So US Doctor pay is going to decrease with health care reform, but by how much?

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rorod

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Does anyone know to what level doctor's salaries will adjust to? I mean I've read things like specialty docs will see their compensation decrease, anybody have a reasonable guess by how much (are we talking 5%,25%,50%)? I've also read that primary care docs will see their compensation rise. Is this true or will they also see their pay decrease and again any guess by how much in either direction?

Is there another country's health care system that US policymakers are trying to model our new health care system on that we could then extrapolate from their doctor salaries?

If doctor salaries decrease by a significant amount, will burdens such as medical school tuition, malpractice liability, long hours worked somehow be eased?

I mean I understand the current health care system is unsustainable and that sacrifices need to be made, but I think it has to be a shared sacrifice with all the players giving a little. But sometimes it just seems like the medical profession is completely bearing the brunt, or am I missing something?
 
rorod said:
Does anyone know to what level doctor's salaries will adjust to? I mean I've read things like specialty docs will see their compensation decrease, anybody have a reasonable guess by how much (are we talking 5%,25%,50%)? I've also read that primary care docs will see their compensation rise. Is this true or will they also see their pay decrease and again any guess by how much in either direction?

Is there another country's health care system that US policymakers are trying to model our new health care system on that we could then extrapolate from their doctor salaries?

If doctor salaries decrease by a significant amount, will burdens such as medical school tuition, malpractice liability, long hours worked somehow be eased?

I mean I understand the current health care system is unsustainable and that sacrifices need to be made, but I think it has to be a shared sacrifice with all the players giving a little. But sometimes it just seems like the medical profession is completely bearing the brunt, or am I missing something?
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To answer your first question: nobody knows. There is no little detail in how to actually implement 'healthcare reform' that it is impossible to guess.

That said, if we were to try and model ourselves after other successful systems then yes you might get an idea. However, in most of them the cost to become a Dr is comparable to becoming any other profession.

If these are legit questions for you or anyone I would strongly suggest reading The Healing of America by T.R. Reid. He is a journalist that traveled the globe several years ago (pre-obama) and looked at various healthcare models. It does a great job outlining the differences and what works and what doesn't.

Here is a link if you want to look at it. http://www.amazon.com/Healing-Ameri...8218/ref=sr_1_1?ie=UTF8&qid=1322002244&sr=8-1
 
LifeTake2 said:
... The Healing of America by T.R. Reid. He is a journalist that traveled the globe several years ago (pre-obama) and looked at various healthcare models. It does a great job outlining the differences...
Click to expand...

👍 I both loved that book and sounded intelligent at interviews because of it
 
LifeTake2 said:
To answer your first question: nobody knows. There is no little detail in how to actually implement 'healthcare reform' that it is impossible to guess.

That said, if we were to try and model ourselves after other successful systems then yes you might get an idea. However, in most of them the cost to become a Dr is comparable to becoming any other profession.

If these are legit questions for you or anyone I would strongly suggest reading The Healing of America by T.R. Reid. He is a journalist that traveled the globe several years ago (pre-obama) and looked at various healthcare models. It does a great job outlining the differences and what works and what doesn't.

Here is a link if you want to look at it. http://www.amazon.com/Healing-Ameri...8218/ref=sr_1_1?ie=UTF8&qid=1322002244&sr=8-1
Click to expand...

I also liked his documentary, which is on netflix.
 
In short term--we are looking at at least 2% cut to reimbursements. If you have any overhead in your business, then it will be more than that. The more overhead, the bigger the cut.

Source: http://www.politico.com/news/stories/1111/68904.html
Quote from the above Politico link:
"And the alternative to a supercommittee deal on health care entitlements — the 2 percent automatic cuts in health care payments and defense funding that will now take place in 2013 — wasn't harsh enough to force a deal on Medicare and Medicaid. "

Long term--nobody knows. IMO it will be more than anybody expects.
 
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kind of wish I got more into computers and programming when I was in my teens, wouldn't have to suffer through this doctor thing now, but can't really live with regrets, it is what it is.
 
I'd love to make good money etc but I'm sure I won't be homeless with a physician salary even if it was decrease. The only thing I'm worried about is being able to pay off loans without too many hardships.
 
MrBean said:
Just be glad you chose medicine. If you were a C&S major, most likely you would be one of those occupy Wall street folks. 🙂 I worked for a software company during my undergrad. The company has downsized significantly due to outsourcing. They can get people from India, Russia and China to write clean codes for far less.
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True, but the code isn't always clean and is much harder to regulate/enforce from afar.

But you're right, CS majors are playing a dangerous game because every kid in a developing country with a computer and a dream can become your competition and for pennies on the dollar. I think it'll certainly drive prices down soon and the high salaries that CS majors enjoy will eventually fall.

</doom&gloom>
 
Yeah, don't go into medicine for the money. Do it because you love it. If you're successful and passionate you WILL make enough money to survive comfortably. The obsession with making high salaries on SDN is ridiculous. Do people even realize the median income in the US? You will be FINE. If loan repayment is a big concern for you, just seek out some service options or something; there are many ways to be very financially comfortable in medicine. I'll be happy to make more than I had growing up which wasn't a whole lot!
 
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kansaskid said:
Yeah, don't go into medicine for the money. Do it because you love it. If you're successful and passionate you WILL make enough money to survive comfortably. The obsession with making high salaries on SDN is ridiculous. Do people even realize the median income in the US? You will be FINE. If loan repayment is a big concern for you, just seek out some service options or something; there are many ways to be very financially comfortable in medicine. I'll be happy to make more than I had growing up which wasn't a whole lot!
Click to expand...

This is nice in dream land, but not in the real world. Sure, you'll make more than enough to be comfortable, but it's not "ridiculous" to be concerned about how you're going to pay back the astronomical loans that most people have accrued. And how much longer do you think those loan forgiveness programs are going to be around given that GME funding is on the chopping block? People working under the assumption that those programs will be there are being a bit naive IMO. While you'll definitely make decent money (compared to the national median), depending upon your debt loan those loans will follow you and hurt your financial life for at LEAST 10 years - almost certainly more for most folks.

Caring about money doesn't mean you don't "love it" or aren't "passionate." I love how being worried about money suddenly makes you a greedy bastard on SDN. You wouldn't get this sort of hostility in ANY OTHER PROFESSION if you asked about salaries - it's a legitimate concern, and it's a major factor when ultimately deciding what you want to do or where you want to work.

Believe it or not, it actually is possible to be concerned about your pay while having a strong passion for medicine and desire for being a physician. These things aren't mutually exclusive, and sticking your head in the sand screaming "LALALALALA" when salary discussions come up isn't going to make you a better physician.
 
Why does everyone think doctor pay is going down? If anything, it's going to skyrocket. With the new healthcare law, we have 30 million+ people with insurance coming into the system. Baby boomers will be collecting medicare soon. That's probably an influx of 50 million people over the next 15 years. The total number of incoming doctors is going to remain flat or only slightly increased over the same time period.

At least that's how I see it.
 
notbobtrustme said:
At least that's how I see it.
Click to expand...
Most doctors aren't worried about getting new patients. They already have more than they can handle. Lowering reimbursement rates just means that they are getting paid less because they don't have time to add more patients.

The insurance companies are the ones who should benefit the most, because their pools of healthy people should be increasing.
 
notbobtrustme said:
Why does everyone think doctor pay is going down? If anything, it's going to skyrocket. With the new healthcare law, we have 30 million+ people with insurance coming into the system. Baby boomers will be collecting medicare soon. That's probably an influx of 50 million people over the next 15 years. The total number of incoming doctors is going to remain flat or only slightly increased over the same time period.

At least that's how I see it.
Click to expand...

This is great in theory, but when you have one entity (CMS) that effectively sets reimbursement rates and is under constant pressure to cut costs, how do you think that's going to ultimately affect physician salaries?

Certainly not "skyrocketing," that's for sure.
 
NickNaylor said:
This is nice in dream land, but not in the real world. Sure, you'll make more than enough to be comfortable, but it's not "ridiculous" to be concerned about how you're going to pay back the astronomical loans that most people have accrued. And how much longer do you think those loan forgiveness programs are going to be around given that GME funding is on the chopping block? People working under the assumption that those programs will be there are being a bit naive IMO. While you'll definitely make decent money (compared to the national median), depending upon your debt loan those loans will follow you and hurt your financial life for at LEAST 10 years - almost certainly more for most folks.

Caring about money doesn't mean you don't "love it" or aren't "passionate." I love how being worried about money suddenly makes you a greedy bastard on SDN. You wouldn't get this sort of hostility in ANY OTHER PROFESSION if you asked about salaries - it's a legitimate concern, and it's a major factor when ultimately deciding what you want to do or where you want to work.

Believe it or not, it actually is possible to be concerned about your pay while having a strong passion for medicine and desire for being a physician. These things aren't mutually exclusive, and sticking your head in the sand screaming "LALALALALA" when salary discussions come up isn't going to make you a better physician.
Click to expand...

Come on Nick, you're not really giving this a fair look. Median household income in the US is about $49,500. The typical doctor income is more than "decent" compared to this. More importantly, very few people with any common financial sense have trouble paying back their loans while still living a happy lifestyle. This only gets sweeter after 10-15 years when your income will rise and most of your loans are gone.

I agree, there's nothing morally wrong with caring about your compensation while loving what you do as a doctor. However, there's a difference between simply caring about your compensation and being obsessed with it. Just listening to some people talk, there's a huge lack of perspective on their "suffering" and the "burdens" they have to bear as underpaid doctors. Let's acknowledge that we all are going to make enormous amounts of money, and will never struggle the way the vast majority of the country does to make ends meet. Let's acknowledge that we're not entitled to a certain salary, but are equally free to pursue another job. Let's acknowledge that many of doctors, particularly academics, already make 30-40% less than their peers but are happy because they get to do what they love.

I fully support seeking out your maximum compensation. However, I think we should do it mindful of reality and where we really fit when compared to the rest of society.
 
Prohok said:
I'd love to make good money etc but I'm sure I won't be homeless with a physician salary even if it was decrease. The only thing I'm worried about is being able to pay off loans without too many hardships.
Click to expand...

This.
While I'm still a pre-med, the thought of salary decreasing by a lot can take a toll on all the loans I would have to pay provided I get in and graduate.
 
Narmerguy said:
Come on Nick, you're not really giving this a fair look. Median household income in the US is about $49,500. The typical doctor income is more than "decent" compared to this. More importantly, very few people with any common financial sense have trouble paying back their loans while still living a happy lifestyle. This only gets sweeter after 10-15 years when your income will rise and most of your loans are gone.

I agree, there's nothing morally wrong with caring about your compensation while loving what you do as a doctor. However, there's a difference between simply caring about your compensation and being obsessed with it. Just listening to some people talk, there's a huge lack of perspective on their "suffering" and the "burdens" they have to bear as underpaid doctors. Let's acknowledge that we all are going to make enormous amounts of money, and will never struggle the way the vast majority of the country does to make ends meet. Let's acknowledge that we're not entitled to a certain salary, but are equally free to pursue another job. Let's acknowledge that many of doctors, particularly academics, already make 30-40% less than their peers but are happy because they get to do what they love.

I fully support seeking out your maximum compensation. However, I think we should do it mindful of reality and where we really fit when compared to the rest of society.
Click to expand...

So now that we've acknowledged all of those things, now what? Where do we go from there?

Let's acknowledge that a majority of the population is either unwilling or unable to handle the rigor of becoming a physician, much less actually working as a physician. Let's acknowledge there are significant costs - many tangible, some not - that come along with becoming a physician, and that the high compensation is due, in part, to defray some of those costs. No, the difficulties aren't along the same lines as someone starving or struggling to pay for rent, but that line of reasoning can be extended infinitely and at some point everyone seems to be incredibly wealthy and greedy in comparison to those less fortunate.

I've always been baffled by the "it's a choice" argument. So because I chose to become a physician I somehow resigned all of my rights to trying to have the most enjoyable, and, dare I say it, lucrative job possible, which is what EVERY SINGLE LABORER IN AMERICA WANTS AND DESIRES? What is it about medicine that makes its future workers so willing to give away all of their benefits in the name of some kind of superficial "passion" or "happiness" that they developed and assume they're going to feel about a job THEY HAVE NEVER DONE?

I agree with you that medicine is in many respects different than any other occupation and that there are inherent parts of the job that make aspects of it undesirable. You accept those costs if you choose to enter the profession. But there are also parts of the career that support the salaries that physicians are paid. I also agree that perspective is critical and that the entitlement that many carry around is asinine and needs to be checked, and obsession with compensation, which at that point becomes greed, is a definite negative. But just because you (using that generally, not necessarily to refer to you) want to be a physician solely because of a "passion" and for "happiness" doesn't necessarily mean that we should go around hitting physicians with high salaries or that want to earn high salaries with the shame stick.

By the way, I'd like to add that I will almost certainly be going into academics. I'm not arguing from the perspective of someone that is going to be a private ortho spine surgeon making a ridiculous salary.

I apologize in advance for typos and any incoherence. I wrote this on my phone at the gym.
 
NickNaylor said:
So now that we've acknowledged all of those things, now what? Where do we go from there?

Let's acknowledge that a majority of the population is either unwilling or unable to handle the rigor of becoming a physician, much less actually working as a physician. Let's acknowledge there are significant costs - many tangible, some not - that come along with becoming a physician, and that the high compensation is due, in part, to defray some of those costs. No, the difficulties aren't along the same lines as someone starving or struggling to pay for rent, but that line of reasoning can be extended infinitely and at some point everyone seems to be incredibly wealthy and greedy in comparison to those less fortunate.

I've always been baffled by the "it's a choice" argument. So because I chose to become a physician I somehow resigned all of my rights to trying to have the most enjoyable, and, dare I say it, lucrative job possible, which is what EVERY SINGLE LABORER IN AMERICA WANTS AND DESIRES? What is it about medicine that makes its future workers so willing to give away all of their benefits in the name of some kind of superficial "passion" or "happiness" that they developed and assume they're going to feel about a job THEY HAVE NEVER DONE?

I agree with you that medicine is in many respects different than any other occupation and that there are inherent parts of the job that make aspects of it undesirable. You accept those costs if you choose to enter the profession. But there are also parts of the career that support the salaries that physicians are paid. I also agree that perspective is critical and that the entitlement that many carry around is asinine and needs to be checked, and obsession with compensation, which at that point becomes greed, is a definite negative. But just because you (using that generally, not necessarily to refer to you) want to be a physician solely because of a "passion" and for "happiness" doesn't necessarily mean that we should go around hitting physicians with high salaries or that want to earn high salaries with the shame stick.

By the way, I'd like to add that I will almost certainly be going into academics. I'm not arguing from the perspective of someone that is going to be a private ortho spine surgeon making a ridiculous salary.

I apologize in advance for typos and any incoherence. I wrote this on my phone at the gym.
Click to expand...

Hear! Hear! 👍
 
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