Are doctors underpaid?

[collegeguy87]

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I'm considering medicine, but I'm a little reluctant because I have a lot of family financial obligations. On the one hand, I enjoy science, helping people and I've shadowed some doctors... and I could see myself enjoying what doctors do. This summer, I worked in management consulting, and I could see myself also enjoying that.

Somehow the prospect of taking out student loans and going through residency sounds a little daunting? Is this a concern for other people?

 

[Green Grass]

Sure, it's a concern, but not enough to detour me from pursuing medicine. It's going to be a pain to pay them off, but if you make it your priority then it shouldn't be a problem...hopefully.

 

[Haemulon]

Physician salaries are not what they used to be, for sure, and education costs continue to go up. Being a physician probably isn't the easiest route for someone after big bucks. That being said, we don't see too many starving doctors either. Even the lower paying specialties still offer pretty good salaries and job security compared with most other professions. If medicine is the career for you, then you can make it work. If it is not for you, well ... then its not for you. Think about what you would like to do with the rest of your life and make your decision based on that instead. I will suggest to you that just being able to see yourself as a physician probably is not enough. You really have to know that it is for you. It is a huge committment of time and money after all, as you pointed out.

 

[sleepy425]

look, my sister puts it best. you can make as much money as you want to make in medicine. in most fields, if you work really hard, and if you go into private practice, you'll make enough to satisfy almost any need you have. if you go into academics, you won't make as much. if you choose a surgical subspecialty, you can make enormous amounts of money. now for surgery, that doesn't just mean neurosurgery. urology is a surgical subspecialty, but you do a year of general surgery, 4-5 years of residency, and then you're done. so in other words, you can definitely make very good money, but as haemulon said, medicine is a very long road to making money, and there are much faster, easier ways to make a lot of money.

 

[deleted74029]

you can make as much money as you want to make in medicine.

I want to make..............

........100 billion dollars.

 

[atomi]

You've got to be joking. Physicians are one of the most highly paid professionals. I would consider (and so would most of the public) many of them overpaid. You need to realize that if you become a doctor, many will look at you with resentment simply because of how much money you make. A dermatologist charges $300 to remove a mole in 2 minutes. $300 for 2 minutes of work and maybe another 5 of paperwork. Oral surgeons charge thousands for routine wisdom tooth removal. The ridiculous insurance system has some blame in this, but these specialists are still making insane amounts of money for relatively simple procedures.

 

[THX]

You've got to be joking. Physicians are one of the most highly paid professionals. I would consider (and so would most of the public) many of them overpaid. You need to realize that if you become a doctor, many will look at you with resentment simply because of how much money you make. A dermatologist charges $300 to remove a mole in 2 minutes. $300 for 2 minutes of work and maybe another 5 of paperwork. Oral surgeons charge thousands for routine wisdom tooth removal. The ridiculous insurance system has some blame in this, but these specialists are still making insane amounts of money for relatively simple procedures.

You should also blame the mal-practice suits.

 

[nontrdgsbuiucmd]

As a many years out of college person looking at medical school now, I'd suggest you consider going into management consulting or whichever other career is of interest for several reasons. One, It took me several jobs over a number of years to figure out what I did and did not like about different fields. "my boss is a jerk" is not a good reason to quit, some aspects of disagreeability are present in any job & industry, for example. The only way I could tell medicine was a good fit for me was, after working in a well-paid position for years and seeing what the future could bring, I found I really did not want that future but rather was driven by other things.

Two, I'm hearing that some schools want med students with some experience, at least a few years. I've heard that many times regarding my state school from people who've interviewed there. There may be arguments on either side, a few years in a professional job tend to allow a person to become more patient, realistic, professionally mature, hopefully altruistic, etc. There are consulting positions that consult to healthcare, which would be directly applicable; mckinsey has a healthcare practice group (or they did a few years ago)

Three, couldn't hurt to save a chunk of money to reduce the debt you need to go into for med school, 50K less of student loans at 6% from M1 through end of residency would save you quite a bit in monthly payments after finishing as a doctor.

 

[atomi]

Being a physician probably isn't the easiest route for someone after big bucks.

It's not the easiest, but it carries the least risk and requires little creative thought. The process is pretty much all put in place. Sure, you can make 7 figures on Wall St. with the right credentials, but what kind of job security do you have? I'll let you talk to all my banking friends who are currently unemployed. You'll never get rich working for the man, and if you're a doctor you may well still end up working for the man if you're not willing to take risks. Not that there's anything wrong with working for the man.

 

[phonyreal98]

I want to make..............

........100 billion dollars.

*highfive*

To reiterate what other people in the thread have been saying, every single physician I've talked to has told me essentially the same thing: "There are easier ways to make money than going into medicine."

 

[mdmdt]

I want to make..............

........100 billion dollars.

Well, he is a doctor after all...

 

[atomi]

As a many years out of college person looking at medical school now, I'd suggest you consider going into management consulting or whichever other career is of interest for several reasons. One, It took me several jobs over a number of years to figure out what I did and did not like about different fields. "my boss is a jerk" is not a good reason to quit, some aspects of disagreeability are present in any job & industry, for example. The only way I could tell medicine was a good fit for me was, after working in a well-paid position for years and seeing what the future could bring, I found I really did not want that future but rather was driven by other things.

Two, I'm hearing that some schools want med students with some experience, at least a few years. I've heard that many times regarding my state school from people who've interviewed there. There may be arguments on either side, a few years in a professional job tend to allow a person to become more patient, realistic, professionally mature, hopefully altruistic, etc. There are consulting positions that consult to healthcare, which would be directly applicable; mckinsey has a healthcare practice group (or they did a few years ago)

Three, couldn't hurt to save a chunk of money to reduce the debt you need to go into for med school, 50K less of student loans at 6% from M1 through end of residency would save you quite a bit in monthly payments after finishing as a doctor.

I agree fully with everything you just said. However, I would consider borrowing all the free money you can available to you as a med student, and taking your lump sum savings and putting it into an investment with a 6 year timeframe, then selling that investment once done with med school and into residency and paying off all or as much of the debt as possible. This is instead of using up all of your savings at the outset.

 

[Compass]

His topic is poorly worded. He's asking whether or not medicine is feasible for the foreseeable future. Going into debt and paying it off for the next 20 years is not a reasonable financial goal. Proper financial planning or a well-paying job that does not require diving into debt would be the best option here, if family standards of living come before debt.

 

[nontrdgsbuiucmd]

You've got to be joking. Physicians are one of the most highly paid professionals. I would consider (and so would most of the public) many of them overpaid. You need to realize that if you become a doctor, many will look at you with resentment simply because of how much money you make. A dermatologist charges $300 to remove a mole in 2 minutes. $300 for 2 minutes of work and maybe another 5 of paperwork. Oral surgeons charge thousands for routine wisdom tooth removal. The ridiculous insurance system has some blame in this, but these specialists are still making insane amounts of money for relatively simple procedures.

Wow! I want to be a dermatologist if they make.. let see.. $300 for two minutes' work, that's $150 per minute * 60 minutes * 8 hours a day comes to $9,000 per hour! Work long days, and you're clearing 100K per day.

Another way to consider this is how many years training does it take to get into the field, pass the tests, make no income, give up nights and weekends, etc.

My questions as a former business owner with mid-sized staff are: If a dermatologist removes a mole in 2 minutes, how long does it take to prep for seeing that patient? How many patients with moles are seen before one decides to go forward and have it removed? How many staff are needed to fill out paperwork? What does he pay for rent/telephones/office supplies? How long before he gets paid that $300? If he bills $300, how much does medicare really pay him? What is his bad debt writeoff for those without insurance? How many hours does he spend after seeing all patients to negotiate with insurers? As mentioned above, how much does he pay malpractice insurance?

Sorry, but the doctors I know work really, really hard, have very long hours, and make good money but not more than senior execs that I know for similar hours work.

 

[UGAmkw]

This might be a little off topic but I really get pissed off when people say that doctors are overpaid. Health care is a privledge, not a right. People are paying for a service, much like they do when they take their car to be fixed, only Doctors have gone through 12 years of training while a mechanic might have a couple. So in reality doctors cannot be OVERPAID because there is not another job which requires as much training.

 

[atomi]

Wow! I want to be a dermatologist if they make.. let see.. $300 for two minutes' work, that's $150 per minute * 60 minutes * 8 hours a day comes to $9,000 per hour! Work long days, and you're clearing 100K per day.

Another way to consider this is how many years training does it take to get into the field, pass the tests, make no income, give up nights and weekends, etc.

My questions as a former business owner with mid-sized staff are: If a dermatologist removes a mole in 2 minutes, how long does it take to prep for seeing that patient? How many patients with moles are seen before one decides to go forward and have it removed? How many staff are needed to fill out paperwork? What does he pay for rent/telephones/office supplies? How long before he gets paid that $300? If he bills $300, how much does medicare really pay him? What is his bad debt writeoff for those without insurance? How many hours does he spend after seeing all patients to negotiate with insurers? As mentioned above, how much does he pay malpractice insurance?

Sorry, but the doctors I know work really, really hard, have very long hours, and make good money but not more than senior execs that I know for similar hours work.

I know, I'm not stupid. But the point is that specialists still get away with charging ridiculous amounts for simple procedures. In regards to senior execs, it takes a hell of a lot less time to become a doctor than a senior exec, and residency is nothing compared to the b.s. you have to put up with in corporate ladder climbing. Plus there is no guarantee that you get to be a senior exec. And honestly, for the same time and hours, would you rather be a doctor or a senior exec? While they're both busy, one of those professionals has a much, much more stressful life.

 

[Haemulon]

I know, I'm not stupid. But the point is that specialists still get away with charging ridiculous amounts for simple procedures. In regards to senior execs, it takes a hell of a lot less time to become a doctor than a senior exec, and residency is nothing compared to the b.s. you have to put up with in corporate ladder climbing. Plus there is no guarantee that you get to be a senior exec. And honestly, for the same time and hours, would you rather be a doctor or a senior exec? While they're both busy, one of those professionals has a much, much more stressful life.

Huh? 😕

 

[TehDoc]

lol

 

[atomi]

12 years of training

No, just no. Undergraduate is not medical training. Neither is the first 2 years of medical school. Furthermore, just because you went to school for a long time doesn't mean the work you do is inherently worth more. You don't need an M.D. to be able to properly remove a mole. You do need an M.D. to be able to charge $300 to do it. I say this as someone applying to medical school.

 

[Haemulon]

The first 2 years of medical school don't count as medical training? 😕

 

[UGAmkw]

Are you serious, OK 12 years of SCHOOL/TRAINING, either way you are not getting paid for doing it. Socialized Medicine breeds laziness. Ok next time you get a mole why dont you just get some dude off the street to cut it off, if you dont like it, GUESS WHAT, you don't have to do it!

 

[chad5871]

Are you serious, OK 12 years of SCHOOL/TRAINING, either way you are not getting paid for doing it. Socialized Medicine breeds laziness. Ok next time you get a mole why dont you just get some dude off the street to cut it off, if you dont like it, GUESS WHAT, you don't have to do it!

Well, you do get paid for residency, although not that much - and most of your money has to go to pay off your debt anyway.

 

[Pghboy18]

I know, I'm not stupid. But the point is that specialists still get away with charging ridiculous amounts for simple procedures. In regards to senior execs, it takes a hell of a lot less time to become a doctor than a senior exec, and residency is nothing compared to the b.s. you have to put up with in corporate ladder climbing. Plus there is no guarantee that you get to be a senior exec. And honestly, for the same time and hours, would you rather be a doctor or a senior exec? While they're both busy, one of those professionals has a much, much more stressful life.

Yeah, you're right. It takes a long time to become a senior exec, and the corporate world is full of bull****. But a HUGE difference between the exec track and medicine is the fact that, on the exec track, you're well taken care of while you're climbing that ladder. And, at least in finance, rarely after the first couple years will someone work a physician's (especially resident's) hours. Honestly, how many thirty year old's in the corporate world do you know that are consistently working 80+ hour weeks and making $50,000 ? There are some that work those hours, but none who get compensated so poorly for them. I'm in my first year at a PE firm and make more than trained residents that are 10 years older than I am. Not to mention the debt involved in med school

Oh, and those "simple" procedures look a lot simpler than they actually are, usually because the physcian has had extensive training. Remember, everything that you do as a doctor you have to do well enough not to get sued.

Bottom line is that medicine is much more difficult than the corporate world in many ways. That's why the barrier to entry is so much higher.

 

[p30doc]

what I do know is that pre-meds are underpaid

 

[UGAmkw]

yeah i know, I was referirng to undergrad and medical school, but with as many hours as you work during residency, what they pay is probably about minimum wage. The fact of the matter is, while the average debt coming out of medical school is 150k, you would have to be an idiot pay that kind of money and not want to be well compensated for it. You want to help people, become a nurse. It just would not be worth it to spend that much money and time.

 

[Law2Doc]

...A dermatologist charges $300 to remove a mole in 2 minutes. $300 for 2 minutes of work and maybe another 5 of paperwork.

Um no. While dermatologists make plenty, when your dermatologist bills you $300 he isn't getting anything close to $300. And the paperwork doesn't just take 5 minutes if he expects to get paid. Perhaps what you SEE takes 5 minutes.

 

[redbull928]

I think doctors don't make too much $$ in the long run. As an engineer, even when you're 21 you can make $65,000~$75,000/yr. Although engineers reach their cap, think about the years they'll be working and the potential to invest. Time = $$$ I say become a doctor only if you want to 🙂

 

[deleted106503]

No, they're paid what they should be making based on simple economics. I'm not saying each individual is making exactly what he/she should be (some more, some less), but as a whole, they are.

 

[jult24er]

No, they're paid what they should be making based on simple economics. I'm not saying each individual is making exactly what he/she should be (some more, some less), but as a whole, they are.

What does that mean?

 

[Law2Doc]

No, they're paid what they should be making based on simple economics. I'm not saying each individual is making exactly what he/she should be (some more, some less), but as a whole, they are.

Gotta disagree with this. Economic principles can be applied when folks get to set their own prices. In that case the laws of supply and demand kick in and doctors get paid what the market with bear for their services. But in fact, the insurance industry (through private insurance) and the government (through medicaid) set the prices doctors can charge. The result is that pricing is based on political interests and another industry altogether, not by physicians or patients. On top of that is the fact that it's probably bad policy to let the market dictate what lifesaving measures should cost, because by definition most people would pay all they've got to extend their life. So the government has stepped in and made laws forcing hospitals not to turn away emergencies and the like, which in turn cuts into the bottom line. And thus "simple economics" are not at play in medicine, probably shouldn't be, and never will be. And so don't even try to use such analysis -- it will give you a headache.


It cannot be disputed that physician training is among the longest and most expensive out there, with high tuition med school followed by long low paid residencies. So one might actually predict that their salaries ought to be higher than they are. Instead, lots of folks emerge from 7+ years of school and training with eg a primary care salary of, say, $150 (with such salary having a net present value going into med school of well under six digits -- you have to remember the time value of money) and as much as $250 in debt, and the expectation that reimbursements. That's pretty crummy actually. Which is why most physicians will agree (and tell you pretty regularly on this road) that medicine is not the path you take to be rich. It is only a path you take if you are excited or interested in the job function.

 

[deleted106503]

What does that mean?

It's basic supply and demand. If an area has few doctors (supply) and wants more (demand), they will continue to increase salaries offered to lure more physicians. If an area is flooded with doctors and doesn't need anymore, they will be paid less.

The same applied to teachers. Teachers are paid what they should be (as a whole). I never understood the argument that "we don't pay our teachers enough" when people complain about the school system. If they want to have higher salaries, then increase the job requirements and job duties. Right now, the education required to become a teacher as well as the on-time duties (8-9 months a year of work?) don't justify higher salaries.

I also specified that some doctors will make more than they should be and others less. That's because it's not perfect. Some people working the same exact position with the same exact hours will probably not be getting paid exactly the same as their co-worker (like entering into a practice where seniority comes into play sometimes).

 

[Law2Doc]

It's basic supply and demand. If an area has few doctors (supply) and wants more (demand), they will continue to increase salaries offered to lure more physicians. If an area is flooded with doctors and doesn't need anymore, they will be paid less.

False. Doesn't work this way. Doctors can't set their own prices. They live on reimbursements set by another industry. Supply and demand doesn't apply here. See my post above yours.

 

[deleted106503]

Gotta disagree with this. Economic principles can be applied when folks get to set their own prices. In that case the laws of supply and demand kick in and doctors get paid what the market with bear for their services. But in fact, the insurance industry (through private insurance) and the government (through medicaid) set the prices doctors can charge. The result is that pricing is based on political interests and another industry altogether, not by physicians or patients. On top of that is the fact that it's probably bad policy to let the market dictate what lifesaving measures should cost, because by definition most people would pay all they've got to extend their life. So the government has stepped in and made laws forcing hospitals not to turn away emergencies and the like, which in turn cuts into the bottom line. And thus "simple economics" are not at play in medicine, probably shouldn't be, and never will be. And so don't even try to use such analysis -- it will give you a headache.


It cannot be disputed that physician training is among the longest and most expensive out there, with high tuition med school followed by long low paid residencies. So one might actually predict that their salaries ought to be higher than they are. Instead, lots of folks emerge from 7+ years of school and training with eg a primary care salary of, say, $150 (with such salary having a net present value going into med school of well under six digits -- you have to remember the time value of money) and as much as $250 in debt, and the expectation that reimbursements. That's pretty crummy actually. Which is why most physicians will agree (and tell you pretty regularly on this road) that medicine is not the path you take to be rich. It is only a path you take if you are excited or interested in the job function.

With caps on what insurance/hospitals will pay/bill, salaries can be suppressed, but no one is forcing a physician to work or enter that profession. In the second paragraph, you introduce a scenario where someone enters as a PCP making $150k with $250k in debt. You can't pay them based on how much debt they incurred since not everyone makes the same "sacrifice." Not everyone makes that same choice. Some leave school with only $150k of debt (or less depending on fin aid given) and become neurosurgeons or radiologists making $500k+. My friend (MRI radiologist) constantly tells me not to go to somewhere like GW to incur that kind of debt to become a PCP. That to me is kind of obvious, but then again there are people that go to Harvard taking out loans to study poetry...

I still believe that doctors are making around what they should be. If a doctor felt he/she wasn't, they can find an opportunity elsewhere whether it be the same position in a different location or a new job in something like medical consulting. I really don't think the effect of healthcare limiting payment suppresses salaries that much. If it did, then it would be corrected by fewer people entering medical school and a lag in the number of practicing physicians 7 or so years down the line. It all pretty much works itself out in the end because people have choices and adjust accordingly.

 

[foster033]

The same applied to teachers. Teachers are paid what they should be (as a whole). I never understood the argument that "we don't pay our teachers enough" when people complain about the school system. If they want to have higher salaries, then increase the job requirements and job duties. Right now, the education required to become a teacher as well as the on-time duties (8-9 months a year of work?) don't justify higher salaries.

It's not always just about how long you went to school....

increase job duties...don't you think educating the future generation is a pretty significant responsibility?

 

[Law2Doc]

With caps on what insurance/hospitals will pay/bill, salaries can be suppressed, but no one is forcing a physician to work or enter that profession.

You are mixing two concepts. Whether people will go into medicine, and whether they are adequately paid. They are not linked as tightly as you suggest -- most people aren't going into medicine based on the money they can derive. But the laws of supply and demand are premised on the notion that people can set their own prices for their products/services. Once you don't have that, this law of economics may not be used.

 

[deleted106503]

It's not always just about how long you went to school....

increase job duties...don't you think educating the future generation is a pretty significant responsibility?

It is a large responsibility (I never said it wasn't). Maybe some teachers aren't being as responsible and are too lazy? I certainly had teachers that had a sincere care for how I performed whereas others just had us take tests with no feedback and tried to be more of the "cool" and "fun" teacher than anything else. I was fortunate to have the same teacher for three years in high school for math and she was there everyday from 6:30 AM to 4:00 PM and really got to know each student and tried her best to help those that didn't understand the material as well (pre-calc, calc ab, calc bc). She was furious when the school capped the $50/student reward for getting a 5 on the AP exam ($2,500 limit). 🙁

Anyway, since we don't live in a socialist (or communist) country and people have the ability to change what they do for a living as well as make career choices, the wages work themselves out in the end *as a whole*.

 

[deleted106503]

You are mixing two concepts. Whether people will go into medicine, and whether they are adequately paid. They are not linked as tightly as you suggest -- most people aren't going into medicine based on the money they can derive. But the laws of supply and demand are premised on the notion that people can set their own prices for their products/services. Once you don't have that, this law of economics may not be used.

I think you have to factor in the knowledge one is taking on a lot of debt. I really doubt someone will go into this field without taking ANY consideration in being able to pay off that debt. Do you know someone that took on $250k of loans without even thinking that they may become a doctor and be okay making $40k a year? I'm not sure a person like that has existed in healthcare, haha. I'm fairly certain everyone that has applied to medical school KNOWS that they will be paid at least enough to pay off their loans. Nothing in life is guaranteed including residency positions. Some physicians will make 10x more than others so financially there will be winners and losers (I don't like those terms). It's a risk people know when entering medical school...or hopefully they know or else they will feel underpaid if they don't land that residency they always wanted.

As far as setting prices, I was talking about being able to negotiate a salary with a hospital or in a practice group. If an agreement cannot be met, the doctor has the ability to find something else. Either similar pay with reduced work (my MRI friend took a 10% pay cut to stop working weekends) or a different location.

The other portion you mentioned referred to what insurance companies will pay and what hospitals will bill. One can argue that hospitals have the ability to price gouge since healthcare is a need, not a want. Maybe they are charging too much and doctors are overpaid? 🙂 I don't believe that is the case, but I do know some hospitals make a ton of money. Specifically HCA since my friend's brother works in TN for them and his dad is also a CEO of one of their hospitals in FL. The money they have to spend amongst them is ridiculous. They treat their doctors well since that's their bread and butter (ha!). That story's for another day...

I still stand by doctors making what they should be.

 

[circulus vitios]

I don't mean to hijack this thread, but it is on the topic of salaries. People talk about the 'good days' of medicine (in the 60s/70s I presume?) and how doctors earned boatloads of money. How much more did the average family practice physician earn in the 'good days'?

 

[deleted106503]

I don't mean to hijack this thread, but it is on the topic of salaries. People talk about the 'good days' of medicine (in the 60s/70s I presume?) and how doctors earned boatloads of money. How much more did the average family practice physician earn in the 'good days'?

I'm curious to know this as well given how many MD programs there are that have goals of upping the PCP count more than specialists.

As far as I'm concerned, 100k salary (today) is enough to pay off 250k in debt single handedly over time. Anything else over that is bonus imo. I have a few friends that went to law school (GW) and took on $140k of debt and make $75k right now and aren't poor.

 

[bozz]

That to me is kind of obvious, but then again there are people that go to Harvard taking out loans to study poetry...

lol, Harvard's tuition isn't any higher than many low-tier private schools'

 

[jult24er]

It's basic supply and demand. If an area has few doctors (supply) and wants more (demand), they will continue to increase salaries offered to lure more physicians. If an area is flooded with doctors and doesn't need anymore, they will be paid less.

The same applied to teachers. Teachers are paid what they should be (as a whole). I never understood the argument that "we don't pay our teachers enough" when people complain about the school system. If they want to have higher salaries, then increase the job requirements and job duties. Right now, the education required to become a teacher as well as the on-time duties (8-9 months a year of work?) don't justify higher salaries.

I also specified that some doctors will make more than they should be and others less. That's because it's not perfect. Some people working the same exact position with the same exact hours will probably not be getting paid exactly the same as their co-worker (like entering into a practice where seniority comes into play sometimes).

In medicine, supply is set mostly by the # of physicians liscensed by the government. AMA obviously does its best to keep supply down and doctors salaries up. So areas can increase salaries, but the supply of doctors wont necissarily go up. Classic case of rents. http://en.wikipedia.org/wiki/Economic_rent#Example_and_controversy

 

[jult24er]

Gotta disagree with this. Economic principles can be applied when folks get to set their own prices. In that case the laws of supply and demand kick in and doctors get paid what the market with bear for their services. But in fact, the insurance industry (through private insurance) and the government (through medicaid) set the prices doctors can charge. The result is that pricing is based on political interests and another industry altogether, not by physicians or patients. On top of that is the fact that it's probably bad policy to let the market dictate what lifesaving measures should cost, because by definition most people would pay all they've got to extend their life. So the government has stepped in and made laws forcing hospitals not to turn away emergencies and the like, which in turn cuts into the bottom line. And thus "simple economics" are not at play in medicine, probably shouldn't be, and never will be. And so don't even try to use such analysis -- it will give you a headache.


It cannot be disputed that physician training is among the longest and most expensive out there, with high tuition med school followed by long low paid residencies. So one might actually predict that their salaries ought to be higher than they are. Instead, lots of folks emerge from 7+ years of school and training with eg a primary care salary of, say, $150 (with such salary having a net present value going into med school of well under six digits -- you have to remember the time value of money) and as much as $250 in debt, and the expectation that reimbursements. That's pretty crummy actually. Which is why most physicians will agree (and tell you pretty regularly on this road) that medicine is not the path you take to be rich. It is only a path you take if you are excited or interested in the job function.

Economists use economic models to analyze situations in which the government has price controls all the time. If the price is below where the market would set it, you have shortages and lines, i.e., medicaid.

 

[link2swim06]

Um no. While dermatologists make plenty, when your dermatologist bills you $300 he isn't getting anything close to $300. And the paperwork doesn't just take 5 minutes if he expects to get paid. Perhaps what you SEE takes 5 minutes.

I gotta disagree partly with this, the dermatologist I go to has charged me $1000 for removing four moles and being in the room for less than 5 minutes. He has hired help to do 90% of this paper work and since he owns practice consisting of 12 dermatologist he shares this hired help to do billing for all of them. I know for a fact this guy makes over 3 million a year and work 4 days a week for appox. 7 hrs/ day. I understand alot of this income is coming from being the owner of the practice but never the less he gets away with doing almost no paper work. (I watched him when I shadowed him for a week)

 

[Haemulon]

I'm curious to know this as well given how many MD programs there are that have goals of upping the PCP count more than specialists.

As far as I'm concerned, 100k salary (today) is enough to pay off 250k in debt single handedly over time. Anything else over that is bonus imo. I have a few friends that went to law school (GW) and took on $140k of debt and make $75k right now and aren't poor.

While 100k is a lot of money by many standards, it really isn't as much as it first appears once you think through it. The monthly payments on 250k are nothing to sneeze at, and while they can certainly be paid with a 100k salary, when you add on at least that much more for a home and other domestic things like everyone else has (being very conservative) plus the higher tax bracket, one isn't exactly living high on the hog. Also keep in mind that there was essentially 4 years of zero pay while accumulating the debt, and 3-5+ years of 40-50k pay while continuing training (working double the hours of what most professions work, which essentially equates to a wage more on par with those making 20-25k per year). That has to be factored in since it takes a while to catch up to what one could have potentially been making in other fields during that time.

During all of this training time of essentially making little to nothing, accumulating huge debt, and being more or less isolated from family, friends, and a normal lifestye, one's peers in other professions move forward and enjoy professional and monetary successes while the med student/resident slaves away with their eyes on the goal. After these years of dedication and sacrifice, the trained physician can then look forward to a lifetime of early hours and long days for ever decreasing reimbursments and increasing paperwork, red-tape, and law suits while battling the extraordinary pressures of expectation imposed by a public that rightly expects nothing short of the very best from their doctors.

Is it worth it? For me ... ABSOLUTELY. Can one still achieve great financial success and personal satisfaction from this career path? Absolutely. But it would be a shame to trivialize the dedication and sacrifice that is required for those those that choose this path. 6 figure salaries by themselves do not necessarily mean lavish lifestyles and cushy careers. Additionally, there are large personal, financial, time, and emotional costs to get to that point and these costs have a value as well.

 

[Law2Doc]

Economists use economic models to analyze situations in which the government has price controls all the time. If the price is below where the market would set it, you have shortages and lines, i.e., medicaid.

Not the same thing at all. The economic concept of "supply and demand" is premised on the notion that prices are under somebodies control and will be raised to an equilibrium based on supply vs demand. This doesn't work when the bulk of pricing is set by another industry whose goal is to keep the prices lower than the market will bear. Meaning if doctors can't raise their prices and yet insurance companies are lowering them even as demand is exceeding supply, the economic model cannot work. This is what is going on in the world of medicine. At the same time the media is touting a physician shortage, insurance companies are cutting reimbursements. So demand is high, supply is low, and prices doctors can charge are going down. As a consequence, physicians have lost ground against inflation in each of the last ten or so years. So no, this isn't an applicable economic model to point to. This is hardly the "simple economics" model the prior poster suggests. this is a convoluted model where simple economics cannot be applied. Perhaps some extremely complex multivariable economics model can be created to play a role, but I wouldn't bet on it.

 

[Law2Doc]

6 figure salaries by themselves do not necessarily mean lavish lifestyles and cushy careers. Additionally, there are large personal, financial, time, and emotional costs to get to that point and these costs have a value as well.

Agreed. Especially about the time. bear in mind that a six digit salary that doesn't start for a decade or more may be equivalent to a five digit salary in NPV. Meaning someone starting at a much lower salary and working steadily for a decade may make much more than someone starting at a higher salary at a later date. This concept all too often seems to be lost on folks coming right out of college, but it's the concept all of finance is based upon.

 

[deleted74029]

I say this as someone applying to medical school.

Whew! For a second there I thought you were someone who didn't know what they were talking about.

 

[Haemulon]

I gotta disagree partly with this, the dermatologist I go to has charged me $1000 for removing four moles and being in the room for less than 5 minutes. He has hired help to do 90% of this paper work and since he owns practice consisting of 12 dermatologist he shares this hired help to do billing for all of them. I know for a fact this guy makes over 3 million a year and work 4 days a week for appox. 7 hrs/ day. I understand alot of this income is coming from being the owner of the practice but never the less he gets away with doing almost no paper work. (I watched him when I shadowed him for a week)

I don't know about this particular circumstance, but keep in mind that higher than expected reimbursements for some procedures are often necessary to make up for other reimbursements that sometimes do not even make up for the actual costs of performing the procedure (as in it actually costs physicians money to see some patients). Plus, like LTD said, reimbursement rates are mostly set by insurance companies and the government, not by the physicians. Large systems can negotiate rates somewhat, but the game is what the game is for now.

Many people just want to pay their 10 or 20 dollar co-pay and their few hundred dollar a month premiums (obviously some people pay a lot more, some less, some none). Meanwhile, a few complicated visits to a physician or emergency room, some diagnostic tests, or maybe some procedures can wipe out an individual's premium contributions for the year, leaving the rest for insurance companies, physicians, and the taxpayers to pay, depending on the insurance involved. Thus, higher costs and fees all around. It is just not as simple as supply and demand economics.

 

[atomi]

I gotta disagree partly with this, the dermatologist I go to has charged me $1000 for removing four moles and being in the room for less than 5 minutes. He has hired help to do 90% of this paper work and since he owns practice consisting of 12 dermatologist he shares this hired help to do billing for all of them. I know for a fact this guy makes over 3 million a year and work 4 days a week for appox. 7 hrs/ day. I understand alot of this income is coming from being the owner of the practice but never the less he gets away with doing almost no paper work. (I watched him when I shadowed him for a week)

Exactly. People get on here and pretend they know what they are talking about. Specialists like dermatologists and oral surgeons bill an outrageous amount of money for basic procedures. The insurance companies pay it (and those uninsured are unable to afford to). They make an insane amount of money by doing this. There is something not right about it IMO.

 

[deleted74029]

This OB-GYN makes 12 million a year:
http://www.drmatlock.com/