Medscape 2014 "I would choose the same specialty"

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Lol compare the ones at the top to the bottom. All the ones toward the top are the ones with either the highest reimbursement or a mix of good lifestyle and high reimbursement. The bottom are the ones with basically the lowest compensation or combo of bad lifestyle + low compensation. Hilarious.


fig24.jpg
 
rocketbooster said:
Lol compare the ones at the top to the bottom. All the ones toward the top are the ones with either the highest reimbursement or a mix of good lifestyle and high reimbursement. The bottom are the ones with basically the lowest compensation or combo of bad lifestyle + low compensation. Hilarious.


fig24.jpg
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I'd say it's probably less "hilarious" and more "exactly what anyone would've guessed." I suppose it is relatively amusing to see it in print, though.
 
Keep in mind that Medscape surveys are fuggin awful from a statistics perspective... Response bias galore, and piddling number of respondents.

That being said, glad I'm (hopefully) going into ortho.
 
KinasePro said:
Keep in mind that Medscape surveys are fuggin awful from a statistics perspective... Response bias galore, and piddling number of respondents.

That being said, glad I'm (hopefully) going into ortho.
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Yeah basically <5% response rate for each specialty lol. It's still hilarious though. :clap:
 
Derm is really the only outlier at the top though. A huge chunk of the middle is within ~10% of each other which isn't too far off from each other given the low response rate of the Medscape surveys. FM/IM are definitely pretty low though...I'd guess IM is so terrible because a large chunk of general internists are people who actually wanted to subspecialize but didn't cut it. It could also include a large number of "burnt out" hospitalists, since they technically count as general IM.
 
No surprise or mystery to it. Clearly lifestyle and income each play a role in the results.

It will be interesting to see how these numbers react over the upcoming decades if the predictions come true in regards to specialists getting axed extra hard and average hours plummet with abandonment of fee-for-service model.

...Will the derms and internists of 2025 still have a ~300% difference in "specialty-satisfaction" if the pay difference is only 50k in derm's favor and both are working ~45 hours/week?

Maybe they will only be 2x happier.

Stay tuned.
 
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Frazier said:
No surprise or mystery to it. Clearly lifestyle and income each play a role in the results.

It will be interesting to see how these numbers react over the upcoming decades if the predictions come true in regards to specialists getting axed extra hard and average hours plummet with abandonment of fee-for-service model.

...Will the derms and internists of 2025 still have a ~300% difference in "specialty-satisfaction" if the pay difference is only 50k and both are working ~45 hours/week?

Stay tuned.
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Nope. I would still do Derm even if the difference was only 50 k. The hours of Internal Medicine are inherent to the specialty itself.
 
DermViser said:
Nope. I would still do Derm even if the difference was only 50 k. The hours of Internal Medicine are inherent to the specialty itself.
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Sure, but I wasn't pondering if suddenly derms would wish they were internists.
Rather: to what degree will that current 300% difference [across the two samples] dwindle as pay and hours potentially become less polar.

In other words, would derms score fall, stay the same (i.e. head and shoulders above every other specialty)? Would internist scores raise, stay the same (i.e. bottom of barrel)?

This assumes that the practice environment makes drastic shifts and morphs into something more similar to medicine in europe than present USA.
 
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Frazier said:
Sure, but I wasn't pondering if suddenly derms would wish they were internists.
Rather: will that current 300% difference [across the two samples] dwindle as pay and hours potentially become less polar.

This assumes that the practice environment makes drastic shifts and morphs into something more similar to europe than present USA.
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That's the thing though, you can't compare hours of IM to Derm. Even if you take them both as outpatient, you can fly through Derm patients faster bc you're only dealing with 1 organ system, vs. IM in which you have to deal with multiple organ systems in 1 15 minute visit. An IM primary care doc can't possibly do a cohesive good job only being allotted 15 minutes per patient.
 
DermViser said:
That's the thing though, you can't compare hours of IM to Derm. Even if you take them both as outpatient, you can fly through Derm patients faster bc you're only dealing with 1 organ system, vs. IM in which you have to deal with multiple organ systems in 1 15 minute visit. An IM primary care doc can't possibly do a cohesive good job only being allotted 15 minutes per patient.
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How will that scenario be affected by the proposed shift from abandoning current "fee-for-service" model to instead "bundled/performance outcome" (or whatever it is termed now) reimbursement model?

That's not rhetorical... I don't know the answer.
 
Frazier said:
How will that scenario be affected by the proposed shift from abandoning current "fee-for-service" model to instead "bundled/performance outcome" (or whatever it is termed now) reimbursement model?

That's not rhetorical... I don't know the answer.
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So far, I've mainly heard of bundled payments being used in the inpatient model, since that is the area that amasses the most costs. I haven't really heard of it much on the outpatient side of medicine. What I'm saying is that a 15 min. derm visit is much more practical than a 15 min. Gen. IM visit.
 
DermViser said:
So far, I've mainly heard of bundled payments being used in the inpatient model, since that is the area that amasses the most costs. I haven't really heard of it much on the outpatient side of medicine. What I'm saying is that a 15 min. derm visit is much more practical than a 15 min. Gen. IM visit.
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ah, gotcha
 
Frazier said:
ah, gotcha
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That's why I think it's so stupid to attribute happiness to only reimbursement or lifestyle, many things are inherent to the specialty itself which contribute greatly to happiness. It's much more complex.
 
DermViser said:
That's why I think it's so stupid to attribute happiness to only reimbursement or lifestyle, many things are inherent to the specialty itself which contribute greatly to happiness. It's much more complex.
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True. I am sure some CT surgeon somewhere derives pleasure/happiness from giving a patient renewed life post heart transplant.
 
postbacpremed87 said:
True. I am sure some CT surgeon somewhere derives pleasure/happiness from giving a patient renewed life post heart transplant.
Click to expand...

I even know pathologists who love their jobs bc in reading slides, they get to definitively diagnose pathologic conditions on biopsy. They like the visual nature of the specialty. Every surgeon will tell you that a good pathologist is a keeper bc their read dictates how much tissue to keep taking out. All physicians are necessary. The key is to find the field that gives you the positives you like, and which you are ok with the negatives.
 
NeuroSpeed said:
And somewhere an anesthesiologist derives pleasure from inducting that overly-yappy patient.
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postbacpremed87 said:
...sure
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Most anesthesiologists like the field bc it's very time oriented in which you can change physiology right away and which you are truly caring for the patient as he/she is undergoing surgery. Anesthesiologists usually love the interaction of physiology and pharmacology. The Anesthesiology thread is one of the most active on SDN and they'll all tell you that lifestyle is not a reason to go into Anesthesiology (mainly bc it isn't a lifestyle specialty).
 
DermViser said:
I even know pathologists who love their jobs bc in reading slides, they get to definitively diagnose pathologic conditions on biopsy. They like the visual nature of the specialty. Every surgeon will tell you that a good pathologist is a keeper bc their read dictates how much tissue to keep taking out. All physicians are necessary. The key is to find the field that gives you the positives you like, and which you are ok with the negatives.
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That's why it is important to find a specialty you love. I love the field of neurology and neuroscience in general. Many people are turned off by the lack of available treatments for horrible diseases, but that provides intrigue for me. I think the CNS/PNS are fascinating and the diseases that afflict it are frightening. Your patient will be so thankful for just putting a name to their symptoms. It allows you the chance to solve puzzles and be a brilliant diagnostician. Plus I am sure that several efficacious treatments will be developed in the field of neurology over the course of my career.
 
postbacpremed87 said:
That's why it is important to find a specialty you love. I love the field of neurology and neuroscience in general. Many people are turned off by the lack of available treatments for horrible diseases, but that provides intrigue for me. I think the CNS/PNS are fascinating and the diseases that afflict it are frightening. Your patient will be so thankful for just putting a name to their symptoms. It allows you the chance to solve puzzles and be a brilliant diagnostician. Plus I am sure that several efficacious treatments will be developed in the field of neurology over the course of my career.
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I think it's great to have an idea of what you want to do, but it's important to be flexible. For example, Neuroanatomy/Neuroscience learned in basic sciences, is very different than the day to day practice of clinical Neurology. Of course, this can be altered by doing certain fellowships, in which you can learn procedures which can make the specialty more action-oriented.
 
DermViser said:
I think it's great to have an idea of what you want to do, but it's important to be flexible. For example, Neuroanatomy/Neuroscience learned in basic sciences, is very different than the day to day practice of clinical Neurology. Of course, this can be altered by doing certain fellowships, in which you can learn procedures which can make the specialty more action-oriented.
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I am flexible. I do like different aspects of the field...stroke/vascular is fascinating as well as the procedural aspects of interventional and NCC . Doing a clinical neurophysiology fellowship and then working in private practice is an option too. We will see. After it is all said and done I will probably go into something completely different like general surgery.
 
rocketbooster said:
Lol compare the ones at the top to the bottom. All the ones toward the top are the ones with either the highest reimbursement or a mix of good lifestyle and high reimbursement. The bottom are the ones with basically the lowest compensation or combo of bad lifestyle + low compensation. Hilarious.


fig24.jpg
Click to expand...

Not sure why it's hilarious.

Underpaid, overworked vs well paid and well rested.

Btw, I like this one better because it includes other questions:

fig25.jpg
 
@JackShephard said:
Not sure why it's hilarious.

Underpaid, overworked vs well paid and well rested.

Btw, I like this one better because it includes other questions:

fig25.jpg
Click to expand...

I think the most mind blowing thing about these numbers is IM, the highest percent of them would choose to be a physician, but by far the lowest % would choose their specialty again. So seems like they think they are in a great profession but are stuck in the wrong field, that sort of feeling must eat at your soul.

Also pretty amazing that psychiatrists seem to be consistently grouping into the mix of the competitive specialties instead of down with FM/IM/Neuro where most would expect it
 
Armadillos said:
I think the most mind blowing thing about these numbers is IM, the highest percent of them would choose to be a physician, but by far the lowest % would choose their specialty again. So seems like they think they are in a great profession but are stuck in the wrong field, that sort of feeling must eat at your soul.

Also pretty amazing that psychiatrists seem to be consistently grouping into the mix of the competitive specialties instead of down with FM/IM/Neuro where most would expect it
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Why would one expect psychiatrists to be down with FM/IM/Neuro? Psychiatry is an excellent outpatient specialty. I can completely see how it's satisfying.
 
DermViser said:
Why would one expect psychiatrists to be down with FM/IM/Neuro? Psychiatry is an excellent outpatient specialty. I can completely see how it's satisfying.
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By "would expect" I meant from competitiveness and general reputation. Personally I love psych, thats why its going to be my career haha
 
Armadillos said:
By "would expect" I meant from competitiveness and general reputation. Personally I love psych, thats why its going to be my career haha
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The problem is that competitiveness and reputation feed off eachother and a lot of that feeds off of one's underlying values on what they desire in a specialty. When you're told what are the "competitive" specialties in medical school, that can color perceptions of a field when it's labeled "not competitive".
 
DermViser said:
Why would one expect psychiatrists to be down with FM/IM/Neuro? Psychiatry is an excellent outpatient specialty. I can completely see how it's satisfying.
Click to expand...

Yeah, I'd never expect psych to be down with FM/IM. It's fairly low competition-wise because Psych applicants basically self-select. You have to be willing to 1) Deal with the problems in Psych (which not many doctors are up to), 2) Deal with the fact that you'll essentially never physically examine another patient and 3) Deal with the overall lack of respect/"not real doctor" vibe. Not many medical students can put up with all that, so competition is fairly low. Overall, it's an excellent specialty in terms of hours worked vs salary and lifestyle. Psych easily touches 200K with the majority of psychiatrists working 40hrs/wk or less. It's kind of the same reason I'm not surprised Peds is up from mid to high in satisfaction in all these surveys...again the applicants basically self-select because they enjoy the field. There's no incentive to go into Peds if you don't like it because 1) The pay is lower and 2) You need to like working with kids.

FM/IM on the other hand tends to be the dumping ground for a lot of the people scrambling, IMGs trying to match into US residencies, etc.

I'm not really sure what the deal is with Neuro...they make pretty solid money overall. Most of the salaries I've seen are low-mid 200s. Maybe its the nature of the field but I don't see why
 
calvnandhobbs68 said:
Yeah, I'd never expect psych to be down with FM/IM. It's fairly low competition-wise because Psych applicants basically self-select. You have to be willing to 1) Deal with the problems in Psych (which not many doctors are up to), 2) Deal with the fact that you'll essentially never physically examine another patient and 3) Deal with the overall lack of respect/"not real doctor" vibe. Not many medical students can put up with all that, so competition is fairly low. Overall, it's an excellent specialty in terms of hours worked vs salary and lifestyle. Psych easily touches 200K with the majority of psychiatrists working 40hrs/wk or less. It's kind of the same reason I'm not surprised Peds is up from mid to high in satisfaction in all these surveys...again the applicants basically self-select because they enjoy the field. There's no incentive to go into Peds if you don't like it because 1) The pay is lower and 2) You need to like working with kids.

FM/IM on the other hand tends to be the dumping ground for a lot of the people scrambling, IMGs trying to match into US residencies, etc.

I'm not really sure what the deal is with Neuro...they make pretty solid money overall. Most of the salaries I've seen are low-mid 200s. Maybe its the nature of the field but I don't see why
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I think it's hard for people to wrap their minds around problems in Psych bc in academic medicine they're so used to doing something TO patients, whether it's a physical exam maneuver or a procedure. As far as 1) that can also vary GREATLY depending on your population, whether it's an adult or child, etc.
 
What's the deal with neurology? I really don't understand why they would be looked down upon/why it would be a "bad" specialty. Is there something I'm just missing?
 
Derms are laughing all the way to the bank while being the happiest physicians overall. Now I understand why other specialties resent derms... Overall psych is not that bad, but they are crying on their way to the bank...
 
BestDoctorEver said:
Derms are laughing all the way to the bank while being the happiest physicians overall. Now I understand why other specialties resent derms... Overall psych is not that bad, but they are crying on their way to the bank...
Click to expand...

Actually, no they're not Mr. Class of 2018, MS-0. Psychiatry also ranked #2 on the list on overall satisfaction.
 
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BestDoctorEver said:
Derms are laughing all the way to the bank while being the happiest physicians overall. Now I understand why other specialties resent derms... Overall psych is not that bad, but they are crying on their way to the bank...
Click to expand...

I don't get why premeds insist on posting here.
 
Kapooya said:
What's the deal with neurology? I really don't understand why they would be looked down upon/why it would be a "bad" specialty. Is there something I'm just missing?
Click to expand...

At least for me, neurology deals with a lot of depressing issues that you can't do much for. Well-respected writer/doctor/lawyer/whatever can't even wipe his ass because of advanced Alzheimers? Good luck doing anything about it.

Neurology makes you confront just how fragile a human being is, and it's not a pretty sight.
 
Armadillos said:
I think the most mind blowing thing about these numbers is IM, the highest percent of them would choose to be a physician, but by far the lowest % would choose their specialty again. So seems like they think they are in a great profession but are stuck in the wrong field, that sort of feeling must eat at your soul.
Click to expand...

Yep. To them the grass is greener. They hear about the $$$ and lifestyle of the others and think "damn I could have done that instead." Of course many of them could have been just as dissatisfied in one of the "better" specialties, but they don't know that. On the other hand those that are dissatisfied with Derm (for example) know that they got one of the best gigs in medicine. If not derm then screw it, they would rather be outta medicine all together.
 
BestDoctorEver said:
Derms are laughing all the way to the bank while being the happiest physicians overall. Now I understand why other specialties resent derms... Overall psych is not that bad, but they are crying on their way to the bank...
Click to expand...

Psych has a pretty good income to lifestyle ratio as others have said. Not to mention MANY fields are experiencing a tough job market nowadays (Rads, Path, Cards, etc) while Psych is hardly saturated anywhere, including coastal California. That job market will only improve as somewhere around 70% of psychiatrists are age 50 and older compared to 43% for physicians in general.

Merritt Hawkins says "The dearth of psychiatrists continues to represent a “silent shortage.” Psychiatry was third on the list of Merritt Hawkins’ most requested search assignments. Though the shortage of psychiatrists receives less attention than the primary care shortage, the 2012 Review suggests it remains equally acute."

These jobs don't sound half bad.

VA @ Palo Alto, CA https://www.usajobs.gov/GetJob/ViewDetails/359703400
$130,000.00 to $240,000.00 / Per Year; M-F 8AM-4:30PM

Mission Viejo California Private Practice http://jobs.psychiatry.org/jobseeke...utpatient/__company__/?vnet=0&max=25&t735=120
150,000 to 400,000; M-F; no nights, weekends or holidays
 
Slack3r said:
At least for me, neurology deals with a lot of depressing issues that you can't do much for. Well-respected writer/doctor/lawyer/whatever can't even wipe his ass because of advanced Alzheimers? Good luck doing anything about it.

Neurology makes you confront just how fragile a human being is, and it's not a pretty sight.
Click to expand...
Your example is quite crude and shocking, but true. I absolutely loved learning Neuroanatomy and Neuroscience. But felt so helpless on the Neurology rotation. Truly get to see the real human limits of neuro intervention.
 
it is interesting to see ortho being so unsatisfied with their income despite being one of the highest paid specialties.

any speculation, speculators?
 
SurgeDO said:
it is interesting to see ortho being so unsatisfied with their income despite being one of the highest paid specialties.

any speculation, speculators?
Click to expand...
Probably the guys that take trauma call; unpredictable schedule with add-on cases and busy nights on call leads to dissatisfaction.
 
qwerty89 said:
Psych has a pretty good income to lifestyle ratio as others have said. Not to mention MANY fields are experiencing a tough job market nowadays (Rads, Path, Cards, etc) while Psych is hardly saturated anywhere, including coastal California. That job market will only improve as somewhere around 70% of psychiatrists are age 50 and older compared to 43% for physicians in general.

Merritt Hawkins says "The dearth of psychiatrists continues to represent a “silent shortage.” Psychiatry was third on the list of Merritt Hawkins’ most requested search assignments. Though the shortage of psychiatrists receives less attention than the primary care shortage, the 2012 Review suggests it remains equally acute."

These jobs don't sound half bad.

VA @ Palo Alto, CA https://www.usajobs.gov/GetJob/ViewDetails/359703400
$130,000.00 to $240,000.00 / Per Year; M-F 8AM-4:30PM

Mission Viejo California Private Practice http://jobs.psychiatry.org/jobseeker/job/13179237/Adult Psychiatrist, Full-Time Outpatient/__company__/?vnet=0&max=25&t735=120
150,000 to 400,000; M-F; no nights, weekends or holidays
Click to expand...
400k? I am sure they put that 400k as a bait...
 
qwerty89 said:
Psych has a pretty good income to lifestyle ratio as others have said. Not to mention MANY fields are experiencing a tough job market nowadays (Rads, Path, Cards, etc) while Psych is hardly saturated anywhere, including coastal California. That job market will only improve as somewhere around 70% of psychiatrists are age 50 and older compared to 43% for physicians in general.

Merritt Hawkins says "The dearth of psychiatrists continues to represent a “silent shortage.” Psychiatry was third on the list of Merritt Hawkins’ most requested search assignments. Though the shortage of psychiatrists receives less attention than the primary care shortage, the 2012 Review suggests it remains equally acute."

These jobs don't sound half bad.

VA @ Palo Alto, CA https://www.usajobs.gov/GetJob/ViewDetails/359703400
$130,000.00 to $240,000.00 / Per Year; M-F 8AM-4:30PM

Mission Viejo California Private Practice http://jobs.psychiatry.org/jobseeker/job/13179237/Adult Psychiatrist, Full-Time Outpatient/__company__/?vnet=0&max=25&t735=120
150,000 to 400,000; M-F; no nights, weekends or holidays
Click to expand...

The only downside is that NPs are finding out about how good these jobs can be (130k salary with 35-40 hr weeks), and the government (via scope of practice laws) and employers want this to happen.

I wonder how long it will last.
 
@JackShephard said:
The only downside is that NPs are finding out about how good these jobs can be (130k salary with 35-40 hr weeks), and the government (via scope of practice laws) and employers want this to happen.

I wonder how long it will last.
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This is not what I want to hear now... I hope they never let NP prescribe narcs in FL... I am not sure NP psych make that much-- it is more like 80K-100K, but still a good salary considering most of them don't have hefty student loan.
 
qwerty89 said:
Psych has a pretty good income to lifestyle ratio as others have said. Not to mention MANY fields are experiencing a tough job market nowadays (Rads, Path, Cards, etc) while Psych is hardly saturated anywhere, including coastal California. That job market will only improve as somewhere around 70% of psychiatrists are age 50 and older compared to 43% for physicians in general.

Merritt Hawkins says "The dearth of psychiatrists continues to represent a “silent shortage.” Psychiatry was third on the list of Merritt Hawkins’ most requested search assignments. Though the shortage of psychiatrists receives less attention than the primary care shortage, the 2012 Review suggests it remains equally acute."

These jobs don't sound half bad.

VA @ Palo Alto, CA https://www.usajobs.gov/GetJob/ViewDetails/359703400
$130,000.00 to $240,000.00 / Per Year; M-F 8AM-4:30PM

Mission Viejo California Private Practice http://jobs.psychiatry.org/jobseeker/job/13179237/Adult Psychiatrist, Full-Time Outpatient/__company__/?vnet=0&max=25&t735=120
150,000 to 400,000; M-F; no nights, weekends or holidays
Click to expand...

LOL @ Palo Alto home prices.

http://www.realtor.com/realestatean...k-Blvd_Palo-Alto_CA_94306_M27358-17464?row=50

All about the markets. Amazing.
 
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