MD & DO In what specialties is the sky NOT falling?

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badasshairday said:
Disagree. I do many things for and on patient that are too sick for surgery or have no surgical options. Often times we invent novel procedures even in the community. Patient with chest wall hematoma and coagulopathy and with aortic dissection. Too sick forsurgery. Endovascular, don'tand to mess with a dissection to get into intercostal arteries to embolize (which nobody does embolizations than IR anyways). Hmmm how about percutaneous thrombin injection of intercostal artery to shut down bleed. acute limb ischemia, tumor embolization, trauma and gi bleeding embolizations, TIPS portal venous interventional not done by anyone else. Etc.
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vascular cant do any of that?
 
Rekt said:
Eventually someone's going to be right though.

Removing the possibility of medicare for all for the time being (which would hurt reimbursement across the board), taking a look at EM specifically things are especially grim and unlikely to recover. The past two years are the first time grads have had some difficulty with job placement, which will only get worse as these many new programs that opened recently and are still opening flood the market. We're also being directly targeted by the clowns in DC trying to cut EM reimbursement (which is going to pass this year because it's being sold as saving money for patients, but will just put more money into insurance pockets). And just today one of the largest national employers of EM docs cut salaries across the board by 4-10%, stopped paying for scribes, cut benefits, and increased the work hours needed to be considered full time. The other national employers will quickly follow suit because it's free money for them.

Saying that "everyone cries doom and gloom all the time everything will be fine" without any critical thought is how you end up in the above situation.
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I want to like this twice. Any talks of EM docs getting together and going into the urgent care game?
 
Rekt said:
Eventually someone's going to be right though.

Removing the possibility of medicare for all for the time being (which would hurt reimbursement across the board), taking a look at EM specifically things are especially grim and unlikely to recover. The past two years are the first time grads have had some difficulty with job placement, which will only get worse as these many new programs that opened recently and are still opening flood the market. We're also being directly targeted by the clowns in DC trying to cut EM reimbursement (which is going to pass this year because it's being sold as saving money for patients, but will just put more money into insurance pockets). And just today one of the largest national employers of EM docs cut salaries across the board by 4-10%, stopped paying for scribes, cut benefits, and increased the work hours needed to be considered full time. The other national employers will quickly follow suit because it's free money for them.

Saying that "everyone cries doom and gloom all the time everything will be fine" without any critical thought is how you end up in the above situation.
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You’re definitely looking too much into what I said but duly noted thanks
 
Aight since we have some soothsayers up in here, somebody tell me the top 5 safest specialties from 2025-2040 that’s not surgical subspecialties or derm?
 
Natural Killer Cell said:
Aight since we have some soothsayers up in here, somebody tell me the top 5 safest specialties from 2025-2040 that’s not surgical subspecialties or derm?
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of course I’m biased but I don’t see how hem/onc isn’t a particularly safe specialty given aging population.

New drugs
Longer treatment for previously poor outcome cancers
Near 0 ability for AI intrusion given complexity at times and highly emotional aspect of visits/disease
 
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Natural Killer Cell said:
Aight since we have some soothsayers up in here, somebody tell me the top 5 safest specialties from 2025-2040 that’s not surgical subspecialties or derm?
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1. Nanomolecular Vascular Injections
2. Gentic Embryologist - Invasive Editing
3. Combined Spinal/Bionic Limb Replacement
4. Genetic Embryologist - Non Invasive
5. Pediatrics
 
Honestly, I think the surgical field is the only area that's safe. Even dermatology is not safe. All it will take is for mid levels to get approval to run clinics without MD supervision, and just like that derm is not safe anymore.
 
Pediatrics has a lot going on in terms of tech and the possibilities surrounding genetics and perinatal medicine. Plenty of subspecialties are highly procedural and thus skill-based. On both the PC and subspecialty side, parents seem to want their children to have a pediatrician.


The residents I’ve spoken to also face a deluge of job offers after their second year.
 
9blade said:
Honestly, I think the surgical field is the only area that's safe. Even dermatology is not safe. All it will take is for mid levels to get approval to run clinics without MD supervision, and just like that derm is not safe anymore.
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lol no. Excellent example of people not knowing what derm does. Specialists of all kinds open “skin” clinics and yet derm still does fine. Everyone thinks they can do botox, suggest moisturizers, give topicals for acne and give some mild steroids for simple eczema, but when it comes to starting someone on Rituximab, cyclophosphamide etc or excising a chunk of nose/ear/face, or following a patient with cutaneous lymphoma or multiple dysplastic nevi and previous cancers, or when they suddenly get a complication from filler/laser/etc, or when someone’s skin is falling off or when a patient shows up to the ER red from head to toe, or with ulcers the size of your shoe, let’s see how comfortable mid levels and self-proclaimed skin experts are. This is not analogous to mid-levels identifying a common cold and suggesting some hot tea and rest. Even if you have AI to diagnose it (which probably won’t exist for most derm conditions), you still have to manage it which is hard considering most people have never even heard of most derm conditions.

Medical derm has been and will continue to be just fine.
 
LoGo said:
lol no. Excellent example of people not knowing what derm does. Specialists of all kinds open “skin” clinics and yet derm still does fine. Everyone thinks they can do botox, suggest moisturizers, give topicals for acne and give some mild steroids for simple eczema, but when it comes to starting someone on Rituximab, cyclophosphamide etc or excising a chunk of nose/ear/face, or following a patient with cutaneous lymphoma or multiple dysplastic nevi and previous cancers, or when they suddenly get a complication from filler/laser/etc, or when someone’s skin is falling off or when a patient shows up to the ER red from head to toe, or with ulcers the size of your shoe, let’s see how comfortable mid levels and self-proclaimed skin experts are. This is not analogous to mid-levels identifying a common cold and suggesting some hot tea and rest. Even if you have AI to diagnose it (which probably won’t exist for most derm conditions), you still have to manage it which is hard considering most people have never even heard of most derm conditions.

Medical derm has been and will continue to be just fine.
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Okay sure, people always come back with this retort for every specialty. but the question is whether derm will maintain their revenue when midlevels have shaved off all their "easy stuff".
 
LoGo said:
lol no. Excellent example of people not knowing what derm does. Specialists of all kinds open “skin” clinics and yet derm still does fine. Everyone thinks they can do botox, suggest moisturizers, give topicals for acne and give some mild steroids for simple eczema, but when it comes to starting someone on Rituximab, cyclophosphamide etc or excising a chunk of nose/ear/face, or following a patient with cutaneous lymphoma or multiple dysplastic nevi and previous cancers, or when they suddenly get a complication from filler/laser/etc, or when someone’s skin is falling off or when a patient shows up to the ER red from head to toe, or with ulcers the size of your shoe, let’s see how comfortable mid levels and self-proclaimed skin experts are. This is not analogous to mid-levels identifying a common cold and suggesting some hot tea and rest. Even if you have AI to diagnose it (which probably won’t exist for most derm conditions), you still have to manage it which is hard considering most people have never even heard of most derm conditions.

Medical derm has been and will continue to be just fine.
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No need to be condescending. If you're a derm resident, relax. I'm not attacking your field. I've shadowed dermatologists for a long time, one of my family member is a dermatologist, so I have an idea of what they do. I never claimed that there aren't complications that would need to go to a dermatologist. Using your logic, most fields in medicine should be safe because when the complication arises, the MD is the last stop to try and bail them out. I made the comment because just in my home town, there is a Derm clinic ran by a NP who does most of the stuff you described above. I shadowed her for 3 weeks(maybe not enough time to see severe complications) and every time she got stuck on something she didn't know, she would refer to a dermatologist. Of the many patients I saw during my shadowing, she referred maybe 3 patients to a dermatologist. The rest she treated on her own. The rest of these, are patients not being seen by dermatologists and thus cutting into their bottom line. You think if they gave midlevels nationwide permission to practice on their own without supervision, that more people wouldn't attempt opening up clinics and only sending out complicated/life-threatening conditions to dermatologists?

The topic of the thread is which specialty is the safest. Nobody is claiming doctors will be eliminated. Complications happen in every field, so docs will always be in business. However, midlevels will be quicker to try and take a bite out of dermatology instead of surgery. Hence my comment that surgery fields are really only the safe ones. Big cities are already starting to get saturated with dermatologists and you think increasing independent mid levels/competition won't do anything to cut into the bottom line of derm docs?
 
7331poas said:
Okay sure, people always come back with this retort for every specialty. but the question is whether derm will maintain their revenue when midlevels have shaved off all their "easy stuff".
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9blade said:
No need to be condescending. If you're a derm resident, relax. I'm not attacking your field. I've shadowed dermatologists for a long time, one of my family member is a dermatologist, so I have an idea of what they do. I never claimed that there aren't complications that would need to go to a dermatologist. Using your logic, most fields in medicine should be safe because when the complication arises, the MD is the last stop to try and bail them out. I made the comment because just in my home town, there is a Derm clinic ran by a NP who does most of the stuff you described above. I shadowed her for 3 weeks(maybe not enough time to see severe complications) and every time she got stuck on something she didn't know, she would refer to a dermatologist. Of the many patients I saw during my shadowing, she referred maybe 3 patients to a dermatologist. The rest she treated on her own. The rest of these, are patients not being seen by dermatologists and thus cutting into their bottom line. You think if they gave midlevels nationwide permission to practice on their own without supervision, that more people wouldn't attempt opening up clinics and only sending out complicated/life-threatening conditions to dermatologists?

The topic of the thread is which specialty is the safest. Nobody is claiming doctors will be eliminated. Complications happen in every field, so docs will always be in business. However, midlevels will be quicker to try and take a bite out of dermatology instead of surgery. Hence my comment that surgery fields are really only the safe ones. Big cities are already starting to get saturated with dermatologists and you think increasing independent mid levels/competition won't do anything to cut into the bottom line of derm docs?
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Sorry if I came off condescending - that was not my intent at all. The question of the thread is which specialties have the sky falling, and Derm is not one of them in my view. Derm has a few things going that make it more resilient to mid-levels. Not immune, just as most specialties, but not a “sky is falling” situation:
- practice diversity (Medical, surgical, peds, cosmetic) means large patient pool and small losses to a fraction of one area isn’t as impactful overall,
- ability to hang a sign and get patients (no necessity to rely on big employers),
- the fact that there are no diagnostic or treatment algorithms in derm (and largely based on proper training/experience) makes effective practice of non-basic stuff challenging
- The fact that there is already so much common skin disease that Derm can’t manage it all on their own anyway (mild acne, BCC, warts, mild eczema etc)
- and importantly the fact that people care about their skin (and will often choose their skin provider and actively seek out appointments).

All this makes independent practice takeover by mid-levels less likely. Yes Derm probably needs to lobby to make sure it stays that way and prevent a long, slow shift of the landscape (over next 10-20 yrs) and actively defend their turf, but the more likely scenario is more mid-levels work under a dermatologist, which doesn’t really take a job away from a dermatologist. Overall, the bigger question in derm is private equity, not mid-level encroachment. So no, the sky is not falling in derm.
 
LoGo said:
Sorry if I came off condescending - that was not my intent at all. The question of the thread is which specialties have the sky falling, and Derm is not one of them in my view. Derm has a few things going that make it more resilient to mid-levels. Not immune, just as most specialties, but not a “sky is falling” situation:
- practice diversity (Medical, surgical, peds, cosmetic) means large patient pool and small losses to a fraction of one area isn’t as impactful overall,
- ability to hang a sign and get patients (no necessity to rely on big employers),
- the fact that there are no diagnostic or treatment algorithms in derm (and largely based on proper training/experience) makes effective practice of non-basic stuff challenging
- The fact that there is already so much common skin disease that Derm can’t manage it all on their own anyway (mild acne, BCC, warts, mild eczema etc)
- and importantly the fact that people care about their skin (and will often choose their skin provider and actively seek out appointments).

All this makes independent practice takeover by mid-levels less likely. Yes Derm probably needs to lobby to make sure it stays that way and prevent a long, slow shift of the landscape (over next 10-20 yrs) and actively defend their turf, but the more likely scenario is more mid-levels work under a dermatologist, which doesn’t really take a job away from a dermatologist. Overall, the bigger question in derm is private equity, not mid-level encroachment. So no, the sky is not falling in derm.
Click to expand...

Thanks for the insight, it was very informative.
 
LoGo said:
The question of the thread is which specialties have the sky falling, and Derm is not one of them in my view. Derm has a few things going that make it more resilient to mid-levels.
Click to expand...

I will vehemently disagree with this assessment. Yes, dermatology is one of the most complex fields with a massive amount of knowledge necessary to be a competent independent dermatologist. But... like every other field in medicine, dermatology has it's bread and butter, and 95% of dermatology falls into that category. Those are the quick visits, that are relatively straightforward and pay well. The other 5% is incredibly complex and require a competent Derm MD to properly diagnose and manage. This 5% will always be there, but dermatology loses money on these cases or at best breaks even. Spending 30 minutes working up complex patients would not allow any non academic dermatologist to stay in business.

Like it or not any midlevel can cherry pick the easy cases, or even attempt the harder cases and then refer after they've harmed the patient, and just poach all low hanging fruit. Sorry, but there are nowhere near enough med-derm cases to go around and even if there were then, PA/NPs would be generating 2x the revenue of a derm MD that sees only complex med-derm.

Moral of the Story: Midlevels are terrible at dermatology and will never have the skills to be competent at managing diseases of the skin, but they will/can absolutely tank the job market. Derm is consistently one of the top 5 fields where midlevels end up. They are an enormous threat to dermatologists and more importantly patient safety.
 
LoGo said:
Sorry if I came off condescending - that was not my intent at all. The question of the thread is which specialties have the sky falling, and Derm is not one of them in my view. Derm has a few things going that make it more resilient to mid-levels. Not immune, just as most specialties, but not a “sky is falling” situation:
- practice diversity (Medical, surgical, peds, cosmetic) means large patient pool and small losses to a fraction of one area isn’t as impactful overall,
- ability to hang a sign and get patients (no necessity to rely on big employers),
- the fact that there are no diagnostic or treatment algorithms in derm (and largely based on proper training/experience) makes effective practice of non-basic stuff challenging
- The fact that there is already so much common skin disease that Derm can’t manage it all on their own anyway (mild acne, BCC, warts, mild eczema etc)
- and importantly the fact that people care about their skin (and will often choose their skin provider and actively seek out appointments).

All this makes independent practice takeover by mid-levels less likely. Yes Derm probably needs to lobby to make sure it stays that way and prevent a long, slow shift of the landscape (over next 10-20 yrs) and actively defend their turf, but the more likely scenario is more mid-levels work under a dermatologist, which doesn’t really take a job away from a dermatologist. Overall, the bigger question in derm is private equity, not mid-level encroachment. So no, the sky is not falling in derm.
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ok. I see your point and where you're coming from. I appreciate the informative post
 
Rekt said:
Eventually someone's going to be right though.

Removing the possibility of medicare for all for the time being (which would hurt reimbursement across the board), taking a look at EM specifically things are especially grim and unlikely to recover. The past two years are the first time grads have had some difficulty with job placement, which will only get worse as these many new programs that opened recently and are still opening flood the market. We're also being directly targeted by the clowns in DC trying to cut EM reimbursement (which is going to pass this year because it's being sold as saving money for patients, but will just put more money into insurance pockets). And just today one of the largest national employers of EM docs cut salaries across the board by 4-10%, stopped paying for scribes, cut benefits, and increased the work hours needed to be considered full time. The other national employers will quickly follow suit because it's free money for them.

Saying that "everyone cries doom and gloom all the time everything will be fine" without any critical thought is how you end up in the above situation.
Click to expand...

We all saw the EM bubble bursting eventually. Seems like whenever something is “hot” it becomes saturated and falls down to earth.
 
I’ve been following this for a while and will just say this. I came from a prior career where everyone thought the sky was falling, and to some extent it did - industry contraction, stagnant salaries, realignment, etc.

But here is the thing with our world. Medicine is an inelastic commodity. People are always going to need care and from all various specialties. Doctors in their 50s+ paid a lower adjusted cost for med school and had proportionally higher salaries. The sky they see falling is different from new grads. Eventually, due to our growing debt and potentially lower salaries, there will come an inflection point. I have no idea how this all shapes up in the end, but we can’t look at our fathers medical careers and thing our will look anything like that.
 
tradkeke said:
Hearing attendings talk, going on the sub-specialty forums here, and listening to other medical students about literally almost every specialty, everyone has a doom and gloom outlook (take a look at the recent EM forum posts).

Is there any specialty where everyone isn't dreading the future?
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Ophtho. Optometrist encroachment is real, but honestly? After doing 20+ cataracts I dont even WANT to do lasers and would gladly give them to one of my optoms (I dont, and will continue to do them, just making the point). The number of newly graduated ophthos has flatlined the last few years, but older ophthos are retiring at a much faster rate, especially the way reimbursements has been trending. The key to that, obviously, is that this specialty also provides extra income avenues through laser cataract surgery and premium lenses, as well as lasik, and will only continue to get busier as the next generation hits their 60s-70s. There will be more cataracts than physicians available to do them at some point. So if you dont mind being busy and employ all of the advanced refractive options, or specialize in retina, you will be all set.
 
There's not much doom and gloom in peds. We already have low salaries due to largely medicaid reimbursement, but peds is a very happy group of folks. Upper level residents get lots of job offers, and if you do a fellowship, you can call and get a job most places save for very few subspecialties.
 
CidHighwind said:
We all saw the EM bubble bursting eventually. Seems like whenever something is “hot” it becomes saturated and falls down to earth.
Click to expand...

What made you think EM was a bubble vs just a good paying gig? Does the same hold true for "hot" surgical specialties?
 
Funke said:
There's not much doom and gloom in peds. We already have low salaries due to largely medicaid reimbursement, but peds is a very happy group of folks. Upper level residents get lots of job offers, and if you do a fellowship, you can call and get a job most places save for very few subspecialties.
Click to expand...

Fake news. Peds is the only specialty that requires you to do a fellowship to practice peds hospitalist medicine.
 
Gilakend said:
What made you think EM was a bubble vs just a good paying gig? Does the same hold true for "hot" surgical specialties?
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It's residency expansion + the corporate takeovers + the glut of midlevels.

The surgical subs don't have these issues, as far as I know...for now. Let's just hope it stays that way.
 
slowthai said:
It's residency expansion + the corporate takeovers + the glut of midlevels.

The surgical subs don't have these issues, as far as I know...for now. Let's just hope it stays that way.
Click to expand...

You can trace when EM got competitive by that one thread where all the attendings were posting that they were making 300+ an hour. Before that it was essentially FM/IM in competitiveness
 
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slowthai said:
It's residency expansion + the corporate takeovers + the glut of midlevels.

The surgical subs don't have these issues, as far as I know...for now. Let's just hope it stays that way.
Click to expand...

Guess what? Every future mid level providers in school are gunning for Derm, Psych, and sub surgical specialties in school now. Game theory dictates a mass hiring of these PAs and NPs in these field to make as cash as possible before the fields crash in 10-15 years.

As a sole provider, you can fight the good fight but will yield to temptation when your buddy next door is making an extra 300-400K per year off the backs of mid level providers.

Those same docs will train these NPs and PAs in order to increase yield.
 
Gilakend said:
What made you think EM was a bubble vs just a good paying gig? Does the same hold true for "hot" surgical specialties?
Click to expand...

EM is still a giant bubble. It will pop once we decentivize the use of emergency medicine and incentivize the use of primary care. As of right now many are using the emergency department without financial repercussions and it won't happen forever. I can promise you one thing and it is that emergency physicians aren't making the majority of their money from people with private insurance.
 
Epilepsy365 said:
Guess what? Every future mid level providers in school are gunning for Derm, Psych, and sub surgical specialties in school now. Game theory dictates a mass hiring of these PAs and NPs in these field to make as cash as possible before the fields crash in 10-15 years.

As a sole provider, you can fight the good fight but will yield to temptation when your buddy next door is making an extra 300-400K per year off the backs of mid level providers.

Those same docs will train these NPs and PAs in order to increase yield.
Click to expand...

When I referred to midlevels, I was really talking about their ability to actively compete with/"replace" physicians in their respective fields. EM and psych are prone to it because of the way the fields appear to lend themselves to algorithmic approaches. Same with derm. Midlevels are actually competing with dermatologists now. But the barrier of entry is astronomical for surgical fields and radiology, for obvious reasons.

For the record, I have a huge problem with midlevels practicing independently in any field, from family medicine to neurosurgery. It's completely and totally unacceptable. I promise you, these people will not accept anyone but a board certified cardiothoracic surgeon for their CABG. That "outcomes are equivalent" nonsense goes straight out the window when it's their lives on the line. Accepting unsupervised midlevel practice in primary care minimizes and discounts the training of the physicians that practice primary care. It's sickening. The minimum standard for patient care is determined by physicians, end of story. Not midlevels, not administrators, not politicians.
 
slowthai said:
When I referred to midlevels, I was really talking about their ability to actively compete with/"replace" physicians in their respective fields. EM and psych are prone to it because of the way the fields appear to lend themselves to algorithmic approaches. Same with derm. Midlevels are actually competing with dermatologists now. But the barrier of entry is astronomical for surgical fields and radiology, for obvious reasons.

For the record, I have a huge problem with midlevels practicing independently in any field, from family medicine to neurosurgery. It's completely and totally unacceptable. I promise you, these people will not accept anyone but a board certified cardiothoracic surgeon for their CABG. That "outcomes are equivalent" nonsense goes straight out the window when it's their lives on the line. Accepting unsupervised midlevel practice in primary care minimizes and discounts the training of the physicians that practice primary care. It's sickening. The minimum standard for patient care is determined by physicians, end of story. Not midlevels, not administrators, not politicians.
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Well said, and I totally agree about the encroachment of midlevel's in emergency medicine. I see it in the ED where I work currently. During the day we have NP's and PA's who run our express area (3S,4,5) but will routinely pick up a 3H patient. They sign up for patients working under a physician, but the care is completely unsupervised. Overnight shifts are a completely different ball game where our NP's and PA's pick up patients with ANY acuity level and care for patients completely unsupervised. The only patients that the overnight physician will take responsibility for are the patients that code.
 
ChiTownBHawks said:
My fourth year EM rotation was like that. The amount of medical stupidity I saw first hand was jaw dropping. Things an MS2 right before step 1 wouldn’t even do: blatantly incorrect diagnosis, bizarre comments stated to patients that made no medical sense whatsoever, handing out abx like candy for literally no reason at all, imaging like you got a kick-back for it. It was totally nuts.

It’s still mind-blowing when I think about it. We are in for a real **** storm as abx resistance is about to be in full effect once these *****s gain complete independence
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Ha, its cute you think they're the problem.
 
Newyear said:
EM is still a giant bubble. It will pop once we decentivize the use of emergency medicine and incentivize the use of primary care. As of right now many are using the emergency department without financial repercussions and it won't happen forever. I can promise you one thing and it is that emergency physicians aren't making the majority of their money from people with private insurance.
Click to expand...

People always talk about the amount of primary care BS that occurs in the ED, but I never realized how bad it was until rotating there for the last week. I say out of 50 patients I saw, only 8 needed to be there. The patients who come in with non-emergent complaints never get a full work-up either, so they leave just as clueless and no better off than as they came in.
 
Guys, just look at this:


Makes me just wanna

ezgif-1-24c62b5f2960.gif
 
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The_Bird said:
Pediatrics has a lot going on in terms of tech and the possibilities surrounding genetics and perinatal medicine. Plenty of subspecialties are highly procedural and thus skill-based. On both the PC and subspecialty side, parents seem to want their children to have a pediatrician.


The residents I’ve spoken to also face a deluge of job offers after their second year.
Click to expand...

How much does Peds make on average nowadays?
 
MGMA has general peds at 250k, academic at 160-220k depending on level.
 
BoneWizard said:
MGMA has general peds at 250k, academic at 160-220k depending on level.
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MGMA is definitely on the inflated side. From what I understand it is mostly for hospital-employed physicians, and also includes benefits. It probably includes a disproportionate amount of pediatric hospitalists, which now require a ridiculous fellowship.
 
ace_inhibitor111 said:
MGMA is definitely on the inflated side. From what I understand it is mostly for hospital-employed physicians, and also includes benefits. It probably includes a disproportionate amount of pediatric hospitalists, which now require a ridiculous fellowship.
Click to expand...
That information is pretty accurate for Peds, most people are easily finding offers for 200-250k 100% outpatient. If you're making under 200k even in peds, then you are doing something very very wrong or you're in academics or only working part time. Also the academic rates (~150-200k) also seem about right at least based on my school and a few others. I think those numbers are more or less accurate
 
ace_inhibitor111 said:
MGMA is definitely on the inflated side. From what I understand it is mostly for hospital-employed physicians, and also includes benefits. It probably includes a disproportionate amount of pediatric hospitalists, which now require a ridiculous fellowship.
Click to expand...
This was for general peds. The subspecialties range from $250-400k.
I don't think just considering salary is a good measure of what a specialty pays. I'd rather have a 200k/yr job with 20 weeks of vacation than a $150/hr job with no benefits.
 
BoneWizard said:
This was for general peds. The subspecialties range from $250-400k.
I don't think just considering salary is a good measure of what a specialty pays. I'd rather have a 200k/yr job with 20 weeks of vacation than a $150/hr job with no benefits.
Click to expand...

200k job with 20 weeks off is a $150/hr job.
 
Rekt said:
Eventually someone's going to be right though.

Removing the possibility of medicare for all for the time being (which would hurt reimbursement across the board), taking a look at EM specifically things are especially grim and unlikely to recover. The past two years are the first time grads have had some difficulty with job placement, which will only get worse as these many new programs that opened recently and are still opening flood the market. We're also being directly targeted by the clowns in DC trying to cut EM reimbursement (which is going to pass this year because it's being sold as saving money for patients, but will just put more money into insurance pockets). And just today one of the largest national employers of EM docs cut salaries across the board by 4-10%, stopped paying for scribes, cut benefits, and increased the work hours needed to be considered full time. The other national employers will quickly follow suit because it's free money for them.

Saying that "everyone cries doom and gloom all the time everything will be fine" without any critical thought is how you end up in the above situation.
Click to expand...

Every specialty that hits hard times turns around in 5-10 years.
 
Newyear said:
EM is still a giant bubble. It will pop once we decentivize the use of emergency medicine and incentivize the use of primary care. As of right now many are using the emergency department without financial repercussions and it won't happen forever. I can promise you one thing and it is that emergency physicians aren't making the majority of their money from people with private insurance.
Click to expand...

You really overestimate the American people’s ability to plan and think ahead. People who can’t get their s*** together enough to hold a job or own a car could care less about financial incentives.
 
ace_inhibitor111 said:
MGMA is definitely on the inflated side. From what I understand it is mostly for hospital-employed physicians, and also includes benefits. It probably includes a disproportionate amount of pediatric hospitalists, which now require a ridiculous fellowship.
Click to expand...

Mgma is not inflated. It’s the largest dataset used to negotiate contracts every day.
 
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IM-esque specialties for people who like the medicine in IM, but not necessarily the practice?
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