Radiology vs. Dermatopathology and Obamacare

[Transformers]

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The trite theme is once again lifestyle and money between specialties in light of Obama healthcare in the rather unpredictable future of medicine.

Today, my dermatologist told me today that she had to move her services to the hospital because of the outlook for Obamacare, insurance claims, and regulatory reimbursements. It became too much of a hassle and so she settled for a rather fixed salary to work in the hospital's clinic without the hassle of insurance companies. From a strictly financial point of view, she cautioned about entering derm itself due to the difficulty of maintaining a thriving private practice and recommended that dermatopathology is a relatively safe option (you don't deal with patients and look at slides all day) but she foresees cuts as well. She also advocated radiology (don't deal directly with patients and look at scans all day). Two similar fields....and of course two lucrative, lifestyle medical fields- but both very different in nature. For some reason, she strongly advocated rads over derm and mentioned how it will be relatively unscathed in the future compared to dermatology/dermatopathology. I was actually stunned seeing a disgruntled DERMatologist out of all the specialties in medicine. She even mentioned one or two dermatologist residents dropping out to do rads.

What validity is there to her claims and how does Obamacare compare for someone interested in these two specialties?

 

[Gryphes]

The trite theme is once again lifestyle and money between specialties in light of Obama healthcare in the rather unpredictable future of medicine.

Today, my dermatologist told me today that she had to move her services to the hospital because of the outlook for Obamacare, insurance claims, and regulatory reimbursements. It became too much of a hassle and so she settled for a rather fixed salary to work in the hospital's clinic without the hassle of insurance companies. From a strictly financial point of view, she cautioned about entering derm itself due to the difficulty of maintaining a thriving private practice and recommended that dermatopathology is a relatively safe option (you don't deal with patients and look at slides all day) but she foresees cuts as well. She also advocated radiology (don't deal directly with patients and look at scans all day). Two similar fields....and of course two lucrative, lifestyle medical fields- but both very different in nature. For some reason, she strongly advocated rads over derm and mentioned how it will be relatively unscathed in the future compared to dermatology/dermatopathology. I was actually stunned seeing a disgruntled DERMatologist out of all the specialties in medicine. She even mentioned one or two dermatologist residents dropping out to do rads.

What validity is there to her claims and how does Obamacare compare for someone interested in these two specialties?

Interesting post. I am just as ignorant as anyone being a student, but I wouldn't take stock into what one person says. I actually recently talked to a hospitalist who just quit to go to a business school for alternative career option, and he felt the exactly opposite from the dermatologist you talked. He felt radiology will be the next place for huge cut in reimbursement, upto 30 %.

But of course, again, keep it in the perspective-he was just one hospitalist (and a disgruntled one too, like your dermatologist). At the end, no one has crystal ball, and I think even the guys in the White House have no idea how things will span out while messing with the legistlation. At the end of the day, you just have to look at your options, choose what is most important (money, life style, type of work, patient contact amount ,etc) out of the present, then run with it. Assuming risk sucks, but I don't think anyone is immune from it.

 

[bronx43]

The trite theme is once again lifestyle and money between specialties in light of Obama healthcare in the rather unpredictable future of medicine.

Today, my dermatologist told me today that she had to move her services to the hospital because of the outlook for Obamacare, insurance claims, and regulatory reimbursements. It became too much of a hassle and so she settled for a rather fixed salary to work in the hospital's clinic without the hassle of insurance companies. From a strictly financial point of view, she cautioned about entering derm itself due to the difficulty of maintaining a thriving private practice and recommended that dermatopathology is a relatively safe option (you don't deal with patients and look at slides all day) but she foresees cuts as well. She also advocated radiology (don't deal directly with patients and look at scans all day). Two similar fields....and of course two lucrative, lifestyle medical fields- but both very different in nature. For some reason, she strongly advocated rads over derm and mentioned how it will be relatively unscathed in the future compared to dermatology/dermatopathology. I was actually stunned seeing a disgruntled DERMatologist out of all the specialties in medicine. She even mentioned one or two dermatologist residents dropping out to do rads.

What validity is there to her claims and how does Obamacare compare for someone interested in these two specialties?

She's an idiot. Straight up. Diagnostic imaging has a far better chance of getting cut in the near future than dermatology reimbursement rates.

 

[gonogo]

To the OP: It's likely that both derm and radiology will be hit by cuts. The current trend is that medicine won't be nearly as lucrative in the future as it has been in the past. If it's really important for you to make lot of money, I'd consider going into business/investment/consulting.

 

[jake2]

Just goes to show everyone is always afraid of their livelihood being taken away. Doctors overall have incredible job security compared to the average joe, let alone dermatologists, but human nature is human nature.

Honestly though, this is the first time I've ever heard of a Derm complain about impending reimbursement cuts. I thought a good deal of their practices was out of pocket so they could charge whatever, get in, and go home by 4:00. (Still wouldn't convince me to be the rash guy though...)

 

[bronx43]

Just goes to show everyone is always afraid of their livelihood being taken away. Doctors overall have incredible job security compared to the average joe, let alone dermatologists, but human nature is human nature.

Honestly though, this is the first time I've ever heard of a Derm complain about impending reimbursement cuts. I thought a good deal of their practices was out of pocket so they could charge whatever, get in, and go home by 4:00. (Still wouldn't convince me to be the rash guy though...)

I don't know how true it is that all derm practices have a substantial portion of their revenue come from out-of-pocket services. Furthermore, there is increasing pressure from non-dermatology board certified clinics offering the same services, and the layman probably doesn't know the difference between a board-certified dermatologist vs a physician "trained" in cosmetic derm procedures.

 

[penguin24]

Derm & Rads are both very awesome fields, I'd consider myself blessed in either one.

Derm seems to have the edge when it comes to hours worked, but Rads has the edge for total income. (I know some Derms make millions, but the AVERAGE Derm makes less than the AVG Rads).

Patient contact is all fine and dandy, but it has it's dark-side. If you set up your practice, you must build up a referral base that can take years to occur so that you stay busy from 8-5pm. Thus, the starting salary can be quite low. If you have to move, then you start all over again.

Rads OTOH, is the ultimate referral specialty b/c you don't need the 'patient' to tell his family/friends what a wonderful radiologist you are in order for you to get more business, if you work the shift you automatically get all the images sent to you. Thus, the starting salaries in Rads are very juicy. If you have to move, you show up on your 1st day of work and have a stack of images waiting for you to read.

The Medical Student's Survival Guide by Dr Polk has a nice discussion about this. Radiologist work much longer hours than Derm, but at least you can be certain you will make a nice living, as opposed to starting up a clinical practice and 'hope' that your patients will refer their friends.

 

[bronx43]

Derm & Rads are both very awesome fields, I'd consider myself blessed in either one.

Derm seems to have the edge when it comes to hours worked, but Rads has the edge for total income. (I know some Derms make millions, but the AVERAGE Derm makes less than the AVG Rads).

Patient contact is all fine and dandy, but it has it's dark-side. If you set up your practice, you must build up a referral base that can take years to occur so that you stay busy from 8-5pm. Thus, the starting salary can be quite low. If you have to move, then you start all over again.

Rads OTOH, is the ultimate referral specialty b/c you don't need the 'patient' to tell his family/friends what a wonderful radiologist you are in order for you to get more business, if you work the shift you automatically get all the images sent to you. Thus, the starting salaries in Rads are very juicy. If you have to move, you show up on your 1st day of work and have a stack of images waiting for you to read.

The Medical Student's Survival Guide by Dr Polk has a nice discussion about this. Radiologist work much longer hours than Derm, but at least you can be certain you will make a nice living, as opposed to starting up a clinical practice and 'hope' that your patients will refer their friends.

The question was radiology vs dermatopathology. There is no direct patient contact in either one.
And keep in mind that it's only in our currently messed up health care system that patient contact yields less financial and other benefits than having no patient contact. Having a patient base and cultured relationships between said patients is the ultimate security against the tides of supply and demand. Having no influence on patients means you are entirely replaceable should supply and demand not be on your side.

 

[penguin24]

The question was radiology vs dermatopathology. There is no direct patient contact in either one.
And keep in mind that it's only in our currently messed up health care system that patient contact yields less financial and other benefits than having no patient contact. Having a patient base and cultured relationships between said patients is the ultimate security against the tides of supply and demand. Having no influence on patients means you are entirely replaceable should supply and demand not be on your side.

Patient contact is inversely proportional to income potential. No amount of health care reform can ever change that. Talking to patients is a money-pit.

Take two scenario's:
1) Doctor spends 15 minutes educating a patient about nutrition
2) Doctor spends 15 minutes removing cataracts from patient

There is no way any insurer will pay doctor #1 more/equal as doctor #2

There will always be risks in life, no matter if you apply for a Rads residency or become a hedge-fund manager. You keep on predicting the 'end' of Radiologists making a lot of money, and there is some guy on Aunt Minnie who swears that Neurology will be the 'next big thing' in medicine, but you guys are rooting for the underdogs; more than likely today's money-makers will be tomorrow's money-makers. If you are a M4, why would you go into a low-paying specialty b/c 'There's a chance health care reform will suddenly convert it to a higher-paying specialty, and then you can tell all your Radiology friends you told them so'. Why not just pick a winner and hope it will stay a winner after health care reforms. That sounds like the most logical thing to do, at least for me.

 

[bronx43]

Patient contact is inversely proportional to income potential. No amount of health care reform can ever change that. Talking to patients is a money-pit.

Take two scenario's:
1) Doctor spends 15 minutes educating a patient about nutrition
2) Doctor spends 15 minutes removing cataracts from patient

There is no way any insurer will pay doctor #1 more/equal as doctor #2

There will always be risks in life, no matter if you apply for a Rads residency or become a hedge-fund manager. You keep on predicting the 'end' of Radiologists making a lot of money, and there is some guy on Aunt Minnie who swears that Neurology will be the 'next big thing' in medicine, but you guys are rooting for the underdogs; more than likely today's money-makers will be tomorrow's money-makers. If you are a M4, why would you go into a low-paying specialty b/c 'There's a chance health care reform will suddenly convert it to a higher-paying specialty, and then you can tell all your Radiology friends you told them so'. Why not just pick a winner and hope it will stay a winner after health care reforms. That sounds like the most logical thing to do, at least for me.

My point about the end of the lucrative days of radiology has more to do with conveying to other M4s that going into a field purely for the money in the current political milieu isn't the smartest thing to do. If someone likes or dislikes all specialties equally, then I agree with your assessment that one might as well select a currently lucrative field and hope that it never drops as predicted. However, if one has a natural inclination towards a certain lower paying field, then the individual would have to assess just how much he/she likes that specialty, and whether or not it's enough to offset the likelihood of lucrative fields remaining lucrative.

And I never said that low paying specialties will be high paying tomorrow. In fact, my prediction is simply that there will be a much more narrow range between specialties' incomes. And I don't know why you brought up the cataracts vs nutrition consult example. Both are "direct patient contact." And even though you don't exactly develop a relationship with a cataracts patient, you still build your own name and referral base in a certain area. This is in sharp contrast with support specialties like pathology or radiology.

 

[Gunneria]

this is my first post....what i conclude from this is that:

1. rads is higher avg starting salary than derm but derm has higher earning potential. I suppose this has some validity but wouldnt u speculate the private practice model to die down over the years as reimbursements are cut and it might be more aligned to switch to hospital based-clinic pay as suggested by transformers?

2. Then what about DERMPATH vs. RADS in terms of avg starting salary and earning potential?

 

[doctalaughs]

this is my first post....what i conclude from this is that:

1. rads is higher avg starting salary than derm but derm has higher earning potential. I suppose this has some validity but wouldnt u speculate the private practice model to die down over the years as reimbursements are cut and it might be more aligned to switch to hospital based-clinic pay as suggested by transformers?

2. Then what about DERMPATH vs. RADS in terms of avg starting salary and earning potential?

There's a lot of misinformation floating around in the posts above.

First off, I agree that rads on average make more money than derm, although for a longer residency and probably a bit longer hours.

Second, I would argue it would be harder to cut reimursement for derm, because of a larger repitoire of codes and ownership over the patient as a clinician.

Third, general derm is one of the few areas where you can build your practice VERY quickly due to a relative shortage. Most (not all) areas of the country you can be busy soon.

Fourth, dermpath was the right place to be about 10 years ago. It's still nice, and probably the bright point relative to other path subspecialties, but nothing like it was before since we have overtrained there. Some dermatopathologists were literally making millions a decade ago but it's hard to find a job now in larger cities, and they probably now make about the same amount of money as a general dermatologist (and less than a radiologist).

 

[N-Surge]

1. Dermatology more at risk? All I have to say is Night Hawk.

2. Radiologists can choose a direct patient care route as well, Interventional.

3. Both fields rock! Go for what you believe you will enjoy best. Pretty sure you will find this mattering more in the end. No joke. Maybe the Princeton and Nobel Laureate dudes don't have a clue. But I think they probably do. Heck, even B.I.G., Puffy, and Mace knows, "Mo' Money, Mo' Problems". I'm just say'n...

 

[werd]

dermpath still retains a much higher income potential than general derm, easily 500k a year, 1M+ if you're in the right place. among other derm specialties, mohs took a recent hit but still pays more than general, and peds derm, as always, pays as much or less than general derm.

some dermatologists don't accept insurance (they do it because they can) and thus increase their salaries, but most deal with insurance per usual. cosmetic procedures are, of course, paid for outside of insurance and often pay well.

 

[fun8stuff]

dermpath still retains a much higher income potential than general derm, easily 500k a year, 1M+ if you're in the right place. among other derm specialties, mohs took a recent hit but still pays more than general, and peds derm, as always, pays as much or less than general derm.

some dermatologists don't accept insurance (they do it because they can) and thus increase their salaries, but most deal with insurance per usual. cosmetic procedures are, of course, paid for outside of insurance and often pay well.

werd, you play sc2?

 

[Gunneria]

To add to the mix, what about RAD-ONC vs. dermpath vs. radiology?

 

[Osteopathology]

For the people who are looking at medicine as a way to make cash .. please look elsewhere. You will work long and hard and retire comfortable, thats about it.

If you want to grab the big bucks -- business.

Osteo

 

[opthointerested]

The grass is always greener....

Listen, if any of you think that making money in business is easy, then you're sadly mistaken. Those CEOs making ridiculous bank work ridiculous hours. I like to complain about how much I work and then talk to my sister who is the financial director of a big company and she sleeps 3-4hrs a night - EVERY NIGHT, not q4. I realize it's stupid to use the whole, "I know this one guy" example but at least talk to people making good money in business and they'll admit they work hard.

You can still make money in medicine, you just have to work harder - but the grass isn't greener, wake up!

We have this perspective in medicine that if you graduate and pick a "good specialty" then you're guaranteed money. News flash, you still have to work for it - even in Derm.

 

[bronx43]

For the people who are looking at medicine as a way to make cash .. please look elsewhere. You will work long and hard and retire comfortable, thats about it.

If you want to grab the big bucks -- business.

Osteo

It's HARD to make the big bucks in business. This topic has been beaten to death a thousand times over in this forum, but an absurd number of doctors and medical students have a pathetically distorted view of business.

 

[penguin24]

For the people who are looking at medicine as a way to make cash .. please look elsewhere. You will work long and hard and retire comfortable, thats about it.

If you want to grab the big bucks -- business.

Osteo

If you dropped out of medicine and went into business for yourself like a true entrepreneur, what is the chance you could consistently make >400K/yr?
My guess is 1%

If you went into Ortho surg, Rads, or Cards, what is the chance you could consistently make >400K/yr?
My guess is 35%

Does that sound accurate to you guys?

 

[werd]

werd, you play sc2?

sorry, nope...

 

[bronx43]

If you dropped out of medicine and went into business for yourself like a true entrepreneur, what is the chance you could consistently make >400K/yr?
My guess is 1%

If you went into Ortho surg, Rads, or Cards, what is the chance you could consistently make >400K/yr?
My guess is 35%

Does that sound accurate to you guys?

Probably less than 1% for the first, and more than 35% for the second (if no cuts in reimbursement).

 

[doctalaughs]

Probably less than 1% for the first, and more than 35% for the second (if no cuts in reimbursement).

True, but it's not hard to soon make 100k in business and work minimal hours if you are intelligent, graduated from a good college with good grades and get along with others (ie most of us). And that's working 40 hrs a week.

What most medical students and physicians don't realize is that 100k/yr is financially much better per hour than 250k/yr starting many years later with 300k in debt (given compounding and investment). Not to mention, there are VERY few physician jobs where you can work 40 hrs/wk with no nights and no weekends.

Do it if you like it... there ARE better and more stable finiancial jobs out there. You can't just compare salaries (look at money/hr and when you are able to start investing).

 

[gonogo]

Comparing business and medicine is like comparing apples and oranges. Business is far more lucrative. Anyone who made it to med school would have likely made it to a top business school. I have yet to find a graduate of a top business school who's not making decent money. And when I say decent money I'm talking about 300k or more before they turn 30. But obviously you have to work really hard (but you work hard in medicine, don't you?). As you climb the ladder, because of bonuses, total compensation is usually in the millions a year, not including all the perks (traveling first class, etc...). If you're going to compare ortho/rads/derm vs business, you have to compare the top med students in the country with the ones in the top business schools. Again, those guys who are at the top business schools usually land very prestigious jobs.

 

[Gunneria]

guys, we are going off topic here....based on your personal experiences, what are the avg salaries and estimated reimbursements (i know you're no fortune tellers) of rad onc, derm, and radiology? Nothing is sure but I'm going off the notion you and your peers have had more encounters and are familiar with the current demands

 

[Gute]

guys, we are going off topic here....based on your personal experiences, what are the avg salaries and estimated reimbursements (i know you're no fortune tellers) of rad onc, derm, and radiology? Nothing is sure but I'm going off the notion you and your peers have had more encounters and are familiar with the current demands

all 3 pay very well and have great lifestyles. you should pick based on which one you like the best, as all 3 have much different ways of practicing medicine.

in terms of avgs: rads>radonc>derm, but it can be quite variable, esp in PP world where some groups value lifestyle and cashflow differently

 

[fun8stuff]

Comparing business and medicine is like comparing apples and oranges. Business is far more lucrative. Anyone who made it to med school would have likely made it to a top business school. I have yet to find a graduate of a top business school who's not making decent money. And when I say decent money I'm talking about 300k or more before they turn 30. But obviously you have to work really hard (but you work hard in medicine, don't you?). As you climb the ladder, because of bonuses, total compensation is usually in the millions a year, not including all the perks (traveling first class, etc...). If you're going to compare ortho/rads/derm vs business, you have to compare the top med students in the country with the ones in the top business schools. Again, those guys who are at the top business schools usually land very prestigious jobs.

i think there are different skill sets that aren't necessarily compatible. i some times wonder if i would have done as well in business, but i doubt it. i'm sure there are many that would have, but also many that wouldn't have. i'm too introverted. i think i am where i am because i am good at taking tests. that's it. i doubt i'm the only one.

 

[penguin24]

These discussions about 'if you only care about money, drop out of medicine and go into business' are really a moot point. I disagree w/ this argument; however, let's just say for the sake of argument that we all could become successful businessmen. So what? We already made our commitment to medicine. Talking about wall-street vs medicine vs CEO is just mental masturbation.

OTOH, for many of you M3/M4's out there, deciding btwn Rad/RadOnc/Derm is a very realistic decision that you will have to make. We should limit our conversations to actual real choices that we have, not to some fantasy world where I am some high-profile stockbroker.

 

[Gunneria]

So is the conclusion (though somewhat not definitive) that the average starting salary + 10 years out spectrum is rads>rad onc> derm? Do you guys have any anecdotes or current figures that can quantify this?

 

[bronx43]

Comparing business and medicine is like comparing apples and oranges. Business is far more lucrative. Anyone who made it to med school would have likely made it to a top business school. I have yet to find a graduate of a top business school who's not making decent money. And when I say decent money I'm talking about 300k or more before they turn 30. But obviously you have to work really hard (but you work hard in medicine, don't you?). As you climb the ladder, because of bonuses, total compensation is usually in the millions a year, not including all the perks (traveling first class, etc...). If you're going to compare ortho/rads/derm vs business, you have to compare the top med students in the country with the ones in the top business schools. Again, those guys who are at the top business schools usually land very prestigious jobs.

So, comparing business and medicine is like comparing apples and oranges, yet you go ahead and do it?

You either know very few people in "business" or by some sheer luck of draw, everyone you know is doing really well. But, honestly, a top business school guarantees you nothing. I know just as many people from H/S/W that ended up making $200k in corporate finance as people who are making $400k+. A few of the guys from Wharton who joined several startups after graduation are now basically unemployed. Very very very few people are able to get high up enough to command "millions a year" in bonuses or total compensation, because there simply aren't many of those jobs around. You would have to be a MD at a bulge bracket, at least principal level at a big buyside firm (I'm talking AUM greater than $10 billion), C level position at a Fortune 500, partner at consulting or other financial service firms, or a successful entrepreneur.
And the other poster is right about comparing "top" of med school and "top" of business school. The two succeed by very different skillsets that are not transferrable and certainly not directly comparable. To get a high position in business, it's all about how well you can network, how hard you work, and how lucky you are. Once you get to a high position, it becomes how good of a salesman/manager you are. Getting a competitive residency in medicine is about how much you study, how good your memory is, and how good you are at test taking. See the lack of direct equivalency?
And the idea that ANYONE who got into medical school can get into a top 7 business school is just asinine. Period.

 

[CandidateofDerm]

All fields in medicine are going to feel the pain, but it won't be as bad as some fear. Unfortunately I think rads will feel a lot of pain. Compare it to derm. Think how many more rads there are than derms. Think how much more they b I'll with facility fees than dermas who don't have these inflated hospital charges merely fow owning and using equipment. Now think about what a big target this makes rads. It is arguably the biggest well paid specialty in the country. You cut 10 percent from derm you save peanuts in the grand scheme and worsen access with the groups of independent clinics. You cut radiology fees by 10 percent and you start seeing bigger returns especially if you cut facility fees. He other problem is that when the cuts start coming, rads will b e in a very poor position to decline reading poorer paying gov insurance aptients

 

[durfen]

Radiology will be cut in two major ways and one minor:
1. Lower utilization - Better guidelines so ER docs don't CT everything under the sun. Better followup guidelines so benign incidental findings are not accidentally followed up by primary care physicians.
2. Lower reimbursement for *acquisition*, not necessarily for the professional fee (which is already very low). If you need to read 50 cts and 100 xrays per 8 hour day, work 8-16 hours per day as an attending to make your money after doing a residency that is 3 years longer and requires pretty technically-oriented people, I don't think professional fees will be cut that much.
3. Patient-centered radiology at outpatient acquisition centers will lower volume, and through that lower overall reimbursement (though reimbursement per patient would be higher).
4. Other specialties (*cough* cardiology) get 'certified' and begin to self-refer and read their own imaging.

yes there are 4 above.

However, in the future I see good times:
1. Obamacare will increase overall patientload, people will go to the doctor more often and thereby get more imaging. Imaging utilization will increase initially and then level out (but not decrease) due to pretty stable incidence of disease.
2. Older population get more imaging
3. Dose and cost reduction and method improvement increases the value of screening using imaging in modalities other than mammography, such as ct colonography. The same will increase overall imaging utilization even with diagnostic studies.

The #1 thing here is, like dermatology, the radiologist is trained to look for other things, not just the disease that particular primary specialty is interested in.

phew that's all i can think of at this time.

 

[bronx43]

Radiology will be cut in two major ways and one minor:
1. Lower utilization - Better guidelines so ER docs don't CT everything under the sun. Better followup guidelines so benign incidental findings are not accidentally followed up by primary care physicians.
2. Lower reimbursement for *acquisition*, not necessarily for the professional fee (which is already very low). If you need to read 50 cts and 100 xrays per 8 hour day, work 8-16 hours per day as an attending to make your money after doing a residency that is 3 years longer and requires pretty technically-oriented people, I don't think professional fees will be cut that much.
3. Patient-centered radiology at outpatient acquisition centers will lower volume, and through that lower overall reimbursement (though reimbursement per patient would be higher).
4. Other specialties (*cough* cardiology) get 'certified' and begin to self-refer and read their own imaging.

I agree with 1. I don't understand what you're trying to say with 2. Can you clarify?
Why would reimbursement per patient be higher? That isn't going to happen unless patient volume is drastically reduced. Even then, it's no guarantee.
4 is already happening for the most part other than CXR.

 

[CandidateofDerm]

I agree with 1. I don't understand what you're trying to say with 2. Can you clarify?
Why would reimbursement per patient be higher? That isn't going to happen unless patient volume is drastically reduced. Even then, it's no guarantee.
4 is already happening for the most part other than CXR.

Radiologists make a lot of money for hospitals and thus themselves through salaries not through pesky professional fees but through equipment fees. This is why cards want to own the own machines. It is the technical fee! This is what allows rads to command high salries. Fields like derm do not have these technical fees. Therefore, this will make rads a target because rads takes up x of cms Medicare budget more than other fields. On the plus side you will have the aha lobbying on your side because your fates are intertwined!

 

[bronx43]

Radiologists make a lot of money for hospitals and thus themselves through salaries not through pesky professional fees but through equipment fees. This is why cards want to own the own machines. It is the technical fee! This is what allows rads to command high salries. Fields like derm do not have these technical fees. Therefore, this will make rads a target because rads takes up x of cms Medicare budget more than other fields. On the plus side you will have the aha lobbying on your side because your fates are intertwined!

I know how radiologists and hospitals are reimbursed for diagnostic imaging. I was confused about the working 8-16 hours and a residency that is "3 years longer" part.

 

[Long Dong]

but i think they probably do. Heck, even b.i.g., puffy, and mace knows, "mo' money, mo' problems". I'm just say'n...

lol

 

[Gunneria]

so DERM = RAD ONC > RADS for the future?

 

[C5toC9]

isn't that already true looking at avg boards scores?

 

[bronx43]

isn't that already true looking at avg boards scores?

... huh? Right now, rads is making more than derm and comparable to rad onc (though prob for more hours). So it's more like rads = rad onc > derm.

 

[C5toC9]

sorry, i was referring to avg board scores, not salary

 

[fun8stuff]

so DERM = RAD ONC > RADS for the future?

In 2009 the avg step 1 & 2 for rads was 238/242, rad onc 238/241, derm 242/251. There are a lot of radiology community programs that lower the Step 1 avg, as the avgs are a bit higher for the academic programs. Rad onc typically puts more emphasis on research and who you know.

 

[shffl]

This topic is interesting because Radiologist or Dermatopathologist are the two specialties that I am considering if I get into med school. At the same time, the whole deal with Obamacare is making my decision to go to medical school a bit tougher. I have worked for a while in the field of business after graduating with a bio degree. Initially, my mind was set on making a lot of money. Obviously business is the way to go right? Well, to a certain extent it's true. However, not everyone come out of it making big bucks. There are A LOT of people out there in the business field not making a lot of money. Business graduates are found working as cashiers, retail store managers, personal bankers, accountants, loan officers, etc and I bet only a few percent of total business graduates out there make lucrative incomes. If you compare the proportion of business graduates making less than ideal income to those who make a sizable amount, then you get the picture of how difficult it is to come out ahead in the business field.

Yes it is possible for you to make big bucks in business and no it is not easy. Here is what I think. Not everyone is accustomed to business ... just like how not everyone is accustomed to science and medicine. In my opinion, I don't believe I have the people skill nor the mindset to be successful in the realm of business. I like money but I don't think I am in the right place for it. This is why I am considering the decision to become a physician again. The income that I seek is definitely there as a physician. Whether or not I can get my ideal income ($300k+) is entirely up to me but I believe my chance of success in the field of medicine is greater than that of business due to my type of personality. I like the topic in medicine. I enjoyed my science classes during college. The only reason I didn't pull through with it was because I had decided money was more important and I chose to test the waters of business path. People say never go into medicine if you are only in it for the money and I stand by that. However, because I have experienced what is out there, I can safely confirm that if I ever want to make money, I need to do what I enjoy and am capable at which is in the field of medicine. Now the only obstacles that are stopping me are the future of physicians salary and lifestyle. This is why I have been stuck in indecision between pursuing a career as a physician or a respiratory therapist where the pay is pretty good and education term is shorter. I think I will stop here before I get off topic...

If you look up salaries of California state workers, the top 5 are the two football coaches from UCLA and Berkeley and the other 3 are all from UCSF (two whom were dermatopathologists if I recall properly).

 

[2012mdc]

This topic is interesting because Radiologist or Dermatopathologist are the two specialties that I am considering if I get into med school. At the same time, the whole deal with Obamacare is making my decision to go to medical school a bit tougher. I have worked for a while in the field of business after graduating with a bio degree. Initially, my mind was set on making a lot of money. Obviously business is the way to go right? Well, to a certain extent it's true. However, not everyone come out of it making big bucks. There are A LOT of people out there in the business field not making a lot of money. Business graduates are found working as cashiers, retail store managers, personal bankers, accountants, loan officers, etc and I bet only a few percent of total business graduates out there make lucrative incomes. If you compare the proportion of business graduates making less than ideal income to those who make a sizable amount, then you get the picture of how difficult it is to come out ahead in the business field.

Yes it is possible for you to make big bucks in business and no it is not easy. Here is what I think. Not everyone is accustomed to business ... just like how not everyone is accustomed to science and medicine. In my opinion, I don't believe I have the people skill nor the mindset to be successful in the realm of business. I like money but I don't think I am in the right place for it. This is why I am considering the decision to become a physician again. The income that I seek is definitely there as a physician. Whether or not I can get my ideal income ($300k+) is entirely up to me but I believe my chance of success in the field of medicine is greater than that of business due to my type of personality. I like the topic in medicine. I enjoyed my science classes during college. The only reason I didn't pull through with it was because I had decided money was more important and I chose to test the waters of business path. People say never go into medicine if you are only in it for the money and I stand by that. However, because I have experienced what is out there, I can safely confirm that if I ever want to make money, I need to do what I enjoy and am capable at which is in the field of medicine. Now the only obstacles that are stopping me are the future of physicians salary and lifestyle. This is why I have been stuck in indecision between pursuing a career as a physician or a respiratory therapist where the pay is pretty good and education term is shorter. I think I will stop here before I get off topic...

If you look up salaries of California state workers, the top 5 are the two football coaches from UCLA and Berkeley and the other 3 are all from UCSF (two whom were dermatopathologists if I recall properly).

http://www.sacbee.com/statepay/

1. Cal football coach
2. ucla bball coach
3 and 4 - UCSF dermpath guys
5 - ucla transplant surgeon

 

[fun8stuff]

http://www.sacbee.com/statepay/

1. Cal football coach
2. ucla bball coach
3 and 4 - UCSF dermpath guys
5 - ucla transplant surgeon

uh does that include grant money or something?? sounds a little off for an academic position...

 

[Long Dong]

When i was looking into fellowships 2 years ago dermpath was making the most money in medicine per hours worked. That's why almost all pathologist are jonesin for a dermpath fellowship.

http://www.nydailynews.com/ny_local...columbia_dermatology_professor_tops_nonp.html

 

[durfen]

Sorry dropped off the earth for a while there:

I think this was answered, but I'll go through it. The business of radiology goes this way for most people not in radiology: 1. Dr orders imaging....2. ... . .... ... 3. Profit!
Most of the profit occurs with the technical fee for actual acquisition of the scan, the scanner itself costs between 100k for a ****ty one and 2 million + paying the technologists who have to be specially trained in RT(CT) or RT(MR) so the costs have to be recouped somehow. Then the professional fee is what you actually pay for the read, and I have to say that is abysmally small compared to the technical fee (<10% sometimes). Still you make good bucks because you will read from many individual scanners so you are never idle as the radiologist. In any case, the upshot is that the place the cuts will take place is at the technical side and likely not at the professional side, starting with scanner prices falling as hospital disposable income decreases.

2. The other question was residency lenght. It is true that Med guys need to do a fellowship afterwards that can be up to 3 years in addition to a 3 year residency, but they also get to moonlight as attendings and thereby make dough. Radiologists have to do 5 year residency + 1 year fellowship. You can moonlight as a fellow, but not as much.

 

[boogah]

late to the discussion on business, but here is something to consider...scroll all the way down where it compares harvard mba grads vs upenn vs stanford etc...and their average salaries 2 yrs out, 10 yrs out, and 20 yrs out. not as high as we hope to believe, just putting it out there.

http://finance.yahoo.com/college-ed...hools-top-dollar?mod=edu-continuing_education

The grass is always greener....

Listen, if any of you think that making money in business is easy, then you're sadly mistaken. Those CEOs making ridiculous bank work ridiculous hours. I like to complain about how much I work and then talk to my sister who is the financial director of a big company and she sleeps 3-4hrs a night - EVERY NIGHT, not q4. I realize it's stupid to use the whole, "I know this one guy" example but at least talk to people making good money in business and they'll admit they work hard.

You can still make money in medicine, you just have to work harder - but the grass isn't greener, wake up!

We have this perspective in medicine that if you graduate and pick a "good specialty" then you're guaranteed money. News flash, you still have to work for it - even in Derm.

 

[Long Dong]

http://www1.salary.com/Physician-Assistant-Medical-salary.html

http://www1.salary.com/Pharmacist-salary.html

http://www1.salary.com/Dentist-Salary.html

http://www1.salary.com/Dermatologist-salary.html

http://www1.salary.com/Radiologist-salary.html

 

[jake2]

late to the discussion on business, but here is something to consider...scroll all the way down where it compares harvard mba grads vs upenn vs stanford etc...and their average salaries 2 yrs out, 10 yrs out, and 20 yrs out. not as high as we hope to believe, just putting it out there.

http://finance.yahoo.com/college-ed...hools-top-dollar?mod=edu-continuing_education

I have to say, I'm really surprised by those numbers. For HBS, I would have expected they would be considerably higher. Perhaps its an issue of only counting base salary, not bonuses and stock options and such where business people actually make most of their money.

Or maybe the grass is just always greener on the other side...