How Low Would You Go?

[medicinesux]

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With all the talk of medicare cuts and declining reimbursements, how low would you go in base annual salary (before taxes and after malpractice & business expenses) before you would definitely leave medicine in pursuit of other opportunities?

Poll is anonymous

 

[thusell]

This poll doesn't make any sense. For example, I'd be quite willing to stay in medicine with a salary of 90K if I could do a really, really crappy job and focus on how much free time I had. But if I wanted that, I'd move to Europe or something.

 

[medicinesux]

assume salaries are for current full time average workloads.

 

[thusell]

Then you need to include higher numbers.

 

[mlw03]

the premise of this question is unfair. i'm 25 years old and were i to leave medicine i have no other job opportunities. my BS in microbiology could probably get me a job as a lab tech, that's about it. so now that i'm about to graduate with over $125K in debt i don't know what choice i have other than to work as a doctor. it's the only job i'm qualified for. i suppose i would answer the question by saying that i'd have to keep working as a doctor as long as i could make more doing that than working as a lab tech.

 

[njbmd]

With all the talk of medicare cuts and declining reimbursements, how low would you go in base annual salary (before taxes and after malpractice & business expenses) before you would definitely leave medicine in pursuit of other opportunities?

Poll is anonymous

the premise of this question is unfair. i'm 25 years old and were i to leave medicine i have no other job opportunities. my BS in microbiology could probably get me a job as a lab tech, that's about it. so now that i'm about to graduate with over $125K in debt i don't know what choice i have other than to work as a doctor. it's the only job i'm qualified for. i suppose i would answer the question by saying that i'd have to keep working as a doctor as long as i could make more doing that than working as a lab tech.

If you obtain a medical degree you have options. You won't be a BS in microbiology you will have a doctorate in some type of medicine (osteopathic or allopathic) and that puts you well above the "lab tech" bench.

Reimbursement are dropping and debt load is increasing. Medicine is not a ticket to a high salary and "easy street". Even those physicians who are in the higher paying specialties are working hard. The thing to thing about rather than your salary is if there is something out there in medicine that would satisfy you other than clinical practice which is largely going "belly up".

 

[thusell]

Even those physicians who are in the higher paying specialties are working hard. The thing to thing about rather than your salary is if there is something out there in medicine that would satisfy you other than clinical practice which is largely going "belly up".

Yes and no. The physicians in the higher-paying specialties are working harder to make more relative to THEMSELVES. But not to everyone else. A Dermatologist who wants to "take it easy" will still make much more than a harder-working primary care physician. The question is: why? The answer is because of socialized medicine. Nobody needs a Dermatologist. Period. If every Dermatologist on earth right now died, the average life span would decrease by about one year and we'd have drier skin. Oh, right, and everyone would apparently die of undiagnosed skin cancer.

Socialized medicine demands that the people who do the most necessary work be paid relatively little so that everyone can afford it. Therefore, a surgeon works quite hard and makes (relatively) little. I'm not saying surgeons are starving because they're not. But you're not getting paid relative to your actual worth, as you would in the free market. Of course, if they made the pay TOO low, everyone would just quit, so they can't do that.

So they put your salary just enough so that people will defensively rationalize why the system works. Like, it's hard to complain about "only" making $200K. Except that you're working 80+ hours a week and still taking overnight call, so actually that's like working for free.

 

[thusell]

Put it this way: ever notice there are two types of people in medicine? One type says that "you shouldn't choose medicine if you don't love it" and actually means it. The other type is running around constantly asking people how much they make in their specialty, how long they have to work as an attending, and so on ...and then writes some kindergarten personal statement about how much they love the field as they check on the average national salary on some obscure website they Googled for. Of course, that personal statement works because their attendings also wrote the exact same personal statement a few years ago.

The difference between me and them is that I don't mind if people make a lot of money, so long as they get recompensated for their work. I don't care if a Derm makes $400K; however, that would mean that a surgeon should then make $1.5M then. Lots of dentists don't accept insurance and get to make bank. They'll argue up and down that MEDICINE should be affordable to all, but they'll kill you if you try to make them fall under the same auspices and have their salaries drop like rocks.

So it's all just one big game where, rather than arguing based on principle people just demand whatever is best for THEM PERSONALLY and screw everyone else. That's the medical field today.

 

[mig26x]

Im an intern and I also have a MPH in epidemiology. If I have to work as an MD for 90,000 per year and work 80 hours per week, I prefer to earn 50,000 as an epidemiologist and work 40 hours per week. That simple.

 

[thusell]

If I have to work as an MD for 90,000 per year and work 80 hours per week ...

...I'd just do one operation a day and it wouldn't be a long one. And if it ran long, I'd just walk off and leave the patient open on the table and some bleeding heart could take over if they wanted to on their time. Then I'd sleep for the remainder of the day, or look at naked women on the Internet. Who are the ******s who expect you to do this job and work this much for so little? What are we, the friggin' Care Bears?

 

[Southpaw]

The thing to thing about rather than your salary is if there is something out there in medicine that would satisfy you other than clinical practice which is largely going "belly up".

I think medicine with a middle man is largely going belly up. I have no business degree, and I'm only an MS3, so I admit I'm largely uneducated on the issue. But I believe there must come a time when physicians simply decide to not accept insurance.

From an altruistic standpoint, working for as little cost to the patient while still making a living, makes perfect sense. But that's not what we're doing. We're working like dogs for as little cost as possible to insurance companies. We're lining the pockets and setting up lavish retirements for the higher ups in insurance companies. We're getting squeezed from everywhere. So...why do it? Oh, that's just the way it is huh, nice. Perfect.

If we control the numbers of physicians going into the work force, which our regulatory bodies should do, we should set the amount for which we work for. Lawyers do it. Just about every business in America seems to do it. Businessman do it. Picture this, a man goes to a financial analyst to discuss options for his retirement plan. They talk, come up with a plan to implement, and afterwards the analyst submits a claim for reimbursement to some company who says how much the analyst should make. Sounds ******ed right? But, it's what we do.

Clinical practice was better before managed care because we essentially determined what we worked for. That's how a business should be run. And today, physicians are the ONLY people in healthcare resistant to looking at what they do from a capitalist mindset.

 

[thusell]

People talk about how "if we made medicine free market, nobody could afford anything!" To a certain extent, YEAH. The fact that we have luxury cars on the market doesn't mean that everyone can afford a luxury car. To wit, "T.S." On the other hand, people will be able to afford MOST things because if physicians make the price too high nobody will pay them and the physicians will starve. I'm not sure why some people can't grasp these two simple concepts. Maybe it's because their parents were hippies or they spent too much time smoking reefer when they were growing up or maybe they went to some Ivy League school or perhaps they had massive brain trauma.

 

[McGillGrad]

I would not mind making 50k (after taxes) if all children under 16 had access to free medical care and if medical care premiums were based on individual behaviors. For example, people who abused their body paid more than people who lived healthier lives. Each bad habit increases the amount you pay into healthcare.

Oh, and if my tuition was around 5-10k per year (like my lucky Canadian friends).

Yes, yes I am only a medical student but I have experience in the business world and medicine is head and shoulders above what I have seen in finance.

 

[Coastie]

And this is why medicine (economics, access to quality care) is in trouble, folks.

I would not mind making 50k (after taxes) if all children under 16 had access to free medical care and if medical care premiums were based on individual behaviors. For example, people who abused their body paid more than people who lived healthier lives. Each bad habit increases the amount you pay into healthcare.

Oh, and if my tuition was around 5-10k per year (like my lucky Canadian friends).

Yes, yes I am only a medical student but I have experience in the business world and medicine is head and shoulders above what I have seen in finance.

 

[McGillGrad]

Medicine is in trouble because the wrong people go into medicine for the wrong reasons.

If you go into medicine for power and money then you will be unhappy and vent on an anonymous message board because you lack self-esteem, social skills or the business savvy to succeed with the most meager of salaries.

Becoming a MD does not change who you are, but anonymous losers think that they will somehow become attractive, charismatic and wealthy after medical school. The truth is that if you are not attracting mates, charming people, or know business before medical school, then you won't after.

A loser is a loser. But hey, they can always post some asinine drive-by comment without any supporting arguments and put a laughing smiley face over it and that is enough to get them through another day without playing chicken with a bullet.

And this is why medicine (economics, access to quality care) is in trouble, folks.

 

[labst]

I would not mind making 50k (after taxes) if all children under 16 had access to free medical care and if medical care premiums were based on individual behaviors.

You could have shortened your post to "I am a socialist." And before you get all riled up, this is why: You want everyone to have free medical care. Socialist. And for everyone else, you want to penalize them based on behavior. Why? Because I can tell you want universal coverage for them, too, and you have to ration your care. Just like your lucky Canadian friends. And then you want to bottom out physician pay, which basically disconnects salary from performance and achievement, in order to pay for this half-assed scheme.

Don't worry, that's the way things are headed anyways, since most people think they're getting "free" health care. And that's fine, too, because we'll be just like Canada then and most people will have free health care that allows them to die in the streets while they wait for a hospital bed. But just like Canadian doctors, I won't care because I'll be on the golf course. (It won't matter because I'll still get my guaranteed $50K.)

 

[Coastie]

I gotta know: Did you learn your charming debate skills at McGill or down at SABA? Canada would be the perfect place for you to practice, but since you can't go back, I imagine you want to turn the US into Canada. Those who are in the U.S. are against a Canadian system. Please, keep the northern socialism where it belongs: in the trash bin of history.

Medicine is in trouble because the wrong people go into medicine for the wrong reasons.

If you go into medicine for power and money then you will be unhappy and vent on an anonymous message board because you lack self-esteem, social skills or the business savvy to succeed with the most meager of salaries.

Becoming a MD does not change who you are, but anonymous losers think that they will somehow become attractive, charismatic and wealthy after medical school. The truth is that if you are not attracting mates, charming people, or know business before medical school, then you won't after.

A loser is a loser. But hey, they can always post some asinine drive-by comment without any supporting arguments and put a laughing smiley face over it and that is enough to get them through another day without playing chicken with a bullet.

 

[McGillGrad]

Oh how cute. Did it really take you this long to come up with that?

I don't go to Saba, but nice try.

You wouldn't know, but in the Canadian system doctors make about 180-200k as a GP. That's not much lower than in the US and we have universal healthcare and better medical schools.

I gotta know: Did you learn your charming debate skills at McGill or down at SABA? Canada would be the perfect place for you to practice, but since you can't go back, I imagine you want to turn the US into Canada. Those who are in the U.S. are against a Canadian system. Please, keep the northern socialism where it belongs: in the trash bin of history.

 

[labst]

You wouldn't know, but in the Canadian system doctors make about 180-200k as a GP. That's not much lower than in the US and we have universal healthcare and better medical schools.

Wow, it sounds wonderful! I'm going to kick out all the Canadians who come here for their health care now and tell them that it's very wonderful up in Canada. They will be very appreciative and cheer.

 

[DPPM]

You wouldn't know, but in the Canadian system doctors make about 180-200k as a GP. That's not much lower than in the US and we have universal healthcare and better medical schools.

Don't know about "better" medical schools in Canada, but I definitely think universal health care is something worth exploring. I wish people would stop having such a knee-jerk reaction to it, because I think it might even improve the lifestyle of US physicians as well as the general population if done right.

 

[Trisomy13]

I would not mind making 50k (after taxes) if all children under 16 had access to free medical care and if medical care premiums were based on individual behaviors. For example, people who abused their body paid more than people who lived healthier lives. Each bad habit increases the amount you pay into healthcare.



.

Not for/against universal healthcare here, but I want you to think more about people paying into healthcare based on how they live their lives. Or, how they abuse their bodies, as you put it. There are some examples probably everyone would agree to.. cigarette smoking, alcohol abuse, drugs, etc. Although how do you tease apart those with familial or genetic predisposition to alcoholism? Do you make the "pay in" cheaper for drug users who are born into a poor neighborhood where drugs are rampant, and have more obstacles to a healthy life? Well, those are probably easy targets. "Everyone makes a choice" I can hear you already typing. I wish reality were that clear for me, and for everyone born into adverse environments, but it's not. I've seen circumstance destroy lives, and on occasion, help people rise from the ashes.
Regardless, how about the long distance runner who has lived a healthy life but undeniably abused his body and now has osteoarthritis requiring B/L total knees? Was he healthy? Abusive? Should he pay more or less?
What about the promiscuous individual? Will you propose a maximum number of annual sex partners before declaring the practice abusive to one's body? Is having another child after your OB tells you it might be dangerous abusive to your body?

just food for thought.

 

[labst]

If I have to pay for other people's care, then I get to prescribe how they live. It's that simple. That's where we're going with socialism because by definition you have to ration health care under socialism. The problem is that socialists are also leftists and their values are defined in that manner. So they don't punish a woman for having five abortions and multiple STDs. But they will punish you for being fat, which you should feel badly about because some people in Mother Russia are starving. Don't worry about drug-use. But be ashamed for smoking. Unless it's marijuana, then it's OK.