What are your 90%/50%/10% predictions for the next 10 years?

[Backpack234]

Saw this on reddit for CS careers. Would love to see what EM docs think is in their future.

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[RustedFox]

Explain the concept, please.

 

[WilcoWorld]

Explain the concept, please.

Something you are 90%, 50% and 10% confident will happen.

 

[Backpack234]

What do you think is 90% likely to happen in the next 10 years? 50% likely? 10% likely?

90% likely: EM residency positions continue to boom.

50% likely: Covid isn’t such a big deal anymore.

10%: a single non-evil SDG takes over a contract and becomes a great place for docs to work

 

[Apollyon]

Explain the concept, please.

90% I'll be alive, 50% I'll have a job, 10% I'll be rich.

 

[WilcoWorld]

As in, in the next 10 years I'm:
90% confident ACEP will not fight the CMG's on our behalf
50% confident that Stroke Center Accreditation will be found to be harmful to non-stroke patients
10% confident that NP's will fall out of vogue

 

[RustedFox]

90% confident that COVID smolders out.

50% confident that the demand for emergency care continues to rise, minimally mitigating the impending oversupply issue.

10% confident any EM governing body does anything actually useful, including AAEM.

 

[sylvanthus]

90%
Covid becomes endemic and we get boosters every year with the flu.

Midlevels gain independence in all states and more and more specialities.

EM job market gets worse, more residency programs open up, programs start becoming filled with subpar applicants.

Charting requirements increase

Insurance gains more control over what we order and do

More paperwork

More metrics

Pay decreases in relation to inflation.

50%

Single payor/some kind of socialized medicine happens. Maybe a base level with option tonpurchase more coverage?

10%

We or are national organizations grow a sack and try and fix the above.

 

[Rekt]

90%
Covid becomes endemic and we get boosters every year with the flu.

Midlevels gain independence in all states and more and more specialities.

EM job market gets worse, more residency programs open up, programs start becoming filled with subpar applicants.

Charting requirements increase

Insurance gains more control over what we order and do

More paperwork

More metrics

Pay decreases in relation to inflation.

50%

Single payor/some kind of socialized medicine happens. Maybe a base level with option tonpurchase more coverage?

10%

We or are national organizations grow a sack and try and fix the above.

Thread over.

 

[DocEspana]

90% my income (and most people's income) will not rise to meet inflation. Really I'm 90% sure it won't raise at all, but it definitely won't raise to meet inflation.

50% there will be a significant change in one of the two banes of my existence: stroke protocol or sepsis protocol. The change that brings one of these protocols into line with actual data, as opposed to 20 year old wishful thinking, enough to make actively harming the patient a little no longer the standard of care.

10%: the corporate practice of medicine model has any sort of Nationwide blow delivered to it. Even a small one. And I am super on board with helping AAEM give it the old college try, but I'm very realistic as to what impacts it could actually have for me on the opposite Coast. If it matters, I would put 25% at the chance that this makes a difference in california. But literally only in California. And still only 25%. I see them losing three out of four times in hypothetical futures.

 

[Groove]

90% sure some of my colleagues test themselves for COVID right before their string of holiday night shifts

50% sure we'll find a last minute replacement willing to work

10% sure that last minute replacement will get any extra money to work the shift

 

[BoardingDoc]

90% sure some of my colleagues test themselves for COVID right before their string of holiday night shifts

50% sure we'll find a last minute replacement willing to work

10% sure that last minute replacement will get any extra money to work the shift

Your coworkers sound like douches.

 

[Groove]

Your coworkers sound like douches.

Everyone loves to test themselves where I'm currently at for some odd reason. I can't count the 10 day paid quarantines since the pandemic. You'd have to tie me down and force a test on me. Even if I knew I had it, with mild sx, I'd probably never tell anyone, double mask and come to work anyway. I've taken only one sick day since graduating med school 13 yrs ago and that was for a PTX.

 

[deleted1114045]

Sorry. I know I'm a catastrophist. Better wrong than unprepared! I shouldn't respond to things like this, but I couldn't resist.

90%-

Emergency Medicine- Increase in hospital-based employment models. Small CMGs go out of business or consolidate/are bought out by large groups. A few large CMGs dominate the medical field.

Medicine- continues a slow decline with an overabundance of physicians and continued nursing shortages. Physician and nursing wages slowly head towards each other.

Economy- We limp along, not with robust growth, but not with Great-Depression like crashes.

US politics- Increasing partisanship, but we limp along as a nation more or less united.

International politics- China surpasses the US in political power, military power, and economic power. The transfer of power is slow, gradual and we avoid a third world war. We partner together to help avoid war and serious outbreaks of interstate violence.

50%-

Emergency Medicine- We take a 30-40% pay cut as patients are increasingly unable to afford care, don’t pay their bills, lose their insurance. An oversupply of graduating ER residents floods the market, favoring a CMG model or hospital-based employment and the vast majority of Democratic groups lose their contracts.

US politics- Trump runs. Win or lose, it is ugly. Legitimate third parties arise as the far right and far left demand demagogues to cater to their personal political religions. The third party system allows for very extreme political parties to dominate despite far less than a majority of voters who favor their policies. Extremist leaders arise on far left and far right.

Economy- We experience a Great depression-like bursting of the bubbles of medicine/education/housing. Great economic suffering for the poor. Homeless problem explodes.

International politics- China is aggressive in establishing an empire, exerting serious political power against Taiwan, Japan, India, the Middle East and in Africa. The belts and roads initiative transforms Africa into a first world behemoth. With its incredibly cheap labor, unparalleled natural resources, under the tutelage and with the economic resources of China, Africa develops with unprecedented growth, allowing Eastern Asia to become a consumer economy and creating an Asian empire that will easily eclipse the political power of the US and Western Europe.

10%-

Emergency Medicine- The state of medicine is so bad that the government bails out the entire industry. Nationalizing a system in crisis is viewed as the only way to maintain our medical system. In this scenario, our wage is cut by 50-60%. Our current overflowing waiting rooms become the norm. Security and nurses become increasingly intolerant of the Kens and Karens of the world and more and more people are escorted out of our hospitals and waiting rooms kicking and screaming and videotaping the whole thing for the pleasure of their social media friends.

Medicine- shortages of specialists, and equipment lead to serious rationing of care. No more heart stents or surgeries for 80-year-olds. No chemo for stage four cancer. Hospice involved sooner. Local ethic boards follow protocols on who gets dialysis/surgery/critical care/ etc.

US politics- Legitimate internal migration crises as people try to escape violence. Coups, rebellions, atrocities committed against minority religious, ethnic, and political groups. Political division within the military and police, leading to a patchwork of law enforcement. Constant low-grade guerilla warfare in inner cities and rural regions. Regions of “no go” zones in inner cities and rural regions where police and national guard simply try to contain rather than eliminate. Gangs and Antifa type organizations administrate in the inner-city no-go zones. Hispanic gangs come to dominate in rural regions along the border. White supremacist organizations dominate certain rural regions in the South.

Economy- GDP plumets and per capita GDP plumets. Stock market in shambles. International investment in US goes away. Corporations go bankrupt in droves. Entire economy nationalized. Personal bank accounts confiscated. Monthly withdrawals from bank accounts limited. Most wealth over $200,000 confiscated by government for redistribution.

World politics- Missteps in dealing with rising China from inept, extreme US and European leaders leads to a third world war that we lose. Likely strategic nuclear weapons used, destroying our cities and infrastructure.

 

[RustedFox]

I see that @RonWeezy listens to the same AM paranormal/parapolitical radio shows that I do when I'm on nights.

 

[BoardingDoc]

Sorry. I know I'm a catastrophist. Better wrong than unprepared! I shouldn't respond to things like this, but I couldn't resist.

90%-

Emergency Medicine- Increase in hospital-based employment models. Small CMGs go out of business or consolidate/are bought out by large groups. A few large CMGs dominate the medical field.

Medicine- continues a slow decline with an overabundance of physicians and continued nursing shortages. Physician and nursing wages slowly head towards each other.

Economy- We limp along, not with robust growth, but not with Great-Depression like crashes.

US politics- Increasing partisanship, but we limp along as a nation more or less united.

International politics- China surpasses the US in political power, military power, and economic power. The transfer of power is slow, gradual and we avoid a third world war. We partner together to help avoid war and serious outbreaks of interstate violence.

50%-

Emergency Medicine- We take a 30-40% pay cut as patients are increasingly unable to afford care, don’t pay their bills, lose their insurance. An oversupply of graduating ER residents floods the market, favoring a CMG model or hospital-based employment and the vast majority of Democratic groups lose their contracts.

US politics- Trump runs. Win or lose, it is ugly. Legitimate third parties arise as the far right and far left demand demagogues to cater to their personal political religions. The third party system allows for very extreme political parties to dominate despite far less than a majority of voters who favor their policies. Extremist leaders arise on far left and far right.

Economy- We experience a Great depression-like bursting of the bubbles of medicine/education/housing. Great economic suffering for the poor. Homeless problem explodes.

International politics- China is aggressive in establishing an empire, exerting serious political power against Taiwan, Japan, India, the Middle East and in Africa. The belts and roads initiative transforms Africa into a first world behemoth. With its incredibly cheap labor, unparalleled natural resources, under the tutelage and with the economic resources of China, Africa develops with unprecedented growth, allowing Eastern Asia to become a consumer economy and creating an Asian empire that will easily eclipse the political power of the US and Western Europe.

10%-

Emergency Medicine- The state of medicine is so bad that the government bails out the entire industry. Nationalizing a system in crisis is viewed as the only way to maintain our medical system. In this scenario, our wage is cut by 50-60%. Our current overflowing waiting rooms become the norm. Security and nurses become increasingly intolerant of the Kens and Karens of the world and more and more people are escorted out of our hospitals and waiting rooms kicking and screaming and videotaping the whole thing for the pleasure of their social media friends.

Medicine- shortages of specialists, and equipment lead to serious rationing of care. No more heart stents or surgeries for 80-year-olds. No chemo for stage four cancer. Hospice involved sooner. Local ethic boards follow protocols on who gets dialysis/surgery/critical care/ etc.

US politics- Legitimate internal migration crises as people try to escape violence. Coups, rebellions, atrocities committed against minority religious, ethnic, and political groups. Political division within the military and police, leading to a patchwork of law enforcement. Constant low-grade guerilla warfare in inner cities and rural regions. Regions of “no go” zones in inner cities and rural regions where police and national guard simply try to contain rather than eliminate. Gangs and Antifa type organizations administrate in the inner-city no-go zones. Hispanic gangs come to dominate in rural regions along the border. White supremacist organizations dominate certain rural regions in the South.

Economy- GDP plumets and per capita GDP plumets. Stock market in shambles. International investment in US goes away. Corporations go bankrupt in droves. Entire economy nationalized. Personal bank accounts confiscated. Monthly withdrawals from bank accounts limited. Most wealth over $200,000 confiscated by government for redistribution.

World politics- Missteps in dealing with rising China from inept, extreme US and European leaders leads to a third world war that we lose. Likely strategic nuclear weapons used, destroying our cities and infrastructure.

I don't claim to have a crystal ball, but I would probably personally relabel your last category as <1% instead of 10%

 

[deleted1114045]

I don't claim to have a crystal ball, but I would probably personally relabel your last category as <1% instead of 10%

That would be wonderful if it doesn’t happen. I would label it at higher. Which specific part would you disagree with?

 

[BoardingDoc]

That would be wonderful if it doesn’t happen. I would label it at higher. Which specific part would you disagree with?

I mean, everything except the medicine part? In a nutshell you are describing the downfall of America from a/the leading power in the world to a third world country. I would personally rate the chances of that as being <1%.

I would agree with your 10% odds for the medical items.

 

[Kryptocoin]

90%-
High attrition rate from the EM in the next 10yrs. ED becomes a toxic place to work with the crowded ER and entitled pts. Overburdensome admins continue their insane demands and threats leading to even more exodus or "retirement" aka prn part-time.

50%-

Oversupply of EM physicians. EM becomes even more centralized with 90% of us working for EM version of the Big Three of Telecom ( Sprint, Verizon , ATT).

10%-
Pay increase.

 

[Matthew9Thirtyfive]

Sorry. I know I'm a catastrophist. Better wrong than unprepared! I shouldn't respond to things like this, but I couldn't resist.

90%-

Emergency Medicine- Increase in hospital-based employment models. Small CMGs go out of business or consolidate/are bought out by large groups. A few large CMGs dominate the medical field.

Medicine- continues a slow decline with an overabundance of physicians and continued nursing shortages. Physician and nursing wages slowly head towards each other.

Economy- We limp along, not with robust growth, but not with Great-Depression like crashes.

US politics- Increasing partisanship, but we limp along as a nation more or less united.

International politics- China surpasses the US in political power, military power, and economic power. The transfer of power is slow, gradual and we avoid a third world war. We partner together to help avoid war and serious outbreaks of interstate violence.

50%-

Emergency Medicine- We take a 30-40% pay cut as patients are increasingly unable to afford care, don’t pay their bills, lose their insurance. An oversupply of graduating ER residents floods the market, favoring a CMG model or hospital-based employment and the vast majority of Democratic groups lose their contracts.

US politics- Trump runs. Win or lose, it is ugly. Legitimate third parties arise as the far right and far left demand demagogues to cater to their personal political religions. The third party system allows for very extreme political parties to dominate despite far less than a majority of voters who favor their policies. Extremist leaders arise on far left and far right.

Economy- We experience a Great depression-like bursting of the bubbles of medicine/education/housing. Great economic suffering for the poor. Homeless problem explodes.

International politics- China is aggressive in establishing an empire, exerting serious political power against Taiwan, Japan, India, the Middle East and in Africa. The belts and roads initiative transforms Africa into a first world behemoth. With its incredibly cheap labor, unparalleled natural resources, under the tutelage and with the economic resources of China, Africa develops with unprecedented growth, allowing Eastern Asia to become a consumer economy and creating an Asian empire that will easily eclipse the political power of the US and Western Europe.

10%-

Emergency Medicine- The state of medicine is so bad that the government bails out the entire industry. Nationalizing a system in crisis is viewed as the only way to maintain our medical system. In this scenario, our wage is cut by 50-60%. Our current overflowing waiting rooms become the norm. Security and nurses become increasingly intolerant of the Kens and Karens of the world and more and more people are escorted out of our hospitals and waiting rooms kicking and screaming and videotaping the whole thing for the pleasure of their social media friends.

Medicine- shortages of specialists, and equipment lead to serious rationing of care. No more heart stents or surgeries for 80-year-olds. No chemo for stage four cancer. Hospice involved sooner. Local ethic boards follow protocols on who gets dialysis/surgery/critical care/ etc.

US politics- Legitimate internal migration crises as people try to escape violence. Coups, rebellions, atrocities committed against minority religious, ethnic, and political groups. Political division within the military and police, leading to a patchwork of law enforcement. Constant low-grade guerilla warfare in inner cities and rural regions. Regions of “no go” zones in inner cities and rural regions where police and national guard simply try to contain rather than eliminate. Gangs and Antifa type organizations administrate in the inner-city no-go zones. Hispanic gangs come to dominate in rural regions along the border. White supremacist organizations dominate certain rural regions in the South.

Economy- GDP plumets and per capita GDP plumets. Stock market in shambles. International investment in US goes away. Corporations go bankrupt in droves. Entire economy nationalized. Personal bank accounts confiscated. Monthly withdrawals from bank accounts limited. Most wealth over $200,000 confiscated by government for redistribution.

World politics- Missteps in dealing with rising China from inept, extreme US and European leaders leads to a third world war that we lose. Likely strategic nuclear weapons used, destroying our cities and infrastructure.

Lol what is happening here

 

[deleted1114045]

I mean, everything except the medicine part? In a nutshell you are describing the downfall of America from a/the leading power in the world to a third world country. I would personally rate the chances of that as being <1%.

I would agree with your 10% odds for the medical items.

The Roman empire fell and was reborn numerous times. Her greatest dynasty lasted about 250 years. At one time, the Vikings were the terror of the ocean, raiding from Russia to Italy, and exploring from America to Africa. Their descendants built great empires in Denmark and Sweden, that, in their turn, had navies and armies that conquered all of Scandinavia, England, and some of France. Today, Sweden makes furniture and Denmark is essentially a non-entity in world politics. The Dutch empire was a financial superpower during the 16 and 1700s. Today, its political, military, and economic influence is negligible. England replaced them for 250 years, as the world super power with an empire on which the sun never set. Today, England’s share of the world’s GDP has fallen by more than 80 percent. At one point, France looked to be set to take over the world, conquering most of Europe and pillaging the treasures of the ancient Egyptians. They were the undisputed leaders in science, culture and philosophy. Now…not so much. Twice, in thirty years Germany was an economic and military juggernaut that threatened to take over the entire world. Now, she has relatively little power. Empires come and go, wax and wane. So will the USA.

Amazon product

 

[deleted1114045]

Countries rise and fall much like viral outbreaks. Which side of the curve is our country on?

 

[deleted1114045]

This is how countries/empires rise and fall. Do 9-15 look familiar? 17? Then you shouldn't be surprised at 16 or 18.

 

[Kryptocoin]

The US didn't really become the undisputed world superpower until after WW2. So in the overall context of other fallen empires, we are still a very young superpower. We have a good 80+ yrs left.

Wealthy Chinese still park their money in US assets.

 

[BoardingDoc]

The Roman empire fell and was reborn numerous times. Her greatest dynasty lasted about 250 years. At one time, the Vikings were the terror of the ocean, raiding from Russia to Italy, and exploring from America to Africa. Their ancestors built great empires in Denmark and Sweden, that, in their turn, had navies and armies that conquered all of Scandinavia, England, and some of France. Today, Sweden makes furniture and Denmark is essentially a non-entity in world politics. The Dutch empire was a financial superpower during the 16 and 1700s. Today, its political, military, and economic influence is negligible. England replaced them for 250 years, as the world super power with an empire on which the sun never set. Today, England’s share of the world’s GDP has fallen by more than 80 percent. At one point, France looked to be set to take over the world, conquering most of Europe and pillaging the treasures of the ancient Egyptians. They were the undisputed leaders in science, culture and philosophy. Now…not so much. Twice, in thirty years Germany was an economic and military juggernaut that threatened to take over the entire world. Now, she has relatively little power. Empires come and go, wax and wane. So will the USA.

Amazon product

I don't disagree with the likely inevitability of the fall from grace of the USA at some point in the future. I disagree with your timeframe. You describe the collapse of various world powers in history. These events took place over anywhere from 50-100 years or more (with the exception of post WW I Germany which I would argue is a relatively unique case given the catastrophic economic implications that the treaty of Versailles put it under). You are describing the same phenomenon as happening within the next 10 years which is historically unprecedented and which I don't personally feel is terribly likely.

 

[deleted314957]

The US didn't really become the undisputed world superpower until after WW2. So in the overall context of other fallen empires, we are still a very young superpower. We have a good 80+ yrs left.

Wealthy Chinese still park their money in US assets.

We’ve got problems. But, half or more of Chinese still s*** in a hole or on the ground. And, it’s kinda considered the norm. Think about that one.

 

[The kitchen sink]

Sorry. I know I'm a catastrophist. Better wrong than unprepared! I shouldn't respond to things like this, but I couldn't resist.

90%-

Emergency Medicine- Increase in hospital-based employment models. Small CMGs go out of business or consolidate/are bought out by large groups. A few large CMGs dominate the medical field.

Medicine- continues a slow decline with an overabundance of physicians and continued nursing shortages. Physician and nursing wages slowly head towards each other.

Economy- We limp along, not with robust growth, but not with Great-Depression like crashes.

US politics- Increasing partisanship, but we limp along as a nation more or less united.

International politics- China surpasses the US in political power, military power, and economic power. The transfer of power is slow, gradual and we avoid a third world war. We partner together to help avoid war and serious outbreaks of interstate violence.

50%-

Emergency Medicine- We take a 30-40% pay cut as patients are increasingly unable to afford care, don’t pay their bills, lose their insurance. An oversupply of graduating ER residents floods the market, favoring a CMG model or hospital-based employment and the vast majority of Democratic groups lose their contracts.

US politics- Trump runs. Win or lose, it is ugly. Legitimate third parties arise as the far right and far left demand demagogues to cater to their personal political religions. The third party system allows for very extreme political parties to dominate despite far less than a majority of voters who favor their policies. Extremist leaders arise on far left and far right.

Economy- We experience a Great depression-like bursting of the bubbles of medicine/education/housing. Great economic suffering for the poor. Homeless problem explodes.

International politics- China is aggressive in establishing an empire, exerting serious political power against Taiwan, Japan, India, the Middle East and in Africa. The belts and roads initiative transforms Africa into a first world behemoth. With its incredibly cheap labor, unparalleled natural resources, under the tutelage and with the economic resources of China, Africa develops with unprecedented growth, allowing Eastern Asia to become a consumer economy and creating an Asian empire that will easily eclipse the political power of the US and Western Europe.

10%-

Emergency Medicine- The state of medicine is so bad that the government bails out the entire industry. Nationalizing a system in crisis is viewed as the only way to maintain our medical system. In this scenario, our wage is cut by 50-60%. Our current overflowing waiting rooms become the norm. Security and nurses become increasingly intolerant of the Kens and Karens of the world and more and more people are escorted out of our hospitals and waiting rooms kicking and screaming and videotaping the whole thing for the pleasure of their social media friends.

Medicine- shortages of specialists, and equipment lead to serious rationing of care. No more heart stents or surgeries for 80-year-olds. No chemo for stage four cancer. Hospice involved sooner. Local ethic boards follow protocols on who gets dialysis/surgery/critical care/ etc.

US politics- Legitimate internal migration crises as people try to escape violence. Coups, rebellions, atrocities committed against minority religious, ethnic, and political groups. Political division within the military and police, leading to a patchwork of law enforcement. Constant low-grade guerilla warfare in inner cities and rural regions. Regions of “no go” zones in inner cities and rural regions where police and national guard simply try to contain rather than eliminate. Gangs and Antifa type organizations administrate in the inner-city no-go zones. Hispanic gangs come to dominate in rural regions along the border. White supremacist organizations dominate certain rural regions in the South.

Economy- GDP plumets and per capita GDP plumets. Stock market in shambles. International investment in US goes away. Corporations go bankrupt in droves. Entire economy nationalized. Personal bank accounts confiscated. Monthly withdrawals from bank accounts limited. Most wealth over $200,000 confiscated by government for redistribution.

World politics- Missteps in dealing with rising China from inept, extreme US and European leaders leads to a third world war that we lose. Likely strategic nuclear weapons used, destroying our cities and infrastructure.

You should write a TV script for this, I’d watch.

 

[The kitchen sink]

90%-
High attrition rate from the EM in the next 10yrs. ED becomes a toxic place to work with the crowded ER and entitled pts. Overburdensome admins continue their insane demands and threats leading to even more exodus or "retirement" aka prn part-time.

50%-

Oversupply of EM physicians. EM becomes even more centralized with 90% of us working for EM version of the Big Three of Telecom ( Sprint, Verizon , ATT).

10%-
Pay increase.

High attrition countered by the expanding EM slots open up the vacuum for CMGs to prey on new graduates to fill the void at lower costs. All part of the plan :/

 

[deleted1114045]

I don't claim to have a crystal ball, but I would probably personally relabel your last category as <1% instead of 10%

World politics- Russia is acting as Hitler did in the years before world war three. China is siding with Russia. Russia, NATO could take on. Russia and China against the Western world? Given that it is happening in Asia, Russia and China have a distinct homecourt advantage. That conflict could burn through hundreds of millions of soldiers and civilians and destroy the world. Beware of a normalcy bias.

NATO Green Lights Historic Deployment of Troops to ‘Deter’ Putin

GINTS IVUSKANS/AFP via Getty ImagesThe North Atlantic Treaty Organization has decided to deploy elements of the NATO Response Force in an effort to thwart Russia’s onslaught in Ukraine."What we see now is a full fledged invasion of Ukraine," NATO Secretary General Jens Soltenberg said in a press...

news.yahoo.com

World War three has potentially just begun.

 

[BoardingDoc]

World politics- Russia is acting as Hitler did in the years before world war three. China is siding with Russia. Russia, NATO could take on. Russia and China against the Western world? Given that it is happening in Asia, Russia and China have a distinct homecourt advantage. That conflict burns through hundreds of millions of soldiers and civilians and destroys the world. Beware of a normalcy bias.

NATO Green Lights Historic Deployment of Troops to ‘Deter’ Putin

GINTS IVUSKANS/AFP via Getty ImagesThe North Atlantic Treaty Organization has decided to deploy elements of the NATO Response Force in an effort to thwart Russia’s onslaught in Ukraine."What we see now is a full fledged invasion of Ukraine," NATO Secretary General Jens Soltenberg said in a press...

news.yahoo.com

World War three has potentially just begun.

I am deeply unsettled and outraged by Putin's actions in Ukraine. This does not change my perception of probability that I assign to your doomsday scenario (or this new one for that matter).

Also, I find it very odd that you pitch a doomsday scenario, I disagree, you see current global events as evidence to support your doomsday position, and your response ... is to gloat that you think you were right about the apocalypse?

I really don't get doomsday preppers. You do whatever makes you happy though.

 

[thegenius]

I agree that nothing severe, like WW3 or a global depression, will occur from the Russia/Ukraine thing. I just hope that the world levies strong enough sanctions against Russia that they can't invade and keep Ukraine, literally, due to finances.

 

[deleted1114045]

I agree that nothing severe, like WW3 or a global depression, will occur from the Russia/Ukraine thing. I just hope that the world levies strong enough sanctions against Russia that they can't invade and keep Ukraine, literally, due to finances.

What are your 90%/50%/10% predictions for what happens in the Ukraine?​

 

[thegenius]

I don't have any.

Ok fine...
90% chance thousands die. 90% chance hundreds of thousands leave Ukraine.
50% chance millions leave Ukraine
0% chance anyone really benefits from this invasion except private companies that sell weapons.

 

[deleted1114045]

I don't have any.

Ok fine...
90% chance thousands die. 90% chance hundreds of thousands leave Ukraine.
50% chance millions leave Ukraine
0% chance anyone really benefits from this invasion except private companies that sell weapons.

What will be its effect on our economy? 90% 50% 10%

 

[southerndoc]

The Ukraine discussion is like the Covid political discussion. I vote we create a separate thread if we want to discuss politics related to Ukraine (unfortunately, as much as I'd like, I can't chime in... those that know me personally know about my part-time gig that prevents me from doing so).

 

[deleted1114045]

The Ukraine discussion is like the Covid political discussion. I vote we create a separate thread if we want to discuss politics related to Ukraine (unfortunately, as much as I'd like, I can't chime in... those that know me personally know about my part-time gig that prevents me from doing so).

Pretty tough to talk about predictions of what emergency medicine looks like if we can't talk about politics or world events. Nothing in politics doesn't effect us. Both politic parties are constantly scheming to ruin the lives of emergency physicians by foisting some new program or law on us. Economics are critical to our practice as even if people have no money, we will be obligated to see them. 6 dollar/gallon gas, inflation, and skyrocketing house prices is necessarily going to increase the already ginormous wave of homeless people that seek refuge in our departments. A war in Asia is going to effect our supply chains. Supply chains are critical to us as we have the largest required toolbox of any specialty, when it comes to equipment, and required supplies and medications.

 

[WilcoWorld]

True, everything is interconnected, but I think you're using a lot of speculation in this post 👆 and the scope is probably too broad to make for a productive discussion.

By the logic that we need to discuss this, because the invasion of Ukraine impacts EM by decreasing Russian oil supply-->increasing gas prices-->increasing inflation-->increasing homelessness --> increasing ED visits. We also can't talk about EM without talking about mass incarceration, or dieting trends on Tic Tok, or abortion laws in Texas, or what the movie Free Guy tells us about the mental health of gamers. I could draw out connections between all of those and EM in 4 or fewer moves, but I'd rather hear what other EP's think about, say, their local practice pattern on management of small non-op intracranial hemorrhages.

Said otherwise, in order to have a good conversation we have to choose some part of the universe to focus on. I don't think @southerndoc is suggesting something unreasonable.

 

[bronx43]

World politics- Russia is acting as Hitler did in the years before world war three. China is siding with Russia. Russia, NATO could take on. Russia and China against the Western world? Given that it is happening in Asia, Russia and China have a distinct homecourt advantage. That conflict could burn through hundreds of millions of soldiers and civilians and destroy the world. Beware of a normalcy bias.

World War three has potentially just begun.

Except not really.

 

[Babinski66]

Everyone loves to test themselves where I'm currently at for some odd reason. I can't count the 10 day paid quarantines since the pandemic. You'd have to tie me down and force a test on me. Even if I knew I had it, with mild sx, I'd probably never tell anyone, double mask and come to work anyway. I've taken only one sick day since graduating med school 13 yrs ago and that was for a PTX.

Yikes! You could drop dead and your job would replace you in a heartbeat. Please take care of yourself fam. Taking a sick day is not a sign of weakness

 

[grt398]

90% - physicians continue losing autonomy, regulations continue to increase, continued expansion of midlevels providing the "appearance" of care and the large media outlets trumpeting bogus studies in line with that

50% - Bretton Woods II is over, the world will transition away from the USD as the reserve currency and this is going to have an effect that very few of the general public have begun to understand. Fiat reserve currencies are replaced by some combination of gold/BTC. See the article "Energy Cancelled" by Arthur Hayes on Medium or the BitMex blog. Here's a Bitmex link that works: Energy Cancelled | BitMEX Blog

Here's one of the original major media articles: If Russian Currency Reserves Aren’t Really Money, the World Is in for a Shock

10% - the legacy financial system mostly disappears and is replaced by true decentralized finance. This should happen, it would be beneficial for humanity, but I suspect much of this will be co-opted by the current players.

 

[miacomet]

Everyone loves to test themselves where I'm currently at for some odd reason. I can't count the 10 day paid quarantines since the pandemic. You'd have to tie me down and force a test on me. Even if I knew I had it, with mild sx, I'd probably never tell anyone, double mask and come to work anyway. I've taken only one sick day since graduating med school 13 yrs ago and that was for a PTX.

Wait, they pay you to take time off?

 

[Dr Mantis Toboggan]

Wait, they pay you to take time off?

Serio. I’d get a PCR test 2x a week if my job did that.

 

[emergentmd]

90% medicine across the specialties will have it worse than we will

50% I will still be working

10% of current docs 40-60 yrs old will be FIRE and I will be one of them.

Everyone in medicine and EM right now should be able to FIRE in 10 yrs. Just put in the work, diversify, and start to create passive income.

 

[EctopicFetus]

90% medicine across the specialties will have it worse than we will

50% I will still be working

10% of current docs 40-60 yrs old will be FIRE and I will be one of them.

Everyone in medicine and EM right now should be able to FIRE in 10 yrs. Just put in the work, diversify, and start to create passive income.

Lifestyle bloat and ignorance of simple finance will preclude thE last statement. One of my residents tells me “I am just not good with money”. As if that was some excuse. I said RESMD if someone gave you $10m would you make an effort in how to manage that? Then I reminded said doc that they would be making $500k a year for at least 20 years not including their spouse who will make low 6 figures as well. The lightbulb went on. Everyone is ABLE to fire in a decade But few will reach FI in 20 years let alone 10.

FI was my goal before I even finished residency. I am not much of an RE guy. Now I am at a point where it is more of a game than financial stress that keeps me going.

 

[sylvanthus]

Im not in a huge rush to FIRE, trying to do a balanced approach. No point busting my balls and living frugally to not see my kids as much or not be able to enjoy vacations, have a decent house while they are growing up, etc, just to retire early.

So I bought the decent house, bought a travel trailer for fun family trips, gonna get a sailboat, etc. I am still saving for retirement (80-100k a year) , but would rather live a balanced lifestyle than retire early to an empty home when the kids are outta the house. That sounds depressing as f))5 to me atm.

Kudos to those of you who will retire at 40 but not for me atm, need some of the rewards along the way and not when im too old to really enjoy em.

 

[Interpolfanclub]

Im not in a huge rush to FIRE, trying to do a balanced approach. No point busting my balls and living frugally to not see my kids as much or not be able to enjoy vacations, have a decent house while they are growing up, etc, just to retire early.

So I bought the decent house, bought a travel trailer for fun family trips, gonna get a sailboat, etc. I am still saving for retirement (80-100k a year) , but would rather live a balanced lifestyle than retire early to an empty home when the kids are outta the house. That sounds depressing as f))5 to me atm.

Kudos to those of you who will retire at 40 but not for me atm, need some of the rewards along the way and not when im too old to really enjoy em.

This is where I'm at as well. I love being with my kids, working a sustainable amount while still saving plenty and not feeling totally burned out because I'm killing myself to save a ton. I'd rather have balance. You have to save for a rainy day but you also have to enjoy life while you're young and healthy enough to do it. Lord knows we see plenty of sick people who can't.

 

[deleted1114045]

Im not in a huge rush to FIRE, trying to do a balanced approach. No point busting my balls and living frugally to not see my kids as much or not be able to enjoy vacations, have a decent house while they are growing up, etc, just to retire early.

So I bought the decent house, bought a travel trailer for fun family trips, gonna get a sailboat, etc. I am still saving for retirement (80-100k a year) , but would rather live a balanced lifestyle than retire early to an empty home when the kids are outta the house. That sounds depressing as f))5 to me atm.

Kudos to those of you who will retire at 40 but not for me atm, need some of the rewards along the way and not when im too old to really enjoy em.

Life is like a bowl of lucky charms. Most immature people eat just the marshmallows. Some eat the oat cereal first and save the marshmallows until the end. The wisest enjoy marshmallows in every bite.

 

[bravotwozero]

10% of current docs 40-60 yrs old will be FIRE and I will be one of them.

Everyone in medicine and EM right now should be able to FIRE in 10 yrs. Just put in the work, diversify, and start to create passive income.

So you believe that everyone in EM should be able to FIRE in 10 years, but only 10% of us will actually get there. Interesting.

 

[EctopicFetus]

So you believe that everyone in EM should be able to FIRE in 10 years, but only 10% of us will actually get there. Interesting.

I mean I truly believe everyone should be ABLE to do it but it doesn't mean it is right for everyone. I take this to mean if you make 400k you can spend 100k a year and live a good life and save the rest and in 10 years you will be able to replace that 100k from returns in your investments.

Looking at this another way to break this down. Earn 400k, taxes 100k (likely quite high), spend 100k. That leaves you with 200k a year in savings. over 10 years that's $2M before any stock market returns which at 5% interest (with no return on your money) gets you the initial 100k.

It is hard to say you couldn't live on 100k but for may of us (myself included) why would I do that. reality is with the return of 5% which is super low you end up somewhere closer to $3M at the end of that decade. I would simply saythe amount of tax savings you would get from putting some of that money in tax deferred accounts will take care of things like student loan payments (by lowering your taxes).

I realize this means no fancy vacations, no private schools etc. Note the key IMO is "SHOULD BE ABLE" not will be able or should. my 2 cents.

I'm more of a FATFI guy and a FAT lifestyle now. I didn't bust my ass coming from nothing to live at 25-35% of my income. If I do it is only cause I make enough that I can live how I want regardless of the % of income I make.

 

[emergentmd]

So you believe that everyone in EM should be able to FIRE in 10 years, but only 10% of us will actually get there. Interesting.

Not just EM but almost every doc. A large retirement nest egg has as much to do with starting early with compounding as much as what you make.

Most doc should be able to save 100K/yr and still live a very comfortable lifestyle. Do this for 10 yrs and you likely will have about 1.5M after 10 yrs.

Even if you did not save another penny, in 20 yrs, you would have 8-10M. Its really simple. Save early and let time be your greatest asset.