An article of concern

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Loads of debt and years of training= a higher income

End of debate...
 
I came across this article on MSNBC this morning

http://www.msnbc.msn.com/id/44433135/ns/health-health_care/#.TmjLtOwy5IU

“We’re willing to pay physicians so much because we value health care so much,” she explained. “But, physicians are making five times the median income. Is that what we really want?”

While salaries should probably come down, let's not get ahead of ourselves. Comparing the US system to socialized systems - including how the educational systems operate - is like comparing apples to oranges.

And of course let's not forget the pharmaceutical, insurance, and medical device industries which, according to most health economists, are a bigger part of the cost problem. Physicians salaries comprise a proportionally small share of the overall cost of healthcare. I don't remember the exact figure, but I think something like 10% of healthcare costs go to physician wages.
 
Free market regulation fixes these problems...
 
Crap, it's in the Times too.
http://www.nytimes.com/2011/09/08/us/08docs.html?_r=1&ref=health

I feel like I should write an op-ed reply. The headline is clearly "doctors get paid too much." Yet, nowhere does it mention the astronomical costs fo medical education, low income of residency, and opportunity costs of arriving at a "coveted" and "overpaid" 150K/year to be a PCP at age 34.

Garbage. And scary.
 
I would support reducing physician salaries only if tuition was reduced significantly. I forget the average time, but if you're a PCP paying off your student loans, it no doubt takes many years before you're free of the burden.
 
I would support reducing physician salaries only if tuition was reduced significantly. I forget the average time, but if you're a PCP paying off your student loans, it no doubt takes many years before you're free of the burden.

Age 40+ is the average.
 
The study also neglected to normalize salaries with respect to GDP (PPP) to eliminate the effects of cost-of-living and inflation artifacts. I would wager that the average salary in most fields in the US are higher than their international counterparts. Sorry, PI, but a simple Euro-to-Dollar conversion isn't going to cut it.
 
Let's not forget the US produces the best doctors in the world. And the VERY long education to become a doctor. And the substantially low pay during residency and beginning years. And the very long hours of work.

This and a lot of other things warrant the average physicians higher salary.
 
I would be fine being paid a lower salary if the education was entirely subsidized by the state. Otherwise, hell no.
 
I came across this article on MSNBC this morning

http://www.msnbc.msn.com/id/44433135/ns/health-health_care/#.TmjLtOwy5IU

“We’re willing to pay physicians so much because we value health care so much,” she explained. “But, physicians are making five times the median income. Is that what we really want?”

I lol'ed at this. I'd love to see the person who wrote this article... come in with an osteosarcoma and want to have one of the best oncologists and orthopedic surgeons operating on him... at MGH or Sloan-Kettering.

Then we'd tell him, that he has to see the other lower paid physician who has had equal training and success rates. He probably wouldn't like that very much.
 
While salaries should probably come down, let's not get ahead of ourselves. Comparing the US system to socialized systems - including how the educational systems operate - is like comparing apples to oranges.

And of course let's not forget the pharmaceutical, insurance, and medical device industries which, according to most health economists, are a bigger part of the cost problem. Physicians salaries comprise a proportionally small share of the overall cost of healthcare. I don't remember the exact figure, but I think something like 10% of healthcare costs go to physician wages.

Loads of debt and years of training= a higher income

End of debate...

+1 on both of the above.

Let us also not forget that the average CEO of a health insurance company makes way more than a physician makes, yet you do not see people complaining about their salaries. No, people blame the physicians.

That is not to say that I am bashing CEO's and their salaries, merely I am making a point that the majority of the anger the public is feeling is misdirected and misunderstood.

If more people knew the costs both in terms of money spent (tuition and other educational expenses plus living expenses during undergrad and med school and low salaries during residency) and in terms of lost opportunities and lost income during the time we take to become physicians, perhaps they would stop have knee-jerk reactions to physician salaries.
 
+1 on both of the above.

Let us also not forget that the average CEO of a health insurance company makes way more than a physician makes, yet you do not see people complaining about their salaries. No, people blame the physicians.

That is not to say that I am bashing CEO's and their salaries, merely I am making a point that the majority of the anger the public is feeling is misdirected and misunderstood.

If more people knew the costs both in terms of money spent (tuition and other educational expenses plus living expenses during undergrad and med school and low salaries during residency) and in terms of lost opportunities and lost income during the time we take to become physicians, perhaps they would stop have knee-jerk reactions to physician salaries.


Definitely true. Doctors are just a recognizable entity to lay the blame on, and there is clearly a misunderstanding of the length and cost of the training process that physicians go through. It's concerning; I can't think of a realistic way to disseminate this anger. Healthcare reform that did limit the profiteering in from insurance companies would be wonderful, but who knows when that's coming.
 
Of each dollar spent on health care in the United States, 31% goes to hospital care, 21% goes to physician/clinical services, 10% to pharmaceuticals, 4% to dental, 6% to nursing homes and 3% to home health care, 3% for other retail products, 3% for government public health activities, 7% to administrative costs, 7% to investment, and 6% to other professional services (physical therapists, optometrists, etc).
http://en.wikipedia.org/wiki/Health_care_in_the_United_States

versus

as much as 70 percent of health care costs are due to salaries of health care workers, said Jonathan P. Weiner, a professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health.
http://www.msnbc.msn.com/id/44433135/ns/health-health_care/#.TmjrU5jcn21

It appears that the MSNBC article is talking about all of the salaries of healthcare workers and readers are being misled into thinking that the 70% figure is only the physicians
 
Definitely true. Doctors are just a recognizable entity to lay the blame on, and there is clearly a misunderstanding of the length and cost of the training process that physicians go through. It's concerning; I can't think of a realistic way to disseminate this anger. Healthcare reform that did limit the profiteering in from insurance companies would be wonderful, but who knows when that's coming.

I had a very astute friend theorize that the reason why we're the convenient tropes for the rich or upper-middle class is because we work with the public.

The majority of Americans don't encounter a well-paid insurance company exec, a corporate lawyer, or a Wall-street trader. Pretty much every American, however, DOES see a doctor, and that physician may be the "richest" or wealthiest person they ever meet, even if the salary is only $150K/year.
 
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I would be fine being paid a lower salary if the education was entirely subsidized by the state. Otherwise, hell no.
Yup, as long as I am a slave to these loans, no one better touch my paycheck in the future.
 
I came across this article on MSNBC this morning

http://www.msnbc.msn.com/id/44433135/ns/health-health_care/#.TmjLtOwy5IU

“We’re willing to pay physicians so much because we value health care so much,” she explained. “But, physicians are making five times the median income. Is that what we really want?”

She must think we don't value our kids' educations because we aren't willing to pay teachers anything. In fact, we are reducing their pay and benefits. Damn our kids! They don't need any stinking education!

Is that what we really want?
 
This article is terribly written. Two biggest points:

Do not ALL of the countries she compared us to have FREE medical education? The layperson probably doesn't know this and failing to mention it is terrible journalism.

Also from what I read she fails to account for any differences in productivity. Maybe US orthos make more because they do more procedures.

Bad press but this article likely has no clout with people who affect reimbursements.
 
I do think that orthopedic surgeons have a pretty generous salary relative to the rest of the physician population, so of course their salaries get mentioned in the article. Nobody thinks that a pediatrician making $120K/year in a large metro area with $150K in student loans is really living a life of luxury.
 
This is likely to significantly increase pressure to slash physician salaries, without any corresponding relief from medical school tuition or lawsuits.

In a few months, Medicare reimbursements will fall by one-third unless Congress acts to stop the cut. With this study out, along with the press it's getting, and pressure to cut down on health care costs and government spending in general, do you really think that the cut will be stopped?

Don't count on it.

Doombai...your alarmist posts are getting annoying. Please stop speaking so much about things you know little about.
 
Just read the article again... 70% of healthcare costs are due to healthcare wages?

...what?


FAIL

I had a very astute friend theorize that the reason why we're the convenient tropes for the rich or upper-middle class is because we work with the public.

The majority of Americans don't encounter a well-paid insurance company exec, a corporate lawyer, or a Wall-street trader. Pretty much every American, however, DOES see a doctor, and that physician may be the "richest" or wealthiest person they ever meet, even if the salary is only $150K/year.

+1000000

Very true. Like lawyers we become easy targets. Of course most people don't actually pay or vist a lawyer regularly.
 
If people really want to complain about "over-compensation" they should look at the salaries of some of the top health insurance CEOs and then look at the comparison for physician salaries:


Ins. Co. & CEO With 2007 Total CEO Compensation
Aetna Ronald A. Williams: $23,045,834
Cigna H. Edward Hanway: $25,839,777
Coventry Dale B. Wolf : $14,869,823
Health Net Jay M. Gellert: $3,686,230
Humana Michael McCallister: $10,312,557
U.Health Grp Stephen J. Hemsley: $13,164,529
WellPoint Angela Braly (2007): $9,094,271
L. Glasscock (2006): $23,886,169


Ins. Co. & CEO With 2008 Total CEO Compensation
Aetna, Ronald A. Williams: $24,300,112
Cigna, H. Edward Hanway: $12,236,740
Coventry, Dale Wolf: $9,047,469
Health Net, Jay Gellert: $4,425,355
Humana, Michael McCallister: $4,764,309
U. Health Group, Stephen J. Hemsley: $3,241,042
Wellpoint, Angela Braly: $9,844,212


Compare those to these "rich, greedy SOB docs" (/sarcasm). Uh oh, it looks like someone's argument does not hold water.


Source: http://www.healthreformwatch.com/2009/05/20/health-insurance-ceos-total-compensation-in-2008/
 
Comparing the US system to socialized systems - including how the educational systems operate - is like comparing apples to oranges.

Especially comparing surgeons' income in the US to France. It's not uncommon for US surgeons to work twice as many hours a week as surgeons in France, and it's ridiculous that the article didn't even once mention average hours worked on top of the other factors already pointed out (cost of training, length of training....)
 
Here was one of the comments:

"Let's say a doctor coming out of med school makes $150,000 per year. Let's assume he pays 33% taxes. That's $100,000 after taxes. Let's also say his annual costs of survival (rent, food, clothing, etc.) are $50,000 per year. That leaves $50,000. Let's assume he works at a hospital so he doesn't have to pay a staff.
That leaves $50,000 per year (very rough numbers) to pay down his loan. If my math is anywhere near correct, he can pay off his loan in the first 2-3 years of working.
I may have forgotten the yacht, or the sprawling 5,000 ft2 house, or the BMW, or the Movado.
Please tell me again why doctor's can't make less?"


🙁
 
Here was one of the comments:

"Let's say a doctor coming out of med school makes $150,000 per year. Let's assume he pays 33% taxes. That's $100,000 after taxes. Let's also say his annual costs of survival (rent, food, clothing, etc.) are $50,000 per year. That leaves $50,000. Let's assume he works at a hospital so he doesn't have to pay a staff.
That leaves $50,000 per year (very rough numbers) to pay down his loan. If my math is anywhere near correct, he can pay off his loan in the first 2-3 years of working.
I may have forgotten the yacht, or the sprawling 5,000 ft2 house, or the BMW, or the Movado.
Please tell me again why doctor's can't make less?"


🙁
lol
 
Mmmmeeeeeeh.

At some point the laws of freshman economics kick in.

Demand: Continually increasing, likely to increase more quickly as baby-boomer demographic wave crashes.

Supply: Rigidly controlled by medical schools, massive barriers to entry (new school is expensive), existing supply protects its scarcity.

For these reasons, I don't think that anybody has to worry about physician salaries dropping considerably in the near future. For these reasons I also think medical care should be treated more like a utility than a commodity, but that's just me.
 
this article fails...along with the rest of the liberal media
 
She must think we don't value our kids' educations because we aren't willing to pay teachers anything. In fact, we are reducing their pay and benefits. Damn our kids! They don't need any stinking education!

Is that what we really want?

I am switching from teaching to medical school! I should just get an MBA and use my intellectual ability to rob others blind. God bless America.

P.S. I am not implying all business majors are soul-less thieves. Just the most successful ones.
 
Mmmmeeeeeeh.

At some point the laws of freshman economics kick in.

Demand: Continually increasing, likely to increase more quickly as baby-boomer demographic wave crashes.

Supply: Rigidly controlled by medical schools, massive barriers to entry (new school is expensive), existing supply protects its scarcity.

For these reasons, I don't think that anybody has to worry about physician salaries dropping considerably in the near future. For these reasons I also think medical care should be treated more like a utility than a commodity, but that's just me.

True to an extent, but free-market economics doesn't really apply to medicine as much as it does other sectors because of how doctors are reimbursed. For example, despite there being an acute shortage of PCP's, there is still a downward pressure on their reimbursement and their salaries are lower than specialties where even a surplus may exist.
 
Here was one of the comments:

"Let's say a doctor coming out of med school makes $150,000 per year. Let's assume he pays 33% taxes. That's $100,000 after taxes. Let's also say his annual costs of survival (rent, food, clothing, etc.) are $50,000 per year. That leaves $50,000. Let's assume he works at a hospital so he doesn't have to pay a staff.
That leaves $50,000 per year (very rough numbers) to pay down his loan. If my math is anywhere near correct, he can pay off his loan in the first 2-3 years of working.
I may have forgotten the yacht, or the sprawling 5,000 ft2 house, or the BMW, or the Movado.
Please tell me again why doctor's can't make less?"



🙁
1. Opportunity cost.
2. Stress.
3. Long hours.
4. Liability.
5. Let me guess, you're a communications major?
 
Supply: Rigidly controlled by medical schools, massive barriers to entry (new school is expensive), existing supply protects its scarcity.
Wrong. The supply is limited at the residency level. We accept thousands of FMGs, well above and beyond what the US medical schools can produce. We've also been adding schools and increasing class sizes regularly.
 
I came across this article on MSNBC this morning

http://www.msnbc.msn.com/id/44433135/ns/health-health_care/#.TmjLtOwy5IU

“We’re willing to pay physicians so much because we value health care so much,” she explained. “But, physicians are making five times the median income. Is that what we really want?”

I believe in going into a job not for the money, but for the experience.

But if people feel that they're paying too much, they can always try doing the surgery themselves...
 
Wrong. The supply is limited at the residency level. We accept thousands of FMGs, well above and beyond what the US medical schools can produce. We've also been adding schools and increasing class sizes regularly.

I refuse to answer on the grounds that I wanted that avatar and you stole it. 😡
 
Ah I was gonna say something about this myself...here's the link to the actual study in Health Affairs:

http://content.healthaffairs.org/content/30/9/1647.full

You have to have a subscription (of course) to get past the abstract but most schools should have some way to get in there.

Whats interesting is that they do address the cost of education in the article:

Over the eight years of post–high school education, at an interest rate of 7 percent, an American medical student would have incurred as much as $225,000 in tuition expenses by medical school graduation. In 2009, 87 percent of medical graduates left medical school with graduate educational debt, and 38 percent had undergraduate medical debt. The mean debt US medical students graduated with in 2009 was $156,456.18

The debt medical students incur is lower than the total cost of medical education. However, the estimated total tuition cost is used for the estimates because economists assume that people try to recoup the total cost of education rather than the portion of it financed through debt. This investment would need to be amortized over the period starting with the completion of a medical residency.

If a physician practiced for thirty-five years (based on a present-value formula), the additional earnings, net of expenses, required to pay off this investment would amount to about $21,300 per year for a primary care physician and about $24,400 per year for an orthopedic surgeon.19,20

Although the tuition cost of medical education in the United States borne by individuals is substantial, it cannot fully account for the observed differences between the earnings of US physicians and physicians in all other countries. The difference between annual net incomes, after practice expenses, of primary care physicians in the United States and in the second most costly country, the United Kingdom, is $27,000—somewhat more than the estimated $21,300 per year of practice required to recoup the average tuition investment in education. The difference between the annual net incomes of orthopedic surgeons in the United States and the United Kingdom is $118,000—nearly five times the estimated $24,400 difference in investment repayment costs.

Keep in mind that this is just a selected excerpt and the actual paper has a lot more info.

Of course, you don't have 35 years to pay off your loans (a fact which seems to be lost on them) but what's really interesting is that the education expense DOES account for the majority of pay difference in PCPs. Yeah, $27,000 is more than $21,300 per year but not by much, especially when you're doing a study where the student loan amounts can swing in such a far direction either way. However, this does not seem to be the case with subspecialists...the difference between incomes there is way higher than the education expense.

One of their conclusions is also very interesting and something I would probably agree with:

One explanation for the higher incomes of US physicians may lie in the broader US income structure. The share of income received by people in the top 1 percent of the US income distribution far exceeds the corresponding share in the comparison countries.21 These higher earnings may mean that the earnings forgone by medical students during their medical education and training are relatively higher in the United States. They certainly indicate that the alternative opportunities available to prospective physicians are more lucrative in the United States.22

When physician fees in each of the comparison countries are compared to the mean incomes of the top 1 percent of households in that country, the results are broadly consistent across countries. Primary care physicians in other countries earn about one-third as much as the average income of the top 1 percent households, while orthopedic surgeons earn between half (in Canada) and 90 percent (in the United Kingdom) as much. The United States, at three-quarters, is in the middle of the pack. High physician fees in the United States may reflect the cost of attracting skilled candidates to medicine in a society with a relatively more skewed income distribution.
 
Of course I have to add that these findings are nowhere mentioned in the news headlines (or even in the articles)...nope instead the headlines are "SKY HIGH SALARIES, COSTLY HIPS BOOST US HEALTH COSTS" or "DOCTOR FEES MAJOR FACTOR IN HEALTH COSTS"

Suck my nuts media
 
Not only that, but it is the nature of the training. It is far more intellectually involved, labor intensive, stressful, specialized than any other profession. Name a profession that has all 4 of these?

Loads of debt and years of training= a higher income

End of debate...
 
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While salaries should probably come down, let's not get ahead of ourselves. Comparing the US system to socialized systems - including how the educational systems operate - is like comparing apples to oranges.

And of course let's not forget the pharmaceutical, insurance, and medical device industries which, according to most health economists, are a bigger part of the cost problem. Physicians salaries comprise a proportionally small share of the overall cost of healthcare. I don't remember the exact figure, but I think something like 10% of healthcare costs go to physician wages.
Its less than that.
 
I thought majority of the high salories were also there for stuff like malpractice protections, could be thinking of something else though.
 
Obama's job plan will cost $450 billion, and he intends to fully pay for it. How will it be paid?

Medicare reimbursement cuts suddenly seem very tempting.

Straight from the horse's mouth, not one mention of the word Medicare (or anything related).
He coupled his pleas for action with a call to the 12-member super committee set up by last month’s debt deal to come up with additional spending cuts to pay for the "American Jobs Act" that includes $253 billion in tax cuts and $194 billion in spending. The tax cuts include $175 billion for an extension of last year’s reduction in the employee payroll tax; $65 billion to cut employer payroll taxes in half and $5 billion for a bonus payroll tax cut for new hires. Under his proposal, taxes would be halved on the first $5 million in wages, which the White House said would benefit 98 percent of all businesses.
 
Straight from the horse's mouth, not one mention of the word Medicare (or anything related).
Read the speech itself. He mentioned "modest adjustments" in Medicare and Medicaid as a way to pay for his jobs plan. That was the extent of the specificity.
 
Read the speech itself. He mentioned "modest adjustments" in Medicare and Medicaid as a way to pay for his jobs plan. That was the extent of the specificity.

Dubaifan - The world is not going to end tomorrow regardless of your fervent belief that it will. You probably have your bunker ready incase reimbursements fall any more.
 
Stop saying I know little about it. Actually, stop your namecalling and condescending attitude or else I will report you.

Back to the topic, the attention this is getting will only hurt any likelihood of the doc fix happening before it's too late.

If you were more familiar with this issue you would know that the doc fix is not as big of an issue as you make it out to be. Alarmism is unnecessary.

If you want to report me for calling you out on trying to spread a misinformed opinion you are free to do that.
 
I do think that orthopedic surgeons have a pretty generous salary relative to the rest of the physician population, so of course their salaries get mentioned in the article. Nobody thinks that a pediatrician making $120K/year in a large metro area with $150K in student loans is really living a life of luxury.

Right. Maybe this MSNBC reporter should have discussed the fact that unionized public employees (e.g. bus drivers, cops, firefighters, etc., with high school educations can easily make $100k/year with great healthcare and pension benefits... Of course MSNBC would not want to be too critical of these "overpaid" folks...😀
 
the fact that unionized public employees (e.g. bus drivers, cops, firefighters, etc., with high school educations can easily make $100k/year with great healthcare and pension benefits...

"Easily," eh? Data, please.
 
And it has nothing to do with the daily labs that cost fifty to one fifty each er lab per patient. CBCs for everyone!

This isn't really a rebuttal to their point. The 70% they quote is for the salaries of all health care workers. Presumably this includes the phlebotomists, the lab techs, and all the other people who need to do their jobs in order for those daily labs to happen and the results to come back. Depending on how loose of a definition of "health care worker" they use, they might include other hospital support staff (janitors, accountants, etc), equipment/disposable manufacturing workers, and/or bench scientists who design and optimize the labs in the first place. It'd be nice to see a more specific definition of whose salaries exactly they are including in that figure.
 
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