Hey guys, just wana know if you ppl agree with this?? Check out this link
http://www.allied-physicians.com/salary_surveys/physician-salaries.htm
http://www.allied-physicians.com/salary_surveys/physician-salaries.htm
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Highest paid speciality
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I'd have to agree with the dead horse sentiment.
The answer is usually something surgical. Cardiac surgeons maybe back in the day. In this current environment, maybe ortho surgeons/neuro surgeons/plastic surgeons.
If you want to stray away from surgery, rads/gas/derm/cards/IR/interventional cards probably all do pretty well.
Pick one, make sure you like it, move on.
The answer is usually something surgical. Cardiac surgeons maybe back in the day. In this current environment, maybe ortho surgeons/neuro surgeons/plastic surgeons.
If you want to stray away from surgery, rads/gas/derm/cards/IR/interventional cards probably all do pretty well.
Pick one, make sure you like it, move on.
I believe that it is correct in demonstrating that Spine Surgery is the highest paid specialty. This may be in jeopardy as the effectiveness of spine surgery in many scenarios is being strongly questioned. Cardiac caths are also decreasing the demand for CT surgeons to a degree.
Good bets for continued very high salary include: Interventional Cards, Orthopedic Surgery, Rad Onc, Radiology, Plastic Surgery.
Good bets for continued very high salary include: Interventional Cards, Orthopedic Surgery, Rad Onc, Radiology, Plastic Surgery.
Too high?
I feel bad for general surgeons.
They are low for quite a few specialties, actually...
As you probably know, reimbursement for general surgery has gone down and continues to do so. While it is true that some people are making 400K right out of the box, I know of quite a few others who are making less than 200, and closer to 150.
Certainly the potential is there to make the kinds of money posted in these surveys, but the conventional wisdom is that for general surgery, the numbers are skewed toward the higher end and that for academic positions, most people aren't going to make anywhere near the numbers posted especially right out of training. The AAMC publishes a book which lists the average salary by faculty position, and geographical region and for general surgery, associate professor in the NE, its around 150K per year. Of course, you don't have malpractice or office staff/supplies to pay out of that, so it may be a better deal in some cases than jobs where you are responsible for that.
In places like Pennsylvania where your malpractice runs 100K per year, you have to bill an awful lot to reach the salaries in these surveys.
YMMV obviously.
I found an interesting thread in another sub-forum on this topic. Written SIX years ago!
http://forums.studentdoctor.net/showthread.php?t=32906
I guess some things just don't change: derm, spine surgery, rads.
And some things do: ophtho
Trying to see if some of the original contributors (who still do frequent these forums) would be willing to go back and post if their views/experiences have changed in the 6 years since their original posts were made! 🙂
http://forums.studentdoctor.net/showthread.php?t=32906
I guess some things just don't change: derm, spine surgery, rads.
And some things do: ophtho
Trying to see if some of the original contributors (who still do frequent these forums) would be willing to go back and post if their views/experiences have changed in the 6 years since their original posts were made! 🙂
Yikes. All that abuse, and you're making less than a moderately biz-saavy FP?
Gen surgeons gotta do something about this. Imagine how bad it will get when Barack "who's middle name shall not be spoken" Obama socializes everything, and oh, btw, increases the top brackets to roughly 50%. Zing!
Gen surgeons gotta do something about this. Imagine how bad it will get when Barack "who's middle name shall not be spoken" Obama socializes everything, and oh, btw, increases the top brackets to roughly 50%. Zing!
Oh, pls coastie....feel free to voice any racist remarks....after all, the US is the land of the free!....his middle name is Hussein.....i take it u feel that is something to be ashamed of?.....i wish my middle name was Hussain.....someone of ur racist nature probably doesn't really know much about THE Hussein.....besides, barak isn't even muslim.....u need not worry....btw, what's ur middle name, redneck???
😎
😎
Hey doctor_doctor,
Way to be a uniter not a divider!👍
Seriously, Obama supporters are some of the most rabidly aggressive, arrogant, and intolerant people I've come across. They are always the first to call someone else racist or categorize someone as an enemy of hope if they happen to disagree with any of Mr. Obama's policy positions. Whether or not Coastie was implying that "Hussein" is a surrogate for "muslim" is anathema. He has a right to call him Barack Hussein Obama without being told he is racist as much as you have a right to say Hillary RODHAM Clinton without being called a misogynist. If Obama supporters are proud of his multicultural background then they should be proud to refer to him by his full multicultural name. There's no point hiding it.
Furthermore, Coastie did not even refer to his middle name but was most likely satirizing how it has joined that ever expanding list of words that are no longer considered PC. Ironically, your poorly-thought-out comments furthered his point while making yourself look quite foolish at the same time. Next time, perhaps you should think before you pounce on someone for an innocent comment.
Way to be a uniter not a divider!👍
Seriously, Obama supporters are some of the most rabidly aggressive, arrogant, and intolerant people I've come across. They are always the first to call someone else racist or categorize someone as an enemy of hope if they happen to disagree with any of Mr. Obama's policy positions. Whether or not Coastie was implying that "Hussein" is a surrogate for "muslim" is anathema. He has a right to call him Barack Hussein Obama without being told he is racist as much as you have a right to say Hillary RODHAM Clinton without being called a misogynist. If Obama supporters are proud of his multicultural background then they should be proud to refer to him by his full multicultural name. There's no point hiding it.
Furthermore, Coastie did not even refer to his middle name but was most likely satirizing how it has joined that ever expanding list of words that are no longer considered PC. Ironically, your poorly-thought-out comments furthered his point while making yourself look quite foolish at the same time. Next time, perhaps you should think before you pounce on someone for an innocent comment.
You're an idiot who obviously doesn't read the newspapers, and obviously doesn't understand that, in America, it has become politically incorrect (per some) to use his whole name. I was making fun of that.
Truly, the worst part of Barack's name is the (D) at the end.
sorry if i misunderstood....but the last time i saw someone mention his middle name on TV, it was a guy repeating it many times, as if to say "Hello people! This guys' middle name is Hussein!!!".....and this guy was definitely refering to it as if to imply that he is a muslim applying for office.....so i apologize if you didn't mean it in that way
😳
😳
anything but another war-mongering republican who's 70+ years too out of touch with reality. 😉 D - all the way
OK people
stop hijacking the thread to argue about politics
My comment is that some of the highest paid fields right now are ortho and radiology. How much money one makes varies according to the person, area of the country where you practice, and academic vs. private practice. General surg. and rural family practice docs are definitely underpaid for the difficulty of their lifestyle. How much you are paid doesn't really have much to do with the true value of your services to society, however (see multiple professional athletes' ridiculously high salary). This week's Journal of American Medical Assn. is the medical education issue and has some interesting articles, including one that plots the salary of certain specialties vs. the % of US medical grads matching in to those particular specialties (i.e. ortho and radiology, with high salaries, match a very high proportion of US seniors vs. IMG's).
stop hijacking the thread to argue about politics
My comment is that some of the highest paid fields right now are ortho and radiology. How much money one makes varies according to the person, area of the country where you practice, and academic vs. private practice. General surg. and rural family practice docs are definitely underpaid for the difficulty of their lifestyle. How much you are paid doesn't really have much to do with the true value of your services to society, however (see multiple professional athletes' ridiculously high salary). This week's Journal of American Medical Assn. is the medical education issue and has some interesting articles, including one that plots the salary of certain specialties vs. the % of US medical grads matching in to those particular specialties (i.e. ortho and radiology, with high salaries, match a very high proportion of US seniors vs. IMG's).
Too high?
Im beyond the "max" for my speciality..what does that mean?
Am I:
You have been in practice for many years.
By self-report, you work in a pretty prestigious position. You are in a special category. People at the low ends of these surveys don't report and arent included.
While they are accurate for a junior general surgical attending in private practice, they are significantly higher than the averages seen at AAMC hospitals and there are very few general surgeons who make anywhere near the max on that scale.
Exactly. Why is that? Why in the world would you pay "someone" sitting on his ass in a room from 7am to 5pm more, much much more, than the guys who are in the trenches who work unlimitted odd hours, cut open people up and save lives, deal with and manage every freaken problem the patient has, perform many skills/procedures that help and save more lives? It just does not make sence!
20 years ago, I would agree. However today, it's that guy "sitting on his ass in a room" who tells the guys "in the trenches" exactly what's wrong with their patients and on many occasions how to fix them. The skill is in the diagnosis. Until our generation relearns how to do a physical examination instead of relying on imaging, and until our legal system allows this to happen again, the guy sitting on his ass in a room is going to continue to be compensated more.
🙄
Many of us are capable of making our own diagnoses via clinical examination and without outside imaging and resent someone without surgical training telling us "how to fix it".
Radiological evaluation is often an important part of diagnosis and treatment, but to assume that it *all* hinges on your input and that it is appropriate for your report to state what the treatment should be is beyond arrogant, IMHO.
Exactly. If I order a chest X-ray on every patient that comes in with cough, and crackles heard on ausultation...my (FM) attendings will slaughter me. Plus, we almost never wait for the "guy sitting on his ass" to read the films when we are in the clinic...we read the films ourselves. If I wait for him to read it, I will never be able to see all my patients, and get out on time.
You guys above are the exception to the rule.
You are currently in academic programs. You will most likely soon learn that private practice is conducted in a completely different manner.
Winged, I wish more surgeons took your attitude. For instance, at my institution, they will not do an appendectomy unless I tell them to. The person can have intense RLQ pain, peritoneal signs and a white count of 17, but unless I definitely state that acute appendicitis is present on my report, they will not operate. They will just rescan until I tell them to do something. There have been countless other times when surgical attendings 30 years my superior ask me at the viewbox what they should do. I agree with you that I have no surgical training and should not be making those decisions! However, these guys will literally do what we tell them...and that's wrong!
In the private hospital that we cover, imagining studies are ordered by nurse practitioners based upon protocols prior to an ER physician even seeing the patient. Headache/AMS/Confusion = Head CT; Chest pain/SOB/Elevated D-Dimer = PE protocol; Abd pain = AP; etc. Everyone who walks through the ER door gets a CXR automatically. ER physicians have lab and imaging results in hand prior to even setting eyes on the patient. Many medicine and surgery attendings have admitting order sheets where they just check qd CXR or KUB as part of basic standing orders. These tests will be done every day the patient is in the hospital without thought.
There are also plenty of internists and surgeons who when consulted will order imaging studies prior to even seeing the patient. I am so tired of asking these guys what they are seeing clinically when they come by to the reading room and them having no clue because they haven't even seen the patient yet!
Radiologist disproportional salaries are driven by these worthless tests that are ordered. A head CT on a 20 year old with HA, who has a history of migranes and 5 other negative studies in the last year literally takes about 1 minute to read AND dictate! The fee collected on that is about $50. A head CT on an 85 year old with multiple chronic findings takes much more time to carefully review and dictate, yet still reimburses the same $50.
The problem is based in the system.
1) Our generation doesn't have half the physical exam skills as the one prior to us. There is to much reliance on imaging now to tell us what's wrong. Why does a person who is short of breath get a bilateral lower extremity doppler venous study and CTA chest when they have decreased breath sounds at the bases, crackles, an S3, and 2+ pitting edema below the knees? They need loop diuretics, not 5 Rad of radiation treatment!
2) The volume of patients is more now than it used to be. Physicians on the front line don't have time to thoroughly spend with each patient. Their reimbursements are also being cut too, so their solution is just to have a higher census to maintain their salary. More scratch my back consults are being ordered as well. All of this leads to further imaging. Ordering imaging studies is an easy solution to finding out answers without having to put much time per patient in.
3) The attitude of this country now is not only do all people have a right to health care, but they have a right to maximal health care. This means no expense is spared for anyone. This means more imaging. Why do we have to order a CT AP on someone with epigastric pain radiating to their back with an amylase of 500 and lipase of 1000?
4) Most importantly, the legal system is out of control. Many of the useless studies are ordered for no other reason but CYA medicine.
Don't blame radiologists for high salaries though. A 1/3 of what Radiologists make could easily be eliminated by changing #1-4 above. Radiologists probably make a 1/3 of their income reading these types of studies which take about 5% of their time on any given work day.
I do think Radiologists should be paid less! However, I think that decrease in income should be due to cutting out stupid studies that shouldn't be ordered in the first place, not by reducing the average reimbursement per study.
You are currently in academic programs. You will most likely soon learn that private practice is conducted in a completely different manner.
Winged, I wish more surgeons took your attitude. For instance, at my institution, they will not do an appendectomy unless I tell them to. The person can have intense RLQ pain, peritoneal signs and a white count of 17, but unless I definitely state that acute appendicitis is present on my report, they will not operate. They will just rescan until I tell them to do something. There have been countless other times when surgical attendings 30 years my superior ask me at the viewbox what they should do. I agree with you that I have no surgical training and should not be making those decisions! However, these guys will literally do what we tell them...and that's wrong!
In the private hospital that we cover, imagining studies are ordered by nurse practitioners based upon protocols prior to an ER physician even seeing the patient. Headache/AMS/Confusion = Head CT; Chest pain/SOB/Elevated D-Dimer = PE protocol; Abd pain = AP; etc. Everyone who walks through the ER door gets a CXR automatically. ER physicians have lab and imaging results in hand prior to even setting eyes on the patient. Many medicine and surgery attendings have admitting order sheets where they just check qd CXR or KUB as part of basic standing orders. These tests will be done every day the patient is in the hospital without thought.
There are also plenty of internists and surgeons who when consulted will order imaging studies prior to even seeing the patient. I am so tired of asking these guys what they are seeing clinically when they come by to the reading room and them having no clue because they haven't even seen the patient yet!
Radiologist disproportional salaries are driven by these worthless tests that are ordered. A head CT on a 20 year old with HA, who has a history of migranes and 5 other negative studies in the last year literally takes about 1 minute to read AND dictate! The fee collected on that is about $50. A head CT on an 85 year old with multiple chronic findings takes much more time to carefully review and dictate, yet still reimburses the same $50.
The problem is based in the system.
1) Our generation doesn't have half the physical exam skills as the one prior to us. There is to much reliance on imaging now to tell us what's wrong. Why does a person who is short of breath get a bilateral lower extremity doppler venous study and CTA chest when they have decreased breath sounds at the bases, crackles, an S3, and 2+ pitting edema below the knees? They need loop diuretics, not 5 Rad of radiation treatment!
2) The volume of patients is more now than it used to be. Physicians on the front line don't have time to thoroughly spend with each patient. Their reimbursements are also being cut too, so their solution is just to have a higher census to maintain their salary. More scratch my back consults are being ordered as well. All of this leads to further imaging. Ordering imaging studies is an easy solution to finding out answers without having to put much time per patient in.
3) The attitude of this country now is not only do all people have a right to health care, but they have a right to maximal health care. This means no expense is spared for anyone. This means more imaging. Why do we have to order a CT AP on someone with epigastric pain radiating to their back with an amylase of 500 and lipase of 1000?
4) Most importantly, the legal system is out of control. Many of the useless studies are ordered for no other reason but CYA medicine.
Don't blame radiologists for high salaries though. A 1/3 of what Radiologists make could easily be eliminated by changing #1-4 above. Radiologists probably make a 1/3 of their income reading these types of studies which take about 5% of their time on any given work day.
I do think Radiologists should be paid less! However, I think that decrease in income should be due to cutting out stupid studies that shouldn't be ordered in the first place, not by reducing the average reimbursement per study.
lol, in ortho we generally ignore what you say. Often my attendings will look at the radiologist's report and wonder what they're smoking in their dark little rooms.
thank you for the self esteem boost😀
I will now go, bang my wife, eat a steak, drink a fine bottle of Bordeaux and smoke a Cuban cigar.
FYI...I'm in private practice since I left fellowship.
Frankly, that sounds just plain dangerous. Very little we do is the final definitive word in isolation and while it is ideal to have concordance btwn history, physical, labs and radiology, sometimes things don't come so neatly packaged. Frankly, a negative appy is less work than a missed one (both legally and medically).
While I work closely with several radiologists here in town (we have each other's cell #s, socialize, etc.) at times I disgree with their assessment, or cannot take the chance when my clinical exam disagrees with the radiological findings, and I'll biopsy or operate based on the PE.
That is inappropriate, I agree. They won't let you get away "clinical correlation is recommended"? 😉
Yes, clearly increasing the number of mid-levels who order via protocol is the answer to decreasing medical costs in this country.🙄
But what you describe happens everywhere, especially in academics. Thank goodness we had some attendings who also realized that daily labs, ABGs after each vent change and daily imaging wasn't always necessary.
I have no problem with what radiologists earn; they have a lengthy training, have to keep up with new technology and provide a valuable service. Do I wish I made as much? Sure, but I don't begrudge those who make more, even if they had less training or a less rigorous residency, than I.
I do ask, please, stop trying to prevent surgeons from doing their own image guided biopsies, especially when we meet the ACR criteria for training and qualifications. Stop trying to lobby Medicare to reimburse us *less* than what you make for the very same procedure. We should be working together.
BTW, thank you for your understanding and tolerance to my earlier response which was a *tad* pissy. 😀
I don't think he was endorsing this approach to ordering radiographs... in fact I think he was criticizing it... 😕
I think that's why he followed it up witih:
Or maybe you were sarcastically agreeing with him that his hospital is wrong for taking this approach? Not trying to be critical for its own sake; I just think he's making a crucial point (that I see as 100% correct) and want to make sure it isn't misinterpreted...
Yes, hence the rolly-eyes emoticon.
