Four years ago, as ObamaCare was being debated, and as action on expanding physician supply languished (as is still the case), I wrote on this blog, “More Jobs, But Not Without More Physicians.” Over the previous decade, with the boom of the housing bubble and the recession that followed, the US had added only 6 million jobs, and half of those jobs were in health care.

This engine of health care jobs continued in the years after 2009 at about 30,000 new jobs per month, but since the beginning of 2013, it has slowed. Since May, health care jobs have grown at only 2/3 the previous rate, and the number of jobs in physicians’ offices has declined from a previous average of 4,000 monthly to zero. In fact, last month there was a small loss of jobs in physicians’ offices. Physicians are being squeezed, and its effect is rippling through the job market.

The top figure shows the long-term trend of jobs in physicians’ offices from 2000 to today. Below it is a graph of the past 18 months, from Jan 2012 to today.

The nation’s greatest engine of jobs is sputtering. Res ipsa loquitur!