My Thoughts

Medicine and Surgery have very high skill ceilings

This is chronically underdiscussed! Just as there are '10x' software engineers that create disproportionate value for their employment, there are truly 10x doctors that practice medicine at an order of magnitude better than the average doc. The problem is modern healthcare organisations want to act as if doctors are completely interchangeable so most people never get to meet one. There are countless stories of patients suffering from YEARS of misdiagnosis or ineffective treatment because of practitioner inexperience. First some signs which are typically red herrings and NOT a good signal: (i) Academic titles like professor or research output - very rarely does it translate to clinical practice. (ii) Decades of experience - not necessarily good or bad in and of itself. Signs you SHOULD look for: (i) Extremely knowledgeable and confident in clinical manner but at the same time UNDOGMATIC and appreciates nuance (ii) Continued training and exposure to different schools of thought (e.g. allopathic, integrative, chinese). The best is if they're constantly honing their craft even when it appears they're already an expert, that tells me they're doing it for the right reasons. (iii) Accepts fee for service without insurance - if you pay a practitioner directly, you are their focus; if insurance pays them, then that will affect your patient-doctor relationship even if it's not obvious. In a world where AI commoditises medical reasoning, you shouldn't need to see too many doctors but if you do see one you want a 10x doctor who cares about their craft.

Which doctors will succeed in the 2030s?

Massive change is about to hit the healthcare industry and clinicians who fail to prepare will be in for a rude awakening. AI commoditises medical reasoning so that anyone can get a diagnosis in seconds. PAs and NPs will deliver majority of heathcare at the COAL face. Consequently, most doctors will see wage suppression. BUT, a minority will be HANDSOMELY rewarded. 2 Ways to succeed in this future: (i) Hyperspecialisation into a supervisory role or (ii) Owning your distribution. Hyperspecialisation is self-explanatory. Owning your distribution means having patients who know about you, share your values and want to see you. You want to have patients who are willing to pay out of pocket for your expertise and reputation. They are not picking you because you accept insurance, or they lack choice, but because you’re the best at what you do. This is also the most enjoyable path for a professional to take.