If docs salaries were capped would you still be one?

Sanctuary

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An interesting question that I'm sure would make for some lively debate:

In Canada, all physicians, with rare exceptions, have their salaries capped at a certain dollar amount per year, period. My question to you guys is:
What if physician salaries in the US were capped -OR- if there was just one national health care system that paid an across-the-board rate to physicians for their services on a yearly basis (essentially being a 'cap' as well). Would you still pursue medicine? Let's assume the cap is at $95,000.00 but will increase with the rate of standard inflation.
 

tacrum43

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Of course I would. The extra money is nice, but $95,000 is enough to live well in most areas. There are others careers that are a lot easier and you can make a lot more money. I think (hope) that most doctors don't go into medicine for the money. However, I have heard that there has been a trend of Canadian MDs moving south to find a better paycheck.
 
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melimi

i def would
i dont think docs make that much money right now anyways (due to malpractice + debt)
plus........ the only thing i plan on def doing with "all that" money is buying a hummer, and 95k/year would be enough
 

superdevil

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Sanctuary said:
An interesting question that I'm sure would make for some lively debate:
no it won't. everyone on SDN will say they'd be a doctor even if they were paid in shoestrings and toenail clippings. (j/k)

Originally Posted by Sanctuary
In Canada, all physicians, with rare exceptions, have their salaries capped at a certain dollar amount per year, period
are you sure about this? my friend's mom is a psychiatrist in quebec and i thought that they made money up to a certain point, and then they were taxed ~double for every dollar earned after the threshold. i didn't think there was a hard "cap". i could be wrong, though.

now, for my opinion....(drumroll, please)...no. i wouldn't. i don't believe in salary capping. if i work 40 hours per week, i expect to be paid for 40 hours work. if i work 80 hours the next week, i would expect to be paid twice my 40 hour salary. if that's unethical or not warm and fuzzy, i don't care. each man or woman should be paid according to the work they do. salary caps might work in karl marx's dream society, but i guess i just wouldn't fit in his utopia.

by the way, my post has nothing to do with the 95k figure you used. i realize that's an excellent salary, i'm just against the principle of salary-capping in general.
 

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I still would. But isn't it also much cheaper to go to med school in Canada so that they don't come out with nearly as much debt as we do?
 

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Sanctuary said:
An interesting question that I'm sure would make for some lively debate:

In Canada, all physicians, with rare exceptions, have their salaries capped at a certain dollar amount per year, period. My question to you guys is:
What if physician salaries in the US were capped -OR- if there was just one national health care system that paid an across-the-board rate to physicians for their services on a yearly basis (essentially being a 'cap' as well). Would you still pursue medicine? Let's assume the cap is at $95,000.00 but will increase with the rate of standard inflation.
Yup. I'd do it for free if my living expenses and loans were paid for.
 

Ross434

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Sanctuary said:
An interesting question that I'm sure would make for some lively debate:

In Canada, all physicians, with rare exceptions, have their salaries capped at a certain dollar amount per year, period. My question to you guys is:
What if physician salaries in the US were capped -OR- if there was just one national health care system that paid an across-the-board rate to physicians for their services on a yearly basis (essentially being a 'cap' as well). Would you still pursue medicine? Let's assume the cap is at $95,000.00 but will increase with the rate of standard inflation.

Nah, I wouldnt go into any career if the salary was "capped". especially one as entrepreneurial as medicine. How can you limit somebody's own business practice? Thats a lot more unethical than doctors wanting to make money.

On the other hand, if 95k was an average, and there was no cap, and med school was cheaper, i'd probably go for it, simply because, there'd be a heck of a lot fewer applicants, meaning it'd be a lot easier to go for the coolest specialty.
 

typeB-md

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i would still go to medical school but after that... "i'm out!!"
 

Blake

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Ross434 said:
On the other hand, if 95k was an average, and there was no cap, and med school was cheaper, i'd probably go for it, simply because, there'd be a heck of a lot fewer applicants, meaning it'd be a lot easier to go for the coolest specialty.
There's no ''coolest'' specialty, but I see what you're saying.
 

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I'm so young right now that I can't really answer your question. I'm mainly just concerned about becoming a doctor, all other priorities ascending.
 

JAMMAN

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Sanctuary said:
An interesting question that I'm sure would make for some lively debate:

In Canada, all physicians, with rare exceptions, have their salaries capped at a certain dollar amount per year, period. My question to you guys is:
What if physician salaries in the US were capped -OR- if there was just one national health care system that paid an across-the-board rate to physicians for their services on a yearly basis (essentially being a 'cap' as well). Would you still pursue medicine? Let's assume the cap is at $95,000.00 but will increase with the rate of standard inflation.
If my hours were capped at 20/wk sure.... ;)
 

Kazema

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I would, but only if tuition/living expenses during med school were paid for.

But then, the specialties I'm looking at don't really have the 50-60 hour work weeks or the earnings potential that other specialties do. Or the 8 year residencies. And I'm looking to live in cities that don't really have high cost of living.

Would I accept a salary cap as a psychiatrist in Pittsburgh? Yes.

Would I accept a salary cap as a neurosurgeon in New York City? No way.
 

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If I was going to be saddled with almost 200K in debt because of medical school, I wouldn't even dream about going to medical school in hopes of earning 95K. It just isn't worth the time or trouble.

I know a lot of people are saying how they love medicine and it's their calling but honestly, I doubt their sincerity. There's nothing wrong with being properly compensated in a field that demands so much. The amount of training that all physicians go through with little pay early on is insane compared to other professions.

Money is good.
 

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Blake said:
There's no ''coolest'' specialty, but I see what you're saying.
I mean go for the specialties that i think are coolest, but which are hardest to get into mostly because they pay so well, like interventional card, ct surg, ortho surg.. I get the feeling that if every specialty made the same amount of money, people would be going more into lifestyle specialties than ever before. could anyone say peds, psych, derm?
 

carn311

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Originally I would have selflessly said: Yes its worth it! but now since I got married I've changed my tune.

Education is an investment. I have a wife and someday I'll have kids to support. I have an obligation to invest our money wisely in any career I choose.

just my 2 cents
 

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If med school was cheaper, I would prob still be a doc for $95k...still a good salary, decent living, a prestigious career, and (cliche time) you're still helping people
 

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Considering my desire to be a physician was never motivated by money, the answer is "of course, it wouldn't affect me one bit." :)
 

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melimi said:
the only thing i plan on def doing with "all that" money is buying a hummer, and 95k/year would be enough
a hummer is the ugliest car i've ever seen and is purely a prestige symbol b/c it's not even a good car...could neve runderstand why anyone would ever want to own one :thumbdown: :barf:
 

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melimi said:
gwahhh??? i've never had a car, i really want an H2
I'm with you on this one. There is NOTHING wrong with wanting nice things and doing the work necessary to get them. Granted, if that's the only thing that drives you, there may be a problem. I hate how this board makes it so taboo to ever want more than bare necessities. Lifestyle inevitably is a certain part of the equation, it just shouldn't be all there is. Nothing melimi said leads me to believe she [?] is entirely superficial...
 

Blue Scrub

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SitraAchra said:
I'm with you on this one. There is NOTHING wrong with wanting nice things and doing the work necessary to get them. Granted, if that's the only thing that drives you, there may be a problem. I hate how this board makes it so taboo to ever want more than bare necessities. Lifestyle inevitably is a certain part of the equation, it just shouldn't be all there is. Nothing melimi said leads me to believe she [?] is entirely superficial...
I agree...just ask med students and residents...many of them came in all idealistic, having that "I want to save the world" mentality...that changes with time...people have families they want as well...you're going to be working hard, and why is it wrong to want to buy nice things if you've worked hard for it? Yes, we all want to be doctors to help people, but we're not all Mother Theresa...having a family and living a comfortable life are things we should not be ashamed of wanting, we're only human in the end...if you want to do good for people solely for doing good, and thats it, perhaps medicine isnt the profession for you? Peace corp perhaps??
 

virilep

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this is kinda like askin would u join the military? the military salaries are somewhat "capped" or rather severly limited. I know there is a love for the game. but honestly, putting all the hard work into and not being paid well enough for it probably wouldn't cut it for me. I'd rather make tons of money in business and open up clinics the clinics wouldn't have to make much money, but if the caps were there, I'd find a way to reach my goal- improve patient health.
 

CarleneM

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that's a tough question. i think the cap would have to be more at around 175,000. the other number is just too low given the years of expensive training. Also, money is a factor for me in choosing this career. I picked med school for psychiatry over grad school in clinical psych for many reasons but one of the reasons was money. i'm not ashamed to admit that. i have an addiction to expensive clothing and living spaces and need a career that enables my addictions...
 

tacrum43

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Blue Scrub said:
I agree...just ask med students and residents...many of them came in all idealistic, having that "I want to save the world" mentality...that changes with time...people have families they want as well...you're going to be working hard, and why is it wrong to want to buy nice things if you've worked hard for it? Yes, we all want to be doctors to help people, but we're not all Mother Theresa...having a family and living a comfortable life are things we should not be ashamed of wanting, we're only human in the end...if you want to do good for people solely for doing good, and thats it, perhaps medicine isnt the profession for you? Peace corp perhaps??
Like I said before, money was not my primary reason when choosing to pursue medical school. However, it was a reason. I go back and forth on whether it's okay to indulge in a nice house and car (I really want an oceanfront house and a BMW someday), or to live more modestly and give the difference to charity. I mean, sure I would like to have nice stuff, but I don't need it and there are so many people in the world that don't have anything and don't have anyway to earn it either. I feel selfish for wanting nice things, even if I work hard and earn them, because in affect I would be denying someone else the basics. I look at people like Mother Theresa and I wonder: how do they do it? How do you completely detach yourself from everything material? I feel like I'm less of a person and less of a Christian for wanting things that I don't really need. Maybe I'm being too much of a Puritan. :confused:
 

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Yes I would, under the following conditions:

- 8 weeks of vacation per year
- 30 hour work week (anything over that would be OT at ~$300/hour)
- Student loans are forgiven
- Pay increases are tied to the percentage increases that Congress members get, not this COLA crap that social security people get screwed over with.

Outside of that, no way. Having a decent lifestyle is one of the reasons I chose medicine and I'm not ashamed of that. I even mentioned that at one of my interviews. Apparently it wasn't that big of a deal, as I got an acceptance from them.
 

superdevil

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i just want to commend everybod who's posted on this page who have had the balls to say that they want to get paid (Code Brown, CarleneM, Blue Scrub, SitraAchra, etc). SDN always seems to imply that making money is in direct (or even indirect) opposition to altruism. i want to make money. i want to have a large family and send my kids to whatever colleges they want to go to. i want my wife to drive whatever kind of car she likes (ok, no hummer, though--8 miles per gallon is just silly). and i want to help people while i acheive these goals.

and i welcome those who say they can live without the money to give the rest away. ;) to each his/her own. :cool:
 

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no way, if they capped my salary I'd never want to be a MD. It's like saying would you buy beer without alcohol? Can I get a HELL NO
 

relema

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If I had to go through that much school and come out that much in debt to get a capped salary I think I would think twice about getting my MD. If they paid for part or all of school then capped the salary then i would still get my MD.
 

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Criteria:

1) Reduced debt loads that I could pay off on a capped salary. I have to agree with those who say they want a decent standard of living. I want a clean family-sized house, not 3 kids to one room like when my mother was a resident. I want my kids to walk out of their undergraduate institutions like me: debt free. For my own happiness, I desperately wish to be a physican. But I would not walk away from a lucrative engineering career to take on a debt load that would eliminate my future children's college education.

2) tied to national primary healthcare -i.e. nationwide emphasis on preventative medicine. None of my college educated friends can afford both rent and health insurance. I only have insurance because I am a hospital employee. This is not a workable system.
 

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I say we get Goodenow to negotiate for us and never accept the idea of a salary cap!
 

gbiz

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Those rich hospital owners wouldnt be paying us that much if they couldnt afford it!
 

supadupadoc

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:cool: thought i'd clear up a few misconceptions here......

ok so i grew up in ontario (province not a state for you americans) and my parents are both physicians there.

yes there are caps in SOME areas (ie. in toronto, not in some of the outerlying areas). caps are NOT 95 000 for god sakes they are way higher. for example, my mother's cap (a g.p.) is approx 400,000 ....... she would have to work incessently to ever reach that cap. yes, for specialists the caps are more of an issue, but they are still very high (in ontario)

also, in regards to what someone mentioned about "it'll be easier to get into med school b/c less competition b/c of caps etc"..... way off. canadian schools, especially ontario ones, are extremely competitive, i'm talking a 3.7 gpa just to get an interview........ regardless of whether you cured world hunger on the side. ontario schools are regarded as some of the best in the world.

on top of all this, you don't get sued on a regular basis, and you don't have to deal with insurance companies, hmo's etc etc. and you get to feel good because u never turn away a patient because they can't afford to pay. and of course, because of universal health care, your patient population has better compliance and is easier to manage long-term.

if salary "caps" (seriously nowhere near what u guys are quoting) in the US meant we could have a system like canada's (or evey industrialized nations' other than the US for that matter)..... oh yeah and 40% LESS COST PER CAPITA(btwn Canada and US), i'd take it anyday.

p.s. ok so at least a dozen ppl are going to be like "so why don't you go back then??" and the short and sweet answer is that my fiancee is american, there is little scope for his career field in canada, and hey, i live in southern california now, which is a little more canadian than most of the country.

don't get up in arms all you pro-americans! yes there are a lot of great things about america and about americans. but this health care system sucks a LOT. don't believe all the propaganda the AMA and pharm inc spews about the perils of "socialized medicine"
 

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There is actually a decent chance my gf and I will end up in Canada ;) Its not too far from home though, Detroit. But we both think we'd be happier there, or Cali, mainly political reasons.
 

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supadupadoc said:
:cool: thought i'd clear up a few misconceptions here......

ok so i grew up in ontario (province not a state for you americans) and my parents are both physicians there.

yes there are caps in SOME areas (ie. in toronto, not in some of the outerlying areas). caps are NOT 95 000 for god sakes they are way higher. for example, my mother's cap (a g.p.) is approx 400,000 ....... she would have to work incessently to ever reach that cap. yes, for specialists the caps are more of an issue, but they are still very high (in ontario)

also, in regards to what someone mentioned about "it'll be easier to get into med school b/c less competition b/c of caps etc"..... way off. canadian schools, especially ontario ones, are extremely competitive, i'm talking a 3.7 gpa just to get an interview........ regardless of whether you cured world hunger on the side. ontario schools are regarded as some of the best in the world.

on top of all this, you don't get sued on a regular basis, and you don't have to deal with insurance companies, hmo's etc etc. and you get to feel good because u never turn away a patient because they can't afford to pay. and of course, because of universal health care, your patient population has better compliance and is easier to manage long-term.

if salary "caps" (seriously nowhere near what u guys are quoting) in the US meant we could have a system like canada's (or evey industrialized nations' other than the US for that matter)..... oh yeah and 40% LESS COST PER CAPITA(btwn Canada and US), i'd take it anyday.

p.s. ok so at least a dozen ppl are going to be like "so why don't you go back then??" and the short and sweet answer is that my fiancee is american, there is little scope for his career field in canada, and hey, i live in southern california now, which is a little more canadian than most of the country.

don't get up in arms all you pro-americans! yes there are a lot of great things about america and about americans. but this health care system sucks a LOT. don't believe all the propaganda the AMA and pharm inc spews about the perils of "socialized medicine"
amen.
oh yeah, I'm an American, and I would work as a physician if there was a $95,000 cap. Most people that live on this planet right now never reach that kind of salary no matter how hard they work.
 
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Sanctuary

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supadupadoc said:
:cool: thought i'd clear up a few misconceptions here......

ok so i grew up in ontario (province not a state for you americans) and my parents are both physicians there.

yes there are caps in SOME areas (ie. in toronto, not in some of the outerlying areas). caps are NOT 95 000 for god sakes they are way higher. for example, my mother's cap (a g.p.) is approx 400,000 ....... she would have to work incessently to ever reach that cap. yes, for specialists the caps are more of an issue, but they are still very high (in ontario)
Good insignt on Canada, Sup. The original post was just a hypothetical scenario with a figure pulled outta thin air. :) I must definitely agree with you. The Canadian, as well as most European health care systems, works great, however I highly doubt that system will surface in the US anytime soon..
 

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I would if their were no loans to be repaid.
 

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supadupadoc said:
:cool: thought i'd clear up a few misconceptions here......

ok so i grew up in ontario (province not a state for you americans) and my parents are both physicians there.

yes there are caps in SOME areas (ie. in toronto, not in some of the outerlying areas). caps are NOT 95 000 for god sakes they are way higher. for example, my mother's cap (a g.p.) is approx 400,000 ....... she would have to work incessently to ever reach that cap. yes, for specialists the caps are more of an issue, but they are still very high (in ontario)

also, in regards to what someone mentioned about "it'll be easier to get into med school b/c less competition b/c of caps etc"..... way off. canadian schools, especially ontario ones, are extremely competitive, i'm talking a 3.7 gpa just to get an interview........ regardless of whether you cured world hunger on the side. ontario schools are regarded as some of the best in the world.

on top of all this, you don't get sued on a regular basis, and you don't have to deal with insurance companies, hmo's etc etc. and you get to feel good because u never turn away a patient because they can't afford to pay. and of course, because of universal health care, your patient population has better compliance and is easier to manage long-term.

if salary "caps" (seriously nowhere near what u guys are quoting) in the US meant we could have a system like canada's (or evey industrialized nations' other than the US for that matter)..... oh yeah and 40% LESS COST PER CAPITA(btwn Canada and US), i'd take it anyday.

p.s. ok so at least a dozen ppl are going to be like "so why don't you go back then??" and the short and sweet answer is that my fiancee is american, there is little scope for his career field in canada, and hey, i live in southern california now, which is a little more canadian than most of the country.

don't get up in arms all you pro-americans! yes there are a lot of great things about america and about americans. but this health care system sucks a LOT. don't believe all the propaganda the AMA and pharm inc spews about the perils of "socialized medicine"
I could deal with salary caps and plan to make salary caps a reality.

Salary caps are really known as global budgets and capacitation payments. In a global budget system, the hospital recieves a yearly budget it needs to remain within. It is a cost control method. In capacitation system, you recieve money per patient, not per procedure, so you are never pressured to preform needless procedures.

Overall, this Topic is like a black hole, there are so many things that could be discussed.

If we were to get rid of the needless administration in the United states we could save 30-40% of what health care costs presently. Privitization makes us use enumerable different insurance agencies which in turn neccisitate, enumerable individuals managing the different agencies accounts. The arguments could go on and on...
 

AStudent

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I know EVERYONE on SDN wants to say "of course I would" but the reason I chose medicine was fivefold.

1) To have autonomy and freedom to care for patients
2) To develop relationships with patients
3) To be apart of a well respected profession
4) Job security
5) Well paid (even though not as lucrative as in past years, it's still well above average)

That being said I don't know if I'm willing to spend another 8 years in school and work 60-80 hours per week for peanuts...I'll have kids to feed.
 

NotShorty

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If MCAT scores were capped at 27, would you work hard enough for a 30+?

If grade point averages were capped at 3.5, would you put forth a 4.0 effort?

I could make more examples if you like, but bottom line is that it's never a good idea to have a glass ceiling put above you.

As long as you live in America, you live in a capitalistic society. The opposite of capitalism, ironically, is a salary cap. You may have also heard of its cousin; Communism. We all know that Communism is bad, right? :) :thumbup:

It's nice to say that as a doctor you will always provide above and beyond what is required of you, but in a few years you'll start to realize (maybe to your dismay) how much your motivation and outlook on life is tied to your income.

It's human nature, and it's inescapable. If you put a limit to how much doctors can make in America, quite simply, a lot of the good doctors will leave America.

Bad idea, bad idea, BAD IDEA!!! :thumbdown: :smuggrin:
 

AStudent

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Unless you're a woman, then you don't have a choice.

:thumbdown:

NotShorty said:
it's never a good idea to have a glass ceiling put above you.
 

LVDoc

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A $95,000 cap is not enough income to be making after four years of medical school and 3+ years of residency training. I understand that many have motivations to enter medicine as a selfless act, but I know that I would like to have enough financial stability to be able to take care of my family and provide them with good accomodations in terms of living, transportation, education, etc. That kind of a cap is simply not enough for me to realistically carry on with my plans, especially if you consider debt, mortage expenses, etc. If that were the case, I don't know what profession I would ultimately choose, but I can say that there are easier ways to make money and have a comfortable lifestyle than having to slave away on call for more than day's time straight. I would probably get an MBA and become a stock broker afterwards, as well as invest in real estate on the side.
 

Scarletbegonias

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NotShorty said:
If MCAT scores were capped at 27, would you work hard enough for a 30+?

If grade point averages were capped at 3.5, would you put forth a 4.0 effort?

I could make more examples if you like, but bottom line is that it's never a good idea to have a glass ceiling put above you.]

Do you know/understand the difference between intrinsic and extrinsic motivation?

Or the difference between communism and socialism?
 

Law2Doc

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NotShorty said:
It's nice to say that as a doctor you will always provide above and beyond what is required of you, but in a few years you'll start to realize (maybe to your dismay) how much your motivation and outlook on life is tied to your income.
Actually you may realize the opposite. I thought exactly like you when I was coming out of college -- that it was unrealistic to think that your motivation and outlook would not be tied to your income. Funny thing was, after a "few years" of a very nice income, I realized that there was much more to career (and life) satisfaction than a high salary. If you look at the nontraditional board, you will see numerous posts of career changers with high salaries leaving their jobs to find more satisfying, more intellectual, more value-adding pursuits in medicine...
 

stoic

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LVDoc said:
A $95,000 cap is not enough income to be making after four years of medical school and 3+ years of residency training. I understand that many have motivations to enter medicine as a selfless act, but I know that I would like to have enough financial stability to be able to take care of my family and provide them with good accomodations in terms of living, transportation, education, etc. That kind of a cap is simply not enough for me to realistically carry on with my plans, especially if you consider debt, mortage expenses, etc. If that were the case, I don't know what profession I would ultimately choose, but I can say that there are easier ways to make money and have a comfortable lifestyle than having to slave away on call for more than day's time straight. I would probably get an MBA and become a stock broker afterwards, as well as invest in real estate on the side (the latter of which I plan to do anyway).
i don't know what sort of lifestyle you're used to living, but if you can't live comfortabley on 95k a year, then that's pretty sad.
 

SOUNDMAN

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I think a lot of people are missing the point. The point is NOT the money or even the amount in my opinion. It's the CAP! Let's face it in the US medicine is a fee for service arrangement. The more you work the, better you are at your job, the more you are rewarded. Why would you cap how hard a person can work? It's what's made this country great.
 

Dr_Amr

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hi there ,

I think the point is not the money, the point is that who decides to go into this profession must like it so much ,

talking about money , do u guys know how much a recenlty-graduated doctor get paid per year in my country (egypt) ?


would you believe it's only 360$ ? :eek:

yea , u read the number , it's written correctly !


and we are still doctors :love:
 

Ross434

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Dr_Amr said:
hi there ,

I think the point is not the money, the point is that who decides to go into this profession must like it so much ,

talking about money , do u guys know how much a recenlty-graduated doctor get paid per year in my country (egypt) ?


would you believe it's only 360$ ? :eek:

yea , u read the number , it's written correctly !


and we are still doctors :love:
Yeah, on a similar note, i know a commercial airline pilot in Dubai who makes $8,000/year (full time). However, thats not including the free aston martin, chaffeur, maids, villa, and college ed for his kids.