These comments reflect what much of the general public thinks about physicians. It's not based on nothing (there are some filthy rich docs such as ortho and derm and radiologists, especially folks who begun practice in the 1970s and 1980's). However, it doesn't reflect the current reality in primary care or fields like neurology, nor the lifestyle/income that most of us training now will likely have.
Also, people are doing more tuition to go to med school than ever before, and doing more and more to get in med school it seems...i.e. extra master's degrees, expensive prep courses, etc. My debt was 132k when I graduated 4.5 years ago and I basically only borrowed my tuition. And I've been paying it off at >500/month on my resident and fellow salaries...I don't mind that but what is shocking is how little of the money goes to principle...and for students with larger loans it's going to be much worse. Also, my student loan interest rates are very low...I'm paying 2.9%, not 6.8% like most of the current students will pay. The public doesn't have any concept what kind of time it takes to become a physician and what kind of money one has to pay to do that...shortest path would be 4 years undergrad + 4 years med school + 3 years residency, but realistically there are many, many people who are doing more than that. Extra master's degrees, research years that pay little, etc. And 3 years is the very shortest residency that one can do...
One thing that would make sense to me is for med schools to do a better job of controlling tuition, and also for residents to get paid a little more, in the recognition of the large student loans most of them have and long hours they work. I just don't see either of these things happening, though.
If the reimbursement situation doesn't change, we'll see a continued decline in private practice docs, except those in the huge "supergroups" like groups of 50 urologists or oncologists. Personally, I don't think this is a good thing for patients. It represents fewer choices for them - some prefer a more personal type of medical care, and some docs prefer to practice that way. I'd personally rather practice in a group of 5 docs than a group of 50 or 500...but realistically I may not feel it's a safe option given the current situation w/gov't and insurance companies basically having physicians by the b-lls.
