I mean 1/5 unemployment is pretty catastrophic. An unemployment rate of 20% for the general US population would be approaching Great Depression level unemployment.
Great point. I was pretty shocked when I saw Yales match list for EM this year and it looks like they might have seen the writing on the walls via advising, etc before everyone else
Agreed. 80% employment for a board certified physician with hundreds of thousands of dollars worth of debt is unacceptable. That makes getting an MD a complete waste of time, energy, and sacrifice.
Worse. It makes the midlevel route more popular
A professional society coming out about the issue like this is pretty damning. RadOnc and paths leadership have had issues longer and still have their heads in the sand. In fact, path leadership basically railed against this very website for being pessimistic because it discourages students from applying.
Fairly certain I read that this data assumes that the number of spots stays the same. Like assumes ZERO growth in spots over the next 10 years and there is still a 9500 surplus. That's what is the most insidious and terrifying IMO. The possibility that this data is best case scenario, not the doomsday prediction.
Exactly. People who are proclaiming that this is overblown need to look at the pharmacy job market and take notes. Drastic oversaturation lets companies take advantage of you. You have no bargaining chips if you are easily replaceable and the jobs you do find are unstable. I think the only people who should be entering EM right now are those who would literally be miserable doing anything else in medicine (which is a small proportion of people).
I understand how job/demand can be projected but how do we know they are accurate? This really is an unprecendented situation. Even with rad-onc in real life I know someone who has graduated recently and is doing quite well.
Because radonc doesn’t have tons of NPPs, FM/IM docs also doing the same job.
Because contrary to popular belief, I do actually give a **** about my fellow doctors. What got us into the midlevel mess was a bunch of doctors pulling levers they shouldn't have. I do believe we as a field could collectively pull levers to get us out of messes too. I don't have loyalty to midlevels as a profession. I have loyalty to what's best for the patient. My previous posts have generally been talking about surgery and my experience in surgery. In surgery, my time in the operating room (and the same of my comrades) is a valuable and limited commodity that there is not enough of to go around. I know a lot of people have said its super ****ty and surgeons should do their own pre op and post op and blah blah blah, but that assumes there are enough surgeons to go around that every single patient could get timely care (to me, that means <1 week for urgent issues and <3 weeks for elective issues). If you took away our midlevels and had surgeons do everything that they do and also operate, that is going to make laughably long delays to surgery.
If you are strictly talking about the residency expansion aspect then yes they are similar. The issue with the current EM situation that makes it unique is that the residency expansion is only one factor in a multi-factorial squeeze. CMGs/PE and increasing pressure from MLPs are also hammering the EM market.
If you're willing and inclined I'd be really interested to read an in depth post about you and your job. What sort of consulting you do, the sort of clients, and in particular what the conversations are like when hospitals are trying to balance revenue vs. quality vs. liability. Particularly who's in the room with you and what other options (besides just replacing docs with midlevels) are commonly suggested. You'll probably get a lot of flak but I think its worth its own post and would be very informative. Are you mostly consulting with businesses already in the red and trying to recover, non-profits, universities, for profits, systems in the black that are trying to be proactive and plan for the future, etc. What is your experience with medical law and what's legals involvement in stuff like this.
Most people already know that part...
I don't think he actually used the words "I am as good as you." He pointed out that he probably has better experience with wound bandages (which could be true), and acknowledged that he can't handle every case that comes into the ER. Idk how accurate his statement of being able to handle 9/10 things is, but this PA didn't really say anything that controversial in my opinion. He pointed out a lot of accurate things - healthcare is a business, hospitals would prefer to pay 2 PAs and 1 MD (paraphrasing) compared to paying for 2 MDs. Some things he didn't acknowledge (i.e. that PAs/NPs are also not likely to live in the middle of nowhere Alaska, Pennsylvania, or New York). Overall, I'm fine with how he said what he said.
Agreed with bolded. I think with trauma too (the 1/10 case the PA mentions above), it does not necessarily need the attention of the ED physician alone, but the ED team. ATLS is protocolized and lots of people need to be involved and many can learn to do the FAST exam, etc. and trauma surgery is really the team that comes in to make major interventions if one is needed. I'm slowly starting to see how ED is in a tough bind. If PAs can talk like this...
Hey man, would appreciate the longer write up if it’s still saved. Would love to hear you detail the situation.
EM is a field of youngsters. Many older docs have already retired. Wouldn’t count on it.
Probably a better ROI overall. At this point if you aren't doing a surg sub specialty then you are basically throwing away your M.D. diploma at this late stage in the game you might as well go the NP route you'll have plenty of opportunities to encroach because they basically are doing everything MDs are doing now.
Include IM subs, OBGYN, peds subs and few others too pls
PE is here to stay because we are in USA where capitalism is king
And stopped allowing fly by night MD and DO schools to emerge.
