I have been closely following events relating to our increasingly shared and "uberized" economy. I think that this new approach will have a major effect in some yet unforeseen ways on healthcare delivery (see: Relevance of an "Uberized" Economy for Healthcare and Even Perhaps Pathology). For example, I suspect that many of the physicians who work for HealthTap have other jobs (see: HealthTap's MDs Offer Web-Based E-Consultations; Also Lab Tests from Quest). It was therefore with great interest that I read an op-ed piece in the NYT by Tyler Cowen, one of my favorite economists (see: In an Uber World, Fortune Favors the Freelancer). Below is an excerpt from it:
With the rise of companies like Uber, entrepreneurs in a variety of fields are extending the concept of connecting customers and workers in what is sometimes called the new sharing economy....Many taxi drivers dislike the competition from Uber, but we need to think more systematically about the winners and losers as these new institutions develop. The greater convenience they provide consumers is obvious, but is this generally a good or bad thing for people on the other side of the market, the workers? One recent study...suggested that Uber drivers earned more than typical taxi drivers and chauffeurs....Such services are likely to continue to spread. If they do, what else is there to say about their broader implications?....Uber drivers are much more likely to have a college degree than are taxi drivers or chauffeurs, according to ...[a recent] study. It found striking differences between the two groups: 48 percent of Uber drivers have a college degree or higher, whereas that figure is only 18 percent for taxi drivers and chauffeurs....
To get a better handle on how some workers might lose, consider a hypothetical situation in which such services ...do not exist. Let’s say a software company receives periodic contracts to execute projects, but it has to rely entirely on current full-time staff. The company then must train its workers to handle a wide variety of possible projects, and so the amount and cost of corporate in-house education go up. But all things being equal, because this training costs something to the company, worker wages will be lower. ....But some self-starting workers might have learned the material on their own anyway. Those workers receive more in-house education than they need, which, in turn, means they are paid lower wages and might well be worse off than they would have been in an economy that encourages self-training and freelance opportunities. One implication is that if the Uber idea spreads, it could discourage corporate training and may require that workers have stronger educational backgrounds.
In my blog note about how an uberized economy might affect pathology I floated the following idea:
There may be a number of positions in, say, pathology and hospitals where an on-line workforce could be tapped into periodically. In short, there may be times of unexpected work surges when additional personnel such as medical technologists or even pathologists must be quickly sought and an on-line marketplace for such personnel would be helpful. Needless to say, companies that enter into such a market as intermediaries like Uber would need to pay special attention to training, credentials, and reliability of participating personnel.
Running with Cowen's idea, a director of a hospital pathology department might forsake a broad training approach for medical technologists in the labs which could be considered analogous to Tyler Cowen's reference above to "corporate in-house education." Instead, the director might turn to an on-line shared medical technologist service supplying part-time personnel for the blood bank or microbiology. The salary offered to such part time employees could be higher because of the savings realized by the reduction of in-house education. It would be a good "uberized" deal for these part-timers with specialized skills because they could work fewer hours at a higher rate of pay.