And the Last Shall Be First, Specialists and Nurses Find

John A. Marcille

This magazine, Managed Care, is based in Trenton, N.J., outside of Philadelphia. This affords staff the opportunity to patronize Philly’s major league sporting events, an historically dubious perk at best. To be a Philadelphia sports fan is to learn every connotation of long in the term long-suffering.

Then, this year, came the 76ers: that broken, spunky band of basketball scrappers who no one thought could make it to the finals. They did, and while they were defeated by a vastly more talented and healthy Los Angeles Lakers, the team fought hard to the end.

One of the things those of us late to the bandwagon found out, as we perused the sports pages every day during the Sixers’ improbable ride, was that basketball players make an awful lot of money. Not just the Allen Iversons and Kobe Bryants. Second- and third-stringers sometimes pull down seven figures.

Isn’t it nice to be in demand? Our cover story this month focuses on the provider shortage that managed care, in part, helped to create. For specialists and physician extenders, the want ads on our cover might seem somewhat quaint. Headhunters are knocking at the door long before they have to pick up a newspaper. Will primary care physicians soon bask in the same glow? What will HMOs, already beginning to feel the strain of the shortage, do then?

Perhaps the most intriguing twist in this story is that no one in the late 1990s predicted this would happen. In fact, the prognosticators got it totally wrong, saying that there would be a provider glut.

In business, as in sports (“Go Sixers!”), the unexpected often occurs. That’s what keeps us tuned in. The entertainment industry knows this, hence the rush of reality-based shows that try to synthesize this element.

In health care, it will be interesting to see who emerges as the ultimate survivor in what has become a seller’s market for providers.

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