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Martin Odber

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Can the shortage of doctors be solved using an adaptation of the third law of supply and demand?

The third law of supply and demand states "If demand remains unchanged and supply increases, a surplus occurs, leading to a lower equilibrium price."
( http://en.wikipedia.org/wiki/Supply_and_demand )

If we increased the rate of new doctors entering medicine (using mechanisms such as but not limited to; subsidizing doctors education, further compartmentalizing aspects of health care etc ) until we reached a surplus state then would waiting times and the cost of healthcare go down accordingly?


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    Sep 9 2013: Fist of all, I hadn't heard there is a shortage of doctors. Is there?

    I suppose a major problem would be, where does the money come from to subsidize more doctors' education?
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      Sep 10 2013: Up to 13 hour waits at emergency rooms along with the difficulty of finding a new doctor would indicate yes there is a shortage of doctors.

      As to where the resources come from to improve this condition, good question. Your thoughts?
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        Sep 11 2013: Well, do you really care if there's a long wait at emergency rooms, I mean, how often does one go to an emergency room, if you have a really intense emergency you will be moved to the front of the line.

        What do you mean "difficulty of finding a new doctor"?
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          Sep 11 2013: In answer to your question a simple yes.

          The last time I needed emerg I had ear trouble. I could not wait for an appointment with my doctor as a good deal of my job is effective listening.

          After ten hours of waiting to be seen I had to give up as it was within 4 hours of my next shift. That's ridiculous. If I were in some remote location ok fair enough, but in a major city, I think not, we're better than that.

          Doctors seeking new patients do not necessarily grow on tree's, or such has been my experience. I recently lucked out and found one however I will not just ignore the issue because now "I" am looked after. A community or a nation is a team and all Canadians have the right to accessible good medical care. In fact I feel people of all nations should have that, it's as basic as breathing.
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        Sep 12 2013: yeah, martin, I'm guessing the hospital actually would like to create a long wait for patients at the emergency room because they don't want scads of people coming to the emergency room, which is what would happen if there weren't a long wait. You know, some people would show up with colds and mild flus, which really aren't emergencies, but I think they would show up at the emergency room if they could see someone without a long wait. I would think in most cases doctors would prefer to see people with an appointment on a non-emergency basis, but I can't think why exactly, why is it that upscale professionals usually prefer people make an appointment?

        I can't tell how major a problem doctors not accepting new patients is, I would think not such a problem because if there are people seeking new doctors, it also means they are leaving doctors, doesn't it?
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          Sep 12 2013: Bit of illogic there to "create long lines" so there won't be long lines so not sure what to make of that.

          I'm thinking they are probably underfunded and understaffed, although how to surmount that difficulty as yet I remain unclear on.
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        Sep 14 2013: well, Martin, my first thought is that if you put enough doctors in an emergency room that people wouldn't have to wait, people will start using it like a walk-in clinic, they'll take almost everything there, even things that most of us wouldn't think are emergencies. So the question arises what's wrong with a walk-in clinic? I think the reason doctors prefer to make an appointment is that they use their time well, in a walk-in clinic, there may be times when there are more doctors available than people coming in, so that some doctors are sitting idle, which it's expensive to pay a doctor when he's just sitting idle. Conversely, in a walk-in clinic, there may be times when there are so many patients that there aren't enough doctors to cover them quickly so that noone has a long time to wait. In a normal doctor's office where they make appointments to see the doctor, they can prevent both these situations, they can schedule so that the doctor's time is always well-spent, no downtime, and they can schedule so that they're not getting more people coming in than the doctor can handle, nor making them wait. So I would say there is a real advantage to seeing doctors by appointment, and thus I believe the hospital purposely makes it hard to see a doctor in the emergency room.

        Here in the states we have something called urgent care, it's midway between a standard doctor's office and an emergency room. Do you have these in Canada, perhaps your ear problem would have been better served by urgent care?
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          Sep 14 2013: Hi Greg,

          I am unfamiliar with "urgent care" or the idea's surrounding it.
          It is easy to agree we'd not want high priced doctors to be sitting around doing nothing, if the emerg rooms were clear. I wonder how we could work around that, and still have them close. Perhaps a rotating on call status?
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        Sep 14 2013: right, martin, I'm sure they do have doctors on-call for major emergencies, like if they suddenly need a surgeon to remove a bullet, and the doctor in the emergency room isn't qualified to do it. But I still say if you turn the emergency room into a walk-in clinic, which is what I think would happen if people didn't have to wait long, you'd get too many people with non-emergencies in the middle of the night, what, you want some on-call doctor to get up in the middle of the night, get dressed, and drive to the hospital to treat a bunch of people with colds and flus? And then he's going to be tired the next day when he has to deal with his regular patients who have made appointments at his office. I'm sorry, I just can't see it working, as best I can see the system is fine as it is. But if you see something wrong with my logic, let me know.

        here is the wikipedia article on urgent care: http://en.wikipedia.org/wiki/Urgent_care
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          Sep 14 2013: I like the idea of the Urgent Care Centers Greg.
          Without annual emergency room statistics for the nature of illness by percentage of people who show up cross referenced by season, date and time it would be tricky to really feel comfortable thinking crowded emergency rooms are all about people worried about a cough enough to hang out in emerg for 13 hours to be seen to avoid having to make an apt with their regular doctor but ok crazy as that sounds I guess it "could" be possible.

          Then again, if we could nail down to some level of certainty that say 55-60 percent of persons were hanging out in emerg on a regular basis for things that an RN or otherwise capable staff could handle (coughs, colds, take the temperature of a flu) then perhaps we could staff RN's so there would be enough, and leave the doctors to deal with the 40% that we determine actually do need to see one?

          Where there is demand, there should also be supply to meet it. Sidenote? Another contributor mentioned there are actually "out of work doctors" .. wouldn't they rather be working picking up the slack than sitting around on EI or accruing extra debt they don't need?

          (any time I've found myself in an emerg the folks there really look like they need to be there but I agree that we'd not want staff of any kind sitting idle.)
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        Sep 25 2013: no, martin, the idea isn't that people with coughs currently hang out for 13 hours waiting to see a doctor, the idea is that if you made it too convenient for people with coughs to see a doctor in the emergency room, in other words, they only had to wait, for example, half an hour, then more people with very minor ailments would go to the "emergency room," and it would no longer truly be an emergency room, it would become a walk-in clinic. By making people wait, it weeds out the true emergencies from the lesser stuff. Does this work for you?

        I'm curious, when you had your earache and never got seen by someone, did you go to work and just work despite the pain of the earache, or did you take a sick day? Most jobs you do get a certain number of sick days a year, this might have been a time to take one.
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          Sep 25 2013: Greg?

          No, it doesn't work for me honestly.
          Telling truly sick people its ok to expect them to wait long hours so that more people might be discouraged from using the health system is .. illogical and immoral in my view.

          IF we were talking about lineups at the used tire store? I'm with you all the way.
          But we're not are we. We're talking about ones health and that is about as close to home as it gets, for any and all of us.
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        Sep 26 2013: well, offhand, it works for me, Martin. I think part of it is that few doctors want to work through the middle of the night, I'm sort of guessing that a higher percentage of doctors than the average person have spouses and children and want to work a regular schedule so they're in sync with their family, or really just in sync with the world. But if you want a through-the-night emergency room well-stocked with doctors, they won't be able to do that.

        Maybe psychologically you don't want an emergency room to be too good at what it does because it might encourage lawlessness in the middle of the night, in other words, the gangsters and criminals might get even crazier if they think there's some emergency room with many doctors to deal with all their victims. People might commit more domestic violence if they know there's an emergency room with many doctors to help victims.

        I would guess too that there's some sense that a lot of things do get better if you just sleep on them and see how they feel in the morning. I would think for that reason too the hospital might not want to make it too convenient to go to the emergency room.

        I would slightly guess that doctors like working at the hospital during the day when many of their colleagues are around, in other words they can go to the hospital dining room and talk with many doctors from different fields. Some of that would be lost for doctors working through the middle of the night in the emergency room.

        I still wonder if instead of going to the emergency room, you could have taken a couple of sick days with your earache.
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          Sep 29 2013: Greg, I'm pretty sure over 80% of the entire world, prefers working during daylight hours. It tends to naturally go well with our circadian rhythms. We tend to agree there. I'd also agree that the system as it is doctors pretty much write their own ticket and the public must simply accept it as there really is no other choice provided demand exceeds available doctors.

          I'm not quite so sure that criminals plan their activities around hospital peak service times. I suppose they might but I just can't see that as a primary consideration for them in general.

          To my thinking just like any other business one would look at the demand on a given day hour month based on former years data and then staff accordingly tailoring the schedule as experience updates the data.

          If I needed to put a finger on why the government finds inefficient service acceptable, I'd believe that its because the ones controlling the government do not experience it. Their needs are seen to promptly and efficiently therefore there IS no issue.

          No matter who a voter votes in or out, that individual is subject to "party rule." Faces change and the system remains the same. Which likely means that if a country wants to actually see that what is good for the voters is reflected in their governments choices, they really need to vote directly on the issues such as www.onlineparty.ca.

          As for the earache Greg. When I'd attended that emerg for multiple hours my earache seemed to be the lowest rung on any triage ladder and with good reason. Several people were sobbing and bent over with abdominal pain. Some had had to be carried in. Some had physical injuries. There was a plethora of valid reasons for people being there.

          I' am not offended in the least by some contributors suggesting that emergs are full only because people there have coughs or colds and are abusing the system, I'm amused.

          The world runs 24 hours a day and does not stop because some persons prefer daytime hours, thats news?

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