making any money?

[klptvf]

a serious question because I just do not quite understand it all:

-I am a non trad pre med, so that right there should explain to you why I just dont know that much about it all yet, but:

Do MDs/DOs make any money due to HMOs, insurance, malpractice insurance, etc.?

Do you all see the model of medicine changing in the future, making it harder for graduates to find work?

What areas do you think are going to be in demand in 10-12 years, and what areas will not?

Thank you.

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[Law2Doc]

a serious question because I just do not quite understand it all:

-I am a non trad pre med, so that right there should explain to you why I just dont know that much about it all yet, but:

Do MDs/DOs make any money due to HMOs, insurance, malpractice insurance, etc.?

Do you all see the model of medicine changing in the future, making it harder for graduates to find work?

What areas do you think are going to be in demand in 10-12 years, and what areas will not?

Thank you.

The demand for physicians is currently projected to be higher than the supply, (to the point that med schools have been encouraged to increase class sizes somewhat), so there will not be any difficulty finding work as a US licensed physician in the immediate forseeable future. That being said, HMOs, insurance, and reimbursement issues seem to be drastically cutting into physician paychecks, so it is not unreasonable to suspect that physician salaries will decrease somewhat. My guess is that the salary will still be reasonably comfortable, but certainly not as cushy as it once was. As for areas in demand, thanks to the aging generation of baby boomers, geriatrics is the area that will be in highest demand for the next couple of decades. Other specialties disproportionately affecting older folk (oncology, and a lot of the internal medicine fields etc.) should see some nice growth too.

 

[kimmcauliffe]

right on the money. my uncle is an anesthesiologist easily making six figures a year, only to see a good chunk of that go straight to malpractice insurance. not to say that he's not living comfortably, not the case at all! he's successful and sees malpractice insurance as a necessity.

 

[USCguy]

Seems like endocrinology will be big in the future. Everywhere you look, the diabetes rates are going up...

 

[psionic_blast]

Podiatry as well for the diabetic foot.

 

[Shredder]

• Do MDs/DOs make any money due to HMOs, insurance, malpractice insurance, etc.?

i think you can only make money from those types of insurance if you get involved with working for them. and there are some positions for docs there i believe, in all 3. otherwise dont you spend (lose) money on all forms of insurance? how would you make money, youre paying others to bear your risk

• Do you all see the model of medicine changing in the future, making it harder for graduates to find work?

i think if globalization hits medicine it could increase competition, just like in the tech sector. not sure how legislation and interest groups, mainly the AMA, will affect that though. right now the doctor market in the USA seems primarily restricted to american doctors.

• What areas do you think are going to be in demand in 10-12 years, and what areas will not?

ive heard speculation that geriatrics will be big with the aging of baby boomers. sounds boring to me though. im not sure how this prediction is made, it might take some intricate research. besides, what difference does it make as the choice doesnt have to be made for so many years anyway? but i guess if youre just curious, well im not sure

 

[Lonestar]

MDs and DOs will still make a lot of money for the foreseable future. Yes, malpractice is an issue for certain specialties but not for all. For example, someone mentioned that anesthesiologists pay a chunk in insurance; do you even know the average malpractice paid by anesthesiologists is nowdays? well it is 24K per yr (that is not deducted from your salary). Mainly the group pays for it. Considering the average gasdoc makes close to 300K, i don't see the market going down especially in anesthesia. Cardiologists, pain docs, orthopedic surgeons, radiologists, radiation oncologists, gastroenterologists, and bunch of other specialties make more than gasdocs do. So do i think the future is bright for MDs and DOs? i dunno, you tell me.

I do think competition especially from foreign docs is a threat in the future. I also think that medical tourism (you know going to india/israel/etc for major surgeries and dental procedures) will flourish in the future. Why would anyone pay 100K for surgery in the US, while they can get it in india for 5K with qualified professionals. Why would a hospital pay a radiologist in Macon, Georgia 550K while that same hospital can get a qualified indian radiologist to ready xrays for 25K. These are some very good questions that i don't have answers to. If medicine truly is a "business", i regret to say that the longer years of education of US doctors (and subsequently higher pay) may work against them in the future. But for the near future 10-15 years the outlook is good for docs.

i think all areas of medicine will be in demand in 10-12 yrs. Old people (baby boomers) will have all sorts of problems from cataracts to erectile dysfunction. Medicine will always be in demand unless the supply of docs is altered (i.e competition with foreign docs or dramatic increase in US docs).

 

[pgg]

As for areas in demand, thanks to the aging generation of baby boomers, geriatrics is the area that will be in highest demand for the next couple of decades. Other specialties disproportionately affecting older folk (oncology, and a lot of the internal medicine fields etc.) should see some nice growth too.

Well, since the OP was mostly interested in money, I'd point out that demand != high compensation, never has, never will. If that was true, FPs would be making $400K running clinics in underserved rural areas. One who goes into geriatrics will never have a problem finding a job, but geriatrics will never be a high paying specialty.

High compensation will probably always be associated with those specialties that tend to have elective procedures (derm, plastics, ophthalmology, etc) ... plus those few that have had successful lobbying efforts to protect their income (anesthesia comes to mind here).

Slightly off topic - I wonder about how much longer radiology will be well compensated. Seems like that specialty is alone in its vulnerability to exportation via internet to basements full of slave-wage "radiologists" in India or another developing country. Once they prove that they can read a CXR as well as the guy down the hall, just as quickly ... but for the price of a Happy Meal ... Mind you, I don't see that as a bad thing to anyone except 1st-world radiologists.

 

[Law2Doc]

Well, since the OP was mostly interested in money, I'd point out that demand != high compensation, never has, never will. If that was true, FPs would be making $400K running clinics in underserved rural areas. One who goes into geriatrics will never have a problem finding a job, but geriatrics will never be a high paying specialty.

High compensation will probably always be associated with those specialties that tend to have elective procedures (derm, plastics, ophthalmology, etc) ... plus those few that have had successful lobbying efforts to protect their income (anesthesia comes to mind here).

Slightly off topic - I wonder about how much longer radiology will be well compensated. Seems like that specialty is alone in its vulnerability to exportation via internet to basements full of slave-wage "radiologists" in India or another developing country. Once they prove that they can read a CXR as well as the guy down the hall, just as quickly ... but for the price of a Happy Meal ... Mind you, I don't see that as a bad thing to anyone except 1st-world radiologists.

The OP asked about not only about money but areas of anticipated demand. Older peoples' medical problems are where the future demand will be for the next couple of decades. I totally agree that demand does not dictate physician salaries.
As for radiology, I'd think there is no huge danger of losing business due to export at present (via nighthawk or other programs), because the films will still need to be re-reviewed by a US licensed physician, for legal reasons. It would be a malpractice nightmare if mistakes were made and it turned out that no US licensed physician ever looked at the films. It would be indefensible. And there are not that many US licensed folk who want to read films in Asia for a living, so foreign docs are all there is to work with. But at least this means that a prelmininary screening could be done on films at night while people in the US are asleep -- would reduce overnight calls, which may make radiology more of a lifestyle field, like derm. Plus radiologists are becoming more interventional -- basically pushing their way into surgical fields because with their toys they can see what they are doing without cutting a big hole. So I think that field is safe, for now.

 

[chef_NU]

You guys seem to be misusing the word "demand" in this context. Demand implies that there is a high need for a certain product at a given price. Demand DOES NOT imply high need for a product, without price as a consideration (at least in an economic sense). If you think about medical procedures that have high need at a high price, then I would call those procedures in demand. I would also call those procedures very lucrative. This breaks down of course, in underserved rural areas where this is very high need for FP doctors but no money to pay for it. Lots of people want Bentleys, but we wouldn't say they are "in demand". This is simply because people don't demand them at the price the market dictates.

 

[Law2Doc]

You guys seem to be misusing the word "demand" in this context. Demand implies that there is a high need for a certain product at a given price. Demand DOES NOT imply high need for a product, without price as a consideration (at least in an economic sense). If you think about medical procedures that have high need at a high price, then I would call those procedures in demand. I would also call those procedures very lucrative. This breaks down of course, in underserved rural areas where this is very high need for FP doctors but no money to pay for it. Lots of people want Bentleys, but we wouldn't say they are "in demand". This is simply because people don't demand them at the price the market dictates.

Market forces don't work in medicine as insurance companies and governmental administrators decide in most cases what you can charge. There are no prices based on supply and demand (as a prior poster indicated, rural FPs are in highest need and often the lowest paid, and derm the reverse). But I read the OPs use of demand differently. It is a word which has a meaning in our language exclusive of economic impact. You can seek to go into a field that will be in demand because of job security, not wealth. A steady flow of patients means the field is in demand, notwithstanding what you get paid. By contrast, a field like, say, sports medicine, might fall out of demand if the population ages significantly, because the patient base may not be there, notwithstanding how much you might be able to charge per patient for your services. There are fields of medicine that are more heavilly in need than others because there are more patients with a particular affliction. When the population is older, the areas of most necessary resource allocation will be to that population. Hence it is the field most in demand. But no, you won't earn a Bentley that way, unless one of your older patients puts you in his will. Let's not get hung up on the definitions.

 

[NonTradMed]

a serious question because I just do not quite understand it all:

-I am a non trad pre med, so that right there should explain to you why I just dont know that much about it all yet, but:

Welcome to the board! There are plenty of nontrad premeds, go into the nontrad forums and you will meet many kindered spirits. We are many, and we rule the boards! J/k

Do MDs/DOs make any money due to HMOs, insurance, malpractice insurance, etc.?

From what I can tell, compensation is not as high as the 'golden 80's' but it's still in the top 5% income bracket. Will you get rich from an MD/DO? Probably not, unless you have good business acumen. Will you live comfortably? Probably, yes.

Do you all see the model of medicine changing in the future, making it harder for graduates to find work?

It doesn't look that unless the government decides to completely socialize medicine and even then there is always demand for doctors in rural areas. I don't forsee a huge change in medicine or medical reimbursement that will hurt physicians. Despite what some say on this board, the AMA is still the second most powerful lobbying group in Washington (second to ABA) so the job market is still well cushioned against outside intrusions such as a huge influx of foreign doctors. Also, I think the language barrier and boards prevents foreign physicians from passing boards as readily as they could (just from experience with many Chinese docs).

The bigger issue, as someone pointed out, is global competition. Some people are already opting to fly overseas to see qualified docs in poorer countries and save tons on major operations. This means business for surgeons and other big procedure doctors will see a drop if this trend continues. I don't forsee primary care, and services like OB/GYN and EM to be affected since it's hard to 'plan' to another country or it's not feasible to see a doc for these services.

Bottom line: Medicine is lucrative (as compared to many other industry fields) and will continue to be lucrative in the near future. Despite griping, physicians are still in the top 5% of income bracket, most coming out with a minimal six figure income. Yes, there is debt and long years of hard work, but you will end up with a degree that will allow you to make a comfortable salary and retain job security against layoffs (generally speaking, of course)

Demand will also be high with aging boomers and the raising obesity epidemic in this country. As long as you are willing to work hard, keep up to date and maintain good interpersonal skills, you will be a profitable doc.