How does compensation affect your interest in a specialty?

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I came across this survey of physicians in the field and I'm wondering if it has any bearing on your guys' interest in specializing.

http://www.medscape.com/features/sli...on/2012/public

A lot of premeds I have spoken to have stated they'd like to go into ortho or radiology. I didn't realize before looking at the survey that these are the highest paying fields. Anyways, let me know what you guys think.

That's the premed mentality because many go into medicine for the wrong reasons. But for me personally, a little. I am open to everything but I am not gunning for something ultra competitive so it isn't huge, but it is enough not to sign any primary care scholarship contracts. Truthfully, if peds wasn't the lowest paid, I would sign a contract tofay, but a quarter million dollars worth of debt and three kids currently, specialty pay weighs on my mind.

Obviously compensation matters. You're sinking in 10 years of your life just to train to be a doctor, you don't want to be paid peanuts relative to your time and financial investments (eg lost earnings).

0; as long as I can pay off my loans and live modestly well.

For me, zilch. I'm aiming to go into the lowest paying field because of pure love of the jobs.

I guess it's going to matter for some. But if people are driven to become a doctor mainly through compensation, they are in for a huge surprise. Like a birthday party surprise, except less amusing.

Originally Posted by Aerus

For me, zilch. I'm aiming to go into the lowest paying field because of pure love of the jobs.

I guess it's going to matter for some. But if people are driven to become a doctor mainly through compensation, they are in for a huge surprise. Like a birthday party surprise, except less amusing.

I don't think this is an issue of whether your primary reason for entering medicine should be monetary. Rather, after deciding on medicine, does your degree of educational debt affect your ultimate specialty choice? Personally, I'd say yes. You could have a passion for primary care, but if you have a mountain of student loan debt forcing you to live paycheck to paycheck for the next 25 years, you're going to be miserable.

Originally Posted by EBTrailRunner

I don't think this is an issue of whether your primary reason for entering medicine should be monetary. Rather, after deciding on medicine, does your degree of educational debt affect your ultimate specialty choice? Personally, I'd say yes. You could have a passion for primary care, but if you have a mountain of student loan debt forcing you to live paycheck to paycheck for the next 25 years, you're going to be miserable.

That's true, but one should already consider the huge amounts of school debt when entering the medical field or even going into premed. Financial aid, while existent, is often rare or insufficient for the majority of medical students.

Pick the job/specialty that you're going to be happy doing and that you won't mind working for the rest of your life. Yes, the pay won't be wonderful initially leaving residency, but it's going to get better if you're doing something you love rather than something that pays well. I would be completely miserable as a surgeon, to be honest. That's not much better in my eyes.

Originally Posted by centraldogma

I came across this survey of physicians in the field and I'm wondering if it has any bearing on your guys' interest in specializing.

http://www.medscape.com/features/sli...on/2012/public

A lot of premeds I have spoken to have stated they'd like to go into ortho or radiology. I didn't realize before looking at the survey that these are the highest paying fields. Anyways, let me know what you guys think.

This is part of the reason 3rd year rotations are so important. Many find that a lot if the well paying and lifestyle specialties are not their cup of tea, while some things that aren't that well paid give a lot of job satisfaction. If you come to the realization that you hate something, you probably will appreciate that doing it 80 hours a week for the next 40 years is going to be so bad that no amount of money will make it palatable. It's a life sentence -- the majority of your awake hours for the rest of your life probably. So dont get sucked in to the premed foolishness. If you aren't excited about ortho for other than the salary you really can't do ortho. You need to pick something you enjoy, after seeing as many options as you can firsthand. I would ignore the salary numbers and hours -- they will likely drastically change by the time a premed finishes residency anyhow. Healthcare is very much in a state of flux right now. Ortho spine got hit very hard in the last set of reimbursement cuts (not reflected yet in the medscape numbers); radiology is likely on the chopping block for the next set of cuts.

Originally Posted by Law2Doc

This is part of the reason 3rd year rotations are so important. Many find that a lot if the well paying and lifestyle specialties are not their cup of tea, while some things that aren't that well paid give a lot of job satisfaction. If you come to the realization that you hate something, you probably will appreciate that doing it 80 hours a week for the next 40 years is going to be so bad that no amount of money will make it palatable. It's a life sentence -- the majority of your awake hours for the rest of your life probably. So dont get sucked in to the premed foolishness. If you aren't excited about ortho for other than the salary you really can't do ortho. You need to pick something you enjoy, after seeing as many options as you can firsthand. I would ignore the salary numbers and hours -- they will likely drastically change by the time a premed finishes residency anyhow. Healthcare is very much in a state of flux right now.

qft

The link you sent was really interesting. Thanks! Also, interesting it says about 50% of doctors wouldn't go into medicine again...I wonder how much of this is "grass is always greener" syndrome?

Originally Posted by RedSox10

The link you sent was really interesting. Thanks! Also, interesting it says about 50% of doctors wouldn't go into medicine again...I wonder how much of this is "grass is always greener" syndrome?

That was a really surprising statistic. It was nice that they followed that question up to see why there was so much frustration/regret.

I'd probably say you're right about 'grass is greener'. Doctors seeing they're salaries go down over the past few years believe they might have been more successful in business or another field. I'm sure the sentiment will change once the economic situation shapes up.

Originally Posted by centraldogma

That was a really surprising statistic. It was nice that they followed that question up to see why there was so much frustration/regret.

I'd probably say you're right about 'grass is greener'. Doctors seeing they're salaries go down over the past few years believe they might have been more successful in business or another field. I'm sure the sentiment will change once the economic situation shapes up.

The forces pushing healthcare reimbursement down are not likely to reverse upon a rebound of the economy. Reimbursement will likely continue to decrease for the foreseeable future in many areas.

I literally know people who would pick x specialty over y specialty because it makes 340k instead of 320k....
With that being said, money does matter a lot though and is a major factor.

none, I want to do a job that I truly love. If I wanted to make money I would do something else like business. I have to say this premed mentality bothers me a lot because I think that is part of the problem in the shortage of primary care and how expensive health care is.

I've always been really interested in forensic pathology, but it's so low paying I'm not sure the salary would be enough to pay back loans and support a family so I've definitely be researching other specialities. Money wouldn't be the only reason I choose something, but it will certainly be a factor.

Originally Posted by Law2Doc

This is part of the reason 3rd year rotations are so important. Many find that a lot if the well paying and lifestyle specialties are not their cup of tea, while some things that aren't that well paid give a lot of job satisfaction. If you come to the realization that you hate something, you probably will appreciate that doing it 80 hours a week for the next 40 years is going to be so bad that no amount of money will make it palatable. It's a life sentence -- the majority of your awake hours for the rest of your life probably. So dont get sucked in to the premed foolishness. If you aren't excited about ortho for other than the salary you really can't do ortho. You need to pick something you enjoy, after seeing as many options as you can firsthand. I would ignore the salary numbers and hours -- they will likely drastically change by the time a premed finishes residency anyhow. Healthcare is very much in a state of flux right now. Ortho spine got hit very hard in the last set of reimbursement cuts (not reflected yet in the medscape numbers); radiology is likely on the chopping block for the next set of cuts.

Radiology has been on the chopping block for 5 years. Salaries dropped from ~500K average in 2006 to ~300K average (salaries this year alone dropped over 10%). At the same time, the number of studies read per day has skyrocketed to the point that most rads no longer take lunch breaks, ever. Not that either is a huge deal for most, but it's definitely a drastic change for the established rads in practice. There are no signs of the cuts letting up any time soon either.

Originally Posted by lobo12

none, I want to do a job that I truly love. If I wanted to make money I would do something else like business. I have to say this premed mentality bothers me a lot because I think that is part of the problem in the shortage of primary care and how expensive health care is.

Those are two different issues. Yes, less pay is one reason medical students choose not to enter primary care, but it's not a major contributing factor to our rocketing healthcare costs. Blame the CYA mentality for that.

Nvm

Originally Posted by EBTrailRunner

Those are two different issues. Yes, less pay is one reason medical students choose not to enter primary care, but it's not a major contributing factor to our rocketing healthcare costs. Blame the CYA mentality for that.

The way I see is that if we had a strong primary care focused in prevention, we could save a lot of money. The U.S spends a lot more than other countries which are focused in preventive medicine and strong primary care. So the fact that people are sort of "forced" (for economic reasons) to specialized indirectly affects the way the health care system works.

Originally Posted by lobo12

The way I see is that if we had a strong primary care focused in prevention, we could save a lot of money. The U.S spends a lot more than other countries which are focused in preventive medicine and strong primary care. So the fact that people are sort of "forced" (for economic reasons) to specialized indirectly affects the way the health care system works.

I feel like you don't have a clue. You can't compare us to other counties who price set the cost of medical equipment (look at drugs costs in canada for an easy one to see) and have far less fat people. Obesity is a major problem that dramatically inflates cost, complications, increased time in hospital, poor recovery so on.


If we are so concerned about "cutting costs," how about we talk about rationing end-of-life care, or at least sticking the family with a portion of the bill.

Money will play a role when you have 200k of debt and the reality kicks in that you will be accumulating interest doing residency. If you have 50k student loans from undergrad, may god have mercy on your soul.

Even if you do specialize, the caribbeaners and other FMGs will still suck up the internal med and FM spots (not all of them, but many of them, so whats the big deal?)

Surgery or bust.

About as much as your Step score affects your interests. If you're interested in something in general (e.g. surgery) and have the Step score for ortho over general, you're going to at least consider ortho. If you're debating between surgical subspecialties and you see that one pays $50k extra per year, that might play a little bit of a role. But if you have 0 interest in a specialty, salary isn't going to matter at all. I doubt you could turn a pediatrician into an orthopod just by quadrupling their salary.

A lot of things will weigh on you as your considering specialties, though. If you're anything like me you'll think a little about prestige, salary, and your Step score when you're considering specialties. Your interest will be 90% of the decision, but once you're figuring out the specifics, those things will play a role.

Here's a question:

Why does everyone say that you will be working 80 hours a week for the rest of your life? I know plenty, and I mean plenty, of physicians that work 40 hour weeks after they complete their residency. Anyone care to comment?

Originally Posted by Holy FranZ

I feel like you don't have a clue. You can't compare us to other counties who price set the cost of medical equipment (look at drugs costs in canada for an easy one to see) and have far less fat people. Obesity is a major problem that dramatically inflates cost, complications, increased time in hospital, poor recovery so on.


If we are so concerned about "cutting costs," how about we talk about rationing end-of-life care, or at least sticking the family with a portion of the bill.

Money will play a role when you have 200k of debt and the reality kicks in that you will be accumulating interest doing residency. If you have 50k student loans from undergrad, may god have mercy on your soul.

Even if you do specialize, the caribbeaners and other FMGs will still suck up the internal med and FM spots (not all of them, but many of them, so whats the big deal?)

Surgery or bust.

wait! your claiming that fat people are the problem of the high cost of health care. you have to be kidding... what a deep analysis, I must say.

Originally Posted by lobo12

wait! your claiming that fat people are the problem of the high cost of health care. you have to be kidding... what a deep analysis, I must say.

They're expensive and drive up demand. They are only one of the things I mentioned. I think the estimated 30ish percent (not looking up the numbers right now) and the other 40% of medicare we spent on end of life care play a really real role in the costs.


Go DO, they need "holistic and preventative" minded people like you.



edit: here's a nice little piece of info because you probably don't read good

"the medical care costs of obesity in the United States are staggering. In 2008 dollars, these costs totaled about $147 billion" .... imagine what is it now. Its a major issue.

For the slow and poor of detecting sarcasm: I knowingly put "good"

Choosing a specialty based upon current salary is stupid.

The most important thing is to figure out if you can imagine yourself doing that specialty for the rest of your professional life.

Relative salaries will change. Procedural specialties will always earn a bit more, but with a lifestyle trade off.

Most specialties earn similar incomes. Choosing something you don't like for an extra $50k a year is foolish.

Originally Posted by Holy FranZ

They're expensive and drive up demand. They are only one of the things I mentioned. I think the estimated 30ish percent (not looking up the numbers right now) and the other 40% of medicare we spent on end of life care play a really real role in the costs.


Go DO, they need "holistic and preventative" minded people like you.



edit: here's a nice little piece of info because you probably don't read good

"the medical care costs of obesity in the United States are staggering. In 2008 dollars, these costs totaled about $147 billion" .... imagine what is it now. Its a major issue.

For the slow and poor of detecting sarcasm: I knowingly put "good"

Sure obese people are expensive.... but they are only an element of many, which you did not make it clear in your previous post.

yes, I am "Holistic and preventative" minded, so what???
In regards to become a DO. sure why not. I want to become a Doctor period, I want to take care of patients and do the best that I can and that is up to me, not to whether I am an MD or DO.

What I said is that preventive medicine could save money.... eventually, and preventive medicine is lead by primary care providers. There are plenty of industrialized countries that have a strong focus in primary care and preventive medicine and spend a lot less in health care and they are above in the ranking of "best health care" by the WHO.

I believe in the power of prayer. God is great.

Originally Posted by tantacles

I believe in the power of prayer. God is great.

Haha, that's the opposite of what you just posted in the religion thread. Make up your mind.

Originally Posted by johnnydrama

Haha, that's the opposite of what you just posted in the religion thread. Make up your mind.

His word is the final word. I need not judge you because He will.

Originally Posted by Law2Doc

This is part of the reason 3rd year rotations are so important. Many find that a lot if the well paying and lifestyle specialties are not their cup of tea, while some things that aren't that well paid give a lot of job satisfaction. If you come to the realization that you hate something, you probably will appreciate that doing it 80 hours a week for the next 40 years is going to be so bad that no amount of money will make it palatable. It's a life sentence -- the majority of your awake hours for the rest of your life probably. So dont get sucked in to the premed foolishness. If you aren't excited about ortho for other than the salary you really can't do ortho. You need to pick something you enjoy, after seeing as many options as you can firsthand. I would ignore the salary numbers and hours -- they will likely drastically change by the time a premed finishes residency anyhow. Healthcare is very much in a state of flux right now. Ortho spine got hit very hard in the last set of reimbursement cuts (not reflected yet in the medscape numbers); radiology is likely on the chopping block for the next set of cuts.

OP, these words are so true and you should read them a few times. I was happy with two other specialties but LOVED family medicine. Going into fourth year, I will be applying to family med programs. Is it disheartening anesthesia, for example, pays almost twice as much or even more than twice? Yes. But, as L2D said above, you have to be happy with what you are doing and when I weigh the pros and cons of the three specialties I was interested in, salary became less important than my happiness among other factors.

Originally Posted by cowme

Radiology has been on the chopping block for 5 years. Salaries dropped from ~500K average in 2006 to ~300K average (salaries this year alone dropped over 10%). At the same time, the number of studies read per day has skyrocketed to the point that most rads no longer take lunch breaks, ever. Not that either is a huge deal for most, but it's definitely a drastic change for the established rads in practice. There are no signs of the cuts letting up any time soon either.

Our rad professor today quoted she was earning $12 to interpret a chest x-ray. Now, I don't know how many she could interpret in an hour, but $12 is depressing.

Originally Posted by Bacchus

Our rad professor today quoted she was earning $12 to interpret a chest x-ray. Now, I don't know how many she could interpret in an hour, but $12 is depressing.

That probably works out to $180 per hour. PP radiologists generally spend only a few minutes on CXRs.

Originally Posted by Bacchus

Our rad professor today quoted she was earning $12 to interpret a chest x-ray. Now, I don't know how many she could interpret in an hour, but $12 is depressing.

Yea that risk:benefit ratio is

.

I have a stupid amount of debt

Ruled out family med based basically on that alone.

I also don't want to do gyn stuff, so that too, I guess? Mostly I want one fewer monetary stress headache, though.

Originally Posted by Bacchus

Our rad professor today quoted she was earning $12 to interpret a chest x-ray. Now, I don't know how many she could interpret in an hour, but $12 is depressing.

12 is on the higher end of what I've heard for X rays.

But at a busy practice, you can read close to 100 x rays per day (in addition to advanced imaging-CT/MRI/US, which pays much more per study, but take proportionally much more time to interpret)