"but did any of you who are graduating or in residency not know this before you started med school? we were all given fair and extensive warning before we ever applied to med school that it's not what it used to be like and if you wanted to make lots of money, medicine is not the right career to choose. so are any of you really surprised?"
It is impossible to know what you are getting yourself into ahead of time, financially and otherwsie. Period. You can think you understand, but you won't until you shoulder deep in it. Same way you can think you know what it will be like to be on call, but you won't be able to actually comprehend what it's like until you are awake for "30 hours" with your pager simulating your heartbeat and hours of work left before you can sleep.
I am the son of two physicians (who, by the way, have done OK financially, but by no means make the stereotypical physician salary...) . I spent every moment of medical school I could working with a private practice surgeon, in all aspects of his practice. I feel like I had a pretty good handle on the current state of medical economics, residency training, and what it's like to be a physician.
However, I was wrong, particularly about economic issues. This is not meant to be conceited, but, if I can have the exposure that I detailed above and miss the boat, imagine the naive junior in college with no medical training/background at all who is applying for medical school because he/she "just wants to help people". Pretty soon, they will question "what the hell did I get myself into? It's not supposed to be like this! Why do I OWE medicaid money for perfomring a life-saving operation on a patient who hasn't seen a doctor since the cord was cut?"
That is reality and it takes articles like this one to provide detailed analysis of what is actually going on here. If my medical school can mandate sensitivity training so we can learn how to "better treat" our patient's who just want to sue us, why can't they mix in some practice management, medical economics, and general business coursework? Guaranteed to use that more than knowing the structure of certain g protein coupled receptors...
Also in response to that ridiculous post, physicians with your mentality are the one's responsible for physicians loosing control of their own practices/careers. The complacency of you and countless others, and the idea that we do noble work and nothing else should matter, is the reason we are where we are. The appropriate response is to take control, be aggressive, and take the initiative to do what's best for your practice for a change. Pretty soon, those fat HMOs, etc... described in the article will have patient's will rotten gallbladder's calling them on the phone asking for help because nobody will treat them. All of a sudden, they will have to change their policies. I'm not advocating ignoring sick patient's and letting their diseases go untreated, but a smart, methodical, realistic analysis of what's going on in individual practices could drastically improve the careers of countless surgeons.