Medscape Salary Survey 2012: Radiology goes from $350k to $315k in 1 year

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Originally Posted by Green Grass

2010 MGMA for Academic Radiologists: $351,950 (significantly lower than the $515,354 for all radiologists).

2011 MGMA for All Radiologists: $471,253 (vs. $515,354 in 2010 - this is a 9% decrease in pay between 2010 and 2011)

Projected 2012 MGMA for All Radiologists: $428,840 (based on another 9% decrease from the 2011 data)

Is there a report for the 2011 MGMA? I can't find it anywhere.

Sent from my ADR6300 using SDN Mobile

Originally Posted by cbtk18

Is there a report for the 2011 MGMA? I can't find it anywhere.

Sent from my ADR6300 using SDN Mobile

Yes, but I don't have access to it. These reports are actually quite expensive to buy, but I was able to find the 2010 MGMA data online - pdf version. The 2011 MGMA data is not floating around in pdf format anywhere (at least that I have found).

http://www.mgma.com/blog/Highlights-...sation-survey/

Here is some info about 2010 salaries - which are reported in the 2011 MGMA survey.

Radiology - $471,253 (-1.58 percent drop from previous year)

Originally Posted by Green Grass

http://www.mgma.com/blog/Highlights-...sation-survey/

Here is some info about 2010 salaries - which are reported in the 2011 MGMA survey.

Radiology - $471,253 (-1.58 percent drop from previous year)

How about information on starting salaries out of residency/fellowship? Don't most of these reports have stats for those with 0-5 years experience?

I feel like those numbers might be most informative (and personally relevant).

Originally Posted by johnnydrama

How about information on starting salaries out of residency/fellowship? Don't most of these reports have stats for those with 0-5 years experience?

I feel like those numbers might be most informative (and personally relevant).

http://www.cardiovascularbusiness.co...ensation-tiers

Ask and you shall receive.

First-Year Post-Residency or Fellowship Compensation

• Radiology: Diagnostic-Invasive Median: $350,000
• Radiology: Diagnostic-Noninvasive Median: $288,000

All Physicians First-Year (Excluding First-Year Post-Residency or Fellowship) Compensation

• Radiology: Diagnostic-Invasive Median: $400,000
• Radiology: Diagnostic-Noninvasive Median: $350,000

The survey is based on data collected from 4,295 providers, with 1,986 directly out of residency or fellowship. Data are taken from MGMA’s Physician Placement Starting Salary Survey: 2011 Report Based on 2010 Data.


The odd thing is that they are claiming to use the 2011 MGMA data, but their stated salaries are different from the salaries I found elsewhere. Either way, it appears you start out roughly $50k lower than you can expect.

Originally Posted by johnnydrama

How about information on starting salaries out of residency/fellowship? Don't most of these reports have stats for those with 0-5 years experience?

I feel like those numbers might be most informative (and personally relevant).

I feel like it will be 150-200K first year out of training by the time we are done. Not bad, but nothing like the golden age of medicine.

Originally Posted by badasshairday

I feel like it will be 150-200K first year out of training by the time we are done. Not bad, but nothing like the golden age of medicine.

If that's the case, will primary care docs be working for free then? I don't think that'll happen, most people won't go into longer residencies, and fewer and fewer people will be going into medicine, which will further aggravate the doctor shortage.
When PA's are making 100k, and when a 12+ year education makes you only 50k more, tumble weeds will start rolling.

No way it drops to 150. I think that our salaries (and most specialties salaries) will bottom out at 250k

Originally Posted by cowme

No way it drops to 150. I think that our salaries (and most specialties salaries) will bottom out at 250k

Why? I'd still work at $150k and I'm sure I'm not the only one. If I can earn $150k at a job I like in my preferred location, that would be pretty great actually. (I doubt I will be able to remain in NYC at all.)

Originally Posted by johnnydrama

Why? I'd still work at $150k and I'm sure I'm not the only one. If I can earn $150k at a job I like in my preferred location, that would be pretty great actually. (I doubt I will be able to remain in NYC at all.)

I like you enthusiasm and passion toward radiology, but I think you willingness to accept being paid less than half of what you deserve as a radiologist is endangering the future of the field.

That's my $0.02

Originally Posted by johnnydrama

Why? I'd still work at $150k and I'm sure I'm not the only one. If I can earn $150k at a job I like in my preferred location, that would be pretty great actually. (I doubt I will be able to remain in NYC at all.)

That's great...but I wasn't asking whether people would work for 150k. I'm just saying salaries won't drop that low (unless you are an associate professor at a big name northeast program...I've heard they make NOTHING, which is sad considering they are the ones advancing our field)

Originally Posted by Ibn Alnafis MD

I like you enthusiasm and passion toward radiology, but I think you willingness to accept being paid less than half of what you deserve as a radiologist is endangering the future of the field.

That's my $0.02

I'm not going to accept less than what other people are getting (in the same market). I fully intend to be an above average if not superb radiologist, and will negotiate accordingly.

That said, it's what I want to do and if the salary drops, I won't like it, but I'll accept it.

So whats the verdict ladies and gents,

Why is MedScape salaries much lower than MGMA?

Is it because MGMA includes other perks/bonuses?

Originally Posted by Ibn Alnafis MD

I like you enthusiasm and passion toward radiology, but I think you willingness to accept being paid less than half of what you deserve as a radiologist is endangering the future of the field.

That's my $0.02

I'm with you. I agree that no one needs 600k or some ridiculous amount of money like that, but to suggest that you'd work for what midlevels make is what makes others think-well if this doc will work for crap,why won't others? Fair compensation is appropriate, and just accepting anything will seriously hurt the field.

Originally Posted by Blitz2006

So whats the verdict ladies and gents,

Why is MedScape salaries much lower than MGMA?

Is it because MGMA includes other perks/bonuses?

yes...that and medscape includes part-timers

Originally Posted by Dumb

yes...that and medscape includes part-timers

Right. So would you say that the MGMA data is more 'accurate', for lack of better words...

that's a very good point, about 40% of radiologists in the medscape survey work less than 40 hours per week... but the percent of radiologists in the survey working <40hrs / wk hasn't changed much since last years survey (in fact a greater percentage of them worked <40 hrs in 2011, about 43%), so that 10% decline over 1 year may be accurate..

Originally Posted by Blitz2006

Right. So would you say that the MGMA data is more 'accurate', for lack of better words...

No. MGMA is misleading because they include compensation that is not liquid, including that which cannot be accessed until retirement. Also, I was too lazy to mention it before, but the 515k MGMA 2010 figure is wrong...the poster didn't average all of the rads incomes...it is actually ~490k if you want to compare with other surveys.

Bottomline...subtract 50-100k off any MGMA figure to get the actual yearly gross income.

I'd actually say the best salary breakdown was at salary.com. If you're interested, on the website they detail their methodology, which seems to be quite extensive and professional.

MGMA includes bonuses, and other benefits (including health insurance, malpractice insurance, etc). medscape doesn't. The true salary is probably somewhere in the middle between MGMA and medscape

Originally Posted by Dumb

No. MGMA is misleading because they include compensation that is not liquid, including that which cannot be accessed until retirement. Also, I was too lazy to mention it before, but the 515k MGMA 2010 figure is wrong...the poster didn't average all of the rads incomes...it is actually ~470k if you want to compare with other surveys.

Bottomline...subtract 50-100k off any MGMA figure to get the actual yearly gross income.

I'd actually say the best salary breakdown was at salary.com. If you're interested, on the website they detail their methodology, which seems to be quite extensive and professional.

Would love to know where I went wrong with my MGMA figures (see attachment). I stated in a later post that $515k does NOT include academic salaries.

Originally Posted by Medstudentquest

I'm with you. I agree that no one needs 600k or some ridiculous amount of money like that, but to suggest that you'd work for what midlevels make is what makes others think-well if this doc will work for crap,why won't others? Fair compensation is appropriate, and just accepting anything will seriously hurt the field.

What's the alternative? Not work at all?

$150k >>> 0.

I'm sorry, but no one's pulling a John Galt here.

Originally Posted by Green Grass

Would love to know where I went wrong with my MGMA figures (see attachment). I stated in a later post that $515k does NOT include academic salaries.

Radiology: Diagnostic-Invasive $479,896
Radiology: Diagnostic-Noninvasive $515,354
Radiology: Neurological *
Radiology: Nuclear Medicine $475,915

sorry...490k is the avg. you have to include all of these (not just diag noninv) to compare it to medscape, salary.com, etc.

This is exactly why working for the Gov AKA the voters (we're a republic after all) sucks. They will always look at your income and say to themselves "why do they need to make that much relative to me". The question should be "Do I want to spend this much money on this particular imaging study for my health".

When people buy an I-phone no one b*tched that Jobs or any of his executive staff or engineers made too much money - they asked themselves if they wanted to spend a couple hundred bucks for a phone. The same could be said for most other good and services - look at the individual price and not someones salary - how little would a radiologist need to price their individual studies in order to make out to 150k?. 150k for the amount of work, responsibility, and demand that you undertake is extremely low.

People are living beyond their means at your expense by dictating pay cuts for you via Gov policy. That doesn't upset you?

"Who is John Galt?"

"I hear he goes by the alias Johnny Drama."

Originally Posted by johnnydrama

What's the alternative? Not work at all?

$150k >>> 0.

I'm sorry, but no one's pulling a John Galt here.

Originally Posted by yappy

This is exactly why working for the Gov AKA the voters (we're a republic after all) sucks. They will always look at your income and say to themselves "why do they need to make that much relative to me". The question should be "Do I want to spend this much money on this particular imaging study for my health".

When people buy an I-phone no one b*tched that Jobs or any of his executive staff or engineers made too much money - they asked themselves if they wanted to spend a couple hundred bucks for a phone. The same could be said for most other good and services - look at the individual price and not someones salary - how little would a radiologist need to price their individual studies in order to make out to 150k?. 150k for the amount of work, responsibility, and demand that you undertake is extremely low.

People are living beyond their means at your expense by dictating pay cuts for you via Gov policy. That doesn't upset you?

"Who is John Galt?"

"I hear he goes by the alias Johnny Drama."

Jobs had a salary of $1. Even I'm not going that low.

Seriously though, I'm not likely to earn more than $150k doing anything else I'd enjoy as much as radiology, so yes, I'd work for that amount if I have no other options.

lol. Well when you have his options $1 dollar doesn't seem too bad; but, you get what I was saying.

I hope you never have to earn 150k working full time even though you enjoy it alot. I think I'll really enjoy the field I'm interested in too; but, I always have had this crazy idea of trying to set up my [future] children and wife really well, financially. Given the lost wages & debt this would be difficult on 150k.

I feel making 300k (adjusted for inflation) I could meet my financial goals by the time the costs of my goals came due. More than that... well that would be just great too.

GL.

Originally Posted by johnnydrama

Jobs had a salary of $1. Even I'm not going that low.

Seriously though, I'm not likely to earn more than $150k doing anything else I'd enjoy as much as radiology, so yes, I'd work for that amount if I have no other options.

Originally Posted by yappy

lol. Well when you have his options $1 dollar doesn't seem too bad; but, you get what I was saying.

I hope you never have to earn 150k working full time even though you enjoy it alot. I think I'll really enjoy the field I'm interested in too; but, I always have had this crazy idea of trying to set up my [future] children and wife really well, financially. Given the lost wages & debt this would be difficult on 150k.

I feel making 300k (adjusted for inflation) I could meet my financial goals by the time the costs of my goals came due. More than that... well that would be just great too.

GL.

I'm with you dude.

Originally Posted by yappy

This is exactly why working for the Gov AKA the voters (we're a republic after all) sucks. They will always look at your income and say to themselves "why do they need to make that much relative to me". The question should be "Do I want to spend this much money on this particular imaging study for my health".

When people buy an I-phone no one b*tched that Jobs or any of his executive staff or engineers made too much money - they asked themselves if they wanted to spend a couple hundred bucks for a phone. The same could be said for most other good and services - look at the individual price and not someones salary - how little would a radiologist need to price their individual studies in order to make out to 150k?. 150k for the amount of work, responsibility, and demand that you undertake is extremely low.

People are living beyond their means at your expense by dictating pay cuts for you via Gov policy. That doesn't upset you?

"Who is John Galt?"

"I hear he goes by the alias Johnny Drama."

Jesus Christ, I've addressed this numerous times before.

You can't have it both ways. You either take the government oversight on Medicare fee scheduling, along with legislative protection against oversupply (by mechanism of any health care system training their own providers) OR you sink or swim in a purely free market where you charge what you want in a very competitive market where there will be a glut of physicians compared with the present numbers (think law school).

Ipads are priced as they are, because they operate in a completely free market. Should the price of an Ipad exceed the ability of the public to pay, then they will turn to cheaper alternatives such as the Samsungs or the Kindles. The fact that the medical industry is tightly controlled (and this is to your benefit) renders it impossible for the government to say "ok, charge whatever you want."

Originally Posted by bronx43

Jesus Christ, I've addressed this numerous times before.

You act like people care about your input

Originally Posted by cowme

You act like people care about your input

Don't think he cares about getting credit.

It's just annoying seeing the same irrational trains of thought pop up repeatedly.

lol.

Originally Posted by cowme

You act like people care about your input

Uh... no, kid. I'm not. I don't give a rat's ass what you people think. But, if you're going to keep posting the same stupid crap over and over again, then you should defend your position against counter arguments.

If you have a valid response to my post (which I doubt), please post it. Otherwise, it's pathetic to pick out lone sentences, and go all highschool up in here.

Nobody wants to get paid 40K/year after doing 15 years of training. But
If you really care whether you make 200K or 250K, you will be miserable.
1. The income even in the same geographic region is very variable. There are a lot of group to group variability.
2. Nobody can not predict the future, but I bet you will see many swings your job condition and income in the next 35 years. It is a part of each job. There will be times that you will be miserable, times that you will be happy and times you will be OK. Don't doubt it. The important thing is to do what you like. If you hate what you do, no matter what you make, you will be miserable. On the other hand if you can not be happy with 200K, be sure you will not be happy with 150K or 300K.
3- Medicine in general has one of the best job securities and job prospects and still the most anxious people are doctors. The most obsessed ones with salary and job are doctors. Sometimes I think, probably we do not have anything else in our life to be proud of. We have invested our whole life on something and there is no way we can even imagine our investment has failed. That is why we are over-anxious about the future.
4- I can assure you whatever you do in medicine, whether Peds or Ortho, Pathology or Surgery, Radiology or OB-Gyn, you can make a comfortable life. You will not be rich to the point that you quit working. You will have a high middle class life style and you will not struggle providing yourself and your family a decent life, BUT you will be working the rest of your life in the same field. So rather than calculating the numbers, choose wisely. If you don't like it, get out. Life is more valuable than wasting your time doing something you hate, even if you make a bank.

holy crap that was inspiring

Originally Posted by bronx43

you should defend your position against counter arguments.

If you have a valid response to my post (which I doubt), please post it.

Bronx, I'm a bit disappointed in you brah. You didn't bother replying to either of my valid responses in the Future of Rads vs. Ortho or the Doom and Gloom threads.

Originally Posted by shark2000

Nobody wants to get paid 40K/year after doing 15 years of training. But
If you really care whether you make 200K or 250K, you will be miserable.

That's not entirely true. Money adds up, especially if you have kids, and have loans to pay off (which is true of most newbie docs after residency). 200k is ~125k after taxes. If you have kids, add about 15k per child. Also, your wife won't be working because she has her hands full with the kids, so add about 10-15k to support her. Assume you want to pay off 10% of your loans per year, that adds another 10-20k. Now add savings (another 10-15k, more if you want to save for college for your kids). There is half your salary right there, and we haven't even discussed rent/mortgage payments, utilities, transportation and entertainment. The extra 50k can absolutely make the difference between living comfortably and feeling guilty for going out to dinner.

Originally Posted by cowme

That's not entirely true. Money adds up, especially if you have kids, and have loans to pay off (which is true of most newbie docs after residency). 200k is ~125k after taxes. If you have kids, add about 15k per child. Also, your wife won't be working because she has her hands full with the kids, so add about 10-15k to support her. Assume you want to pay off 10% of your loans per year, that adds another 10-20k. Now add savings (another 10-15k, more if you want to save for college for your kids). There is half your salary right there, and we haven't even discussed rent/mortgage payments, utilities, transportation and entertainment. The extra 50k can absolutely make the difference between living comfortably and feeling guilty for going out to dinner.

That's your flaw my friend. Just marry another doctor and your problems are solved.

Originally Posted by cowme

That's not entirely true. Money adds up, especially if you have kids, and have loans to pay off (which is true of most newbie docs after residency). 200k is ~125k after taxes. If you have kids, add about 15k per child. Also, your wife won't be working because she has her hands full with the kids, so add about 10-15k to support her. Assume you want to pay off 10% of your loans per year, that adds another 10-20k. Now add savings (another 10-15k, more if you want to save for college for your kids). There is half your salary right there, and we haven't even discussed rent/mortgage payments, utilities, transportation and entertainment. The extra 50k can absolutely make the difference between living comfortably and feeling guilty for going out to dinner.

Definitely a first world problem, though. Heck, that's above the 97th percentile of income for the United States, a not too shabby country.

Of course. I'm just saying it's not unreasonable to care about 250k vs 200k. I think 250k is truly the cutoff for a family of four to live comfortably.

Originally Posted by cowme

Of course. I'm just saying it's not unreasonable to care about 250k vs 200k. I think 250k is truly the cutoff for a family of four to live comfortably.

This is silly. Especially if you live somewhere with cheap real estate and good public schools. Many people manage to raise 4 kids on much less.

If on the other hand you need to live in Manhattan and want to send 4 children to private schools, $250k won't be close to enough.

Doctors live in a range where we really shouldn't complain about salary, but we'll never have the effortless lifestyle of the truly rich. Aside from a few tech exceptions, that lifestyle is much more likely to be inherited than earned these days.

Originally Posted by johnnydrama

This is silly. Especially if you live somewhere with cheap real estate and good public schools. Many people manage to raise 4 kids on much less.

If on the other hand you need to live in Manhattan and want to send 4 children to private schools, $250k won't be close to enough.

Doctors live in a range where we really shouldn't complain about salary, but we'll never have the effortless lifestyle of the truly rich. Aside from a few tech exceptions, that lifestyle is much more likely to be inherited than earned these days.

Let's continue our calculations shall we?

So far, we've got:
200K - 80K for taxes: 120K left
down to 90K with 2 kids (average family size in US)
add another 10K for the wife. Down to 80K
65K after paying 10% of 150K of loans (the average med school debt)
45K after adding 20K/year for savings (10% of your salary. And this is assuming saving for public colleges for your kids. Add more if you want to send them to an Ivy)

So now the rest:

Live in a cheap area you say? OK, lets go with Pittsburgh, generally considered the city with the lowest cost of living. According to Trulia, the average 3 Bedroom home goes for 125K. With a 15 year mortgage, that will put you around 15K/year.

Now you have 30K left. Add another 3K for utlities. 27,000 remain.

Oh, but you'll need a car. Nothing too fancy, just get an average car, for the average cost an American spends. That'll cost you around 10K/year with soaring gas prices and maintenance etc. 17K left. And that is for one car. If the wife needs one to run errands while you are at work, add another 8-10K

So there. You have about 1,400 dollars/month to spend on everything else for a family of four (groceries, furniture, insurance, shopping, home repairs, eating out, coffee, movies, vacation). And this is assuming you live in Pittsburgh. If you decided to stay in place you actually wanted to live, like in california, or in boston.....Good luck.




I agree this is a first world problem. And it will resolve by the time you are 15 years established, and have paid off your house and loans. But most doctors didn't expect to wait until they were 45 to really be able to live comfortably.

I was one of those who was raised by parents on a ~28-35k combined family incomes as one of four kids. The thing is I saw myself going down the same route, not going to college, working to just get by in the military, and blowing money on stupid kid stuff like cars and dates.

Then I saw a medical profession that really interested me where I could have a respectible education with real employment prospects. I think that's why I get sensitive about this stuff. You work hard to get ahead then it seems as though circumstances are trying to push you back into that hole they call poverty.

50k is a huge deal.

Originally Posted by yappy

50k is a huge deal.

Honestly, it depends which $50k.

The difference between 0 and 50 is incalculable.

50 to 100 is a completely different lifestyle.

100 to 150 is huge, but less significant.

200 to 250 should be a factor, but should not be the main deciding factor when choosing a specialty.

Someone like Mitt Romney with $250m considers earning $350k "basically nothing".

The marginal utility of money decreases as you get more of it.

You know...i couldnt help wondering what it would look like if the reality of salaries in medicine was turned on its head, so that radiologists and anesthesiologists made $150 - $200k, and primary care and internists, $300 - $400k....and perhaps neurosurgeons were paid, say, umm...$250 - $300k...

Ok, I know this is FAR from realistic, but just a thought...i can only imagine

Originally Posted by Descarteo

You know...i couldnt help wondering what it would look like if the reality of salaries in medicine was turned on its head, so that radiologists and anesthesiologists made $150 - $200k, and primary care and internists, $300 - $400k....and perhaps neurosurgeons were paid, say, umm...$250 - $300k...

Ok, I know this is FAR from realistic, but just a thought...i can only imagine

Honestly? I'd still go into radiology. But I know I may be the exception.

Originally Posted by johnnydrama

Honestly? I'd still go into radiology. But I know I may be the exception.

Yes, yes you are.

no he's not. I would have chosen radiology regardless of the salary. My rant about 200K earlier is just venting. This is still the only field in medicine I could tolerate, and if it didn't exist, I would have dropped out of medicine altogether.

Originally Posted by cowme

no he's not. I would have chosen radiology regardless of the salary. My rant about 200K earlier is just venting. This is still the only field in medicine I could tolerate, and if it didn't exist, I would have dropped out of medicine altogether.

I think at least 30% if not 50% of the students going into radiology are doing it for the high salary, which is silly because it might not be there when they finish residency.

It helps explain a bit of the doom and gloom on Aunt Minnie.

Originally Posted by bronx43

Jesus Christ, I've addressed this numerous times before.

You can't have it both ways. You either take the government oversight on Medicare fee scheduling, along with legislative protection against oversupply (by mechanism of any health care system training their own providers) OR you sink or swim in a purely free market where you charge what you want in a very competitive market where there will be a glut of physicians compared with the present numbers (think law school).

Ipads are priced as they are, because they operate in a completely free market. Should the price of an Ipad exceed the ability of the public to pay, then they will turn to cheaper alternatives such as the Samsungs or the Kindles. The fact that the medical industry is tightly controlled (and this is to your benefit) renders it impossible for the government to say "ok, charge whatever you want."

People may not like what Bronx is saying, but he is absolutely correct. The very reason that physicians can expect to make the inflated incomes that they do is because there is a tight, artificial control on the supply of doctors. As mentioned above, Law schools have much less of this control, thus their wages are much more depressed. When I was younger I remember my father recounting his father's criticism of the medical profession back in the 70's. His father said something along the lines of, "the only reason that doctors are wealthy is because they limit their supply. And the Dermatologists have it especially good." (I thought that last part was funny). So yes, the very reason that you can expect to earn AS MUCH AS 3-400K in rads is because of the artificial supply. But human nature is such that, no matter how much anyone earns, they always expect to earn more. If you earned 1 billion dollars one year, and then had it cut to half of that the next, you would complain--never mind the fact that you still earned HALF A BILLION DOLLARS. The same idea is true in radiology. The incomes in the field in recent years have become fairly inflated, and now that they are being brought down to more reasonable (albeit still high) levels, people complain. It's human nature. But you have to take a step back and realize that you are still earning A LOT of money. Any high earning profession or field is more subject to earnings fluctuations that the average joe blow is. CEOs do not get ever-higher compensation year after year, and like wise neither do doctors. THat volatility is the price you pay for being in a relatively high-earning field.

Someone previously on this thread mentioned that physicians are, on the whole, anxious people. I would agree with that. Look at some of the threads on SDN and Aunt Minnie. People are seriously worried about their (inflated) incomes going down 10%, while half the country is on the brink of losing their homes and jobs. And many of these people are well educated, bright, ambitious driven people--who will never earn 350K or have the job security of a physician. Doctors, for whatever reason, are some of the most paranoid and I think risk-averse people out there. Stop worrying. The sky is not falling. Medicine is an awesome profession that beats the hell out of most other professional jobs--the majority of which are mind-numbing and stressful.

Everyone on here talking about "limiting supply" are like the people who complain about IP law, or how some good ideas lack capital, in order to explain why some companies are successful. If ONLY "X" were not the case "Y" good/service/whatever would not have as much value.

I got a new one: If only autonomous robots could run companies based on real time market data and be uploaded with all the best risk analysis software. Then flesh and blood CEO's couldnt break 50k!

Or how about:

If the NBA opened up their ranks a little bit more. Enrolled any willing HS student who could hit a shot from the free throw line. Then professional athletes would only get paid a $20 per game!

This isn't some zero sum game like Bronx suggests. The bottleneck is in the infrastructure/staff/medicare funding/clinical sites/ and legth of time to train and educate physicians. The demand is running away from the supply due to those reasons and a aging population. Guess what this would mean in most industries? Not a pay cut. The market doesn't care what barriers there are for entry weather it be capital, education, IP, etc. In fact the mark of a successful business model is to have something proprietary about it.

The reason salaries went down was because of capitation.

Bronx, honestly man, I think you need to stick to clinical medicine. I dont see you running a lemmon aid stand with your "if-wishes-were-fishes" mentality towards market pressures.

1- The average income for family in US is around 50K. For a PHD (which is highly educated and skillful member of society) the average is around 80-100K. If you can make a happy life with 200K which is in top 97% of the Americans and top 99% of the world, there is something wrong with you and not with the salary itself. Do not repeat that you have student loans. Even taking that into account, your salary is in the same percentile.

2- While you can not take any risk and you are anxious that 20 years from now your salary may drop 20% or 30%, do not complain that business people make a million. They can loose all they have over a night. So it is like a gamble, the more you risk, the more you take. If you are not a risk taker, do not envy those who put all they have on the table.

3- Doctors in general are over-obsessed with money. Why? because we do not have anything in life. We spent the best years of our life studying while others had enough fun. Now we want at least convince ourselves that we did not waste our time and we are better than them. That is why if you do it solely for money, you will be miserable anyway. Even if you make 800K, you will envy the next door non-doctor neighbor who is making 2 mil without doing all the BS you have gone through. That is the end result of doing medicine just for money.