future of cards

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If some store manager at a Trader Joe's is making $870K, then are they living in mansions? I mean, come on, guys, I'm betting where you live as physicians your neighbors aren't store managers at K-Mart or anything. Let's keep it in perspective.

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If some store manager at a Trader Joe's is making $870K, then are they living in mansions? I mean, come on, guys, I'm betting where you live as physicians your neighbors aren't store managers at K-Mart or anything. Let's keep it in perspective.

Honestly, I rather make 400K as a cardiologist instead of 870K as a store manager. I agree with you rural. People need to put things into perspective. The only thing I gripe SOOO much about is the public perception.
 
I think you misunderstood. To become an IC doc after high school it takes ~15 years of education. To become a TraderJoes manager (you can start working in HS...diploma not necessary). Hence after ~ 7 years if you have good work ethics one can argue you can make it as a manager and start make $120K annually. 15 - 7 = 8 to work as Manager before the 15 year IC pathway catches up (sorry but i apparently have to do the basic math since confusion came from my last post).

Therefore while someone is still trying to get there IC credentials in the other path they would have already started working as a manager making 120K with ~7-8 years to spare and hence the figure ~870K. As in the TraderJoes path would have already made 870K by the time you get your first paycheck as IC doc.

And OBVIOUSLY no one is arguing that they would rather work as convenience store manager than a physician. I'm just saying all this BS talk that physicians make too much makes no sense to me. We make the right amount (if anything less than the right amount) based on the years of training, the sacrifices and the actual value of service we provide.

OP
 
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I think you misunderstood. To become an IC doc after high school it takes ~15 years of education. To become a TraderJoes manager (you can start working in HS...diploma not necessary). Hence after ~ 7 years if you have good work ethics one can argue you can make it as a manager and start make $120K annually. 15 - 7 = 8 to work as Manager before the 15 year IC pathway catches up (sorry but i apparently have to do the basic math since confusion came from my last post).

Therefore while someone is still trying to get there IC credentials in the other path they would have already started working as a manager making 120K with ~7-8 years to spare and hence the figure ~870K. As in the TraderJoes path would have already made 870K by the time you get your first paycheck as IC doc.

And OBVIOUSLY no one is arguing that they would rather work as convenience store manager than a physician. I'm just saying all this BS talk that physicians make too much makes no sense to me. We make the right amount (if anything less than the right amount) based on the years of training, the sacrifices and the actual value of service we provide.

OP

No, I got the math. I just don't buy the numbers. Like I said, store managers at Trader Joe's don't make $120K. Not unless Trader Joe's is run by extremely unintelligent people. And if you go to the neighborhoods where doctors live, you're not finding people who work at K-Mart or Trader Joe's or Sears or KFC.
 
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No, I got the math. I just don't buy the numbers. Like I said, store managers at Trader Joe's don't make $120K. Not unless Trader Joe's is run by extremely unintelligent people. And if you go to the neighborhoods where doctors live, you're not finding people who work at K-Mart or Trader Joe's or Sears or KFC.


fyi:
http://benbrownmd.wordpress.com/2010/06/20/informedconsent/
The Deceptive Income of Physicians
Doctors do not make as much money as you think
By Benjamin Brown, M.D.
 
No, I got the math. I just don't buy the numbers.

Don't buy the numbers? I worked there bro. I'm not just picking a number out of thin air

"Store managers, "captains" in Trader Joe's parlance -- the nautical titles are a holdover from Coulombe (newly promoted captains are commanders; assistant store managers are first mates) -- can make in the low six figures"

Here is the link: just skim it, halfway down were they talk about employee salaries
http://money.cnn.com/2010/08/20/news/companies/inside_trader_joes_full_version.fortune/

Here is another link pretty much says the same thing.
http://jobs.aol.com/articles/2010/12/29/trader-joes-six-figures-for-assistant-managers/

Not sure why it is so hard to believe that they make that much. If you actually go to the store and realize the fanatic "health nut" followers they have over there that are willing to pay 5 bucks for 2 eggs because its labled "organic" than you realize what gold mind traderjoes has stumbled upon. their fan base is insane and they shell out the dough because they feel like it make them better because they're eating "healthy". I'm going to stop here before i get way off on a tangent again.

OP
 
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No, I got the math. I just don't buy the numbers. Like I said, store managers at Trader Joe's don't make $120K. Not unless Trader Joe's is run by extremely unintelligent people. And if you go to the neighborhoods where doctors live, you're not finding people who work at K-Mart or Trader Joe's or Sears or KFC.

Who cares….lets not drive this off topic. Regardless, OP is right. For the amount of time it takes for us to catch up on the lost income is absurd. It really is disheartening to me even tho I enjoy what I do. Sometimes I ask myself if I made a mistake or if I will be worse off because of it.

Lets hope I am wrong.

**OP I quickly read and made a mistake on your last post regarding the 870. Sorry
 
No worries IMDoc. Keep your head up. It is rare for me to tell anyone that went into the field of medicine (no matter what line) that they made a mistake. At the end of the day majority of physicians agree that the gratification that comes with the services we provide for our fellow man trumps most headaches associated with our jobs.

Semantics apart I think we all agree that even though we love our line of work it is a sad state currently that we have to justify our worth and our salary to the insurance companies, the hospitals and the general population at large (or at least those that feel we make "ungodly salaries")

OP
 
fyi:
http://benbrownmd.wordpress.com/2010/06/20/informedconsent/
The Deceptive Income of Physicians
Doctors do not make as much money as you think
By Benjamin Brown, M.D.

It's debatable. While physicians don't make as much as people think -- especially given that people breezily throw around B.S. like "yeah, the minimum our specialty makes is $250,000!" -- they also don't make "just a few dollars more than teachers." Breaking down salaries into hourly wages doesn't work because teachers work very little and doctors work a lot, yes, but that's the point. Teachers make disproportionately more than they should, but they're still making at best what a poor doctor makes and that only after decades. Teachers should make less than half what they are paid -- P.S., I don't care who gets mad about that because their mom is a teacher -- but you can't change that.
 
Don't buy the numbers? I worked there bro. I'm not just picking a number out of thin air

No offense, but I think you are. The article says they "can make in the low six figures," which is markedly different from "they do make." Look, the point of the article is to portray Trader Joe's as an upscale place that markets to foo-foo Northeastern liberal yuppies. And it does. And I'm sure they get paid better than normal. But their starting salaries for are NOT $60,000. Sorry, they're not. If they were, everyone should work there. It's like when people say that doctors "can" make $750,000. That's great. How many are? (I'm sure everyone on SDN is like "ooo, I do!! MEEE!!!")

(Another example is that people routinely talk about how nurses "can make up to" $100,000 and then make it like they all do. No, they don't.
 
No offense, but I think you are. The article says they "can make in the low six figures," which is markedly different from "they do make." Look, the point of the article is to portray Trader Joe's as an upscale place that markets to foo-foo Northeastern liberal yuppies. And it does. And I'm sure they get paid better than normal. But their starting salaries for are NOT $60,000. Sorry, they're not. If they were, everyone should work there. It's like when people say that doctors "can" make $750,000. That's great. How many are? (I'm sure everyone on SDN is like "ooo, I do!! MEEE!!!")

(Another example is that people routinely talk about how nurses "can make up to" $100,000 and then make it like they all do. No, they don't.

Would have to agree…one of the reasons I went into medicine is because if I am an "average" physician I will make at LEAST 100K per year (or whatever the average salary for ALL physicians are)…sure you can make more money in other fields but HOW MANY people actually make the 7 figures in those fields?
 
No offense, but I think you are. The article says they "can make in the low six figures," which is markedly different from "they do make." Look, the point of the article is to portray Trader Joe's as an upscale place that markets to foo-foo Northeastern liberal yuppies. And it does. And I'm sure they get paid better than normal. But their starting salaries for are NOT $60,000. Sorry, they're not. If they were, everyone should work there. It's like when people say that doctors "can" make $750,000. That's great. How many are? (I'm sure everyone on SDN is like "ooo, I do!! MEEE!!!")

(Another example is that people routinely talk about how nurses "can make up to" $100,000 and then make it like they all do. No, they don't.

Hmmm....oddly I disagree and agree with your posts.

The data on Trader Joe salaries seem all over the place. Your comments on starting salaries do not coincide with OP's statements. He said that after 7 years you can start at 120. Even those comments I have some difficulty stomaching. Let me clarify.

I have never worked retail- but market economics tells me that what Trader Joe does is not common at all. This makes sense. Like he said they've cornered a ridiculously high margin market. Fine. But even with that the data seems to indicate average managerial salaries are around 100k starting. Thats fairly decent. For what its worth Air traffic controllers make over 120k with a 4 year degree and up to 180k. Its a high stress job. There are many jobs like this. Coal miners in WV can make close to 90k. Technically trained specialists in metal working (non-hazardous- relatively) can make 100k simply because so few people have their skills....the list goes on. These kinds of jobs are far and few in between.

There are many significant caveats. One- they are on the significant high end. Like another poster said you wont see Trader Joe managers in nice neighborhoods. Or KMart. Most managerial positions at retail pay closer to 60 than 100. Even the 120 by OP is a bit stretch. Two, job security is a serious issue. What happens when trader joe fires the manager or lays off or whatever in any of these jobs? I can't imagine someone having a guaranteed trader joe managerial position for the rest of his life. Or even moving up- I mean how many of these upward mobile opportunities are there exactly? And what kinds of marketable transferable skills does someone get at Trader Joes to take with him if he loses his job? will he continue at said 100k salary? How many stories have we heard of traders on Wall, or ad execs or publishers et al who have lost these 100k jobs only to work at 60k salaries? What happens in 10 years when the economy tanks and trader joe's crazy yuppie nutsack customers lose their jobs and stop shopping at Trader Jokes?

At the same time, I really really dislike that post (Ben Brown) about physician's pay. Its been circulating everywhere, and especially around libertarian news sites (here's looking at you Forbes). The article is flawed on many levels. Least of all the argument of hourly wages for a physician. There are some other issues including the numbers he picks for years studied, hours studied and so forth. The reality is- most of what we learn is simply not used nor required to be remembered. Medical education is almost always a means to an end- whether at undergrad level or the medical level- especially when most people simply do not remember most of what they've learned (I digress).

Of course the reasons why we study as much are a different issue entirely-

At the same time the issue about teachers-I'm not sure where he gets his data from nor your aspersions cast at that profession but the average teacher makes around 30k in many states. There are a few oddball socialist states- NY but most places teachers barely make ends meet. I'm not sure talking down to them helps our cause....


Back to OP's point. I think a lot of physicians definitely make more than they really should- including most of the ROAD specialties except anesthesiology (call etc technicality). Surgerical cardiology and so forth are most certainly fields that deserve their pay and in many cases higher pay...

Ah and speaking of hours... how many hours would a noninvasive cardiologist have to work to make the 280k?
 
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Your comments on starting salaries do not coincide with OP's statements.

It's in the article he linked to. In the same paragraph where it describes "six figure" salaries for managers, it says that starting salaries for full-time employees can be $60,000. I'm sure there's like one guy ever who started working at Trader Joe's with a $60,000 salary.

I agree with you, Trader Joe's isn't common. In fact, the article plainly says that, too. The reason Trader Joe's works is because Trader Joe's relies on the idiocy of the Northeastern liberal elite. It says that Trader Joe's has convinced them that the products they carry are "special" and "higher quality," so not only do they accept the limited selection, but they embrace it because they believe that they are getting a special product. There's no "Jif" at Trader Joe's, but there's going to be a peanut butter that's made out of peanuts grown organically in some mysterious place that have been hand-cracked and then mashed with a platinum press and it costs $20. And all those people go "woah, of course I'd pay $20 for peanut butter!! I'm amazing!! You peasants can eat your pathetic Jif!"

Like another poster said you wont see Trader Joe managers in nice neighborhoods. Or KMart. Most managerial positions at retail pay closer to 60 than 100. Even the 120 by OP is a bit stretch.

Right. That's my point (and I was the one who wrote that). If Trader Joe's managers made $120K, unless they're financial idiots, they should be able to live in a doctor's neighborhood. I mean, within a few years you can save up for down-payment for a very nice house, especially given that you have at least a 10-year jump on the doctor, who has training and then is paying back loans. But you don't ever see that. Why not?

At the same time the issue about teachers-I'm not sure where he gets his data from nor your aspersions cast at that profession but the average teacher makes around 30k in many states. There are a few oddball socialist states- NY but most places teachers barely make ends meet. I'm not sure talking down to them helps our cause....
Teachers make peanuts when they start, but they make quite good money in many places after not too long. There are lots of places teachers make close to six-figures. Their salaries are public record -- look up the salaries of your teachers or your kids' teachers. But before you do, guess what they make. You'll be amazed at the discordance. Then keep in mind that most of them will continue to get paid after they retire in their 50s FOR LIFE.
 
It's in the article he linked to. In the same paragraph where it describes "six figure" salaries for managers, it says that starting salaries for full-time employees can be $60,000. I'm sure there's like one guy ever who started working at Trader Joe's with a $60,000 salary.

I agree with you, Trader Joe's isn't common. In fact, the article plainly says that, too. The reason Trader Joe's works is because Trader Joe's relies on the idiocy of the Northeastern liberal elite. It says that Trader Joe's has convinced them that the products they carry are "special" and "higher quality," so not only do they accept the limited selection, but they embrace it because they believe that they are getting a special product. There's no "Jif" at Trader Joe's, but there's going to be a peanut butter that's made out of peanuts grown organically in some mysterious place that have been hand-cracked and then mashed with a platinum press and it costs $20. And all those people go "woah, of course I'd pay $20 for peanut butter!! I'm amazing!! You peasants can eat your pathetic Jif!"



Right. That's my point (and I was the one who wrote that). If Trader Joe's managers made $120K, unless they're financial idiots, they should be able to live in a doctor's neighborhood. I mean, within a few years you can save up for down-payment for a very nice house, especially given that you have at least a 10-year jump on the doctor, who has training and then is paying back loans. But you don't ever see that. Why not?


Teachers make peanuts when they start, but they make quite good money in many places after not too long. There are lots of places teachers make close to six-figures. Their salaries are public record -- look up the salaries of your teachers or your kids' teachers. But before you do, guess what they make. You'll be amazed at the discordance. Then keep in mind that most of them will continue to get paid after they retire in their 50s FOR LIFE.


Well that is a surprise and isn't. I think I vaguely remember that their pensions help them but I didn't think about it until you mentioned it. Its too bad really.
 
Hmmm....oddly I disagree and agree with your posts.

The data on Trader Joe salaries seem all over the place. Your comments on starting salaries do not coincide with OP's statements. He said that after 7 years you can start at 120. Even those comments I have some difficulty stomaching. Let me clarify.

I have never worked retail- but market economics tells me that what Trader Joe does is not common at all. This makes sense. Like he said they've cornered a ridiculously high margin market. Fine. But even with that the data seems to indicate average managerial salaries are around 100k starting. Thats fairly decent. For what its worth Air traffic controllers make over 120k with a 4 year degree and up to 180k. Its a high stress job. There are many jobs like this. Coal miners in WV can make close to 90k. Technically trained specialists in metal working (non-hazardous- relatively) can make 100k simply because so few people have their skills....the list goes on. These kinds of jobs are far and few in between.

There are many significant caveats. One- they are on the significant high end. Like another poster said you wont see Trader Joe managers in nice neighborhoods. Or KMart. Most managerial positions at retail pay closer to 60 than 100. Even the 120 by OP is a bit stretch. Two, job security is a serious issue. What happens when trader joe fires the manager or lays off or whatever in any of these jobs? I can't imagine someone having a guaranteed trader joe managerial position for the rest of his life. Or even moving up- I mean how many of these upward mobile opportunities are there exactly? And what kinds of marketable transferable skills does someone get at Trader Joes to take with him if he loses his job? will he continue at said 100k salary? How many stories have we heard of traders on Wall, or ad execs or publishers et al who have lost these 100k jobs only to work at 60k salaries? What happens in 10 years when the economy tanks and trader joe's crazy yuppie nutsack customers lose their jobs and stop shopping at Trader Jokes?

At the same time, I really really dislike that post (Ben Brown) about physician's pay. Its been circulating everywhere, and especially around libertarian news sites (here's looking at you Forbes). The article is flawed on many levels. Least of all the argument of hourly wages for a physician. There are some other issues including the numbers he picks for years studied, hours studied and so forth. The reality is- most of what we learn is simply not used nor required to be remembered. Medical education is almost always a means to an end- whether at undergrad level or the medical level- especially when most people simply do not remember most of what they've learned (I digress).

Of course the reasons why we study as much are a different issue entirely-

At the same time the issue about teachers-I'm not sure where he gets his data from nor your aspersions cast at that profession but the average teacher makes around 30k in many states. There are a few oddball socialist states- NY but most places teachers barely make ends meet. I'm not sure talking down to them helps our cause....


Back to OP's point. I think a lot of physicians definitely make more than they really should- including most of the ROAD specialties except anesthesiology (call etc technicality). Surgerical cardiology and so forth are most certainly fields that deserve their pay and in many cases higher pay...

Ah and speaking of hours... how many hours would a noninvasive cardiologist have to work to make the 280k?

How do you figure this? I think all physicians are underpaid especially if they are practicing good medicine.
 
haha... look at the mess i made. sorry i ever mentioned traderjoes. really derailed this post i feel.

i only stated that in trying to make the counter argument to physicians making "ungodly" salaries.

That if a trader joes manager can make 6 figures (100K vs 120K ... whatever) after being with a company for 6 years with no college education required that making 300K after 12-14 years of education is hardly ungodly considering the training/the sacrifices and the responsibilities that come with that compensation.

now lets please retire this traderjoes thing and try to revert this discussion back to future of cardiology which is not becoming a trader joes manager ;-)

OP
 
How do you figure this? I think all physicians are underpaid especially if they are practicing good medicine.


First, I agree OP. Second- I dont' think 300k is ungodly though it seems some in the public do. This may be more of a PR issue than reality- and strong PR can fix this. I suspect doctors are to blame- with how disjointed they are- but this has been discussed ad infinitum.

Future of Cards - I'd like to know if the 55 hour is true? For nonIV it doesn't seem to be a bad deal- I wouldn't mind 55 hour work week if that means almost 300k starting. Especially if I don't have to worry about ungodly call nights. From what I gather its something like 5:1 with most call associated with phone calls from patients and the occasional ED.
 


Nice find!!

In all sincerity, I never felt rads deserved their pay. Same with most ROADS (except ironically anesthesiologists and yet they're taken over by CRNA- I ask why cant CRND (replace A w Dermatology) exist? Rads do an important job but why they're more valuable than pathology is beyond me. Obv. its due to the cost of the machines bla bla but I never understood that concept- my training has nothing to do with dealing with the costs of machines. I get that its expensive. But reimbursements should reflect the value provided. If pathology is devalued so should rads- and the costs of imaging should be borne on tax cuts (only for those machines or be used in hospitals).

The reality is- pathology labs are expensive too- so many lab techs/scopes/imaging centers needed.

anyway anything like that for cards?
 
The only thing that I've ever held against other specialties are that, for example, Dermatologists get to take cash for services and therefore rake in money hand over fist taking care of acne or wrinkles while lots of other specialties who actually take care of ill people are forced to see everyone and be reimbursed at low rates determined by the government. And before someone says that Dermatologists deal with skin cancer, you're just kidding yourself because they're not making their money by doing whole-body skin exams, regardless of what anyone tells you.

Now, you can say that this set-up isn't their fault and you'd be correct. It's the fault of administrators, politicians, and the public, who are happy to pay for Botox but scream in agony if they have to pay for an appendectomy that costs almost nothing because "it's their right." But Dermatologists are reaping the rewards of that situation.
 
Why is that a nice find? I look at all fields as my brethren who deserve to be paid well. Without Ct or MRI how would you diagnose a stroke or severe colitis/appendicitis? Your argument doesn't hold up. Furthermore why would you want to see any field get reimbursement cuts? In regards to cardiology, I saw an article making a point that despite the cuts, they are amongst the top paid physicians. I plan on making 350K in a semi urban area and saving/investing a lot.
 
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Does anyone have any idea on the future of cards imaging subspecialists? How is the lifestyle/hours like? How is the salary like compared to their generalist/interventionalist/EP counterparts? Is it possible to ONLY read imaging all day, with a few clinic days spread in? How common are these types of jobs?
 
Why is that a nice find? I look at all fields as my brethren who deserve to be paid well. Without Ct or MRI how would you diagnose a stroke or severe colitis/appendicitis? Your argument doesn't hold up. Furthermore why would you want to see any field get reimbursement cuts? In regards to cardiology, I saw an article making a point that despite the cuts, they are amongst the top paid physicians. I plan on making 350K in a semi urban area and saving/investing a lot.

Sorry my comment was misinterpreted. I can see why though. I just meant nice find for getting useful data to look at. In the context of what else I said I see how it appears as if I'm satisfied with negative news.

That wasn't my intention. I meant- "nice find! I wish more concrete data was available for us students to determine the future outlook of medicine." Not, nice find, screw rads.

I stand by my other statements though. While its true radiology is needed- so is pathology- and yet their income stream is significantly lower. They're work is just as important- but they make less if only because the gross cost of equipment is lower (collectively it is higher because of the many parts involved). I dont understand though why radiology should be so competitive- when path isn't. And why rads should make more money when path doesn't. That was what I was referring to.

One could say the same about the need for pathology to dx dz- the same statement you make applies to them as well. That dichotomy is what I do not like. While I can argue that path should make more than they do now (and I think they should considering the importance of early detection)- I think rads makes too much. I simply do not understand how 9-5 jobs should be paid 400k when stress etc is not involved.

I'm not saying any field should have cuts. I'm saying certain fields should and have it redistributed to other areas- surgery/IV cards/etc.
 
Agree with you regarding pathology but if you want my honest opinion unless you're working long days and doing life saving procedures then I don't think you deserve to make what an IV cards guy does. Neurosurgeon, vascular surgeon etc...yes they deserve even more but to your point of path and rads I agree.



Sorry my comment was misinterpreted. I can see why though. I just meant nice find for getting useful data to look at. In the context of what else I said I see how it appears as if I'm satisfied with negative news.

That wasn't my intention. I meant- "nice find! I wish more concrete data was available for us students to determine the future outlook of medicine." Not, nice find, screw rads.

I stand by my other statements though. While its true radiology is needed- so is pathology- and yet their income stream is significantly lower. They're work is just as important- but they make less if only because the gross cost of equipment is lower (collectively it is higher because of the many parts involved). I dont understand though why radiology should be so competitive- when path isn't. And why rads should make more money when path doesn't. That was what I was referring to.

One could say the same about the need for pathology to dx dz- the same statement you make applies to them as well. That dichotomy is what I do not like. While I can argue that path should make more than they do now (and I think they should considering the importance of early detection)- I think rads makes too much. I simply do not understand how 9-5 jobs should be paid 400k when stress etc is not involved.

I'm not saying any field should have cuts. I'm saying certain fields should and have it redistributed to other areas- surgery/IV cards/etc.
th
 
Sorry my comment was misinterpreted. I can see why though. I just meant nice find for getting useful data to look at. In the context of what else I said I see how it appears as if I'm satisfied with negative news.

That wasn't my intention. I meant- "nice find! I wish more concrete data was available for us students to determine the future outlook of medicine." Not, nice find, screw rads.

I stand by my other statements though. While its true radiology is needed- so is pathology- and yet their income stream is significantly lower. They're work is just as important- but they make less if only because the gross cost of equipment is lower (collectively it is higher because of the many parts involved). I dont understand though why radiology should be so competitive- when path isn't. And why rads should make more money when path doesn't. That was what I was referring to.

One could say the same about the need for pathology to dx dz- the same statement you make applies to them as well. That dichotomy is what I do not like. While I can argue that path should make more than they do now (and I think they should considering the importance of early detection)- I think rads makes too much. I simply do not understand how 9-5 jobs should be paid 400k when stress etc is not involved.

I'm not saying any field should have cuts. I'm saying certain fields should and have it redistributed to other areas- surgery/IV cards/etc.

Just saw your great post.

About me: I am an attending radiologist with MSK subspecialty. My girlfriend is a cardiologist, finishing her training this year. We live in a very desirable location with a very competitive market. Though I am lucky to have a nice job, we have a hard time to find a reasonable job for her here. Still don't know what to do, esp giving the fact that I am a partner now and radiologist job market is as bad or worst that cardiology.

Now about your post: It is just a comment and I am sure that I can not change your biased opinion. But a few points:

1- Radiology is not a 9-5 job at all, at least in the last 8 years. FYI, I was on call last night from 9pm to 7am. I read about 140 studies including 60 CTs and MRs. From trauma to stroke to appy to PE. And again FYI, our IR people are on call 1/4 or 1:5. I work about 4 weeks night shifts a year and work almost full the every third to fourth weekend. Also there are many so called evening shift which means I work till 10 PM. There are still 9-5 radiology jobs but in the boonies with lower pay and they are rapidly taken over by hospital system. I never ever say that the lifestyle is as harsh as IC, but really not better than non-invasive cards. AND I'd rather have a lighter schedule (call me lazy), but no jobs available with that schedule. Groups are trying to keep salaries up by not hiring and increasing hours of work.
With all my respects for my pathology friends, show me a pathologsit who worked last night non stop the whole night and I will pay you one grand. If I don't answer the non stop phone calls from ED, my pager starts to ring nonstop because they page me. Close the pathology department and nobody will not notice for 3 days. Anyway, I strongly believe that they are underpaid.

2- Income across medical specialties is a relatively random process. Why an orthopod makes twice an OB-Gyn? Why a general surgeon makes less than a GI? Why a pediatrician makes less than an IM? Why a spine surgeon makes two times of what an IR or IC makes? While you can give reasons for all of this, all of them will be just Justification. There is not a really good answer to them.
But one thing is obvious: New procedures pay better, no matter what it is. It can be Nuclear stress test or can be liver MRI. It can be Transchatheter chemoembolization of liver mass or can be transcatheter replacement of aortic valve.

3-As a reminder, most of a revenue in cardiology and obviously in radiology comes from IMAGING. This is why you get paid more than a neurologist or an ICU physician. If you have any objection that why imaging pays better than office visit, you are free to do that. But YOU ARE SHOOTING YOURSELF IN THE FOOT. I get paid 40 buck to read a brain CT and if I am not wrong you get paid 50-60 bucks to get paid to read an echo. Now you can object that I am overpaid. They will decrease my 40 bucks to 20 bucks. Then next year they will think that how come CT pays 20 bucks and echo pays 60 bucks. And .....

4- I personally always believe that physicians in any field should be paid well. Calling another field overpaid is neither professional nor useful. In fact it will come back to you.

This is what exactly happened in one of the hospitals that we cover. It may help you in the future:
It was last year when we were in a hospital meeting and there were all groups of physicians. The hospital is busy center with a relatively busy call for both diagnostics and interventional. After fighting back and forth the hospital decided that they are not going to pay the IR on call person for being on call. I can exactly remember that even a trauma surgeon said that you get paid for the procedure itself. Why do you complain?
Anyway, a few months later the hospital stopped paying for STEMI call and for trauma surgery on call. They hospital clearly stated that none of the other physicians are get paid to be on call.

5- I hate all the cuttings to our reimbursements year after year to the point that the market has become so tight that my girlfriend and I, after doing 14-15 years of education each, can not find jobs in the same area.

Good Luck..
 
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This thread is a giant advertisement for cash only primary care, psych, and outpatient surgery.
 
4- I personally always believe that physicians in any field should be paid well. Calling another field overpaid is neither professional nor useful. In fact it will come back to you.

This is what exactly happened in one of the hospitals that we cover. It may help you in the future:
It was last year when we were in a hospital meeting and there were all groups of physicians. The hospital is busy center with a relatively busy call for both diagnostics and interventional. After fighting back and forth the hospital decided that they are not going to pay the IR on call person for being on call. I can exactly remember that even a trauma surgeon said that you get paid for the procedure itself. Why do you complain?
Anyway, a few months later the hospital stopped paying for STEMI call and for trauma surgery on call. They hospital clearly stated that none of the other physicians are get paid to be on call.

This.
 
Just saw your great post.

About me: I am an attending radiologist with MSK subspecialty. My girlfriend is a cardiologist, finishing her training this year. We live in a very desirable location with a very competitive market. Though I am lucky to have a nice job, we have a hard time to find a reasonable job for her here. Still don't know what to do, esp giving the fact that I am a partner now and radiologist job market is as bad or worst that cardiology.

Now about your post: It is just a comment and I am sure that I can not change your biased opinion. But a few points:

1- Radiology is not a 9-5 job at all, at least in the last 8 years. FYI, I was on call last night from 9pm to 7am. I read about 140 studies including 60 CTs and MRs. From trauma to stroke to appy to PE. And again FYI, our IR people are on call 1/4 or 1:5. I work about 4 weeks night shifts a year and work almost full the every third to fourth weekend. Also there are many so called evening shift which means I work till 10 PM. There are still 9-5 radiology jobs but in the boonies with lower pay and they are rapidly taken over by hospital system. I never ever say that the lifestyle is as harsh as IC, but really not better than non-invasive cards. AND I'd rather have a lighter schedule (call me lazy), but no jobs available with that schedule. Groups are trying to keep salaries up by not hiring and increasing hours of work.
With all my respects for my pathology friends, show me a pathologsit who worked last night non stop the whole night and I will pay you one grand. If I don't answer the non stop phone calls from ED, my pager starts to ring nonstop because they page me. Close the pathology department and nobody will not notice for 3 days. Anyway, I strongly believe that they are underpaid.

2- Income across medical specialties is a relatively random process. Why an orthopod makes twice an OB-Gyn? Why a general surgeon makes less than a GI? Why a pediatrician makes less than an IM? Why a spine surgeon makes two times of what an IR or IC makes? While you can give reasons for all of this, all of them will be just Justification. There is not a really good answer to them.
But one thing is obvious: New procedures pay better, no matter what it is. It can be Nuclear stress test or can be liver MRI. It can be Transchatheter chemoembolization of liver mass or can be transcatheter replacement of aortic valve.

3-As a reminder, most of a revenue in cardiology and obviously in radiology comes from IMAGING. This is why you get paid more than a neurologist or an ICU physician. If you have any objection that why imaging pays better than office visit, you are free to do that. But YOU ARE SHOOTING YOURSELF IN THE FOOT. I get paid 40 buck to read a brain CT and if I am not wrong you get paid 50-60 bucks to get paid to read an echo. Now you can object that I am overpaid. They will decrease my 40 bucks to 20 bucks. Then next year they will think that how come CT pays 20 bucks and echo pays 60 bucks. And .....

4- I personally always believe that physicians in any field should be paid well. Calling another field overpaid is neither professional nor useful. In fact it will come back to you.

This is what exactly happened in one of the hospitals that we cover. It may help you in the future:
It was last year when we were in a hospital meeting and there were all groups of physicians. The hospital is busy center with a relatively busy call for both diagnostics and interventional. After fighting back and forth the hospital decided that they are not going to pay the IR on call person for being on call. I can exactly remember that even a trauma surgeon said that you get paid for the procedure itself. Why do you complain?
Anyway, a few months later the hospital stopped paying for STEMI call and for trauma surgery on call. They hospital clearly stated that none of the other physicians are get paid to be on call.

5- I hate all the cuttings to our reimbursements year after year to the point that the market has become so tight that my girlfriend and I, after doing 14-15 years of education each, can not find jobs in the same area.

Good Luck..

No one is arguing about IR or IC. I don't think thats an issue. No one is saying that medicine is paid too much or too little. I think context is important here. No matter what I say or you say the reimbursements for physicians will drop. There is going to be a collective decrease simply because the overall payments available to physicians is declining.

This is my argument. It contradicts what I would ideally like. That is, for physicians in all specialties as you say to be well paid. The reality, however, is this- it means there needs to be year over year increase in reimbursements to physicians everywhere. This means the total pot of money needs to increase. Everyone knows this will not happen anytime soon.

In other words- we need to appreciate reality versus what we want. Reality today is a decrease in income streams. A result of both politics and economics. I'm not going to hash that out- everyone knows this.

What needs to be clear is that doctors need to recognize that certain groups are too protected at the expense of others. Why can't PAs start dermatology clinics? What makes dermatology so much more challenging than anesthesiology that independent PAs cant practice?

I appreciate your work hours- something I was unaware of- though should have been- of course Rads would be needed during trauma cases!! I apologize. However, we need to recognize that a lot of medicine has hours and call. Comparatively speaking, the lifestyle of a radiologist is markedly better than a general surgeon. Yet income streams are significantly disparate.

My point is- to improve the overall medical outlook we need to mitigate the costcutting currently in place. The only way this can happen is to control where the costs are. Simply arguing that everyone should make money is not going to help us when there is less and less available.

I'm sorry your hospital has this kind of policy- I suspect this is a common and widespread practice. The question is why is it happening? is it to reimburse primary care (hardly) or is it due to decreased payments from the insurance? If so, what other options are available to the hospitals? Are the administrators enriching themselves at your expense? Is this last part a common issue. If so, then that is a serious issue that needs to be addressed. Otherwise, what other options are available to account for declining reimbursements?
 
Sorry my comment was misinterpreted. I can see why though. I just meant nice find for getting useful data to look at. In the context of what else I said I see how it appears as if I'm satisfied with negative news.

That wasn't my intention. I meant- "nice find! I wish more concrete data was available for us students to determine the future outlook of medicine." Not, nice find, screw rads.

I stand by my other statements though. While its true radiology is needed- so is pathology- and yet their income stream is significantly lower. They're work is just as important- but they make less if only because the gross cost of equipment is lower (collectively it is higher because of the many parts involved). I dont understand though why radiology should be so competitive- when path isn't. And why rads should make more money when path doesn't. That was what I was referring to.

One could say the same about the need for pathology to dx dz- the same statement you make applies to them as well. That dichotomy is what I do not like. While I can argue that path should make more than they do now (and I think they should considering the importance of early detection)- I think rads makes too much. I simply do not understand how 9-5 jobs should be paid 400k when stress etc is not involved.

I'm not saying any field should have cuts. I'm saying certain fields should and have it redistributed to other areas- surgery/IV cards/etc.

1) Massive oversupply of Pathologists relative to demand
2) A relative dearth of new technology in Pathology; Radiology, on the other hand, is on the forefront of technology.
3) New technology is what keeps Radiology reimbursements high; new technology is expensive.
4) Pathologists don't retire; they die at the scope.
 
1) Massive oversupply of Pathologists relative to demand
2) A relative dearth of new technology in Pathology; Radiology, on the other hand, is on the forefront of technology.
3) New technology is what keeps Radiology reimbursements high; new technology is expensive.
4) Pathologists don't retire; they die at the scope.

No, I think my point is being missed. I understand the causal factors associated with relative reimbursement rates. Sometimes I don't clarify my thoughts due to time constraints...

What I don't understand is how we can use this as a continued justification for salaries etc. That equipment alone can dictate salaries is not fair when, on the other hand, we discuss the number of years/time etc involved in training-yet this plays a relatively minor role in salary reimbursements. If it were more important than general surgery would be paid extremely well.

For a long time radiology was not as well compensated as other fields it only changed after the 1990s.

The reasons involved are complex but are associated with how reimbursements were determined from the 1990s onwards.

Simply put education attainment/complexity of knowledge =/= reimbursements. If this is the case then we need to stop using that as a reason why we should be paid as much. IF we want that to play a role then we need to accept its value and place less emphasis on other calculations (ie newness of technology/equipment use/etc.)
 
Well, another problem is the wRVU system. It takes into account some of the issues you mentioned but overall is an artificial (non-market-based) valuation of the work. Also consider that insurance companies can ream reimbursements into the ground as they see fit. The best way to establish true value for work performed would be to allow the market to determine pricing, and each physician can set his/her fees and collect payment in cash. I mean, why does the insurance have to pay 20-30 bucks for an imaging modality? If a radiology group or hospital didn't have overhead for billing insurance, etc...they cost per read would be even lower. In that case, a patient could easily pay 10 bucks (or whatever the radiologist charges) for a read.
 
No, I think my point is being missed. I understand the causal factors associated with relative reimbursement rates. Sometimes I don't clarify my thoughts due to time constraints...

What I don't understand is how we can use this as a continued justification for salaries etc. That equipment alone can dictate salaries is not fair when, on the other hand, we discuss the number of years/time etc involved in training-yet this plays a relatively minor role in salary reimbursements. If it were more important than general surgery would be paid extremely well.

For a long time radiology was not as well compensated as other fields it only changed after the 1990s.

The reasons involved are complex but are associated with how reimbursements were determined from the 1990s onwards.

Simply put education attainment/complexity of knowledge =/= reimbursements. If this is the case then we need to stop using that as a reason why we should be paid as much. IF we want that to play a role then we need to accept its value and place less emphasis on other calculations (ie newness of technology/equipment use/etc.)


1- I never ever think that a cardiologist is overpaid. Why? Because I am happy with what I do. If cardiology pays a million, still I choose what I do. If you think another field is overpaid, it is because you are miserable with your choice. It is obvious that I am not saying cardiology is better or worse than radiology or dermatology. YOU are in the wrong place. Back in your subconsciousness you are jealous or regret your choice. Think about it. AND Get along with your misery at it will not get better.

2- Having a bigger piece of pie, never ever worked in medical system never works. They are not going to decrease my pay for MRI and give it to you to read echo. I explained it in my last post and you did not understand. My pay does not come from "machines". It comes from the same place that your pay as a cardiologist comes.

3- Put 10 doctors in the same room and ask them who has more complexity of knowledge and education attainment. Everybody mentions his field. You are so blind and biased towards what you do that you think cardiology is the ultimate knowledge and all of us in other fields are just some illiterate dumbs. You didn't answer me why cardiology should make more than ICU physician?

4- Your understanding of radiology is totally wrong. Radiology was always a well paid. I can find the reference somewhere. But in 80s an average radiology salary was more than general surgery. And general surgeons were in their GOLDEN YEARS in 80s with very high salary.

5- The thing you don't understand is that radiology and cardiology both make their money through the same route and it is called imaging. In fact, echo and stress test or angiography was invented by radiologist and then was taken away by cardiology. Here is not the place to argue over turf wars. But both fields went up and down parallel to each other from many aspects including market, pay, .... But you are saying "If imaging is done by cardiologists, it should pay well. But if it is done by radiologists, it should be paid crap. "

Anyway, despite all the cuts, I believe that radiology will always be a well paid job as cardiology will. You have to find a way to adjust with your misery whenever you will pass through the radiology department.
 
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1- I never ever think that a cardiologist is overpaid. Why? Because I am happy with what I do. If cardiology pays a million, still I choose what I do. If you think another field is overpaid, it is because you are miserable with your choice. It is obvious that I am not saying cardiology is better or worse than radiology or dermatology. YOU are in the wrong place. Back in your subconsciousness you are jealous or regret your choice. Think about it. AND Get along with your misery at it will not get better.

2- Having a bigger piece of pie, never ever worked in medical system never works. They are not going to decrease my pay for MRI and give it to you to read echo. I explained it in my last post and you did not understand. My pay does not come from "machines". It comes from the same place that your pay as a cardiologist comes.

3- Put 10 doctors in the same room and ask them who has more complexity of knowledge and education attainment. Everybody mentions his field. You are so blind and biased towards what you do that you think cardiology is the ultimate knowledge and all of us in other fields are just some illiterate dumbs. You didn't answer me why cardiology should make more than ICU physician?

4- Your understanding of radiology is totally wrong. Radiology was always a well paid. I can find the reference somewhere. But in 80s an average radiology salary was more than general surgery. And general surgeons were in their GOLDEN YEARS in 80s with very high salary.

5- The thing you don't understand is that radiology and cardiology both make their money through the same route and it is called imaging. In fact, echo and stress test or angiography was invented by radiologist and then was taken away by cardiology. Here is not the place to argue over turf wars. But both fields went up and down parallel to each other from many aspects including market, pay, .... But you are saying "If imaging is done by cardiologists, it should pay well. But if it is done by radiologists, it should be paid crap. "

Anyway, despite all the cuts, I believe that radiology will always be a well paid job as cardiology will. You have to find a way to adjust with your misery whenever you will pass through the radiology department.


I'm sorry that this conversation got out of hand. I think there is some serious misconceptions here.

I'm a medical student. I'm confident I can enter any field except plastics/derm. I'm not interested in surgery or clinic. I'm not a fan of being in a lab all day.

What I mean is this- I have no bone in one career or another. I find cardiology intellectually challenging. I'm sure other fields are as well.

I'm more interested in ascertaining the issues currently involved in medical salaries and what factors play a role and what can be done to mitigate the problems we face.

I do believe that certain fields should be paid less.

I have no misery walking through radiology- nor any other field simply because I don't know what I will do...although after having my psych rotation I wonder if you are not projecting?
 
You have to find a way to adjust with your misery whenever you will pass through the radiology department.

Seriously buddy? I hope I'm just reading this line the wrong way.

..although after having my psych rotation I wonder if you are not projecting?

My thoughts exactly young student physician. You sure you don't want to be a psychiatrist... seem to have it down. Haha.

OP
 
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Seriously buddy? I hope I'm just reading this line the wrong way.



My thoughts exactly young student physician. You sure you don't want to be a psychiatrist... seem to have it down. Haha.

OP

I never pass through cardiology department, FYI.

No field is better or worst by itself. It is all about the right person in the right field.

For example, IMDoc607 is clearly someone who is happy with what he is doing. and I can name a lot of radiologists (or cardiologists) who is miserable in what they do.

Read the previous posts again and find out who is jealous and who is not.
 
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I'm sorry that this conversation got out of hand. I think there is some serious misconceptions here.

I'm a medical student. I'm confident I can enter any field except plastics/derm. I'm not interested in surgery or clinic. I'm not a fan of being in a lab all day.

What I mean is this- I have no bone in one career or another. I find cardiology intellectually challenging. I'm sure other fields are as well.

I'm more interested in ascertaining the issues currently involved in medical salaries and what factors play a role and what can be done to mitigate the problems we face.

I do believe that certain fields should be paid less.

I have no misery walking through radiology- nor any other field simply because I don't know what I will do...although after having my psych rotation I wonder if you are not projecting?

You have to do another psych rotation, dude. You have not learned it well.
 
I never pass through cardiology department, FYI.
FYI eh?
Got it. You're a super happy radiologist who never passes through the cardiology department... just sometimes through the cardiology forums for sh*ts and giggles.

Thanks for clarifying that.

OP
 
FYI eh?
Got it. You're a super happy radiologist who never passes through the cardiology department... just sometimes through the cardiology forums for sh*ts and giggles.

Thanks for clarifying that.

OP

Nope. Because my girlfriend is in her last year of cardiology fellowship and we are trying hard to find a job for her here in the area which is a very tight market for everything.

I looked here and saw this forum about jobs.

I am not here to argue with you or anybody else. And these days I am not super happy. We both just feel not good because her search for jobs is disappointing. Also, radiology jobs are very far and few. I don't know how we can make it work.
 
Sorry to hear about your plight bro. Job market is crap especially in bigger markets. I share your pain. Definitely not a gratifying feeling to finish 15 years of training only to be told move out to smaller cities as no good job opportunity in the big ones.

Heck even some of the smaller cities are tight competition. I called this group that put a job listing last month for IC in smaller city in Washington, 30 mins north of Oregon border. They got 174! replies/applicants, interviewed 4 and already filled in less than 3 weeks. Depressing.

Well at least with you having a job it can provide her with more time to look until hopefully something opens up. The problem is a lot of private groups (what is left of them) are in a hire freeze as they don't know how the new affordable heath care act will change their practice.

OP
 
Sorry to hear about your plight bro. Job market is crap especially in bigger markets. I share your pain. Definitely not a gratifying feeling to finish 15 years of training only to be told move out to smaller cities as no good job opportunity in the big ones.

Heck even some of the smaller cities are tight competition. I called this group that put a job listing last month for IC in smaller city in Washington, 30 mins north of Oregon border. They got 174! replies/applicants, interviewed 4 and already filled in less than 3 weeks. Depressing.

Well at least with you having a job it can provide her with more time to look until hopefully something opens up. The problem is a lot of private groups (what is left of them) are in a hire freeze as they don't know how the new affordable heath care act will change their practice.

OP


Thanks for your comment.

Our problem is two sided. Radiology market is also very tight. So the odds is pretty low for both of us having jobs in the same region. She decided that if she can not find a good job this year, she may stay at her program for some kind of additional training like heart failure or imaging or something like that to increase the chances and to buy some time.

I hope all of us can find the job that we like in the region that we like.

Good Luck.
 
I'm glad this thread is turning around from what seemed to be a nasty thread. Anyway let's forget about discussing every other field except cardiology.

OP if you have any advice for me let me know.


Thanks everyone
 
And again FYI, our IR people are on call 1/4 or 1:5.

IR call isn't really relevant because it's well-known by everyone in the hospital that getting an IR guy to come in after hours is almost impossible. Even diagnostic radiologists acknowledge that. You could make me on call 24/7 if I could always fight coming in. Oh, and when I say "fight coming in," I mean "successfully," lol. I realize that someone's going to say that surgeons always fight coming in. :)
 
Thanks for your comment.

Our problem is two sided. Radiology market is also very tight. So the odds is pretty low for both of us having jobs in the same region. She decided that if she can not find a good job this year, she may stay at her program for some kind of additional training like heart failure or imaging or something like that to increase the chances and to buy some time.

I hope all of us can find the job that we like in the region that we like.

Good Luck.
Ok well
Glad conversation has turned professional I was worried it wouldn't

How permanent are the private practice problems OP?

Do you feel we can change the system so that private practice can succeed down the road or is this systemic?

Why do some private practice's still exist?
 
Ok well
Glad conversation has turned professional I was worried it wouldn't

How permanent are the private practice problems OP?

Do you feel we can change the system so that private practice can succeed down the road or is this systemic?

Why do some private practice's still exist?

As a follow up, I have read many times on this forum, that certain private practices get bought out. What would one say is the biggest difference betweeen private practices that get bought out, versus those that are able to remain independent? What are specific factors that allow a practice to remain independent, versus being bought out?
 
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What would one say is the biggest difference betweeen private practices that get bought out, versus those that are able to remain independent? What are specific factors that allow a practice to remain independent, versus being bought out?

...guts
 

When you guys mean "bought out", doesn't this just mean you get acquired, but you still have a job (i.e. work for the company/institution that acquired your practice)? Are people just griping because the income isn't as stellar compared to when you were private practice?

For example, heard from many people that the Kaiser system in CA pays cardiologists well, provides great benefits, and great work hours...so isn't being acquired by a larger institution not so bad after all? Or even if you work as clinical faculty at university based systems... those guys pay decent (from what I can see on publicly displayed salaries online)...
 
When you guys mean "bought out", doesn't this just mean you get acquired, but you still have a job (i.e. work for the company/institution that acquired your practice)? Are people just griping because the income isn't as stellar compared to when you were private practice?

For example, heard from many people that the Kaiser system in CA pays cardiologists well, provides great benefits, and great work hours...so isn't being acquired by a larger institution not so bad after all? Or even if you work as clinical faculty at university based systems... those guys pay decent (from what I can see on publicly displayed salaries online)...

its not so much the pay but that you have to work longer hours for similar pay more paper work, less autonomy
 
If we wanted to get rich, we should have joined the corrupt political system or become suave investment bankers taking advantage of the Federal Reserve policy of loose Keynesian economics!

We should be physicians for the sake of loving our craft.

Too naive? I agree.

We should all just get as much capital from being a physician as possible and then start our real business with spreading pharmaceutical power to the rest of the world. Getting Western drugs over to China can be very profitable in theory.
 
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