Abstract
Medicine has traditionally been regarded as a rewarding career both financially and socially. How true, however, is that tradition in today's world of rising costs and decreasing revenues? The educational debt of the physician-in-training is steadily increasing, and currently does not affect specialty choice. As the cost of medical education continues to rise, the applicant pool begins to shrink, thereby possibly affecting the quality of future physicians. Once the physician has completed training however, the majority enjoy a positive return on investment. Their incomes generally fail to remain ahead of inflation, and therefore, have remained within a narrow band of $40,000 in 1970 dollars. Finally, the demand for physician services cannot be attributed solely to either the consumer (patient) or to the supplier (physician). Rather, the demand for medical services appears to be a unique combination of the two. In conclusion, medicine still is an attractive career path, but the choices and consequences are becoming much more demanding.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Starr P. The Social Transformation of American Medicine. New York: Basic Books, Inc, 1982.
Bane F. Physician's for a Growing America: Report of the Surgeon General's Consultant Group on Medical Education. Washington, DC: US Government Printing Office, 1959.
Coggeshall LT. Planning for Medical Progress through Education: A Report Submitted to the Executive Council of the Association of American Medical Colleges. Evanston: Association of American Medical Colleges, 1965.
Miller JI. Report to the President of the United States by the National Advisory Commission on Health Manpower. Washington, DC: US Government Printing Office, 1967.
Kletke PR, Marder WD, Silberger AB, eds. The Demographics of Physician Supply: Trends and Projections. Chicago: AMA Center for Health Policy Research, 1986.
Roback G, Randolph L, Mead D. Physician Characteristics and Distribution in the U.S. 1984 ed. Chicago: American Medical Association, 1985.
Council on Long-Range Planning and Development. Healthcare in transition: consequences for young physicians. JAMA 1986;256:3384–90.
Clare FL, Spratley E, Schwab P, Iglehart JK. Data watch: trends in health personnel. Health Aff 1987;6:90–103.
Leach DC. Money and manpower in graduate medical education. Henry Ford Hosp Med J 1986;34:263–6.
Owens A. Earnings: have they flattened out for good? Medical Economics 1986;63:162–81.
Korcok M. Medical education: prosperitas interrupta. JAMA 1983;249:12–6.
Brown LD. Introduction to a Decade of Transition. Durham: Duke University Press, 1987.
Bazzoli GJ. Does educational indebtedness affect physician specialty choice? Journal of Health Economics 1985;4:1–19.
Nelson S. Traditional medicine: a modern casualty? Hospitals 1987:61:98.
McCarty DJ. Why are today's medical students choosing high-technology specialties over internal medicine? N Engl J Med 1987;317:567–9.
Board of Trustees. The Effects of Educational Indebtedness on the Career Choices of New Physicians. Chicago: American Medical Association, 1983. (Report E(I-83)).
Hough DE, Bazzoli GJ. The economic environment of resident physicians. JAMA 1985;253:1758–62.
Paxton HT. Why you're spending a lot more to run your practice. Medical Economics 1987;64:170–96.
Human Resources Division, General Accounting Office. Medical Malpractice: Insurance Costs Increased But Varied Among Physicians and Hospitals. Washington, DC: General Accounting Office, 1986.
Human Resources Division, General Accounting Office. Medical Malpractice: Characteristics of Claims in 1984. Washington, DC: General Accounting Office, 1987.
Kirchner M. Are fees breaking all restraints? Medical Economics 1986;63:122–34.
Holoweiko M. Non-surgeons' earnings: which specialties are hung up? Medical Economics 1986;63:206–25.
Division of National Cost Estimates, Office of Actuary, Healthcare Financing Administration. National Healthcare Expenditures. Health Care Financing Review 1986;8:1–19.
Anonymous. National healthcare expenditures: 1986–2000. Health Care Financing Review 1987;8:1–36.
Gonzales ML, Emmons DW, eds. Socioeconomic Characteristics of Medical Practice. Chicago: Center for Health Policy Research, American Medical Association, 1986.
Burnstein PL, Cromwell J. Relative incomes and rates of return for US physicians. Journal of Health Economics 1985;4:63–78.
Marder WD, Kletke P, Filberger A, Willke RJ. Physician Supply and Utilization by Specialty: Trends and Projections. Chicago: AMA Center for Health Policy Research, 1988.
Luke RD, Bauer JC, eds. Issues in Health Economics. Rockville: Aspen Publication, 1982.
Council on Long-Range Planning and Development. The Environment of Medicine. Chicago: American Medical Association, 1985.
Feldstein PJ. Health Economics. New York: Wiley Medical Publication, 1979.
Wilensky GR, Rossiter LF. The relative importance of physician-induced demand in the demand for medical care. Milbank Q 1983;61:252–77.
Wennberg JE, Barnes BA, Zubkoff M. Professional uncertainty and the problem of supplier-induced demand. Soc Sci Med 1982;16:811–24.
Wennberg J, Gittelsohn A. Variations in medical care among small areas. Sci Am 1982;264;120–34.
Wennberg JE. Commentary: on patient need, equity, supplier-induced demand, and the need to assess the outcome of common medical practices. Med Care 1985;23:512–20.
Feldman R, Sloan F. Competition among physicians, revisited. J Health Polit Policy Law 1988;13:239–61.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Eschenbach, K., Woodward, R.S. Medicine as a career: Choices and consequences. Theor Med Bioeth 10, 217–229 (1989). https://doi.org/10.1007/BF00489440
Issue Date:
DOI: https://doi.org/10.1007/BF00489440