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The story that I put up yesterday has further repercussions (I borrow this word from Sir Humphrey Appleby in Yes Prime Minister): where are those gastroenterologists coming from ?

From medical school, of course.

If we assume a gastroenterologist becomes independent at the age of 32 (graduates at 24, one year of houseman, seven years of specialty training) and retires at 60, the “working life expectancy” is 28 years. Since we need 56 extra gastroenterologists, there has to be 2 medical school graduates each year joining this program.

On a first glance, this is not a problem: we have 250 to 300 graduates each year.

(It would be a problem, however, if we follow what recently mentioned by the media: to screen everyone over 50-year of age yearly. In that case we need 1.5 million colonoscopy yearly, or around 420 gastroenterologists, which means 14 new gastroenterologists each year fresh from medical school.)

Nonetheless, there is a problem: how to persuade two highly intelligent young doctors each year to use (waste ?) their life and join this program ? Remind you, this is a monotonous life that work on nothing else. From our understanding of human nature, this is of course impossible. Even if they make a promise when they join, we know just too well how good a man (or woman, no sexual discrimination) can keep his promise. The result is – they either leave the system early, or they yet create another system of bureaucracy. Alas, even more people are needed !

Of course the more likely happening is these "screening gastroenterologists" will share their work load with the equal number of existing "general" gastroenterologists. Will their life be less boring ? No, just that all specialists of this field need to take half of their time to work on this program - with the same sequel.

There is an even deeper implication. If the number of medical student remains the same, our deduction means that each year two (hopefully not more) graduates would then be diverted from other important specialties. By promoting this program, we have a trivial fewer – say – ophthalmologist, surgeon, or cardiologist. Do you mean these people are now often at a leisure and enjoying extra pair of hands ?