One in six newly graduated medical specialists can’t find work

[rmorelan]

simple solution to doctor shortage and jobless specialists:

1. lower salaries of specialties

2. fewer ppl will go and specialize so more specialists will remain employed and lower specialty unemployment rate.

3. govt will be able to employ more specialists at lower fee...e.g. 3 opthos together doing 800K-1mil as opposed to 1. still pretty decent.

3. more ppl will end up in FM and help with primary care

4. OMA will complain about brain drain and ppl moving to US but we all know those are empty threats

 

government can be a lot more direct than that - just simply cut all opthos residency positions for the next three years (as an example - not saying actually do that! ). Blunt, brutal, but quick. Not saying they would but if they want more FMs they can do that pretty easily really.

 

Doesn't fix one issue though that according to some estimates will will be in surplus FM land within a few years. We will have distribution issues but churning out FM docs won't really directly solving things either.

 

Oh and going to the US isn't quite that empty US has a specialty shortage and a lot of people write the US tests do give themselves that option.

[aaronjw]

i may be kidding right now but unless we find a great oil dig or natural resource that puts the economy back up, health care will need to adapt to changing times.

 

Health care in Canada has been adapting to changing times since 1867

[future_doc]

Arguably, the two most important aspects of government are protection and enhancement of our most vulnerable citizens, and healthcare, and it would be a slippery slope indeed if these were tinkered with adversely.

[medigeek]

My preceptors are discussing it with the students already. The statistic may be useless in and of itself but the general trend its highlighting is clear:# of residency spots > # of job openings!

 

We can discuss the semantics for days here; I think the important issue here is: what should current medical students, especially preclerkship students that have the doors wide open, be doing at this point?

 

Should we just forget the surg specialties all together? Is going to the US a realistic option?

 

Solutions for the over-saturation aren't going to be helpful for current students as they will take many years to implement and see effect. So it seems like the only thing current students can do is be proactive in their choices and decisions. How should we do that?

 

simple solution to doctor shortage and jobless specialists:

1. lower salaries of specialties

2. fewer ppl will go and specialize so more specialists will remain employed and lower specialty unemployment rate.

3. govt will be able to employ more specialists at lower fee...e.g. 3 opthos together doing 800K-1mil as opposed to 1. still pretty decent.

3. more ppl will end up in FM and help with primary care

4. OMA will complain about brain drain and ppl moving to US but we all know those are empty threats

 

 

 

Or... just go back to the rotating internship for 1 year - becoming a GP. That fixes the family physician shortage first of all, and next allows people to actually research the future job market for something they want to do. If they want to specialize further from there, then they can. In any case, they have being a GP as a fall back.

 

Cutting salaries will result in some brain drain though. If a surgeon can make 800k in the US vs. 280k here, good chance they'll go.

[NLengr]

Or... just go back to the rotating internship for 1 year - becoming a GP. That fixes the family physician shortage first of all, and next allows people to actually research the future job market for something they want to do. If they want to specialize further from there, then they can. In any case, they have being a GP as a fall back.

 

Cutting salaries will result in some brain drain though. If a surgeon can make 800k in the US vs. 280k here, good chance they'll go.

 

I agree. This is a great solution but one that will be fought tooth and nail by both the CCFP and the government (who have no interest in paying for more doctors).

 

Plus the few studies that have looked at practice patterns of CCFP family docs vs. GP's showed no difference in practice patterns when assessed three years into practice.

[Dongzhuo]

The only way to stop everyone from super specializing is to dramatically cut salaries by way of fee code. Once it is no longer financially enticing many will no longer go that route. If ophtho`s made 180K a year they will drop from the top dog in medicine (one of) to the pit. Increase GP renumeration.

[Dongzhuo]

A lot of people don't realize that while we have a shortage of physicians the government can't afford to fund them all. Healthcare resources are finite, for every specialist physician the government recruits they need to consider OR time, staff, supplies etc.

 

What they do need to do is give these old physicians retirement packages so the new grads can take over. You're not going to take your money to the grave, geez. Honestly, I know an ophthalmologist who is borderline decrepit but refuses to retire because of pride issues, not to mention safety concerns but that's another story.

 

MD retirement is not really about having enough money to retire comfortably. MD`s aren`t really a job. The more noble ones may call it a calling. It`s like being the Pope, or a King, or Michael Jackson. You are an MD. If a person is a cashier, they are more rather a person who works as a cashier at a store. They are not defined as a cashier. Retiring means giving up on all that and returning to...civilian life. Most old docs will linger on...

[aaronjw]

I laugh at the financial crisis of 2008 as a reason why physicians didn't retire out like it was expected that they would.

 

My uncle, and many I know like him, retired out not long after the peak of 2008, sometime in early 2009 I believe. He did very well for himself in his career but certainly not to the extent that a physician would factoring in lifetime earnings. The difference is he spent within his means and saved knowing that there was no guaranteed money tree in his career like there is with physicians by comparison. He took the exact same hit that most physicians would have taken in lost investment from tanking markets.

 

Anyone suggesting physicians delayed retirement because of the financial crisis is ONLY due to financial crisis that they put themselves in. If you can't manage to retire on lifetime earnings upwards of $7M+ then oh well boohoo.

[seeking1]

I've been saying the same thing for years.

 

Maybe now that the **** has hit the fan, the specialty societies and government might tell the whiny brat CCFP to STFU.

 

Haha, I love it when you go on the war path against the CCFP brooksbane! I kind of agree, although I'm sure there's a million reasons people will bring up to prevent the return to GP's.

 

brooksbane, are you an FP? I'm not trying to paint you as a hypocrite or whatever, I'm just interested because I keep forgetting your specialty.

 

(PS I think we should have people on this forum indicate clearly what specialty/residency type they're in in their sigs, it would make it easier to talk about stuff.)

[Lunasly]

I laugh at the financial crisis of 2008 as a reason why physicians didn't retire out like it was expected that they would.

 

My uncle, and many I know like him, retired out not long after the peak of 2008, sometime in early 2009 I believe. He did very well for himself in his career but certainly not to the extent that a physician would factoring in lifetime earnings. The difference is he spent within his means and saved knowing that there was no guaranteed money tree in his career like there is with physicians by comparison. He took the exact same hit that most physicians would have taken in lost investment from tanking markets.

 

Anyone suggesting physicians delayed retirement because of the financial crisis is ONLY due to financial crisis that they put themselves in. If you can't manage to retire on lifetime earnings upwards of $7M+ then oh well boohoo.

 

So, if your uncle didn't manage his money well, wouldn't you agree that he should not have retired?

[aaronjw]

So, if your uncle didn't manage his money well, wouldn't you agree that he should not have retired?

 

Strawman logic in effect...

[NLengr]

The only way to stop everyone from super specializing is to dramatically cut salaries by way of fee code. Once it is no longer financially enticing many will no longer go that route. If ophtho`s made 180K a year they will drop from the top dog in medicine (one of) to the pit. Increase GP renumeration.

 

That's not the only way. It's a very stupid way however.

 

The easiest way is to limit specialty training positions. If you don't train X number of specialists, there won't be X number of specialists.

[doctorme]

Bad news for those of just beginning med school. Do they indicate anywhere what fields will still have jobs in the larger centers across Canada?

[LifeIGuess]

Health care in Canada has been adapting to changing times since 1867

 

yeah i know, adapting towards booming times is much easier than going the other way

[LifeIGuess]

government can be a lot more direct than that - just simply cut all opthos residency positions for the next three years (as an example - not saying actually do that! ). Blunt, brutal, but quick. Not saying they would but if they want more FMs they can do that pretty easily really.

 

Doesn't fix one issue though that according to some estimates will will be in surplus FM land within a few years. We will have distribution issues but churning out FM docs won't really directly solving things either.

 

Oh and going to the US isn't quite that empty US has a specialty shortage and a lot of people write the US tests do give themselves that option.

 

the problem really is not that we need fewer specialists, going the direct way and cutting out those spots is really targeting the supply when theres really no need to cut out on the supply as long as a specialty is in demand..optho was just an e.g. and maybe even a scapegoat but the problem should be dealt at where it starts which is lack of sufficient funds to keep enough specialists employed to meet the demands of those needed procedures..reigning in on those fees will help employ more specialists while giving the added benefit of having more ppl enter into FM, although entering into FM is not the primary goal here...surplus FMs is actually not the public's problem, its more of a problem for the workforce in general with the risk of becoming a public problem if workforce ends up going to US due to surplus supply. however, in the long term fees can always be adjusted to correct for any supply issues if that ever becomes a problem..the hassle of uprooting a family to move to states might be conceivable for some but not for 100% of the newly graduating docs so it will not likely be a huge threat. surplus supply may even help out with the distribution problem as more docs will tend to move away from urban areas to counteract for saturation.

[RunningGuns]

The only way to stop everyone from super specializing is to dramatically cut salaries by way of fee code. Once it is no longer financially enticing many will no longer go that route. If ophtho`s made 180K a year they will drop from the top dog in medicine (one of) to the pit. Increase GP renumeration.

 

It doesn't make sense to cut the salaries of specialists, who have more medical training than GPs, to a salary that's less than the average GP ($229,177.00/year). I agree that the most logical approach is to limit the number of spots for specialists and surgical specialists that are in surplus.

[Lactic Folly]

In light of Dongzhuo's other thread, s/he probably means to stop everyone from *wanting* to subspecialize.

[LifeIGuess]

It doesn't make sense to cut the salaries of specialists, who have more medical training than GPs, to a salary that's less than the average GP ($229,177.00/year). I agree that the most logical approach is to limit the number of spots for specialists and surgical specialists that are in surplus.

 

there are lots of hundred thousands between 230K and 7-800K

[RunningGuns]

there are lots of hundred thousands between 230K and 7-800K

 

Dongzhuo specifically said an average salary of $180,000.00/year for ophthalmologists. That's what my comment was directed towards.

[rmorelan]

It doesn't make sense to cut the salaries of specialists, who have more medical training than GPs, to a salary that's less than the average GP ($229,177.00/year). I agree that the most logical approach is to limit the number of spots for specialists and surgical specialists that are in surplus.

 

I do agree with you - although it is really strange sometimes how various specialties relatively are paid. There is a lot of complications and a lot of politics it seems with the entire thing.

[rmorelan]

yeah i know, adapting towards booming times is much easier than going the other way

 

ha, always is

[RunningGuns]

I do agree with you - although it is really strange sometimes how various specialties relatively are paid. There is a lot of complications and a lot of politics it seems with the entire thing.

 

I think that ophthalmology may have been the wrong specialty to use as an example. I, personally, really value my sight and would almost be willing to pay anything for it. I don't really feel the same way about any of my GPs services. Therefore, I think it's fair that ophthalmologist's be compensated significantly more then them. Even a salary of, let's say, $800,000.00/year seems low when I consider the gift of being able to see again!

 

I agree that compensation isn't perfect, or ideal, on the whole though.

[Dongzhuo]

I think that the honour associated with a job is compensation in a sense. That's why everyone wants to be US President when it only pays 400k. For example, even if a surgeons salary was 200k...people would still do it. Its only GP and other jobs that people are not really wanting to do that needs additional financial incentive to entice people to do it. View it like rural incentives.

[Med0123]

I think that ophthalmology may have been the wrong specialty to use as an example. I, personally, really value my sight and would almost be willing to pay anything for it. I don't really feel the same way about any of my GPs services. Therefore, I think it's fair that ophthalmologist's be compensated significantly more then them. Even a salary of, let's say, $800,000.00/year seems low when I consider the gift of being able to see again!

 

I agree that compensation isn't perfect, or ideal, on the whole though.

 

Hum hum, what about general surgeon dealing with cancer or acute and often life-threatening surgical conditions?

 

It is very difficult to compare specialties between them using the "importance of the organ" factor, compensation should be based on length of the training, rigor of the training, average hrs/week and patients, degree of responsibility on the life-limb and nature of the call.

[LifeIGuess]

I think that ophthalmology may have been the wrong specialty to use as an example. I, personally, really value my sight and would almost be willing to pay anything for it. I don't really feel the same way about any of my GPs services. Therefore, I think it's fair that ophthalmologist's be compensated significantly more then them. Even a salary of, let's say, $800,000.00/year seems low when I consider the gift of being able to see again!

 

I agree that compensation isn't perfect, or ideal, on the whole though.

 

while i agree with you that the gift of sight is hard to replace and assigning a value to it is difficult, unfortunately, living with finite resources requires us to distribute funds in a way that imposes the need to place a fair value on the provision of service based not on the outcome or result but rather that effort put in.