The Scientific Leader Blog

Unfortunately, i wasn’t terribly surprised that nearly half of physicians in the US are seriously considering quitting medicine, according to CNN.    They’re sick of red tape from government agencies, and from insurance companies that are also highly regulated by the government.

I wasn’t surprised because for three years, I was Chief Learning Officer of Sutter Health.  It was my first job in Healthcare, and in California, I learned the byzantine and arcane rules that govern health care that make no sense.  For example, in California, I couldn’t teach physicians anything without attorneys ensuring that physicians who don’t care for Sutter patients also could get the class, because it’s considered an anti-trust kickback.  All I wanted to do was help them improve their quality and service while lowering the costs; but that’s not entirely legal in the quasi-socialized healthcare that is US medicine.

CNN notes that the survey by the Physician’s Foundation identified an exodus among family physicians and internists, who are typically your family doctor or primary care physician (PCP).  They predict a shortage of 35,000 to 40,000 physicians by 2025.  Most medical students are choosing the higher paid specialty care areas.  This is what economists would expect – shortages only come when price ceilings are instituted, such as is required by Medicare and Medical. Unlike physical and financial assets, Human Capital is owned by people like physicians, and has legs.  Human Capital can walk to another job, or career when labor markets are distorted by government regulatons.

You’ll note that this survey is before the Democrats take control of the white house and congress; and are promising increasing forms of healthcare all of which will likely reduce the income or at least bureaucracy of physicians and exacerbate their desire to leave healthcare.

Boutique Medicine
Many physicians solution is to skip the entire government system.  Instead, they charge patients an annual fee up front, and don’t take insurance, but some do make old fashioned house calls.  A third of the doctors in the survey noted earlier are restricting or withdrawing completely any patients on Medicare or Medicaid, something predicted by the AMA in 2005.

Medical Tourism
Another place physicians and patients are moving is to offshore medicine – high quality and much lower cost with no red tape.  Companies such as the Apollo Hospitals in India have US board certified physicians, but charge 10-20% of US charges.  While they have little to no government regulatory oversight, their clinical quality and service rival or are better than what you’ll find in the US.

The Scientific Leader recommends taking seriously the value of human assets’ impact on your business.  In the case of physicians, who are often self-employed, or in for-profit medical groups working with a not-for-profit hospital, they aren’t even employees.  But is there any doubt that physicians make a big difference in your health?  Do you use an evidence-based model to detect and manage these risky uncertainties in your business?

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