A Hypothetical Situation

[greenbean]

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There are obviously alot factors that influence a person's decision to go into medicine and to choose a particular field. I would like to describe my hypothetical world and ask some ?s to generate some discussion.

We are in the USA. We will all pay 50% income tax, that's right everyone, regardless of income. Healthcare will be free(you don't have to pay for hospital stays, doctor's fee's, medications, lab tests/imaging). Cost of education will be minimal for higher education(I will arbitrarily say $10k/yr).

Doctors salaries will be $50k/yr. This is regardless of what field they will work in and will be fixed.So a neurosurgeon will make the same as a psychiatrist. They will work 40 hrs per week, no more and no less. For those who go over their 40 hr limit, they will get overtime pay. Essentially, physicians will become employees of the government(ie like VA docs today). The years of training will be same as they are now. So, if it takes 7 yrs to be a neurosurgeon,then so be it. If a certain field starts to develop a shortage, it will be more students would be steered into going into those said fields.

There will be a nationwide electronic medical record. This way, any medical care provider can look up info on a pt regardless of where they seek their care.

Malpractice will not exist and rather will be covered by taxation to review cases of gross negligence/incompetence. Hmo's/private insurance won't exist either, because health care is guaranteed by the gov't.

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So, I've made up my hypothetical world.
1. With the situation described, would you have still decided to go into medicine at all? Would you be more likely to go into medicine,less likely, or the situation described would not factor at all?

2. With the situation described, would you have still decided to go into the particular specialty of medicine that you have dedicated yourself to? Or would it make no difference?

Feel free to critique my hypothetical world too. I love listening to others' opinions and i guess thats why i like this site so much. toodles

 

[bkpa2med]

First off, if the training remains the same let me tell you this that if doctors salaries are $50k you won't get very far. Doctor's complain about FP salaries which are ~$180k where I'm from.

 

[dawg44]

There are obviously alot factors that influence a person's decision to go into medicine and to choose a particular field. I would like to describe my hypothetical world and ask some ?s to generate some discussion.

We are in the USA. We will all pay 50% income tax, that's right everyone, regardless of income. Healthcare will be free(you don't have to pay for hospital stays, doctor's fee's, medications, lab tests/imaging). Cost of education will be minimal for higher education(I will arbitrarily say $10k/yr).

Doctors salaries will be $50k/yr. This is regardless of what field they will work in and will be fixed.So a neurosurgeon will make the same as a psychiatrist. They will work 40 hrs per week, no more and no less. For those who go over their 40 hr limit, they will get overtime pay. Essentially, physicians will become employees of the government(ie like VA docs today). The years of training will be same as they are now. So, if it takes 7 yrs to be a neurosurgeon,then so be it. If a certain field starts to develop a shortage, it will be more students would be steered into going into those said fields.

There will be a nationwide electronic medical record. This way, any medical care provider can look up info on a pt regardless of where they seek their care.

Malpractice will not exist and rather will be covered by taxation to review cases of gross negligence/incompetence. Hmo's/private insurance won't exist either, because health care is guaranteed by the gov't.

```````
So, I've made up my hypothetical world.
1. With the situation described, would you have still decided to go into medicine at all? Would you be more likely to go into medicine,less likely, or the situation described would not factor at all?

2. With the situation described, would you have still decided to go into the particular specialty of medicine that you have dedicated yourself to? Or would it make no difference?

Feel free to critique my hypothetical world too. I love listening to others' opinions and i guess thats why i like this site so much. toodles

1) No, not as likely if I went into medicine I would be a pharmacist and make more than a neurosurgeon in this situation or CRNA and make triple.
2) No because more than likely I wouldn't be in medicine.

 

[McDoctor]

No and No.

If I had it to do all over again, I would go to film school because I like movies.

BTW, the various levels of local, state and federal government still can't figure out how to get my street plowed in the winter. I don't want them making healthcare decisions for me and my family.

 

[deleted87716]

I can't figure out what you're trying to ask.

Would we go into medicine if there were no income differences between specialties? Or, would we go into medicine if we could easily make a better living doing practically anything else?

 

[greenbean]

well, i will add the following to answer kent

lets just say everyone makes the same amount no matter what profession they are in and this will depend on the amount of education they have: doctor=lawyer=engineer=professor=mba

my question was to ask whether as many people would go into medicine with a lower but steady salary and all the hassles of malpractice/finding pts would be eliminated and also to see if people would change the fields of medicine they choose based on the situation described... from the responses generated so far, there are some who wouldn't even think about medicine given the case described

 

[deleted87716]

Hmm...good luck finding a decent doctor in that hypothetical world of yours. I suspect all the best and brightest will be serving up lattes at Starbucks. 😉

 

[group_theory]

Hmm...good luck finding a decent doctor in that hypothetical world of yours. I suspect all the best and brightest will be serving up lattes at Starbucks. 😉

Good luck finding ANY doctors, let alone a decent one.

You're asking people to give up their 20s (and delay having a family ... or else have a family but live below poverty) and study long hours just so they can make $50k (and after 50% tax, net income of $25k) ... in a field controlled by the government (since income and work hours are controlled by the government, what's next) - and what's worse ... have to pay back their loans ($10k/year x 8 years = $80k + interest just in tuition, but what about books, food, rent, gas/car insurance for away rotations, fees require for all 3 steps of the boards, ERAS/NRMP/Airline/Hotel for MS4 year when you look for residency)

In the end, you won't have any physicians at all ... since you will have to pay both in terms of time and in terms of money ... to take care of people

And since you are limiting work hours to 40 hrs/week, who will cover the late evening and night shift, or answer phone calls when nobody is on? Or do you expect the few remaining physicians that are left to take all the calls (and just technically not count it towards the 40 hr/week rule)

 

[brookliner7]

well, i will add the following to answer kent

lets just say everyone makes the same amount no matter what profession they are in and this will depend on the amount of education they have: doctor=lawyer=engineer=professor=mba

my question was to ask whether as many people would go into medicine with a lower but steady salary and all the hassles of malpractice/finding pts would be eliminated and also to see if people would change the fields of medicine they choose based on the situation described... from the responses generated so far, there are some who wouldn't even think about medicine given the case described

well, though I think the stress of being a physician would be a lot higher than an engineer professor etc.heck, i would do it anyways.

Money is one thing, but to me, the most important thing is being able to help people to the highest degree that I am capable of.🙂

 

[aesop13]

I have relatives that live in Canada, and if you may or may not know, Canadians recieve free health care, and dental if the problem is affecting their health adversely.

Income tax over there is nearly 50% for everyone, including doctors.

My cousins say that when you go to a doctors office, it's like visiting a free clinic (it essentially is). I don't know if any of you have been to a free clinic, but it's over crowded because it's free so people with the most mundane and sometimes people that are simply paranoid, all come. The waiting time is much longer than in the US and once you get in, all that's in the office is basic essentials. A clipboard, sethoscope, and a couple chairs.

If the doctor diagnoses you with something like the common cold, he'll most likely just tell you to take some over the counter meds and get some rest. The general physician in Canada just essentially acts as a gateway for specialist.

Which is why now in Canada pharmacists are allowed to prescribe medicine now, after you visit them for a consult. I'm assuming this is to cut down on the wait time at the doctor's office. According to them, the highest paid physican, which would probably a cardiothoracic surgeon or some sort, is paid around 170-200K. General physicans are paid as in the OP's thread, around 50-70K.

 

[aesop13]

and to answer ur question i probably wouldn't do it.

 

[Miami_med]

Your hypothetical world sounds like the dark side of Atlas Shrugged.

I think any profession that forces a fixed wage and perpetual service to government whims tends to be underserved. Those that do are often not the best and the brightest. Your suggestion would probably kill medicine faster than any other course of action.

I'm scared to death of the steps that we are taking in that direction already. It's scary to think that between the politicians, the doctors, and the public at large, there is such a miniscule understanding of basic economic principles that something like this might actually be temporarily allowed to occur.

 

[LanceArmstrong]

well, i will add the following to answer kent

lets just say everyone makes the same amount no matter what profession they are in and this will depend on the amount of education they have: doctor=lawyer=engineer=professor=mba

my question was to ask whether as many people would go into medicine with a lower but steady salary and all the hassles of malpractice/finding pts would be eliminated and also to see if people would change the fields of medicine they choose based on the situation described... from the responses generated so far, there are some who wouldn't even think about medicine given the case described

This just sounds very communist / socialist to me.

The fact is people are motivated by money, prestige and one-upping each other.👍

With 7 year of education a salary of 50k in the current market is not even seen in professions such as a phd in ancient babylonian art or botany.

If the government were to pay all physicians such a low base pay I think most would have to find other ways to supplement their income by providing a service thats not otherwise usually availble...

My 2 cents.

 

[JoBlo]

That whole hypothetical scenario basically amasses to a severe doctor shortage (the result being year long waits for clinic visits, etc)... the only way to circumvent the shortage would be to decrease admission and training standards = poorer trained and less compentant physicians.

 

[m0nk3y]

i think it's clear that nearly everyone who wants to be a doctor is at least partially in it for the money. personally, given the above hypothetical situation, there's almost no way i'd go into medicine. i don't think i love medicine enough to give up my 20s for the same gain as someone who started working right out of college for, say, an investment bank. heck i'd probably end up doing that considering i'm a finance major at nyu. 40 hours a week and start working immediately as opposed to 8 years of school and residency? heck yeah.

 

[Miami_med]

It's as much about freedom and efficiency as it is money.