I have to say that the power in Seattle, or at least, the power that I am paying for, has been responsible for more computer mishaps than I can count. For no apparent reason, we often have these little brown-outs, where the lights flicker and computers go haywire. I will add, we do have surge protectors but they seem to be useless for this type of thing.

Yesterday evening one of these brown outs apparently fried our router, and has made our DSL connection precarious at best. Thus, the lack of postings today. I’ve had to use my–horror of horrors–back up dial-up. Yes, thank you dial up that you are there for me, and can come to the rescue.

But why is this necessary? Why are power lines above ground? So every time the wind blows the wrong way, the power goes out? The best example of this was last year in Florida, when four hurricanes hit. Power was out for months for some people. My parents had no power for 10 days, and had to toss several hundred dollars worth of food. If the power lines had been underground, there would be no problem. In a place like Florida, where power goes out on a regular basis, with all the lightening, storms, and what-not, they’ve been fighting this issue for years. The power company says it “can’t put them underground,” and that “it’s too expensive.” So is it cheaper to have to replace them after a hurricane?

Anyway, this system makes me feel like I’m living in a third world country. That in a city as computer and tech oriented as Seattle, we can’t do something as simple as put powerlines underground?

Everyone has heard of the great nursing shortage of 2005, but what about the great physician shortage? Are we running low on doctors, or is this just another one of those woe-is-me-the-sky-is-falling scenarios?

Now, if some of you remember, this is the exact opposite of what was predicted ten years ago. In 1994, there was the dire prediction that we were facing an oversupply of doctors. The Journal of the American Medical Association actually predicted that we would be inundated by an excess of 165,000 doctors by 2000.

So what happened? How have the foreboding words of excess transformed into shortage in just ten years?

For one thing, the Great Glut of 2000 never happened. Doctors did not turn to having to wait tables or drive taxis, and job offers are in fact, plentiful to newly minted docs entering the market. In fact, there are about 800,000 practicing physicians in the U.S. today.

So it goes to show, that you really can’t take too much stock in either predicted shortages or surpluses. There are growing numbers of physicians who are leaving hands-on medicine and moving into research, consulting, medical writing and editing, or whatever. They’ve left medicine for a variety of reasons; the cost of malpractice insurance, the encroachment of HMOS on their ability to provide patient care, and a desire for a more normal work schedule and lifestyle (like being able to spend time with their kids).

Then there is the aging of the baby boomers. This statistic is always thrown out whenever the subject of health costs/manpower shortages come up. The 79 million baby boomers reaching retirement age,and the assumption that all of them are going to be sickly and diseased, and will be akin to a band of locusts descending and sucking up the resources. Yes, some of the old timers will be sick, will need a heart bypass, will be taking arthritis medicine, but I tend to think that it is not going to be all that bad.

But moving along, in response to the predicted surplus of doctors (chicken little, the sky is falling) medical schools stopped opening in the U.S. and the number of new docs was purposely kept in check. Thus, the number of physicians roughly replace the ones retiring, but according to the new predictions, it will not be enough to replace the large numbers predicted to soon be retiring. Sort of sounds like the same story we hear about nurses.

The Association of American Medical Colleges has now acknowledged that the predictions of the surplus were in error, and has recommended increasing the number of U.S. medical students by 15%.

But do we really need more doctors, or are these jsut numbers that we are throwing around? For example, in the late 1990s, a pediatrician I knew in San Francisco was planning on leaving medicine because the field was overcrowded. SF has a very low number of children, compared to other cities, and it is a desirable and very expensive place to live. There were too many pediatricians, not enough patients, and since he didnt’ want to relocate, he decided on a different career move. The marketplace is uneven, and indeed, some say that there really isn’t a shortage, just a maldistribution of talent.

Some areas of the U.S. are severely underserved, while others have all the docs you can ever ask for. In addition, some specialities are going to go the way of the dodo bird if they don’t get some fresh blood (pardon the pun). According to an article in USA Today, high on the list of specialities facing extinction general surgeons, radiologists, anesthesiologists — who have a wide range of duties. New grads are interested in high tech, cutting edge medicine, which pays well and may give them more regular working hours.

Because physicians are affluent and in short supply, they tend to locate where they want to live — not, as McDonald’s or a Chinese restaurant might, where the most customers are.

Jackson Hospital, a 120-bed hospital in Marianna, Fla., a town of 6,200 an hour west of here, needs a urologist, a radiologist, an ear, nose and throat specialist and a gynecologist. “It’s supply and demand, and it’s hard to get doctors here,” hospital administrator Charles Ellis says.

Churning out more doctors isn’t necessarily going to convince to move to areas where they are needed, or to enter specific specialities. Even incentives such as offering to pay the cost of medical school in return for services–well, how long can you force someone to work in your town? Two years? Four years? Ten years? All that accomplishes is a temporary reprieve and a revolving door.

Anyway, today there is a predicted shortage. Who knows what tomorrow will bring?