Don't get chest pain.

[drbutkus]

http://www.inspire.com/groups/lung-cancer-survivors/discussion/group-warns-of-looming-thoracic-surgeon-shortage/

Those figures are now obsolete. Within ten years, 80 percent of chest surgeons now in practice will have retired. There is no one to replace them with.

Sure, cardiologists have done wonderful things with catheters and stents, but the data still shows that the old fashioned bypass has some of the best long term prognoses. And cardiologists cannot ply their trade if there isn't a chest cutter on standby.

It has gone from being one of the glory jobs of medicine to being just a steaming pile of dung. They sit and wait for the cardiologist to make a mistake or fail, and then they have to emergently operate on the worst and most complex of cases. PET scans have taken away a chunk of their business re: lung masses.

The figures in that article do not reflect the realities in DM. I know, with completely certainty, that a chest surgeon locally could not be guaranteed a salary above 140,000. That is after sixteen years of post high school education, with malpractice premiums of 50,000.

There is no easy or short term solution.

[Mr. Hawk]

The market will solve it. As the career adviser said to my class on the first day of law school "and please understand this: you can't all go to Minneapolis". Think about it.

[MikeyJoe]

If there is a shortage of cardiologists, won't cardiology get far more expensive and lucrative making cardiology more attractive to medical students?

[drbutkus]

The problem with "market" solutions is the time delay built into the training system. That, and the fact that Boards of Medicine are immune to concerns about availability and such. They are becoming increasingly restrictive, moving in the opposite direction of increasing physician availability.

It isn't beyond the pale that within a few short years, one or two of DM's hospitals won't offer cardiac care.

[Mr. Hawk]

It isn't beyond the pale that within a few short years, one or two of DM's hospitals won't offer cardiac care.
Then some enterprising young cardiologist is going to make a killing.

I realize that doctors are about as far removed from any understanding of free markets as can be (well, perhaps with the exception of teachers), but I would have assumed that this basic level of economic understanding would be generally understood.

[ISUFan98]

Good article. Also nice to see Dr. Reed being quoted.

He is a great surgeon and educator.

[drbutkus]

It isn't beyond the pale that within a few short years, one or two of DM's hospitals won't offer cardiac care.
Then some enterprising young cardiologist is going to make a killing.

I realize that doctors are about as far removed from any understanding of free markets as can be (well, perhaps with the exception of teachers), but I would have assumed that this basic level of economic understanding would be generally understood.


I realize that lawyers, free to charge whatever they want, accountable to no oversight, and free from any meaningfully significant outcome analysis, are incapable of understanding the inability of others to "make a killing" in an environment wherein fees are established by the government, overcharging is a felony, and your financial arrangement and involvement with your client has multiple overseeing entities.

The medical profession bears it's share of responsibility for the cumbersome payment schemes we now have. But if a chest surgeon took the "show me the money" approach, god help me with the outcry from people on this board.

It is cardiac surgeons that are disappearing. We got bundles of cardiologists. Maybe the gubmint will step in and alter credentialling, so that, after his 10,000th Little Debbie, MH will meet his chest surgeon just as he is put under: Dr. Habinagudtym Vishinuwirheer

[Mr. Hawk]

It isn't beyond the pale that within a few short years, one or two of DM's hospitals won't offer cardiac care.
Then some enterprising young cardiologist is going to make a killing.

I realize that doctors are about as far removed from any understanding of free markets as can be (well, perhaps with the exception of teachers), but I would have assumed that this basic level of economic understanding would be generally understood.

I realize that lawyers, free to charge whatever they want, accountable to no oversight, and free from any meaningfully significant outcome analysis, are incapable of understanding the inability of others to "make a killing" in an environment wherein fees are established by the government, overcharging is a felony, and your financial arrangement and involvement with your client has multiple overseeing entities.

The medical profession bears it's share of responsibility for the cumbersome payment schemes we now have. But if a chest surgeon took the "show me the money" approach, god help me with the outcry from people on this board.

It is cardiac surgeons that are disappearing. We got bundles of cardiologists. Maybe the gubmint will step in and alter credentialling, so that, after his 10,000th Little Debbie, MH will meet his chest surgeon just as he is put under: Dr. Habinagudtym Vishinuwirheer
So in other words: "yes, MH, you're right. We don't know much about economics at all".

[funnelcake]

Man, I love me a good doc/lawyer fight.........

[Mr. Hawk]

It's not really a fight. It's more of a pwning.

[ISUFan98]

Man, I love me a good doc/lawyer fight.........

Is there a way for both of them to lose?

[Monster]

Man, I love me a good doc/lawyer fight.........

Is there a way for both of them to lose?

They both win - we're the ones who lose.

[ISUFan98]

Man, I love me a good doc/lawyer fight.........

Is there a way for both of them to lose?

They both win - we're the ones who lose.

Us --> pwned

[PhilHartman]

I win

[PipeDaddy]

What MH again fails to understand is that medicine is not under the rules of the free market. And actually, I do think he gets that - but not in the correct fashion. He can't fathom the idea that the government may already be artificially suppressing physician salaries in some fields.

Don't get me wrong - I think there are specialties that are grossly overpaid - radiologists, dermatologists, orthopedists, neurosurgeons, anesthesiologists that masquerade as "pain specialists" and so forth. The current reimbursement system is rigged in their favor to say the least.

But the reality is, in the current setting of cardiothoracic surgery, there is no recourse to solve the problem of the shortage except by the hand of politicians.

It's the same thing with primary care and why ultimately primary care will become exclusively a mid-level profession. That's a shame and will ultimately end up costing more health care dollars and usage, and diminish care, but what can you do?

Unintended economic consequences... politicians never anticipate them.