The government has pursued active policies of flooding the medical labor market with imported labor for a generation attempting to create a buyers market.

Psychiatry residencies do not fill now–there are more training slots then there are people to fill them, and that is filing half of them from the international pool of qualified applicants.

1/3 the people in the field are an embarassment now and really don’t have the qualities to be in the profession.

They have no exclusive procedures that only they are credentialed to do–any doctor can talk to people and prescibe–as long as they know how. They get competetion as do the PCP’s from the usual undertrained non-medical provders–everybody thinks they are an expert on the mind because they have one. They get competetion from all the mental health providers–a quarter million psychologists, plus social workers, LPC’s, marriage and familty therapists (my state just forced insurance co to reimburse them and let them make daignoses).

In short, they swim in a sea of competetion and all they have to recommend them are their skills and what they are worth to people.

All over the world, whereever there is anything like economic freedom for physicians, they prosper financially. Surgical fees in the private side of the UK market are the highest in the world–and their competetion is “free”! Most states hold physicians in servitude to the publics demand for low-cost services.

Free market? What type of “free market” argument can one even start to make given the anaconda like constriction on the supply side of the equation that has been present since the implementation of the findings of the Flexner Report?

I am a shrink who makes 200K a year, which is a little less than my CPA with half of the post-sec ed earns, and I earn it in the free market based on negotiated rates (not medicare or medicarid). You couldn’t get me to walk in those prisons for only 200K, those guys are paid what the state has to pay one of the lowest earning medical specialties to tolerate the special stresses and abuses that go along with that job. I spent one day in a state prison psych facility and left never to return. It is a free market salary so what are you crabbing about? If you think they are overpaid, then you are free to put up with their shit and do it and bask in the joy of your “unearned” wealth. If they are flying them around it is because they can get more work out of them that way.