Are doctors and surgeons paid too little?

[Radon XP]

Let's get something straight: you shouldn't go into medicine just for the money, because there are certainly other paths that are less grueling and will pay more (such as banking). But let's get another thing straight: anyone willing to do the tough work that a doctor does should expect a handsome compensation.

For all the work doctors and surgeons do, though, I don't think they are paid nearly enough. FP Doctors should make at least $200,000 per year and surgeons should make at least mid-six figures or more. All that schooling, and all that tough work, should be rewarded handsomely.

There's all these folks saying doctors are paid too much, or that doctors shouldn't care about money...that's complete rubbish. Doctors are paid far too little, and they should certainly care about money to the extent that they are professionals doing a job in exchange for a benefit. I have nothing against volunteering your time to help folks in need, and I will do the same thing if I am a doctor one day, but I also want to earn a decent living - and not just an average one, but a decent one.

So do you think doctors and surgeons are paid too little?

Of course, physicians are screwed by the government, by the HMO's, and by the greedy good-for-nothing lawyers, so it's a sad state of affairs for modern medicine in regards to all that red tape.

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[seelee]

Let's get something straight: you shouldn't go into medicine just for the money, because there are certainly other paths that are less grueling and will pay more (such as banking). But let's get another thing straight: anyone willing to do the tough work that a doctor does should expect a handsome compensation.

For all the work doctors and surgeons do, though, I don't think they are paid nearly enough. FP Doctors should make at least $200,000 per year and surgeons should make at least mid-six figures or more. All that schooling, and all that tough work, should be rewarded handsomely.

There's all these folks saying doctors are paid too much, or that doctors shouldn't care about money...that's complete rubbish. Doctors are paid far too little, and they should certainly care about money to the extent that they are professionals doing a job in exchange for a benefit. I have nothing against volunteering your time to help folks in need, and I will do the same thing if I am a doctor one day, but I also want to earn a decent living - and not just an average one, but a decent one.

So do you think doctors and surgeons are paid too little?

Of course, physicians are screwed by the government, by the HMO's, and by the greedy good-for-nothing lawyers, so it's a sad state of affairs for modern medicine in regards to all that red tape.

No job "deserves" a specific pay grade. A person "deserves" to get paid whatever the market deems his service or good is worth. Unfortunately, the widespread use of insurance companies combined with the entitlement mentality promoted by the government has all but anillated the market in medicine.

It is interesting to hear physicians complain now about medicaid and medicare, when it was medicaid and medicare that is almost entirely responsible for the medical boom over the past 30 years or so. The government essentially wrote a blank check to the medical industry providing for several decades worth of growth and advancements that we would not have been able to afford otherwise.

The downside is that now we are in a financially untenable position, and we have a population that has been convinced that they should have limitless care with no out of pocket expense.

 

[bronx43]

Let's get something straight: you shouldn't go into medicine just for the money, because there are certainly other paths that are less grueling and will pay more (such as banking). But let's get another thing straight: anyone willing to do the tough work that a doctor does should expect a handsome compensation.

For all the work doctors and surgeons do, though, I don't think they are paid nearly enough. FP Doctors should make at least $200,000 per year and surgeons should make at least mid-six figures or more. All that schooling, and all that tough work, should be rewarded handsomely.

There's all these folks saying doctors are paid too much, or that doctors shouldn't care about money...that's complete rubbish. Doctors are paid far too little, and they should certainly care about money to the extent that they are professionals doing a job in exchange for a benefit. I have nothing against volunteering your time to help folks in need, and I will do the same thing if I am a doctor one day, but I also want to earn a decent living - and not just an average one, but a decent one.

So do you think doctors and surgeons are paid too little?

Of course, physicians are screwed by the government, by the HMO's, and by the greedy good-for-nothing lawyers, so it's a sad state of affairs for modern medicine in regards to all that red tape.

Banking is less grueling? Sure... if you say so, if you can even get a job.

The more important issue, as seelee said, is the idea that a profession "deserves" a certain compensation without any appeals to market value. When it comes down to it, everyone thinks they're underpaid. This is true for any employee of any industry - banking, medicine, consulting, accounting, construction, etc. Therefore, it is largely fruitless to get into any discussion where the topic at hand requires subjective appeals to hardships.

What exactly is a salary? It's a compromise between the employer/consumer and the employee/producer - the lowest amount of money an employer will pay that will retain the service or good of the employee/producer. If said amount is too low, the producer/employee will no longer offer his/her labor or good. On the other hand, if the amount is too high, there is excess in the transaction. It's the same principle you employ on a daily basis. Would you pay $2k for a television, if you can buy the same one for half the price?

And this is really the mindset one should use when looking at physician salaries. At what compensation would there be a shortage of qualified individuals going into medicine? Given the current income levels and the competitiveness of getting into medical school, it's quite obvious that the price point is at least at equilibrium, if not on the high side.

 

[Dr Oops]

Banking is less grueling? Sure... if you say so, if you can even get a job.

The more important issue, as seelee said, is the idea that a profession "deserves" a certain compensation without any appeals to market value. When it comes down to it, everyone thinks they're underpaid. This is true for any employee of any industry - banking, medicine, consulting, accounting, construction, etc. Therefore, it is largely fruitless to get into any discussion where the topic at hand requires subjective appeals to hardships.

What exactly is a salary? It's a compromise between the employer/consumer and the employee/producer - the lowest amount of money an employer will pay that will retain the service or good of the employee/producer. If said amount is too low, the producer/employee will no longer offer his/her labor or good. On the other hand, if the amount is too high, there is excess in the transaction. It's the same principle you employ on a daily basis. Would you pay $2k for a television, if you can buy the same one for half the price?

And this is really the mindset one should use when looking at physician salaries. At what compensation would there be a shortage of qualified individuals going into medicine? Given the current income levels and the competitiveness of getting into medical school, it's quite obvious that the price point is at least at equilibrium, if not on the high side.

The problem is you cant have educated shoppers in healthcare.

Also i think there is a disconnect between the nuumber of applicants/competitiveness vs incomes levels. Income levels are have been and continuing to drop yet most pre-meds dont know this or claim they will work for peanuts because its what theyve wanted to do since they were slapped by the doctor at birth.

 

[bronx43]

The problem is you cant have educated shoppers in healthcare.

Also i think there is a disconnect between the nuumber of applicants/competitiveness vs incomes levels. Income levels are have been and continuing to drop yet most pre-meds dont know this or claim they will work for peanuts because its what theyve wanted to do since they were slapped by the doctor at birth.

I know you can't have educated shoppers in health care. What is the relevance?

Pre-meds don't know the income levels of physicians? How is this true at all, and how can you demonstrate this? Just because you can say it doesn't mean it's true.
Either way, my thesis in the post was that incomes aren't determined by lamenting how "hard" a certain profession is, or some other measure of subjectivity.

 

[sunshinevet]

I find it hilarious when doctors go on about how "underpaid" they are...

 

[Dr Oops]

I know you can't have educated shoppers in health care. What is the relevance?

Pre-meds don't know the income levels of physicians? How is this true at all, and how can you demonstrate this? Just because you can say it doesn't mean it's true.
Either way, my thesis in the post was that incomes aren't determined by lamenting how "hard" a certain profession is, or some other measure of subjectivity.

Im not gonna a run a study to show how uninformed pre-meds as well as med students are. Go around and ask your classmates i bet they still dont know. How would they all people have to go off of are those recruiting websites, which are very unreliable. I'll bet they know even less about the state of health care and the reforms going on.

How hard a profession is plays a role in its compensation though. Public perception of that difficulty also plays a role in the market value of that job.

 

[violetchild]

^
So true, just look at celebrities... do they really deserve all the money they get paid?

 

[globalmobile]

^
So true, just look at celebrities... do they really deserve all the money they get paid?

That's the saddest part Celebrities and top athletes are paid easily in millions. They definitely do not deserve all that money, but that's how the system works. It's mass production and our attention is what pays their bills.

Back in the day, actors were as poor as the commoners, and kings and queens were the celebrities. It's interesting how things change. I guess Oprah has reached financial status of a "queen".

 

[Dr Oops]

That's the saddest part Celebrities and top athletes are paid easily in millions. They definitely do not deserve all that money, but that's how the system works. It's mass production and our attention is what pays their bills.

Back in the day, actors were as poor as the commoners, and kings and queens were the celebrities. It's interesting how things change. I guess Oprah has reached financial status of a "queen".

It doesnt bother me that those celebrities make that much money. It does bother me however when people are like "doctors make too much money" while there's celebrities and athletes makings 20x more and clearly not as vital to society.

 

[bronx43]

Im not gonna a run a study to show how uninformed pre-meds as well as med students are. Go around and ask your classmates i bet they still dont know. How would they all people have to go off of are those recruiting websites, which are very unreliable. I'll bet they know even less about the state of health care and the reforms going on.

How hard a profession is plays a role in its compensation though. Public perception of that difficulty also plays a role in the market value of that job.

So, what exactly are you basing your conclusions about physician salaries on? Anecdotal evidence? I hope I don't have to explain the lack of validity anecdotal evidence has in any objective discussion, so I ask again. What reliable, non-anecdotal source do you have which is inaccessible to others? I'd wager a guess that you have none, because neither I, nor anyone I know, have any, which inevitably leads to the conclusion that you and I both are dependent on publicly available data.
Now, I'm not making a definitive claim that survey data from various online sources are entirely accurate. I'm simply questioning how you can make the opposite claim. In order to justify the statement that survey data is "very unreliable," you would have to have better, more reliable data, which you don't.
I understand that the difficulty of a profession plays a role in its compensation, and that role lies entirely within free market principles. And you're right in that public perception plays a role, because public perception is a factor in providing a steady supply of labor into any industry or profession. However, I really don't see public perception changing given the status quo, therefore there really shouldn't be any impetus to drive up salaries.
And finally, I have had discussions with my medical school and pre-med friends. Every single one has fairly accurate information on physician compensation. They might not know within 10k of every single specialty, but they are more than aware of the fact that primary care physicians hover around $150k, and that specialists can make $200k - 500k.

 

[bronx43]

^
So true, just look at celebrities... do they really deserve all the money they get paid?

Obviously, they do, because someone is willing to pay them that much in an open market.

 

[avatarftw]

I agree with one of the above posters: one deserves to get paid what the market deems their services are worth. I'm not mad that athletes and celebrities are making tens of millions of dollars (I read on forbes that Beyonce pulled in something like 70 million last year) but I AM mad/disappointed that the general populace decides to spend their money on entertainment and relatively little on their health care. On facebook I read how people spend 200 dollars on a dress or 300 dollars for a darn college football game but begrudge the 20 dollar copay for the doctor.

It seems that we're similar to the collapse of the Roman empire; everybody is paying attention to entertainment and the show while the country could be doing better.

It doesnt bother me that those celebrities make that much money. It does bother me however when people are like "doctors make too much money" while there's celebrities and athletes makings 20x more and clearly not as vital to society.

 

[avatarftw]

Everybody deserves to be paid what another is willing to pay him/her. Some professions may make little based on your or my values and others too much but everybody has different values.

I don't have a problem with them making money either.

To others in this thread:

Point 1 - Athletes bring entertainment. If people didn't buy a ticket to the sporting event, the athlete wouldn't be making the money they do. That simple.

Point 2- If you didn't pay to see the movies, the actresses wouldn't be making that money.

Point 3 - There are harder jobs than being a doctor. They don't get paid as well. You don't have to be a genius to be a doctor. No way in hell should all family practitioners have a minimum salary requirement of $300k/year. No way in hell should a surgeon be paid $9,615 a week (the OP thinking surgeons should be paid mid six figures).

 

[bronx43]

I agree with one of the above posters: one deserves to get paid what the market deems their services are worth. I'm not mad that athletes and celebrities are making tens of millions of dollars (I read on forbes that Beyonce pulled in something like 70 million last year) but I AM mad/disappointed that the general populace decides to spend their money on entertainment and relatively little on their health care. On facebook I read how people spend 200 dollars on a dress or 300 dollars for a darn college football game but begrudge the 20 dollar copay for the doctor.

It seems that we're similar to the collapse of the Roman empire; everybody is paying attention to entertainment and the show while the country could be doing better.

The US may be more of a celebrity obsessed nation that it should be, but if it should ever fall like every other empire in history, it would be because we are spending TOO much on health care - not too little. We spend far more on health care every year than we do on the entertainment industry. It's just that the entertainment industry is far more ostentatious as far as exposure, and far more obvious in its expenses. Successful entertainers make exorbitant amounts of money because there are so few of them.
The reason why the public is reluctant to pay out of pocket for health care is because they have been largely shielded from it by various third party payers. It's only human nature to lament changes which lead to the active process of having to spend money without actually gaining anything.

 

[Dr Oops]

So, what exactly are you basing your conclusions about physician salaries on? Anecdotal evidence? I hope I don't have to explain the lack of validity anecdotal evidence has in any objective discussion, so I ask again. What reliable, non-anecdotal source do you have which is inaccessible to others? I'd wager a guess that you have none, because neither I, nor anyone I know, have any, which inevitably leads to the conclusion that you and I both are dependent on publicly available data.
Now, I'm not making a definitive claim that survey data from various online sources are entirely accurate. I'm simply questioning how you can make the opposite claim. In order to justify the statement that survey data is "very unreliable," you would have to have better, more reliable data, which you don't.
I understand that the difficulty of a profession plays a role in its compensation, and that role lies entirely within free market principles. And you're right in that public perception plays a role, because public perception is a factor in providing a steady supply of labor into any industry or profession. However, I really don't see public perception changing given the status quo, therefore there really shouldn't be any impetus to drive up salaries.
And finally, I have had discussions with my medical school and pre-med friends. Every single one has fairly accurate information on physician compensation. They might not know within 10k of every single specialty, but they are more than aware of the fact that primary care physicians hover around $150k, and that specialists can make $200k - 500k.

I already said I have none and I have no intention of running a study to find out. But those public data points u bring up about physicians salaries are mostly from recruiting firms so they exaggerate their numbers to get people to sign thru them. Do u have a study which proves other wise?
Public perception is very fickle and if we want to save medicine as a profession we need to change this incorrect public perception people have.

knowing Specialties make 200-500K isnt what I would consider educated. Have you asked them whether they know about nurses pushing for primary care? Do they know what a DNP is? Do they know about the new Residency work hours? Most med students let alone premeds dont know about these things.

 

[avatarftw]

True, there is a lot of ignorance amongst premeds and medical students. A lot of them don't know what an "RVU" is and how physicians are compensated. Heck, their personal finance knowledge is lacking as well. Many don't know how the FICO score is calculated, how credit cards are more advantageous than debit cards (and safer) in many ways, and simple concepts like opportunity cost, time value of money, NPV, etc.

I already said I have none and I have no intention of running a study to find out. But those public data points u bring up about physicians salaries are mostly from recruiting firms so they exaggerate their numbers to get people to sign thru them. Do u have a study which proves other wise?
Public perception is very fickle and if we want to save medicine as a profession we need to change this incorrect public perception people have.

knowing Specialties make 200-500K isnt what I would consider educated. Have you asked them whether they know about nurses pushing for primary care? Do they know what a DNP is? Do they know about the new Residency work hours? Most med students let alone premeds dont know about these things.

 

[globalmobile]

It doesnt bother me that those celebrities make that much money. It does bother me however when people are like "doctors make too much money" while there's celebrities and athletes makings 20x more and clearly not as vital to society.

A friend of mine said that, once. It almost went down right then and there. It's the stupidest rumour ever. The thing is, if they want to put a salary cap on doctors, fine. BUT MAKE THE EDUCATION FREE DAMMIT. Don't put students through all these expected debts, and then set them at a salary for the rest of their life, not to mention getting the worst tax cuts. And it's already so difficult to become a doctor, PLUS there is a shortage of doctors. I know they are depending on people to go into it for the passion, but there is only so much a person will take.

The disbursement of money in the world, in general, is just a long, sad story. Don't get me started on all the $$$ thrown in the Iraqi "war."

 

[globalmobile]

For the record: if they would, hypothetically, put a salary cap on physician salary, it wouldn't change my goal to become one. I would be one pissed off doctor though lol

 

[Apollyon]

Ortho and cards make bank, but that's because they bust their damn asses. It's not like they're sitting around. You can add general and other subspecialty surgeons to that list. And can you fault someone for getting paid well for for working hard, and doing a good job at that?

 

[globalmobile]

Ortho and cards make bank, but that's because they bust their damn asses. It's not like they're sitting around. You can add general and other subspecialty surgeons to that list. And can you fault someone for getting paid well for for working hard, and doing a good job at that?

Wait, was that directed to me or in general? Because I definitely agree with what you're saying.

 

[African]

True, there is a lot of ignorance amongst premeds and medical students. A lot of them don't know what an "RVU" is and how physicians are compensated. Heck, their personal finance knowledge is lacking as well. Many don't know how the FICO score is calculated, how credit cards are more advantageous than debit cards (and safer) in many ways, and simple concepts like opportunity cost, time value of money, NPV, etc.

I was enjoying the back and forth till the above highlighted sentence. Did you mean the opposite? I have a debit card meaning i spend MY MONEY, and according to you i am at disadvantage compared to someone who spends somebody else" money? Would you elaborate?

 

[avatarftw]

Credit cards are much better than debit cards in the following ways:

1. You get an interest-free loan from the time you buy the product until you have to pay the bill. During such time your money can accrue (yes, not very much) in your savings or checking account. Its a good habit to get into.

2. Your credit score improves.

3. With debit cards, theft is much more commonplace. Also, if there is fraudulent activity on your debit card you must report it within 2 business days or else you are liable for something like 200 dollars or more. With credit cards your liability is 50 dollars and many times it is waived.

4. With my cash back credit card (no annual fee) I get 5% off on various categories each month.

Mind you, this assumes that you don't buy more than what you need and that you never carry a balance. I have discipline and don't spend much money anyways so it works for me. There are many more disadvantages with debit cards but I need to stop getting distracted by SDN and study biochem!

I was enjoying the back and forth till the above highlighted sentence. Did you mean the opposite? I have a debit card meaning i spend MY MONEY, and according to you i am at disadvantage compared to someone who spends somebody else" money? Would you elaborate?

 

[bronx43]

I already said I have none and I have no intention of running a study to find out. But those public data points u bring up about physicians salaries are mostly from recruiting firms so they exaggerate their numbers to get people to sign thru them. Do u have a study which proves other wise? Public perception is very fickle and if we want to save medicine as a profession we need to change this incorrect public perception people have.

knowing Specialties make 200-500K isnt what I would consider educated. Have you asked them whether they know about nurses pushing for primary care? Do they know what a DNP is? Do they know about the new Residency work hours? Most med students let alone premeds dont know about these things.

Tell me you're not serious.
I never made the claim that online survey data reflects accurately physicians' salaries. I am simply refuting the validity of your claim that they are grossly inaccurate. Therefore, it is not up to me to provide evidence of the negative. It would be like my claiming physicians average $2 million dollars a year, then backing it up with some subjective, unsubstantiated reasoning, then respond to your criticism by asking for a study to prove it isn't.

And why exactly is the savior of the profession of medicine public perception? If anything is going to save medicine, it's going to be reform and strict cost control. Public perception is just that - perception.

So, ok... you don't consider knowing the range of physician salaries to be "educated," but what point are you trying to convey? You can keep moving the goal post, but what thesis are you trying to argue for?

 

[bronx43]

For the record: if they would, hypothetically, put a salary cap on physician salary, it wouldn't change my goal to become one. I would be one pissed off doctor though lol

I don't know where people got this idea of a "cap" from. Obviously, if we retain the current FFS structure, then there can technically never be a "cap" on physician income. You would simply make as much as you can work, and be paid for each service delivered.
On the other hand, if FFS is abolished, and physicians are employed on a salary by the government, then there would technically be a "cap," however it would be a slight misnomer since the word "cap" implies the existence of a "bottom" or "base," which there won't be as long as you're employed.

 

[bronx43]

Ortho and cards make bank, but that's because they bust their damn asses. It's not like they're sitting around. You can add general and other subspecialty surgeons to that list. And can you fault someone for getting paid well for for working hard, and doing a good job at that?

Ortho and cards bank because of the high reimbursement rates they receive for their services. Of course, this is in comparison to something like general surgery or general internal medicine, which have deplorably low reimbursement rates. Given equal amount of work, ortho and cards will make more. Therefore, I'm generally wary of the "they bust their asses" argument, unless your point is that they actually put in work for the money they make, in which case I guess I agree.

 

[Dr Oops]

Tell me you're not serious.
I never made the claim that online survey data reflects accurately physicians' salaries. I am simply refuting the validity of your claim that they are grossly inaccurate. Therefore, it is not up to me to provide evidence of the negative. It would be like my claiming physicians average $2 million dollars a year, then backing it up with some subjective, unsubstantiated reasoning, then respond to your criticism by asking for a study to prove it isn't.

And why exactly is the savior of the profession of medicine public perception? If anything is going to save medicine, it's going to be reform and strict cost control. Public perception is just that - perception.

So, ok... you don't consider knowing the range of physician salaries to be "educated," but what point are you trying to convey? You can keep moving the goal post, but what thesis are you trying to argue for?

I wasnt. I cant prove it, you cant disprove it so its a wash. Even though anecdotal, I have found that many people dont know whats going on with the landscape of medicine, including those who are med students, which is shameful. Your peers being able to narrow down specialties to making between 200k-500k is better than nothing but is that really knowledgeable? The money thing was only a glancing point.

I wasnt really formulating a thesis here, but if I were, I would say its that: Public perception isnt the key to saving medicine (which while connected to healthcare reform isnt the same thing Im talking about), but it is an important front on the battlefield. Yet here we are with people who are going into the profession, knowing so little about it and its no wonder that physicians are losing ground everyday.

You probably know as well as anybody that medicine is not a free market and it will never be in a developed country. Therefore it is up to us doctors, residents and students to protect the sanctity of it. Not only for ourselves and our families but for our patients.

Here's were the educated consumer comes in. People dont know the difference between their practitioners. We have in place government restrictions on who can practice (another reason we cant have complete free market) so that people can say hey this person is a doctor so I can pretty safely assume they know what theyre doing.

But all these ancillary practitioners are blurring the lines so they can make the $$$ with little regard to patient safety.

It absolutely scares the **** outta me everytime I read a nurse in some news article saying they know just as much as a doc with their 2-4 yrs of training. The public however doesnt understand the ramifications of such statements and say well if its on the news it must be true. Especially when its on multiple news stations and stories in papers and they even have other physicians backing them up!

Plain and simple its a campaign strategy to get what they want. More practice rights and more money. The only people that lose are doctors and patients.

I know it seems like a digression but here's were it comes back to what we were talking about. Hardly any of your peers know about this. We are uneducated, its hard to blame ourselves with the amount of work we do, I used to know more about the situation before school but Ive little time to try and keep up now. But thats exactly why doctors dont make the money they used to.

EDIT: this thread is a perfect example of what im talking about http://forums.studentdoctor.net/showthread.php?t=768392

 

[carlosc1dbz]

I wasnt. I cant prove it, you cant disprove it so its a wash. Even though anecdotal, I have found that many people dont know whats going on with the landscape of medicine, including those who are med students, which is shameful. Your peers being able to narrow down specialties to making between 200k-500k is better than nothing but is that really knowledgeable? The money thing was only a glancing point.

I wasnt really formulating a thesis here, but if I were, I would say its that: Public perception isnt the key to saving medicine (which while connected to healthcare reform isnt the same thing Im talking about), but it is an important front on the battlefield. Yet here we are with people who are going into the profession, knowing so little about it and its no wonder that physicians are losing ground everyday.

You probably know as well as anybody that medicine is not a free market and it will never be in a developed country. Therefore it is up to us doctors, residents and students to protect the sanctity of it. Not only for ourselves and our families but for our patients.

Here's were the educated consumer comes in. People dont know the difference between their practitioners. We have in place government restrictions on who can practice (another reason we cant have complete free market) so that people can say hey this person is a doctor so I can pretty safely assume they know what theyre doing.

But all these ancillary practitioners are blurring the lines so they can make the $$$ with little regard to patient safety.

It absolutely scares the **** outta me everytime I read a nurse in some news article saying they know just as much as a doc with their 2-4 yrs of training. The public however doesnt understand the ramifications of such statements and say well if its on the news it must be true. Especially when its on multiple news stations and stories in papers and they even have other physicians backing them up!

Plain and simple its a campaign strategy to get what they want. More practice rights and more money. The only people that lose are doctors and patients.

I know it seems like a digression but here's were it comes back to what we were talking about. Hardly any of your peers know about this. We are uneducated, its hard to blame ourselves with the amount of work we do, I used to know more about the situation before school but Ive little time to try and keep up now. But thats exactly why doctors dont make the money they used to.

EDIT: this thread is a perfect example of what im talking about http://forums.studentdoctor.net/showthread.php?t=768392

Celebrity doctors should use their influence to educate the masses about topics in medicine such as low reimbursement.

 

[Apollyon]

Wait, was that directed to me or in general? Because I definitely agree with what you're saying.

General - definitely not directed at you.

Ortho and cards bank because of the high reimbursement rates they receive for their services. Of course, this is in comparison to something like general surgery or general internal medicine, which have deplorably low reimbursement rates. Given equal amount of work, ortho and cards will make more. Therefore, I'm generally wary of the "they bust their asses" argument, unless your point is that they actually put in work for the money they make, in which case I guess I agree.

Just look in the hospital, and see who's there until 8pm during the week and until 2 or 3 on Saturday (or even Sunday). They make bank because they bust their asses at long hours. They don't trade higher reimbursement for lesser hours.

 

[bronx43]

I wasnt. I cant prove it, you cant disprove it so its a wash. Even though anecdotal, I have found that many people dont know whats going on with the landscape of medicine, including those who are med students, which is shameful. Your peers being able to narrow down specialties to making between 200k-500k is better than nothing but is that really knowledgeable? The money thing was only a glancing point.

I wasnt really formulating a thesis here, but if I were, I would say its that: Public perception isnt the key to saving medicine (which while connected to healthcare reform isnt the same thing Im talking about), but it is an important front on the battlefield. Yet here we are with people who are going into the profession, knowing so little about it and its no wonder that physicians are losing ground everyday.

You probably know as well as anybody that medicine is not a free market and it will never be in a developed country. Therefore it is up to us doctors, residents and students to protect the sanctity of it. Not only for ourselves and our families but for our patients.

Here's were the educated consumer comes in. People dont know the difference between their practitioners. We have in place government restrictions on who can practice (another reason we cant have complete free market) so that people can say hey this person is a doctor so I can pretty safely assume they know what theyre doing.

But all these ancillary practitioners are blurring the lines so they can make the $$$ with little regard to patient safety.

It absolutely scares the **** outta me everytime I read a nurse in some news article saying they know just as much as a doc with their 2-4 yrs of training. The public however doesnt understand the ramifications of such statements and say well if its on the news it must be true. Especially when its on multiple news stations and stories in papers and they even have other physicians backing them up!

Plain and simple its a campaign strategy to get what they want. More practice rights and more money. The only people that lose are doctors and patients.

I know it seems like a digression but here's were it comes back to what we were talking about. Hardly any of your peers know about this. We are uneducated, its hard to blame ourselves with the amount of work we do, I used to know more about the situation before school but Ive little time to try and keep up now. But thats exactly why doctors dont make the money they used to.

EDIT: this thread is a perfect example of what im talking about http://forums.studentdoctor.net/showthread.php?t=768392

It seems like you're talking about a subject I didn't really mean to broach. I agree that the medical field has certain threats that should be dealt with should physicians want to maintain their status, but it's entirely different from what I was trying to discuss.
But, I'm still not going to give you a pass on that epic fail of logic (in bold). "It's a wash?" What the hell is a wash? Are you insinuating that because I can't disprove a negative that somehow your claims are just as justified as the null hypothesis? Really? So, If I claim that doctors are making $2 million a year, and you can't disprove it, it's "a wash?" Anyone can claim anything, appeal to the impossibility of disproving their stance, then throw their hands up to suggest equality of the two positions. But, that's not really how it works. If you make a claim against a certain null hypothesis, you must provide evidence to prove your point within a statistically significant margin.

 

[bronx43]

Just look in the hospital, and see who's there until 8pm during the week and until 2 or 3 on Saturday (or even Sunday). They make bank because they bust their asses at long hours. They don't trade higher reimbursement for lesser hours.

Yes... I realize they work hard, and I already stated that concession. You don't have to repeat your point ad nauseum. My point was that there are people and specialties that work just as many hours for a lot less money, and that reimbursement rates play just as big a factor as how "hard" someone works.
I see general surgeons working even longer hours for not nearly as much money. I know OB attendings at my institution that put just as many hours as the hardcore surgeons, but probably pull around half as much as the orthos.

 

[Apollyon]

You don't have to repeat your point ad nauseum.

If once is "ad nauseam" to you, then you have quite an enlightenment in your future training.

I do not know how you know how much the general surgeons make (in that the ones I know working buckets of hours make buckets of cash). As for Ob/Gyn vs Ortho vs Cards, there is a direct relationship between time spent in residency and money made as an attending.

 

[bronx43]

If once is "ad nauseam" to you, then you have quite an enlightenment in your future training.

I do not know how you know how much the general surgeons make (in that the ones I know working buckets of hours make buckets of cash). As for Ob/Gyn vs Ortho vs Cards, there is a direct relationship between time spent in residency and money made as an attending.

Actually, you brought it up twice in two different posts without adding any new insight.

I don't know what you keep clamoring on about. I don't disagree that working more = more money. I'm simply stating that reimbursement rates also play a determining role in how much you make. That really isn't a suggestion or some inference to some higher meaning. It's simple fact. If you deem this statement to be untrue, then state your case. If not, then there needn't be any more discourse.
Now, how those reimbursement rates are determined are somewhat arbitrary, as general surgery procedures are overall reimbursed less than orthopedic procedures. I don't know why, and I'm not sure there is even a verifiable reason. It just so happens that Medicare and private insurances pay more for them. Training length plays a factor, but it's obviously not proportional, or even consistent across specialties. But, even if it was, that is an entirely argument altogether.

 

[Downbytheicu]

I think you all are missing an important element to this discussion. Someone said that a salary is what a market has decided that the service is worth for that specialty. I'd agree with that statement, but mind the bold. You know the difference in salary between a thorough, compassionate physician who consistently keeps up with current evidence and a guy who is a bit of a jerk and doesn't keep up with articles except to pass the boards every 10 years? Not a cent if they see the same number of patients. The thing that is missing from this discussion is that the prices for all physicians are fixed at a rate that are devoid from the quality of care. A free market would pay a superior physician more than a poor physician, agreed? So, bringing it back to the OP, I would say that good physicians and surgeons are definitely underpaid. Who defines good? It should be the patient, but our third party billing system, the patient is completely separated from the cost of care. That is a huge problem.

 

[Apollyon]

Actually, you brought it up twice in two different posts without adding any new insight.

I don't know what you keep clamoring on about.

Oh man...once...then a second time. Repeated ONCE. That makes 2 total.

This is neither clamor nor calumny. However, since you seem prone to hyperbole, I shall stop now.

 

[avatarftw]

You could just not pay attention to celebrities or not watch their shows. I didn't even know that there was a show called "Two and a Half Men."

Heck, I didn't even know who the heck Ke$ha was or about the Jersey Shore MTV show until very late. If we didn't care about them or watched less tv, I'm sure that their salaries and endorsements would decrease. However, its society's fault that they are being paid what they get. Personally, I don't care and consequently add little to their checkbooks.

Also, I seriously only heard about this Justin Bieber kid last month. What value does he add to society? He improves our quality of life, I guess....

'Two and a Half Men' Kid Signs $300,000-Per-Episode Deal

http://tv.yahoo.com/blog/two-and-a-half-men-kid-signs-300000perepisode-deal--1624

 

[African]

Credit cards are much better than debit cards in the following ways:

1. You get an interest-free loan from the time you buy the product until you have to pay the bill. During such time your money can accrue (yes, not very much) in your savings or checking account. Its a good habit to get into.

2. Your credit score improves.

3. With debit cards, theft is much more commonplace. Also, if there is fraudulent activity on your debit card you must report it within 2 business days or else you are liable for something like 200 dollars or more. With credit cards your liability is 50 dollars and many times it is waived.

4. With my cash back credit card (no annual fee) I get 5% off on various categories each month.

Mind you, this assumes that you don't buy more than what you need and that you never carry a balance. I have discipline and don't spend much money anyways so it works for me. There are many more disadvantages with debit cards but I need to stop getting distracted by SDN and study biochem!

Good luck with the biochem but you have not convinced me of getting a credit card hell you just made me more opposed to getting one, with your 'politician' talk of saying so much with so little sense. The idea that i should borrow money i dont have because in the extremely improbable case of losing my debit card i will have a shorter time period of two days to report is ludicrous.
The part about saving money earned flipping burgers while i buy flat screen tv with borrowed money had me laughing, lol


'no annual fees' 'zero interest' Gosh where did i hear that before?

 

[avatarftw]

Ok, when you apply for a home mortgage (assuming you haven't already) or for a lease then you will have higher interest rate, costing you thousands of dollars.

Read articles about how credit cards are safer than debit cards.

No, you have only two business days to report fraudulent activity with your debit cards (in general). With credit cards the companies usually cover you and waive the fee that you are supposed to be accountable for.

I'm NOT advocating that you buy more than what you have. Its pretty simple; its a question of self control. If you have 300 dollars per month, for example, to spend in your checking account then you just have to limit yourself to 300 dollars spent/month with your credit card.

I DO have self control so I reap the benefits. If you don't, then do not get a credit card.

Good luck with the biochem but you have not convinced me of getting a credit card hell you just made me more opposed to getting one, with your 'politician' talk of saying so much with so little sense. The idea that i should borrow money i dont have because in the extremely improbable case of losing my debit card i will have a shorter time period of two days to report is ludicrous.
The part about saving money earned flipping burgers while i buy flat screen tv with borrowed money had me laughing, lol


'no annual fees' 'zero interest' Gosh where did i hear that before?

 

[globalmobile]

I agree with one of the above posters: one deserves to get paid what the market deems their services are worth. I'm not mad that athletes and celebrities are making tens of millions of dollars (I read on forbes that Beyonce pulled in something like 70 million last year) but I AM mad/disappointed that the general populace decides to spend their money on entertainment and relatively little on their health care. On facebook I read how people spend 200 dollars on a dress or 300 dollars for a darn college football game but begrudge the 20 dollar copay for the doctor.

I completely agree. This reminds me of when I knew a lot of people on financial aid that complained about paying anything for education, yet they spent $50 on mani/pedis and went shopping all the time and had a wii and an xbox...no joke. I also know a couple of people who used the financial aid money to buy new cars. I was one of the people who is using my education to help the community one day, and am suffering in loans while the aid money goes into beautification and electronics and cars. I know that others use their aid money for education and really pursue wonderful futures, but the ones who spent it and complain about financial and medical bills: It's a disappointment for sure.

 

[globalmobile]

I don't know where people got this idea of a "cap" from. Obviously, if we retain the current FFS structure, then there can technically never be a "cap" on physician income. You would simply make as much as you can work, and be paid for each service delivered.
On the other hand, if FFS is abolished, and physicians are employed on a salary by the government, then there would technically be a "cap," however it would be a slight misnomer since the word "cap" implies the existence of a "bottom" or "base," which there won't be as long as you're employed.

Ahh ok, thanks for mentioning this! Good to know.

 

[globalmobile]

I usually like Dr. Oz, but recently, I noticed he is really siding with patients and committed to pointing out flaws and complaints about physicians. While this is a good thing in order to better the doctor-patient communication, he seems to focus on what the physicians can do to improve, but he does not try to dispel common misconceptions that patients have towards doctors. The physicians on the show try to do that, but not Dr. Oz. I understand that part of it his popularity value, that he is much more liked if he is "with the people" and pointing out that doctors don't spend enough time with patients and don't this or that. But It's a shame, bc he is very popular so if he brought these issues on his show and helped his audience understand, it could really help the physician's world. He could be a key communicator for all the concerns we are discussing.