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The Rust Belt has garnered unfortunate attention these last few years. Our recent election cycle made its job losses, poor alternatives, and lowered wages abundantly clear. While the economic benefits of free trade and technology to our society as a whole should be celebrated, we failed to hedge against the downsides. The United States continues to rank far below other developed economies in terms of money invested in labor markets, including retraining, according to 2017 data from the U.K.-based Organisation for Economic Co-operation and Development.
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September 2017While it may be easy to dismiss this phenomenon as unique to manufacturing, these market forces have now turned their focus onto physicians.
An inefficient market with pressing needs, inelastic demand for services, and profitability is an attractive target for technological disruption; healthcare is one such market. Technological advancements have moved medicine forward, expanding our capabilities to provide better care; however, technological advancements seem to have an ever-increasing potential to displace physicians rather than to assist them. The arc of coronary artery bypass grafting (CABG) is a cautionary tale of what can result from inefficient resource allocation in the face of technology. CABG was the dominant form of coronary revascularization for decades. Training programs boomed to supply the proliferation of financially lucrative “heart disease” centers at hospitals, driving down hospital volumes of CABG surgery, even as percutaneous coronary intervention (PCI) was showing increasing benefits and rapidly surpassing CABG in volume (Health Aff. 2007;26:162-168).
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