Should Women Be Doctors?

I'm not a Dr., but I get paid better

Is Medical School a Worthwhile Investment for Women?
The average female primary-care physician would have been financially better off becoming a physician assistant.

Those damn conservative at Atlantic have the intolerance to publish this article claiming the women doctors worse less than men doctors, and that financially at least, they would be better off (on average) becoming physicians assistants:

Focusing on the financial repercussions of these career choices, we use a tool common for analyzing investment called a net-present-value (NPV) calculation. An NPV calculation adds up the costs of obtaining a degree, and all of the earnings received over the career that degree enables, taking into account the fact that money earned later is not as valuable as money earned earlier (due to interest), summarizing a career decision in a single number. This captures the insight that in order for an investment in the high up-front cost medical degree to overcome the lower up-front cost of a PA degree, not only do a doctor's wages have to significantly exceed those of the PA, but the doctor needs to be willing to work enough hours to make those wages pay off.

Some "non-Dr" pictures here

To see if doctors do indeed work long enough hours, we looked at data from a Robert Wood Johnson survey of physicians on how many hours female and male primary-care physicians work at different points in their careers. We combined that with data from the American Academy of Physician Assistants.

We then compared the earnings of male and female physicians in our data and estimate what those individuals would have earned if they had worked as PAs.

We found that, for over half of woman doctors in our data, the NPV of becoming a primary-care physician was less than the NPV of becoming a physician assistant. In contrast, the vast majority of male primary-care physicians earned an NPV greater than the NPV earned by a male PA. That is, while the vast majority of male doctors are financially better off for having become a doctor, the median female primary care physician would have been financially better off becoming a PA.

Even though both male and female doctors both earn higher wages than their PA counterparts, most female doctors don't work enough hours at those wages to financially justify the costs of becoming a doctor.

We also examined alternative medical professions such as pharmacy, and our basic findings were the same. Programs that have high upfront training costs only make financial sense if you plan to work enough hours later on, and many women doctors do not end up working enough to justify the costs they pay.

It is worth noting that this specific result pertains to women primary-care physicians who work about 40 hours a week. Obviously, some women doctors work more hours, and some work many fewer. Women working significantly more than this do get a financial advantage from becoming a physician.

In a nation where physicians are going to be increasingly in demand, and medical care will likely be rationed based on the availability of physicians, does it make sense to even allow women to try to become doctors? I mean, as long as we're going to carefully regulate medicine and all.  It's not like choice should play into this, right?  Or can we mandate that women Drs put in the same hours that the men do?

Or we could pay them less and make more of them.

Found at Althouse.

And to complete the weirdness...



Rule 5 Sunday done come on Sunday this week at the Other McCain, with "Every Rose Has It's Thorn."

Obamacare Tax Kills Five New Plants

New Obamacare tax on medical devices causes US company to scrap five planned plants:

An Indiana-based medical equipment manufacturer says it's scrapping plans to open five new plants in the coming years because of a looming tax tied to President Obama's health care overhaul law.

Cook Medical claims the tax on medical devices, set to take effect next year, will cost the company roughly $20 million a year, cutting into money that would otherwise go toward expanding into new facilities over the next five years.

"In reality, we're not looking at the U.S. to build factories anymore as long as this tax is in place. We can't, to be competitive," he said.

The Affordable Care Act imposed a 2.3 percent tax on medical devices beginning in 2013. It is projected raise nearly $30 billion over the next decade.

But the Cook Medical spokesman said the impact is greater than just a 2.3 percent uptick in taxes. He said the impact on actual earnings is another 15 percent, and he projected the company's total tax burden next year will rise to over 50 percent.

Why in the hell would you put a special tax on medical devices? The rule is 'Tax what you seek to discourage; subsidize what you seek to encourage.'

How much do you want to bet that the tax will raise far less than the $30 billion projected, precisely due to effects like this?

How America Dies

The New England Journal of Medicine summarizes how people died in the United States from 1900 to the present.  The quick message:

In 1900 pneumonia, tuberculosis, gastrointestinal infections composed nearly half the total deaths.  With infections largely controlled, we are left to die mostly of heart disease and cancer now at more advanced ages.  Everything else is loose change.

The article has an interesting interactive chart that shows how these trends have changed through the century+.  Go to the NEJM article, and click on the graphic at upper right.  The toll of the Spanish Flu epidemic is startling.  Just today, health researches said a new "bird flu" epidemic could start at any time.  Or never...

I found this interesting:

Accounting for the history of disease also requires us to examine why some disparities in disease are seen as proof of a natural order while others are considered evidence of injustice. The 4.3-year life-expectancy gap between blacks and whites in the United States provokes outrage, but the 4.9-year gap between men and women does not. It is tempting to assume that differences between the sexes are natural and those between races are not. But a 19th-century Journal reader might be skeptical of this explanation: men then lived at least as long as women. The survival advantage of women that appeared in the 20th century owed as much to changes in childbearing, improvements in obstetrical practice, and a new epidemic of heart disease disproportionally affecting men as to differences between the X and Y chromosomes. Disparities in health and disease are outcomes that are contingent on the ways society structures the lives and risks of individuals.

 Spotted at Hot Air.

It's Not About Broccoli!

It's kind of sad when a serious legal blog has to explain that it's not about the broccoli, it's about freedom.  But to be fair, they are  trying to explain it to the New York Times readers...

Yesterday’s New York Times has an interesting article about how the broccoli mandate analogy came to play a major role in the cases challenging the constitutionality of the Obamacare individual health insurance mandate. It traces the analogy back to various libertarian and conservative sources and suggests that broccoli is a key reason why the mandate case has turned out to be closer than most liberal pundits expected.

The article includes some interesting facts, but it ultimately misses the point. The mandate’s legal problems are not the result of some clever rhetorical gambit about broccoli. In fact, the broccoli analogy is not a significant point in itself, but merely a useful shorthand for the key flaw in the federal government’s defense of the mandate: the fact that all the arguments in its favor would also justify pretty much any other mandate Congress might care to impose, and would therefore lead to structurally unlimited federal power. If the government’s reasoning would make a broccoli mandate constitutional, it can be used to justify virtually anything...