D
deleted804295
Well if serving others in vulnerable states is comparable to sitting at a computer coding all day sure.
I've done both and as fun as coding is it really doesn't give meaning to life.
I was pre-med in 2003 and started this account in 2004 before med school: why I (probably) would choose a different career if I had to do it over
- Thread starter Lion-O
- Start date
I've done both and as fun as coding is it really doesn't give meaning to life.
- Joined
- Apr 6, 2014
- Messages
- 14,146
- Reaction score
- 22,778
I mean I dont really find copying forward 90% autogenerated notes and waiting days to find placements to be super fulfilling either :/ I'm matching DR and will be looking at a screen all day regardless. Could have started staring at screens for money at age 22 instead of 32!
- Joined
- Sep 12, 2010
- Messages
- 6,101
- Reaction score
- 3,089
Part of this thread is how corporations get patients and keep them in their system. Hard for pp to gain traction
- Joined
- Sep 12, 2010
- Messages
- 6,101
- Reaction score
- 3,089
In private practice land, the midlevels set up shop and don't correct patients that they're not Physicians. They have a collaborative doc who is 90 miles away and has agreements all over the state with other midlevels. It's the wild west out here. No checks and balances
D
deleted1064759
Jeez man you sound miserable. What made you decide DR? Do you prefer less patient interaction? Was it your top choice?
- Joined
- Mar 26, 2015
- Messages
- 459
- Reaction score
- 172
Obviously you can't reverse time and become 22 again, but will throw it out there that if you want to do stuff in tech DR opens a lot of doors for you. Most 22 year olds are honestly just de-bugging old code and running tests - I have a lot of friends who did CS and went straight to FAANG and it's not interesting or stimulating though they all agree the money is good. As a radiologist in tech you can actually run interesting projects and make an impact on the technology of the future. Don't forget that you aren't trapped on the clinical side of medicine.
Do you think CV will impact radiologist drastically in future?
- Joined
- Sep 12, 2010
- Messages
- 6,101
- Reaction score
- 3,089
Liability is also much lower for them than a physician
- Joined
- Mar 26, 2015
- Messages
- 459
- Reaction score
- 172
Job security is much lower for them. Everything is a trade off.
- Joined
- Aug 3, 2018
- Messages
- 3,496
- Reaction score
- 8,766
My wife and I were married as medical students . I recently retired and my wife will within a year. My son went into medicine despite my wife's protests. The forces we physicians are up against to advocate for our patients are massive. Both the insurance industry and the government share the same goal, and that is cost. Quality is just lip service. All the huge administrative costs and paperwork come from government regulations. Insurers and health systems have to comply with the regulations and therefore must hire people to keep them in compliance. Either Corporate medicine or govt run healthcare takes us to the same place .Rationing generic quality healthcare to control cost. Advancing the privileges of mid levels will continue. Soon, that 250 k salary that everyone talks about for physicians will be the average salary for a mid level hospital administrator. My neighbor, a rather unimpressive sort, is a VP for the regional health system. Always flying on the corporate jet, newpaper reports 700k salary, has 3 homes. I guarantee he is not the intellectual peer of anyone on this network. I wouldn't do what he does for twice the money. I do admire his survival skills, as he was able to slurp his way up the cone, or corporate ladder. Wouldn't it great if we didn't need to spend so much money on govt or corporate beauracrats and actually use it to take care of people?
Last edited:
- Joined
- Jan 12, 2010
- Messages
- 674
- Reaction score
- 1,380
Sorry, should have qualified that! I'm an academic attending - residents can't be supervised/trained by midlevels so I'm secure in my job as long as my residency program keeps its doors open
- Joined
- Sep 12, 2010
- Messages
- 6,101
- Reaction score
- 3,089
In Penn State several years ago they had an np training the anesthesia residents...
- Joined
- Sep 12, 2010
- Messages
- 6,101
- Reaction score
- 3,089
Stop producing at a breakneck pace or question anything a nurse or admin says. Then you are labeled disruptive and job security for a doc is in jeopardy also. Physicians also defer alot of their life to finally become a physician. What's the opportunity costs for those other guys?
- Joined
- Apr 6, 2014
- Messages
- 14,146
- Reaction score
- 22,778
Dont mean to sound miserable! I think I'll be a very happy radiologist. But I went straight from a Medicine subI with 80+ hour weeks into a relaxed Rads elective and the difference was night (or rather darkroom) and day. The stuff I wrote about in my personal statement is great in theory, but in practice/medschool I realized most of modern medicine is staring at screens and being a good cog in the machine.
Dont get me wrong not all grass is greener. I do not envy the guys doing crazy hours on wall street or starting out in law firms or consulting.
But this persons FAANG gig...I envy that a lot.
Tell me about it, dealing with that conversation all weekend between younger pre-med rising junior and elder rising CS senior who already has full time offer for next summer at A->Z.
When I was applying to med school, I didn't even think about the loans. All I knew was that I needed to be a doctor, and I'd pay them off later. I suspect many of you have the same mindset. I went to a private school and graduated with a lot of debt at the time (~280,000). Paid it off in 2 years, which I'm glad I did. Nowadays it seems that's average/low debt compared to what med students have. Please see the link I put in my OP: there is the possibility you literally might not be able to pay off your debt depending what field you choose.
There is an active group of doctors attempting to do this (see Physicians for Patient Protection), but the pessimist in me feels we're too powerless compared to the massive corporations that run healthcare.
Not only that, but (and I could be mistaken) academic medicine has completely buried its head in the sand. It blows my mind how little I was educated on the financial side of medicine in med school and residency. You go through the academic system, and minimally do you get any instruction on the business of healthcare. It's a shame, because the vast majority of us come out the other side and simply have to learn as we go for the first few years post residency. This leads to rampant abuse and being taken advantage of when you emerge into the real world.
This I completely agree with. The world is unpredictable. For instance, I have many friends who've lost their jobs due to the pandemic, absolutely by no fault of their own. I feel lucky and grateful I haven't been terribly impacted.
Going into medicine currently isn't great... but I couldn't tell you a better alternative.
Every field now has been inundated with midlevels. Cards, GI, IR, ortho, EM, hospitalist. You name it and they have PAs/NPs doing their consults. Procedurally, doctors seem still somewhat protected, but the line gets blurrier all the time. At my hospital, PAs do all the paracenteses and thoracenteses for IR.
Believe it or not, I'm not completely miserable. It's worse than it was, and I fear what the future will bring, but the positive aspects I listed in the original post still hold true. For now I'm happy.
I can't emphasize this enough, but when you get to my age chances are you will have a family, you will have settled down, your kids will be in school. Trust me, the idea of moving to a better area or a better job (honestly, even another country) crosses your mind. But then you realize your spouse has a job and connections, your kids have been at the same school for years, and uprooting is not a realistic choice. As a pre-med and med student, you take it as a given that you will be moving frequently, often great distances. Don't get me wrong, I was there. I never thought of future-me with a family and kids and a house and the inability to move as needed. Yet here I am.
Last edited:
whataschool_classof24
Full Member
- Joined
- Aug 1, 2020
- Messages
- 87
- Reaction score
- 192
I would be absolutely terrified of this if I were a patient!
- Joined
- Mar 14, 2019
- Messages
- 8,428
- Reaction score
- 9,780
If you were a typical patient, you wouldn't know the difference, which is why it is proliferating.
whataschool_classof24
Full Member
- Joined
- Aug 1, 2020
- Messages
- 87
- Reaction score
- 192
Fair point. Guess I should say I would be terrified if I knew it was a PA instead of an IR.
- Joined
- Aug 19, 2019
- Messages
- 70
- Reaction score
- 35
Nowadays every pre-med should know what medicine is really like especially when it comes to money before they commit themselves to this path. I mean who in their right mind would go through a neurosurgery or other lengthy residency for 100k-150k as we get closer and closer to socialized medicine. They will be miserable....
Take what I say with a grain of salt. When I was pre-med and in med school, I too had many doctors tell me not to go into it, and I too felt many of their concerns were overblown. And I still feel that way - many of the issues those older doctors had did not end up being issues for me. Maybe my issues won't be issues for you.
I think what it comes down to is: what are your expectations of being a doctor vs. what is the reality of being a doctor? My expectations were to have the ultimate say and decision-making in the patients I cared for. I did not expect to be responsible for a team of midlevels assigned to me by a giant corporation. But, if you go into medicine with the expectation that you will not have pure autonomy and that you will be more of a supervisor than a provider of direct patient care, perhaps you will not feel the same discontent I do.
...
Some years ago I took part in interviewing applicants to the med school I worked at. To this day, I am so impressed by the caliber of the people applying to med school. You guys/gals are incredible. The grades, the MCAT scores, the blood/sweat/tears, the research, the volunteering, the achievements, the diverse backgrounds; and on top of all that, the ability to converse easily and be personable. It honestly makes me proud to be part of that group, because in many ways I did not and still do not match up to what many pre-med students have done.
What is most utterly disheartening to me is that for those of you who make it through one of the most rigorous, competitive processes on Earth will enter an environment where your achievements... will not matter. Your worth will be dictated by the RVUs you generate and your patient satisfaction scores. You are provider, not a physician.
...
I don't mean to be completely negative. I've listed the parts that bother me the most. Here are some positive aspects that keep me going:
I think what it comes down to is: what are your expectations of being a doctor vs. what is the reality of being a doctor? My expectations were to have the ultimate say and decision-making in the patients I cared for. I did not expect to be responsible for a team of midlevels assigned to me by a giant corporation. But, if you go into medicine with the expectation that you will not have pure autonomy and that you will be more of a supervisor than a provider of direct patient care, perhaps you will not feel the same discontent I do.
...
Some years ago I took part in interviewing applicants to the med school I worked at. To this day, I am so impressed by the caliber of the people applying to med school. You guys/gals are incredible. The grades, the MCAT scores, the blood/sweat/tears, the research, the volunteering, the achievements, the diverse backgrounds; and on top of all that, the ability to converse easily and be personable. It honestly makes me proud to be part of that group, because in many ways I did not and still do not match up to what many pre-med students have done.
What is most utterly disheartening to me is that for those of you who make it through one of the most rigorous, competitive processes on Earth will enter an environment where your achievements... will not matter. Your worth will be dictated by the RVUs you generate and your patient satisfaction scores. You are provider, not a physician.
...
I don't mean to be completely negative. I've listed the parts that bother me the most. Here are some positive aspects that keep me going:
- It is incredibly humbling and touching that humans allow you into the most vulnerable part of their lives. To entrust you to make decisions about their health and well-being. To look at you with eyes that say, "I'm scared, please help me." To make a difference in people's lives is a large part of pushes me through. If this aspect of medicine genuinely interests you as a pre-med, I will say it does pay off when you become a doctor.
- I do feel like I'm an expert in my field. I know that I offer patients care that only a board certified physician in my field can provide.
- Despite my general dissatisfaction with midlevel proliferation and being labeled a provider, I'm respected in my day to day job. I know the hospital staff and my peers respect me, as I respect them. For the most part, in the hospital setting (at least where I work), physicians are still leaders and there is no ambiguity between the level of training between doctors and midlevels.
- I get paid very well, maybe 2-3x what I thought I'd be making when I got into medicine. I make 3x more than my parents ever did. I am able to live very comfortably, drive a nice car, save for kids' college, and save ~20-30% of my income for retirement. (Who knows how long this will hold up, and my outlook might be significantly different if I'd come out of school with more debt.)
At least that will weed out the competition, who are in only for money leaves only with who cares about patient care, will force to reduce education expenses and hence better for everybody to afford and be happy.
This entire thread highlighted one thing, even being Dr it may not bring happiness in one's life.
D
deleted804295
Only for money??? You realize the most competitive surgical residencies are 7-9 years long. This is with accruing interest from 6 figure medical school debt.
It would be unjust to pay an individual who went through all of *that* 100k.
- Joined
- Aug 19, 2019
- Messages
- 70
- Reaction score
- 35
Agreed. Not to mention a 8+ year rigorous academic pathway beforehand.
I am talking in general to pursue medicine, expecting big bucks at end of residency. It is a vicious circle, starts with education cost resulted debt used to justify fat pay results in fat charges to patients who pays fat premium and cycle goes on...
- Joined
- Nov 18, 2017
- Messages
- 879
- Reaction score
- 1,007
- Joined
- Nov 18, 2017
- Messages
- 879
- Reaction score
- 1,007
May I ask what your specialty and approximate take-home pay (post-tax) is?
Another acronym is Big N that included likes of Microsoft as well..
- Joined
- Oct 22, 2013
- Messages
- 8,597
- Reaction score
- 19,852
I appreciate where this is coming from, but it's fallacious to think that what physicians get paid is at all related to length or difficulty of training or what is fair. Currently, they are correlated, but not always. What physicians are paid is a complicated equation that depends on practice setting, payer mix, and sources of income / division of labor, not to mention insurer and CMS policy (moreso CMS cuz its a bigger player in the market)
Pediatric heme/onc docs go through 6 years of training, often with similar debt, and while their schedule might not be as physically taxing as a trauma surgeon's they do vital, important, and heavily taxing work. They are also one of the lowest compensated specialties in all of medicine, as are all pediatric specialists.
A general surgeon will *lose* income in the long run if they choose to go into pediatric surgery instead of private practice general surgery, but peds surg demands 3-5 more years of training than a straight-through gen surg path. And although pediatric surgeons still make more than most physicians in this country, even more than many surgeons in some cases, they are limited in where they can practice by the nature of the demands for their expertise (kids needing specialized surgery in areas that arent the brain or heart (which have their own peds subspecialists in CT and NSG) is much rarer than for adults and the practice settings tend to be academic).
an MD/PhD neurosurgeon will train for 11-14 years before becoming an attending, and if they choose to devote half their time to research as many academic neurosurgeons do they would make about 1/3 of what their private practice spine colleagues make all the while having longer training, more academic/scientific/administrative responsibilities, and busier schedules.
Neither in this system or in any other healthcare system are these two things -- effort/length of training and pay -- causatively linked. Also, in no other healthcare system in countries comparable to the US (where most have "socialized" medicine, although what that means differs depending on who u ask but certainly by US standards) do docs top out at 100-150k in annual income (with maybe the exception of Spain for non-surgical docs), also their debt is almost nonexistent. If you included wealth, taxes, debt, cost of living, and benefits into the calculation of what docs in other countries make vs the US I think you would find that a subset of US physicians make a lot more (subspecialists in private practice) but most docs are actually losing out in comparison.
I think it's also really important to think why APPs ("midlevels") are unique to the US healthcare system. No other healthcare system in the world has needed to train or produce APPs. Why is that? Cost cost cost. We are, sooner or later, going to have to reckon with the fact that if we don't have a way to systematically control cost in our healthcare system that as long as demand keeps increasing, which it will, cost cutting efforts will need to be made. The longer we wait, the more aggressive those efforts will need to be, and the profession will suffer as a result.
Last edited:
D
deleted804295
I'm not sure where you're disagreeing.
Are you saying physicians who have 6 figure debt and long residencies should make around $100k?
- Joined
- Oct 22, 2013
- Messages
- 8,597
- Reaction score
- 19,852
I'm saying that what physicians get paid and how long their training is or how challenging their job is have nothing to do with one another. If the system could get away with paying NSGs 100k, it would. It doesnt for reasons that have nothing to do with length of training, but with supply and demand and policy decisions that get made in corporate board rooms and Washington D.C. it doesn’t matter what anyone thinks anyone else *should* be paid because that’s not how economics works in our society.
- Joined
- May 26, 2018
- Messages
- 3,036
- Reaction score
- 2,227
what you all think should be the minimum salary for PCPs?
- Joined
- Mar 14, 2019
- Messages
- 8,428
- Reaction score
- 9,780
This^^^^. @Sunbodi -- at the end of the day you will be correct, because when the cost/benefit of incurring the debt and the opportunity cost of the training no longer makes sense, supply/demand will come into play, as the supply of willing participants decreases below the demand, and salaries respond. But cost and length of training does not dictate income anywhere -- academics, medicine, professional sports, Wall Street, Silicon Valley, etc., it is supply and demand.
Eventually cost and length of training impact supply, but incomes are not set by "hard" someone works, or by how long they train, or by how much their education costs. By your reasoning, doctors who receive full merit scholarships (or need based) should make less than those were full pay.
- Joined
- Mar 14, 2019
- Messages
- 8,428
- Reaction score
- 9,780
Whatever the market dictates. Price fixing never works, anywhere. If the market goes low enough, nobody will become PCPs, and the market will adjust, just like every other market, in history.
- Joined
- Aug 19, 2019
- Messages
- 70
- Reaction score
- 35
Midlevels will be the new PCP's soon enough.
- Joined
- May 26, 2018
- Messages
- 3,036
- Reaction score
- 2,227
I never advocate for price fixing. Just asking what everyone thinks a fair salary is given length of education, cost and how other sectors are paying.
- Joined
- Aug 3, 2018
- Messages
- 3,496
- Reaction score
- 8,766
This^^^^^^^^ You can beat your chest and rend your garments, but you are worth what the market will pay. Your services, like anything are worth what you can get for them.
- Joined
- Mar 14, 2019
- Messages
- 8,428
- Reaction score
- 9,780
Okay .. but you didn't ask about fair salary, you asked about minimum salary, which is a form of price fixing.
Opinions on fair salary don't matter, because salaries aren't set by what employees think is fair. They are based on supply/demand, and as the paradigm shifts to having midlevels do more and more things previously done by PCPs, demand will drop, and relative salaries will drop as a result, which is the objective of the payers. Nothing to be done about it.
Those who care about money and are good enough will gravitate even more than they already do to higher paying specialties, while those who aren't motivated by money and those who are not good enough will be doomed to making less (relatively speaking) than their predecessors. Nothing fair about it, but it is what it is. The alternative is going out on your own, setting your own salary, and waiting for the big bucks (or whatever you think is "fair") to just roll in.
Unfortunately, as has been pointed out above, length of education, cost, and how other sectors are paying is irrelevant. What's relevant is how much of the job can be outsourced to NPs and PAs, and how much it would cost to have them do it instead. If it doesn't make sense, you don't do it. If it took 12 years and cost $500,000 to train to drive a truck, that wouldn't make a truck driver worth $300,000 a year. Goods would just be shipped using a less expensive alternative, and truck drivers would have to find something else to do, which also wouldn't be fair.
Last edited:
- Joined
- Aug 7, 2020
- Messages
- 370
- Reaction score
- 502
I am learning a lot from everyone, especially the personal stories. Found this from Medicaleocnomics.com Dec 2018:
What’s ruining medicine for physicians?
1. 44% Paperwork and administrative burdens
2. 41% Difficulty using EHRs
3. 26% Government regulations
4. 24% Prior authorizations
5. 19% Replacing primary care physicians with NPs/PAs
6. 18% No negotiating leverage with payers
7. 15% Rising practice staff and overhead costs
8. 15% Imbalance in primary care vs. specialist reimbursements
9. 12% MOC costs and requirements
What’s ruining medicine for physicians?
1. 44% Paperwork and administrative burdens
2. 41% Difficulty using EHRs
3. 26% Government regulations
4. 24% Prior authorizations
5. 19% Replacing primary care physicians with NPs/PAs
6. 18% No negotiating leverage with payers
7. 15% Rising practice staff and overhead costs
8. 15% Imbalance in primary care vs. specialist reimbursements
9. 12% MOC costs and requirements
- Joined
- Sep 12, 2010
- Messages
- 6,101
- Reaction score
- 3,089
Mid-levels are fighting for pay parity and have it already in Oregon. How does that save the system money?
- Joined
- Nov 21, 2005
- Messages
- 4,688
- Reaction score
- 2,652
I basically agree with what the OP has said. I have an NP who I oversee in Texas and we get along very well, but she is very seasoned (worked L&D as a nurse for 25 years, worked in Neurosurgery for 14). She is 65 and knows what she doesn't know. Of course we work urgent care so the mindset is a little different than being someones sole PCP. I personally can't complain about my career path. Never really wanted to be a PCP and I see urgent care as the safety net for the community. My base schedule is 10 days a month. I can pick up shifts or do locums on my week off (this has changed since COVID but things are returning to normal). My pay has been "cut" due to COVID only because I am on base pay only right now due to no extra shifts. I personally could not imagine having a private practice - would not want the headache, don't want to be married to my practice, being on call, etc. I haven't had to be on call for 8 years now and I would never go back. Admin gets uglier by the week. I learned about admin the hard way when I first got out of residency- Went through 5 perm jobs in 5 years. That's why I ended up as locums for so long. Got sick of being burned by "the man" for stupid stuff and staff that doesn't like you who are not your employees so it's he said/she said games that nurses play. Am at the point that I don't trust anyone at work ever. My only consolation is that I'm in a building that is stand alone and I don't generally deal with admin at all unless there is a patient complaint and I get a call from the director. Otherwise I go to work, see the patients and go home.
- Joined
- Mar 14, 2019
- Messages
- 8,428
- Reaction score
- 9,780
I've been thinking about this a little bit, and the answer is that it doesn't, but that's not the point. Oregon is not New York or San Francisco. I'll go out on a limb and assume the cost of living, and salaries, are a lot lower there than in big cities. I'll also take the liberty of assuming that there is a huge PCP shortage there, as compared to more popular locations with significantly higher salaries.
If my assumptions are correct, mid-levels demanding and receiving pay parity in Oregon has nothing to do with what large practice groups are doing to lower costs in other parts of the county. What happened in Oregon in that mid-levels are not replacing PCPs, but are relieving a shortage by performing comparable functions. Since those skills are apparently in high demand and low supply, they are correct to demand and receive pay parity.
And, to address points raised by @srk2021 and others above, this is yet another example of salaries being set by the market, not by what is "fair," or how much time, expense and effort went into training. Watch and see what happens if and when mid-levels receive pay parity in areas where there is no acute PCP shortage. In those instances, mid-levels will find themselves fighting themselves out of jobs, because, without cost savings, there is absolutely no reason to replace a physician with a mid-level.
- Joined
- Nov 18, 2017
- Messages
- 879
- Reaction score
- 1,007
- Joined
- Nov 18, 2017
- Messages
- 879
- Reaction score
- 1,007
- Joined
- Oct 22, 2013
- Messages
- 8,597
- Reaction score
- 19,852
technology can up-end things. For example, suppose that tomorrow we discovered a non-surgical therapy that could cure all brain cancers outright, even Glioblastoma. There would no longer be a need for NSGs to cut out brain tumors. Demand would decrease. NSGs are busy and rare enough that this would likely have a little effect on the gap between supply and demand...
but supply isn't static. Suppose that 10 years prior to our miracle brain cancer cure, demand for NSGs was increasing so much that NSG residencies decided to double the number of NSGs they train. Well, now in our hypothetical scenario the market for NSGs will tighten and supply is no longer "scarce". Hardly an apocalyptic scenario -- and its a world without brain cancer!! Yay!! -- but it would certainly affect the NSG market.
This isn't purely hypothetical either! Consider RadOnc. 10 years ago, RadOnc was one of the most competitive specialties, on par with derm/ortho/NSG in terms of competitiveness, especially at top programs. RadOnc residency slots rapidly expanded over the past 10 years due to the increased demand. However, at the same time, (grossly oversimplifying) a bunch of other factors in and outside of medicine started contracting the demand / per rad-onc. And policy came in as well, with CMS mandating as recently as last year that RadOncs could supervise the delivery of radiotherapy remotely, further reducing the demand for RadOncs. Job market contracted, recent grads have had a harder time finding a job, and that information has trickled down the training pipeline with this year RadOnc having a 99.9% match rate (literally only 1 person went unmatched and they applied to only the top 5 programs and got too cocky) and some programs beginning to reduce slots (in other words, responding to a perceived glut in supply).
Medicine is bizarre in that in spite of being essential to society, Medicine as a guild will always want to produce as much scarcity as possible but society needs supply to go up because healthcare is, well, essential for the functioning of society and to most thinking people something we, as a society, have a moral obligation to make accessible (this isn't just commie talk, i've been to Republican and Democratic senator's offices on Capitol Hill and they ALL want to expand healthcare access for their constituents they just disagree on who is doing the healthcare and FWIW GOP Senators seem more bullish on APPs than Dems because it's easier to find ways to increase the # of APPs in your (rural) state than MD/DOs). When you have a market that will not clear (supply must go up to meet demand, but supply is suppressed by guild behavior serving the interests of those in the guild) then something has got to give. Hence APPs. In other healthcare systems they simply trained more doctors and the distribution of doctors is more or less forced by fiat.
If we want to continue having a medical profession in this country where we command high incomes and get to practice more or less wherever we want with few caveats, we have to accept the fact that we will need to meet the demand for healthcare in other ways. If we don't want that method to be the expansion of APP practice rights, then we need to loosen our guild behavior and accept that most specialties would look more like RadOnc today than NSG in terms of their practice flexibility. If every part of this country were as desirable to live as any other, I dont think we would have much of a problem with that, but thats far from the case and its a big country. My own unsolicited opinion on this matter is make every single part of the country a desirable place to live with smart urban/rural planning and you will go farther in solving the provider distribution problem than anyone else has to date.
Last edited:
- Joined
- Nov 18, 2017
- Messages
- 879
- Reaction score
- 1,007
I just want to say that this is really well-written and thoughtful
Whoever marries you is blessed
- Joined
- Sep 12, 2010
- Messages
- 6,101
- Reaction score
- 3,089
Mid-levels in corporations bill incident to physician. People still pay the same copays, and hospitals get higher pay for them than you think.
Mid-level are fighting for pay parity everywhere. Just because it's not in other states yet doesn't mean it won't get there
- Joined
- Sep 12, 2010
- Messages
- 6,101
- Reaction score
- 3,089
They don't just replace a physician with a mid-level
They need a physician to take the fall.
Just the ratio of mid-level to Physician will increase
- Joined
- Mar 14, 2019
- Messages
- 8,428
- Reaction score
- 9,780
But, if the reimbursement rates and salaries are mandated to be the same, what is the benefit to the corporation? All things equal, who wouldn't rather have a physician?
Parity only works in locations where the provider shortage is so severe that you need the bodies. The move to mid-levels is driven by the fact that the gross margins on them (what practices bill for them less what they pay them) is greater than for physicians. Not by anyone saying they are better trained, better educated, or just plain better than physicians.
