I think its kind of pathetic that when considering combined residency all people talk about is who will hire them.
Instead of worrying about long term job prospects and medical training's translation into how insurance reimburses, why don't you try to be creative for once in your life.
Grow a pair and instead of seeing whats there (job, insurance reimbursement), see whats not there with combined training after you graduate:
What: Get a mortgage for a foreclosed bed & breakfast or ranch and open 10 beds for 30-120 day detox/rehab for rx opiates. Say forget insurance, if your facility doesnt meet the criteria for payment and charge 4-6k a month.
How: Epidemic health crisis with unmet needs (never enough beds), as well as when its met it is priced astronomically. By owning/managing, being the primary doc as well as counselor, and not dealing with insurance you can charge much less than the 50k plus it costs anywhere else in the US for 90 days. You can provide better care, accomodations and continuity of care while charging less cause you aren't a corporation or non contributing owner who has to pay other people to do all these things and net an ever increasing profit for your self. Also you get cash/credit up front from patients, but a low up front investment with the ease of a mortgage (commercial, maybe residential if u live there). You don't have to hire medical billing coders or invest in building a new facility. less expensive if you want it to work so you dont have to spend money on marketing and you maintain full occupancy by price alone. The equity in the mortgage besides money after expenses is your retirement fund or business reserve. Live there to really save money ornat least till you get it running well enough at first
Who: This idea has basically universal applicability with the need for rehab beds as well as the availablity of housing that can be used (boutique motel, camping ground). Basically anything with the minimum number lf beds/bathrooms and space to make the financials work.
Instead of seeing yourself as wage slaves, think of how you can provide healthcare better on your own and less expensive. This could be a physical rehab facility if you're pm&r, a facility for people with end stage dementia, hospice, etc.
By being an owner/operator and providing expensive labor that anyone else would have to pay 200k plus you get the advantage compared to others. There are also tax and other financial benefits by not having to deal with formal business structures. Any time you dont deal or take insurance you get money up front as waiting 6 months for reimbursement is what kills all small practice owners now besides no labor cost to code.
2.6 trillion healthcare GDP, 30% of total US GDP. Physician take home 5% of that. Less than every other industrialized country. You're basically a ***** if you can't make money as a physician on your own with all the business advantage and as the one labor force that drives all of healthcare spending.
Your RX to a pharmacy (likely large corporation) to an insurance corporation (or government alternative) to a pharmaceutical corporation. And each transaction is inflated by a tax (sales, income) and wall street stock payout to the corp or if its government the guise of non-profit