Obamacare and Physician Salaries

[Syndicate]

Pure speculation

True but very logical speculation as well.

I know n=1 but a very good friend of mine used to be premed but got a C in orgo, changed his major to economics and currently is working for an IB firm in NYC. Will he be a successful IBer? I don't know. Will I be a successful physician? I don't know. But why did he try out for medical school first and then switch to an easier career when he failed the tryout?

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[Mad Jack]

 

[BlueLabel]

True but very logical speculation as well.

I know n=1 but a very good friend of mine used to be premed but got a C in orgo, changed his major to economics and currently is working for an IB firm in NYC. Will he be a successful IBer? I don't know. Will I be a successful physician? I don't know. But why did he try out for medical school first and then switch to an easier career when he failed the tryout?

All I'm saying here is that on here we have a lot of experienced people well versed in this process and that gives us a lot of insight on what it takes to be successful as a physician. Do you really think you have an equal or greater level of insight as to what it takes to make it into and be successful in IB? Because I sure don't.

 

[circulus vitios]

Good point but I would say that there are a lot of future doctors who would be qualified for those IB jobs if they planned for an IB career all the way back in high school. The education, work ethic, training, dedication, cost, and discipline that goes into becoming a doctor is far greater than that of becoming successful in careers like IB. If you can become a successful specialist, chances are you could have become a successful hedge fund manager given your attributes. Of course, I'm speaking generally.

That is completely wrong. Look up the resumes of typical bulge bracket analysts. Look up the attrition rates of bulge bracket firms while you're at it. The vast majority of analysts burn out or are asked to leave within 2-3 years. Investment banking isn't an industry where you can sit around forever -- it's up or out, and very small number of analysts make it all the way to VP, let alone the higher ranks.

I know people who went to Columbia and Cornell who were looking to get into financing. Most had 3.8+ GPA's in various econ/math majors. At the end of undergrad only 5 or so out of 20 actually got a job in finance, with most of the others going into medicine/law after a couple years of unsuccessfully breaking into banking/finance. Med school was considered a back-up to these folks. Out of the 5 or so that ended up in finance straight out of undergrad only 2 have not been terminated, and yes they are making big bucks now (approx 5 years out of undergrad >500k working close to 100hrs/wk).

Those 2 guys also party/drink harder than anyone I know now.

 

[Tommyguns89]

Good point but I would say that there are a lot of future doctors who would be qualified for those IB jobs if they planned for an IB career all the way back in high school. The education, work ethic, training, dedication, cost, and discipline that goes into becoming a doctor is far greater than that of becoming successful in careers like IB. If you can become a successful specialist, chances are you could have become a successful hedge fund manager given your attributes. Of course, I'm speaking generally.

I actually dont disagree for the most part but the sticking point like you said is planning for it and being mature enough to follow through in high school. Getting into the feeder schools for those jobs these days is pretty hard. Its probably comparable to getting into a top medical school only you have to have that level of maturity in high school and there are less feeder schools. Not to mention I dont know a single person who had their careers accurately planned out in high school. I guess the point is that there is that the window to get on the IB track is so very small, if you arent on it in high school chances are you never will be. In medicine if you have a decent GPA in college while on a different career track the only thing standing between you and acceptance(if you dont need to go to a "top school") is the pre-reqs, MCAT and clinical experience/volunteering/shadowing.

 

[darkjedi]

Having come from the banking industry into medicine, I can say for sure that you do not have to be super qualified to be an ibanker. Sure you have to be intelligent, but it is not like med school admissions, where only the best and brightest can make it through all the GPA/MCAT/EC hoops. The priority is not nearly as focused on intelligence as it is in medical school applications. In banking, 2 things trump all, and that is the people you know and your undergraduate institution.

This means two things. One, just because you were successful as an ibanker, doesn't mean you could've gotten into med school. And two, just because you got into med school (or became a succesful physician) doesn't mean you would've been a successful banker. The two industries utilize different skillsets and value different attributes.

 

[circulus vitios]

Having come from the banking industry into medicine, I can say for sure that you do not have to be super qualified to be an ibanker. Sure you have to be intelligent, but it is not like med school admissions, where only the best and brightest can make it through all the GPA/MCAT/EC hoops. The priority is not nearly as focused on intelligence as it is in medical school applications. In banking, 2 things trump all, and that is the people you know and your undergraduate institution.

This means two things. One, just because you were successful as an ibanker, doesn't mean you could've gotten into med school. And two, just because you got into med school (or became a succesful physician) doesn't mean you would've been a successful banker. The two industries utilize different skillsets and value different attributes.

I think it's a lot easier to work your ass off and get a high GPA and MCAT than it is to get a bachelors or graduate degree at one of the handful of schools that are targeted by investment banks. I did the former and there's no way in hell I could have done the latter.

 

[Temerit]

which means they'll just perform more procedures, sometimes unnecessary ones that don't cause harm but do minimal good.

This is completely wrong. The ACA through the centers for Medicare/Medicaid innovation are attempting to move completely from a fee for service model to a pay for performance model. In doing so they are hoping to eliminate the incentive to perform wasteful procedures. There are obviously problems with instituting a pay for performance model -- most importantly, how are you going to judge physician performance? So, like an above poster pointed out there's really no way to tell exactly what will happen. There are too many factors at play and we're going to have to wait to see how things shake out.

Physician pay isn't going to take a nosedive though.

 

[Tommyguns89]

This is completely wrong. The ACA through the centers for Medicare/Medicaid innovation are attempting to move completely from a fee for service model to a pay for performance model. In doing so they are hoping to eliminate the incentive to perform wasteful procedures. There are obviously problems with instituting a pay for performance model -- most importantly, how are you going to judge physician performance? So, like an above poster pointed out there's really no way to tell exactly what will happen. There are too many factors at play and we're going to have to wait to see how things shake out.

Physician pay isn't going to take a nosedive though.

Sounds like doctors would be more likely to select their patients carefully based on who was more likely to have a positive outcome, leading to some patients who need care the most having a harder time.

 

[darkjedi]

I think it's a lot easier to work your ass off and get a high GPA and MCAT than it is to get a bachelors or graduate degree at one of the handful of schools that are targeted by investment banks. I did the former and there's no way in hell I could have done the latter.

I'm not denying that. It's also not impossible to break into an investment bank even if you come from a non-Ivy, though decidedly harder. The difference in difficulty between getting into med school and getting into investment banking is pretty subjective however. One relies upon hard work, grades, test scores, while the other relies more upon luck, prestige and connections.

 

[Temerit]

Sounds like doctors would be more likely to select their patients carefully based on who was more likely to have a positive outcome, leading to some patients who need care the most having a harder time.

Right, which is why I could see such a transition turning out to be either positive or negative depending on how implementation is actually carried out. Issues like this are what fascinate me about public policy, because you always have to consider alternate ways in which policy might influence the behavior of actors within the system that the policy is targeting. Many of these alternate and unintended alterations of behavior can effectively defeat the purpose of the policy and fail to achieve its aims.

 

[Syndicate]

I think it's a lot easier to work your ass off and get a high GPA and MCAT than it is to get a bachelors or graduate degree at one of the handful of schools that are targeted by investment banks. I did the former and there's no way in hell I could have done the latter.

But for those who attended one of those top 10/ivy undergrads and were able to get into medical school, they could have easily gotten into investment banking.

 

[SunsFun]

Pay for performance is a disaster. Who would dictate a physicians performance? If a patient doesn't listen is it the physician's fault?
Should I get paid more or less depending on how good I cook the steak from time to time?

These strategies put financial pressure on medical providers. In such programs, reimbursement reflects provider performance on quality metrics based on adherence to certain care processes, scores on patient satisfaction surveys, or patient outcomes.
In fact, however, the Medicare pay-for-performance strategy is not market-driven; it is a strategy to replace the function of a market with government management of health care delivery. This approach will not solve the problem of sluggish quality improvement; nor will it drive patients to better value care. It will, however, introduce perverse new incentives into the delivery of health care that direct resources away from real improvement and even harm quality.

You give the exact same reasons, more or less, as the teacher give against standardized testing and using the test as another metric to determine salary. Nobody is suggesting taking two physicians in completely different locations and judging them against each other based on the outcomes of two different patient populations. But two ER docs working at the same hospital and taking similar shifts can be compared to a much greater extend.

Look, currently we do not have a market-driven healthcare. Not even close. It is well-established industry that had set up barriers to entry and various check points in the process to benefit the providers, insurance companies, and pharma. There isn't going to be any replacement of free market with socialism.

It puzzles me how you can be so certain about what is going to happen in decades to come with ACA in place. The bundled payment plans are only in the "beta testing" phase right now in limited locations, as far as I understand it. It is way too early to know one way or another. There are good examples of some type of incentive system having positive outcomes in other countries (Britain leading the world in preventative care).

 

[sazerac]

Sounds like doctors would be more likely to select their patients carefully based on who was more likely to have a positive outcome, leading to some patients who need care the most having a harder time.

I wonder if it would lead to patients demonstrating that they do take all their medications as directed and follow all other physician requests, so that they can be seen by the picky and desirable physicians? Like doctors will only see patients with high MICO scores or something.

 

[HeadEast2014]

Doctors making more money - Good. Poor are just poor and can't receive healthcare - Tough Luck. What's fair about self-sacrifice on the physicians part? If physicians gave up all their money they would have achieved sainthood in the views of this country, this idea of morality is distorted. There is no such thing or concept as equality. If I want to be on the same level as Michael Jordan, the only way is to break his arms and legs. People are born rich some poor, some with unique talents some not, some intelligent some idiots.

The higher the salaries for not just physicians but anyone is good. They increase our standard of living, they create value, it's a voluntary exchange between free individuals. Our lives are much better off without anyone trying to dictate the healthcare system and destroying the incentive to pursue medicine when there's already a saturation/shortage issue in PC.

Poor people being denied access to healthcare is tough luck? Couldn't disagree more with this. We are the richest country in the world, and our infant mortality rate, maternal mortality rate, and (perhaps a more of a measure of lifestyle than healthcare system) average lifespans are embarrassing (I happened across the world rankings on the CIA World Factbook a few days ago--really good resource for country comparisons).

The simple fact of the matter is that free market arguments don't at all apply in healthcare, and those that promote them are either misguided or looking to profit by misguiding others. If I'm having a heart attack, I'm going to the NEAREST hospital, not Johns Hopkins Hospital even though I know it rocks (because I live in Missouri).
I don't get a vote in my provider in the same way I do when buying a car--thus, relying on the magical free market to fix our healthcare problems instead of being proactive is irresponsible and a recipe for disaster... And the only way to justify the disaster is to say "tough luck poor people, I guess you don't get care"...

 

[Pacna]

Poor people being denied access to healthcare is tough luck? Couldn't disagree more with this. We are the richest country in the world, and our infant mortality rate, maternal mortality rate, and (perhaps a more of a measure of lifestyle than healthcare system) average lifespans are embarrassing (I happened across the world rankings on the CIA World Factbook a few days ago--really good resource for country comparisons).

The simple fact of the matter is that free market arguments don't at all apply in healthcare, and those that promote them are either misguided or looking to profit by misguiding others. If I'm having a heart attack, I'm going to the NEAREST hospital, not Johns Hopkins Hospital even though I know it rocks (because I live in Missouri).
I don't get a vote in my provider in the same way I do when buying a car--thus, relying on the magical free market to fix our healthcare problems instead of being proactive is irresponsible and a recipe for disaster... And the only way to justify the disaster is to say "tough luck poor people, I guess you don't get care"...

You are not analyzing the alternative which is quite a bit more immoral. Any alternative to a free market solution injects physical violent force into the equation. You want to tax a population to pay for poorer peoples' health care? That has to be enforced through threats of violence (and actual violence in the case of those who refuse to pay). You want to force doctors to treat those who can't pay? That has to be enforced through the same threats of violence as the previous example.

Nobody is saying "tough luck" to those in need. Personally, I volunteer my time and money frequently to the disadvantaged. However, I'm not willing to use the guns of the state to make YOU do that. If you want to be a greedy jerk and leave the needy in the ditch, that's your prerogative. However, if you want to help those in need, you don't have the right to force others to join you.

 

[HeadEast2014]

You are not analyzing the alternative which is quite a bit more immoral. Any alternative to a free market solution injects physical violent force into the equation. You want to tax a population to pay for poorer peoples' health care? That has to be enforced through threats of violence (and actual violence in the case of those who refuse to pay). You want to force doctors to treat those who can't pay? That has to be enforced through the same threats of violence as the previous example.

Nobody is saying "tough luck" to those in need. Personally, I volunteer my time and money frequently to the disadvantaged. However, I'm not willing to use the guns of the state to make YOU do that. If you want to be a greedy jerk and leave the needy in the ditch, that's your prerogative. However, if you want to help those in need, you don't have the right to force others to join you.

It sounds like your argument here could apply to any government service. Any form of tax could be construed as a "threat of physical violent force". If you oppose healthcare regulation on these principles, then it seems to me that you would also have to oppose taxes that go to education or infrastructure for the same reason.

 

[notbobtrustme]

You are not analyzing the alternative which is quite a bit more immoral. Any alternative to a free market solution injects physical violent force into the equation. You want to tax a population to pay for poorer peoples' health care? That has to be enforced through threats of violence (and actual violence in the case of those who refuse to pay). You want to force doctors to treat those who can't pay? That has to be enforced through the same threats of violence as the previous example.

Nobody is saying "tough luck" to those in need. Personally, I volunteer my time and money frequently to the disadvantaged. However, I'm not willing to use the guns of the state to make YOU do that. If you want to be a greedy jerk and leave the needy in the ditch, that's your prerogative. However, if you want to help those in need, you don't have the right to force others to join you.

Put your money where your mouth is and refuse all government loans for your education.

 

[Beargryllz]

You are not analyzing the alternative which is quite a bit more immoral. Any alternative to a free market solution injects physical violent force into the equation. You want to tax a population to pay for poorer peoples' health care? That has to be enforced through threats of violence (and actual violence in the case of those who refuse to pay). You want to force doctors to treat those who can't pay? That has to be enforced through the same threats of violence as the previous example.

Nobody is saying "tough luck" to those in need. Personally, I volunteer my time and money frequently to the disadvantaged. However, I'm not willing to use the guns of the state to make YOU do that. If you want to be a greedy jerk and leave the needy in the ditch, that's your prerogative. However, if you want to help those in need, you don't have the right to force others to join you.

I'm fine with the alternative and don't find it particularly immoral. I don't fear for my life when the gas station clerk rings up my bill despite being faced with massive taxes. I don't fear for my life when I cash my paychecks or count my investment returns each year. I would fear for my life if I was suddenly terminated and left without income or health care. Do you understand?

 

[SunsFun]

You are not analyzing the alternative which is quite a bit more immoral. Any alternative to a free market solution injects physical violent force into the equation. You want to tax a population to pay for poorer peoples' health care? That has to be enforced through threats of violence (and actual violence in the case of those who refuse to pay). You want to force doctors to treat those who can't pay? That has to be enforced through the same threats of violence as the previous example.

Nobody is saying "tough luck" to those in need. Personally, I volunteer my time and money frequently to the disadvantaged. However, I'm not willing to use the guns of the state to make YOU do that. If you want to be a greedy jerk and leave the needy in the ditch, that's your prerogative. However, if you want to help those in need, you don't have the right to force others to join you.

You're going to pay taxes to provide free care regardless. It just might be better idea to take care of the problems with preventative measurements rather than waiting it out and going to ER.

 

[RogueUnicorn]

Jesus christ a lot of derp in the first half of this thread. Looks like a lot of you have to do a bit of reading, and not just CNN or Fox News.

 

[Pacna]

Put your money where your mouth is and refuse all government loans for your education.

Would you tell a slave to stop accepting food from his/her master? It's not hypocritical to be born into an ideologically inconsistent situation.

For the record, all of my student loans are private loans. However, this doesn't matter either way as per above. My loans are affected by the government's interference in the loan market.

 

[Pacna]

It sounds like your argument here could apply to any government service. Any form of tax could be construed as a "threat of physical violent force". If you oppose healthcare regulation on these principles, then it seems to me that you would also have to oppose taxes that go to education or infrastructure for the same reason.

Correct.

 

[sourdoughllama]

Jesus christ a lot of derp in the first half of this thread. Looks like a lot of you have to do a bit of reading, and not just CNN or Fox News.

sdfwer derp derp derp cabbage patch kids

 

[BestDoctorEver]

I can't wait for the table to turn so specialists' compensation can be in the 150k-200k/year and PCPs in 300k+. PCPs have been getting the end of the stick long enough IMO.

 

[RogueUnicorn]

sdfwer derp derp derp cabbage patch kids

yea pretty much actually

I can't wait for the table to turn so specialists' compensation can be in the 150k-200k/year and PCPs in 300k+. PCPs have been getting the end of the stick long enough IMO.

totally reasonable and not at all completely daft. because you know, of course everything has to be a zero-sum game, let's make sure to take money away from people with a decade longer training so we can compensate PCPs adequately. makes a lot of sense.

 

[sourdoughllama]

yea pretty much actually

totally reasonable and not at all completely daft. because you know, of course everything has to be a zero-sum game, let's make sure to take money away from people with a decade longer training so we can compensate PCPs adequately. makes a lot of sense.

For someone who makes fun of others posts, your claim is "totally reasonable and not at all completely daft." Who knew specialist residency training takes 13 or 14 years total?? Mind blown

 

[BestDoctorEver]

yea pretty much actually

totally reasonable and not at all completely daft. because you know, of course everything has to be a zero-sum game, let's make sure to take money away from people with a decade longer training so we can compensate PCPs adequately. makes a lot of sense.

Sorry that I did not know that compensation should be commensurate with how long people spend in training. I guess we should ask these anesthesiologists why they are getting 400k+ while ID docs are getting 180-220k...

 

[RogueUnicorn]

For someone who makes fun of others posts, your claim is "totally reasonable and not at all completely daft." Who knew specialist residency training takes 13 or 14 years total?? Mind blown

you ever meet a pediatric ct surgeon? i'll wait while you pick up pieces of your mind

Sorry that I did not know that compensation should be commensurate with how long people spend in training. I guess we should ask these anesthesiologists why they are getting 400k+ while ID docs are getting 180-220k...

you are forgiven for not knowing that making a salary for a longer period of time means more money. that ID docs and other primary type specialties are getting underpaid doesn't mean the other specialties are being overpaid.

 

[sourdoughllama]

you ever meet a pediatric ct surgeon? i'll wait while you pick up pieces of your mind

.

 

[BestDoctorEver]

you ever meet a pediatric ct surgeon? i'll wait while you pick up pieces of your mind


you are forgiven for not knowing that making a salary for a longer period of time means more money. that ID docs and other primary type specialties are getting underpaid doesn't mean the other specialties are being overpaid.

Huh... Ortho docs 450k (30 years) and PCPs 200k (32 years)... These are simple multiplications... Seriously!

 

[TheWeeIceMan]

totally reasonable and not at all completely daft. because you know, of course everything has to be a zero-sum game, let's make sure to take money away from people with a decade longer training so we can compensate PCPs adequately. makes a lot of sense.

I don't know man, it sure seems like CMS is playing it like a zero-sum game.

 

[RogueUnicorn]

The vast majority of medical training is under 10 years (residency + fellowship). Digging up the 5% of specialties that go past that is ridiculous. Anesthesia vs PCP? Radiology vs PCP? Surgery vs PCP? Stop with your high horse posts and back it up with concrete, non-exaggerated opinions.

I don't have percentages but there are a TON of fields that bump up to or are over 10 years. That's not opinion, it's fact. Regarding surgery, it's a 5-7 year program for general, minimum, versus 3 for PCP. Add in a fellowship and there you go. Not to mention that a ton of people take a year off to match in competitive surgical subs, surgical training is very long, probably for good reason. The vast majority of medical training is indeed under 10 years but the vast majority of non-PCP physicians aren't making it rain like some of you seem to think. Regarding, anesthesia, I don't know much about them but I do know ~50% of grads undergo further fellowship training. Not to mention you are actually licensed for PCP practice with only internship, something that might actually fly if you're really out in the sticks. (not a realistic scenario in most cases) I like my horse.

Huh... Ortho docs 450k (30 years) and PCPs 200k (32 years)... These are simple multiplications... Seriously!

Ortho docs = 60 hours/week. PCP docs = 40 hours/week.... seriously! And most importantly, I am not even in the slightest saying there isn't income equity, but rather that two wrongs don't make a right, something you've conveniently ignored.

I don't know man, it sure seems like CMS is playing it like a zero-sum game.

It sure does but it certainly doesn't help our case when potential future members of the profession buy into that mindset

 

[sourdoughllama]

I like my horse.

That's fine with me. You show up, make fun of people for making poor arguments, and then make poor arguments. 0/10

 

[RogueUnicorn]

That's fine with me. You show up, make fun of people for making poor arguments, and then make poor arguments. 0/10

and my arguments are poor why?

 

[BestDoctorEver]

Ortho docs = 60 hours/week. PCP docs = 40 hours/week.... seriously! And most importantly, I am not even in the slightest saying there isn't income equity, but rather that two wrongs don't make a right, something you've conveniently ignored.

I am glad you are agreeing with me! Anyway it seems like the system is not going in the 'two rights' direction; therefore, I am waiting for the 'two wrongs' correction so I can purge that resentment out of me... Just kidding bro!

 

[RogueUnicorn]

I am glad you are agreeing with me! Anyway it seems like the system is not going in the 'two rights' direction; therefore, I am waiting for the 'two wrongs' correction so I can purge that resentment out of me... Just kidding bro!

I don't think we've ever disagreed on the core that PCPs need to be paid more

 

[sourdoughllama]

and my arguments are poor why?

1- I claimed in my first reply that specialist training does not take a decade more than PCP. I don't care if you add all the fellowships you want to other specialties. 10+ years does not equal PCP + 10 years.
2- I called you out for posting high horse posts with no facts. You come back with "those aren't opinions, they're facts." Okay then, where are your sources? "I like my horse"? Really?

I don't have percentages but there are a TON of fields that bump up to or are over 10 years. That's not opinion, it's fact. Regarding surgery, it's a 5-7 year program for general, minimum, versus 3 for PCP. Add in a fellowship and there you go. Not to mention that a ton of people take a year off to match in competitive surgical subs, surgical training is very long, probably for good reason. The vast majority of medical training is indeed under 10 years but the vast majority of non-PCP physicians aren't making it rain like some of you seem to think. Regarding, anesthesia, I don't know much about them but I do know ~50% of grads undergo further fellowship training. Not to mention you are actually licensed for PCP practice with only internship, something that might actually fly if you're really out in the sticks. (not a realistic scenario in most cases) I like my horse.

3- If you're gonna come in and make fun of people for "derping" then step it up and back up your claims with facts and numbers. If you're gonna belittle others then you better be prepared to be scrutinized

 

[HeadEast2014]

Correct.

Thanks for clearing that up. I think sometimes people come at the same problem from such extremely different starting points that consensus just isn't possible. Politely agree to disagree!

 

[Pacna]

Thanks for clearing that up. I think sometimes people come at the same problem from such extremely different starting points that consensus just isn't possible. Politely agree to disagree!

Fair enough! 🙂

 

[Reckoner]

Fair enough! 🙂

I've seen you post about this a few times, and I'm curious: what party/political school of thought do you associate with? Not trying to debate you or anything, I've just never met someone so consistent in their opposition to all government.

 

[Pacna]

I've seen you post about this a few times, and I'm curious: what party/political school of thought do you associate with? Not trying to debate you or anything, I've just never met someone so consistent in their opposition to all government.

The conclusions I've come to are most consistent with voluntaryism. 👍

 

[Reckoner]

The conclusions I've come to are most consistent with voluntaryism. 👍

Interesting, thanks for sharing!

 

[Pacna]

Interesting, thanks for sharing!

Always happy to discuss philosophy. 🙂

 

[Tommyguns89]

Poor people being denied access to healthcare is tough luck? Couldn't disagree more with this. We are the richest country in the world, and our infant mortality rate, maternal mortality rate, and (perhaps a more of a measure of lifestyle than healthcare system) average lifespans are embarrassing (I happened across the world rankings on the CIA World Factbook a few days ago--really good resource for country comparisons).

The simple fact of the matter is that free market arguments don't at all apply in healthcare, and those that promote them are either misguided or looking to profit by misguiding others. If I'm having a heart attack, I'm going to the NEAREST hospital, not Johns Hopkins Hospital even though I know it rocks (because I live in Missouri).
I don't get a vote in my provider in the same way I do when buying a car--thus, relying on the magical free market to fix our healthcare problems instead of being proactive is irresponsible and a recipe for disaster... And the only way to justify the disaster is to say "tough luck poor people, I guess you don't get care"...

We are the richest in the sense that we have the most millionaires and billionaires. When you compare median incomes there are quite a few countries ahead of us. This is important because the truly rich dont pay taxes in this country as it is easier for them to lobby for a complicated tax code that they can exploit. Why do you think Mitt Romney refused to release his tax records from years when he wasnt planning on running for president? Im just saying realistically if the country is going to pay for everyone's care it will be on the backs of the middle and working class.

 

[masaraksh]

Its pretty easy to make the argument that PCPs are overpaid.

 

[kyamh]

Its pretty easy to make the argument that PCPs are overpaid.

People get paid in medicine in a manner proportional to their responsibility load and to their stress load. Makes sense to me that PCPs don't get paid as much...

 

[Tommyguns89]

People get paid in medicine in a manner proportional to their responsibility load and to their stress load. Makes sense to me that PCPs don't get paid as much...

I thought that pay was mostly dependent on the amount of procedures you do?

 

[kyamh]

I thought that pay was mostly dependent on the amount of procedures you do?

Not an expert...but PCPs have a lot that they do....their schedules are super busy and they see a ton of patients. As I understand, however, their workload is less rewarded because they ultimately don't have that much responsibility for their patients...if anything goes seriously wrong then the patients go to non PCPs.

 

[Tommyguns89]

Not an expert...but PCPs have a lot that they do....their schedules are super busy and they see a ton of patients. As I understand, however, their workload is less rewarded because they ultimately don't have that much responsibility for their patients...if anything goes seriously wrong then the patients go to non PCPs.

Maybe Im not an expert either, but I dont thing that is the reason pay is different. If it was(and using the same logic to compare different specialist) why would a dermatologist make more than a trauma surgeon?