I haven't read the other replies, as I don't want them to contaminate my opinion. 😉
First, when you compare US doctor salaries to salaries for physicians in Europe, you're not comparing apples to apples. In particular, medical education in those countries is highly subsidized. Also, primary care physicians are much better compensated (in Germany, average for a primary care doc is in the neighborhood of $125k annually, as compared to $80k-ish in the US). What you don't see abroad, are crazy lopsided scenarios where a cardiologist is pulling down $300k-$400k yearly doing unnecessary angioplasties, stents, etc. while primary care docs, OBs, etc. can barely make ends meet.
A US Primary care physician is compensated just fine. In fact if you are a primary care physician in a group practice you can easily be racking in 500k a year. 80k? Where are you getting 80k from? Furthermore in Germany physicians are making significantly less than 125k. Next, Cardiologists are doing unnecessary angioplasts? Oh just like how orthopedic surgeons are cutting off limbs because they want to make money? Cardiologists make more money because they train longer and because it's more competitive and they see more people.
The other driving force in medical care these days is the disappearance of the private practice doc or small group. More and more, doctors are taking salaried positions with medical centers and medical management companies in order to reap the benefits and security that come from having a professional management company handle all of the administrative and accounting rigamarole. Yes, they are making less money. But they're also taking on a lot less risk on an annual basis, and the start-up costs are negligible (in many situations).
Rural areas will feel the most pain. In these areas, there is insufficient demand for professional management groups to come in and do the legwork to organize and run mega-practices. And even if the demand were there, rural patients as a group have lower incomes and carry adequate health insurance at lower rates than the general population.
Rural practices can make a lot of money. I'm not sure about the stats for doctors, but for Dentists rural practices make significantly more than urban practices.
As to the general question of "would you do it" in the face of shrinking compensation, I can't help but chuckle. As a whole, we do a lousy job of compensating people who work in the caring professions. Some of the most physically and emotionally draining jobs (I'm thinking aids in nursing home or in-home caregivers for Alzheimer's patients, for example) are the poorest paid in the country. It's not unheard of for some in-home care providers to make less than minimum wage when all is said and done.
Becoming a part-time or full-time provider for someone with Alzheimer's does not require a college degree and pays very well. I was a provider for my grandmother for a long time and was paid quite nicely for basically 2-4 hours of work a day. About 12.5-15 bucks an hour and you can have up to 4 clients ( So basically about 60-80 bucks a day) . In institutional sets you need an CNA, my boyfriend's sister works in a nursing home and gets paid very nicely for a degree that took her 2 weeks to get.
A local domestic violence non-profit I've volunteered with for years has a position open that I'm well qualified for. I've applied. It's about $28k annually (plus marginal benefits) for well over 40 hours per week of work. Well, probably less, as last year staff were furloughed for several weeks. None of the perks you'd see at reputable companies. Long hours, lousy pay, and non-stop horrible stories of women getting the hell beat out of them, stalkers, emotional violence, marital rape, strangulation, and general domestic terrorism. I can't think of a job that's more emotionally demanding than that one. Everyone agrees the service provided is important, but nobody wants to give money to make sure the office can stay open. Unfortunately, the prevailing wisdom is that women trapped in abusive relationships "deserve" what they get for staying (read: being unable to leave).
Social work is compensated badly in my opinion. However the problem is that a lot of their jobs can be filled up with volunteers looking to go to psych school or medical school or just alturistic people. My friend who ran the international business club for women ( Or something like that) constantly volunteered there.
Clearly, becoming a doctor is the better deal. At least then you get the respect of people in your community. For me, the goal has always been--and will always be--to help people. One of the things I struggle with is the reality that, if I want to help people, there are dozens of great ways I can do that right NOW. Without giving up years of my life, never seeing my family, going hundreds of thousands of dollars into debt, and facing uncertainty regarding where we'd live when it comes to matching for a residency.
yup
I want to be a doctor because I believe it's the best use of my talents. Are the other things I could do? Sure. Heck, I'll bet I'd be really good at a lot of them. But deep down, I truly believe I can best put my talents to work for the greater benefit of humanity as a physician. Being the best "me" I can be dictates that I be true to myself. That means being a doctor. I'd work at a domestic violence non-profit for $28k. I'd be a doctor for a lot less than that. Even if it were completely uncompensated, I'd still strongly consider it. That's how strongly I feel about becoming a doctor.
