Limiting physician salary

[SpecterGT260]

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Lets just go with lab tech. 4 year undergrad... what do you think average UG debt is? Well, it doesnt matter because college grads and med students will have the same UG debt. So it is not difficult to make 40k out of college. Let's call it 35 for good measure, with it capping at 60k after 10 years. Is that fair and reasonable?

So starting at graduation, our lab tech makes 47.5k/year for 5 years, then 60 from then on (is that a fair assumption? some years are below 47.5, some above, but over 10 years that is the average salary.


The medical student, over 10 years, accrews 250k in debt, which normally translates into 400k after interest is counted, and then works at about 55k for.... 4 years, on average? The true average is probably between 3.5 and 4 including all residency types. Then goes on to make 200k, to keep things simple.

In this model, it takes 10 years for the physician to catch the college grad (assuming equal UG debt). The other chart had this number at 17 years post HS (or 13 years post college). Despite the problems in the comparison, I think the point is still pretty valid.

 

[Postictal Raiden]

Lets just go with lab tech. 4 year undergrad... what do you think average UG debt is? Well, it doesnt matter because college grads and med students will have the same UG debt. So it is not difficult to make 40k out of college. Let's call it 35 for good measure, with it capping at 60k after 10 years. Is that fair and reasonable?

So starting at graduation, our lab tech makes 47.5k/year for 5 years, then 60 from then on (is that a fair assumption? some years are below 47.5, some above, but over 10 years that is the average salary.


The medical student, over 10 years, accrews 250k in debt, which normally translates into 400k after interest is counted, and then works at about 55k for.... 4 years, on average? The true average is probably between 3.5 and 4 including all residency types. Then goes on to make 200k, to keep things simple.

In this model, it takes 10 years for the physician to catch the college grad (assuming equal UG debt). The other chart had this number at 17 years post HS (or 13 years post college). Despite the problems in the comparison, I think the point is still pretty valid.

And exactly what point is that?

We can apply this principle to just about anything. If someone didn't go to school, and decided to work at McDonald's making 20K/year, in 4 years he/she will be 80K plus cost of education (let's say 25K) ahead of the lab tech. Not to mention, that McDonald's employee may get promoted to a manager and starts making ~40K/year before your lab tech guy starts making money.

Let's assume that this McDonald's employee is lazy and unambitious and doesn't receive any promotion. It will take about 6 years for the lab tech guy to catch up with him/her (10 years after high school).

 

[DoctwoB]

All these comparisons are missing the point. Arguing what a salary "should" be is a pointless endeavor that just goes in circles. There will always be people that work harder for less money and people that work less hard for more money.

An MD salary is based on an arbitrary reimbursement formula created by committees arguing about complex reimbursement formulas. What a salary "should" be very rarely enters the equation. Payer vs. physician supply is then used to determine what multiple of said arbitrary number is actually paid. Better physician unity could increase salary through better collective bargaining, but we're currently too fragmented for this to occur.

Given that our salaries can be changed arbitrarily, it falls upon the medical profession and its individual specialties to defend their interests, because you can bet your a** that no one else will. Thats why I hate that the AMA is more of a social action group then what it should be: a lobby defending doctors interests. Ultimately doctors need a voice that is looking out for their own interests because everyone else (nurses, optometrists, malpractice lawyers) all have their own groups that are much more concerned about protecting their interests then the common good.

 

[ClemsonFirst]

I can make a graph showing the homeless make more than MDs, that doesn't make it true.

If it is possible, then yeah it would be true. The main argument of the graph is that physicians have a huge amount of debt and work tremendous hours compared to other careers like UPS driver. Why should physician pay have to suffer if social prestige and home life already are? It's not like it is an easy job, and I feel doctors should be properly compensated for the amount of work they do and degree of stress the work entails.

 

[SpecterGT260]

And exactly what point is that?

We can apply this principle to just about anything. If someone didn't go to school, and decided to work at McDonald's making 20K/year, in 4 years he/she will be 80K plus cost of education (let's say 25K) ahead of the lab tech. Not to mention, that McDonald's employee may get promoted to a manager and starts making ~40K/year before your lab tech guy starts making money.

Let's assume that this McDonald's employee is lazy and unambitious and doesn't receive any promotion. It will take about 6 years for the lab tech guy to catch up with him/her (10 years after high school).

Do you not get the point or do you not think the point is very strong?

The point is that while physicians make quite a bit compared to the average worker, it takes a significant portion of the physicians career just to catch up to the average worker in terms of net earnings. By all rights, physicians should make more in the long run. it is a demanding and high risks job which should be made to be attractive to the brightest and hardest working among a society. Yes... it can be applied to any job... which is why I said "lets take lab tech for example". I don't exactly get the profoundness of you bringing up mcdonalds workers.... Sure... we coulda gone that route too. Or "mystery job X". The point is to compare net salaries across jobs. 200k/year sounds pretty sweet...... but most people out there are unwilling to wait 8-12 years for it and then have to work another decade or two to work off the debt.

 

[SpecterGT260]

All these comparisons are missing the point. Arguing what a salary "should" be is a pointless endeavor that just goes in circles. There will always be people that work harder for less money and people that work less hard for more money.

An MD salary is based on an arbitrary reimbursement formula created by committees arguing about complex reimbursement formulas. What a salary "should" be very rarely enters the equation. Payer vs. physician supply is then used to determine what multiple of said arbitrary number is actually paid. Better physician unity could increase salary through better collective bargaining, but we're currently too fragmented for this to occur.

Given that our salaries can be changed arbitrarily, it falls upon the medical profession and its individual specialties to defend their interests, because you can bet your a** that no one else will. Thats why I hate that the AMA is more of a social action group then what it should be: a lobby defending doctors interests. Ultimately doctors need a voice that is looking out for their own interests because everyone else (nurses, optometrists, malpractice lawyers) all have their own groups that are much more concerned about protecting their interests then the common good.

I don't think it misses the point at all.... the comparison is not "the point", it is a counter point. The graph aims to point out exactly what you are saying here and highlight a shortcoming in the argument of people who bitch about physician salary.

 

[link2swim06]

If it is possible, then yeah it would be true. The main argument of the graph is that physicians have a huge amount of debt and work tremendous hours compared to other careers like UPS driver. Why should physician pay have to suffer if social prestige and home life already are? It's not like it is an easy job, and I feel doctors should be properly compensated for the amount of work they do and degree of stress the work entails.

Ya I agree with with point the general point you are making. However, I don't agree with people dramatizing the situation by claiming things which are incorrect/impossible. Its poor form to start off your argument by blatantly lying to the reader.

I realize no one in this tread made this graph, but it appears every few months on SDN.

 

[SpecterGT260]

Ya I agree with with point the general point you are making. However, I don't agree with people dramatizing the situation by claiming things which are incorrect/impossible. Its poor form to start off your argument by blatantly lying to the reader.

I realize no one in this tread made this graph, but it appears every few months on SDN.

I would agree that a graph based on real data would be much more powerful.

 

[ClemsonFirst]

Ya I agree with with point the general point you are making. However, I don't agree with people dramatizing the situation by claiming things which are incorrect/impossible. Its poor form to start off your argument by blatantly lying to the reader.

I realize no one in this tread made this graph, but it appears every few months on SDN.

I definitely understand that. I had no idea how true or plausible the data behind the graph was, but I think people seriously overestimate doctor pay and the amount of effort it takes to perform well.

 

[Perrotfish]

Yes for most other PhD programs. Most non-science PhDs will be funded through a teaching associateship, assuming no research funding.
.

Common misconception. I would make two points.

1) A teaching associateship is not funding, its a full time job which you use to pay your tution. You could work at Walmart for the same effect.

2) ANY help paying your tuition, even teaching, is more and more the exception rather than the rule. The proliferation of underwriting free student loans means that more and more of the useless doctorates are demanding tuition, espicially as more and more really low ranked schools convert from being colleges to universities.

And "coupled" may be a poor word choice, but of course the board of directors
for med schools are sitting back thinking "they will be able to afford it with
their salaries" - so of course physician salary and tuition are related

The board of directors for your medical school are thinking 'they will be able to pay it because the government loans it to them with no underwriting'. They don't give a **** if you can afford it. Law schools charge just as much and they KNOW their graduates will never be employed. They're fine if it works out for you, but your future salery has no relationship to the cost of your tuition. At least not as long as the federal government guarentees student loans.

 

[Perrotfish]

I don't think it misses the point at all.... the comparison is not "the point", it is a counter point. The graph aims to point out exactly what you are saying here and highlight a shortcoming in the argument of people who bitch about physician salary.

The graph is crappy because the counterpoint is made up data. He's arguing about the salary of a UPS driver when he doesn't know what it is. He's never worked a blue collar job and assumes that you are free to work 80 hours a week of overtime (you're not). He's never talked toa UPS driver and he assumes that that salary is freely available to any high school grad who applies (its not, at UPS truck driver is a terminal position for those who have worked their way up through the blue collar heirarchy. that's why the salary is so high). So he wildly overestimates what the driver can make while significantly underestimating the benifits of his own degree.

When physicians compare their salary to other professions, they tend to overestimate either the avilibility or the benifits of the profession they're making a comparisson to. When estimating the availibity of other jobs physicians tend to assume that anyone with a medical degree could do any white collar job ('I could have made millions in I-banking/as a CEO/as a marketing exec) and that any job other than theirs that makes less than millions probably only requires a highschool degree (any guy off the street can make an FP's salary as a master plumber/Navy Chief/New York City Police officer). When they estimate what other people make they often overestimate by an order of magnitude. I actually had to look up the salary of a basic plumbr in NY because I got so sick of surgeons lameting that they chose to fix bones instead of pipes.

These kind of half researched comparisons don't make for a good argument, and the fact that so many people fail to see the problem with it makes us look out of touch.

 

[SpecterGT260]

The graph is crappy because the counterpoint is made up data. He's arguing about the salary of a UPS driver when he doesn't know what it is. He's never worked a blue collar job and assumes that you are free to work 80 hours a week of overtime (you're not). He's never talked toa UPS driver and he assumes that that salary is freely available to any high school grad who applies (its not, at UPS truck driver is a terminal position for those who have worked their way up through the blue collar heirarchy. that's why the salary is so high). So he wildly overestimates what the driver can make while significantly underestimating the benifits of his own degree.

When physicians compare their salary to other professions, they tend to overestimate either the avilibility or the benifits of the profession they're making a comparisson to. When estimating the availibity of other jobs physicians tend to assume that anyone with a medical degree could do any white collar job ('I could have made millions in I-banking/as a CEO/as a marketing exec) and that any job other than theirs that makes less than millions probably only requires a highschool degree (any guy off the street can make an FP's salary as a master plumber/Navy Chief/New York City Police officer). When they estimate what other people make they often overestimate by an order of magnitude. I actually had to look up the salary of a basic plumbr in NY because I got so sick of surgeons lameting that they chose to fix bones instead of pipes.

These kind of half researched comparisons don't make for a good argument, and the fact that so many people fail to see the problem with it makes us look out of touch.

We have covered that. I think 2 or 3 posts ago I said exactly this


I'm not arguing that the graph is good.... I'm arguing that the point is valid (and therefore should be remade with real data)

 

[Perrotfish]

We have covered that. I think 2 or 3 posts ago I said exactly this


I'm not arguing that the graph is good.... I'm arguing that the point is valid (and therefore should be remade with real data)

When you use real data the graph you get disproves the point that the crappy graph is trying to make. The phsyician's lifetime earnings skyrockets past the less educated before he's 30 and then keeps climbing. It makes the argument that our education pays very well, several times what people make working a blue collar job out of high school, and therefore leaves us open to the accusation we make too much.

 

[link2swim06]

When you use real data the graph you get disproves the point that the crappy graph is trying to make. The phsyician's lifetime earnings skyrockets past the less educated before he's 30 and then keeps climbing. It makes the argument that our education pays very well, several times what people make working a blue collar job out of high school, and therefore leaves us open to the accusation we make too much.

We shouldn't be comparing to blue collar jobs. We should be comparing to 4 year college degrees or even CRNA or PAs.

Medicine is 4 years + 3-6 years of low pay AFTER college. Therefore, a valid comparison would be to show a 4 year college degree (i.e. chemical engineering) likely making more in their lifetime than a pediatrician (w/o the extra decade of education/living like a student). Even a PA only has 2 extra years post college vs our 7 years.

I haven't done the math on any of these jobs, but I wouldn't be surprised if they earn more in their lifetime than a pediatrician.

 

[SpecterGT260]

When you use real data the graph you get disproves the point that the crappy graph is trying to make. The phsyician's lifetime earnings skyrockets past the less educated before he's 30 and then keeps climbing. It makes the argument that our education pays very well, several times what people make working a blue collar job out of high school, and therefore leaves us open to the accusation we make too much.

On the long haul, yes. It takes many years on top of the many more years of education to catch up. I already plotted one using realistic figures. It makes the argument that investment is a good thing. I don't disagree with that

 

[Perrotfish]

We shouldn't be comparing to blue collar jobs. We should be comparing to 4 year college degrees or even CRNA or PAs.

Medicine is 4 years + 3-6 years of low pay AFTER college. Therefore, a valid comparison would be to show a 4 year college degree (i.e. chemical engineering) likely making more in their lifetime than a pediatrician (w/o the extra decade of education/living like a student). Even a PA only has 2 extra years post college vs our 7 years.

I haven't done the math on any of these jobs, but I wouldn't be surprised if they earn more in their lifetime than a pediatrician.

If you select out the handful of higher degrees that you strongly suspect make more than you our salary and then select out the lowest paid kind of doctor to compare them with, then the Peds salry might look bad in comparisson. That's not really anymore fair than the UPS graph, though. If you're comparing us to the educated to argue we don't need a salary cut, you'd need to compare us to all the educated. The english majors. The non-premed biology majors. The civil engineers. And compare that to the full spectrum of physicians. In that case I think you'd see a graph that shows the very worst paid doctors (in general Peds) making slightly less than a handful of the highest paid non-medical degrees like chemical engineering, most physicians making more than anyone, and everyone would still be scratching their head why we think we absolutely shouldn't have a paycut. 'We're so poor there is still a handful of other professions in the same league as us' isn't a strong argument.

 

[qwerty89]

http://blogs.wsj.com/ideas-market/2012/07/24/does-becoming-a-doctor-pay-off-for-women/

"We found that, for over half of woman doctors in our data, the NPV of becoming a primary-care physician was less than the NPV of becoming a physician assistant. In contrast, the vast majority of male primary-care physicians earned an NPV greater than the NPV earned by a male PA. That is, while the vast majority of male doctors are financially better off for having become a doctor, the median female primary care physician would have been financially better off becoming a PA.

Where does this result come from? As you might have guessed, it is partially due to a wage gap. Male doctor earns more per hour relative to the male PA than the female doctor earns relative to the female PA. However, a big part of the difference comes from an hours gap. The vast majority of male doctors under the age of 55 work substantially more than the standard 40 hour work week. In contrast, most female doctors work between 2 to 10 hours fewer than this per week.

Even though both male and female doctors both earn higher wages than their PA counterparts, most female doctors don't work enough hours at those wages to financially justify the costs of becoming a doctor."

 

[link2swim06]

If you select out the handful of higher degrees that you strongly suspect make more than you our salary and then select out the lowest paid kind of doctor to compare them with, then the Peds salry might look bad in comparisson. That's not really anymore fair than the UPS graph, though. If you're comparing us to the educated to argue we don't need a salary cut, you'd need to compare us to all the educated. The english majors. The non-premed biology majors. The civil engineers. And compare that to the full spectrum of physicians. In that case I think you'd see a graph that shows the very worst paid doctors (in general Peds) making slightly less than a handful of the highest paid non-medical degrees like chemical engineering, most physicians making more than anyone, and everyone would still be scratching their head why we think we absolutely shouldn't have a paycut. 'We're so poor there is still a handful of other professions in the same league as us' isn't a strong argument.

Its quite different than the UPS example because this isn't a fictitious comparison. There are tens of thousands CRNA making more than your average PCP.

The other problem is physicians work more hours than most professions. We should really be comparing hourly wage, not salary.

I think the easiest comparison is pay divided by hours of training. A English major might make $30/hr and have 3,000 hours of training/education/studying. Giving a ratio of 30/3000 = $0.01 additional hourly wage per hour of training. A doctor might make $180/hr and have 50,000 hours of training/education studying. Giving a ratio of 180/50,00 = $0.0036 additional hourly wage per hour of training.

The English major is making about 3 times as much per hour of training.

 

[yappy]

I just wanted to bump my own post for discussion. It seems that it may have gotten lost among the other posts. If the new grad takes care of their debt in the manner described in "part 1" the whole game changes.

Part One

How low will physician wages go, exactly. I mean... looking through Meritt Hawkings I see a position, for example, where a GI doc starts out @ 500k with the potential to make 700k in the SW. Is this normal for physicians or is this considered to be a low wage?

http://www.merritthawkins.com/job-search/job-details.aspx?job=11172&contract=164110

EDIT:

Okay... here is one a little on the low side. Internal medicine in the midwest for 225k starting salary.

http://www.merritthawkins.com/job-search/job-details.aspx?job=11203&contract=162323

If you run taxes on that income, married w/ 2 dependents, you get $13,825.37/month. Assuming 6.8 interest with 180k in debt one could pay off the student loans in 24 months @ 8042.75/month and still have 5782.62 of post tax income to live off of. Not bad... nothing like the GI though.

After running that calculation it seems that a great position to be in is to graduate with less than 180k of debt and make 300k+ after residency. If one can do that the student loans could be paid back in a little over a year while still enjoying a 5k/month post tax income. Realistic?

________________________

Part Two

Last night I read an interesting blog on this subject. The physician blogger suggested that the reason there is such a focus on physician income is because a physician has close interaction with people from an array of different socioeconomic groups. The positioning of an ER physician next to a poor family shows a stark contrast in life styles; however, most other professions are insulated from interacting with people who are lower on the economic ladder. The blogger then concluded that this results in an "out of sight out of mind" phenomenon where CEO's, high profile lawyers, contractors, accountants etc. all fly under the radar. Do you think there is much merit to that?

 

[peteB]

Its quite different than the UPS example because this isn't a fictitious comparison. There are tens of thousands CRNA making more than your average PCP.

The other problem is physicians work more hours than most professions. We should really be comparing hourly wage, not salary.

I think the easiest comparison is pay divided by hours of training. A English major might make $30/hr and have 3,000 hours of training/education/studying. Giving a ratio of 30/3000 = $0.01 additional hourly wage per hour of training. A doctor might make $180/hr and have 50,000 hours of training/education studying. Giving a ratio of 180/50,00 = $0.0036 additional hourly wage per hour of training.

The English major is making about 3 times as much per hour of training.

Well then, if that was true, wouldn't everyone want to be an English major instead of a doctor? Yes if you look at purely hours of training versus salary, doctors may not be ahead. (Though there is also the issue of rampant unemployment/underemployment for English majors that has perpetually been a problem and doesn't affect doctors) But the extra hours of training allow the average doctor to achieve a lifestyle for most of their lives that the average English major never will. The average doctor will have many times the disposable income of the average English major at any point in the professional lives of each. This also means that the average doctor will be able to invest a lot more than the English major. So every bit of marginal income the doctor gets with respect to additional training must actually be weighted by a multiplier to account for these additional benefits that the doctor will have, and then you will see that the doctor actually comes out ahead.

 

[SpecterGT260]

Well then, if that was true, wouldn't everyone want to be an English major instead of a doctor? Yes if you look at purely hours of training versus salary, doctors may not be ahead. (Though there is also the issue of rampant unemployment/underemployment for English majors that has perpetually been a problem and doesn't affect doctors) But the extra hours of training allow the average doctor to achieve a lifestyle for most of their lives that the average English major never will. The average doctor will have many times the disposable income of the average English major at any point in the professional lives of each. This also means that the average doctor will be able to invest a lot more than the English major. So every bit of marginal income the doctor gets with respect to additional training must actually be weighted by a multiplier to account for these additional benefits that the doctor will have, and then you will see that the doctor actually comes out ahead.

No.... because pan handlers have the best payoff there. The point isn't who makes more, the point is who gets paid off on their investment. Medicine as a career is an investment and the point being made is that doctors are not making outrageous amounts compared to other people in terms of hours invested

 

[peteB]

No.... because pan handlers have the best payoff there. The point isn't who makes more, the point is who gets paid off on their investment. Medicine as a career is an investment and the point being made is that doctors are not making outrageous amounts compared to other people in terms of hours invested

Pan handlers have the best payoff in terms of lifestyle and disposable income? Did you even read my post?

What I've noticed over the past few days of arguing with you on various threads is that you have a serious issue with reading comprehension. This isn't a personal attack or anything, I am genuinely concerned about your reading skills. You seem to only be picking up on words here and there and not understanding the entire argument.

 

[peteB]

Medicine as a career is an investment and the point being made is that doctors are not making outrageous amounts compared to other people in terms of hours invested

Well when you look at hours invested, some doctors are clearly making a lot more than others without much more investment. The GI doc making 400-500 hasn't put in 2-3 times as many hours of training as the Family doc barely making 150-200. How's that?

 

[pkwraith]

The cost of your salery is isn't coupled to the cost of your education. If it was then the guys getting doctorates in poetry, or low end Law Degrees, (many of them also paying 300K) would also be making physician salaries. They are, instead, unemployable at any price.

WTF cares about doctorates in poetry? Is MD a useless doctorate? No. The poetry market is not a major concern, whether in volume or necessity.

The government doesn't help set the salary of lawyers like in healthcare. The government doesn't have an expectation of maintaining a certain amount of lawyers.

If you are addressing salaries, you need to address costs. What appears to be your argument is that look at these people who get ****ed. So you want medical students to get ****ed by not addressing costs? Yeah, thanks for proving my point. You should reread my post again, to see what you're actually arguing against.

 

[SpecterGT260]

Pan handlers have the best payoff in terms of lifestyle and disposable income? Did you even read my post?

What I've noticed over the past few days of arguing with you on various threads is that you have a serious issue with reading comprehension. This isn't a personal attack or anything, I am genuinely concerned about your reading skills. You seem to only be picking up on words here and there and not understanding the entire argument.

What I've noticed from you is that you always miss the point. Yes. Homeless people have the best lifestyles 🙄

Stop being so argumentative. You don't even seem to have a point..... it was a comparison of payoff per investment and you haven't said anything that stands as a valid counterpoint


Also, I'm posting from my phone so yes I will occasionally miss things. But if you weren't so preoccupied nitpicking every post I make in hopes of retribution for the prowler thread you like to bring up maybe we would have a real discussion instead of the mess that nearly every thread you've participated in has been 🙂:beer:

 

[SpecterGT260]

Well when you look at hours invested, some doctors are clearly making a lot more than others without much more investment. The GI doc making 400-500 hasn't put in 2-3 times as many hours of training as the Family doc barely making 150-200. How's that?

Who ever said the payoff needs to be equal? 😕

 

[peteB]

Who ever said the payoff needs to be equal? 😕

Never said it has to be equal. But you said the difference isn't that great. I'd say 2-3 times is a pretty large difference.

 

[SpecterGT260]

Never said it has to be equal. But you said the difference isn't that great. I'd say 2-3 times is a pretty large difference.

I said between doctors as a whole and other professions (with the edge in many cases favoring others by this specific metric)..... how is it my reading comp a and not just your panache for argument that is the problem here? If you aren't following try asking for clarification rather than being a douchenozzle. I'm not interested in fighting with you. Its Friday and I am in my happy place.

Tl;Dr chill the eff out 😀

 

[peteB]

What I've noticed from you is that you always miss the point. Yes. Homeless people have the best lifestyles 🙄

Stop being so argumentative. You don't even seem to have a point..... it was a comparison of payoff per investment and you haven't said anything that stands as a valid counterpoint


Also, I'm posting from my phone so yes I will occasionally miss things. But if you weren't so preoccupied nitpicking every post I make in hopes of retribution for the prowler thread you like to bring up maybe we would have a real discussion instead of the mess that nearly every thread you've participated in has been 🙂:beer:

I did have a point, which you didn't read. I'm not going to restate it. You can go and read it again if you want.

I'm not nitpicking your post. Your entire rebuttal to my point made no sense because you didn't understand what I said. I was trying to clarify myself.

I'm going to stop debating with you completely because you obviously can't follow arguments. I'm tired of having to repeat my arguments over and over because you just don't get them.

The mess in all those threads was caused by you, not me. The problem is you have very poor reading comprehension and no idea how to have a proper debate.

 

[peteB]

I said between doctors as a whole and other professions (with the edge in many cases favoring others by this specific metric)..... how is it my reading comp a and not just your panache for argument that is the problem here? If you aren't following try asking for clarification rather than being a douchenozzle. I'm not interested in fighting with you. Its Friday and I am in my happy place.

Tl;Dr chill the eff out 😀

Panache for argument? You shouldn't be talking, you're dragging these arguments out as long as anyone.

And yea, it is your reading comprehension. Your response proved that you totally missed my point. Same thing in pretty much every argument we've had.
Also, douchenozzle? butthurt? Never heard adults using those terms.

 

[SpecterGT260]

Panache for argument? You shouldn't be talking, you're dragging these arguments out as long as anyone.

Also, douchenozzle? butthurt? Never heard adults using those terms.

Until now. Am I to be embarrassed that you have such a limited vocabulary? 🙄

I also like douchebaggary, motard, and snuffeluffegus. That last one isn't so much insulting as just fun. Do you know what grasping at straws is usually indicative of? 😉

 

[VisionaryTics]

Why is every thread destroyed by you two bickering?

 

[peteB]

Until now. Am I to be embarrassed that you have such a limited vocabulary? 🙄

I also like douchebaggary, motard, and snuffeluffegus. That last one isn't so much insulting as just fun. Do you know what grasping at straws is usually indicative of? 😉

Well, I'm sorry that I don't speak "Jersey Shore". Don't need to mention what that is indicative of....

 

[Frazier]

Why is every thread destroyed by you two bickering?

They don't like to "lose"? They have large egos?

 

[SpecterGT260]

Well, I'm sorry that I don't speak "Jersey Shore". Don't need to mention what that is indicative of....

Someone else who has never seen the show?

Listen kiddo, I'm going to continue to use such words when I feel it fits, I'm going to continue to not give half a wet bowel movement about your thoughts on that matter, and I'm going to continue to discuss the OP. If you don't have anything in that direction to add, argue, or otherwise bring up I will leave you to your thesaurus delusions of reading comprehension.

I think comparing physician salary to other professions in terms of debt, net earnings, and earnings per hour of training are valid points when countering claims that doctors make too much. ~200k, the average doc salary (median I believe) is not all that much money anymore. DNPs are making near that with a fraction of the debt and life investment. So why don't you outline your points in this rather than pursuing avenues pertaining to your previous butthurt. We've disagreed in threads, but if you weren't so busy being a motard and spewing douchebaggary all over the place you would have noticed that we agree often as well.
Suffeluffegus. 😛

 

[peteB]

Someone else who has never seen the show?

Listen kiddo, I'm going to continue to use such words when I feel it fits, I'm going to continue to not give half a wet bowel movement about your thoughts on that matter, and I'm going to continue to discuss the OP. If you don't have anything in that direction to add, argue, or otherwise bring up I will leave you to your thesaurus delusions of reading comprehension.

I think comparing physician salary to other professions in terms of debt, net earnings, and earnings per hour of training are valid points when countering claims that doctors make too much. ~200k, the average doc salary (median I believe) is not all that much money anymore. DNPs are making near that with a fraction of the debt and life investment. So why don't you outline your points in this rather than pursuing avenues pertaining to your previous butthurt. We've disagreed in threads, but if you weren't so busy being a motard and spewing douchebaggary all over the place you would have noticed that we agree often as well.
Suffeluffegus. 😛

Whatever. I don't really want to argue anymore. The bottom line is, no matter how much you or I or anyone else argues, people see doctors making several times the average person and having much better lifestyles. It's really hard to argue that we are actually not doing as well as they think when they look at us and we're clearly doing well. Even after all that debt, doctors still come out far ahead of pretty much everyone else, except for a small percentage of bankers and businessmen and lawyers, etc. Someone who works multiple low-paying grueling menial jobs to barely survive is not going to buy that you deserve more because you've spent a lot of hours training in a relatively cushy academic environment. It's just not an argument we're going to win with the majority of people.

We just have to let the market do it's thing. If physician salaries get cut, fewer people will go into medicine and then we'll have a much worse physician shortage and the salaries will have to come back up. It's supply and demand that governs salaries more than anything else. If we are somehow able to greatly increase the number of physicians in the country, it doesn't matter how long they train or how many hours they put in, they'll still end up getting a far lower salary just because of economics.

 

[SpecterGT260]

Whatever. I don't really want to argue anymore. The bottom line is, no matter how much you or I or anyone else argues, people see doctors making several times the average person and having much better lifestyles. It's really hard to argue that we are actually not doing as well as they think when they look at us and we're clearly doing well. Even after all that debt, doctors still come out far ahead of pretty much everyone else, except for a small percentage of bankers and businessmen and lawyers, etc. Someone who works multiple low-paying grueling menial jobs to barely survive is not going to buy that you deserve more because you've spent a lot of hours training in a relatively cushy academic environment. It's just not an argument we're going to win with the majority of people.

We just have to let the market do it's thing. If physician salaries get cut, fewer people will go into medicine and then we'll have a much worse physician shortage and the salaries will have to come back up.

Yeah.... I'm pretty sure that was an underlying agreement from the start 😕 that is the eventual outcome. I personally believe that the system can only stress so much before something gives. I think such comparisons, however are (will be) valuable when discussing this in a real world setting.
Why were we arguing again?

 

[peteB]

Why were we arguing again?

Dunno, I'm not arguing anymore 🙂

 

[Winged Scapula]

Since this thread appears to more relevant to Topics in Healthcare, I'll move it there where you two/three can continue to verbal sparring.

 

[VisionaryTics]

Since this thread appears to more relevant to Topics in Healthcare, I'll move it there where you two/three can continue to verbal sparring.

I think we should have a separate forum for PeteB/SpecterGT260 internet slap-fights.

 

[SpecterGT260]

I think we should have a separate forum for PeteB/SpecterGT260 internet slap-fights.

Its exhausting. No thanks Cal

 

[peteB]

Its exhausting. No thanks Cal

You love it. You'll keep coming back for more 😀

 

[PikminOC]

Why does everyone focus on physician salary when the topic of healthcare expenditure comes up??

Docs individually have a great deal of drive, but are unfocused and fragmented. This is why we have no good lobbying group to protect us from the onslaught of these kinds of misperceptions.

The cost of healthcare obviously is only minimally related to physician salary, but that is not the way the public perceives it.

🙁

 

[Smokemont]

Common misconception. I would make two points.

1) A teaching associateship is not funding, its a full time job which you use to pay your tution. You could work at Walmart for the same effect.

This is not a common misconception at least not by me. I just completed a M.S. where I was funded, and where the many PhDs I worked with were funded, preferably through research, but if not through teaching.

So I am speaking from recent personal experience. I would make the following points to your statements:

- A teaching associateship IS funding. This money comes from the department you teach in and typically covers tuition, stipend and partially subsidizes health insurance.

- It is NOT a full time job. They are typically 50% appointments which means 20 hrs/wk.

- If you worked at Walmart you would make NOTHING compared to a TA spot (tuition + stipend + insurance).

Once again, speaking from personal experience.

Your point about salary and cost of tuition is well taken and I agree.

 

[SpecterGT260]

You love it. You'll keep coming back for more 😀

Its not the argument but rather what comes of it. If you think I've been fighting just to fight you have misjudged the situation

 

[SpecterGT260]

Why does everyone focus on physician salary when the topic of healthcare expenditure comes up??

Docs individually have a great deal of drive, but are unfocused and fragmented. This is why we have no good lobbying group to protect us from the onslaught of these kinds of misperceptions.

The cost of healthcare obviously is only minimally related to physician salary, but that is not the way the public perceives it.

🙁

There are people that respond negatively to perceptions of prestige and wealth regardless of the facts. Its easy to connect make believe dots and just land on "doctors are greedy so I can just blame them for all of my health problems"

I agree that physicians need a stronger political presence. I think its been coming together slowly as the mid levels have tried to expand

 

[basupran]

na

 

[Brigade4Radiant]

Lets just go with lab tech. 4 year undergrad... what do you think average UG debt is? Well, it doesnt matter because college grads and med students will have the same UG debt. So it is not difficult to make 40k out of college. Let's call it 35 for good measure, with it capping at 60k after 10 years. Is that fair and reasonable?

So starting at graduation, our lab tech makes 47.5k/year for 5 years, then 60 from then on (is that a fair assumption? some years are below 47.5, some above, but over 10 years that is the average salary.


The medical student, over 10 years, accrews 250k in debt, which normally translates into 400k after interest is counted, and then works at about 55k for.... 4 years, on average? The true average is probably between 3.5 and 4 including all residency types. Then goes on to make 200k, to keep things simple.

In this model, it takes 10 years for the physician to catch the college grad (assuming equal UG debt). The other chart had this number at 17 years post HS (or 13 years post college). Despite the problems in the comparison, I think the point is still pretty valid.

Medical school debt is not an average of 250k its more like 160K

https://www.aamc.org/download/152968/data/debtfactcard.pdf

Its quite different than the UPS example because this isn't a fictitious comparison. There are tens of thousands CRNA making more than your average PCP.

The other problem is physicians work more hours than most professions. We should really be comparing hourly wage, not salary.

I think the easiest comparison is pay divided by hours of training. A English major might make $30/hr and have 3,000 hours of training/education/studying. Giving a ratio of 30/3000 = $0.01 additional hourly wage per hour of training. A doctor might make $180/hr and have 50,000 hours of training/education studying. Giving a ratio of 180/50,00 = $0.0036 additional hourly wage per hour of training.

The English major is making about 3 times as much per hour of training.

This is a very bad comparison. There are about 9000 hours in a year if you comparing a MD to a PHD in english (who makes 40K a year as a lecturer) then your argument falls apart. If you compare a doctor vs english major you need to use real world examples. Most jobs do not pay per hour you get a salary you could works 60 hours a week at a job and you will still just make 40k. Physicians get paid 40-50K in residency and if the get a job as a hospitalist then they work roughly 6 months out of the year and can make 180k a year.

 

[SpecterGT260]

Medical school debt is not an average of 250k its more like 160K

https://www.aamc.org/download/152968/data/debtfactcard.pdf

Well for starters, arbitrarily nitpicking exact numbers is a hypothetical is silly. Don't do that 👍

Also, I doubt they are including cost of living. I am loaning out 50k a year at state tuition rates and I have not seen any schools who are significantly cheaper than we are.


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[SpecterGT260]

Kevin agrees 😀

http://www.kevinmd.com/blog/2011/04/real-life-medical-school-debt.html
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