Expected salary cuts

[EPADHA]

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With cuts (due to bundling) expected in interventional and ablation; the mood in cardiology community is not upbeat to say the least. 🙁
I am not sure if the SGR patch will come through. What kind of cuts should cardiologists expect across the board?

 

[CardDoc22]

I am an interventional cardiologist 4 years out of training: there had been a payment cut by Medicare almost every year for cardiology since I have started to practice, the biggest cuts in medicare's history actually were in cardiology still the cuts will continue as cardiovascular care is probably the biggest budget item in medicare. Next year for interventional cardiology another 20-28% (actually may be more scheduled given 2nd vessel angioplasty will not be payed) in addition to imaging cuts for 2nd procedure 25%. Hospitals will get on the contrary a raise for the procedures. For an acute MI the payment for the cardiologist will be in $600 range - overhead(50-60%) - taxes/deductions 50%? (will see soon) - the nonpaying patients = $100-150 / case includes being on call when you have to show up in the middle of the night in 20-30min after paged and work for 1-2hrs in a high risk operative procedure that requires total 25-30yrs of training . Depending on the case volume the techs and cath lab nurses might get not much lower payment per case.

 

[C5toC9]

Wow, that sucks....

 

[nope80]

yeah thats really alarming....

 

[EPADHA]

I am an interventional cardiologist 4 years out of training: there had been a payment cut by Medicare almost every year for cardiology since I have started to practice, the biggest cuts in medicare's history actually were in cardiology still the cuts will continue as cardiovascular care is probably the biggest budget item in medicare. Next year for interventional cardiology another 20-28% (actually may be more scheduled given 2nd vessel angioplasty will not be payed) in addition to imaging cuts for 2nd procedure 25%. Hospitals will get on the contrary a raise for the procedures. For an acute MI the payment for the cardiologist will be in $600 range - overhead(50-60%) - taxes/deductions 50%? (will see soon) - the nonpaying patients = $100-150 / case includes being on call when you have to show up in the middle of the night in 20-30min after paged and work for 1-2hrs in a high risk operative procedure that requires total 25-30yrs of training . Depending on the case volume the techs and cath lab nurses might get not much lower payment per case.

I think your post hits it in the head. I wanted to do interventional, but held back as the lifestyle was not worth the stress, and I dont love it to the point that I will die if I dont do it.

A lot of the interventional fellows I know are board certifying in nuclear and echo so that they could throw in the towel in a few years..

I wonder how EP is going to fare in all this.

 

[IMDoc607]

I am an interventional cardiologist 4 years out of training: there had been a payment cut by Medicare almost every year for cardiology since I have started to practice, the biggest cuts in medicare's history actually were in cardiology still the cuts will continue as cardiovascular care is probably the biggest budget item in medicare. Next year for interventional cardiology another 20-28% (actually may be more scheduled given 2nd vessel angioplasty will not be payed) in addition to imaging cuts for 2nd procedure 25%. Hospitals will get on the contrary a raise for the procedures. For an acute MI the payment for the cardiologist will be in $600 range - overhead(50-60%) - taxes/deductions 50%? (will see soon) - the nonpaying patients = $100-150 / case includes being on call when you have to show up in the middle of the night in 20-30min after paged and work for 1-2hrs in a high risk operative procedure that requires total 25-30yrs of training . Depending on the case volume the techs and cath lab nurses might get not much lower payment per case.

I am starting to wonder if cardiologists will be making any money in the future. By your posts, it seems that cardiology is the devil for medicare. Your post really makes me wonder if going into cardiology is worth it regardless of how much you may enjoy it. I understand you need to like what you do but to the point where you're working so hard for little return?? hell no

 

[josephf1]

ive been saying this for years
again the hospitalist where i work take no call and make a base of 220 and moonlight and pull in 300. already id, nephro have bailed and are doing hospitalist as well as nothing beats 6 months of vaca if you make the same. cards is heading in that direction as well. starting salaries in gen cards are 250 now in cities, with killer call. i am graduating soon and believe it or not might just be a hospitalist as well.

 

[hookaman]

Too bad I can't stand general medicine...

 

[nope80]

ive been saying this for years
again the hospitalist where i work take no call and make a base of 220 and moonlight and pull in 300. already id, nephro have bailed and are doing hospitalist as well as nothing beats 6 months of vaca if you make the same. cards is heading in that direction as well. starting salaries in gen cards are 250 now in cities, with killer call. i am graduating soon and believe it or not might just be a hospitalist as well.

How much moonlighting would you have to do to pull in 300? In other words, effectively how much would you be working? Usually its 7 on/7 off but that doesn't include moonlighting. With a base salary of 250 for cards, as you mentioned above, how much call would one be taking?

 

[redlined]

As a graduating interventional fellow in 6 mo have to agree with josephf1. The salary number he quoted is accurate for big cities with interventional not adding much more to salary. In the current climate (and probably the future) being a hospitalist makes a lot of sense in many ways.

 

[CanIMakeIt]

I think your post hits it in the head. I wanted to do interventional, but held back as the lifestyle was not worth the stress, and I dont love it to the point that I will die if I dont do it.

A lot of the interventional fellows I know are board certifying in nuclear and echo so that they could throw in the towel in a few years..

I wonder how EP is going to fare in all this.

I was hoping someone can answer that - EP is what I want to do. Hopefully in 3-5 years the dust will have settled and I will know which way to go - EP, Gen, or hospitalist - If I have to go hospitalist route that will be a sad day for me.

 

[badasshairday]

Every specialty is getting hit. In hindsight would you guys have chosen another field? If so, which one?

 

[redlined]

EP easily has the worst job market currently. Dont know if I would have done medicine again....if I did would have done ortho.

 

[bronx43]

EP easily has the worst job market currently. Dont know if I would have done medicine again....if I did would have done ortho.

Because you think ortho would never experience similar cuts? Nothing is safe in medicine.

 

[EPADHA]

Every specialty is getting hit. In hindsight would you guys have chosen another field? If so, which one?

I guess I would choose from Optho, Rad Onc, Dermatology and ENT.. I will make decent salary (about 250 K); get to go home at a decent time and have a life 🙂

I have no problem with 250 K; but I do think we are among the hardest working physicians among all specialities; esp the interventional guys who come in at 2 am to save ppl.. ditto for heart failure. I think getting 150-200 dollars net for a thrombectomy/PCI on STEMI is a joke. My plumber could charge more than that if I made him come in at 1 am to fix up a clogged toilet, and he does not have to worry about door-to-plunger time!

It's not our fault that the population and law makers dont want to lay emphasis on prevention; ACC has been saying this for >10 years. if preventative care and practices were better at least we will sleep more at night as cardiologists ( and feel better about 250 K).

The other concern that I have is that these cuts will dent the prestige that we have enjoyed for so long..

 

[nope80]

If you look at the stats online about average salaries, why do these show much higher salaries? Like 300k for general cards and 400k for interventional?

 

[redlined]

Because you think ortho would never experience similar cuts? Nothing is safe in medicine.

Yes your right thats exactly what I said...ortho would never experience similar cuts. Thanks for the enlightening statement.

 

[bronx43]

Yes your right thats exactly what I said...ortho would never experience similar cuts. Thanks for the enlightening statement.

No problem, kid.

 

[CanIMakeIt]

Every specialty is getting hit. In hindsight would you guys have chosen another field? If so, which one?

I am not sure. I did think about Ophtho a lot. Plus after rotating though Derm recently for a month, I can easily say derm is a well kept secret in the sense that it is not as boring and all about botox as it is made out to be. I had maybe 1 nutcase with leather skin wanting more skin peels etc and very few acne - severe mind you. And before you know it, the day is done with. I really really had fun. Saw so many derm manifestations of systemic disease - it was awesome.

But right now, I am still with Cards. I don't think I have time left to turn around and do Derm.

 

[OptimusPrime]

I am an interventional cardiologist 4 years out of training: there had been a payment cut by Medicare almost every year for cardiology since I have started to practice, the biggest cuts in medicare's history actually were in cardiology still the cuts will continue as cardiovascular care is probably the biggest budget item in medicare. Next year for interventional cardiology another 20-28% (actually may be more scheduled given 2nd vessel angioplasty will not be payed) in addition to imaging cuts for 2nd procedure 25%. Hospitals will get on the contrary a raise for the procedures. For an acute MI the payment for the cardiologist will be in $600 range - overhead(50-60%) - taxes/deductions 50%? (will see soon) - the nonpaying patients = $100-150 / case includes being on call when you have to show up in the middle of the night in 20-30min after paged and work for 1-2hrs in a high risk operative procedure that requires total 25-30yrs of training . Depending on the case volume the techs and cath lab nurses might get not much lower payment per case.

This whole situation is very complex and ultimately a tragedy unfolding before our eyes. As a future interventionalist I’m realizing that my field is falling victim to the rise in healthcare cost, lack of solidarity within the field of cardiology itself, and the lack of backbone and absence of strong lobby in Washington (someone told me ACC is our lobby… well if that is true then ACC is a joke as far as Washington lobbies go).

There is absolutely no reason why a qualified interventionalist saving a life in a patient actively dying from an acute STEMI should get compensated so poorly for their lifesaving measures. To think that there are spine surgeons or interventional neuroradiologist (intervening on acute stroke patients) with on average much poorer outcome results per procedure that on average are much better compensated makes this whole situation even more pathetic.

OP

 

[CanIMakeIt]

This whole situation is very complex and ultimately a tragedy unfolding before our eyes. As a future interventionalist I'm realizing that my field is falling victim to the rise in healthcare cost, lack of solidarity within the field of cardiology itself, and the lack of backbone and absence of strong lobby in Washington (someone told me ACC is our lobby… well if that is true then ACC is a joke as far as Washington lobbies go).

There is absolutely no reason why a qualified interventionalist saving a life in a patient actively dying from an acute STEMI should get compensated so poorly for their lifesaving measures. To think that there are spine surgeons or interventional neuroradiologist (intervening on acute stroke patients) with on average much poorer outcome results per procedure that on average are much better compensated makes this whole situation even more pathetic.

OP

I agree. I think the basic problem is that each of the strong groups with lobbying power do not have 5000 small subgroups - there is just one big group that takes care of all the issues - case in pt - ANA - nursing association - there is not a different lobby group for RN, DNP, NP etc - just ANA. Gun lobby doesn't have assault rifle, hand gun etc - there is just one - NRA and looking at medicine - everywhere you look, it is a dic*-measuring competition and its pathetic - Hundreds of diff organization to appease different interest groups and every one thinks that they are superior to other and keep fighting for turf rather than acting together - it's pathetic actually. In the end, it dilutes our negotiating power and lets the congress and insurance lobby walk all over us as there is no unity. Those people dangle carrot in front of one group (obviously taking it away from another group) and the fighting among the groups resumes anew. So many intelligent people in place and all they care about is prestige, reputation, money etc. If you ask outsiders, who are the caring among health professionals - nursing is the answer- yes because they have a better propaganda machinery even though they are doing the same thing - going for DNP?NP etc to get the piece of the pie but going about it in a united manner. Another examples - physicians being penalized for taking care of patients - based on A1c, blood pressure - well penalize me if do not start appropriate medications, but if the pt is not taking the medications at home, how is it physician's fault - but we are not even fighting for those cuts - why? because that is a primary care issue and doesn't affect any other specialty - FOR NOW - just another way for bean counters to divide us. Unless we are all united and fight for what we worked so hard for - patient care the way it should be, instead of bean-counters telling us how to do it, we will always be grumbling and getting paid what we are. Lastly, do you think lawyers will let us dictate how they practice law or any other professional organization - then why are we allowing every tom,dic*, and harry to be in our business.

Sorry about the long post - this topic just gets me going every time.

 

[bruin08]

I agree. I think the basic problem is that each of the strong groups with lobbying power do not have 5000 small subgroups - there is just one big group that takes care of all the issues - case in pt - ANA - nursing association - there is not a different lobby group for RN, DNP, NP etc - just ANA. Gun lobby doesn't have assault rifle, hand gun etc - there is just one - NRA and looking at medicine - everywhere you look, it is a dic*-measuring competition and its pathetic - Hundreds of diff organization to appease different interest groups and every one thinks that they are superior to other and keep fighting for turf rather than acting together - it's pathetic actually. In the end, it dilutes our ingratiating power and lets the congress and insurance lobby that they can walk all over us as there is no unity. Those people dangle carrot in front of one group (obviously taking it away from another group) and the fighting among the groups resumes anew. So many intelligent people in place and all they care about is prestige, reputation, etc. Even then who are the caring among health professionals - nursing - yes because they have a better propaganda machinery. Another examples - physicians being penalized for taking care of patients - based on A1c, blood pressure - well penalize me if do not start appropriate medications, but if the pt is not taking the medications at home, how is it physician's fault - but we are not even fighting for those cuts - why? because that is a primary care issue and doesn't affect any other specialty - FOR NOW - just another way for bean counters to divide us. Unless we are all united and fight for what we worked so hard for - patient care the way it should be, instead of bean-counters telling us how to do it, we will always be grumbling and getting paid what we are. Lastly, do you think lawyers will let us dictate how they practice law or any other professional organization - then why are we allowing every tom,dic*, and harry to be in our business.

Sorry about the long post - this topic just gets me going every time.

Agreed. You are re-emphasizing physician traits that limit us as a cohesive group. We have learned to work competitively and individually for much of our lives instead of truly as a team, despite its attempted inclusion into didactics. We're mostly focused on advancing our careers instead of willing to make certain sacrifices (e.g. our time). Mostly, I don't know many peers that are actively involved in a major organization, like the AMA, and helping to improve healthcare in the political forum. Most posts I see are focused on how we can compete better to get what we want (status/money). I'm as much to blame as anyone else and hope I can manage to find the time to get more involved this year.

 

[glorfindel]

I agree. I think the basic problem is that each of the strong groups with lobbying power do not have 5000 small subgroups - there is just one big group that takes care of all the issues - case in pt - ANA - nursing association - there is not a different lobby group for RN, DNP, NP etc - just ANA. Gun lobby doesn't have assault rifle, hand gun etc - there is just one - NRA and looking at medicine - everywhere you look, it is a dic*-measuring competition and its pathetic - Hundreds of diff organization to appease different interest groups and every one thinks that they are superior to other and keep fighting for turf rather than acting together - it's pathetic actually. In the end, it dilutes our ingratiating power and lets the congress and insurance lobby that they can walk all over us as there is no unity. Those people dangle carrot in front of one group (obviously taking it away from another group) and the fighting among the groups resumes anew. So many intelligent people in place and all they care about is prestige, reputation, etc. Even then who are the caring among health professionals - nursing - yes because they have a better propaganda machinery. Another examples - physicians being penalized for taking care of patients - based on A1c, blood pressure - well penalize me if do not start appropriate medications, but if the pt is not taking the medications at home, how is it physician's fault - but we are not even fighting for those cuts - why? because that is a primary care issue and doesn't affect any other specialty - FOR NOW - just another way for bean counters to divide us. Unless we are all united and fight for what we worked so hard for - patient care the way it should be, instead of bean-counters telling us how to do it, we will always be grumbling and getting paid what we are. Lastly, do you think lawyers will let us dictate how they practice law or any other professional organization - then why are we allowing every tom,dic*, and harry to be in our business.

Sorry about the long post - this topic just gets me going every time.

+1

A sad commentary on physician behavior, but one that rings true in my experience.

 

[CanIMakeIt]

Agreed. You are re-emphasizing physician traits that limit us as a cohesive group. We have learned to work competitively and individually for much of our lives instead of truly as a team, despite its attempted inclusion into didactics. We're mostly focused on advancing our careers instead of willing to make certain sacrifices (e.g. our time). Mostly, I don't know many peers that are actively involved in a major organization, like the AMA, and helping to improve healthcare in the political forum. Most posts I see are focused on how we can compete better to get what we want (status/money). I'm as much to blame as anyone else and hope I can manage to find the time to get more involved this year.

I agree but if we don't wake up soon, we will have none of that left - no individuality (most, if not all, will be owned by hospitals), no competition (everyone is employed by hospitals so no more competing with each other).

Plus, the people involved in political forums, none of them work together - AMA says one thing, ACP, AAFP says another and then surgical specialties say another. And all the while we are fighting amongst ourselves, everyone else incl bane-of-our-existence insurance companies, dirt-bag politicians, and even our colleagues nursing and other ancillary services are chewing (or any other choice word) away what is left of us - in the end we will have nothing to say in how healthcare is delivered because we will be deemed too incompetent to govern/behave ourselves.

Small example of in-fighting: Peripheral stenting - is there any rule that says that cards, vascular, rads can't work together on these cases - no. and if we did work together, we will have expertise from 3 specialties treating a patient. But because of our politics it is not possible. Plus, the hospital bigwigs won't have the departments working together because that would make more sense for us and threaten their power structure (as long as we are fighting, someone else will be the CEO and dictate terms). Furthermore, in the end the hospital is making the money so why do the administrators always keep showing how much each department is making and pit us against each other - and you were thinking it was all about the patient care. Don't get me wrong, I understand the money is important. Why can't the money be shared by the departments working together, so that there is no fighting about who is making money and who is losing money. That way instead of few cards/rads/vasc available for procedure, we suddenly have tons of people who can do the procedure and that improves pt care - no waiting etc

pardon my rant again.

 

[ukdoc74]

Everyone talks up optho like it is a great field for money and lifestyle. Agree it is a great lifestyle field but money?

I don't think so. They come out making 150k a year. Plus many if not all end up doing a fellowship. Plus you have to have business sense to run a clinic.

Optho is overrated because of great lifestyle but in reality they make much less money than Hospitalists.

 

[CanIMakeIt]

Everyone talks up optho like it is a great field for money and lifestyle. Agree it is a great lifestyle field but money?

I don't think so. They come out making 150k a year. Plus many if not all end up doing a fellowship. Plus you have to have business sense to run a clinic.

Optho is overrated because of great lifestyle but in reality they make much less money than Hospitalists.

no, Ophtho I thought of because I could go around the world and do some good and didn't want to be a trauma surgeon or ER 🙂. Not so much in IM though.

 

[Trifling Jester]

Small example of in-fighting: Peripheral stenting - is there any rule that says that cards, vascular, rads can't work together on these cases - no. and if we did work together, we will have expertise from 3 specialties treating a patient. But because of our politics it is not possible.

It isn't politics its money - you don't get reimbursed more for collaberation. It's the same $x for y procedure no matter how skilled the doctor is who does it or how many people help to do it. When you're in private practice you eat what you kill. You won't survive long splitting a pie 3 ways on one procedure or one patient.

 

[thierryhenry]

Everyone talks up optho like it is a great field for money and lifestyle. Agree it is a great lifestyle field but money?

I don't think so. They come out making 150k a year. Plus many if not all end up doing a fellowship. Plus you have to have business sense to run a clinic.

Optho is overrated because of great lifestyle but in reality they make much less money than Hospitalists.

100% incorrect, coming from a family of Optho docs, this is not true, not even in NYC. Midwest without fellowship depending on the city staffed at a hospital could easily be 300K, thats one day of cataracts a week, working only 4 days of the week (for the last 15 years); and you can imagine the number in the late 80-90's too when Medicare/caid actually reimbursed. Call, never had to go in for emergencies, yes its a very cush lifestyle and always will be..

Recheck your info

 

[CardDoc22]

I am sorry for the lengthy note, but tried to be objective with citations:

The problem with medicine today that the population is getting older, the proportion of the population who needs to be supported is getting larger and the portion of the society who is willing to pay tax for this is getting smaller (tax evasion, current politics, fiscal cliff etc).
When your program director says there will be plenty patient to treat in cardiology he/she is right but who will pay for it?

NYT Debt reconking session cited here by David Leonhardt worth to read:
http://www.nytimes.com/interactive/us/politics/debt-reckoning.html?ex=6#sha=fe5cfc1b4

Q: Don’t most Americans pay for their Medicare benefits, through payroll taxes over their working lives?
A. No, and it is not even close. Two married 66-year-olds with roughly average earnings over their lives will end up paying about $122,000 in dedicated Medicare taxes through the payroll tax, including the part their employers pay, according to Eugene Steuerle, Stephanie Rennane and Caleb B. Quakenbush of the Urban Institute. That married couple can expect to receive about three times as much — $387,000, adjusted for inflation — in benefits. The projected gap is even larger for younger people because of growing health care costs.
In short, the single biggest cause of the long-term deficit is that most people receive much more from Medicare than they give to it."


Medicare enacted - life expectancy was about 69 years, now 82-84? about 400% increase in post retirement life expectancy!!! Was there any proportional adjustment made over time in medicare contributions pay by the baby boomer taxpayers?????
In 1949 for 1 retiree there were 49 taxpaying /working citizens now the proportion is 3-4 taxpayer/1 retiree predicted in 15 yrs it will be about 2/1 retiree. So the current generation and the future ones will pay much higher proportion their income to support the nonproductive members of the society.

If you are a politician who needs votes who will he sacrifices for the “ happiness” of the society when you have to provide more healthcare for less $:
1) The retirees
2) Healthcare workers =nurses or doctors?
Your guess which is easier to sell

This is happening these days – we are probably at the beginning:
1) British Journal Economist July 18, 2009 about Healthcare reform:
“America's hospital industry
Taking a scalpel to costs
Hospital operators brace themselves for health-care reform
EARLIER this month America's hospital bosses gathered in Washington, DC, with vice-president Joseph Biden. To the amazement of many, they vowed to accept a cut of $155 billion in their expected revenues over the next decade as part of a grand bargain on health-care reform. How can they justify giving away such a vast sum?”
…
One of the explicit concessions wrung by the hospital bosses from the White House was a promise to crack down on clinics owned by doctors. These outfits are guilty of anti-competitive self-dealing, since the doctor has a financial motive to refer cases to his own firm, but what hospital bosses were really concerned about was that such clinics are competing hard with them, and siphoning off the most profitable patients.
As this back-room deal illustrates, the strongest motives behind the hospitals' ostensibly generous price cut were self-serving ones: to reduce competition, not boost it, and to head off any increase in government influence over their prices. As health-care reform forges ahead, reformers are desperate to find cost savings and the hospital industry is a juicy target. So its bosses felt they had to cut a deal.”

THIS WAS WRITTEN >3 YEARS AGO.

This above means hospital CEOs support Obama care today to make private MDs go bankrupt and get their business – happened already:
Many cardiologist group went bankrupt and sold out to the hospital because of the above deal.

Two news post election day 2012:
Election Removes Cloud From Health Law's Future
“President Barack Obama's re-election removes the last direct obstacle to his signature health-law overhaul, but doubts remain about whether its intricate new insurance system set to debut in 2014 will be ready in time.
Shares of most of the large health insurers declined more than the broader market Wednesday, while hospital stocks showed big gains.” (there are other reasons too why hospital stocks rose).
http://online.wsj.com/article/SB100...4.html?mod=WSJ_hpp_MIDDLENexttoWhatsNewsThird

the other news the same day that the hospital CEOs protest the above, previously accepted 150 billion MEDICARE hospital payment cut to be phased in – read on MSNBC, could not relocate webpage.
But it will come…..
And likely more healthcare cuts to come to keep the budget balanced, probably drastic in the form of bundled payment to hospitals only, they will not pay the physician separately, the hospital will give you what they think is fare… Governmental pilot studies showed this can save 2-22% on medicare cost. 86% of those saving were from the savings that the hospital administration negotiated with the physician paying them less…..
So simply the government will get out of the “bad guy” picture and will leave the protest by MDs against the hospital CEOs….
There are no private practices, only few patients can afford to pay – so you are stuck with your hospital…See your 2nd contract after the initial one...
Is there any significant component in the healthcare reform/cost reductions so far that does not include reduced reimbursement for physician services???
The economist and politicians know that we physicians are “professionally enslaved” trained for 25-30yrs – it is very difficult to change a profession…Nurses technicians, MA not...
If there is an oversupply of MDs the above concept should work…

I came from a country where physician who can be independent from the hospital and do fee for device - ophtalmologists, dermatologists, plastic surgeons, dentists - are doing well. The MDs who are employed by the hospital are miserable.
What a patient/person "wants" will pay for it BOTOX, breast augmentation etc.
When the same patient is dying –“ doctor it is your duty to save my life” – when the bill comes they forget….
There was a referendum/plebiscite held in my home country where healthcare is socialized – Should the citizens pay 1$ copayment (not kidding) for a doctors visit or NO? The governmental payment was so low that even this 1$ copayment would have made a diffenence for MDs. More than 90% of the people voted NO.
People will vote in favor for if they can get something for free probably throughout the world.
I hope the US is not on a similar path….
It looks like we might not be able to change what is happening in healthcare and politics – but we can change ourself.

One senior nurse in the ICU told me when I started my carrier and she saw me rounding day and night – I felt a bit strange but realized she tried to help to open my eyes:
“Every patient’s death is hard, but to see a physician dying particularly: doctors realize that time that they had NO life, just worked and studied all their life and that life is about to come to an end”.

I am thankful to her opening my eyes…

 

[OptimusPrime]

When you look at the math its actually very simple:

Lobbying by the numbers (opensecrets.org)

American Hospital Association Lobby
2012 $13,275,200
2011 $20,812,147

American College of Cardiology Lobby
2012 $1,645,000
2011 $2,140,000

Regardless of your political leanings we all know when it comes to politics money speaks.

Yes I know AMA is a bigger lobby ($13 million in 2012) and should technically be able to go head to head with hospital lobbies but to be honest most general medicine doctors think cardiologist make too much (as in unfairly more than them) anyways so we should not expect big help coming from them anytime soon.

In short expect private cardiology groups to go the way of the dodo bird and yes in our lifetime we (the cardiologists) will all become slaves to the hospitals in one way or another.

"Prove me wrong kids. Prove me wrong!"
Principal Skinner


OP

 

[ukdoc74]

100% incorrect, coming from a family of Optho docs, this is not true, not even in NYC. Midwest without fellowship depending on the city staffed at a hospital could easily be 300K, thats one day of cataracts a week, working only 4 days of the week (for the last 15 years); and you can imagine the number in the late 80-90's too when Medicare/caid actually reimbursed. Call, never had to go in for emergencies, yes its a very cush lifestyle and always will be..

Recheck your info

Check out this link and talk. Optho just doesn't make money unless you are a chairman.

http://www.texastribune.org/library...edical-cente/departments/ophthalmology/11875/

 

[EtherBunny]

Check out this link and talk. Optho just doesn't make money unless you are a chairman.

http://www.texastribune.org/library...edical-cente/departments/ophthalmology/11875/

It's very difficult to know what the actual compensation for academic faculty is. The base salary can be relatively low, but there are all kinds of bonus systems in place at academic centers. For instance, I used to be a neurosurgery resident at a respected institution in the U.S. The senior spine surgeon had a salary of $315,000, which was posted online. However, with his annual bonus, which was based on his clinical productivity in the department, his actual compensation was much closer to $1,000,000 per year. This discrepancy between quoted salary and actual compensation was true for essentially all of the neurosurgeons in the department. I also know that a similar discrepancy was present in many other surgical departments at the University.

Thus, I wouldn't put too much stock in the quoted opthalmology salaries. I suspect the actual compensation is substantially higher.

 

[CanIMakeIt]

When you look at the math its actually very simple:

Lobbying by the numbers (opensecrets.org)

American Hospital Association Lobby
2012 $13,275,200
2011 $20,812,147

American College of Cardiology Lobby
2012 $1,645,000
2011 $2,140,000

Regardless of your political leanings we all know when it comes to politics money speaks.

Yes I know AMA is a bigger lobby ($13 million in 2012) and should technically be able to go head to head with hospital lobbies but to be honest most general medicine doctors think cardiologist make too much (as in unfairly more than them) anyways so we should not expect big help coming from them anytime soon.

In short expect private cardiology groups to go the way of the dodo bird and yes in our lifetime we (the cardiologists) will all become slaves to the hospitals in one way or another.

"Prove me wrong kids. Prove me wrong!"
Principal Skinner


OP

Just like I said, no unified front - Sad but true. Tens of different organizations and each with their own agenda. And again the same mentality - if it doesn't affect me and mine, why should I care. I agree that specialists should be paid more (may be not 5 times as much but more) just because we will have to take care of more complicated patients but that is no reason to be divided. "Divide and rule" is an old policy but I guess our intelligence/self preservation fear still hasn't over come it 🙁

 

[CanIMakeIt]

There was a referendum/plebiscite held in my home country where healthcare is socialized – Should the citizens pay 1$ copayment (not kidding) for a doctors visit or NO? The governmental payment was so low that even this 1$ copayment would have made a diffenence for MDs. More than 90% of the people voted NO.
People will vote in favor for if they can get something for free probably throughout the world.
I hope the US is not on a similar path….
It looks like we might not be able to change what is happening in healthcare and politics – but we can change ourself.

This is pretty sad state of affairs.