According to the 2010 Physician Workforce Study by the Massachusetts Medical Society, practices across Massachusetts are having trouble recruiting doctors and as a result, patients are having trouble finding doctors to treat them. Berkshire County's situation was labeled "critical" by the report's authors. See Amanda Korman's article Study Finds Doctor Scarcity (Berkshire Eagle, 10/20/2010) for more information.
Is anyone at all surprised by this? I'm not. Who didn't see this coming? The physicians I know have said it is flat out impossible to attract good talent here because:
1) The patients are disproportionately elderly so the job of being a primary care physician here is much more stressful than places where the population age distribution is more normalized. Each patient session takes more time, often because there are a plethora of drug interactions to worry about from all of the prescription meds so many seniors depend upon. One doctor I know said, "You have no idea how nice it would be to have a day with 10 or 12 kids with strep throat come in. That's easy. Instead, more than half of the the patients I see are in their 70's and 80's who have 5 different things wrong with them, 4 of which are serious, and they are on 12 different drugs to manage their care, leading to all kinds of unforeseen interactions and complications. Every day is a grind."
2) The patients are disproportionately covered by some form of government health care plan, which means lower reimbursements and therefore lower incomes for the doctors versus states where a larger portion of the patients are covered by private health care insurance.
Hmmm ... let's see ... I can move to MA and earn less and work in a more stressful environment or I can move someplace else, get paid more, and have it easier ... Not too tough of a choice, is it?
What a mess we've found ourselves in. Our population is aging, young people are fleeing our state to seek opportunity elsewhere, and doctors don't want to practice here. Access to quality health care is a huge factor in any decision for a business to relocate to a region because businesses know this is something their employees care deeply about. We've created a situation in MA that is leading to doctor shortages and the costs of the government programs are drastically exceeding original projections, which means we will likely have to raise taxes and fees. At a time when we need to create real jobs here more than ever, we can now add, "Too tough to find good healthcare," and, "The government just keeps adding taxes and fees," to the list of reasons a business could use to justify not selecting MA as a new home.
Here's the bottom line ... while equal access to health care is a right that no one should be denied, being able to pay for that access is a personal responsibility, not the government's. Just look at what is going on in Europe right now after 40 or 50 years of socialized medicine. It is a disaster - governments from London to Berlin to Madrid are implementing "austerity measures" to save their economies because the spending commitments for entitlements are so out of hand.
We can't ignore the reality. No matter how much we wish it were different, it just isn't working.
The WSJ reported today that three academic economists have been awarded the Nobel Prize in Economics for their research into the phenomenon of high unemployment even though there is a rise in job openings (Trio Share Economics Prize, WSJ, October 12, 2010). They hypothesized that high unemployment benefits which result in the unemployed spending more time looking is actually better for the economy because it means they find jobs which are a better fit for their skills.
Huh? That is probably the most counter-intuitive conclusion I've ever heard in my entire life. One has to wonder if they actually looked at any survey data of unemployed folks. Two data points are not statistically significant, but I know two people who were recently laid off who are eligible to collect the max in MA ($629/week) for something like 70 weeks. Neither have any plans to look for jobs for at least 6 months. One is an avid skier who is going to hit the slopes all winter before starting to look in the spring. The other is relocating to Texas and will start looking once they're settled. Both are looking at their unemployment benefits like an opportunity to take an extended paid vacation.
I've been doing some work trying to hire new staff for a local financial services firm. It is amazing to me how difficult it is to find qualified people who actually want to work these days. When people hear they are actually going to have to show some effort in order to earn a decent living (compensation is roughly 50% base, 50% commission with total compensation potential in the $60-$90k range), they are scared away. Part of my role is the initial telephone screening interview. I've had people tell me they've been unemployed for months who hear the job description and say, "Not interested." We had one kid take the job and quit after only 4 days. The employer couldn't be any more candid with people - telling them right up front, "Expect to work 45-50 hours per week, expect to dial the phone 50+ times per day if you are going to be successful." Kid quit after 4 ... FOUR ... days! He's got a finance degree from MCLA, graduated in May'09, and has been working retail part-time as a cashier ever since. What did he think he was going to get for his first finance job? CFO of a F500 company?
Don't get me wrong. I know how tough it is to have a job you hate. It sucks. It is so tough to get out of bed in the AM if you hate your job. However, if the alternative was going hungry and homeless, people wouldn't be so picky. As a society, we simply can't afford a system that allows people to be picky. We need a system that allows people to eke by for a few weeks until they can find a full-time job doing something that pays half way decent and a part time job that makes up the difference.
Things have changed. Look at home prices. We all wish we could sell our home for what we bought it for, but if you bought a home in 1999-2006, that probably won't happen for years to come. Ditto re: income and lifestyle. If you lost your job during the Great Recession, chances are you will struggle to find a single job that replaces or increases the income. You may need to add a second job in order to approach the same lifestyle. That's just reality.
Seems to me, there are jobs out there. It's the effort that's lacking.
I bought a building this past week - 173 Water Street in Williamstown. Seven suites of offices located right across the street from the Cable Mills site. Given the economy, some would say that is quite a leap of faith. To me, it was a no-brainer.
The American economy is an incredibly sturdy mechanism. It has dealt with shocks like the past two years many times over the years. True, this particular recession is longer and deeper than most. Yet I am confident that a recovery is underway and that good times are indeed forthcoming.
We have plenty of reasons to be optimistic. We will hit incredibly difficult times periodically and each one of those eras teaches us something valuable. We learn how to be smarter and leaner in our businesses. We learn to pay attention, check our foundations and in some cases, make the wise and courageous choice to go do something else. Small business is an integral part of that sturdy mechanism and as American entrepreneurs, we just get better at rolling with the punches.
Survive and flourish ... sometimes it is just about survival, other times we have the opportunity to flourish. Knowing when and how to do both is the key. Get by when you have to, roll with the punches, and then make hay when the sun shines.
Know anyone who needs some office space?
Lucy Pavalock contributed to this blog posting.
Page 1 of 1
1
Support Local News
We show up at hurricanes, budget meetings, high school games, accidents, fires and community events. We show up at celebrations and tragedies and everything in between. We show up so our readers can learn about pivotal events that affect their communities and their lives.
How important is local news to you? You can support independent, unbiased journalism and help iBerkshires grow for as a little as the cost of a cup of coffee a week.
