Doctors salaries are too high

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I think he should be more upset at insurance companies/government/health corporations than he should be ACGME and how much doctors actually make. He said we spend around $100 billion per year on doctor salaries, when we spend around 3.2 trillion on healthcare that's a little over 3% that goes towards physician salaries.

Source: https://www.cms.gov/Research-Statis...onalHealthExpendData/downloads/highlights.pdf

The whole article seemed kind of odd to me.
 
QuentinT88 said:
The problem of doctors’ salaries

Anybody read this recent article about doctors salaries being too high compared to other developed countries? Thoughts?
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Don't get worked up over it. No matter what industry you're in there are always some fools with soapboxes who want to take a swipe at you.

As for the substance of the article, if one writes a piece on physician pay and doesn't mention the role of fee-for-service, I immediately conclude that the author didn't do enough homework to have an informed opinion. Then I hit my mental ignore button.
 
cj_cregg said:
The overspecialization thing was an interesting point I hadn't considered, though.
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That's the only decent point the article made, and one that is generally under-appreciated. If we deemed cognitive tasks, like evaluation and management, to be more similar in value to procedural tasks, we would likely have more generalists, fewer specialists, and perhaps a healthier population.
 
QuentinT88 said:
The problem of doctors’ salaries


Anybody read this recent article about doctors salaries being too high compared to other developed countries? Thoughts?
Click to expand...
Physicians in the US are also FAR more productive and work far more hours thesis their foreign counterparts. On a RVU basis, we're actually underpaid.
 
Goro said:
I think doctors, like airline pilots, deserve every penny they get.
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Why would airline pilots (who actually have pretty low salaries) be considered in the same category as physicians?
 
Kisangani said:
Why would airline pilots (who actually have pretty low salaries) be considered in the same category as physicians?
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The average large jet pilot makes 108k per year. They are responsible for the lives of literally hundreds of people at a time, and have a job in which small errors can have catastrophic consequences. Their level of responsibility is certainly akin to medicine.
 
Kisangani said:
Why would airline pilots (who actually have pretty low salaries) be considered in the same category as physicians?
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Pilots are really ****ing good at what they do. How often do you hear about planes crashing? Compare that to the number of flights that take off and land globally on any given day.
 
Med Ed said:
If we deemed cognitive tasks, like evaluation and management, to be more similar in value to procedural tasks, we would likely have more generalists, fewer specialists, and perhaps a healthier population.
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Likewise, if we were a healthier population, we would likely deem cognitive taks to be more similar in value to procedural tasks.
 
This is the most trash article I have ever read. As someone who is heavily involved with policy work, this article goes about health policy in the completely wrong way.

The article doesn't touch on the fact that the avg medical school costs 50 grand in tuition alone. With total cost including COL it ends up being what, 80 grand a year? Total of over 300k just to become a physician? I wonder how that plays out with physicians that take out loans with interest rates. Oh that's right the cost can end up being over 500k with interest.

The article states that they should allow foreign doctors who complete foreign (comparable) residencies to be able to practice here. What they don't realize is the fact that an MBBS degree is often awarded after 6 years of work after HS rather than 8 years here. "Comparable" residency would be hard to even examine. Who is going to pay to have someone evaluate foreign residencies (there are a lot). If this were the case, why would anybody even go to medical school here and pay so much when they can go to other countries save two years + money.

The article doesn't talk about our health system in detail, nor does it talk about how long doctors work on average (as an attending) here compared to other countries. Other countries when the clock hits 5, you lock the door and that's it. Here, you stay till all the backed up patients in the waiting room are seen (specialty and practice type dependent).

When talking about malpractice, the article states it should be possible for doctors, hospitals insurers, and other providers to refer to the standards of care in other countries as a legal defense in malpractice cases. What is this BS? Anybody want to expand on this for me so I can get an understanding of what point they are trying to get across? The fact that another country has lower standards of care (although sad) should have no implication on malpractice; we aren't in those countries, we are here, in the U.S. & Canada.

Lastly, the article failed to mention the outstandingly low reimbursements from insurance ranging from 6% (Medicare) to 60% trying to nickel and dime physicians any way they could. I don't know why there has been a war on physicians recently, all I know is that if I'm undergoing an advanced procedure that requires skill and concentration, I don't want my doctor to worry about paying her/his bills when operating.

I am not advocating for a certain type of health system nor am I taking political sides*
Sorry I just went on a rant. 100% Open to other opinions and discussions.
 
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SpectreDoc said:
This is the most trash article I have ever read. As someone who is heavily involved with policy work, this article goes about health policy in the completely wrong way.

The article doesn't touch on the fact that the avg medical school costs 50 grand in tuition alone. With total cost including COL it ends up being what, 80 grand a year? Total of over 300k just to become a physician? I wonder how that plays out with physicians that take out loans with interest rates. Oh that's right the cost can end up being over 500k with interest.

The article states that they should allow foreign doctors who complete foreign (comparable) residencies to be able to practice here. What they don't realize is the fact that an MBBS degree is often awarded after 6 years of work after HS rather than 8 years here. "Comparable" residency would be hard to even examine. Who is going to pay to have someone evaluate foreign residencies (there are a lot).

The article doesn't talk about our health system in detail, nor does it talk about how long doctors work on average (as an attending) here compared to other countries. Other countries when the clock hits 5, you lock the door and that's it. Here, you stay till all the backed up patients in the waiting room are seen.
Lastly, the article failed to mention the outstandingly low reimbursements from insurance ranging from 5% (Medicare) to 60% trying to nickel and dime physicians any way they could.

I am not advocating for a certain type of health system nor am I taking political sides*
Sorry I just went on a rant. 100% Open to other opinions and discussions.
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It's literally one of the worst articles I've ever read on the subject, I feel your pain
 
Mad Jack said:
The average large jet pilot makes 108k per year. They are responsible for the lives of literally hundreds of people at a time, and have a job in which small errors can have catastrophic consequences. Their level of responsibility is certainly akin to medicine.
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1. Most of them don't fly large jets. The ones that do and make that kind of money only do so in the last few years of their careers. Average wages amongst all pilots is likely somewhere around 50k, with first officers/new hires barely making enough to scrape by
2. Training level is low in comparison to medicine (does not even require a college degree) and is nowhere near as technical

Not trying to bash the profession, just saying that placing it alongside medicine in terms of responsibility is absolutely not a fair comparison. Especially since most airplanes these days more or less fly themselves. I guess bus, train and ferry conductors should also be part of that same group then in terms of overall responsibility and compensation by that logic?
 
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Where are the articles that compare administrator pay to those in foreign countries?

I think that American economists make way more than twice as much as economists in Ghana. But are we getting high impact articles and interesting new ideas out of them that we can't get from overseas? I think not.
 
You don't become a doctor until your late 20s at the earliest and you have hundreds of thousands worth of debt to pay off. The high salary is also meant to compensate for the debt they accumulate. The higher the pay, the longer the residency, the more your debt will grow.

Believe it or not, when you convert their salary to hourly wages, teachers make a bit more. In addition, teachers/professors have a nice pension where their employer matches it.

The Deceptive Salary of Doctors – BestMedicalDegrees.com
 
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Kisangani said:
1. Most of them don't fly large jets. The ones that do and make that kind of money only do so in the last few years of their careers. Average wages amongst all pilots is likely somewhere around 50k, with first officers/new hires barely making enough to scrape by
2. Training level is low in comparison to medicine (does not even require a college degree) and is nowhere near as technical

Not trying to bash the profession, just saying that placing it alongside medicine in terms of responsibility is absolutely not a fair comparison. Especially since most airplanes these days more or less fly themselves. I guess bus, train and ferry conductors should also be part of that same group then in terms of overall responsibility and compensation by that logic?
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It's not about the level of training, it's about the level of responsibility. Saying "planes fly themselves most of the time" is like saying "monitoring has made anesthesia safe most of the time-" the expertise is there for when the status is not quo, and it's something that you don't appreciate because the profession has gotten so safe that it is taken for granted. And ultimately, the time when they're taking off and landing is the biggest issue and when most crashes are likely to occur, and those are not processes that are automated.

As to who makes how much, despite there being a lot of underpaid pilots, the average industry salary for commercial airline pilots is $124,000 per the industry and $108,000 per the federal government. Yeah, new pilots don't make much until they work their way up to busier routes or larger planes, but that's like saying doctors don't make much because the average resident is only pulling 55k.
 
infectiousdisease101 said:
You don't become a doctor until your late 20s at the latest and you have hundreds of thousands worth of debt to pay off. The high salary is also meant to compensate for the debt they accumulate. Believe it or not, when you convert their salary to hourly wages, teachers make a bit more. In addition, teachers/professors have a nice pension where their employer matches it.

The Deceptive Salary of Doctors – BestMedicalDegrees.com
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That article is deceptive. First off, 80 hours per week during medical school? I'm quite certain the average medical school student does not study 80 hours per week. In addition, they're undercounting teacher hours as teachers spend a large chunk of their non-classroom time lesson planning, grading papers, etc. Finally, taxes don't work that way. You don't just multiply your gross income by your tax bracket. The tax system in the US is progressive which leaves a lot more expendable income for the physician. After taking into account job security, I'd say physicians have it much better than teachers.

Now that's not to say that physician incomes are too high as I believe they've earned every cent, but the article tries to paint physician income in a light that I don't agree with.
 
unaccpted said:
That article is deceptive. First off, 80 hours per week during medical school? I'm quite certain the average medical school student does not study 80 hours per week. In addition, they're undercounting teacher hours as teachers spend a large chunk of their non-classroom time lesson planning, grading papers, etc. Finally, taxes don't work that way. You don't just multiply your gross income by your tax bracket. The tax system in the US is progressive which leaves a lot more expendable income for the physician. After taking into account job security, I'd say physicians have it much better than teachers.

Now that's not to say that physician incomes are too high as I believe they've earned every cent, but the article tries to paint physician income in a light that I don't agree with.
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I noticed that too, but that's negligible for the purposes of the article because I have yet to meet anyone who holds a job while in medical school.

If you're a professor, you can get tenure.
 
There is no conversation towards moving toward European salaries until people start graduating with European debts, a pretty big piece of the puzzle the author neglected to bring up. You're talking about people graduating with $300-400k in loans on the higher end with 6-7% interest at the federal level. People aren't going to be able to pay that off on a European salary.
 
Kisangani said:
Especially since most airplanes these days more or less fly themselves.
Click to expand...

As someone who used to fly quite often (and I mean actually fly the plane, not just be a passenger), I can tell you that planes don’t more or less fly themselves. There is far more to it than just programming it into a computer and reading the paper.

Edit: also, I was on a flight that lost power to both engines and had to make an emergency landing. Pilots have very technical and demanding jobs. Those guys are amazing.
 
cj_cregg said:
Yeah, I was at a primary care conference recently and there was a speaker who talked about how much better health outcomes are pretty much across the board in communities with a higher proportion of primary care providers to specialists. It was really interesting.
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Uh...

im sure that has nothing to do with the frequency of obesity, DM, and hypertension in rural communities.
 
infectiousdisease101 said:
I'm pretty certain no one who makes six figs does so without earning it.
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they-work-hard-for-their-money-1483215441.jpg
 
Compensation is not about how long you went to school. It's about the responsibilities you have.

Kisangani said:
1. Most of them don't fly large jets. The ones that do and make that kind of money only do so in the last few years of their careers. Average wages amongst all pilots is likely somewhere around 50k, with first officers/new hires barely making enough to scrape by
2. Training level is low in comparison to medicine (does not even require a college degree) and is nowhere near as technical

Not trying to bash the profession, just saying that placing it alongside medicine in terms of responsibility is absolutely not a fair comparison. Especially since most airplanes these days more or less fly themselves. I guess bus, train and ferry conductors should also be part of that same group then in terms of overall responsibility and compensation by that logic?
Click to expand...
 
That article reminds me of this blogger who criticized a doctor for falling asleep on the job. They got roasted and the blog was deleted.
 
7331poas said:
Your post implied that somehow having more primary care docs made the population healthier.
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Yes, somehow. SOMEHOW.

Somehow having access to timely and appropriate primary and preventive medical services might lead to a healthier population. How? We're not sure. But somehow.

Who knows? Perhaps next we will be talking about how the best way to improve the health at the population level isn't to withhold medical care from certain groups until they make themselves healthy enough to deserve it.
 
Med Ed said:
Yes, somehow. SOMEHOW.

Somehow having access to timely and appropriate primary and preventive medical services might lead to a healthier population. How? We're not sure. But somehow.

Who knows? Perhaps next we will be talking about how the best way to improve the health at the population level isn't to withhold medical care from certain groups until they make themselves healthy enough to deserve it.
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I think you didn't read my post. The assertion was that rural populations have more comorbidities at baseline.

However I do appreciate the literature presented by the replying poster.
 
cj_cregg said:
Isn't it possible that rural populations (and others underserved in regards to primary care) have more comorbidities at baseline at least in part because they have poor access to primary and preventive care?
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possible. Id probably point to suboptimal insurance rates, rural americans are poorer, have transportation issues, and worse health behaviors.

I don't deny that lack of PCPs definitely contributes though.
 
cj_cregg said:
Literally all of those things are connected to poor access to primary care. This is basic public health and well-supported in the literature.

Suboptimal insurance rates, poor, transportation issues --> less primary care access --> worse health behaviors
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Your first assertion was that lack of primary care docs was the issue. My assertion is that access to primary care docs is the issue (also a slew of other issues that primary care docs dont really solve). I don't think you are totally wrong. I just think that you are partially wrong.

Most rural americans simply cannot go to a pcp. even if they are next door.
 
US Congress = $174,000 per year
British Parliament = $97,000 per year
Sounds like even politicians here have the same dilemma

From a Forbes report in 2013...
Compared to annual pay for doctors in other major industrialized countries, average physician earnings in the U.S. are considerably higher—about 78 percent higher, on average. Unfortunately, this is not quite an apples-to-apples comparison since average earnings includes both specialists and primary care docs. Consequently, comparing average doctor pay in the U.S. (where more than 70% of doctors are specialists) to that in nations such as Canada and France (where less than half of doctors are specialists) is not very illuminating.
When specialty earnings are compared to average GDP per capita, it turns out that physicians everywhere are paid at least several multiples of GDP per capita.
the more relevant comparison is not to the average worker but to members of the talent pool from which American physicians are recruited. When specialty earnings are compared to those of high earners—i.e., those in the 95-99% of the earnings distribution—it turns out that physicians in nearly all other countries, not just the U.S., are paid reasonably well.
the rate of return on a medical education is far below that of students who pursue law degrees or MBAs.
So if we think high earners is the more appropriate reference standard, American specialists actually are slightly underpaid compared to their counterparts elsewhere: on average, the specialty to higher-earner pay ratio is 6 percent lower here than elsewhere.
 
No one ever blames the high salaries of engineers on high iPhone and Tesla prices. In fact, they probably take home more in pay compared to doctors (and pharmacists) with $200k+ in loams and 4-8 years of lost earnings opportunity cost.

Sent from my SM-N910V using SDN mobile
 
Mad Jack said:
Physicians in the US are also FAR more productive and work far more hours thesis their foreign counterparts. On a RVU basis, we're actually underpaid.
Click to expand...

Exactly!

Physicians IMO should be getting paid more. They definitely deserve every penny they get.
 
"In recent years, the number of medical residents has become so restricted that even the American Medical Association is pushing to have the number of slots increased. The major obstacle at this point is funding."

Not trying to stir a political argument, but I feel as though that the U.S. government should transfer the money for foreign aid over to establishing more medical residencies and medical schools here in the U.S. For example, I remember reading how the U.S. supplied something around $1.5 billion/year to Egypt so they can have a stronger military base. PLEASE. That $1.5 billion could do a lot to help out our medical community.

That $1.5 billion would also be enough to eliminate at least 100% of the debt for 50% of our med students in U.S. If add an extra $1.5 billion, almost everyone would be mostly debt free.
 
Med Ed said:
Don't get worked up over it. No matter what industry you're in there are always some fools with soapboxes who want to take a swipe at you.

As for the substance of the article, if one writes a piece on physician pay and doesn't mention the role of fee-for-service, I immediately conclude that the author didn't do enough homework to have an informed opinion. Then I hit my mental ignore button.
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Yeah, seriously.

My left wing politics are well known on here, but this was an article by someone who doesn't understand the subject he's writing about at all. It read like a paper by a high schooler or college freshman.
CyrusHabs7695 said:
Clayton Kershaw makes $35 million a year, doctors aren't paid enough
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And he deserves every penny of it. Same with Matthew Stafford.
 
@Matrix207 In my limited opinion, it's a slippery slope issue and the limitation in residency spots is favorable to currently practicing physicians. As for using federal funding to help establish new medical schools... we've seen what happens when programs are unhindered to pursue low barrier for entry professional degree programs. Pharmacy schools are now a dime a dozen and the employment market is saturated with students. Maybe physicians are immune to S&D market dynamics... is it something that we want to find out?
 
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Pina Colada said:
@Matrix207 In my limited opinion, it's a slippery slope issue and the limitation in residency spots is favorable to currently practicing physicians. As for using federal funding to help establish new medical schools... we've seen what happens when programs are unhindered to pursue low barrier for entry professional degree programs. Pharmacy schools are now a dime a dozen and the employment market is saturated with students. Maybe physicians are immune to S&D market dynamics... is it something that we want to find out?
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You do make a good point. Then maybe have that money provide debt relief to medical students? I don't see why not. That would be pretty awesome. I personally find the $1.5 billion to Egypt a waste of money. That money could do so much good for our medical community.
 
Matrix207 said:
You do make a good point. Then maybe have that money provide debt relief to medical students? I don't see why not. That would be pretty awesome. I personally find the $1.5 billion to Egypt a waste of money. That money could do so much good for our medical community.
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"they should stop spending public money on something I don't like understand and give it to me"
 
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