CMS Proposing Cutting Hospital MD Pay 6-11% while increasing NP/PA pay 8%

[readmypostsMD]

It seems like we are heading that way, but I fault republicans for being a***holes. Hussein Obama basically copied their plan (Heritage Foundation), but they would not accept it because it was Obama. I will be ok if Biden propose a public option.

this aged well with m4a Kamala being picked as Biden vp

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[7331poas]

this aged well with m4a Kamala being picked as Biden vp

Does kamala want m4a?

 

[readmypostsMD]

Does kamala want m4a?

Opinion | Kamala’s Medicare-for-All Straddle

If you like your private health plan, she wouldn’t let you keep it.

www.wsj.com

Basically, yes

 

[aaronrodgers]

If M4A happen then R.I.P. physician income - we already struggle as it is from the opportunity cost because of our length of training and over 200K or more in student loan debt. If every patient becomes Medicare and Medicaid in M4A, everyone’s income will crash along with longer hours and way higher patient load. Burn out will be even higher than it already is.

 

[zero0]

If M4A happen then R.I.P. physician income - we already struggle as it is from the opportunity cost because of our length of training and over 200K or more in student loan debt. If every patient becomes Medicare and Medicaid in M4A, everyone’s income will crash along with longer hours and way higher patient load. Burn out will be even higher than it already is.

It's becoming increasingly obvious physicians are helpless in a system run by lawyers and MBAs. Sadly I don't think anyone cares. Not like people will stop going to med school and becoming doctors. In a society that's quickly circling the drain it's still one of the best deals on the table. And even then in retrospect it's a terrible deal and getting worse, let that sink in.

 

[Eye-eye]

It's becoming increasingly obvious physicians are helpless in a system run by lawyers and MBAs. Sadly I don't think anyone cares. Not like people will stop going to med school and becoming doctors. In a society that's quickly circling the drain it's still one of the best deals on the table. And even then in retrospect it's a terrible deal and getting worse, let that sink in.

I mean, from a financial standpoint, I think most docs would already have done better pursuing some sort of tech/engineer sort of gig. Those salaries seem to be continually adjusted up, while docs' basically only go down with no sign of stopping in sight. Hopefully most docs did not go into medicine just for income, but if things keep going in the direction they are now, eventually the smart ones will avoid the whole med school and long training insanity when they can make the much easier and potentially financially smarter move to just be a PA or something.

 

[readmypostsMD]

It's becoming increasingly obvious physicians are helpless in a system run by lawyers and MBAs. Sadly I don't think anyone cares. Not like people will stop going to med school and becoming doctors. In a society that's quickly circling the drain it's still one of the best deals on the table. And even then in retrospect it's a terrible deal and getting worse, let that sink in.

**** it then.

lets tack on some JDs and MBAs to our MDs and run dis **** ourselves

 

[deleted751227]

I mean, from a financial standpoint, I think most docs would already have done better pursuing some sort of tech/engineer sort of gig. Those salaries seem to be continually adjusted up, while docs' basically only go down with no sign of stopping in sight. Hopefully most docs did not go into medicine just for income, but if things keep going in the direction they are now, eventually the smart ones will avoid the whole med school and long training insanity when they can make the much easier and potentially financially smarter move to just be a PA or something.

True. Have you ever heard people saying “we spend too much on tech” or “costs for financial technology and speculation are too much of a burden” on a mainstream news outlet? How about for healthcare?

If a field is growing, the expectation in a normal system should be that wages and demand for labor to tend to that field should grow as well. Healthcare needs ARE growing but there seems to be reluctance to spend more for wages.

If incentive structures for doctors really will change due to m4a or whatever, you’d expect to see that reflect as changes in the talent we see going into medicine at a minimum of a decade or decade and a half down the line (lotta sunk costs once you’re in med school or even in a premedical track). If that does worsen outcomes, who cares, the people that made these decisions will be dead or out of office.

 

[odyssey2]

I mean, from a financial standpoint, I think most docs would already have done better pursuing some sort of tech/engineer sort of gig. Those salaries seem to be continually adjusted up, while docs' basically only go down with no sign of stopping in sight. Hopefully most docs did not go into medicine just for income, but if things keep going in the direction they are now, eventually the smart ones will avoid the whole med school and long training insanity when they can make the much easier and potentially financially smarter move to just be a PA or something.

People say this a lot, but are there really that many people in tech/engineering making much more than 150k? The people at the top may make more, but the skills required for those fields are very different than those for medicine. Even taking into account length of training and med school debt, it’s not that hard to match into a specialty that will have a bigger payoff than a typical engineering or tech salary, at least at the moment.

 

[zero0]

People say this a lot, but are there really that many people in tech/engineering making much more than 150k? The people at the top may make more, but the skills required for those fields are very different than those for medicine. Even taking into account length of training and med school debt, it’s not that hard to match into a specialty that will have a bigger payoff than a typical engineering or tech salary, at least at the moment.

On average, engineering is a crap deal. People quote anecdotes that make it seem great but it's not. Truth is basically every job sucks today. Not like in the day of the boomer when you could throw a rock and hit a high paying stable career straight out of high school.

 

[Neopolymath]

On average, engineering is a crap deal. People quote anecdotes that make it seem great but it's not. Truth is basically every job sucks today. Not like in the day of the boomer when you could throw a rock and hit a high paying stable career straight out of high school.

Everyone has an uncle that's a total ****up psychology degree dropout working outside sales making $125k. This resonates with me greatly.

 

[mesopic]

People say this a lot, but are there really that many people in tech/engineering making much more than 150k? The people at the top may make more, but the skills required for those fields are very different than those for medicine. Even taking into account length of training and med school debt, it’s not that hard to match into a specialty that will have a bigger payoff than a typical engineering or tech salary, at least at the moment.

Many people in tech are making more than 150k total compensation (salary + bonuses + stock options) even straight out of undergrad. The salary ceiling is lower than some specialties, but total compensation is usually higher (500k+), not to mention the better lifestyle and work environment in tech. Yes, hard skills are different, but if you can do well as a premed, it's definitely doable to pick up. See Compare salaries and career levels across companies | Levels.fyi for crowdsourced data on tech compensation.

 

[Neopolymath]

Many people in tech are making more than 150k total compensation (salary + bonuses + stock options) even straight out of undergrad. The salary ceiling is lower than some specialties, but total compensation is usually higher (500k+), not to mention the better lifestyle and work environment in tech. Yes, hard skills are different, but if you can do well as a premed, it's definitely doable to pick up. See Compare salaries and career levels across companies | Levels.fyi for crowdsourced data on tech compensation.

Anecdotally, my close friends in tech work less than 40 hours a week as well as receiving solid total compensation. One of them will frankly tell you he doesn't do more than 15 hours of real work a week.

That's the biggest difference between a PCP making 250k and someone in tech (at least in my experience) is that physicians actually have to produce something at work every single day to make that money and don't get all the perks of working in tech/business.

 

[odyssey2]

Many people in tech are making more than 150k total compensation (salary + bonuses + stock options) even straight out of undergrad. The salary ceiling is lower than some specialties, but total compensation is usually higher (500k+), not to mention the better lifestyle and work environment in tech. Yes, hard skills are different, but if you can do well as a premed, it's definitely doable to pick up. See Compare salaries and career levels across companies | Levels.fyi for crowdsourced data on tech compensation.

Even with that example, you have to get up to L6/E6 levels at Google or Facebook before you will exceed specialty salaries, which most tech workers are not going to do, and even if they do will take years to get there. Lifestyle and environment may be better but in most cases it's probably easier to get up to 400k-500k as a medical student than as someone entering tech or engineering. Not saying this won't change in the future but I think med students overestimate how lucrative other fields can be sometimes.

 

[slowthai]

Even with that example, you have to get up to L6/E6 levels at Google or Facebook before you will exceed specialty salaries, which most tech workers are not going to do, and even if they do will take years to get there. Lifestyle and environment may be better but in most cases it's probably easier to get up to 400k-500k as a medical student than as someone entering tech or engineering. Not saying this won't change in the future but I think med students overestimate how lucrative other fields can be sometimes.

Agreed. Examples: DR, EM, IM nocturnist, psych, FM (true for the last two if you work more hours than average), etc. These are all pretty attainable for the average med student.

 

[aaronrodgers]

If anyone is aware of TechLead on YouTube you can see for yourself the life of an ex-google ex-facebook software engineer. Not very good either to make it simple but n = 1

 

[mesopic]

Even with that example, you have to get up to L6/E6 levels at Google or Facebook before you will exceed specialty salaries, which most tech workers are not going to do, and even if they do will take years to get there. Lifestyle and environment may be better but in most cases it's probably easier to get up to 400k-500k as a medical student than as someone entering tech or engineering. Not saying this won't change in the future but I think med students overestimate how lucrative other fields can be sometimes.

I disagree that it is easier to make 400k-500k as a medical student than a tech worker, from my personal experience as a tech worker and from the experiences of many friends and family in tech at a variety of companies (FAANG, startups, etc) and in medicine. The average medical student in terms of intelligence and ability to work hard would almost definitely make it to L6/E6 before 35 if they started out of undergrad, and it would definitely be easier/less time-consuming than matching specialties of similar compensation. Taking into consideration possible student debt and years of training in medicine, I think tech in comparison makes a lot of financial sense right now (but of course, that could change). It is pretty astonishing how lucrative it is right now, after being on the "inside" of a tech company for some time.

Besides monetary compensation, I also imagine tech work/lifestyle might be a good or better fit for a decent subset of med students. I know quite a few people who would have been competitive for medical school or were even accepted to medical school who are now very happy in their tech jobs. I think it's important that premeds are aware of these other careers as I think there is some overlap in interests, values, and personality types between medicine and tech.

That being said, I completely agree with a previous comment that there is no perfect job, and I also acknowledge tech is not for everyone. For example, there are probably a lot of medical students who would not feel personally fulfilled in the majority of tech roles.

 

[libertyyne]

For every one l6 e6 at faang, there are thousands of people with tech degrees working for 60k in the midwest. Not to mention the attrition , to get there and the lack of career stability once you are there. Pretty easy to imagine you’d be cranking out 500k at tech or Investment banking . The reality of the situation is very different .

 

[mesopic]

For every one l6 e6 at faang, there are thousands of people with tech degrees working for 60k in the midwest. Not to mention the attrition , to get there and the lack of career stability once you are there. Pretty easy to imagine you’d be cranking out 500k at tech or Investment banking . The reality of the situation is very different .

On average, there is a lower bar for getting a tech degree/job than getting admitted to medical school. Those who have the abilities to get into medical school would most likely get a much better than average tech job, given that they spent their undergraduate time studying CS for example instead of filling premed requirements and that they have the same interest in tech as they do medicine. I have no experience in investment banking but I've heard the lifestyle and attrition are much, much worse than tech.

 

[mesopic]

I've chosen medicine over tech, but I know there are some previous classmates of mine that might have been spared a lot of struggles and pain if they tried CS/tech in undergrad. I hope that there will be more physicians in the future who have explored other options and are happier in their career decision instead of asking "what if" later down the line when their salaries are getting cut (to bring it back to the thread's topic).

 

[odyssey2]

I disagree that it is easier to make 400k-500k as a medical student than a tech worker, from my personal experience as a tech worker and from the experiences of many friends and family in tech at a variety of companies (FAANG, startups, etc) and in medicine. The average medical student in terms of intelligence and ability to work hard would almost definitely make it to L6/E6 before 35 if they started out of undergrad, and it would definitely be easier/less time-consuming than matching specialties of similar compensation. Taking into consideration possible student debt and years of training in medicine, I think tech in comparison makes a lot of financial sense right now (but of course, that could change). It is pretty astonishing how lucrative it is right now, after being on the "inside" of a tech company for some time.
Besides monetary compensation, I also imagine tech work/lifestyle might be a good or better fit for a decent subset of med students. I know quite a few people who would have been competitive for medical school or were even accepted to medical school who are now very happy in their tech jobs. I think it's important that premeds are aware of these other careers as I think there is some overlap in interests, values, and personality types between medicine and tech.

That being said, I completely agree with a previous comment that there is no perfect job, and I also acknowledge tech is not for everyone. For example, there are probably a lot of medical students who would not feel personally fulfilled in the majority of tech roles.

You have a much rosier view of the skills of the average medical student than I do. Matching a high-paying specialty is actually not very difficult for someone at a US MD school. DR and anesthesia both have high match rates of US MD grads and average salaries in 400-500k. They don't require a medical student to do significantly better than average and grads who match can expect that salary within 4-6 years following med school with higher job security than someone gunning for staff software engineer at Google. There are definitely major upsides to the tech route but I disagree that it necessarily makes more financial sense.

 

[slowthai]

You have a much rosier view of the skills of the average medical student than I do. Matching a high-paying specialty is actually not very difficult for someone at a US MD school. DR and anesthesia both have high match rates of US MD grads and average salaries in 400-500k. They don't require a medical student to do significantly better than average and grads who match can expect that salary within 4-6 years following med school with higher job security than someone gunning for staff software engineer at Google. There are definitely major upsides to the tech route but I disagree that it necessarily makes more financial sense.

I agree that it's a strong overestimation of the average med student's abilities. It's a different skillset, for one. It also requires a different mindset and aptitude.

 

[mesopic]

You have a much rosier view of the skills of the average medical student than I do. Matching a high-paying specialty is actually not very difficult for someone at a US MD school. DR and anesthesia both have high match rates of US MD grads and average salaries in 400-500k. They don't require a medical student to do significantly better than average and grads who match can expect that salary within 4-6 years following med school with higher job security than someone gunning for staff software engineer at Google. There are definitely major upsides to the tech route but I disagree that it necessarily makes more financial sense.

Maybe I have a less rosy view of tech workers instead, haha. As others have mentioned, the actual number of hours worked by a lot of tech workers is less than what you'd expect, even for those "gunning" for promotions, and way less than how much the average med student studies or the average resident or attending works. As long as you don't blow your entire salary every year as a tech worker, you'll almost definitely have a much greater net worth at 35 and at least around the same salary compared to the average attending.

I agree that it's a strong overestimation of the average med student's abilities. It's a different skillset, for one. It also requires a different mindset and aptitude.

Definitely agree that it's a different skillset; the person would need to study CS or another eng major instead of filling premed requirements and also have an interest in tech instead of medicine. I think there is overlap in mindset and aptitude for some people, especially those who like logic and problem-solving. You definitely don't need to be good at math for CS, which I've heard holds some people back from exploring tech.

As mentioned before, it's definitely not for all med students, but it's possible that some would be happier/do better in tech than medicine. I just don't think a med student's perceived abilities should hold them back from considering it as an option, as it might be easier or better suited for them than they think. I know I was exposed to tech late in my time as an undergrad and am grateful to have had the opportunity and privilege to explore it, even if I ultimately decided to study medicine instead.

 

[sloh]

Medical students that can match into specialties that pay >350k/year generally have sufficient IQ to also excel in tech. Interests may be different but they will definitely have the aptitude (necessary but not sufficient) to excel.

 

[7331poas]

People say this a lot, but are there really that many people in tech/engineering making much more than 150k? The people at the top may make more, but the skills required for those fields are very different than those for medicine. Even taking into account length of training and med school debt, it’s not that hard to match into a specialty that will have a bigger payoff than a typical engineering or tech salary, at least at the moment.

150k is pretty good considering they didnt go to medical school for 4 years and no gen surg residency for 5 years.