This profession is no longer what it used to be

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When overall physician unemployment is 0.5-0.7%, I think it is difficult to state there is a lack of job security. I am sorry if you are finding yourself in a difficult position. Medicine is certainly not what it used to be, but job security is not that reason.
 
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If this isn't a troll thread, please elaborate.

Physicians are very well paid and respected. Unemployment is extremely low and opportunities abound even if for some reason you choose not to work in your field. Growth appears to be high and is assisted by technology. The only struggle I'm aware of is student loan debt but there are ways to manage it.
 
what the op means by job security is that you can always find a job, but that job per se is not secure.

It used to be you could never fire a physician,,, now it is easy to fire them
 
PieOHmy said:
what the op means by job security is that you can always find a job, but that job per se is not secure.

It used to be you could never fire a physician,,, now it is easy to fire them
Click to expand...
I'm not sure that's true
 
Guys, the unemployment rate is low because residency spots are limited. If you factor in the number of MDs that didn't match and those that got forced into FMs.The future doesn't look bright.
Lots of thread about MS4 that won't match in family medicine; This will only get worse as the number of graduate increase.
 
Not at all. To secure a job these days, you either have to:

- know someone
- move to the middle of nowhere
-= etc..

And this is with X graduate per year. Can you image how worse this will look with X + (new school graduate) in a few years?

NITRAS said:
So the possibility of being fired means no job security?
Click to expand...
 
Trollest said:
Guys, the unemployment rate is low because residency spots are limited. If you factor in the number of MDs that didn't match and those that got forced into FMs.The future doesn't look bright.
Lots of thread about MS4 that won't match in family medicine; This will only get worse as the number of graduate increase.
Click to expand...

maybe don't go to a diploma mill? Most people who didn't match had no business being in medicine in the first place (eg you can find a DO school that will take a 3.0 and an MCAT of 27 or w/e the new equivalent is). These are students who didn't take medical school seriously, didn't show up for the minimum in their clinical years, and still expected the world to kowtow to them. I've seen these students now for the past 5-6 years and you can basically tell who they are from across the room. It's very rare that a student who did everything right didn't match; it may not have been at the program they wanted or where they wanted, but at the end, they will be a full practicing doctor.

Going to an MD school or established DO school and putting in your work gives you at least a 95% chance of matching into anything, probably approaching 100% if you are realistic with yourself (eg step 1 of 220 isn't getting you dermatology).

Not at all. To secure a job these days, you either have to:

- know someone
- move to the middle of nowhere
-= etc..

And this is with X graduate per year. Can you image how worse this will look with X + (new school graduate) in a few years?
Click to expand...

Absolutely false. People from my graduating class in IM went to get jobs in Denver, Philly, NYC, Boston, Chicago, Seattle, Austin. I've personally turned down jobs in Indianapolis, Chicago, NYC, and Miami. Maybe if you want to be a super-specialized niche physician in LA, it might be hard to find a job. For IM and IM subspecialties, I've not seen anyone compromise where they want to work, at least outside looking in.
 
Trollest said:
Not at all. To secure a job these days, you either have to:

- know someone
- move to the middle of nowhere
-= etc..

And this is with X graduate per year. Can you image how worse this will look with X + (new school graduate) in a few years?
Click to expand...
Outside of a few fields (rad onc) this just isn't true.
 
This, I am afraid, is no longer true.


Technology and mid-levels will replace us and yet, we are still expanding the number of graduate even though residency spots have not.


MilknCheerios said:
If this isn't a troll thread, please elaborate.

Physicians are very well paid and respected. Unemployment is extremely low and opportunities abound even if for some reason you choose not to work in your field. Growth appears to be high and is assisted by technology. The only struggle I'm aware of is student loan debt but there are ways to manage it.
Click to expand...
 
What isn't? Have we not lost our "privilege" of "selectivity"? A majority of MD (mostly PCP) will take a job in the middle of nowhere to stay afloat and avoid competition. That's the truth in any big city.
We can't all work for hospitals!
VA Hopeful Dr said:
Outside of a few fields (rad onc) this just isn't true.
Click to expand...
 
Very comforting to hear this
aafisahar said:
Absolutely false. People from my graduating class in IM went to get jobs in Denver, Philly, NYC, Boston, Chicago, Seattle, Austin. I've personally turned down jobs in Indianapolis, Chicago, NYC, and Miami. Maybe if you want to be a super-specialized niche physician in LA, it might be hard to find a job. For IM and IM subspecialties, I've not seen anyone compromise where they want to work, at least outside looking in.
Click to expand...
 
Trollest said:
What isn't? Have we not lost our "privilege" of "selectivity"? A majority of MD (mostly PCP) will take a job in the middle of nowhere to stay afloat and avoid competition. That's the truth in any big city.
We can't all work for hospitals!
Click to expand...
Did you read your own post that I quoted in my response?

Let's review:

Trollest said:
Not at all. To secure a job these days, you either have to:

- know someone
- move to the middle of nowhere
-= etc..

And this is with X graduate per year. Can you image how worse this will look with X + (new school graduate) in a few years?
Click to expand...

To which I said this:

VA Hopeful Dr said:
Outside of a few fields (rad onc) this just isn't true.
Click to expand...


Most fields still have a pretty good job market. I live in SC. Our state capital has 2 major hospitals. Look at all the job openings:

Careers - Prisma Health

Notice of Nondiscrimination
phuscmg.org phuscmg.org

Apply Now - Physician Recruitment | Lexington Medical Center, Columbia, SC

We're always looking for board-certified or board-eligible physicians to join our expanding network. Must be a U.S. Citizen or Permanent Resident.
www.lmcphysicians.com

Let's look at Charlotte so a major city is covered:

The next generation of advanced medicine is taking root at Atrium Health.

www.joinatriumhealth.org www.joinatriumhealth.org

And that's just the hospital employed jobs, I didn't even try to look at any PP groups.

But you're right, man that job market sure does suck.
 
Mid-levels cannot replace physicians, I am a NP and my knowledge is superficial compared to physicians. NP can deal with simple cases, but complex cases require us to refer out. Imagine this, I did not take Biochemistry, Molecular Biology, Genetics and Physics to go to nursing school and NP school. I understand your frustration, but the reality is when you practice as a physician, you will always have to report to someone. You will be evaluated based on established metrics, and you will have to deal with insurances who even dictates how you should practice. Nevertheless, your duty is to serve people, and that duty is not easy.
 
Ultimax said:
Mid-levels cannot replace physicians, I am a NP and my knowledge is superficial compared to physicians. NP can deal with simple cases, but complex cases require us to refer out. Imagine this, I did not take Biochemistry, Molecular Biology, Genetics and Physics to go to nursing school and NP school. I understand your frustration, but the reality is when you practice as a physician, you will always have to report to someone. You will be evaluated based on established metrics, and you will have to deal with insurances who even dictates how you should practice. Nevertheless, your duty is to serve people, and that duty is not easy.
Click to expand...

Except thats not what a lot of mid levels think and since mid levels are cheaper to hospitals, and hospitals these days care mostly about $$, i can definitely see mid levels replacing doctors. Or perhaps mid levels will do a 'fellowship' and are no longer considered 'mid levels'. who knows. It's very important to know what you dont know and realize that which i'm glad you do. but the same cant be said for many mid levels out there.

As you know there are certain nursing groups fighting to be called doctors
 
Also there are still a lot of jobs in medicine in most fields. The question is, are they good jobs? Are they going to be the jobs you want? Maybe not.
I dont know what it was like in the distant past other than the pay was better in regards to purchasing power. But today they tell you to aim for 2 out of the 3, money, vacation, location.

If you sacrifice, and oftentimes vacation, there are jobs in desireable locations. And yes doctors can be easily fired, easier than nurses in many places. Is that how you define job security? It's not really how i define it, but if you think job security = low unemployment rate, then i guess there is still job security.
 
Well, that was one out of many points. I could write a book about this.
VA Hopeful Dr said:
Did you read your own post that I quoted in my response?

Let's review:



To which I said this:




Most fields still have a pretty good job market. I live in SC. Our state capital has 2 major hospitals. Look at all the job openings:

Careers - Prisma Health

Notice of Nondiscrimination
phuscmg.org phuscmg.org

Apply Now - Physician Recruitment | Lexington Medical Center, Columbia, SC

We're always looking for board-certified or board-eligible physicians to join our expanding network. Must be a U.S. Citizen or Permanent Resident.
www.lmcphysicians.com

Let's look at Charlotte so a major city is covered:

The next generation of advanced medicine is taking root at Atrium Health.

www.joinatriumhealth.org www.joinatriumhealth.org
Click to expand...


We have become disposable! Instead of having 4 MDs run a place; the new model 1 MD + 3 midlevels. So, let's not try to be closed minded in our comparison. We are in a bad spot, especially when compared to 2000 or 2009.

Mr. Dr. Prof. Patrick said:
When overall physician unemployment is 0.5-0.7%, I think it is difficult to state there is a lack of job security. I am sorry if you are finding yourself in a difficult position. Medicine is certainly not what it used to be, but job security is not that reason.
Click to expand...

anbuitachi said:
Also there are still a lot of jobs in medicine in most fields. The question is, are they good jobs? Are they going to be the jobs you want? Maybe not.
I dont know what it was like in the distant past other than the pay was better in regards to purchasing power. But today they tell you to aim for 2 out of the 3, money, vacation, location.

If you sacrifice, and oftentimes vacation, there are jobs in desireable locations. And yes doctors can be easily fired, easier than nurses in many places. Is that how you define job security? It's not really how i define it, but if you think job security = low unemployment rate, then i guess there is still job security.
Click to expand...
 
Trollest said:
Well, that was one out of many points. I could write a book about this.



We have become disposable! Instead of having 4 MDs run a place; the new model 1 MD + 3 midlevels. So, let's not try to be closed minded in our comparison. We are in a bad spot, especially when compared to 2000 or 2009.
Click to expand...
Your book would not be a best seller lets put it that way. The pendulum will swing and there won't be as many NPs because they'll price themselves out of a job as they keep pushing for more money. You're an M2 who's information is only from SDN, which far and away is not a rational nor fully accurate source.
 
Chibucks15 said:
Your book would not be a best seller lets put it that way. The pendulum will swing and there won't be as many NPs because they'll price themselves out of a job as they keep pushing for more money. You're an M2 who's information is only from SDN, which far and away is not a rational nor fully accurate source.
Click to expand...
That's already happening. Our group just had new contract negotiations. The NPs were handed a contract and told that if they didn't like it they could be easily replaced.

When the MDs had concerns about portions of the contract, they were either changed or explained in detail why it was the way it was.
 
Idk, idk. And nice assumption there.
You would benefit from reading this article: https://blogs.jwatch.org/hiv-id-obs...-physicians-to-stay-in-their-lane/2019/09/15/

,
Chibucks15 said:
Your book would not be a best seller lets put it that way. The pendulum will swing and there won't be as many NPs because they'll price themselves out of a job as they keep pushing for more money. You're an M2 who's information is only from SDN, which far and away is not a rational nor fully accurate source.
Click to expand...

The NP outpricing themselves should be the least of your worries; you need to think about those PA dudes, and the 200k graduates of 202x.
 
Trollest said:
Well, that was one out of many points. I could write a book about this.



We have become disposable! Instead of having 4 MDs run a place; the new model 1 MD + 3 midlevels. So, let's not try to be closed minded in our comparison. We are in a bad spot, especially when compared to 2000 or 2009.
Click to expand...
That's A model, not THE model.

I know that for most primary care offices in my group its 2-3MDs per midlevel. I'd say about 50% of practices don't have midlevels at all.

Most of our specialty offices don't have midlevels, or have maybe 1 per office.
 
Trollest said:
Idk, idk. And nice assumption there.
You would benefit from reading this article: https://blogs.jwatch.org/hiv-id-obs...-physicians-to-stay-in-their-lane/2019/09/15/

,

The NP outpricing themselves should be the least of your worries; you need to think about those PA dudes, and the 200k graduates of 202x.
Click to expand...
I'd trust the attending. Idk thought it was mentioned earlier you were an M2 but maybe I'm wrong whoops my bad. I'm not saying stay in your lane by any means? I'm saying your assertions are incorrect
 
Chibucks15 said:
I'd trust the attending. Idk thought it was mentioned earlier you were an M2 but maybe I'm wrong whoops my bad. I'm not saying stay in your lane by any means? I'm saying your assertions are incorrect
Click to expand...
OP posted on another thread said they were an m2
 
To clarify, I am an M2 but I read a lot. SDN isn't my only source of information.
 
MilknCheerios said:
If this isn't a troll thread, please elaborate.

Physicians are very well paid and respected. Unemployment is extremely low and opportunities abound even if for some reason you choose not to work in your field. Growth appears to be high and is assisted by technology. The only struggle I'm aware of is student loan debt but there are ways to manage it.
Click to expand...
Respected by who? Let me have some of what you’re smoking

Also maybe you didn’t see the executive order by the Cheeto recently. Pay is about to plummet buddy
 
They will wake up.... It just a matter of time
NecFasc92 said:
Respected by who? Let me have some of what you’re smoking

Also maybe you didn’t see the executive order by the Cheeto recently. Pay is about to plummet buddy
Click to expand...
 
NecFasc92 said:
Respected by who? Let me have some of what you’re smoking

Also maybe you didn’t see the executive order by the Cheeto recently. Pay is about to plummet buddy
Click to expand...
Most of the patients I see

You know, I hear that about pay at least once/year on SDN. Pay's gone up pretty consistently since I graduated residency 6 years ago.
 
VA Hopeful Dr said:
Most of the patients I see

You know, I hear that about pay at least once/year on SDN. Pay's gone up pretty consistently since I graduated residency 6 years ago.
Click to expand...
Regarding pay trump did sign an executive order to eliminate disparities between physicians/PA/NP pay.
 
VA Hopeful Dr said:
Most of the patients I see

You know, I hear that about pay at least once/year on SDN. Pay's gone up pretty consistently since I graduated residency 6 years ago.
Click to expand...
That’s nice. Maybe where you are. But in my city of over 10 million ppl, doctors and nps are seen as one, ie very little respect for our time spent studying/ sacrifice of life/ family/ etc

What are you talking about? He just passed the executive order yesterday...
 
NecFasc92 said:
That’s nice. Maybe where you are. But in my city of over 10 million ppl, doctors and nps are seen as one, ie very little respect for our time spent studying/ sacrifice of life/ family/ etc

What are you talking about? He just passed the executive order yesterday...
Click to expand...
Have you actually read the EO?
 
NecFasc92 said:
Your condescension notwithstanding, I have. Have you?
Click to expand...
Not being condescending at all, trying to figure out what you actually know prior to diving deeper into this (had you only seen a news report of it I would address this on a more basic level).

So now that we've established we're on the same page, let's take a look at the thing. I'm guessing this is the part you're worried about:

(c) conducting a comprehensive review of regulatory policies that create disparities in reimbursement between physicians and non-physician practitioners and proposing a regulation that would, to the extent allowed by law, ensure that items and services provided by clinicians, including physicians, physician assistants, and nurse practitioners, are appropriately reimbursed in accordance with the work performed rather than the clinician’s occupation.

This could be troublesome but for a few things. First, the Secretary has 1 year to get the proposals in place. Has HHS ever done anything significantly earlier than whatever deadline the have? My experience with CMS says no. Second, that's just proposing a regulation. That's not a definite rule. Third, I'm unsure if the 85% rule for NPs is the result of a CMS policy of if that's codified in law. If the latter, this won't happen because it can't. If the former it becomes possible. Fourth, this whole EO seems geared towards shifting people toward Medicare Advantage plans which are administered by insurance companies (probably why Trump is doing it if we're honest about it) and not the government and they can set their reimbursement rates however they want - meaning they can keep paying NPs the same as they are now. This part could even be part of that - if patients have to suddenly pay more to see a midlevel they might decide to go for a MA plan.

If we go past that, there are several potentially good parts of the EO:

(b) proposing a regulation that would ensure appropriate reimbursement by Medicare for time spent with patients by both primary and specialist health providers practicing in all types of health professions; and

More money if more time spent, that sounds good to little ole FP me.

(b) The Secretary, in consultation with the Chairman of the Council of Economic Advisers, shall submit to the President, through the Assistants to the President for Domestic and Economic Policy, a report within 180 days from the date of this order that identifies approaches to modify Medicare FFS payments to more closely reflect the prices paid for services in MA and the commercial insurance market, to encourage more robust price competition, and otherwise to inject market pricing into Medicare FFS reimbursement.

Looks like he wants Medicare to pay more which would be nice.

There's also a fair bit in there about high value care and outliers which are code for more quality-based care. That can be good or bad depending on how its done.
 
If the “Residency Physician Shortage Act” shilled by the AAMC ever passes then it will be all over. They want to increase the number of residents by 50%, at which point we’ll be glorified PAs. Don’t think it will pass but it should be stopped at all costs.
 
It might though. The AAMC still believes that there is a shortage a physician. What this country is lacking, is money. People don't have the funds to see their physician.
At this rate, PCP will be lucky to gross 50k by 2025.
ace_inhibitor111 said:
If the “Residency Physician Shortage Act” shilled by the AAMC ever passes then it will be all over. They want to increase the number of residents by 50%, at which point we’ll be glorified PAs. Don’t think it will pass but it should be stopped at all costs.
Click to expand...
 
Trollest said:
It might though. The AAMC still believes that there is a shortage a physician. What this country is lacking, is money. People don't have the funds to see their physician.
At this rate, PCP will be lucky to gross 50k by 2025.

Click to expand...
PCP grossing 50K by 2025, huh? You wanna bet on that though. I graduate in 2022 (fingers crossed), and hopefully I graduate out of IM residency in 2025. If I make anything less than 200K, you win, and you can have half my income lol.

Sent from my SM-G973U using SDN mobile
 
Go on payscale and see how much PCPs are currently making .. 120k -237k. That's with moderate competition.
I lost count of the number of new schools but once they all graduate and start looking for jobs, having their own clinics. Their salary will go down!
50k take home pay isn't a wild estimate.

Try to be open-minded on this one!

DrStephenStrange said:
PCP grossing 50K by 2025, huh? You wanna bet on that though. I graduate in 2022 (fingers crossed), and hopefully I graduate out of IM residency in 2025. If I make anything less than 200K, you win, and you can have half my income lol.

Sent from my SM-G973U using SDN mobile
Click to expand...
 
I am quite amused. Not long ago, rad onc were making 500k. These days, their median salary is 200k. Let that sink in for a minute.
 
Trollest said:
I am quite amused. Not long ago, rad onc were making 500k. These days, their median salary is 200k. Let that sink in for a minute.
Click to expand...
Supply and Demand those in rad onc over saturated themselves.The bottleneck is still the number of residencies it might change but I don't see it changing soon.
 
Trollest said:
I am quite amused. Not long ago, rad onc were making 500k. These days, their median salary is 200k. Let that sink in for a minute.
Click to expand...
Unless it’s MGMA data or Merril Hawkins I don’t believe them. Everything else is notoriously off
 
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