We have all become familiar with the “cyclical” nature of our economy that intermittently presents us with weak demand during economic downturn. However, as physicians, and those who recruit physicians, the “structural” changes and weaknesses that were part of this recent economic downturn were new and difficult twists that will affect the physician marketplace in the near-term, and probably in the midterm. Many well-held economic concepts seem to have been abrogated these past few years. How so?