Another problem, I think, is that salaries for specialties like surgery or anesthesiology are so high, that fewer doctors are going into general practice. And that is really where we need the bulk of them. As the baby boomer population ages, they will place an even greater demand on the medical profession, and that is part of the concern I think about having a shortage of doctors.
I agree.... the low pay and long hours of FP have deterred many of my colleagues from not specializing. However, there are still many who are drawn to that type of continuity of care.
I just have to correct one thing, surgeons do not make that much in comparison and the opportunity costs are astonishing. While anesthesia make it out in 4 years of residency, it is common for surgeons to require anywhere between 7 to 8 or 9 years before becoming a junior attending. That is nearly double the residency time and double the time for their loans to accumulate interest (if at 8%, you can see how that will easily translate to a much larger loan amount). And in the end, surgeons make the same or less than anesthesiologists.
Despite the differences, many med students are driven by what they like to do and this is why there is a surge in the number of surgery residents my year (and I'm sure Grey's Anatomy helps
) of graduation (and the recent adoption of the 80 hour residency work week cap).
That said, many med students choose between a selection of specialties after ruling out a certain number of specialties based on the lack of compensation. You can't help it, the opportunity costs are too much and add to the little known fact that the Bush regime has recently cut economic hardship for new residents starting my year.
In the past, residents were granted 3 years of economic hardship - where their loans did not accrue interest on the loan principal. Now, I only have 2 years of this, the year after me only has 1 year of EH and the 2010 class has no EH years.... meaning interest accrues IMMEDIATELY after medical school.
At a loan principal of 200,000, 3 years of economic hardship means that after 3 years of residency, I would owe 200,000. Without EH, a loan of 200,000 would easily become 270,000 to nearly 300,000 at the end of 3 years... depending on interest. Now, take into account that it takes nearly 8 years to be a plastic surgeon, 8 years to be an interventional cardiologist, 6 years to be a pulmonologist/nephrologist/gastroenterologist.... and you can easily see that it is easy for the loan principal to more than DOUBLE especially without EH in place.
Take that tidbit and add the fact that we have a government and insurance companies who see the salaries of physicians as a largely flexible number to cut as they see fit.... a fantastic target for those who want to cut medical expenses. That's what you get when you have the wrong people in charge - accountants who do not have any medical sense.
There are exceptions to everything but the typical family practice physician nowadays makes about $150K ...that's after eight years of college and two years of internship. (incurring anywhere from $250-500K of debt) The typical ARNP (Nurse Practitioner) makes about $80K after seven years of college and about two years hospital practicum (incurring $150-250K debt) . I know these facts because medicine is my wife's and brother's business (she is an ARNP, he is an IM Doc) and we are preparing to open her own practice and I've been doing the research for the business plan.
Just a quick FYI Jerry, FPs require 3 not 2 years of residency. Maybe it was 2 before but it's currently 3 from what I know. This fact just makes your argument even stronger.
