I probably won't convince many of the attendings, but perhaps for the premeds reading, I'll convince a few.
It's always easier to convince those with the least amount of experience and knowledge. Keep up the good work.
👍
You're a MOHS surgeon, correct? From what I could find the average annual pay for a MOHS surgeon is >$600,000/yr. You're telling me you wouldn't take on $300,000 one time to enable the earning ability of $600,000/yr.? That math seems pretty easy to me... Even taking on $300,000 in debt for an earning potential of $200,000/yr is a no brainer. The return on educational investment is a gimme. There is no other field possible where you can accumulate no debt and have anywhere close to that earning potential. Even with a JD or MBA, you'll leave with $200K+ and have nothing near your earning potential unless you graduate from a top 10 program.
Huh. Okay, GB, let's walk our way through this, shall we?
So you think that you can just walk right into any field of your choice, eh? That would come as quite a surprise to most medical graduates, I can assure you. You have to enter with the assumption that you will likely earn median wage - anything more is a bonus.
Since you brought it up, though -- the survey from which you drew your data is horrifically skewed (looking right at you, MGMA). Their sample size is ridiculously small and is self selected in that the primary groups filling out the survey are the very large single specialty, hospital, and multispecialty clinics who stand much to gain by their participation. The wRVU chart tells the whole story if you care to do a little math... These are highly skewed toward the very busy and mature practices; if you compare the general dermatology to the Mohs dataset you will begin to see what I'm talking about. Given that, even when considering only the fellowship trained guys, the average number of cases are fewer than 500 per year -- the degree to which that survey is skewed is nothing short of impressive.
...oh, and we train 50-80 per year. For the entire world, no less (granted, the vast majority are here).
You assume a bit much with this.
I believe it was sevofluorane. He and his wife went to the Midwest after gas residency. They each earn $500K+ and paid off their student loan debts in 1 year. Yeah, sounds like the $200K they each owed was a real burden...
That places them at >95%ile for specialty -- quite an achievement, even more of a stretch to assume one can duplicate.
American MDs are still paid quite while compared to the rest of the world. In the late 70s and 80s, Medicare essentially asked doctors what they wanted to be paid, then paid slightly higher than that amount. So, yeah, doctors lived extremely large. Is it any surprise that that ride couldn't last forever? As a whole, doctors are still well compensated for what they do, and those that value money above family time and geography can still make exceptionally high sums. The sense of entitlement I get from SDN is off-putting honestly.
They did no such thing; your understanding of "usual, reasonable, and customary charges" could use a little brushing up. While remediating, consider brushing up on the criteria for valid economic comparison, as well. American MD's are paid more than most other nation's MD's, true enough. Care to compare productivity? Well, those numbers are not readily available -- but I would wager good money that they work more here than they do in alternate systems. How about comparing spending power? That could be done in a couple of ways, multiples of per capita GDP or a more direct comparison of MD wages against the backdrop of general wages... and guess what -- as luck would have it, those comparisons have been done... and we're not doing quite as well as you would lead others to believe. In fact, a more fact based argument could be made that American MD earnings lag behind many developed countries in terms of comparative economic power.
This is not to say that our pricing mechanism is whacked, but that's not what we are comparing here and was not the claim made.
So go ahead and be put off all you want -- the world needs more volunteers and martyrs. Enjoy the flight.
No fiscally sensible physician should ever have trouble paying off their loans and living a perfectly nice life with a nice house and BMW/Benz as desired. If you want more than that, you should've gone with a higher risk/higher reward field like tech, business, or law.
Wow -- you have managed to roll a healthy dose of condescension
and a sense lofty piety into one paragraph. Strong work, kid.
👍
BTW -- you're punching above your weight when you try to tell those who have successfully navigated the system, played by the rules, worked their asses off, etc that they're FOS and your pocket calculator tells you that there's no problem servicing 300k loan payments on 12k / month income. IMO, you do those who would listen to you a great disservice... and that's before taking into consideration the trend lines of student debt accrual and physician income. Debt is a merciless master.
