Physicians Salary???

[djavid]

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There is a post in here about nurses making more than doctors. I also ran across many post about physician salaires etc.

So I started to wonder what do people in here think physician should make per year.

Here is my question:

If a doctor does a 3 year residincy VS a 4 or 5 or 7 etc. How much do you feel they should make a year.

Be specific. Don't give answers like It depends on reimbursement and level of complexity. That just insurance BS. Tell us what you feel you are worth based at least on the number of years you do in residency.

Here are my answers:

3 = 250K
4 = 300K
5 = 350K
6 = 400K
7 = 450K

Oh one more thing, NO TROLLS.

 

[Apollyon]

The failure of your thesis is a linear progression for "time served", versus the realities of supply and demand.

Just last night, I was talking to a general surgery resident about fellowships; he wants to do surg onc, and we found it intriguing that some of the hardest surgical fellowships to obtain were peds, plastics, and onc. Peds and plastics are understandable, but surg onc less so. As he was saying, it's a lot of REALLY sick people that are going to die anyhow, it's not too lucrative, and many of the operations are rather tedious. Still, it has an appeal for him, and he said that getting a spot was a tough go.

If things went the way you posit, there'd be no motivation to actually learn anything or do a good job; just by being there, you would get there.

In other words, what I'm worth does not relate to how much time I've put in.

 

[djavid]

I was not asking for a story. I was asking for a number. I did say NO TROLLS.

The failure of your thesis is a linear progression for "time served", versus the realities of supply and demand.

Just last night, I was talking to a general surgery resident about fellowships; he wants to do surg onc, and we found it intriguing that some of the hardest surgical fellowships to obtain were peds, plastics, and onc. Peds and plastics are understandable, but surg onc less so. As he was saying, it's a lot of REALLY sick people that are going to die anyhow, it's not too lucrative, and many of the operations are rather tedious. Still, it has an appeal for him, and he said that getting a spot was a tough go.

If things went the way you posit, there'd be no motivation to actually learn anything or do a good job; just by being there, you would get there.

In other words, what I'm worth does not relate to how much time I've put in.

 

[Apollyon]

Be specific. Don't give answers like It depends on reimbursement and level of complexity. That just insurance BS. Tell us what you feel you are worth based at least on the number of years you do in residency.

I was not asking for a story. I was asking for a number. I did say NO TROLLS.

I was saying that your question is faulty.

Since you reiterate "NO TROLLS" to a literate answer, I guess YOU are the troll.

Then again, your second post on the site was saying how boring you think this site is, so, maybe, don't go away mad - just go away.

 

[Tapout]

Wasteland....

 

[deleted87716]

If a doctor does a 3 year residincy VS a 4 or 5 or 7 etc. How much do you feel they should make a year.

Salaries suck. They foster mediocrity, and you can be sure that if someone's willing to pay you any kind of guarantee, they'll be making more than from you in order to justify taking the risk in the first place.

 

[JayneCobb]

There is a post in here about nurses making more than doctors. I also ran across many post about physician salaires etc.

So I started to wonder what do people in here think physician should make per year.

Here is my question:

If a doctor does a 3 year residincy VS a 4 or 5 or 7 etc. How much do you feel they should make a year.

Be specific. Don't give answers like It depends on reimbursement and level of complexity. That just insurance BS. Tell us what you feel you are worth based at least on the number of years you do in residency.

Here are my answers:

3 = 250K
4 = 300K
5 = 350K
6 = 400K
7 = 450K

Oh one more thing, NO TROLLS.

Any solution which bases physician pay solely off of years of residency is oblivious to many other factors. How much does the physician in question actually work? I know several FM docs who work their butts off and see 40+ pts per day and easily earn their 225K+ per year. I've also seen general Surgeon who rarely seem to have any work even as an established surgeon. And there are other market forces at play, just look at the recruitment ads for any primary care into rural areas, they inflate their pay due to less desirable location. Personally, I do not feel that residency length automatically equates to skill level or knowledge level.

Perhaps we should base pay off of USMLE scores? [/sarcasm]

 

[JayneCobb]

Salaries suck. "If you give people a floor, they'll sit on it."

don't run when you can walk, don't stand when you can sit, never skip a meal and never miss an opportunity to catch some sleep.

 

[Faebinder]

don't run when you can walk, don't stand when you can sit, never skip a meal and never miss an opportunity to catch some sleep.

I have got to skip more meals... I am doing well but dang those drug reps have got to get better salads.

 

[djavid]

The question has to do with how much you think you are worth per year.

Forget about the number of years in practice. All the time, we hear doctors complaining about their fees and how much they make. But they never say how much they should be making. So, maybe it's time to come up with a number.

I agree that if you work for someone they are making money from your work.

But thats not what I wanted to know. I should have stated the question better.

How about this.

What do you think you should make a year?

 

[djavid]

I was saying that your question is faulty.

Since you reiterate "NO TROLLS" to a literate answer, I guess YOU are the troll.

Then again, your second post on the site was saying how boring you think this site is, so, maybe, don't go away mad - just go away.

My post about this place getting boring was not trolling. I just stated a fact. It is kinda quiet in here. I thought I was speaking to individuals who are going to be doctors and pharmacist etc. based on the answers I recieved it seems they have some growing up to do. I also put that post in a spot where it was not moderated. I did that because I didn't want it to become a trolling issue.

But I'm not here to argue with you. If you don't want to answer the question with a number (as I requested), then don't.

 

[Miami_med]

Salaries suck. They foster mediocrity, and you can be sure that if someone's willing to pay you any kind of guarantee, they'll be making more than from you in order to justify taking the risk in the first place.

I love you Kent (In a strictly plutonic way of course)

 

[Apollyon]

But I'm not here to argue with you. If you don't want to answer the question with a number (as I requested), then don't.

Your question is a dud. What am I worth per year? $2 million. I'm not kidding. But I don't get that much money.

Happy now? Want a cookie? Your question is without merit.

 

[djavid]

Your question is a dud. What am I worth per year? $2 million. I'm not kidding. But I don't get that much money.

Happy now? Want a cookie? Your question is without merit.

Are you always this crass with people?

You don't have to post in here. It is a choice. I don't see anyone else being rude. What makes you think you have that right?
Or maybe it's because your on the net so you feel you can. Everyone else in here is civil, you need to act the same.

 

[Apollyon]

Are you always this crass with people?

You don't have to post in here. It is a choice. I don't see anyone else being rude. What makes you think you have that right?
Or maybe it's because your on the net so you feel you can. Everyone else in here is civil, you need to act the same.

Crass? Dude, you're the one writing NO TROLLS in capital letters. I answered your idiotic question. Did you notice that you haven't gotten any other answers, and you hypocritically didn't say anything about someone else who wrote a "story"?

You're not civil, your question is faulty, I STILL answered it, and YOU are STILL being "crass". Don't play "internet psychologist". YOU need to act in a more civil manner. And, perhaps, with a little more humility. I mean, don't you even see the lack of vision in your thesis for this thread? A few thousand people a day cross SDN, and, yet, remarkably, your thread has generated little on-topic traffic. It's either inane, uninteresting, or unapplicable to most of these people. JayneCobb and KentW decried your methodology, yet you said nothing.

I've put more effort into your own thread than you have (even so, it's only been a few minutes, at that).

Whatever, dude. I still, completely honestly, think I'm worth $2 million/year. Not $2.5, not $3, not $1 million. I don't have any way I came up with that number, but I'm not getting it.

That is all.

 

[mlw03]

I would agree that salary should not be tied to length of training - there are simply too many variables not included (most importantly would be work hours - plenty of primary care docs only work 3 or 4 days per week).

However it's interesting to note that I just came back from Israel and talked to some young doctors over there about salary and found out there $40K per year is pretty good over there. American physician salaries are fairly high on the world scale as I understand things.

I think the OP tried to ask an interesting question, but I think the best answer is that there is just no way to try and tie salary to length of training as econimic principles do not work that way.

 

[DeLaughterDO]

I would agree that salary should not be tied to length of training - there are simply too many variables not included (most importantly would be work hours - plenty of primary care docs only work 3 or 4 days per week).

However it's interesting to note that I just came back from Israel and talked to some young doctors over there about salary and found out there $40K per year is pretty good over there. American physician salaries are fairly high on the world scale as I understand things.

I think the OP tried to ask an interesting question, but I think the best answer is that there is just no way to try and tie salary to length of training as econimic principles do not work that way.

Agreed, if salary were tied to length of training, this is roughly how the economic tree would look:

Physicians with > 5 years postgraduate training
Ph.D
Most other physicians with < 5 years postgrad training
MS/MA grads
BS/BA grads
Associate degree grads
HS/GED grads
.
.
.
.
.
.
.
.
.
Professional sports players.

Instead, we have professional sports players waaaaaay at the top, along with CEOs/CFOs/C*Os of corporations and physicians way at the middle and most Ph.Ds below that.

Now, tell me how pay is in ANY way related to length of education again?

jd

 

[onceinawhile]

However it's interesting to note that I just came back from Israel and talked to some young doctors over there about salary and found out there $40K per year is pretty good over there. American physician salaries are fairly high on the world scale as I understand things.

You absolutely cannot compare salaries across countries. Do you know what is the cost of living? How much they have to put their kids through college? Do they have to fund their own retirement?

 

[Faebinder]

You absolutely cannot compare salaries across countries. Do you know what is the cost of living? How much they have to put their kids through college? Do they have to fund their own retirement?

Does it cost an arm and a leg to pay for the ED in Israel? What is considered "an arm and a leg" in Israel? I agree with onceinawhile.

 

[Winged Scapula]

In addition to pay based on my length of training, I want hazard pay for the emotional distress telling people they have cancer causes me.

You cannot base pay on something as simplistic as education. As noted, above our society doesn't work that way. I long ago realized that I could make more money doing other things, with less cost to get into it - both financially and in time and effort, but chose medicine because it interested me.

I will admit that this year, while interviewing for jobs, I did get angry from time to time over job offers that seemed solely based on how much call I did (since when did that become a factor in salary?) rather than how much money I brought into the system. But as Kent notes, you can bet any offer of a salary is predicated on the fact that they know they will make more money than what they pay you. Salaries are for the birds.

 

[djavid]

When a group of physicians get together and discuss money, the topic of how much their pay is under fire always comes up.

A common comment from them is that they have gone to school for many years and sacrificed much and therefore deserve more money.

So it would seem that although years in education may not be the only factor in determining how much a physician makes (salary or private practice ownership), it is an important factor.

We know that one of our Narsisitic collegues feels he is worth 2 million.

If we don't put a number on our worth someone else will. Right now the insurance companies are placing that number on us and they seem to think we are worth less each year.

So what are you really worth. Pick your own criterea. Find a number. Draw the line.

Kimberly the reason your salary is based on call is because in your going to work for someone who needs to have vascular docs take call. So they chose to put call in the contract. What are you worth? Can you open you own practice? What will that be worth?

 

[McGillGrad]

You should become a head nurse. Your attitude would be well appreciated and your lust for money could be rewarded with a hunky doctor to marry....

Troll

 

[PediBoneDoc]

the discussion of salaries is always an interesting topic on these forums. please to all remember that this is a business. people who are employed (by a practice, hospital, or system (kaiser)) will receive a "salary". most of what is quoted as a "salary" is a guarantee. most of these things are tied some how to production. practices will also tie call to a "guarantee" because that is money given to the practice by the hospital to cover the call (you can get ~$500-2,000/night depending on specialty). in the end most physicians income is rewarded by production. work more and you make more; see more patients and do more procedures and you income increases.

years in training really have nothing to do with your income. the procedural specialties will always collect more than the cognitive specialties because procedures always bill more than office time. consults bill more than primary care for the same office time. in my practice, i can see 4 new pt consults/hr (without a resident) and bill at a level 3 e&m consult code, where as a neurologist may only see 1 new pt in that same hour billing level 5 code. there are a lot of things that come into play. intensive care pays more than inpt care, etc.

in the end your hard work and time in training is not what is being rewarded, it is the service that you provide. some services are reimbursed better than others.

 

[djavid]

It always amazes me how much hostility one gets when physicians start talking about money.

LUST FOR MONEY????????

This discussion was never about lust for money. It was about the business of medicine and money.

If talking about money in medicine makes me a troll then this whole web site should be shut down because if you can't discuss money in relation to you job then what can you discuss.

If anyone thinks for one second that medicine is not a business and your skills will not be looked at as a comodity, you are in a very rude awakaning in a few years.

This has nothing to do with lust for money. It has to do with reality and those who make such comments show their lack of maturity.

I came to post on this website in order to discuss issues that all physician face everyday in practice. This is one of them. If people in here can't handle it then don't post. I thought I was coming into an arena where there are educated individuals discussing important issues. I didn't think I was going into an area where people chose to use the internet to get their frustrations out.

 

[Winged Scapula]

Kimberly the reason your salary is based on call is because in your going to work for someone who needs to have vascular docs take call. So they chose to put call in the contract. What are you worth? Can you open you own practice? What will that be worth?

Not sure what vascular surgery has to do with me. Your response above confuses me.

The reason that many employers in my field either a) require general surgery call and/or b) will pay fellowship trained surgeons less than general surgery has to do with the power of the medical staff. General surgeons wield a lot of power and many of them no longer want to take call either. Therefore, they bully the medical staff to rewrite the hospital by-laws to require call as part of the credentialing process. They have to take call, so they figure everyone else should to. Their salary has gone down, so why should the hospital pay other people who DON'T take call more than them? They tend to be very bitter, IMHO, that fellowship trained surgeons are encroaching on their piece of the pie and are attempting to punish us for that.

However, they forget that some of us actually understand how the process works. Hospitals or MSGs try to tie salary with call, explaining that "we require all of our surgeons to take call" or "because your specialty doesn't reimburse as much as general surgeons we will pay you less." So they figure they will pay me $200,000/year because they assume I think that I will only bill slightly more than that. Trouble is they don't understand that they (the hospital) makes tons of money outside of what I actually bill for because I refer patients for chemo and radiation therapy at their facilities. They also don't really understand what I do because its obvious they haven't included the very well reimbursed imaged guided techniques that I can perform.

Fortunately, there are employers that understand that and there are options (such as private practice) in which I don't have to be tied to ridiculous requirements such as those above. I preferred to choose a private practice group in which I can tailor my work to my desired income. One of the local hospitals where I will be practicing rewrote their bylaws to require general surgery call for all surgeons. While its a nice hospital and I would like to have privileges there for my patient's ease, it a large market it would appear to me that they have cut off their nose to spite their face. I have many other nice facilities in the area which welcome me and my expertise and dont' require call.

 

[MacGyver]

Salaries suck. They foster mediocrity, and you can be sure that if someone's willing to pay you any kind of guarantee, they'll be making more than from you in order to justify taking the risk in the first place.

America will eventually be forced to use to a salaried system, because the current FFS system is out of control. The number of colonoscopies has DOUBLED in the last 10 years and its got nothing to do with changes in screening recommendations and everything to do with GI docs chasing reduced reimbursements.

The govt is going to continue to scale back reimbursement as long as the number of procedures skyrockets every year.

This is the cycle:

Docs go out of control on procedures --> healthcare costs skyrocket --> Medicare cuts reimbursements per procedure to reign in costs --> docs INCREASE the number of procedures to make up for hte shortfall

And hence the cycle repeats ad infinitum. I can tell you one thing. The govt wont let this continue. They'll reduce colonoscopies to $5 a pop if they have to.

 

[djavid]

I'm sorry I thought you mentioned in a previous post that you were doing a vascular fellowship. My mistake.

and, they do know they make more money from you from chemo and radiation etc referals. They know that, they just don't care.

Not sure what vascular surgery has to do with me. Your response above confuses me.

The reason that many employers in my field either a) require general surgery call and/or b) will pay fellowship trained surgeons less than general surgery has to do with the power of the medical staff. General surgeons wield a lot of power and many of them no longer want to take call either. Therefore, they bully the medical staff to rewrite the hospital by-laws to require call as part of the credentialing process. They have to take call, so they figure everyone else should to. Their salary has gone down, so why should the hospital pay other people who DON'T take call more than them? They tend to be very bitter, IMHO, that fellowship trained surgeons are encroaching on their piece of the pie and are attempting to punish us for that.

However, they forget that some of us actually understand how the process works. Hospitals or MSGs try to tie salary with call, explaining that "we require all of our surgeons to take call" or "because your specialty doesn't reimburse as much as general surgeons we will pay you less." So they figure they will pay me $200,000/year because they assume I think that I will only bill slightly more than that. Trouble is they don't understand that they (the hospital) makes tons of money outside of what I actually bill for because I refer patients for chemo and radiation therapy at their facilities. They also don't really understand what I do because its obvious they haven't included the very well reimbursed imaged guided techniques that I can perform.

Fortunately, there are employers that understand that and there are options (such as private practice) in which I don't have to be tied to ridiculous requirements such as those above. I preferred to choose a private practice group in which I can tailor my work to my desired income. One of the local hospitals where I will be practicing rewrote their bylaws to require general surgery call for all surgeons. While its a nice hospital and I would like to have privileges there for my patient's ease, it a large market it would appear to me that they have cut off their nose to spite their face. I have many other nice facilities in the area which welcome me and my expertise and dont' require call.

 

[djavid]

This is exaclty why I asked the question. How much do think you should make per year? Because in the future it most likely will come to that.


It will be a salary with a bonus. It is like that now in many places. The question is what will that salary be?

As far as the procedures being done, these are procedures that need to be done. America is aging. colonoscopies are needed after the age 50. It is not the doctor who is driving up the cost. It is simple mathematics.

America will eventually be forced to use to a salaried system, because the current FFS system is out of control. The number of colonoscopies has DOUBLED in the last 10 years and its got nothing to do with changes in screening recommendations and everything to do with GI docs chasing reduced reimbursements.

The govt is going to continue to scale back reimbursement as long as the number of procedures skyrockets every year.

This is the cycle:

Docs go out of control on procedures --> healthcare costs skyrocket --> Medicare cuts reimbursements per procedure to reign in costs --> docs INCREASE the number of procedures to make up for hte shortfall

And hence the cycle repeats ad infinitum. I can tell you one thing. The govt wont let this continue. They'll reduce colonoscopies to $5 a pop if they have to.

 

[Miami_med]

Salary should be tied to the value a service commands on the free market. Education is loosely associated, because services that require education are harder to come by, thus making someone offering the service more valuable. Medicine is so far removed from a free market that it is really impossible to determine what anyone is actually worth. We're really just making it up as we go along, with a few Washington beauracrats pulling arbitrary numbers out of you know where and putting them in reimbursement schemes.

 

[djavid]

Fair enough, but there still has to be a number. And, who better than physicians themselves to come up with that number.

I don't want some HMO MBA choosing what I'm worth.

Salary should be tied to the value a service commands on the free market. Education is loosely associated, because services that require education are harder to come by, thus making someone offering the service more valuable. Medicine is so far removed from a free market that it is really impossible to determine what anyone is actually worth. We're really just making it up as we go along, with a few Washington beauracrats pulling arbitrary numbers out of you know where and putting them in reimbursement schemes.

 

[gutonc]

Here are my answers:

3 = 250K
4 = 300K
5 = 350K
6 = 400K
7 = 450K

Oh one more thing, NO TROLLS.

Using your system, I get 400K for my residency+fellowship then another 350K for my PhD which directly relates to my fellowship. If I'm lucky, when this is all over, I'll be making 200K or a little bit more (adjusting for inflation b/w now and then). And I'll be cool w/ that. Would I like to get paid more...sure. Do I feel I'm worth more, hizell yes. Do I think I'm worth $750K (or even 400K using the OP's new math)? Not really. I honestly don't think anyone is worth $750K a year.

Would I join a physician's union whose sole purpose was to put more Benjamins in my pocket? No. I think that any physician's union would have to include all physicians in training and in practice and the advocacy would have to be for salaries/stipends/reimbursements, work hours, patient safety, etc. The reason that the nurses unions have such broad public support is that they spin their desire for more money as a patient care issue. Physicians (at least in the public mind) spin it as "we went to school longer, therefore we need more cash."

The lay public largely supports the idea of resident work-hour restrictions because they see it as a patient safety issue. If we as physicians can somehow put patient safety as our primary concern in the public eye, and increased reimbursement as only a means to that end, then they will be more likely to support us. And to bring the discussion full circle, you could easily make the argument to Joe or Jane Patient that, in order to safely and effectively take out your gallbladder/irradiate your tumor/hook you up to Mr. Kidney/give you this chemo/keep you breathing and support your BP/etc I had to go through this many years of training and therefore, in the interest of your safety, I deserve to be paid $X.

 

[doctormommy]

It should be noted that more years of training do not always equal more money. For example, a medicine resident considering several fellowships can tell you that the future salary determines the competitiveness of a training program. GI is notoriously competitive and will ensure high pay and pretty light call. Cards is nearly as competitive and will also ensure high pay but can have bad call. Pulm/CCM is much less competitive and has notoriously bad call and very sick patients, requires the upkeep of at least 3 boards, and the pay is much less since its not a procedure based specialty (yes they do bronchoscopy but not like cards and gi cath and scope everyone). All of these training paths are at least 6 years. And all of these specialties will make less money for an hour of work than an ophthalmologist or a dermatologist, who only trains for 4 years.

But to comment on your question, "how much are we worth?" I have to say that the discrepancy between the "doing" (procedure-based or surgical) and "thinking" (few or no procedures), is outrageous. It results in the brightest students entering into the "lifestyle" fields. I want to call the smartest person in my class when I need someone to manage my critical patients, or when I need a diagnosis for an obscure disease, not when I need a mole cut off. (Nobody get offended, I know derm does more than cut off moles, but you can't deny the fact that your job is pretty cush and I can't deny the fact that you worked your tail off in school to get your residency.)

More years of residency doesn't equal more pay.
More hours of work doesn't equal more pay.
Higher USMLE scores equals more pay.

 

[Faebinder]

One way we can get back the ability to get paid without government control is to be able to demand from the patient front payment before service. The problem is that medicare wont let you do that. Hence the union is critical, because it will enable a large group of doctors to say no to medicare and ask the patients for their payment upfront. I am surprised the doctor groups out there dont call to unionize. The physician's payment front the overall amount paid for each occurance is very minor.... and considering we are small players compared to the hospitals, we should be allowed to take our payment separate upfront. Billing for $400 on one patient when medicare needs to pay the hospital $25,000 is pretty small and medicare should not be bargaining with us over $100 when it has to go pay $25,000 to the hospital.

So unionizing remains the best option but that remains right now illegal.

 

[Winged Scapula]

I'm sorry I thought you mentioned in a previous post that you were doing a vascular fellowship. My mistake.

Good lord...I probably said it was the one I was least likely to do or I might have mentioned that the Chief of Vascular suggested, at my Chief's dinner, that should I change my mind, that I should consider Vascular. A comment about poking my eyes out with sharp sticks ensued...

...and, they do know they make more money from you from chemo and radiation etc referals. They know that, they just don't care.

You're right...they DO KNOW, or at least they should, but they think I DON'T KNOW how much money they are making off me, nor do they care. Hence my decision not to work for someone else.

 

[PediBoneDoc]

One way we can get back the ability to get paid without government control is to be able to demand from the patient front payment before service. The problem is that medicare wont let you do that. Hence the union is critical, because it will enable a large group of doctors to say no to medicare and ask the patients for their payment upfront. I am surprised the doctor groups out there dont call to unionize. The physician's payment front the overall amount paid for each occurance is very minor.... and considering we are small players compared to the hospitals, we should be allowed to take our payment separate upfront. Billing for $400 on one patient when medicare needs to pay the hospital $25,000 is pretty small and medicare should not be bargaining with us over $100 when it has to go pay $25,000 to the hospital.

So unionizing remains the best option but that remains right now illegal.

physician groups have tried to fight on a number of occasions and it has squashed as being illegal. physician groups have also tried to fight the changes that have come from large insurance carriers who control a market share. most of these things have been tried across the country with varying success. there are many physicians have cut out medicaid in our area not because of payments but because of the increasing number of cases of fraud secondary to lack documentation, but that is another issue. problem when physicians start complaining about income, the media portrays us a money hungry. can't win (big frown face).

 

[Miami_med]

It should be noted that more years of training do not always equal more money. For example, a medicine resident considering several fellowships can tell you that the future salary determines the competitiveness of a training program. GI is notoriously competitive and will ensure high pay and pretty light call. Cards is nearly as competitive and will also ensure high pay but can have bad call. Pulm/CCM is much less competitive and has notoriously bad call and very sick patients, requires the upkeep of at least 3 boards, and the pay is much less since its not a procedure based specialty (yes they do bronchoscopy but not like cards and gi cath and scope everyone). All of these training paths are at least 6 years. And all of these specialties will make less money for an hour of work than an ophthalmologist or a dermatologist, who only trains for 4 years.

But to comment on your question, "how much are we worth?" I have to say that the discrepancy between the "doing" (procedure-based or surgical) and "thinking" (few or no procedures), is outrageous. It results in the brightest students entering into the "lifestyle" fields. I want to call the smartest person in my class when I need someone to manage my critical patients, or when I need a diagnosis for an obscure disease, not when I need a mole cut off. (Nobody get offended, I know derm does more than cut off moles, but you can't deny the fact that your job is pretty cush and I can't deny the fact that you worked your tail off in school to get your residency.)

More years of residency doesn't equal more pay.
More hours of work doesn't equal more pay.
Higher USMLE scores equals more pay.

The patchwork of competitiveness/shortages is a testament to how pay doesn't properly follow the market. Highly competative specialties probably show a discrepancy between atleast perceived income and market value or an artificial shortage of training programs. Similarly, specialties that are highly in demand probably demonstrate lower than true market pay.

 

[Apollyon]

Hmm...I'm crass, but the OP is banned. The proof is in the pudding, maybe?

 

[Surgeon Guy]

Just for comparison, does anyone have one of those charts that shows the compensation for physicians in say, 1995? Really, anything around 10 years ago. Maybe this will give a little more perspective on this. Thanks.

 

[deleted87716]

Just for comparison, does anyone have one of those charts that shows the compensation for physicians in say, 1995? Really, anything around 10 years ago. Maybe this will give a little more perspective on this. Thanks.

This may help: http://www.hschange.com/CONTENT/851/

 

[Surgeon Guy]

Found an article that may be interesting to some of you...

http://mdsalaries.blogspot.com/2007/03/this-surgeon-makes-12-million-dollars.html

Would this be possible to do for everyone, or do you think one would have to establish themselves as a first class physician first?

 

[ditch doctor]

I heard this on NPR about 3 months ago... there's some FP doc in NC that is 100% fee for service, no insurance at all. He works like 9-4, and sees patients the entire time. *NO* talking to insurance companies. Does all his own lab work, injections, vitals, microscopy etc. He has only a secretary to do the schedule/reception/answer phones, so there is very little overhead. He spends about an hour with every patient. Charges for everything; office visit 40/hr (and he actually stays in for a full hour), injections are cost of drug plus like $5-$10 etc... Loves his job and makes almost double what his colleagues in the same area and field are making. His patients were mostly the poor and the "too rich for medicaid and too poor for insurance". But they all *looooooove* him. At first, he met a lot of resistance from insurance companies but all the patients started self-filing and they realized he charges his patients about 1/2 what is considered "usual and customary" and now the insurance companies love him, too.

He likened insurance to a car warranty. Everyone should carry really good catastrophic insurance for big time surgery and such and pay for 'simple' office visits/checkups/colds/etc. out of pocket. Kinda like paying for oil changes and brakes, but having a warranty for rebuilding a transmission etc. He said it was funny how people wouldn't bat an eye at a $150-$200 brake job, but the thought of having only catastrophic insurance and paying $40/hr for an office visit (what he charges) was so foreign.

I dunno... sounded good in theory...

 

[Faebinder]

The problem is that the line between emergency and elective blurs badly. So if a patient cant afford his diabetic/asthma meds and doesn't take em.... then he ends up in the ED on diabetic ketoacidosis/asthma excerbation.. we switched from an elective setting to an emergency setting and now we get patients who just go to the ED to get their diabetic/asthma medication refilled.

But I guess those are not the same patients he is seeing in his office, since it sounds like those patients are insured and can afford it.

 

[mgdsh]

Found an article that may be interesting to some of you...

http://mdsalaries.blogspot.com/2007/03/this-surgeon-makes-12-million-dollars.html

Would this be possible to do for everyone, or do you think one would have to establish themselves as a first class physician first?

excellent link... thanks