Editorial: Every cloud has its silver lining

THERE'S a reason why new physicians seem gloomier than usual.

A nationwide survey released last week by the American Medical Association reported that new physicians are having a hard time finding that first job. The study found that more than 7 percent of physicians who finished their residency training two summers ago were still looking for a position six months later.

Don't go shedding too many tears for physicians, though. Doctors still live comfortably, with the average pay for physicians reaching $199,000 in 1996. And the increase of new physicians doesn't mean they aren't getting jobs, it's just that some of them aren't being showered with immediate offers.

Dr. Paul Baranch, who just completed his anesthesiology residency at Massachusetts General Hospital, told the Boston Globe his classmates were able to find jobs, but not necessarily in the locales they wanted. "Ten years ago you'd get 10 offers," Baranch said. "Today you have to use the alumni list and go out and beat the bushes."

The reduction in job offers means that physicians are having to turn to other regions of the country that may not be their first choice. But this nationwide glut can help a state, such as Nevada, scouring for doctors.

Western states that have small towns located hundreds of miles from a major urban area, including Nevada, have had difficulty for decades attracting enough physicians to set up practice. If a glut of doctors continues then there is an even greater likelihood that physicians might be more willing to practice in rural areas.

Nevada's shortage of physicians isn't restricted to rural communities. Even Las Vegas has had difficulty attracting enough physicians in primary care and in specialties, such as pediatrics and oncology, according to Larry Matheis, executive director of the Nevada State Medical Association.

But in recent years Las Vegas has benefited from the explosive growth of managed care in California. Doctors who resist working for HMOs have headed east to Nevada. While managed care generally has been destructive for quality medical care, in a perverse way California's rush to embrace managed care has helped our state as physicians leave to establish their practices here.

Maybe every cloud does have a silver lining, even when it comes to an oversupply of physicians or the increase in managed care. What may be bad news for doctors could end up being good news for Nevadans if it helps draw more physicians here.

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