5 Overblown Fears About Healthcare Reform

[hope12]

http://www.usnews.com/money/blogs/flowchart/2010/3/22/5-overblown-fears-about-healthcare-reform.html
Doctors will revolt. Doctors don't like the current system, in which insurance companies call the shots. But instead of sweeping reform and more government involvement, they prefer gradual reform that puts more control in the hands of … doctors. In one recent survey, nearly one third of physicians said they'd consider leaving medicine if reform passes, which it now has. Doctors worry that the new rules will cut into their incomes—which may happen, eventually. But it's implausible that thousand of doctors who have dedicated years to a complex profession will simply quit. What will they do? Become accountants? Open a Subway franchise? Besides, with millions of new patients seeking care, the demand for doctors will actually rise, not decline. And if cost controls discourage the docs who are in it to get rich, maybe that will help bring costs down for everybody else. Meanwhile, the American Medical Association and dozens of other physicians' lobbying groups will continue to look out for doctors' interests in Washington.

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[Green Grass]

And if cost controls discourage the docs who are in it to get rich, maybe that will help bring costs down for everybody else.

Meanwhile, the American Medical Association and dozens of other physicians' lobbying groups will continue to look out for doctors' interests in Washington.

First, some of us aren't "in it to get rich", but we certainly want to live comfortably and not be paying on our loans until we are 60 years old. There's a big sacrifice in pursuing medicine as a career and I think the older generation representing us in Washington has forgotten that.

Second, I don't necessarily think the AMA is always looking out for doctors' interests. If that was the case, maybe something positive would have been included in the health care bill. Sure we can all get the warm and fuzzies from treating patients, but we also have to take care of ourselves. Increased taxes, no tort reform, and expanded medicaid is NOT looking out for your own.

 

[clueless1]

There are a lot of things doctors can do outside of medicine - they are highly trained, generally intelligent and hard-working individuals. The borderline mocking tone of this writer is insulting...

I'm not saying doctors are going to leave en masse (I doubt it), but his rhetorical questions of "What will they do? Become accountants? Open a Subway franchise?" shows how low his regard for physicians is. The answer to his question is "Anything they want". And becoming an accountant or opening a Subway franchise might not look too bad in a few years...

 

[PostLessOne]

Opportunity costs mean that a lot of doctors won't leave. However, there are a lot of older physicians out there who have enough saved up that they have the option of retiring. Lower reimbursements enough, and those folks will leave or cut their hours back sharply.

 

[docB]

Doctors will revolt. Doctors don't like the current system, in which insurance companies call the shots. But instead of sweeping reform and more government involvement, they prefer gradual reform that puts more control in the hands of … doctors. In one recent survey, nearly one third of physicians said they'd consider leaving medicine if reform passes, which it now has. Doctors worry that the new rules will cut into their incomes—which may happen, eventually. But it's implausible that thousand of doctors who have dedicated years to a complex profession will simply quit. What will they do? Become accountants? Open a Subway franchise?

It’s really not implausible. There are many physicians whose practices are only marginally profitable at this point. It won’t take much to push them out. Many more of us are so unhappy with the profession as it is now that each incremental worsening of the field brings us closer to an exodus. The majority of docs I know would leave clinical medicine in an instant if they would make comparable income in a non-clinical job. I think this will definitely drive out a lot of older docs who are within 5 to 10 years of retirement.

Besides, with millions of new patients seeking care, the demand for doctors will actually rise, not decline. And if cost controls discourage the docs who are in it to get rich, maybe that will help bring costs down for everybody else. Meanwhile, the American Medical Association and dozens of other physicians' lobbying groups will continue to look out for doctors' interests in Washington.

If the demand rises but reimbursement goes down what good is that. Imagine if there were suddenly millions more people wanting to buy a car for $1000. Would the automakers be happy? What if there was a law that said they have to deliver those $1000 cars? Would they go out of business?

As for the AMA and other physician groups representing us that’s not going to be that big of a help. They have shown their tendencies to compromise to the point of being almost suicidal so that they don’t wind up on the losing side of an issue. The bend but don’t break philosophy only works if you don’t wind up broken at the end.

 

[bronx43]

There are a lot of things doctors can do outside of medicine - they are highly trained, generally intelligent and hard-working individuals. The borderline mocking tone of this writer is insulting...

I'm not saying doctors are going to leave en masse (I doubt it), but his rhetorical questions of "What will they do? Become accountants? Open a Subway franchise?" shows how low his regard for physicians is. The answer to his question is "Anything they want". And becoming an accountant or opening a Subway franchise might not look too bad in a few years...

What the author is saying is true. Even if paycuts come, specialists can still expect around $200k, and primary care $150k. There aren't many opportunities out there that can provide that kind of income with the kind of stability that medicine offers. So, I agree with him. What are doctors going to do if they leave medicine?

 

[clueless1]

What the author is saying is true. Even if paycuts come, specialists can still expect around $200k, and primary care $150k. There aren't many opportunities out there that can provide that kind of income with the kind of stability that medicine offers. So, I agree with him. What are doctors going to do if they leave medicine?

To reiterate: whatever they want.

I'm not saying this will happen, but it isn't like having a medical degree prevents your from doing anything else. Lawyers, for example, have done an excellent job of convincing everyone that a law degree is useful for just about anything, and therefore you see lawyers doing everything from practicing law to running companies. I imagine that most people that have been in medicine for any period of time know MD's that have moved on to do different things (consulting, gone into business, gone to work for pharma companies, etc.).

Again, arguing that doctors WON'T move on to other things isn't the same as saying that they CAN'T.

 

[bronx43]

To reiterate: whatever they want.

I'm not saying this will happen, but it isn't like having a medical degree prevents your from doing anything else. Lawyers, for example, have done an excellent job of convincing everyone that a law degree is useful for just about anything, and therefore you see lawyers doing everything from practicing law to running companies. I imagine that most people that have been in medicine for any period of time know MD's that have moved on to do different things (consulting, gone into business, gone to work for pharma companies, etc.).

Again, arguing that doctors WON'T move on to other things isn't the same as saying that they CAN'T.

There is no physical barrier preventing doctors from leaving medicine. That was never the point the author was trying to make.
The point is that there's no reason for doctors to leave medicine, because the vast majority wouldn't be able to find a better alternative. How are most doctors going to make $150-200k outside of medicine?
The fields that you mentioned (consulting, business, pharma) are rather limited, and difficult to get into. They also don't pay better than medicine. It's ALOT harder than you think to get a job at a pharmaceutical company, especially one that immediately pays in the six figures.
Medical consulting is a very very small market, and most firms would probably only take doctors who also have MBAs. If you're talking about management consulting, then that's an even more limited profession for doctors. Try getting a job at AT Kearney, ZS Associates, Diamond, Bain, etc.
And I don't know what you mean by business. You mean entrepreneurship? If you do, keep in mind that the vast majority of startups fail.

So to reiterate- doctors CAN leave medicine, but it's foolish to think that more than a small handful would be able to find other opportunities that can pay as much as a career in medicine.

 

[cpants]

There is no physical barrier preventing doctors from leaving medicine. That was never the point the author was trying to make.
The point is that there's no reason for doctors to leave medicine, because the vast majority wouldn't be able to find a better alternative. How are most doctors going to make $150-200k outside of medicine?
The fields that you mentioned (consulting, business, pharma) are rather limited, and difficult to get into. They also don't pay better than medicine. It's ALOT harder than you think to get a job at a pharmaceutical company, especially one that immediately pays in the six figures.
Medical consulting is a very very small market, and most firms would probably only take doctors who also have MBAs. If you're talking about management consulting, then that's an even more limited profession for doctors. Try getting a job at AT Kearney, ZS Associates, Diamond, Bain, etc.
And I don't know what you mean by business. You mean entrepreneurship? If you do, keep in mind that the vast majority of startups fail.

So to reiterate- doctors CAN leave medicine, but it's foolish to think that more than a small handful would be able to find other opportunities that can pay as much as a career in medicine.

I agree with you. Most high paying careers, like medicine, require a lot of experience and training before you start getting the big bucks. There really aren't a lot of options that doctors could just walk into and pull in 200k+/year. As those salaries get pushed closer and closer to 100k, it will get a lot more tempting to leave, go back to school, start a new career, etc. New applicants to medical school will be less qualified.

People will look at doctors and say boohoo you are still making more than most people at 100k. You are still rich. But most people don't realize the sacrifices that go into this career. The years of education. The huge debt. The backbreaking hours most doctors work. The huge responsibility. Good luck recruiting the best and brightest without proper compensation.

 

[bronx43]

I agree with you. Most high paying careers, like medicine, require a lot of experience and training before you start getting the big bucks. There really aren't a lot of options that doctors could just walk into and pull in 200k+/year. As those salaries get pushed closer and closer to 100k, it will get a lot more tempting to leave, go back to school, start a new career, etc. New applicants to medical school will be less qualified.

People will look at doctors and say boohoo you are still making more than most people at 100k. You are still rich. But most people don't realize the sacrifices that go into this career. The years of education. The huge debt. The backbreaking hours most doctors work. The huge responsibility. Good luck recruiting the best and brightest without proper compensation.

Yeah, but I don't think salaries will ever drop THAT low. Retail pharmacists are making upwards of $120k, and there's no way a system can be sustainable when you have pharmacists making more than physicians.

My advice for any undergrad, who attends a top national university, is to go into finance. If I can go back in time, that's what I would have done.

 

[NoMoreAMCAS]

My advice for any undergrad, who attends a top national university, is to go into finance. If I can go back in time, that's what I would have done.

Me too. Just way too many problems with healthcare now. Not that finance isn't also risky, but it doesn't require 11-15 years of schooling/training and a massive accumulation of debt.

 

[bronx43]

Me too. Just way too many problems with healthcare now. Not that finance isn't also risky, but it doesn't require 11-15 years of schooling/training and a massive accumulation of debt.

Finance isn't so much risky as it is a downright soul sucker, especially IBD. The money in finance is far beyond anything available outside of successfully starting a Fortune 500 corporation, and that's the essential draw of it. The actual work is nothing short of inefficient drag. However, if you can withstand it, you'll be pulling some serious cash.
I got a couple of buddies in PE, and a few still in banking. They all work ridiculous hours, but they're pulling in $250-350k at the age of 25.

 

[MOHS_01]

Finance isn't so much risky as it is a downright soul sucker, especially IBD. The money in finance is far beyond anything available outside of successfully starting a Fortune 500 corporation, and that's the essential draw of it. The actual work is nothing short of inefficient drag. However, if you can withstand it, you'll be pulling some serious cash.
I got a couple of buddies in PE, and a few still in banking. They all work ridiculous hours, but they're pulling in $250-350k at the age of 25.

Same here... and 30-35yo friends and acquaintances pulling in high six figures routinely... to one even pulling damn near 8 figures -- last year ...

 

[bronx43]

Same here... and 30-35yo friends and acquaintances pulling in high six figures routinely... to one even pulling damn near 8 figures -- last year ...

8 figures? Damn... that's IBD director, PE partner, or HF principal money. That's pretty badass.

 

[MOHS_01]

8 figures? Damn... that's IBD director, PE partner, or HF principal money. That's pretty badass.

His title during the summer of 2008 was senior VP at one of the big four accounting firms... before that he was a president at a financial analytical firm in Manhattan. He has since had two promotions and at one point at least was a director of something or other -- our world's are sufficiently different that we don't talk shop much, preferring to focus on the finer things in life (kids, ass, etc)

I'd be lying if I said that I was not jealous a bit. He has taken my brother under his wing, though, and is helping him navigate the waters (for which I am eternally grateful). My brother is not doing too bad for himself now (25 and in the earning peer group you mentioned). Another year or two and he'll be positioned well, I believe.

 

[bronx43]

His title during the summer of 2008 was senior VP at one of the big four accounting firms... before that he was a president at a financial analytical firm in Manhattan. He has since had two promotions and at one point at least was a director of something or other -- our world's are sufficiently different that we don't talk shop much, preferring to focus on the finer things in life (kids, ass, etc)

I'd be lying if I said that I was not jealous a bit. He has taken my brother under his wing, though, and is helping him navigate the waters (for which I am eternally grateful). My brother is not doing too bad for himself now (25 and in the earning peer group you mentioned). Another year or two and he'll be positioned well, I believe.

Senior VP at an accounting firm? Are you sure? I have never heard of a VP in accounting making 8 figures. Accounting is easily one of the less lucrative avenues of business. Those numbers sound more along the lines of finance compensations.

 

[MOHS_01]

.

 

[Apollyon]

8 figures? Damn... that's IBD director, PE partner, or HF principal money. That's pretty badass.

I am such a doctor. What I see here is "inflammatory bowel disease", "pulmonary embolism", and "heart failure".

(I'm thinking it's "hedge fund"; is it "private equity"? And "IBD" - "Investor's Business Daily?)

 

[MOHS_01]

Apollyon,

2 out of 3 correct, I think... I believe IBD stands for investment banking division.

 

[Llenroc]

Me too. Just way too many problems with healthcare now. Not that finance isn't also risky, but it doesn't require 11-15 years of schooling/training and a massive accumulation of debt.

I went to an Ivy League school and hundreds of people would turn out for Wall Street firm recruiting events, for maybe 5-10 jobs. Of those maybe maybe two are in investment banking, and the remaining in somewhat less desireable trader positions, and a few even secretarial/human resources type work (for the girls ). Those jobs (especially the investment banking ones) are very hard to get. To say to someone, "if you want to make money do investment banking" is pretty ludicrous, unless their family is well connected to begin with. You might as well say, "don't work, you should get a rich father."

It's not like medicine where if you do A, B, and C, with X, Y, and Z results you can be somewhat assured of getting a position somewhere in medical school.

But don't let this deter you young grasshoppers for seeking out corporate jobs. In fact, I encourage it. If you happen to fail, you've got med school as a back up. Econ majors have nothing. If you succeed, chances are your corporate career won't last more than 3-5 years due to the pyramid structure at these organizations (especially in financial services), after which you can always go to medical school.