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All the doctors want to live in LA and NY. This problem only gets worse as medical school, etc becomes more competitive and costly.

browningstreet 2y ago
Have you seen the medical offices in Scottsdale?
KennyBlanken 2y ago
The problem is a mix of people leaving rural areas which increases per patient overhead at facilities, plus mergers and private equity takeovers. Hospital chains and healthcare systems have been consolidating like crazy for decades and it's still going strong - 80 or so hospitals merge every year. PE has also been snapping up private practices like crazy, too. https://www.kff.org/health-costs/issue-brief/ten-things-to-know-about-consolidation-in-health-care-provider-markets/ https://www.kff.org/health-costs/issue-brief/ten-things-to-k...
- ghaff 2y ago
  Though the consolidation is something of a mixed bag. My community hospital network had some pretty good docs but lab work, appointments, and so forth was pretty much faxes and phone calls which sometimes worked. Now they're on Mass General Brigham's electronic records system and it's a lot better.
ghaff 2y ago
It's not quite that bad. For example, the Boston area is arguably as good or better than those two cities. And some higher-income relatively small town/rural areas are pretty decent. But it definitely becomes a bigger consideration as you get older--although you can of course get unlucky at any time.
- whiterknight 2y ago
  (desirable coastal cities with young people and vibrant entertainment)
  - ghaff 2y ago
    It's a lot more than that but, as you get away from at least medium-sized cities, things get scantier especially if you need specialized care.
    - TylerE 2y ago
      It’s a problem in the medium sized cities too? Because many of the smaller rural facilities are being closed down (often in the wake of for-profit buyouts), and then all those displaced patients overrun the remaining facilities in surrounding towns.
    - whiterknight 2y ago
      Are we saying anything different?

browningstreet 2y ago

Have you seen the medical offices in Scottsdale?

KennyBlanken 2y ago

The problem is a mix of people leaving rural areas which increases per patient overhead at facilities, plus mergers and private equity takeovers. Hospital chains and healthcare systems have been consolidating like crazy for decades and it's still going strong - 80 or so hospitals merge every year. PE has also been snapping up private practices like crazy, too. https://www.kff.org/health-costs/issue-brief/ten-things-to-know-about-consolidation-in-health-care-provider-markets/ https://www.kff.org/health-costs/issue-brief/ten-things-to-k...

ghaff 2y ago
Though the consolidation is something of a mixed bag. My community hospital network had some pretty good docs but lab work, appointments, and so forth was pretty much faxes and phone calls which sometimes worked. Now they're on Mass General Brigham's electronic records system and it's a lot better.

ghaff 2y ago

It's not quite that bad. For example, the Boston area is arguably as good or better than those two cities. And some higher-income relatively small town/rural areas are pretty decent. But it definitely becomes a bigger consideration as you get older--although you can of course get unlucky at any time.

whiterknight 2y ago
(desirable coastal cities with young people and vibrant entertainment)
- ghaff 2y ago
  It's a lot more than that but, as you get away from at least medium-sized cities, things get scantier especially if you need specialized care.
  - TylerE 2y ago
    It’s a problem in the medium sized cities too? Because many of the smaller rural facilities are being closed down (often in the wake of for-profit buyouts), and then all those displaced patients overrun the remaining facilities in surrounding towns.
  - whiterknight 2y ago
    Are we saying anything different?