| There are just so many factors in play, and many statements in this articles can spawn their own large-scale discussions. > More than 100m people today live in an area without enough primary-care doctors I have several friends who are primary care doctors, and their patient panels are 2000-3000 people. That is an absurd number of people, and requires a ton of work on their part, leading to poor work/life balance. Being a primary care physician is becoming more difficult and less attractive, even for people who otherwise would be really interested in being generalists and building the kinds of relationships that come with being a PC. > the problem is particularly bad in rural areas Generally, highly-educated people tend to live in urban areas (there are many sources that track this trend). In addition, rural areas tend to imply private practices (because there aren't as many large hospitals in those places), and private practices are even harder to work at — whereas a hospital has an entire department dedicated to billing and dealing with the myriad insurance types their patients have, private practices have to mostly manage on their own with minimal staff. This winds up taking a ton of their time, and is a major reason some folks I know have not gone that route. > As the baby-boomers age the need for medical care rises and the doctors among them retire This may be a "usual suspect", but it is a real one. > it takes 10-15 years after arriving at university to become a doctor in America IMO, this alone largely answers the question in the title. While training, physicians don't generally earn a lot of money (relatively, and especially since many of them train in large hospitals, which are based in large cities, which have higher costs of living). The expected reward for spending a 10-15 years of your life studying and working hard, long hours, in schools and then residency programs that are short-staffed and have multi-day shifts, must be high enough to justify the cost, even for those that go into it with a very idealistic mindset. |