Most needed doctors??

[Dr. Leca]

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What would be the specialty thats indemand right now? The most productive type of physician???

 

[Wizard of Oz]

Primary care docs in underserved areas.

not sure what you mean by productive

 

[ForbiddenComma]

Dermatologists!

 

[Law2Doc]

Primary care docs in underserved areas.

not sure what you mean by productive

Agree. Primary care for underserved would be the obvious response.
Geriatrics is certainly an area of growing need thanks to aging baby boomers as well.
There is also certainly an eternal demand for OB/GYNs because too many people thumb their nose at the non-lifestyle hours and higher medmal insurance costs.

 

[scpichu888]

the most needed docs are definitely primary care ones in underserved areas (medicine and family med)

 

[Shredder]

Path and Rads, they make the diagnoses and call shots, House style. Not to mention great lifestyles. No money or lifestyle in primary care, best left alone. No money means no need/demand. It's an economic axiom that need/demand is signaled by price, putting underserved primary care pretty much dead last actually.

 

[silas2642]

Path and Rads, they make the diagnoses and call shots, House style. Not to mention great lifestyles. No money or lifestyle in primary care, best left alone. No money means no need/demand. It's an economic axiom that need/demand is signaled by price, putting underserved primary care pretty much dead last actually.

Where did you go for school, Shredder? Did you end up at Dartmouth? Just kinda curious.

 

[BigNavyPedsGuy]

Path and Rads, they make the diagnoses and call shots, House style. Not to mention great lifestyles. No money or lifestyle in primary care, best left alone. No money means no need/demand. It's an economic axiom that need/demand is signaled by price, putting underserved primary care pretty much dead last actually.

If by "make the diagnoses and call the shots" you mean sit in a room, look at pictures and dictate their findings into a computer, then yes, they sure do.

 

[ForbiddenComma]

Didn't anyone hear me?

Dermatologists!!

 

[sirus_virus]

Didn't anyone hear me?

Dermatologists!!

we hear you. But they do a good job at making their demand very high by cutting down on their supply(residency spots)

 

[ForbiddenComma]

But what use is a family practice in an underserved area, next to someone who can Botox rich old ladies???

 

[Law2Doc]

we hear you. But they do a good job at making their demand very high by cutting down on their supply(residency spots)

yes. demand is irrelevent in derm. They say we need X number of people get to become dermatologists and thats how many do. No supply and demand rules apply. The number of folks with incurable rashes could double and the only thing that would change would be the number of months you have to wait for an appointment.

 

[sirus_virus]

yes. demand is irrelevent in derm. They say we need X number of people get to become dermatologists and thats how many do. No supply and demand rules apply. The number of folks with incurable rashes could double and the only thing that would change would be the number of months you have to wait for an appointment.

yes sir

Edit**
or mam

 

[Shredder]

Where did you go for school, Shredder? Did you end up at Dartmouth? Just kinda curious.

Didn't end up there or any of my choice schools, only got in at like my last choice--you? I was a bad applicant, surely bc of underlying sentiments like the ones I voice on SDN that schools hate

Path and Rads are pretty cool though, valuable components of the medical team. They do make the definitive diagnoses as opposed to the guesswork of other docs

 

[YouDontKnowJack]

Didn't end up there or any of my choice schools, only got in at like my last choice--you? I was a bad applicant, surely bc of underlying sentiments like the ones I voice on SDN that schools hate

Path and Rads are pretty cool though, valuable components of the medical team. They do make the definitive diagnoses as opposed to the guesswork of other docs

but path and rads aren't most needed now because there is no shortage.

the relatively small number of radiologists is sufficient, and even if not, they can still upload the radiographs to Australia and have their radiologists read them overnight.


I don't think there is any group of "needed" docs right now. We just need half of the big city docs to move out to the rural areas, and we got the nation covered.

 

[WatchingWaiting]

What would be the specialty thats indemand right now? The most productive type of physician???

This is a very interesting question, because although the party line is underserved community PCPs, these guys make the least money in all of medicine, which makes you wonder how much of a shortage there honestly is. I think most of these calculations are based on just looking at the flat to decreasing number of physcians providing primary care in underserved communities over time and completely ignoring the huge increase in number of nurse practitioners, physician assistants, and the like who have pretty much picked up the slack.

 

[Law2Doc]

This is a very interesting question, because although the party line is underserved community PCPs, these guys make the least money in all of medicine, which makes you wonder how much of a shortage there honestly is. I think most of these calculations are based on just looking at the flat to decreasing number of physcians providing primary care in underserved communities over time and completely ignoring the huge increase in number of nurse practitioners, physician assistants, and the like who have pretty much picked up the slack.

It's not a free market economy supply and demand system driving the salaries. Doctors don't get to set their own prices. Folks do procedures, see patients and submit reimbursement forms. If you want more, you do more lucrative procedures (i.e. the specialties) or have more throughput. Having a backlog of patients needing your service (i.e. high demand) doesn't make the insurance companies give you more on your reimbursement claims. So having PCP docs poorly compensated is not inconsistent with there being a shortage of them.

 

[Towelie]

There is certainly a great deal of disagreement in medicine today as to whether or not there is a "shortage" of physicians in the United States. Many physicians disagree with the AAMC's recommendation to increase class sizes, and argue that this recommendation will serve only to increase the number of physicians in specialized fields, and will not do a great deal to help the areas where there is a great need for physicians--rural and urban underserved areas.

 

[WatchingWaiting]

It's not a free market economy supply and demand system driving the salaries. Doctors don't get to set their own prices. Folks do procedures, see patients and submit reimbursement forms. If you want more, you do more lucrative procedures (i.e. the specialties) or have more throughput. Having a backlog of patients needing your service (i.e. high demand) doesn't make the insurance companies give you more on your reimbursement claims. So having PCP docs poorly compensated is not inconsistent with there being a shortage of them.

Actually, it does. I'm not sure what planet you're coming from, but insurance companies do in fact negotiate rates with PCPs and can (and do) get more PCPs in particular areas by offering to pay them more. It's well known that median physician salaries in all areas of medicine are higher in medium-sized towns in the midwest than in big cosmopolitan cities on the coasts, in spite of the huge differences in cost of living between the areas. Although it's hardly a fair playing field for the doctor since he's negotiating with a much larger entity (I always like the analogy of the small farmer negotiating rates with the big railroad monopoly in the late 19th century), physicians do have the ability to choose which insurance plans they accept and which they don't (this applies to accepting/not accepting Medicare patients as well). And private practice physicians do in fact choose to not accept particular insurance plans if particular insurance plans set reimbursements too low.

Anyway, there is a middle ground between true free market and fiat dictated renumeration. Every presentation I have seen on the supposed shortage of primary care physicians has failed to adjust for their huge increase in allied health providers who are basically functioning as PCPs with minimal MD oversight for pretty much 5-10% of the more challenging presentations.

 

[YouDontKnowJack]

Actually, it does. I'm not sure what planet you're coming from, but insurance companies do in fact negotiate rates with PCPs and can (and do) get more PCPs in particular areas by offering to pay them more. It's well known that median physician salaries in all areas of medicine are higher in medium-sized towns in the midwest than in big cosmopolitan cities on the coasts. Although it's hardly a fair playing field for the doctor since he's negotiating with a much larger entity (I always like the analogy of the small farmer negotiating rates with the big railroad monopoly in the late 19th century), physicians do have the ability to choose which insurance plans they accept and which they don't (this applies to accepting/not accepting Medicare patients as well). And private practice physicians do in fact choose to not accept particular insurance plans if particular insurance plans set reimbursements too low.

Anyway, there is a middle ground between true free market and fiat dictated renumeration.

they don't earn a whole lot more though. which is probably why many people don't think it's worth moving out to rural areas

 

[Wizard of Oz]

There is certainly a great deal of disagreement in medicine today as to whether or not there is a "shortage" of physicians in the United States. Many physicians disagree with the AAMC's recommendation to increase class sizes, and argue that this recommendation will serve only to increase the number of physicians in specialized fields, and will not do a great deal to help the areas where there is a great need for physicians--rural and urban underserved areas.

In my neck of the woods, it seems to me that where there is a shortage (underserved areas), then it's wonderful to have PA's and NP's come out and alleviate some of the patient burden. In the metro areas, however, we need to enact "scope of practice" legislation to limit their ability to prescribe.

Does this ring a bell in the rest of the country?

 

[willow18]

we hear you. But they do a good job at making their demand very high by cutting down on their supply(residency spots)

It's crazy how they can do that. A true monopoly. There's no shortage of people wanting to go into it, but they keep the openings down (with some silly excuses). The result: it's near impossible to get a non-cosmetic-procedure derm appointment in most areas in the country. Wanna get checked for cancer? Wait a month. Need skin sanding/botox/etc? Got the ATM handy? Come right in!

 

[Law2Doc]

There is certainly a great deal of disagreement in medicine today as to whether or not there is a "shortage" of physicians in the United States.

I would agree with that. Part of it is how you define shortage. The former AAMC president considered a failure of US med schools to fill US residencies as a shortage by definition. So by that definition we have operated at a shortage for quite a few years now.
But in my opinion, it's hard to argue against the fact that there are more people hitting old age now than any time in recent history, that they are living longer, and that older people on average seek considerably more medical care than other age groups. It also appears that, due to a recent stretching of careers of many physicians, more physicians are going to be retiring or dying over the next few decades than in recent history. Both these would point to a need for more physicians in the short term. Time will tell.