How frequent are these salaries?

[VA Hopeful Dr]

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Not bashing, challenging them on their statement that a certain specialty works the hardest.


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Really?

Also, a bunch of advanced practitioners are acting as primary care docs to tons of people. No one can “replace” a properly trained surgeon.


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You're saying I can be "replaced" by a mid-level while you can't.

Seems like specialty bashing to me

 

[smq123]

Just a gentle reminder to please keep it polite and on-topic.

Thanks. Now, back to your regularly scheduled programming.

 

[smq123]

800k to 1 mil is the kind of money I think IM doc should make. These are the people who work the most in the hospital

I don't think it's a contest. Every specialty works hard, in their own way. And in every specialty there are some really hard workers, and some really lazy people.

Anyway, to bring it back to the OP, I think that that guy's situation is a good reminder that it's not how much you make, it's how much you save. Spending $4million on a Borders bookstore (sorry, I can't stop harping on that particular business decision) is a poor choice, no matter how much you make. Read "The Millionaire Next Door" for reference.

 

[W19]

And a mid-level can't truly replace a well trained PCP either.

Just because a stupid intern is being stupid is no reason to bash other specialties.

Not going down this road by also saying a 'stupid' FM doc... Anyway go on. Don't want to derail this thread by engaging in a back and forth argument with you

 

[atomi]

Spending $4million on a Borders bookstore (sorry, I can't stop harping on that particular business decision) is a poor choice, no matter how much you make.

It’s in Alaska. Blockbuster video still exists there. Normal business rules don’t apply. Maybe the real estate and liquidation value alone was worth more.

 

[smq123]

It’s in Alaska. Blockbuster video still exists there. Normal business rules don’t apply. Maybe the real estate and liquidation value alone was worth more.

That's a good point, although I would clarify that Blockbuster Video existED there. (The last two stores closed a few weeks ago). And that's a good point about the liquidation value. However, I still maintain that investing the $4million in a more conventional fashion would have allowed the surgeon to retire comfortably, without having to deal with the stress of all that. Just seems like a dumb move....although, perhaps, not as dumb as getting your mistress knocked up.

 

[OrthoTraumaMD]

Really?



You're saying I can be "replaced" by a mid-level while you can't.

Seems like specialty bashing to me

not quite what I meant to say, I understand how it might have come off rude so I apologize. However my original point is still true. Midlevels can do primary care independently, i have had one as my provider and so have many of my friends. Midlevels cannot operate independently.


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[atomi]

That's a good point, although I would clarify that Blockbuster Video existED there. (The last two stores closed a few weeks ago). And that's a good point about the liquidation value. However, I still maintain that investing the $4million in a more conventional fashion would have allowed the surgeon to retire comfortably, without having to deal with the stress of all that. Just seems like a dumb move....although, perhaps, not as dumb as getting your mistress knocked up.

Lol that blockbuster lasted until 2018.

Your point is valid. I’m continuously amazed at how greedy older docs can become and fall for ridiculous get rich quick investments. The one I’ve noticed lately is docs buying fast food restaurants. Really? Youve got 10 mil in the bank with investments and retirement accounts and you feel that’s not enough? So you want to invest in something slimy like fast food and paying people minimum wage to serve unhealthy food?

I thought we were supposed to be better than that.

Baby boomers...what can you do?

 

[Goro]

Lol that blockbuster lasted until 2018.

Your point is valid. I’m continuously amazed at how greedy older docs can become and fall for ridiculous get rich quick investments. The one I’ve noticed lately is docs buying fast food restaurants. Really? Youve got 10 mil in the bank with investments and retirement accounts and you feel that’s not enough? So you want to invest in something slimy like fast food and paying people minimum wage to serve unhealthy food?

I thought we were supposed to be better than that.

Baby boomers...what can you do?

Suggest investing in one of these. Much better appreciation values:

 

[VA Hopeful Dr]

not quite what I meant to say, I understand how it might have come off rude so I apologize. However my original point is still true. Midlevels can do primary care independently, i have had one as my provider and so have many of my friends. Midlevels cannot operate independently.


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That "cannot" is a legal thing. All it would take is the stroke of a governor's pen to change that.

 

[VA Hopeful Dr]

Not going down this road by also saying a 'stupid' FM doc... Anyway go on. Don't want to derail this thread by engaging in a back and forth argument with you

Given your posting history, that's a wise move

 

[OrthoTraumaMD]

That "cannot" is a legal thing. All it would take is the stroke of a governor's pen to change that.

Uh, no. Not just legal, but actual “cannot.” They do not have the ability, the knowledge, or the skill to perform surgery. To presume that a midlevel will ever have the same amount of skill as a trained surgeon post residency is absurd. Midlevels can prescribe pills and manage blood pressure, but no sane/informed patient will be convinced to let someone cut them open for major surgery unless they’re actually a physician. So legally, will never happen.


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[W19]

Uh, no. Not just legal, but actual “cannot.” They do not have the ability, the knowledge, or the skill to perform surgery. To presume that a midlevel will ever have the same amount of skill as a trained surgeon post residency is absurd. Midlevels can prescribe pills and manage blood pressure, but no sane/informed patient will be convinced to let someone cut them open for major surgery unless they’re actually a physician. So legally, will never happen.


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You are giving 'patients' or clients too much credit...

 

[ButterButter]

Uh, no. Not just legal, but actual “cannot.” They do not have the ability, the knowledge, or the skill to perform surgery. To presume that a midlevel will ever have the same amount of skill as a trained surgeon post residency is absurd. Midlevels can prescribe pills and manage blood pressure, but no sane/informed patient will be convinced to let someone cut them open for major surgery unless they’re actually a physician. So legally, will never happen.


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The same was said of CRNAs, and considering that most patients having surgery have no idea what a CRNA is, they don't have the ability to advocate for a physician at the head of the bed. Of course, midlevels will never have the same amount of skill as a trained surgeon, but hospitals and insurance companies don't care about skill, they care about the bottom line. I'm not saying it's going to happen (ever), but to presume that it will never happen because they don't have the same skill-set as a physician is failing to understand the driving forces acting on the sidelines of medicine.

 

[VA Hopeful Dr]

The same was said of CRNAs, and considering that most patients having surgery have no idea what a CRNA is, they don't have the ability to advocate for a physician at the head of the bed. Of course, midlevels will never have the same amount of skill as a trained surgeon, but hospitals and insurance companies don't care about skill, they care about the bottom line. I'm not saying it's going to happen (ever), but to presume that it will never happen because they don't have the same skill-set as a physician is failing to understand the driving forces acting on the sidelines of medicine.

Yep.

20 years ago it was "Optometrists will never perform surgery"

15 years ago it was "Midlevels will never perform endoscopy"

Never say never about who is going to be allowed to do what in medicine.

 

[VA Hopeful Dr]

Uh, no. Not just legal, but actual “cannot.” They do not have the ability, the knowledge, or the skill to perform surgery. To presume that a midlevel will ever have the same amount of skill as a trained surgeon post residency is absurd. Midlevels can prescribe pills and manage blood pressure, but no sane/informed patient will be convinced to let someone cut them open for major surgery unless they’re actually a physician. So legally, will never happen.


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Yes. Now.

Who's to say that in 10 years we won't have surgery "fellowships" for NPs that teach them some of the more bread and butter of general surgery (hernia repair, appendectomy).

Will they be as good or safe as a board certified surgeon? Of course not. Same way CRNAs are not on the same level as anesthesiologists or NPs/PAs aren't on the same level as any doctor they are working with.

 

[atomi]

Yes. Now.

Who's to say that in 10 years we won't have surgery "fellowships" for NPs that teach them some of the more bread and butter of general surgery (hernia repair, appendectomy).

Will they be as good or safe as a board certified surgeon? Of course not. Same way CRNAs are not on the same level as anesthesiologists or NPs/PAs aren't on the same level as any doctor they are working with.

You have some points, but PAs will never be performing spine surgery alone. Ever. Not in this country.

 

[Oso]

oooh drama.

 

[Lawpy]

One thing I struggle to understand on SDN is this endless comparison and criticism by physicians from different specialties and talking about which fields are less likely to be taken over by midlevels. These discussions are divisive and only lead to further infighting and alienation, which gives midlevels a stronger and more unified ground to exploit these divisions and continue to promote their absurd demands of independent practice rights despite having significantly inferior education and experience. I also see on here and in real life the sad tendency of some physicians to throw their colleagues and trainees under the bus in favor of defending and vouching strongly for midlevels.

Why can't physicians just be more unified and help each other out rather than tearing each other down? There should be much stronger physician lobbying groups to argue at local, state and national levels against independent midlevel practice rights and to protect physician interests for patient safety.

 

[nimbus]

The same was said of CRNAs, and considering that most patients having surgery have no idea what a CRNA is, they don't have the ability to advocate for a physician at the head of the bed. Of course, midlevels will never have the same amount of skill as a trained surgeon, but hospitals and insurance companies don't care about skill, they care about the bottom line. I'm not saying it's going to happen (ever), but to presume that it will never happen because they don't have the same skill-set as a physician is failing to understand the driving forces acting on the sidelines of medicine.

Speaking as an anesthesiologist, the procedural complexity of surgery is an order of magnitude greater than anesthesia. Even some surgeons never fully master their craft after decades of practice. I don’t see midlevels as a viable threat to surgery.

 

[VA Hopeful Dr]

You have some points, but PAs will never be performing spine surgery alone. Ever. Not in this country.

Ever is a very long time.

But given how many spine surgeons shouldn't be performing spine surgery alone, you may have a point.

 

[VA Hopeful Dr]

One thing I struggle to understand on SDN is this endless comparison and criticism by physicians from different specialties and talking about which fields are less likely to be taken over by midlevels. These discussions are divisive and only lead to further infighting and alienation, which gives midlevels a stronger and more unified ground to exploit these divisions and continue to promote their absurd demands of independent practice rights despite having significantly inferior education and experience. I also see on here and in real life the sad tendency of some physicians to throw their colleagues and trainees under the bus in favor of defending and vouching strongly for midlevels.

Why can't physicians just be more unified and help each other out rather than tearing each other down? There should be much stronger physician lobbying groups to argue at local, state and national levels against independent midlevel practice rights and to protect physician interests for patient safety.

Because as a rule, doctors are dinguses?

 

[OrthoTraumaMD]

Speaking as an anesthesiologist, the procedural complexity of surgery is an order of magnitude greater than anesthesia. Even some surgeons never fully master their craft after decades of practice. I don’t see midlevels as a viable threat to surgery.

Thank you for the vote of sanity.


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[VA Hopeful Dr]

Thank you for the vote of sanity.


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So the rest of us aren't sane?

 

[OrthoTraumaMD]

So the rest of us aren't sane?

No, but by calling your fellow physicians a**holes, and defending mid-level creep, you have already shown whose side you are on. So I’m ending the conversation.


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[VA Hopeful Dr]

No, but by calling your fellow physicians a**holes, and defending mid-level creep, you have already shown whose side you are on. So I’m ending the conversation.


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That's what you got out of this?

So first of all, I absolutely include myself in the physicians are dinguses category. Second, you can't tell me you haven't noticed just how many doctors are at best jerks and at worst horrible people. Now are 100% of physicians jerks? Of course not. Do we seem to have more of them than many other fields? Its hard to deny that. You might not see that given your field, but you wouldn't believe the stuff that I (an FP) and my internist wife have been on the receiving end from other doctors.

Second, I'm not defending midlevel creep. At all. In point of fact, I don't like it and have testified before my state government about its dangers. But that doesn't change the fact that its happening and its unlikely that any field will be completely spared.

 

[smq123]

I think this discussion has run its course. I'm going to close the thread.