Overrated and Underrated Medical Specialties based on $$$$

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NaughtyGirl

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Recent Forbes magazine article for the highest paid and lowest paid medical speciaties.

Looks like Radiology, Anesthesiology, and Radiation Oncology are overrated.

Orthopedics, Cardiology, and Dermatology are just what we thought.

Urology and Hematology/Oncology are underrated.

Prediction
Underrated specialties are going to get very competitive very soon. Everyone will still gun for Derm and Ortho. And overrated medical specialties are going to decrease in competitiveness.

http://www.forbes.com/sites/jacquel...e-best-and-worst-paying-jobs-for-doctors-2/2/
http://www.forbes.com/sites/jacquelynsmith/2012/07/20/the-best-and-worst-paying-jobs-for-doctors-2/
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DrEnderW said:
Those figures seem pretty high... I've never came across numbers like that before.
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Those figures are ridiculous if they are talking about first year out of residency. But they look like the regular figures of those specialties. Except Derm makes a lot more than that the last time I checked.
 
Very interesting discussion...


Who is to say what a doctor should earn? It is what the market bears. When you start saying that some doctors should make less and other should make more, you are just doing exactly what the payors, government, etc. want you to do. Primary care specialties should be paid more than what they get but it should not be at the expense of cardiology, radiology, derm, anesthesiology, etc.
 
cardiology is WAY overrated, but it really isn't competitive compared to the other specialties
 
Most surveys of salaries are skewed lower by the presence of academic and part-time physicians, so keep that in mind. I bet those numbers in the Forbes article are for private-practice docs.
 
mille125 said:
Very interesting discussion...


Who is to say what a doctor should earn? It is what the market bears. When you start saying that some doctors should make less and other should make more, you are just doing exactly what the payors, government, etc. want you to do. Primary care specialties should be paid more than what they get but it should not be at the expense of cardiology, radiology, derm, anesthesiology, etc.
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I was in the process of posting something very similar to this when my phone crapped out.

These articles mean nothing to me. I know I'm going to live very comfortably once I'm working. I don't care if my job is underrated, overrated, or rated just right.
 
tco said:
I was in the process of posting something very similar to this when my phone crapped out.

These articles mean nothing to me. I know I'm going to live very comfortably once I'm working. I don't care if my job is underrated, overrated, or rated just right.
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That's the best attitude you can have.

Before anyone starts pining for the good ol days, remember that just about every career is in wage decline.
 
Who knows what they are going to get paid in ten or twenty years? The current system is unsustainable and will change gradually or catastrophically. Do what's right for you. I haven't met a poor doctor yet in the USA. But there are plenty who think they are, even in the currently highest-paid specialties. You can always want and think you deserve more than what you've got, if that's your bag.
 
Members don't see this ad :)
Yeah, this list was flipped upside down 15 years ago.
 
DrBowtie said:
Gotta correct for average hours/call.
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Agreed.

I don't like derm but for it's income + lifestyle, it moves to #1. No way a dermatologist would want to trade with an orthopedist (assuming equal love of work).
 
You guys are idiots if you think reimbursement will be anything like it is today once we get out of training. FFS and the RUC are on the way out, either by political force or market forces. A lot of the procedures done by MDs today like colonoscopy, etc will be done by NP/PA in the future, especially as the reimbursement for them plummets. Once these changes happen, there is little reason for derm to intrinsically make any more money than fam med.
 
xenotype said:
You guys are idiots if you think reimbursement will be anything like it is today once we get out of training. FFS and the RUC are on the way out, either by political force or market forces. A lot of the procedures done by MDs today like colonoscopy, etc will be done by NP/PA in the future, especially as the reimbursement for them plummets. Once these changes happen, there is little reason for derm to intrinsically make any more money than fam med.
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Anyone who thinks they can predict exactly what reimbursement will be like in the future is an idiot.
 
Wordead said:
Anyone who thinks they can predict exactly what reimbursement will be like in the future is an idiot.
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But to a degree, that's exactly what people who gun for high-paying specialties implicitly do. The only difference is they don't say it out loud.
 
xenotype said:
You guys are idiots if you think reimbursement will be anything like it is today once we get out of training. FFS and the RUC are on the way out, either by political force or market forces. A lot of the procedures done by MDs today like colonoscopy, etc will be done by NP/PA in the future, especially as the reimbursement for them plummets. Once these changes happen, there is little reason for derm to intrinsically make any more money than fam med.
Click to expand...

Ya, no. You clearly know nothing about colonoscopies if that is your example.
 
those high salaries are generally only possible if your willing to sacrifice any personal life, except maybe with derm, thats a lifestyle speciality, but with most of the others, say cards for example, your working your ass off for your whole career because you are taking care of very critical patients a lot of the time.
 
punkedoutriffs said:
But to a degree, that's exactly what people who gun for high-paying specialties implicitly do. The only difference is they don't say it out loud.
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That difference is significant.
 
Yeah the ROAD specialties are still the way to go. Even though salaries are going down everywhere, the lifestyle (work hours) are still about the same.

I would say those numbers actually look pretty good for averages in private practice. I heard $350k for ophtho and it's about $300k in Forbes. Ophtho starting salary can range a lot. You can start at $200k if you're starting at a newer practice or $500k if you're taking over someone's established practice. I've heard about $500k for ortho and cards too so sounds about right. I agree the cards one is definitely misleading now since cards was cut by 25% in this last year. We'll see where cards is at for next year. And the word on the street is ortho, rads, and rads onc are next on the list to cut since the highest paid fields are always targeted the most. I think they already started getting cut but you'd have to ask someone with more knowledge. In terms of lifestyle and salary, I personally like ophtho because it has great hours and has already been heavily cut in the last 10 years. Its salary has seemed to stabilized in terms of being done with the massive cuts so I think you will at least have an idea of what your future salary will be. In the 80s and 90s ophthos could easily become millionaires. That was back when cataract surgery reimbursement was $2000 while now it's down to $700 after the field got targetted for cuts lol.
 
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I have always been told do what you like in medicine and the money will follow. Now, this may not be true completely, but I think if you enjoy what you are doing then it makes a world of difference.

Take me for example. I like Psy and will not be making a ton but I would be miserable being anything surgical, cardio. And eyes freak me out......:laugh:
 
NaughtyGirl said:
Recent Forbes magazine article for the highest paid and lowest paid medical speciaties.

Looks like Radiology, Anesthesiology, and Radiation Oncology are overrated.
Click to expand...

Radiology is leading the pack of bears in the medical job market. I would expect a increase in anes and surgical subspeciality applications simply due to the usmle allstars after money bailing on it. Rad-onc maybe as well, although most med students don't know enough about it to apply, and those that do are aware its high income potential is based on a single treatment modality (IMRT), which is sticking its neck out begging to be chopped down (which is already beginning). Basically there will be some competitive specialties slipping, some non-competitive specialties climbing, leaving a distribution of everything being moderately competitive except for a few ultra competitive fields (derm and surg specialties), and very few 'easy' fields to get into. Maybe that's a good thing. Everything on a level playing field so people can really follow their interests.
 
xenotype said:
You guys are idiots if you think reimbursement will be anything like it is today once we get out of training. FFS and the RUC are on the way out, either by political force or market forces. A lot of the procedures done by MDs today like colonoscopy, etc will be done by NP/PA in the future, especially as the reimbursement for them plummets. Once these changes happen, there is little reason for derm to intrinsically make any more money than fam med.
Click to expand...

Uh, no.

As much as I think derm is ridiculously overpaid as a specialty and doesn't necessarily require the level of competition it has, that's unfortunately just how the system is. And I dont' think it's changing anytime soon
 
J DUB said:
I have always been told do what you like in medicine and the money will follow. Now, this may not be true completely, but I think if you enjoy what you are doing then it makes a world of difference.

Take me for example. I like Psy and will not be making a ton but I would be miserable being anything surgical, cardio. And eyes freak me out......:laugh:
Click to expand...

Agreed. I would rather work slightly longer hours and take more call if I enjoyed the specialty vs. working fewer hours and falling into a depression because I hated what I'm doing.
 
ghost11 said:
those high salaries are generally only possible if your willing to sacrifice any personal life, except maybe with derm, thats a lifestyle speciality, but with most of the others, say cards for example, your working your ass off for your whole career because you are taking care of very critical patients a lot of the time.
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My brother is a cardiologist (imaging) and he works on avg 45 hours a week.
 
I dont see how heme/onc will raise its paying status anytime soon. For urology i agree, it is one of the highest payers in EU.
I could see cardiologist go down or up just as easily as radiology. They are fighting for many interventional stuff. But maybe rads have more leeway outside interventional stuff than cardio.
 
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NaughtyGirl said:
Recent Forbes magazine article for the highest paid and lowest paid medical speciaties.

Looks like Radiology, Anesthesiology, and Radiation Oncology are overrated.

Orthopedics, Cardiology, and Dermatology are just what we thought.

Urology and Hematology/Oncology are underrated.

Prediction
Underrated specialties are going to get very competitive very soon. Everyone will still gun for Derm and Ortho. And overrated medical specialties are going to decrease in competitiveness.

http://www.forbes.com/sites/jacquel...e-best-and-worst-paying-jobs-for-doctors-2/2/
http://www.forbes.com/sites/jacquelynsmith/2012/07/20/the-best-and-worst-paying-jobs-for-doctors-2/
Click to expand...

In regards to your predictions, urology is already very competitive (albeit not most competitive), heme/onc is already one of the most competitive IM fellowships, radiology and anesthesiology have already been in slight decline, and radonc will always be competitive as long as radiation is used as a CA treatment modality (if for no other reason than there are only ~175 spots available per year).
 
mimelim said:
Ya, no. You clearly know nothing about colonoscopies if that is your example.
Click to expand...

Nope, I really don't know much about colonoscopies, but

Thread
BS NP study pushing 'equivalence' as usual
Article on a 'groundbreaking' NP that does colonoscopies all day

Most things are not so different than anesthesia. They can just claim equivalency with some bad studies, convince government regulators to loosen regulations with generous lobbying money from nursing unions, and then start competing with physicians in almost any field. Do you really believe screening colonoscopies are so hard to do that only GI docs can do them?

As for derm, etc staying the way they are, I really doubt it. The RUC is losing political credibility rapidly as it gets attacked weekly by scathing NYT reports. If the IPAB is ever filled, itll completely castrate the power of the RUC, and the MPAC has started advising direct cuts to CMS for certain procedures as well. This is all besides the fact that ACOs may not use FFS at all, and that prices have inflated so much in US healthcare that alternative business models are bound to start popping up that are cheaper.
 
xenotype said:
Nope, I really don't know much about colonoscopies, but

Thread
BS NP study pushing 'equivalence' as usual
Article on a 'groundbreaking' NP that does colonoscopies all day

Most things are not so different than anesthesia. They can just claim equivalency with some bad studies, convince government regulators to loosen regulations with generous lobbying money from nursing unions, and then start competing with physicians in almost any field. Do you really believe screening colonoscopies are so hard to do that only GI docs can do them?

As for derm, etc staying the way they are, I really doubt it. The RUC is losing political credibility rapidly as it gets attacked weekly by scathing NYT reports. If the IPAB is ever filled, itll completely castrate the power of the RUC, and the MPAC has started advising direct cuts to CMS for certain procedures as well. This is all besides the fact that ACOs may not use FFS at all, and that prices have inflated so much in US healthcare that alternative business models are bound to start popping up that are cheaper.
Click to expand...

Why not have NPs do surgery then?
 
Frazier said:
I think he was making a stock market reference.

Bulls = XYZ is going up, up up!

Bears = XYZ is going downnn.
Click to expand...

Okay yeah that's what I thought. I just wasn't really sure if he was referring to competitiveness, pay, or both.
 
xenotype said:
Nope, I really don't know much about colonoscopies, but

Thread
BS NP study pushing 'equivalence' as usual
Article on a 'groundbreaking' NP that does colonoscopies all day

Most things are not so different than anesthesia. They can just claim equivalency with some bad studies, convince government regulators to loosen regulations with generous lobbying money from nursing unions, and then start competing with physicians in almost any field. Do you really believe screening colonoscopies are so hard to do that only GI docs can do them?

As for derm, etc staying the way they are, I really doubt it. The RUC is losing political credibility rapidly as it gets attacked weekly by scathing NYT reports. If the IPAB is ever filled, itll completely castrate the power of the RUC, and the MPAC has started advising direct cuts to CMS for certain procedures as well. This is all besides the fact that ACOs may not use FFS at all, and that prices have inflated so much in US healthcare that alternative business models are bound to start popping up that are cheaper.
Click to expand...

If you knew about colonoscopies, you would have the answer to your question 😉

Surgeons scope people too, not just GI docs.
 
IJL said:
Okay yeah that's what I thought. I just wasn't really sure if he was referring to competitiveness, pay, or both.
Click to expand...

both. bad job market for the past few years, starting to catch up to residency applications as word spreads to med students. I wonder if they will become less snobby about their usmle cutoffs or if they will continue with high unfilled rates.
 
thefritz said:
both. bad job market for the past few years, starting to catch up to residency applications as word spreads to med students. I wonder if they will become less snobby about their usmle cutoffs or if they will continue with high unfilled rates.
Click to expand...

Is 8.4% considered to be a high unfilled rate?
 
xenotype said:
Nope, I really don't know much about colonoscopies, but

Thread
BS NP study pushing 'equivalence' as usual
Article on a 'groundbreaking' NP that does colonoscopies all day

Most things are not so different than anesthesia. They can just claim equivalency with some bad studies, convince government regulators to loosen regulations with generous lobbying money from nursing unions, and then start competing with physicians in almost any field. Do you really believe screening colonoscopies are so hard to do that only GI docs can do them?

As for derm, etc staying the way they are, I really doubt it. The RUC is losing political credibility rapidly as it gets attacked weekly by scathing NYT reports. If the IPAB is ever filled, itll completely castrate the power of the RUC, and the MPAC has started advising direct cuts to CMS for certain procedures as well. This is all besides the fact that ACOs may not use FFS at all, and that prices have inflated so much in US healthcare that alternative business models are bound to start popping up that are cheaper.
Click to expand...

CRS and even some GS do colonoscopies. I have an ego: As a Vascular Surgery PGY2, I honestly think that I have the best technical colonoscopy skills of any resident in any surgical program at our institution, regardless of level. This is not about being technically able to do something well. It is about sound decision making and analysis. It is about the borderline situations that having a strong fundamentally sound background gives you an edge in.
 
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