[trashface]

This viewpoint is just plain crazy. If you worked in tech you'd be totally disposable, just like all the rest of us programming drones. Hit 40-50 and boom, unless you've transitioned into management, suddenly no one wants to hire you, or if they do its half of what you were making before.

Your MD degree and the AMA literally writing laws on your behalf limits labor supply competition like nothing in tech. You may have noted 250K+ tech layoffs in last year or so. Many of those people could probably code circles around you. Where are the physician layoffs? There aren't any.

If you want fewer hours, work fewer hours. What are they going to do, fire you? They can't. There is a shortage as this notes.

[haldujai]

Physicians are disposable too, look at what happened with primary care, nephrology, anesthesia and is starting in radiology where private equity firms move in and outsource physician care to allied health professions and create an “eat what you kill environment”.

In other countries like Canada it’s also near impossible to get a job in a surgical specialty (and until 2 years ago other ones like radiology), especially in a desirable city despite huge shortages and backlogs because our jobs use a lot of expensive resources.

> If you want fewer hours, work fewer hours. What are they going to do, fire you? They can't.

They can, many jobs set a minimum FTE you can work.

They also reduce fee codes (with a system known as relative value units/RVUs) so you have to work harder to make the same money. We’re at the mercy of payers in US/Can.

My specialty (radiology) has had work-unit compensation periodically slashed over the last 10 years (20-30%) that’s been offset by reading more cases (and to a lesser extent technological advances making reading faster although studies have gotten far more complicated to read with modern treatments).

There’s also the increasing clinical demand and generally caring about the humans on the other end. I don’t want to read 50-90 CT scans on a ER shift but I have to because the studies are being ordered, the patients need their reports, and we don’t have enough radiologists.

[djmips]

The grass is always greener. Most Canadian software engineers are getting paid much less for the same work as across the border. Currently there are layoffs, hiring freezes and pay increase freezes. Canadian software engineers make less than doctors. FAANG salaries are a thing but you have to be willing to move to the US in order to attempt to achieve that.

[haldujai]

Yes, if you consider non NYC/SV salaries physicians come out ahead in the vast majority of cases, we earn more or less the same no matter where we live.

I’m happy with my compensation but I’m also happy with my job/not optimizing solely for it. My point is that if I was I would have chosen a different career.

I also left Canada to make less in the US as a physician because I wanted more work/life balance and not to be working in a system constantly on the brink of collapse. The hospital I trained at was on “life or limb critical capacity” so often I had to set up an e-mail filter to send it to my junk.

Speaking of hiring freezes, from 2010-2020 the only jobs for radiologists were in small towns or undesirable locations, it’s better now for rads. Most surgeons and proceduralists (cardiology being a horrible one) still can’t find jobs in major metros without 2+ fellowships and at least one somewhere prestigious. It’s still hard with that.

As in all things, it really depends what you want in life. But if you have the aptitude to reach the highest levels of physician income and have mobility you’re probably skilled enough to have done the same in other professions (e.g. finance, software) with an easier (physically speaking) path and less opportunity cost.

[moneywoes]

Any reading on these PE driven radiology changes?

[wrp]

This needs explanation. If there is such an extreme shortage of talent, why can't doctors demand better terms, e.g. shorter hours?

[haldujai]

Sometimes they do, look at the UK strike for an example although the environment here is no where near as toxic.

One of the shortage issues is that it takes 9-12 years to train a specialty physician. For example we need more radiologists today but we can’t fix that until we increase residency spots which won’t impact the job market for 6 years so until then I’m reading more than I want to, even though I’d gladly work less for less total compensation.

Someone has to do the work though and I can’t just say “not me” and leave the studies unreported. There is a human on the other end who needs care.

[LadyCailin]

They can, just not alone. If they were to unionize in sufficient numbers, there would be nothing to do but meet the demands. But “unions are bad” is the prevailing belief in the US, not to mention the huge amount of efforts that companies and the government go through to suppress them.

[nradov]

Many physicians still work in sole proprietorships or partnerships. From an employment perspective they are management, not labor.

Some physicians working as employees of large provider organizations are unionized. The government doesn't do anything to suppress this. Rather the opposite.

https://jamanetwork.com/journals/jama/article-abstract/27949...

[MichaelZuo]

This is what I don't get, if there was such an extreme shortage then the average visit to a family doctor should cost hundreds of dollars.

[moneywoes]

Curious, are there any other fields with laws built to limit competition. Lawyers?