Impending oversupply of Radiologists

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badasshairday

badasshairday

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What are the powers that be doing to prevent this? Seems like everyone is doing a fellowship or two these days to get a job. In the not too distant past, people were getting good jobs right out of residency. Despite these changes, we are still pumping out 1100 Radiologists out of residency each year.
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badasshairday said:
What are the powers that be doing to prevent this? Seems like everyone is doing a fellowship or two these days to get a job. In the not too distant past, people were getting good jobs right out of residency. Despite these changes, we are still pumping out 1100 Radiologists out of residency each year.
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The DR job market looks like it's gonna hit a wall pretty soon. The demand will get squeezed by efforts to reduce overall imaging and the costs associated with it, and the influx of supply isn't slowing at all to compensate for this demand reduction, as well as the decrease in retiring radiologists. The governing bodies can obviously just reduce residency positions - but they won't, until demand actually crashes.
 
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SxRx said:
For what it's worth, I found this.....it's dated for Nov 2009. So it was a year and a half ago.

http://www.radrounds.com/profiles/blogs/radiology-job-market-survey
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They still got almost 2 offers apiece, so I don't know what they're complaining about as far as the "difficult to find a job" sentiment (albeit I'm sure most were in less than prime locations). Did they all expect bucket loads of jobs lined up for them in major metros?
I can only imagine the market is worse now, and will become completely anemic when cost cuts come and reduce imaging usage. IR will probably become ridiculously competitive in years to come.
 
I'm sure there are cycles in this like any thing else that runs on supply/demand.

The thing with being a radiologist is that it takes 6 years of residency to train one. So an oversupply now does not mean that an M3 won't have a good outlook once they finish residency...I hope
 
hartbot said:
I'm sure there are cycles in this like any thing else that runs on supply/demand.

The thing with being a radiologist is that it takes 6 years of residency to train one. So an oversupply now does not mean that an M3 won't have a good outlook once they finish residency...I hope
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I don't understand where this notion of the cyclic behavior of job markets came from. Any changes in the "tightness" of a job market in medicine is dependent on external factors (such as legislation or demographics), which either alters the demand or supply. There is no intrinsic cyclical nature which dictates fluctuations in the availability of jobs. I don't know the definitive reason for the condition of the radiology job market, but it does seem at least partially structural, as more radiologists are retiring later. The reason for this relative "delay" in retirement can be linked to the financial outlook of the US, and it is certainly not going to be favorable in the near or medium term. The governing bodies should be re-adjusting the influx of providers, but they're not. That, coupled with the impending decrease in demand, is why I'm very bearish on radiology.
 
Radonkulous said:
Not if they keep training 1100 radiologists a year. You might get a job, but it'll be out in the boonies somewhere. PCP is a perfect out if you like it. 3 years and you're done and can go pretty much anywhere in the country.
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That's one of the better things about primary care, especially if your significant other has a geographically limited career. I wince when I see some of these married residents where one is a CT surg and the other is a rad onc (or some other combination of equally specialized fields). The chance of those couples ending up in a decent location is slim... that is if they can even find jobs in the same location.
 
Hmmm. Here's an article from 1996 predicting an oversupply of radiologists. Howd that turn out?

http://www.ncbi.nlm.nih.gov/pubmed/8685355

Yea the market sucks now, but this is hardly unique to radiology. Also, most people are getting jobs, they just may have to sacrifice their desired starting salary of 500k or may not be able to get a job in San Diego. And yes, there are jobs available outside of the boonies. Trust me, there are not enough rural positions to support 1000 newly minted radiologists a year.

Look, your guess is as good as mine with the future of the field. But I don't see any tort reform coming in the future, the health care bill imploded, and congress is now suggesting screening all smokers with CT for lung cancer, so I could see even more demand on the horizon.
 
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Count me as part of the group that doesn't think the sky is falling. It's absolutely true that the recent economic downturn has kept older radiologists from retiring and has made practices hesitant to hire. Those are temporary concerns, however, and the healthcare law looks more like healthcare expansion than it does reform. People have been predicting radiology's demise for two decades now, but it's more central to modern medicine than ever. I don't expect to make 750K with 12 weeks vacation, but things will be alright. Besides, I'd rather make 175K and be a radiologist than make the same amount as a FP anyway.
 
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Radonkulous said:
That may be true, but we weren't seeing major reimbursement cuts that we are seeing today. Salary is getting cut across the board, and radiology will probably be hit the hardest.
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This is just wild speculation. There is nothing to suggest that rads Will be hit any harder than other fields other than the fact that they have so much room to fall since they make so much now. That is simple economics. A 10% pay cut across all doctors will hit the ones making 400K more than those making 200k. By that logic, ortho and neurosurg are doomed too.

Unlike surgery fields, however, rads can compensate more. By improving dictation systems, PACS, or working more than 8 hour days rads can read more films in a day. You can't do an extra joint replacement or acoustic neuroma resection if you want to compensate for decreased reimbursements.
 
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colbgw02 said:
Count me as part of the group that doesn't think the sky is falling. It's absolutely true that the recent economic downturn has kept older radiologists from retiring and has made practices hesitant to hire. Those are temporary concerns, however, and the healthcare law looks more like healthcare expansion than it does reform. People have been predicting radiology's demise for two decades now, but it's more central to modern medicine than ever. I don't expect to make 750K with 12 weeks vacation, but things will be alright. Besides, I'd rather make 175K and be a radiologist than make the same amount as a FP anyway.
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The "recent" economic downturn is not temporary. I don't want to go into a long diatribe about American economics and finance, but things aren't getting better any time soon. We will be seeing massive changes before any kind of sustainable equilibrium can be reached. However, I will give you that these effects aren't unique to radiology, as older doctors in other fields are delaying retirement as well. I'm not exactly predicting radiology's demise. The whole system is set to implode, and I simply don't think radiology is in a great position to cope with the paradigm shift.
 
bronx43 said:
The "recent" economic downturn is not temporary. I don't want to go into a long diatribe about American economics and finance, but things aren't getting better any time soon. We will be seeing massive changes before any kind of sustainable equilibrium can be reached. However, I will give you that these effects aren't unique to radiology, as older doctors in other fields are delaying retirement as well. I'm not exactly predicting radiology's demise. The whole system is set to implode, and I simply don't think radiology is in a great position to cope with the paradigm shift.
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I'm curious what specialties you think are better poised to deal with the paradigm shift?
 
bronx43 said:
That's my entire point... that there are no cyclical changes in the aggregate demand of health care. If there was, then we should be seeing wild fluctuations in health care spending that correspond with the boom bust cycles.
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I don't know why you think that health care fields are immune to cyclical job markets. I've linked an article for you that sounds eerily similar to today.

" Like other job markets, that in radiology tends to fluctuate cyclically. The market is currently very favorable for those seeking a position. In 1988, in the estimation of the radiologists surveyed, the demand in private practice was increasing, and radiology group practices had begun to hire more graduates. By 1994, there were fewer vacancies in the job market, and in 1995 the hiring rate for radiologists was only 70% of the level in 1991 (10,11). At that time, there was much concern over potential changes in health care reimbursement, and many program directors were pessimistic about the future of graduating residents. From 1995 to 1998, as the job market improved for applicants (12–14), program directors were more optimistic regarding the prospects of their residents finding jobs, and by 1999 virtually all who wanted to work had a job. "

http://neuroradiology.rad.jhmi.edu/...hip and Fellowship Match - Current Status.pdf

Maybe this is different. Maybe the economy and health care system will implode any minute. But if that happens, then all of us are pretty much f***ed
 
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cowme said:
I don't know why you think that health care fields are immune to cyclical job markets. I've linked an article for you that sounds eerily similar to today.

" Like other job markets, that in radiology tends to fluctuate cyclically. The market is currently very favorable for those seeking a position. In 1988, in the estimation of the radiologists surveyed, the demand in private practice was increasing, and radiology group practices had begun to hire more graduates. By 1994, there were fewer vacancies in the job market, and in 1995 the hiring rate for radiologists was only 70% of the level in 1991 (10,11). At that time, there was much concern over potential changes in health care reimbursement, and many program directors were pessimistic about the future of graduating residents. From 1995 to 1998, as the job market improved for applicants (12–14), program directors were more optimistic regarding the prospects of their residents finding jobs, and by 1999 virtually all who wanted to work had a job. "

http://neuroradiology.rad.jhmi.edu/...hip and Fellowship Match - Current Status.pdf

Maybe this is different. Maybe the economy and health care system will implode any minute. But if that happens, then all of us are pretty much f***ed
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Read my initial statement. I said that any changes in job markets in health care is dependent on external factors such as legislation, which artificially affects either the demand or supply for certain services. This is different from calling the job market "cyclic" like how it is in standard industries, where the job market follows closely natural business cycles that is created by expansion of credit, mis-allocation of capital, and the subsequent correction. There may be an indirect effect as far as the performance of equity markets on retirement, but the job market expanded all throughout the early 2000's after the dot com crash.

And no, not all fields are equally affected by an implosion in the American financial system. Currently, the system is grossly inflated to 17% of the GDP. A large portion of this usage is on high-end care with high costs and low cost-effectiveness. When the economy contracts drastically, everything will trend down market, as the usage of services with low cost effectiveness will be heavily reduced. Essentially, the more specialized and the more upmarket services you provide (or rely on), the worse off you'll be. The same will be true for elective procedures. As far as radiology is concerned, there will always be a market for radiology, as imaging is central to modern health care. The question is how will that market be changed - the only reasonable answer is that it'll contract as well, as the system will naturally cut down excess imaging.I predict that the best fields to come out of all this will be down market providers such as primary care. And even within primary care, I think providers with an established practice and good rapport with their patient base will be the most secure. Those that run their practice like a factory with little minimal patient rapport will see their patient base erode as upmarket providers flood the primary care market.
 
hmmmmmmmm. I really want to get into radiology and do IR. Bronx is making radiology seem like the worst specialty choice of all, as if I won't have a job at the end of residency.
 
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badasshairday said:
hmmmmmmmm. I really want to get into radiology and do IR. Bronx is making radiology seem like the worst specialty choice of all, as if I won't have a job at the end of residency.
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As someone pointed out above, People like Bronx have been predicting the end of radiology (as we know it) for years, yet it's still looking fine today outside of a bad job market. All of his arguments are complete speculation based on his personal opinions. He raises good points, but I've seen nothing to suggest any limits on imaging in the future (that Bronx considers a foregone conclusion).

Oh and by the way, the current job market may suck across the board, but there is a big shortage of IR (and mammo) docs right now, and any fellowship trained IR can pretty much land any job they want.
 
badasshairday said:
hmmmmmmmm. I really want to get into radiology and do IR. Bronx is making radiology seem like the worst specialty choice of all, as if I won't have a job at the end of residency.
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I already said radiology will always have a good sized market. It's far from the worst specialty in the world, as imaging is so crucial to modern medicine. There are fields with far worse futures, especially those that rely on expensive elective services. I'm simply pointing out that radiology won't remain what it is today. I know far too many people who are going into radiology simply for the fact that they're seeing all the compensation surveys out there touting $500k for 45-50 hour weeks.
And IR is a pretty good field, as it offers a downmarket alternative to surgery.
 
bronx43 said:
I already said radiology will always have a good sized market. It's far from the worst specialty in the world, as imaging is so crucial to modern medicine. There are fields with far worse futures, especially those that rely on expensive elective services. I'm simply pointing out that radiology won't remain what it is today. I know far too many people who are going into radiology simply for the fact that they're seeing all the compensation surveys out there touting $500k for 45-50 hour weeks.
And IR is a pretty good field, as it offers a downmarket alternative to surgery.
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Agree with this 100%. I chose rads because I loved the field, and while its nice they make great money, I could care less if salaries go down.

But don't let anyones speculation about the future of the field dissuade you from picking your desired specialty. Nobody knows what the job market will be in ANY field, and you are 7-8 years away from worrying about this.
 
cowme said:
As someone pointed out above, People like Bronx have been predicting the end of radiology (as we know it) for years, yet it's still looking fine today outside of a bad job market. All of his arguments are complete speculation based on his personal opinions. He raises good points, but I've seen nothing to suggest any limits on imaging in the future (that Bronx considers a foregone conclusion).

Oh and by the way, the current job market may suck across the board, but there is a big shortage of IR (and mammo) docs right now, and any fellowship trained IR can pretty much land any job they want.
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I never predicted the end of radiology - that would be rather preposterous and totally unsupported by my world view. But, I find it rather amusing that your only defense seems to come in the form of the normalcy bias, instead of actual analysis of current trends. It's not really personal opinion that the US is over-leveraged, and the only way out are heavy duty cuts to spending. And it's certainly not a personal opinion that insolvency, coupled with a loose monetary policy results in the destruction of fiat currencies.
I mean, I really don't care if people believe me. I'm just here to share some of my thoughts on the business of medicine going into the next decade. Read what I wrote, do your own research, then do as you please.
 
bronx43 said:
I already said radiology will always have a good sized market. It's far from the worst specialty in the world, as imaging is so crucial to modern medicine. There are fields with far worse futures, especially those that rely on expensive elective services. I'm simply pointing out that radiology won't remain what it is today. I know far too many people who are going into radiology simply for the fact that they're seeing all the compensation surveys out there touting $500k for 45-50 hour weeks.
And IR is a pretty good field, as it offers a downmarket alternative to surgery.
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OK. I see your point, especially about folks choosing rads for the perceived money/lifestyle rather than actual interest. They will likely have buyer's remorse.
 
I hear you Bronx, but there are many, MANY ways to cut costs in health care that are far easier and more practical to implement than placing constraints on imaging studies ordered.

For instance, at the hospital I work at, a CT scan costs ~1000 bucks.
A CBC costs 120 bucks, and is ordered every day (sometimes twice per day) for month long admissions.
 
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colbgw02 said:
Out of curiosity, why is recent in quotation marks? Are you implying that the economic downturn started long ago?
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Oh, I was just trying to convey that the underlying structural deficits of the American financial system have been in place for a long time, and that the sub-prime crash was simply a manifestation of that. It's really not surprising at all that cheap credit spearheaded by the Fed would lead to mis-allocation of capital and unsustainable expansion in certain sectors, which ultimately leads to painful correction.
 
bronx43 said:
I never predicted the end of radiology - that would be rather preposterous and totally unsupported by my world view. But, I find it rather amusing that your only defense seems to come in the form of the normalcy bias, instead of actual analysis of current trends. It's not really personal opinion that the US is over-leveraged, and the only way out are heavy duty cuts to spending. And it's certainly not a personal opinion that insolvency, coupled with a loose monetary policy results in the destruction of fiat currencies.
I mean, I really don't care if people believe me. I'm just here to share some of my thoughts on the business of medicine going into the next decade. Read what I wrote, do your own research, then do as you please.
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👍 Quoted for truth.
 
badasshairday said:
:scared: I really hope not.
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I'm going into radiology primarily to do IR and I DO hope it becomes very competitive...As IR matures, develops more techniques and becomes more clinical, I want motivated type A's in the field, not people who want to do 50%DR and 50%IR...It'll only improve the quality of work we do and help us take this field to where it could be
 
IRGuru said:
I'm going into radiology primarily to do IR and I DO hope it becomes very competitive...As IR matures, develops more techniques and becomes more clinical, I want motivated type A's in the field, not people who want to do 50%DR and 50%IR...It'll only improve the quality of work we do and help us take this field to where it could be
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Well I agree with everything you say except about hoping it becomes competitive. I want to be sure to get a spot!
 
Radonkulous said:
A decade from now, rads will probably average out around 300k, not the 450k+ you see today. PCP jobs will probably go up to around 250k+ average. Specialties will always make more because of more training, but the gap will be significantly narrowed.
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Im doing my intern year right now, almost done thank god, and Im currently rotating with a PCP at his clinic a couple days a week. Weve had extensive discussions about compensation, mainly because he seems to really enjoy it and is very knowledgible about it. He told me that back when he was an internal medicine resident, at a very presitigious institution, many years ago ~25-30 yrs, he decided not to do a fellowship because everyone then was talking about how PCPs were going to make more money and how specialists were going to go down. He basically laughed at me when I brought up the idea that radiologists would probably be paid the same as him soon. This doom and gloom prophecy has existed for decades, usually revolving around the various healthcare changes/reforms that come and go. The bottom line is that this paranoia has existed for a long time and simply has never panned out. He then went on to tell me that he now works 65 hours a week and makes basically the same salary he made when he started out, accounting for inflation. Oh, and he also told me that his income has actually been slowly declining over the past few years, not increasing. So yes, radiologists might make less than they make now, but so will everyone else. Quite frankly the thought of being an internist for 65 hours a week to pull in just over 200K makes me want to blow my brains out.
 
I live in Northeast Tennessee, about an hour and a half from Knoxville and there are shortages of Radiologist's in my town and in Knoxville. I have spoken with friends of mine who are working in Kansas, Florida, and Virginia and they all say that overall there are shortages in Radiologist's in their areas as well. I do not think there will be any trouble getting Radiology jobs in the future. Also do not expect the pay scale to go down either. I mentioned this to a Radiologist friend of mine in Knoxville and he laughed and told me he was told the same thing about the pay going down when he was in medical school in the early '80s.
 
sanche60 said:
Im doing my intern year right now, almost done thank god, and Im currently rotating with a PCP at his clinic a couple days a week. Weve had extensive discussions about compensation, mainly because he seems to really enjoy it and is very knowledgible about it. He told me that back when he was an internal medicine resident, at a very presitigious institution, many years ago ~25-30 yrs, he decided not to do a fellowship because everyone then was talking about how PCPs were going to make more money and how specialists were going to go down. He basically laughed at me when I brought up the idea that radiologists would probably be paid the same as him soon. This doom and gloom prophecy has existed for decades, usually revolving around the various healthcare changes/reforms that come and go. The bottom line is that this paranoia has existed for a long time and simply has never panned out. He then went on to tell me that he now works 65 hours a week and makes basically the same salary he made when he started out, accounting for inflation. Oh, and he also told me that his income has actually been slowly declining over the past few years, not increasing. So yes, radiologists might make less than they make now, but so will everyone else. Quite frankly the thought of being an internist for 65 hours a week to pull in just over 200K makes me want to blow my brains out.
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There's always a struggle between the normalcy bias and gloom and doom. On the one hand, the world would have ended an infinite number of times according to the ever-present apocalyptic prophets. On the other hand, massive changes in history have always been met with stubborn resistance and appeals to a stable equilibrium. While it's certainly impossible to predict when a stable equilibrium is going to be punctuated, you can look underneath the currents of stability and at the reasons for why things are the way they are, and whether or not those trends are sustainable in the short, medium, and long term.
Looking at your post and your attending's viewpoint, it seems to me that his argument is supported by nothing but the normalcy bias. In other words, the reason why he thinks the status quo will be maintained is that the status quo has always been maintained in the past couple of decades. This really isn't an argument at all, nor is it much different from bankers at Bear Sterns thinking the subprime market won't crash, simply because it hasn't yet crashed. But, I guess it's only natural to partake in that mindset when you've seen such predictions come and go. Therefore, I think it's absolutely necessary to look deeper at the drivers of the status quo to get a good idea of future possibilities. And as far as the impending changes in American health care, it's safe to say that talks of reform in 2011 is vastly different from the same talks in 1990, because of the difference in the economic and financial situation of the nation. Back then, the failure of reform had relatively small consequences as the nation was just about to kick start its credit-driven growth of the 1990-2000's. Currently, the failure of reform of the health care system (as well as SS and defense spending) will inevitably lead to a crash in the American financial system. When this will happen? Who knows, but if the equity market starts to freefall after QE2 ends, we'll likely see QE3 or some other form of monetary expansion. And if that occurs, the writing is on the wall for the future of the USD.
 
Radonkulous said:
There is definitely truth to that, but back then the country wasn't 14 trillion dollars in debt and healthcare wasn't engulfing the GDP. I just don't see current healthcare delivery sustainable. I don't blame doctors as much as my blame insurance companies and big pharma. Doctors' salary is at most 10-20% of healthcare spending, but the big bad money hungry doctor is the first one to be attacked.

What I think should happen is an increase in PCP salary while keeping everyone else's salary stable or increase at least with inflation. I don't know much about healthcare, but from my limited increase we can use a few more good PCPs if the end goal is better health in this country.

With regards to radiology salary, I think they deserve every penny they get if people are willing to pay for imaging.
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The problem with that salary figure is that it's driven by FFS. It doesn't exist in a vacuum where that number has no other effects or ramifications. There is a large cost associated with every "unit" of care offered, some of which is relayed into the physician's pocket. Therefore, if a physician's "salary" is X, the total cost incurred onto the system is many multiples of that. Obviously, the ridiculous amount of health care services offered in this country can't be solely attributed to doctors. It has been a slow build-up, fueled by a multitude of factors, such as legislation and overall expectations of the general public. However, it's naive not to put at least some of the blame on physicians themselves, as the profit motive will inevitably lead to higher usage. That was in fact one of the big reasons for the implementation of HMOs.
 
Tell me Bronx: how is this "normalcy bias" so different than your assumption that the American healthcare system will inevitably crash? I would say both are wild speculation based on past events. One takes an optimistic viewpoint based on 50+ years of stability, one takes a pessimistic viewpoint based on a 3 year vicious recession. But hey, I guess a pessimist is never disappointed...
 
cowme said:
Tell me Bronx: how is this "normalcy bias" so different than your assumption that the American healthcare system will inevitably crash? I would say both are wild speculation based on past events. One takes an optimistic viewpoint based on 50+ years of stability, one takes a pessimistic viewpoint based on a 3 year vicious recession. But hey, I guess a pessimist is never disappointed...
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There are deeper seeded problems than simply a 3 year recession. But that's besides the point. To address your question, my point is that it's a struggle between the two sides, at least on a philosophical level. You can't take either at face value, because there's no intrinsic argument provided by those viewpoints. Instead, you have to examine the drivers of change vs stability, and determine why certain things are more likely to occur. And my stance on this issue isn't an assumption. It's a conclusion I drew after examining the data and facts.
 
If you're arguing that the U.S. economy is in a lot worse shape than it was 20 years ago, then you'll get no argument from me. But I still haven't heard any good reasons why radiologists will be disproportionately affected. I think there's a lot of decent speculation that healthcare, in general, and radiology, in particular, will see a downturn. But, in the end, it still sounds like speculation to me. If you're trying to discourage people from entering medicine in favor of a more promising industry, then okay, but I don't see much of a reason to dissuade an interested medical student from radiology. After all, if that person is looking at rads for the money, then they're in it for the wrong reasons to begin with.
 
colbgw02 said:
If you're arguing that the U.S. economy is in a lot worse shape than it was 20 years ago, then you'll get no argument from me. But I still haven't heard any good reasons why radiologists will be disproportionately affected. I think there's a lot of decent speculation that healthcare, in general, and radiology, in particular, will see a downturn. But, in the end, it still sounds like speculation to me. If you're trying to discourage people from entering medicine in favor of a more promising industry, then okay, but I don't see much of a reason to dissuade an interested medical student from radiology. After all, if that person is looking at rads for the money, then they're in it for the wrong reasons to begin with.
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I've already said everything I have to say in this thread in this thread. I was simply addressing the posts above that endorse the normalcy bias as an argument for the maintenance of the status quo. Everything else is simply repeat.

But on a side note, I don't understand why everyone thinks that a collapse of the system will necessarily affect every field equally. I support the notion that all fields will take a hit as the health care sector contracts, but it's absurdly simple-minded to assume that all fields are equal at the end of this systemic correction. Certain specialties have far better intrinsic value and "business model" than others. And as I said before, radiology will always maintain its status in modern medicine, but the mechanics of how that market works will be changed drastically.
 
Just out of curiosity, bronx...why are you taking such a vested interest in this thread (and every other discussing radiology's future)? I assume you aren't applying in the field, so it seems like you are devoting a huge amount of time to a topic that doesn't affect you.

We appreciate your opinions that you "drew after examining the data and facts.", but you haven't really given us said data and facts... I'm not trying to spark another argument with you, I honestly am just curious where you are coming from.
 
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cowme said:
Just out of curiosity, bronx...why are you taking such a vested interest in this thread (and every other discussing radiology's future)? I assume you aren't applying in the field, so it seems like you are devoting a huge amount of time to a topic that doesn't affect you.

We appreciate your opinions that you "drew after examining the data and facts.", but you haven't really given us said data and facts... I'm not trying to spark another argument with you, I honestly am just curious where you are coming from.
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I honestly just have interest in any thread of any specialty which discusses the future and business aspects of medicine. I come from a business background, so much of my perspective will be based upon that. I'm not going to practice clinical medicine in the future, so I don't really care what happens to any specific specialty down the road. I do, however, hold opinions on which specialties will fare best within the context of my world view. I'm pretty active in some subforums, if there is a trend there which addresses some topics that interest me. In the past, I posted a lot in Topics in Healthcare, Med Business, Family Medicine, even Anesthesiology (there's a lot of noise in that forum due to their traffic).
 
Fair enough. Are you doing something business related after med school? Did you always know you wouldn't practice clinical medicine or was it something that you changed your mind on during school?
 
bronx43 said:
I honestly just have interest in any thread of any specialty which discusses the future and business aspects of medicine. I come from a business background, so much of my perspective will be based upon that. I'm not going to practice clinical medicine in the future, so I don't really care what happens to any specific specialty down the road. I do, however, hold opinions on which specialties will fare best within the context of my world view. I'm pretty active in some subforums, if there is a trend there which addresses some topics that interest me. In the past, I posted a lot in Topics in Healthcare, Med Business, Family Medicine, even Anesthesiology (there's a lot of noise in that forum due to their traffic).
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I'm curious to hear your list. My belief is that primary care and any cosmetic/elective specialties will do very well in the future.
 
bronx43 said:
I'm not going to practice clinical medicine in the future, so I don't really care what happens to any specific specialty down the road.
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Wow. Did you just recently decide this? Do you plan on completing a residency? I'm just curious as to why you'd be going through all of this if you don't plan on practicing.
 
CityLights said:
Wow. Did you just recently decide this? Do you plan on completing a residency? I'm just curious as to why you'd be going through all of this if you don't plan on practicing.
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Have the same exact question.
 
CityLights said:
Wow. Did you just recently decide this? Do you plan on completing a residency? I'm just curious as to why you'd be going through all of this if you don't plan on practicing.
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There are a lot of ways to make a living as an MD without formal residency. I would argue that many of them are better than practicing in a profession that appears to be be undergoing an internal collapse.

As medicine salaries decline, we will follow the path of lawyers in that regard (ie. professionals who finish training and then use that training to pursue something else altogether). White coat aint what it used to be.

With regard to the question:

As a PGY-5, I can't even remotely imagine an oversupply of radiologists. We are so overwhelmed with work right now as a profession if anything its a feeling of constantly being understaffed or undersupplied.

The real issue is the impending Medicare budget cuts with all this nonsense about Sustainable Growth Rate. They recently combined the CT abdomen and pelvis charge and took a couple other big blood lettings for a 20% cut in reimbursement. 20% is a crapload folks. And that wasn't the first, nor will it be the last.

All of medicine is being hit, but some fields (radiology, cardiology) are taking unusually hard shots. Derm reins supreme in that it has its small business owner/cosmetic component that is far more resistant to the whims of some idiot committee in congress.

Eventually I suspect medicine in this country will follow a path similar to what has occurred in London, where doctors make less than lawyers.
 
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CityLights said:
Wow. Did you just recently decide this? Do you plan on completing a residency? I'm just curious as to why you'd be going through all of this if you don't plan on practicing.
Click to expand...

Been a busy couple weeks, but yeah, I've had this feeling creep in since MS1, which was emphatically confirmed after MS3. I was always a conceptually minded person - facts didn't tickle my brain as much as logic puzzles, and the deluge of medical minutiae made me want to impale myself. Then the actual clinical work was just protocol based drudgery. I mean, there is a little bit of "thinking" involved, but everything involves only one logical turn. Coming into medical school, I didn't do my due diligence about the nature of the work, so I had no idea what the content was going to be like. And coming from a business background and having all my friends in business (high finance, consulting, entrepreneurship, etc), I definitely don't feel like my future will be in being a clinician. I've got some medical entrepreneurial ideas based on my wider world view about the future of American health care, but I don't have anything set in stone.
As I've said before in another thread, it's actually a great position to be in as a doctor, because nothing precludes you from taking risk to maximize your returns, but even if you fail, you can fall back on your primary skill of practicing medicine.
 
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