There are lots of alternative non-clinical career choices available in industry including, but not limited to:
Physician Consultants
Physician Writers
Physician Executives
Physician Entrepenuers
Physician Inventors
Physician Professors
I have done most of the above at one point or another during my career, and am still involved in a number of entrepeneurial projects that will keep me busy for many years, including the development of DNA coated gold nanoparticles that can be implanted into tumors to measure the radiation dose being delivered. Likewise my business partners and I are building cancer centers in the middle east and may build a pharmaceutical manufacturing plant there as well.
There are also possibilities of continuing clinical medicine with cash-only practices (until Obama finds a way to end this) and the possibility of migrating to states like Virginia which has voted to reject Obamacare.
There are also non-medical careers that one might consider. Anyone intelligent enough to graduate from medical school should be able to compete in the job market. All of us have undergraduate degrees in a variety of fields that would provide some alternative employment opportunities. Most of us have graduated at or near the top of our class. I know there are lots of physicians who are going to seminars and mapping out strategies to exit clinical medicine and start alternative careers. I also saw an article about a physician who was selling clothes on ebay, making more money than she made seeing patients.
And then there are those like me who are close enough to retirement, who may just say enough is enough and get out of clinical medicine and become a full time Spyder Ryder, heading off to Galt Gulch
I will point this out...having lived in Germany for fifteen years.
Around 2005, in Germany....roughly 5,000 German doctors gave notice and left the country (they actually unregistered and gave intent)...and they left for countries like Australia, US, Canada, etc. By spring of 2006...the German government realized a huge problem was underway and quickly agreed to some salary upgrades and cost upgrades (they admitted quickly that it would send health insurance higher, but they had no choice).
In a country of 80 million, and with a university system geared to produce X number of doctors per year....they could not readily make up the missing doctors. So you began to notice foreign doctors (mostly Turkey & Russia) showing up and being a junior partner in a local clinic.
They sit and review the exit numbers now on a monthly basis. They can’t force the doctors to stay....so money is the only enticement.
For well over forty years....price control was the thing that kept German universal health care affordable and within reason. It’s basically in a failure state now.
This past year...while the percentage for a citizen is set at roughly 15.5 percent of your salary for your health care package (your employer pays the same)....they’ve had to start a extra fee (roughly $8 a month) on top of the percentage. This month, they announced that this fee in 2011 will go to around $30 a month. Within five years....the monthly fee....on top of your 15.5 percent deduction...will be around $60 a month. You can see the game being played out.
Based on the economic system in all of these countries....you will be unable to pay for regular health care...under any package...by 2040. Medicare, universal health care....it doesn’t matter. And it’s simply a matter of your expectations of living into your 70’s, while smoking and drinking as much as you please. The system isn’t broke, but our expectations are.