May is Skin Cancer Awareness Month. What better time to talk about health care in the Sunshine State?
The Great Plains are traditionally the best places for doctors to work when salaries offered are compared to house prices and overall cost of living. But not everyone wants to live in the Dakotas, which, presumably is why a dermatologist can get paid $600,000 per year for showing up.
We’ve noticed that it is tough to get an appointment with almost every kind of doctor in Palm Beach County. Concierge medicine, in which people pay $3,000 or $5,000 per year to a primary care doctor to get the kind of service that was standard in the 1950s (pre-Medicare/Medicaid), seems to be much more common here than it was in the Boston area. Getting in to see a dentist can also be tough, with the high-rated providers backed up for 1-2 months. A physician neighbor who moved here less than a year ago and joined a private practice says that he is already busy.
I’m wondering if the Great COVID Migration has opened up a lot of opportunities for young doctors to establish themselves in Florida. The migration to Florida from the lockdown states wasn’t a randomly selected group. The first element of selection was a love of freedom. Doctors get half of their income from the government and nearly all of the other half is heavily regulated by the government. Doctors get paid more when low-skill migrants are admitted to the U.S. (a larger population leads to larger Medicaid payments, if nothing else). The typical doctor, therefore, is not aligned with “small government” state politics in Florida. The second element of selection was an ability to work from home. It was a lot easier for someone in engineering or finance to move than a doctor who sees patients in person. Finally, there is the question of state licensing and regulation. It is illegal for a doctor to move from one state to another and hang out a shingle. He/she/ze/they must first get licensed in the new state. A dentist friend who might otherwise want to escape Massachusetts says “It is very tough to get a license in Florida. They make it next to impossible for dental.” A cardiologist friend said that it would take her six months to get a license in Florida.
If the above list of selection effects is correct, there should be a smaller percentage of physicians in the group that migrated to Florida from California and the Northeast in the past two years than the percentage of doctors in the general population. In other words, the state has been flooded with new patients but hasn’t received too many new doctors.
What do readers think? Is Florida a good place for a doctor finishing residency/fellowship?
Some inspiration for docs… our minivan (Bugs and Daffy covering the massive holes left by the Maskachusetts front license plate installation) at a nearby strip mall next to a $400,000+ Rolls Royce SUV.
I don’t think that the lady who owns this marvelous (other than the severe door ding from our Odyssey) machine will quibble about $5,000 per year for concierge medicine.
My elderly parents have been in Florida 20 years and seem to have trouble finding care. They routinely can only see PAs.
When we were scoping pediatricians we could only get new appointments by a referral of an existing patient. Does worry me a tad being a new refugee from California. Not a enough to stay in California.
Based on what you say, a dermatologist will get 600K in the Dakotas due to lack of competition. Thus, increasing the number of physicians will decrease competition and depress salaries. I can see the physicians of Florida lobbying against an increase in supply of colleagues.
Doctors’ incomes are more dependent on state-by-state negotiations with insurance companies for going rates of services than free-market forces. We make less here in Alabama than the same specialists in neighboring Georgia and Mississippi because Blue Cross has negotiated lower pay here. Of course a market flooded with doctors would make it harder to find patients, but that’s not really in play here.
Though concierge Internal Medicine and Plastics would be more in line with free market forces.
According to their website, a doctor should be able to get a Florida license without too much difficulty compared to moving to some other states.
https://flboardofmedicine.gov/licensing/medical-doctor-unrestricted/
“Some inspiration for docs… our minivan (Bugs and Daffy covering the massive holes left by the Maskachusetts front license plate installation) at a nearby strip mall next to a $400,000+ Rolls Royce SUV.
I pulled the rear license plate on my new car and discovered the dealership had drilled twice. If dealership did that on a front bumper I would either put a front license plate or take to auto body repair shop for a repair and paint.