My guess would be somewhere without taxes?
If you thought Silicon Valley engineers had it well, think again. The 500-1000k doctors are real and listed right there, unlike the mythical staff engineer who hit the jackpot at a GAFA and can only live in the valley.
Keep in mind that H1B workers are always paid 10-20% less than local workers, so doctors actually make more than these numbers.
It was that point I truly understood what people mean when they say you don't become a doctor for the money.
very few exceptions. Although you do see some in plastic surgery and other cosmetic medical fields.
Effectively all PhD’s in hard sciences are fully funded including a (small but livable) stipend for expenses.
There is a shortage...sort of...there is a very limited quota of Medical Resident spots opened up by various AMA medical boards (read: cartel.) There are a line of aspiring physicians, but they can only practice as board certified specialists if the boards open up seats, and there is a forced constrained supply (probably to increase wages for those inside the club.)
1970 to now: US Population (or US senior citizen population)
1970 to now: Medical schools
1970 to now: Medical school graduates
1970 to now: Medical Resident spots for "shortage" specialties
I'm willing to bet the shortage is due to these plots not growing proportionally. Also, you cant increase medical school graduates w/o also increasing resident spots, otherwise, graduates go into other fields.
There are three basic ways the AMA cartel hurts healthcare:
1. First, as others have pointed out, there is an significant artificial restriction in supply of physicians. Many more people could be admitted to medical school, successfully finish training, and practice well than there are now.
2. There's an artificial restriction in the supply of providers, and more deeply, an artificial restriction in the schema we have about who we get services from and how they're trained. The AMA uses FUD to reinforce a model where the only appropriate training model is undergraduate -> MD -> residency -> post residency, and because almost everything pertaining to well-being is health, those who have undergone that training model supercede others regardless of training history.
At least in the US, we don't really question this assumption at all, even though there's no evidence it's superior to a different model that has different routes, like undergraduate -> specialty training -> broadening of training, or undergraduate -> broad non MD medical training -> additional training. Mix and match however you want. Whenever other provider types have broadened their training (dentists, psychologists, optometrists, etc.) there has always been pushback from the AMA, and the scientific evidence has never supported that pushback. So why not allow LPNs, PAs, pharmacists, optometrists, dentists, psychologists, audiologists, etc. to broaden their scope of practice, with the appropriate background and training?
The insistence on the undergrad -> MD -> residency model becomes even more absurd when you consider how brief MD training programs are becoming. It's not uncommon for them to only have 2 or even 1.5 years of academic coursework, with the rest clinical training, so how is that actually different from, say, a PA with additional years of experience in practice? Especially when you consider PA programs often require more medical experience before entering than medical school entrants -- it's all 1.5-2 years of coursework plus years of hands-on supervised clinical training.
3. This cartel actually hurts physicians as well, by increasing their workloads to impossible extents, and by creating artificial restrictions in specialty certification. This gets a lot less attention and is maybe harder to explain, but the licensure and specialty certification requirements are also getting more and more absurd, to the point that in many specialties they no longer realistically reflect actual skill, and are simply ways to further increase the rent-seeking advantages within medicine, and to line the pockets of the AMA and specialty organizations.
Practice and provider regulations, in my opinion, are one of the major drivers of healthcare costs in the US, and it almost never gets any discussion, because it's immediately shutdown. The argument is "if you in any way increase the supply of providers providing care, under any other model than an MD, people will get hurt."
I say this as someone who has worked in healthcare and has many immediate family working in healthcare, in a variety of roles, from nurses, to physicians, to other professional roles.
(See also: opioid crisis and cannabis regulation for how well our current regulatory system is working.)
Except if you want to call unions cartels because they negotiate on behalf of their members with employers than anyone trying to barter in business is engaging in cartel like behavior. Its deconstructive because in practice unions only exist to counteract the power imbalance between worker and employer. A cartel in business forms not to counteract power imbalance through collective action but to monopolize existing power.
You might call those origin points irrelevant but they make the world of difference to me. In the absence of unions labor is almost universally exploited. In their presence, businesses are hopefully and sometimes forced to bargain on more equal footing. Thats a net benefit. A business cartel likewise exists to imbalance what was closer to equilibrium and thus is a net negative.
There is a huge burnout process going on. I see so many doctors try to make a business on shark tank/dragons den work or they try to become media personalities.
Many seem stuck because the job isn't what many would expect. They have invested heavily time/effort in study, they have high debt and they have increased expectations from family/community.
Undergraduate medical education in Europe is commonly five or six years so yes, it could really be streamlined. If summers weren’t taken off you could fit medical school into four years. “Weed our and tire out” makes it sound like there are people who drop out of medical school when it barely happens at all.
In Canada .5 dropout, in the US 3 1/2%, in the UK 5%. In Canada there are very few spots so the effort to get in and have a way to pay for the education happens before. Once you are in the pressure to remain is extremely high. But 11% still seriously think about quitting.
The decisions and effort need to be put in early in life. Very few go to college and decide to become a doctor. They usually have gone to college to become a doctor and select schools/programs based on that. For some it starts earlier than highschool.
When you finally become a doctor after the lifetime of work the job may not be exactly what was envisioned but it is too late.
I know of smart people who decided to started programming, drawing/painting, inventing, writing, practicing law after age 35 and are enjoying careers. I know of no doctor ever.. is medicine that difficult for someone past 30?
The market for doctors is fairly constant, it's very difficult to mint new doctors. Even if a state or university went through the enormous undertaking to create a new med-school, they would, at best, create 200-300 new doctors a year, a drop in the bucket.
The real solution is in alternative degrees like Physician Assistants or Nurse Practitioners. They can get degrees at half the cost of doctors and yet do 80% of a doctor's work.
Any real cost reductions in U.S. healthcare will have to include these alternative healthcare providers.
In USA. Definitely not in EU (currently, although there is a increasing pressure to dismantle and privatize university)
On the other hand, robotic solutions are competing for more and more roles in Hospitals. We have robotic helpers for surgeons yet. At some point in the near future they will start replacing many people and this factor should be included in the picture. Specialists will do online surgeries in all country without spending the time traveling from one hospital to other. The future can need less doctors for treating the same people.
If doctors collectivize, then shouldn’t patients?
Allowed medical schools to control their curriculum more, allow new ones, change the residency system.
One simple change would be to create a 6 year BS/MD degree that students could start directly from high school -- many other countries do this.
There's many ways to get to a shortage, cartels and single payer are but two.
Source? The only news i've read of shortages are Brexit related.
Fun fact: the doctors were the biggest obstacle to the foundation of the NHS and they disappear into private practice at the first opportunity.
Lots of senior care is pretty elastic, since most visits result in no change in drugs or procedures for the patient. They are simply monitoring chronic and/or progressive conditions.
We all get to a point where we need less doctoring, not more. During the 'obamacare' debates some stupid politicians called this transition in the goals of treatment "death panels" , but the realists on the other side of the aisle didn't figure out how to intelligently point out that sometimes letting people die gracefully is kinder than subjecting them to every possible medical treatment.
My brother works with old people in Arizona. He's paid a salary, and makes a game of trying to spend his employer's resources efficiently. On a recent visit I noted his comment about how he's just doing palliative care. Most doctors aren't on salary, and are paid via the standard medicare "fee-for-service" (FFS)  model, which is a good way to make people profitable to their medical providers.
 My earlier comment about my mom's elderly friend's predicament: https://news.ycombinator.com/item?id=20224523
https://news.aamc.org/content/downloadable/209/ [PDF, by way of CDN redirect]
Or at least the (interested sponsors) press release on the study linked in this news article?
It's a huge issue with family and primary care physicians, particularly in rural areas. Paper work requirements and misguided reimbursement goals are making it unsustainable for doctors not involved in large health systems.