Forbes physician best and worst paying jobs

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

MedicineDoc

Full Member
10+ Year Member
5+ Year Member
15+ Year Member
Joined
Feb 13, 2008
Messages
545
Reaction score
9
Last edited:
Preaching to the choir for those of us in the loop, but always nice to see a reasonably balanced article in a lay publication (referring to the Forbes piece.)
 
Really?! Wow! A radiologist makes more than a family physician?! When did this ever happen?! Why and how?
 
Members don't see this ad :)
Really?! Wow! A radiologist makes more than a family physician?! When did this ever happen?! Why and how?

I started the thread for updated numbers not to express a well known generality. The RUC debate has had some press lately but I don't think the any specific actions have been achieved.

I would favor the aafp completely pulling out of the RUC (Specialist dominated physician pay setting committee of the American Medical Association for lay people who may be reading). I can't believe that CMS (center for Medicare services) can even justify continuing to collaborate with the RUC.

http://brianklepper.info/2012/08/08/the-most-powerful-health-care-group-youve-never-heard-of/
 
We, Family Med docs, are just too nice. Family docs can use political tactical power to get higher wages if they want to. I mean, the whole health system depends on good primary care docs. They are in need and will always be in need. Health systems do not depend on Radiologists! They are not needed as much as primary care docs are. There is NO logical reason why a Radiologist is being paid more than a Family Med doc.
 
Can someone correct me if I'm wrong? I've heard from a couple of attendings that specialties like Radiology and Anesthesiology were really barren specialties for a while, like late 80s into the 90s. Then their income increased and the specialties suddenly became extremely competitive. I was told that Anesthesiologists used to have the stigma of being "just a surgeon's bitch." I don't think this sort of sentiment is as common anymore.


Furthermore, I was also told that Dermatology used to be a non-competitive field because it suffered from the same syndrome as Psychiatry, "not real doctors." But again, once people realized you could have massive amounts of volume through Dermatology, and therefore more income, it suddenly became competitive.

Confirm?
 
Can someone correct me if I'm wrong? I've heard from a couple of attendings that specialties like Radiology and Anesthesiology were really barren specialties for a while, like late 80s into the 90s. Then their income increased and the specialties suddenly became extremely competitive. I was told that Anesthesiologists used to have the stigma of being "just a surgeon's bitch." I don't think this sort of sentiment is as common anymore.


Furthermore, I was also told that Dermatology used to be a non-competitive field because it suffered from the same syndrome as Psychiatry, "not real doctors." But again, once people realized you could have massive amounts of volume through Dermatology, and therefore more income, it suddenly became competitive.

Confirm?
This is accurate. For what it's worth, anesthesia is still viewed as the surgeon's bitch. There's a reason why it's not that competitive even though their average income is around $350k.
 
Can someone correct me if I'm wrong? I've heard from a couple of attendings that specialties like Radiology and Anesthesiology were really barren specialties for a while, like late 80s into the 90s. Then their income increased and the specialties suddenly became extremely competitive. I was told that Anesthesiologists used to have the stigma of being "just a surgeon's bitch." I don't think this sort of sentiment is as common anymore.


Furthermore, I was also told that Dermatology used to be a non-competitive field because it suffered from the same syndrome as Psychiatry, "not real doctors." But again, once people realized you could have massive amounts of volume through Dermatology, and therefore more income, it suddenly became competitive.

Confirm?

Pimple popper MD.

I forgot skin cancer !
 
We, Family Med docs, are just too nice. Family docs can use political tactical power to get higher wages if they want to. I mean, the whole health system depends on good primary care docs. They are in need and will always be in need. Health systems do not depend on Radiologists! They are not needed as much as primary care docs are. There is NO logical reason why a Radiologist is being paid more than a Family Med doc.

workers-of-the-world-unite.jpg


:lame:
 
We, Family Med docs, are just too nice. Family docs can use political tactical power to get higher wages if they want to. I mean, the whole health system depends on good primary care docs. They are in need and will always be in need. Health systems do not depend on Radiologists! They are not needed as much as primary care docs are. There is NO logical reason why a Radiologist per hour worked is being paid more than a Family Med doc.

Now I agree with you.

If a radiologist works 60 hrs/week and a family doc works 45 hrs/week then it makes a strong argument why a radiologist would make more on a yearly basis.
 
Now I agree with you.

If a radiologist works 60 hrs/week and a family doc works 45 hrs/week then it makes a strong argument why a radiologist would make more on a yearly basis.

http://www.reuters.com/article/2010/10/25/us-specialist-doctors-idUSTRE69O4RW20101025

Do specialist doctors make too much money?



By Lynne Peeples
NEW YORK | Mon Oct 25, 2010 4:16pm EDT

NEW YORK(Reuters Health) - Primary care physicians earn as little as half what their colleagues who specialize in areas such as surgery and oncology are taking home, according to a new study of doctors' salaries.
The study's authors suggest that this wage gap might be contributing to the current shortage of general-practice doctors in the U.S., as well as driving the nation's rising costs of medical care.
"In other countries, there are typically more primary care than specialty doctors. But here it is the opposite," lead researcher J. Paul Leigh, of the University of California Davis School of Medicine, told Reuters Health in an e-mail. "That can be changed if we could just change the salaries, and let medical students know about it so they don't pursue these specialties so aggressively."
Prior studies of physician wages looked only at annual salaries, which do not take into account how many hours a doctor puts in per week or the number of weeks worked per year.
To get a clearer picture of how wages -- measured both annually and hourly -- differ among a variety of general and specialty practices, Leigh and his colleagues collected detailed information from more than 6,000 practicing doctors in 2004 and 2005.
Overall, the team found that doctors earned an average annual income of $187,857, working about 53 hours per week and 47 weeks per year. This compensation, however, varied widely across specialties, with the lowest wages -- amounting to $60.48 an hour -- paid to primary care physicians.
In other broad categories of practice, surgeons took home the highest average hourly wage of $92. Internal medicine and pediatric docs earned about $85 an hour, the researchers report in the Archives of Internal Medicine.
Looking at salaries among 41 specific subspecialties, however, they found neurologic surgery and radiation oncology to be the most lucrative at $132 and $126 per hour, respectively. These were followed by medical oncologists and plastic surgeons, both making around $114 per hour; immunologists, orthopedic surgeons and dermatologists also took in more than $100 an hour. At the low end of specialist pay, child psychiatrists and infectious disease specialists made around $67 an hour.
The disparities held after accounting for age, race, sex and region of the country.
Further, the researchers found no evidence of salary disparities between racial groups. However, a gender salary gap remained, with women earning an average of $9 less per hour.
"It's not just doctors themselves that are looking at this disparity and choosing higher wages," said Leigh, a healthcare policy researcher. "The economic incentives for medical schools and their students have been out of whack. Schools understand that a cardiac unit is going to bring in more money than a family practice unit."
"Especially now that our costs for medical care are soaring, we need to get these disparities under control," added Leigh. "And the government can. We don't have a free market of supply and demand operating for physicians, rather it's highly regulated by Medicare."
Some of the proposed health care reform laws would increase wages for primary care physicians, noted Leigh. But he doesn't think that is enough. He suggests cutting wages of specialists too.
"Not only are primary care physicians undervalued by society," Leigh said, "but the specialist is overvalued and overcompensated, while not really adding much bang for the buck as far as public health is concerned."
He noted that specialists tend to use the most high-tech medicine, which is "costly and questionable a lot of the time."
Leigh also pointed to some 15 million uninsured people across the U.S. who will be brought into the system when the new reform laws go into effect.
"The first contact for most of these people should be a primary care physician," he said. "But the shortage has made it increasingly hard for these doctors to take on new patients, creating a bottleneck."
In a separate study published in the same issue of the journal, researchers from the Mount Sinai School of Medicine in New York surveyed physicians' opinions on various reform options and found that while most agreed that Medicare reimbursement is flawed, they disagreed on the best way to fix it.
About 80 percent of physicians supported raising primary care pay, for example, yet fewer than 40 percent supported a 3-percent reduction in specialist pay to offset that increase.
SOURCE: link.reuters.com/dud69m Archives of Internal Medicine, online October 25, 2010.
 
Last edited:
Can someone correct me if I'm wrong? I've heard from a couple of attendings that specialties like Radiology and Anesthesiology were really barren specialties for a while, like late 80s into the 90s. Then their income increased and the specialties suddenly became extremely competitive. I was told that Anesthesiologists used to have the stigma of being "just a surgeon's bitch." I don't think this sort of sentiment is as common anymore.


Furthermore, I was also told that Dermatology used to be a non-competitive field because it suffered from the same syndrome as Psychiatry, "not real doctors." But again, once people realized you could have massive amounts of volume through Dermatology, and therefore more income, it suddenly became competitive.

Confirm?

Those fields have both had huge changes in supply and demand. There was a time when anesthesiologists could literally not find work. A few changes in regulations later and bam... instant demand and the field is competitive again. Dermatology is not popular just because of the income, but because of the 9-5 M-F. Anesthesiology is again going to go through a slump as CRNAs become more prominent.
 
Members don't see this ad :)
Anesthesiology is again going to go through a slump as CRNAs become more prominent.


What's going to stop this from being true in just about all areas of medicine? Supposedly primary care, anesth., and ED will take the worst hits from midlevel invasion. This new era of US healthcare seems to be pushing to go in that direction. I am holding on to hope, as supposedly a lot of patients prefer to have physicians in control of their healthcare. Reimbursement and the "new era" $$$ demands will likely change this. With the current political climate being what it is, money, as usual, will be the driving force. It is sad to me from all angles. Some good things can come out of midlevel providers, but, overall, I think all of healthcare stands to lose out in many ways. It may end up where dentistry will be the most financially beneficial for folks; but many of us prefer medicine. Guess we'll have to see if the political landscape begins to change.
 
What's going to stop this from being true in just about all areas of medicine? Supposedly primary care, anesth., and ED will take the worst hits from midlevel invasion. This new era of US healthcare seems to be pushing to go in that direction. I am holding on to hope, as supposedly a lot of patients prefer to have physicians in control of their healthcare. Reimbursement and the "new era" $$$ demands will likely change this. With the current political climate being what it is, money, as usual, will be the driving force. It is sad to me from all angles. Some good things can come out of midlevel providers, but, overall, I think all of healthcare stands to lose out in many ways. It may end up where dentistry will be the most financially beneficial for folks; but many of us prefer medicine. Guess we'll have to see if the political landscape begins to change.

Quality physicians will always be in demand, even with a push towards this "midlevel invasion." IMO primary care physicians will especially be in high demand in a system that is looking to become more efficient and hopefully save money in the process. Not to mention that similar to medical school grads, a lot of midlevels also look towards fields other that primary care.

Granted, my perspective may be a bit naive since I am only at the beginning of this journey here, but I don't think a good physician has much to worry about when it comes to finding a means to make a good living in medicine (with a bit of flexibility of course). Times are a-chaning, but it's not all doom-n-gloom.
 
Quality physicians will always be in demand, even with a push towards this "midlevel invasion." IMO primary care physicians will especially be in high demand in a system that is looking to become more efficient and hopefully save money in the process. Not to mention that similar to medical school grads, a lot of midlevels also look towards fields other that primary care.

Granted, my perspective may be a bit naive since I am only at the beginning of this journey here, but I don't think a good physician has much to worry about when it comes to finding a means to make a good living in medicine (with a bit of flexibility of course). Times are a-chaning, but it's not all doom-n-gloom.

Economic reality will not be kind to you. People bitch and moan, balk and walk, and delay all sorts of care due to their unwillingness to pay their $40 copay. What were you saying again? And what does this tell you about that position?

People are more willing to spend money at a cheap family restaurant or the latest Batman flick than they are to address their health. It's a reflection of the shortsighted, hedonistic society in which we live -- one that is only enabled by the current health insurance environment. You will not be happy when you are thrust from your current cocoon into this world of idgets.:(
 
Economic reality will not be kind to you. People bitch and moan, balk and walk, and delay all sorts of care due to their unwillingness to pay their $40 copay. What were you saying again? And what does this tell you about that position?

People are more willing to spend money at a cheap family restaurant or the latest Batman flick than they are to address their health. It's a reflection of the shortsighted, hedonistic society in which we live -- one that is only enabled by the current health insurance environment. You will not be happy when you are thrust from your current cocoon into this world of idgets.:(


Not to mention we have created an atmosphere where people don't think they should assume responsibility for paying one red cent out of their own money for their own health care. Nope, somebody else must pay for even the most routine care.

This article is interesting, but it shows a common lack of understanding. I especially take issue with the statement that the orthopedic surgeon makes a sum of money for 10 minutes operating on a knee. It would be rare for any knee case to take 10 minutes- the only thing I could see that happening for is maybe a quick arthroscopy in which nothing in need of repair or intervention is found. This is comparable to the exploratory laparoscopy in with no abnormal findings and no intervention required. Nice when it happens, but rare. The article also fails to mention (as is usually the case when trying to compare surgeon pay to other specialties) is that the reimbursement for an operation is a global fee- that includes the preop visit, and all follow up care for a 10-90 days (depending on the operation). Usually articles about a surgeon's hourly pay focus only on the OR time, and not the rest of the time- which can be significant for inpatient surgery.

I'm not saying I think the current system is fair. I don't think it is fair at all. Since the RVU for each CPT code is determined by political fighting in a committee, it's not about fairness. It's about who is the loudest and most politically astute. It doesn't even make sense within a surgical area (example: placement of a mediport has more RVU than a mastectomy or a spleenectomy. Why? Because IR does mediports and they had good representation on the committee). This was one of the many head exploding factors in my decision to leave surgery.
 
Last edited:
^^ Agreed. I would like to address the rationality of paying a doctorate degree holding individual for doing simple education measures... but that would surely open a can of worms.
 
What's going to stop this from being true in just about all areas of medicine? Supposedly primary care, anesth., and ED will take the worst hits from midlevel invasion. This new era of US healthcare seems to be pushing to go in that direction. I am holding on to hope, as supposedly a lot of patients prefer to have physicians in control of their healthcare. Reimbursement and the "new era" $$$ demands will likely change this. With the current political climate being what it is, money, as usual, will be the driving force. It is sad to me from all angles. Some good things can come out of midlevel providers, but, overall, I think all of healthcare stands to lose out in many ways. It may end up where dentistry will be the most financially beneficial for folks; but many of us prefer medicine. Guess we'll have to see if the political landscape begins to change.

That seems to be the trend. Some good things may come of it, but there will be an overall decrease in quality and a "brain drain" in the medical field as a whole.

Quality physicians will always be in demand, even with a push towards this "midlevel invasion." IMO primary care physicians will especially be in high demand in a system that is looking to become more efficient and hopefully save money in the process. Not to mention that similar to medical school grads, a lot of midlevels also look towards fields other that primary care.

Granted, my perspective may be a bit naive since I am only at the beginning of this journey here, but I don't think a good physician has much to worry about when it comes to finding a means to make a good living in medicine (with a bit of flexibility of course). Times are a-chaning, but it's not all doom-n-gloom.

I don't really thing that's accurate. The quality of physicians as a whole will go down. Plenty of good physicians get screwed now. They will get screwed in the future as well. In the future, I predict that the primary care field will be even more eaten away by the midlevel invasion. There are certain fields midlevels can't ever hope to break into. We'll always have a good living, but the cost-benefit analysis is becoming increasingly negatively skewed for entering medicine. Don't enter the field if you don't absolutely want to be a doctor. Most other desires can be more easily satisfied outside of this field.
 
^^ Agreed. I would like to address the rationality of paying a doctorate degree holding individual for doing simple education measures... but that would surely open a can of worms.




Are you implying that primary care consists largely of simple education measures for simple uncomplicated medical problems? Real people we see typically have upwards of 10 or more chronic diseases and are on large numbers of medications. Its usually not little Johnny has a sore throat and Ray ray needs to quit smoking but is otherwise completely healthy. It's more like Ray ray is morbidly obese has COPD, asthma, pulmonary hypertension, sleep apnea, asbestosis, CAD, ischemic cardiomyopathy, CHF, PVD, Stage 3 CKD, afib, Uncontrolled type 2 diabetes, uncontrolled hypertension, Chronic lymphedema, chronic venous stasis and lower extremity edema with frequent episodes of cellulitis and weeping of his lower extremities and Chronic back pain and really likes his pain pills. I've seen midlevels running a CHF clinic do some ridiculous things with patients meds landing them in the hospital not just once but the same person multiple times.
 
Last edited:
Are you implying that primary care consists largely of simple education measures for simple uncomplicated medical problems? Real people we see typically have upwards of 10 or more chronic diseases and are on large numbers of medications. Its usually not little Johnny has a sore throat and Ray ray needs to quit smoking but is otherwise completely healthy. It's more like Ray ray is morbidly obese has COPD, asthma, pulmonary hypertension, asbestosis, CAD, ischemic cardiomyopathy, CHF, PVD, Stage 3 CKD, afib, Uncontrolled type 2 diabetes, uncontrolled hypertension, Chronic lymphedema, chronic venous stasis and lower extremity edema with frequent episodes of cellulitis and weeping of his lower extremities and Chronic back pain and really likes his pain pills. I've seen midlevels running a CHF clinic do some ridiculous things with patients meds landing them in the hospital not just once but the same person multiple times.

*smh*

I'm going to attribute this to a lack of sleep and being up to post at 2am.... The patient education issue not unique to primary care. The point is quite valid... despite any offense taken by anyone currently engaged in said activities. Industry does not pay engineers to torque bolts or apply paint for a reason....

p.s. It sounds like RayRay is doing his very best to burn his 80yr candle up in a shorter period and I find it quite rude for you to try to engage in efforts counter to his wishes. :smuggrin::smuggrin::smuggrin: If only he had a well funded PCP during the early years....:p
 
*smh*

I'm going to attribute this to a lack of sleep and being up to post at 2am.... The patient education issue not unique to primary care. The point is quite valid... despite any offense taken by anyone currently engaged in said activities. Industry does not pay engineers to torque bolts or apply paint for a reason....

p.s. It sounds like RayRay is doing his very best to burn his 80yr candle up in a shorter period and I find it quite rude for you to try to engage in efforts counter to his wishes. :smuggrin::smuggrin::smuggrin: If only he had a well funded PCP during the early years....:p

I met Ray ray once, he was 52 y/o.
 
I was behind him at the WalMart once. He was having trouble getting his twinkies and 2 liters up from the basket on his scooter onto the higher counter of the cigs aisle.

We've all met "Ray Ray." The only thing that's missing is Princess Leia in her gold bikini.

fat-guy-on-scooter.jpeg
 
We've all met "Ray Ray." The only thing that's missing is Princess Leia in her gold bikini.

Just for the record, I was trying to say that "Ray Ray" could be much younger than 80 y/o and he/she is/was a real pt.
 
Just for the record, I was trying to say that "Ray Ray" could be much younger than 80 y/o and he/she is/was a real pt.

The guy in the picture looks like he's probably around 50. It ain't the years...it's the mileage.

I see a real-life "Ray Ray" almost every day.
 
Economic reality will not be kind to you. People bitch and moan, balk and walk, and delay all sorts of care due to their unwillingness to pay their $40 copay. What were you saying again? And what does this tell you about that position?

People are more willing to spend money at a cheap family restaurant or the latest Batman flick than they are to address their health. It's a reflection of the shortsighted, hedonistic society in which we live -- one that is only enabled by the current health insurance environment. You will not be happy when you are thrust from your current cocoon into this world of idgets.:(

It's a b!tch out there for most jobs. No one said it's all sunshine and buttercups...

Cocoon huh? I've spent my fair share of time working my tail off in the non-medical world for a good 10 years so I know the taste of bitterness, and what it feels like to work pay check to pay check but keep on moving forward. I also know jaded when I see it.
 
That seems to be the trend. Some good things may come of it, but there will be an overall decrease in quality and a "brain drain" in the medical field as a whole.



I don't really thing that's accurate. The quality of physicians as a whole will go down. Plenty of good physicians get screwed now. They will get screwed in the future as well. In the future, I predict that the primary care field will be even more eaten away by the midlevel invasion. There are certain fields midlevels can't ever hope to break into. We'll always have a good living, but the cost-benefit analysis is becoming increasingly negatively skewed for entering medicine. Don't enter the field if you don't absolutely want to be a doctor. Most other desires can be more easily satisfied outside of this field.

That's my point.

Not sure how many of you actually held down other full-time jobs for an extended period of time (i.e. paying your own rent and bills, putting food on the table without anyone's help while working for the average salary) before going to medical school... but guess what? It sucks for most people out there, plain and simple... the grass certainly ain't greener either side of the hill.
 
The guy in the picture looks like he's probably around 50. It ain't the years...it's the mileage.

I see a real-life "Ray Ray" almost every day.



Yet another quotable quote! "It's not the years, it's the mileage." Some people do take rougher roads than others. My dad used to say, "That person looks like 100 miles of bad road."
 
That's my point.

Not sure how many of you actually held down other full-time jobs for an extended period of time (i.e. paying your own rent and bills, putting food on the table without anyone's help while working for the average salary) before going to medical school... but guess what? It sucks for most people out there, plain and simple... the grass certainly ain't greener either side of the hill.

Agreed, however the "it's okay we'll always have a good living" argument is an excuse to allow our specialty to gradually give away ground. It's not about have a "good living." It's about being paid what you are worth in the marketplace. And if you're not valued, then you can't blame people for specializing and avoiding primary care. I know many PCP's who gave up practice to do cosmetics/hospitalists/derm-based because their tired of being completely undervalued relative to everyone you refer patients to.
 
Agreed, however the "it's okay we'll always have a good living" argument is an excuse to allow our specialty to gradually give away ground. It's not about have a "good living." It's about being paid what you are worth in the marketplace. And if you're not valued, then you can't blame people for specializing and avoiding primary care. I know many PCP's who gave up practice to do cosmetics/hospitalists/derm-based because their tired of being completely undervalued relative to everyone you refer patients to.

:thumbup: solid response.
 
Yet another quotable quote! "It's not the years, it's the mileage."

I can't take credit. It's from "Raiders of the Lost Ark."

Marion Ravenwood ( Karen Allen ): "You're not the man I knew ten years ago."
Indiana Jones ( Harrison Ford ): "It's not the years, it's the mileage."
 
I can't take credit. It's from "Raiders of the Lost Ark."

Marion Ravenwood ( Karen Allen ): "You're not the man I knew ten years ago."
Indiana Jones ( Harrison Ford ): "It's not the years, it's the mileage."

totally not relevant but as soon as I read your quote, I thought of the film.
Just went and saw it on IMAX, so good.
 
Top