Demographics is huge headwind for doctors. In the past 30 years, median age of the population in North America went from about 27 to almost 40 and is still risi

Demographics is huge headwind for doctors. In the past 30 years, median age of the population in North America went from about 27 to almost 40 and is still rising. Doctors are usually on a fixed fee for service arrangement but every year as people get older, the length of time it takes to perform the average "service" goes up. The amount of time and ressources needed to treat older patients is almost exponential with age. Older patients' state of health is often very complex with all kinds of interactions between illnesses and medication side effects to manage. Sick people get more "services" but also each service takes significantly more time to perform. Yet doctors are expected to be able to perform as many of them each year. There is an oversized population of people in their fifties right now. This is the age where people start to get sick but are still young enough that they are often the main income earner for their family having one or more dependents. Doctors have to work more hours for less money trying to help families cope with increasingly common and tragic medical conditions. When a family is collapsing because of an illness and people pile up in the doctor's office (justifiably) in tears, there is no ethical way to "process" these patients in the time that is supposed to be allocated to them.