will force the government to address these UNFUNDED liabilities. There will be changes, and in the case of medicine, it's likely that some very tough ethical decisions will need to be made regarding distribution/allocation of care.

As for job prospects, the demand will be there. Doctors will not be out of work. It'll be a great career RELATIVE to other options over the next 10 years. Not sure how the funding issues will be addressed. Will physician compensation be on the cutting board? Perhaps, but I think the major savings will come from hard decisions on whom is able to get what in terms of resources. Things may begin to resemble Europe in terms of end of life care and medical decision making.

American consumer capitalism is coming to an end. It'll either be a soft landing or a very hard one. If it's hard, it doesn't mean quick. Who knows how long this will take. But, we're seeing a global shift in balance of trade and consumption.

If this sparks some interest, I can paste some VERY enlightening links later if you want.

These are all just my opinions based on what I've read and watched.
 
The current reality is not matched with prognostications. Right now, salaries are going up, not down. Many practices are being subsidized to cover services. This will not change, unless it changes at a national level. And, if that happens, many people will not get the surgeries or services they need in a timely manner.

Moral of the story? Vote Republican.

-copro
 
cfdavid..please do post those links enlightening stories..you have me interested : )
 
Increases in salaries are not being matched by inflationary rates, and increases in salaries do not take into account patient throughput (depending on the practice). Physician salaries are actually decreasing year over year.
 
Increases in salaries are not being matched by inflationary rates, and increases in salaries do not take into account patient throughput (depending on the practice). Physician salaries are actually decreasing year over year.

An average of $250K this year versus $220K two years ago. That's a 13.6% increase, or 6.8% per year. Well above latest current annual COLA (2.3%) and CPI-calculated inflation (4.0%) rates.

-copro
 
cfdavid..please do post those links enlightening stories..you have me interested : )

O.k. Here's David Walker of the GAO.
http://www.youtube.com/watch?v=KIgrxpp97OQ&feature=related
http://www.youtube.com/watch?v=DXr_Ga_n0pY&feature=related

http://www.youtube.com/watch?v=QxoP_9W6FC8

http://www.youtube.com/watch?v=I-16u9x3tfE

Here's a link as to where David Walker is headed.
http://www.petergpetersonfoundation.org/news.asp

Here's Peter G. Peterson, who has been preaching this stuff from as far back as 1984....
http://www.youtube.com/watch?v=kCpzs45vrRs&feature=related

http://www.youtube.com/watch?v=lowq9vm412U



Here's some compelling information suggesting some rough times.....

http://www.youtube.com/watch?v=4n3g5lUgkWk

http://www.youtube.com/watch?v=l_0pqHzK324&feature=related

http://www.youtube.com/watch?v=lTXEWh2yT_g

From the CEO of Freddie Mac regarding more depreciation in the housing market.

Freddie Mac CEO sees U.S. home prices falling further
WASHINGTON (MarketWatch) -- U.S. housing prices have further to fall, the chief executive of mortgage-finance giant Freddie Mac
4:01pm 03/14/2008
FRE 21.18, -0.12, -0.6%) said Wednesday. On a call with analysts, Richard Syron said housing prices have fallen a third as far as they're going to go. Freddie Mac's shares finished trading on Tuesday at $20.16, up nearly 16% after the Federal Reserve said it would loan Wall Street $200 billion in a move to boost liquidity.


There are several books that I could recommend as well, but they're very bearish. One good one is Crash-Proof by Peter Schiff who was seen above.
I have yet to read any of Pete Petersons, but intend to (notably Gray Dawn).

Here's an article by Peter Peterson. This guy isn't "shooting from the hip". He's so well connected, at the higest levels GLOBALLY, that it's wise to take his predictions/insights seriously whether you choose to believe them or not.

http://www.foreignaffairs.org/20040901faessay83510-p0/peter-g-peterson/riding-for-a-fall.html


********Please realize that I don't pretend to have the answers. My belief from what I've read and watched (there are many more where the above comes from) is that we're headed for a prolonged downturn in the U.S. This will force change, given the unsustainability of our current situation. It's probably good, but will involve a lot of pain and arguably this pain will be most felt by the most vulnerable in our society. We'll see. But, these changes WILL effect all of us.

I've learned to take everything with a grain of salt. For every bear, there is a bull that I could have posted (though they are becoming fewer and fewer).

Here's some more:

http://www.marketwatch.com/news/sto...-5028-4976-9883-BB1975099038}&dist=TNMostRead
 
The current reality is not matched with prognostications. Right now, salaries are going up, not down. Many practices are being subsidized to cover services. This will not change, unless it changes at a national level. And, if that happens, many people will not get the surgeries or services they need in a timely manner.

Moral of the story? Vote Republican.

-copro

I agree, dems will have a field day with salaries by enrolling either everyone or most everyone in Medicare/Medicaid. Where I am, 100% of practices are subsidized. Some more than others, but I was really really surprised to find out what groups are getting. Seems that most groups are barely profitable at all. I'm worried that in tough times, the first thing to go is that big subsidy. And in a poor job market, you can either stay at a reduced rate, or someone else is glad to step in and do the job for less.
 
Yeah, the dems with their massive welfare plans....well..That would just put the nail in our country.

As you see from the youtube links from the GAO, even if we slashed the entire DOD budget (which is actually a LEGITIMATE function of government), we'd still be too deep to climb out.

It's all about the welfare state, and we must kill it: now.
 
I agree, dems will have a field day with salaries by enrolling either everyone or most everyone in Medicare/Medicaid. Where I am, 100% of practices are subsidized. Some more than others, but I was really really surprised to find out what groups are getting. Seems that most groups are barely profitable at all. I'm worried that in tough times, the first thing to go is that big subsidy. And in a poor job market, you can either stay at a reduced rate, or someone else is glad to step in and do the job for less.

These are realistic concerns. But, if the subsidies go, so does the coverage. I seriously doubt that many (if any) practices will want to cover hit-or-miss OB call at night for free. And, until CRNAs are allowed to do it completely alone and/or OB/Gyns learn how to put in epidurals and do their own anesthetics for stat c-sections, you don't have to worry too much. In my experience, they want us there. And, hospitals are willing to pay the subsidy to provide that coverage. They'll close down the OB practice in the hospital before they forego anesthesia coverage.

-copro
 
An average of $250K this year versus $220K two years ago. That's a 13.6% increase, or 6.8% per year. Well above latest current annual COLA (2.3%) and CPI-calculated inflation (4.0%) rates.

-copro

CPI numbers are manipulated, real inflation was around 8% for the past couple of years when the growth in the money supply (M3) was 13-15% and GDP 4% now M3 isn't reported by your freinds at the government and GDP is +- 0% so real inflation is going to be upwards of 12% as suggested by the recent soaring commodity prices.
Just think of it this way 500k for a partner 10 years ago was a different league compared to the same amout now.
Got to thank Big Al and Helicopter Ben for letting inflation eat us alive.
 
CPI numbers are manipulated, real inflation was around 8% for the past couple of years when the growth in the money supply (M3) was 13-15% and GDP 4% now M3 isn't reported by your freinds at the government and GDP is +- 0% so real inflation is going to be upwards of 12% as suggested by the recent soaring commodity prices.
Just think of it this way 500k for a partner 10 years ago was a different league compared to the same amout now.
Got to thank Big Al and Helicopter Ben for letting inflation eat us alive.

I'd be sending out a sequence of these--->:laugh:right now if it weren't so tragic.

That being said, in all honesty, in order for the U.S. to become a producer again, a crappy dollar isn't so bad. Over the long haul, perhaps we'll see a true rebalancing of trade. Obviously, this will be painful.

Here's the real kicker. These chincy tax rebates won't do anything for the economy IMO. Nor will another 1% rate cut, which is being talked about (short term trades in the market? Sure, but long term?). So, at what point will the Fed HAVE to raise rates in order to shore up the dollar?? I think it's gonna come (out of NO other option) at a time when the economy can least afford it. In other words, the Fed is real close to shooting it's final wad...

If what the CEO of Freddie Mac says is true (that home prices have only depreciated 1/3 of what he anticipates), then things look really, really bad. What are all the people that have hung on thus far (the not-so-subprimers) going to do when rates creep up on them?? Another round of defaults?

Then there's the question of whether foreign banks will keep purchasing US securities. What if they go to Euro denominated debt? What happens if they do this at a time when the dollar is already getting bashed from our own monetary policy? Then what will the dollar look like.

The reason this could turn into a huge global issue is because if US "consumers" (pitiful that we're refered to as "consumers" more than CITIZENS) cool off (which is happening already), then China is in deep doo-doo themselves. We're a lot more important to them than they are to us (given the trade imbalance). So, maybe there will be some cooperation to keep things from getting TOO bad. The PROBLEM with this is that it implies that US "consumers" continue their/our spending (and borrowing) spree. This is what's unsustainable, given our social obligations that David Walker has been highlighting.

It's a big f..ing mess right now. And, I think that it's finally being called in on us. I think we're heading into our little reckoning day(s). Many might say it's been long overdue.
 
What are all the people that have hung on thus far (the not-so-subprimers) going to do when rates creep up on them??

Wait, are we supposed to feel sorry for them? I'll tell you what they'll do -

They'll learn that adjustable rate mortgages are tools for wealthy risk-tolerant people, and not a way for marginally qualified or greedy people to squeeze an extra point off what were already historically-low mortgage rates so they could "afford" loans that amount to 10x their annual income. Or maybe they won't learn. After all, an inability to assimilate information or think rationally is the very definition of stupidity, and is what got them into those absurd mortgages in the first place.

Most people who chose to live beneath their means by renting or by taking on fixed-rate mortgages they could truly afford on houses to LIVE IN, rather than houses to GET RICH QUICK IN, will be fine. The only way these people will get screwed is if a declining economy results in layoffs or wage cuts. This is possible, and would be tragic, but foreclosure rates for people with historically appropriate debt ratios and conforming fixed-rate loans really aren't up all that much.

For the better part of a decade, we've watched fools drive up real estate prices in a frenzied orgy of speculation and greed, perverting the old "American Dream" of home ownership and stability by obsessing over how much hype-inflated equity could be flipped, borrowed against, and spent on frivolous stuff.

I feel sorry for them the way I feel sorry for the heroin addict who just got an amp of Narcan.
 
These are realistic concerns. But, if the subsidies go, so does the coverage. I seriously doubt that many (if any) practices will want to cover hit-or-miss OB call at night for free. And, until CRNAs are allowed to do it completely alone and/or OB/Gyns learn how to put in epidurals and do their own anesthetics for stat c-sections, you don't have to worry too much. In my experience, they want us there. And, hospitals are willing to pay the subsidy to provide that coverage. They'll close down the OB practice in the hospital before they forego anesthesia coverage.

-copro


Hospital bylaws will require you to take the call....just like a surgeon who wants privileges at the hospital has to take ER call to cover those drunk guys who get stabbed and has no insurance.

subsidy or not....some one will have to come and put in that epidural.
 
Wait, are we supposed to feel sorry for them? I'll tell you what they'll do -

They'll learn that adjustable rate mortgages are tools for wealthy risk-tolerant people, and not a way for marginally qualified or greedy people to squeeze an extra point off what were already historically-low mortgage rates so they could "afford" loans that amount to 10x their annual income. Or maybe they won't learn. After all, an inability to assimilate information or think rationally is the very definition of stupidity, and is what got them into those absurd mortgages in the first place.

Most people who chose to live beneath their means by renting or by taking on fixed-rate mortgages they could truly afford on houses to LIVE IN, rather than houses to GET RICH QUICK IN, will be fine. The only way these people will get screwed is if a declining economy results in layoffs or wage cuts. This is possible, and would be tragic, but foreclosure rates for people with historically appropriate debt ratios and conforming fixed-rate loans really aren't up all that much.

For the better part of a decade, we've watched fools drive up real estate prices in a frenzied orgy of speculation and greed, perverting the old "American Dream" of home ownership and stability by obsessing over how much hype-inflated equity could be flipped, borrowed against, and spent on frivolous stuff.

I feel sorry for them the way I feel sorry for the heroin addict who just got an amp of Narcan.

Well, I agree with you. It's just a shame that it's come to this. And the fact that people that are, again, not-so-subprimers are going to get nailed when the Fed brings in a hard liner to real in the monetary supply is not only a bit of a shame, but it's also going to grossly compound the economic problems as well as housing values.
 
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