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  • The Doctor Shortage Update.

    Posted by Michael Kennedy on October 5th, 2015 (All posts by )

    There is an interesting piece today in the Daily Mail about young NHS GPs quitting and going to Australia.

    In the past five years, the number of GP appointments made by Britons has risen from 300 million to 370 million a year, an increase of more than 20 per cent.
    The number of GPs employed to meet that demand has risen by around 1,600, or just over five per cent.
    All of which has led to the second major factor behind their exodus — in the UK, they often feel terribly overworked; after moving they find themselves having to spend far less time at the coalface.
    ‘More and more British GPs talk about the pressure they’re under,’ says Guy Hazel. ‘I’m not sure the general public understand how mentally draining it is to see 35 to 40 patients a day. All the British GPs I know are exhausted.’
    An Australian GP, by contrast, will see 20-25 patients per day.

    This concerns the young, newly trained doctors. I posted some concerns about the issue of primary care in the US.

    Primary care here is referred to as “General Practice” in Britain and they seem to be having a loss at both ends of the doctor career.

    Britain is already suffering from a serious, and unprecedented, shortage of GPs, on a scale that doctors’ leaders say is fast becoming a crisis.

    According to figures released last week, a staggering 10.2 per cent of full-time GP positions across the UK are currently vacant, a figure that has quadrupled in the past three years.

    Two-thirds of practices are now finding it ‘difficult’ or ‘very difficult’ to find locums — freelance medics — to cover the shortfall.
    As our population gets steadily older, and sicker, frontline surgeries are becoming increasingly swamped.
    ‘We are in dire straits if we do not act to address the GP recruitment crisis immediately,’ the Royal College of GPs warned last week.

    British doctors are retiring at the age of 59. In America, the biggest shortage looming is in surgical specialties.

    Hieb referenced work in an Arizona area where 85% of payers were government-paid through Medicare, Medicaid and Tricare. Four orthopedic surgeons would do the work that 10, 11 or 12 in more affluent Flagstaff would take on. She said the average orthopedic surgeon in America takes care of 12,000 people. Conversely, the region where Hieb worked was serving approximately 90,000, which later ballooned to 120,000 as Hieb left and only three surgeons remained. She said her 53-year-old former colleague from the region died thereafter under the long and strenuous work.

    Well at least we seem to share a trend with our “cousins” in Britain. Part of the probable in Britain is the astronomical price of housing.

    To help sway the GPs’ choice, the email then contained a brace of estate agents’ photographs featuring homes that had just come on the market, in each location, at around the £600,000 mark.

    In Gold Coast, that money would get you a stunning five-bedroom, four-bathroom, concrete-and-glass riverside mansion, complete with ‘pool, spa, pontoon dock for your boat (boat not included, you would have to buy your own)’ and a BBQ-friendly outside terrace.
    In rain-lashed North London, meanwhile, your £600,000 will stretch to something altogether more grimy: a former council flat, with three bedrooms, a single bathroom, and a pokey, linoleum-floored kitchen with bars on its windows to deter local burglars.
    For good measure, the message added that in Gold Coast, you can ‘enjoy swimming after work on the golden sands where the water is a warm average 24c’.
    Residents of Abbey Road, meanwhile, must content themselves with the pool at Swiss Cottage Leisure Centre.
    The email was, as you may have guessed, a kind of job advert.

    600,000 pounds is about $900,000 and houses in the south of England are in that range and much higher. So is southern California.

     

    9 Responses to “The Doctor Shortage Update.”

    1. Subotai Bahadur Says:

      I’ve had my family experiences with the NHS, a decade ago, and I assume it has gotten worse. And it was bad then, with my daughter seeing patients deliberately killed by the staff at Chelsea and Westminister Hospital.

      I read Brit papers online every day, because that is the only way to find out what is happening politically in this country if you wade through the celebrity news. Brit papers, while Leftist in nature are not obligated to the US Democrats, so they report news that somehow there never is room for on our State-controlled media.

      Since I read those papers, I have exposure to the situation of the NHS. Two things I have noted, which if I was a doctor would demoralize me and make me want out. Apparently, in Britain if you are a doctor who does NOT refer more that a quota number of patients for [expensive] cancer treatment, you get a rather handsome bonus. Now, as populations age, cancer comes up more frequently. So it is now in the financial interests of doctors to NOT save or prolong the lives of patients.

      Most people become doctors because they want to save or help people.

      Another thing I have seen mention of is that after you have contributed up to a set level to your pension fund, your benefits never rise no matter how much more you put in. And that generally maximizes out at about age 59. So the incentive keep putting up with the grind, and the moral issues, just is not there.

      Both those seem built into the system.

      Add to that the societal decay and ongoing invasion of the country, and the lack of hope for any change no matter how much the people want it; and I would be looking fondly at Australia too.

    2. Ginny Says:

      From the patient’s view, isn’t the point going to slowly become obvious that having insurance isn’t the point, but rather access to competent doctors and the drugs that are produced by a competitive market? You all know about it from the other end, which is perhaps more important, but surely health care and medicine is not that different from everything else – a free market produces and a statist one doesn’t.

      I’d heard for years that the Brits limited the surgeries available to those past 65 or 60 or 70 – either I don’t remember or have heard different figures. Is that true? This latest bribe to doctors seem just another notch on a belt that has been tightening.

    3. DirtyJobsGuy Says:

      On the Continent I found lots of German MD’s moving to France due to the better compensation. German docs pay is tightly cost controlled, while the French system is more flexible with a combination of minimal state insurance and then private insurance supplements. One friend of my parents in Kiel was a Pediatrician who found selling Amway paid better and was more flexible.

      Like all heavy state plans the dirty secret is that only sick people need medical attention and most people are not sick! When they get sick or are injured then they see the limits on the system. Total NHS (and other state systems like Medicaid) budgets threaten to overwhelm the entire system unless rationed.

    4. Mike K Says:

      The ethnic English are fleeing “Britain” and moving to France where they are taking over villages in the south which are being abandoned by the shrinking French population. No Muslims and housing is cheap. Those who can afford it, are moving to the southeast near where my friends live.

      I hadn’t heard about the cap on pension benefits, which explains the retirement age. This resembles a phenomenon in Sweden many years ago where salaries were capped so that doctors were working for nothing the last two months of the year. As a result, they all went to the Mediterranean resorts from October to January.

      Leftists know nothing about incentives and are always surprised by the results.

      In the Netherlands, if an ER doctor admits a chronic emphysema patient to ICU, he loses his job.

    5. orthodoc Says:

      “From the patient’s view, isn’t the point going to slowly become obvious that having insurance isn’t the point, but rather access to competent doctors and the drugs that are produced by a competitive market?”

      No. It’ll be the fault of greedy doctors who don’t want to take care of sick people/greedy drug companies who won’t provide cheap medication for sick people/Republicans/Jews.

      You’re assuming that the average idiot Leftist (but I repeat myself) has more situational awareness than a grey squirrel. They don’t.

    6. Mike K Says:

      “the average idiot Leftist (but I repeat myself) has more situational awareness than a grey squirrel.”

      I was mulling this over this morning as I sat in traffic on the 405 in West Los Angeles.

      Progressives, like Woodrow Wilson, decided to turn over all government functions to “experts” as the expert became more common in the 1890s. I’ve been reading Charles Murray’s new book, “By the People,” and he suggests this. They assume, and I think they still assume, that such people will be honest and do the work without benefiting themselves beyond a reasonable level.

      The political and philosophical left does not understand Original Sin as conservatives do. Those conservatives like me, who are agnostic, are convinced that Adam Smith’s “Invisible Hand” is the same thing. Call it “Greed” if you prefer. It is the same thing and we see it in our present malfunctioning government.

      Glenn Reynolds puts it as “graft” which he considers the driving force of all government officials, elected and appointed. This is why New York City is feuding with Uber. This is why the French are attacking Air France executives over layoffs. It is upside down but the same phenomenon and is what has destroyed the French economy.. They are all rent-seekers. The elected want to cash in and so do the Air France workers. I have flown Air France repeatedly and they have great service and great prices.

      Doctors put years and years into what is almost the ultimate middle class profession. We spend years studying and working for a pittance in the expectation that it will all be worth it once we are finally finished. The rent seekers see doctors as arrogant (and sometimes we are) and privileged without ever considering the years spent getting there. I know a lot of people who wanted to be doctors and never quite got the gumption or whatever it is. Engineering, which I started with, is four years and you can make a nice living and maybe your employer will pay for you to get more degrees. Not in Medicine.

      I was talking to a couple of the guys at work this morning, We are all in our 70s and still working. Part time, but still working. One guy is an OB GYN and told me his malpractice premiums in California, which is better than almost every other state, were $60,000/ year. That’s why he is still working. The other guy is an orthopedist and his wife is a pediatric neuro-radiologist. They are both black and are still sort of supporting their daughters who are inter 40s. I bought a new car for my 35 year old daughter Sunday.

      I sure wish the economic would get going again so we can stop supporting these 35 to 40 year old adolescents. They are struggling.

    7. TMLutas Says:

      “You’re assuming that the average idiot Leftist (but I repeat myself) has more situational awareness than a grey squirrel. They don’t.”

      I find that interesting and potentially lucrative. Situational awareness in this context would seem to be something that can be improved upon (at least at baseline low information levels) by a download from an app store. There are, in fact, quite a few very popular apps like this. Yelp comes to mind as does Waze. But what would you put in this app?

    8. Mike K Says:

      There are a lot of doctor reviews on sites that list names and phone numbers and directions. I don;t recall the names. I’m sure Yelp has some, too.

      After I spent several years uninsured in the mid-70s, I was applying to the new COOP for malpractice coverage and I discovered I had about 20 wrongful death lawsuits. I had never been served and knew nothing about them. We had to get all the lawyers’ addresses and demand they serve me or dismiss the suit. They were all dismissed. There were all ER cases that had died.

    9. Mike K Says:

      Another update on the situation in Britain, which will be here soon.

      Tens of thousands of junior doctors marched through London today to protest over new plans that will see evenings and weekends counted as ‘regular working hours’ in their contracts.
      Young medics warned the proposals by Health Secretary Jeremy Hunt are ‘dire’ for the NHS and accused him of ‘peddling vicious lies’ as they walked from Waterloo Place to Parliament Square.
      Up to 20,000 demonstrators waved placards, including some which represented people who couldn’t attend the march because they were at work, as they chanted ‘Hunt must go’.