The Law School Problem (oversupply)

Jules A, MSN · Sep 8, 2016

My thoughts are since healthcare is becoming more hospital/conglomerate based, they will strive to reduce costs by hiring NP's instead of MD's. I suspect unemployment will be higher for newer MD's because of economic forces will always put the NP ahead of the MD, so MD's will be the new unemployed lawyers. However, wages for everyone will decrease with the oversupply.
Thoughts?

I disagree that hospitals will hire NPs over MDs because although we are independent in many states our education and abilities absolutely will never replace the need for MDs. That and at one hospital where I work there are has been some angst as they attempted to hire NPs for hospitalist roles traditionally filled by PAs. It was difficult to find NPs willing to work the hours required, they balked at call duties and the work load so the initiative petered out.

I believe there will be a glut of NPs similar to lawyers in upcoming years. My guess is the work will still be there, just not as plentiful as is the case with RN jobs in many areas now, and the pay will suck.

Goldenfox · Sep 8, 2016

With the projected oversupply of providers in the coming decade, does the future look dim for new NP's and MD's?

MDs will not be impacted by this like NPs will. Yes, several more medical schools have been opened up over recent years, but this doesn't come close in comparison to the number of NP programs out there now. Medical schools are still not easy to get into, they are very expensive, and the program is clinically very challenging and takes a long time; NP programs do not compare to any of this in any way. Even in independent practice states, NPs are aware of their limitations and the legal environment in which they are practicing, and in the rest of the states NP/PA practice is still tethered to some degree of physician oversight. Importantly, even in the independent practice states, NPs do better to establish working relationships with physicians with whom they can consult with or refer complicated cases to---and there WILL be those. Those of us with the 'doctor' title understand that we are not physicians. The docs have had a lot more advanced clinical training than us, and we cannot really replace them.

True that the corporations that own the hospitals will try to save money by hiring more NPs than MDs or PAs. Many of them have tried it and are still trying it right now. It hasn't worked out so well in many areas for a variety of reasons. One of the reasons I have seen a lot is that they want hospitalist NPs to do shift work or night work (that many docs don't want to do). But many NPs don't want to do it either... Also, most NPs are female, and either of child-bearing age and looking for mommy hours or older and looking to get away from nocs, and from taking call, and from shift work altogether. NPs who have been at it for a while and have good experience get dibs on the better and better-paying jobs---the flood of new grads, not so much.

Its also important to consider other variables---such as the political climate and the national economy. The federal government is deep in the red and bleeding. Obamacare is now seriously on the ropes and will probably be gone after next year. Most people don't have any money to pay those ever-increasing premiums, and the government is broke too. There will likely be big cuts in healthcare programs like Medicare and Medicaid---which is where most hospitals earn a lot of their income. Some of them will close, which means that significant numbers of health care workers will lose their jobs. The need for services will still be there, but the glut of providers looking for work means that pay will go down for everyone. I posted this before, but many people still don't care or are not paying attention: if TPP and TISA are approved by the government then we're all screwed because we're going to see a big increase in foreign health care workers who are willing to work for cheap coming into the USA under the new class of employment visas that these trade deals will create. And if we want to get a glimpse of what that scenario will be like for us then all we need do is Google what the H1Bs have done to American professionals in the tech industry.

guest769224 · Sep 8, 2016

if TPP and TISA are approved by the government then we're all screwed because we're going to see a big increase in foreign health care workers who are willing to work for cheap coming into the USA under the new class of employment visas that these trade deals will create.

Let's say this could happen and we are screwed. Your plan to secure employment after foreign workers take over everything is?

Foreign workers cannot displace millions of healthcare professionals. Healthcare facilities would crumble and credentialing/licensing standards are too strict. Many of the public would refuse service.

Unsure why you keep singing this note.

Goldenfox · Sep 8, 2016

Let's say this could happen and we are screwed. Your plan to secure employment after foreign workers take over everything is?
Foreign workers cannot displace millions of healthcare professionals. Healthcare facilities would crumble and credentialing/licensing standards are too strict. Many of the public would refuse service.
Unsure why you keep singing this note.

I am not a politician. I don't have to have a plan for anyone other than myself. A question was asked, and I answered it.

Don't be unsure. Read what the document actually says. Congress published it many months ago. If you believe that employment and any service or manufacturing industry will remain the same as they are now in the USA once these treaties are ratified then you are in for quite a surprise.

guest769224 · Sep 8, 2016

If you believe that employment and any service or manufacturing industry will remain the same as they are now in the USA once these treaties are ratified then you are in for quite a surprise.

No doubt they will have some effect. I do not agree we "are screwed", though.

Jules A, MSN · Sep 8, 2016

Those of us with the 'doctor' title understand that we are not physicians. The docs have had a lot more advanced clinical training than us, and we cannot really replace them.

I pray you are correct although I'm not so sure as I continue to attempt to educate our peers that physicians are our best ally not the enemy.

Aromatic · Sep 9, 2016

I am not a politician. I don't have to have a plan for anyone other than myself. A question was asked, and I answered it.
Don't be unsure. Read what the document actually says. Congress published it many months ago. If you believe that employment and any service or manufacturing industry will remain the same as they are now in the USA once these treaties are ratified then you are in for quite a surprise.

these trade agreements are to broad to tell whats actually going to happen. sounds like security issues would be the biggest thing to watch out for. regarding our jobs id be more worried about the government losing so much money on healthcare currently. sounds like at least these changes might make everything cheaper for us across the board hopefully, but again its early to tell.

But if for some odd reason they do allow a huge of of foreign medical workers to come in we could probably open up a nice big law firm and get some juicy malpractice cash for ourselves since most foreign training is subpar compared to american training overall. Plus communication barriers would seem to increase errors across everything.

Cash is everywhere, just gotta flow with it.

Chisca, RN · Sep 9, 2016

I'm more afraid of robots than H1 visa workers.

PG2018 · Sep 11, 2016

Well, in 2009 I started studying for the LSAT. Then, I learned lawyers had not policed themselves and jobs/incomes aren't what I wanted. Back to the drawing board.

I make bank off of Medicaid of all things. We're like the Walmart for Medicaid insured.

That said, as a conservative Republican, Medicaid and Medicare reimburse too Willy nilly. Slash payments, private insurance will follow, and in a generation med school tuition will drop especially as they begin dissecting virtual cadavers. They'll throttle school back to 36 months and another generation later, basic prereqs will be reduced. By 2080, nobody would need midlevel, I'll be dead, and my kid will have kids kids and will have a trust.