Redistribution of Physician Salaries

[Anicetus]

We all know how little PCP's make compared to Specialists.

For those of us learning healthcare in MS1 for the first time are being exposed to some of the cost problems of healthcare. It seems that Physicians being overpaid is definitely one of them.

Personally, I consider myself as fairly fiscally conservative and generally opposed to socialism, but in light of PCP salaries vs Specialty salaries, I think there is problem here.

Can someone justify why some specialists make so much more than PCP's?

I don't buy the "Because it's longer training and worse hours", because if we look outside of the medical field there are so many problems with that argument and if most of America is down to redistribute the wealth, why would the medical field be opposed to redistributing physician salaries?

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[Chipster.]

Personally, I consider myself as fairly fiscally conservative and generally opposed to socialism, but in light of PCP salaries vs Specialty salaries, I think there is problem here.

I don't buy the "Because it's longer training and worse hours", because if we look outside of the medical field there are so many problems with that argument and if most of America is down to redistribute the wealth, why would the medical field be opposed to redistributing physician salaries?

- Said no actual fiscal conservative, ever.

 

[Jabbed]

1. Physician's do not bill for time (with the possible exception of critical care time blocks).
2. Procedures provide the highest billing. Whether that's just or not is a separate debate. We are in America, where medicine = active intervention. If you're not physically doing something, you might as well be doing nothing.
3. Specialists generally take on significantly more liability than primary care physicians.
4. Wealth redistribution is incongruous with fiscal conservatism.

 

[FindMeOnTheLinks]

Specialists make more money because the procedures they do and advanced care they provide is more expensive than what PCP's are capable of. IE a cardiologist bills more for an EKG than a PCP can bill for a simple physical. "Redistribution" of money towards primary care physicians means the patient would have to pay MORE for primary care, which will never happen.

 

[theseeker4]

We all know how little PCP's make compared to Specialists.

For those of us learning healthcare in MS1 for the first time are being exposed to some of the cost problems of healthcare. It seems that Physicians being overpaid is definitely one of them.

Personally, I consider myself as fairly fiscally conservative and generally opposed to socialism, but in light of PCP salaries vs Specialty salaries, I think there is problem here.

Can someone justify why some specialists make so much more than PCP's?

I don't buy the "Because it's longer training and worse hours", because if we look outside of the medical field there are so many problems with that argument and if most of America is down to redistribute the wealth, why would the medical field be opposed to redistributing physician salaries?

In addition to the replies already given, what should pay more, performing an appendectomy or discussing the best way to lower blood sugar, lower cholesterol, and lower blood pressure? What should pay more, replacing someone's hip, or discussing the progress of a 12 month old on growth charts? What should pay more, examining a throat, sending out a culture to test for strep, and writing a prescription for an antibiotic, or going in and clearing out a blockage in someone's coronary artery?

 

[DermViser]

We all know how little PCP's make compared to Specialists.

For those of us learning healthcare in MS1 for the first time are being exposed to some of the cost problems of healthcare. It seems that Physicians being overpaid is definitely one of them.

Personally, I consider myself as fairly fiscally conservative and generally opposed to socialism, but in light of PCP salaries vs Specialty salaries, I think there is problem here.

Can someone justify why some specialists make so much more than PCP's?

I don't buy the "Because it's longer training and worse hours", because if we look outside of the medical field there are so many problems with that argument and if most of America is down to redistribute the wealth, why would the medical field be opposed to redistributing physician salaries?

I don't know whether your purpose in starting this thread is to be informed or to inflame, but you saying the "cost problems of healthcare" are due to physicians being overpaid shows that you don't really know what you're talking about.

It's obvious based on your wording and tone of your OP, that your purpose is to inflame. Oh by the way, your post is supposed to be posted in Pre-Allo.

 

[DermViser]

Personally, I consider myself as fairly fiscally conservative and generally opposed to socialism, but in light of PCP salaries vs Specialty salaries, I think there is problem here.

if most of America is down to redistribute the wealth, why would the medical field be opposed to redistributing physician salaries?

Yeah, you're definitely not a fiscal conservative by definition if you actually believe the above to be true.

 

[Anicetus]

Pardon my naive MS1-ness, but what about the possibility of disconnecting how much a specialist can bill for with their salary?

So in other words, regardless of how much a physician bills for something, a cardiologist and an internist could be paid with a more flat salary?

Maybe I am missing the connection between purely billing and the salary from it. The reason I am advocating for this is trying to reason a possible solution to the PCP shortage being to redistribute the salaries since this is a huge reason why medical students oppose primary care.

 

[MrChance2]

Politics and economic principals are a big part of it.

 

[Anicetus]

I don't know whether your purpose in starting this thread is to be informed or to inflame, but you saying the "cost problems of healthcare" are due to physicians being overpaid shows that you don't really know what you're talking about.

It's obvious based on your wording and tone of your OP, that your purpose is to inflame. Oh by the way, your post is supposed to be posted in Pre-Allo.

To be informed. I want to get a perspective from all kinds of sides and not just only believe what I am taught in Healthcare in M1.

 

[theseeker4]

Pardon my naive MS1-ness, but what about the possibility of disconnecting how much a specialist can bill for with their salary?

So in other words, regardless of how much a physician bills for something, a cardiologist and an internist could be paid with a more flat salary?

Maybe I am missing the connection between purely billing and the salary from it. The reason I am advocating for this is trying to reason a possible solution to the PCP shortage being to redistribute the salaries since this is a huge reason why medical students oppose primary care.

Why on earth would you want to pay the same amount of money to two different physicians who do completely different jobs, with an incredible gap between their training, expertise, liability, etc.?

 

[Anicetus]

Yeah, you're definitely not a fiscal conservative by definition if you actually believe the above to be true.

I'm fiscally conservative when it comes to 90% of the economics in our country, but when it comes to Physician salaries, I am not yet convinced that we shouldn't just redistribute to help with the PCP shortage.

 

[DermViser]

I'm fiscally conservative when it comes to 90% of the economics in our country, but when it comes to Physician salaries, I am not yet convinced that we shouldn't just redistribute to help with the PCP shortage.

That's like saying you're 90% pregnant. No. You're either fiscally conservative or not. Not just fiscally conservative to things that are not your pet causes. Again if you think healthcare costs in this country are due to physician salaries, then you are very much misguided and misinformed on the topic bc it's actually the opposite of what respected medical economists have said which are no friends to physicians.

 

[Anicetus]

Why on earth would you want to pay the same amount of money to two different physicians who do completely different jobs, with an incredible gap between their training, expertise, liability, etc.?

Because most of the country is advocating for closing the salary gaps DESPITE training, expertise, liability in other jobs.

 

[MrChance2]

OK, so 1000 people have a heart attack, they can pay $100 to see a internist, $120 to see a cardiologist, or $80 to see a PA. What would most people choose? Would the future cardiologists choose cardiology or would they choose to become PAs and save themselves the 10 extra years of training, or would he become a plastic surgeon and do cash only boob jobs + botox and get out of the whole mess?

I think the gap can be closed in a lot of ways, but it is a complex issue. I vote pay 'em all more because all 3 are making orders of magnitude less money than the bank execs that lied to regulators and tanked our economy a few years ago but for some reason businesses don't like giving out money.

 

[Chipster.]

I'm fiscally conservative when it comes to 90% of the economics in our country, but I like money and am worried I won't be able to match into anything except FM

FTFY.

 

[Anicetus]

FTFY.

Except most of my M1 class is like this. I only know one person who wants to do FM out of the goodness of their hearts. Everyone else despises Primary Care.

Maybe I just need to wait and see with time, but it seems most of my class is in this for the money.

 

[100111]

I'm fiscally conservative when it comes to 90% of the economics in our country, but when it comes to Physician salaries, I am not yet convinced that we shouldn't just redistribute to help with the PCP shortage.

... pcp shortage is because of location, not income. I see listings in montana offering 500k+ for physicians and those positions go unfilled.

tons of pcp docs happily take 120 and live in nyc.

 

[Frazier]

As someone who is interested in one of the lower paid specialties, I find the ideals propagated in here to be preposterous.

Pay two different specialties an equal flat salary? ............Huh?

The "problem" with healthcare expenditures in the US is not derived from any physicians income or even aggregated incomes. While there are specialists out there making millions with fraud (or very questionable billing tactics) , they are minority and should not be used to justify some widespread universal sanction...just punish the hell out of them as they arise.

As noted above, the pcp shortage is more like a distribution issue. What you think by lowering specialist income PCPs will want to suddenly move en masse to south dakota?

 

[DermViser]

Except most of my M1 class is like this. I only know one person who wants to do FM out of the goodness of their hearts. Everyone else despises Primary Care.

Maybe I just need to wait and see with time, but it seems most of my class is in this for the money.

Primary Care is despised for more reasons than just salary. Many of the ones who do general medicine don't even do primary care but hospitalist work.

 

[DermViser]

... pcp shortage is because of location, not income. I see listings in montana offering 500k+ for physicians and they positions go unfilled.

tons of pcp docs happy to take 120 and live in nyc.

Bingo. It isn't the money.

 

[DermViser]

Except most of my M1 class is like this. I only know one person who wants to do FM out of the goodness of their hearts. Everyone else despises Primary Care.

Maybe I just need to wait and see with time, but it seems most of my class is in this for the money.

You mean people who take SIX FIGURES in loans doing the physician pathway might actually have money on their mind to pay off their exorbitant debts? How is this at all surprising? If the practicing of primary care is the end point, there are a LOT easier ways in the United States than the physician pathway.

 

[ChEMD]

Except most of my M1 class is like this. I only know one person who wants to do FM out of the goodness of their hearts. Everyone else despises Primary Care.

Maybe I just need to wait and see with time, but it seems most of my class is in this for the money.

Have you considered the fact that many people just don't consider primary care to be very interesting?

 

[DrBowtie]

Pardon my naive MS1-ness, but what about the possibility of disconnecting how much a specialist can bill for with their salary?

So in other words, regardless of how much a physician bills for something, a cardiologist and an internist could be paid with a more flat salary?

Maybe I am missing the connection between purely billing and the salary from it. The reason I am advocating for this is trying to reason a possible solution to the PCP shortage being to redistribute the salaries since this is a huge reason why medical students oppose primary care.

Procedures = billable RVUs. Many specialists are not salaried but rather "eat what you kill" based upon their RVUs.

An office visit isn't worth as much per time in RVUs as specialty care.

PS. You aren't a fiscal conservative.

 

[FindMeOnTheLinks]

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[Anicetus]

You mean people who take SIX FIGURES in loans doing the physician pathway might actually have money on their mind to pay off their exorbitant debts? How is this at all surprising? If the practicing of primary care is the end point, there are a LOT easier ways in the United States than the physician pathway.

Fair enough. But, then why do large numbers of people match primary care if it seems like barely any students have interest in it? Is it purely because they get a reality glimpse when they see their Step 1 score or something?

 

[DermViser]

Fair enough. But, then why do large numbers of people match primary care if it seems like barely any students have interest in it? Is it purely because they get a reality glimpse when they see their Step 1 score or something?

What are you talking about large number of people match primary care? Those who match into IM or Peds have the full intent to subspecialize and those that don't many of them do Hospitalist work which is not primary care. I realize you're an M1, but many of the conclusions you reach as to why things are the way they are, are off.

 

[W19]

I don't know whether your purpose in starting this thread is to be informed or to inflame, but you saying the "cost problems of healthcare" are due to physicians being overpaid shows that you don't really know what you're talking about.

It's obvious based on your wording and tone of your OP, that your purpose is to inflame. Oh by the way, your post is supposed to be posted in Pre-Allo.

I disagree with OP, but I don't think it's a pre-allo post.

 

[MrChance2]

Fair enough. But, then why do large numbers of people match primary care if it seems like barely any students have interest in it? Is it purely because they get a reality glimpse when they see their Step 1 score or something?

That happens plenty, I don't think it is really the #1 case for US grads though. People have different interests, different life plans. Making $200K/yr doing something you love may be better than making $300K-$400K doing something that bores you. Plenty of people prefer a 3 year residency over a 5yr+ residency+fellowship for various reasons. Also keep in mind internal med residency leads to many specialist/procedurist fellowships (cardiology included).

 

[Anicetus]

Procedures = billable RVUs. Many specialists are not salaried but rather "eat what you kill" based upon their RVUs.

An office visit isn't worth as much per time in RVUs as specialty care.

PS. You aren't a fiscal conservative.

^ I don't believe in raising taxes on the rich to solve the economy's problems.

What are you talking about large number of people match primary care? Those who match into IM or Peds have the full intent to subspecialize and those that don't many of them do Hospitalist work which is not primary care. I realize you're an M1, but many of the conclusions you reach as to why things are the way they are, are off.

So then what of the people who purely become family practitioners and general pediatricians? Are they just doing it out of the goodness of their hearts?

 

[Anicetus]

That happens plenty, I don't think it is really the #1 case for US grads though. People have different interests, different life plans. Making $200K/yr doing something you love may be better than making $300K-$400K doing something that bores you. Plenty of people prefer a 3 year residency over a 5yr+ residency+fellowship for various reasons. Also keep in mind internal med residency leads to many specialist/procedurist fellowships (cardiology included).

Maybe I just need to give it time then and see my fellow students change. Honestly, I am kind of just sick of all the PCP bashing going on amongst M1's as if they are the laziest medical students or something.

 

[W19]

I like when people claim they are fiscally conservative, then they vote either republican or democrat. Neither party is fiscally conservative. They just believe in different ways of spending your money. It's all empty rhetoric...

 

[Anicetus]

I like when people claim they are fiscally conservative, then they vote either republican or democrat. Neither party is fiscally conservative. They just believe in different ways of spending your money. It's all empty rhetoric...

I generally don't believe in redistributing the wealth in the ways that liberals want to.

I just think that when it comes to physicians, it is a very specific and particular crowd in society.

 

[DermViser]

I disagree with OP, but I don't think it's a pre-allo post.

Her status is Pre-Medical, thus her post belongs in Pre-Allo REGARDLESS of whether the topic may be an Allo topic.

 

[DermViser]

I generally don't believe in redistributing the wealth in the ways that liberals want to.

I just think that when it comes to physicians, it is a very specific and particular crowd in society.

So only when you stand to benefit. Makes you no different than those liberals.

 

[MrChance2]

Maybe I just need to give it time then and see my fellow students change. Honestly, I am kind of just sick of all the PCP bashing going on amongst M1's as if they are the laziest medical students or something.

General bashing will decrease sharply towards the end of 1st semester when most of those doing it realize they are in the bottom half of the class or worse.

 

[DermViser]

^ I don't believe in raising taxes on the rich to solve the economy's problems.

Right, you just want to redistribute it.

 

[W19]

Except most of my M1 class is like this. I only know one person who wants to do FM out of the goodness of their hearts. Everyone else despises Primary Care.

Maybe I just need to wait and see with time, but it seems most of my class is in this for the money.

Oh boy! You cannot be serious! Are your parents paying for your med school?

 

[Anicetus]

So only when you stand to benefit. Makes you no different than those liberals.

Haven't changed my status to med student yet.

That's one way of looking at it, however I still see any physician as someone who won't ever be starving or at the poverty line so I still don't think it is the same.

 

[DermViser]

Haven't changed my status to med student yet.

That's one way of looking at it, however I still see any physician as someone who won't ever be starving or at the poverty line so I still don't think it is the same.

And it's not your place to decide no matter how much you think it's completely all right bc that person won't starve.

 

[Anicetus]

Oh boy! You cannot be serious! Are your parents paying for your med school?

Nope. Kind of off topic, but no one is funding my medical school. I'm taking out the full loans and strictly following the recommendations. I barely do any fun things that cost money. Most of my classmates spend more money than the recommended "spending money" on our budgets so I usually miss out on those

 

[W19]

I generally don't believe in redistributing the wealth in the ways that liberals want to.

I just think that when it comes to physicians, it is a very specific and particular crowd in society.

Both parties do redistribution of wealth!

 

[DermViser]

Oh boy! You cannot be serious! Are your parents paying for your med school?

She's an M1. Her view will change quite a bit by the time she hits her exit interview and telling her how much money she owes with continuing compounding interest.

 

[W19]

Her status is Pre-Medical, thus her post belongs in Pre-Allo REGARDLESS of whether the topic may be an Allo topic.

OP is a MS1...

 

[Anicetus]

General bashing will decrease sharply towards the end of 1st semester when most of those doing it realize they are in the bottom half of the class or worse.

Our dean told us that they don't publish a rank in the LOR's or anything like that unless we are AOA. This (EDIT) allows even those at the bottom to still "bash" PCP.

I am kind of sick of it and am just reaching out for ways to give PCP more credit.

 

[MrChance2]

Haven't changed my status to med student yet.

That's one way of looking at it, however I still see any physician as someone who won't ever be starving or at the poverty line so I still don't think it is the same.

Just don't judge the reverse too strongly. Its not like PCPs are Mother Theresa and procedurists are money grabbing butchers, there are plenty of ways to help people.

 

[Psai]

We all know how little PCP's make compared to Specialists.

For those of us learning healthcare in MS1 for the first time are being exposed to some of the cost problems of healthcare. It seems that Physicians being overpaid is definitely one of them.

Personally, I consider myself as fairly fiscally conservative and generally opposed to socialism, but in light of PCP salaries vs Specialty salaries, I think there is problem here.

Can someone justify why some specialists make so much more than PCP's?

I don't buy the "Because it's longer training and worse hours", because if we look outside of the medical field there are so many problems with that argument and if most of America is down to redistribute the wealth, why would the medical field be opposed to redistributing physician salaries?

A lot of assumptions here. Why don't you think that doctors are underpaid as opposed to overpaid? Do you even know how much money they make? How this money comes to them and where it gets spent? How about the breakdown of how healthcare dollars are actually spent? Why not pay pcps more without cutting into specialists salaries? Do you think that there is only so much money in a zero sum game?

It's painfully obvious that the only things you know about the business side of medicine is what you read in the news

 

[Hemorrage]

We all know how little PCP's make compared to Specialists.

For those of us learning healthcare in MS1 for the first time are being exposed to some of the cost problems of healthcare. It seems that Physicians being overpaid is definitely one of them.

Personally, I consider myself as fairly fiscally conservative and generally opposed to socialism, but in light of PCP salaries vs Specialty salaries, I think there is problem here.

Can someone justify why some specialists make so much more than PCP's?

I don't buy the "Because it's longer training and worse hours", because if we look outside of the medical field there are so many problems with that argument and if most of America is down to redistribute the wealth, why would the medical field be opposed to redistributing physician salaries?

http://www.jacksonhealthcare.com/me...tion_eight_percent_of_healthcare_of_costs.pdf

8.6% of the healthcare budget is way too much to pay the most important role in health care delivery right? After all, when your mom needs her appendix removed, we'll just ask the PA to do it. I'm sure it'll go just fine

 

[DermViser]

Our dean told us that they don't publish a rank in the LOR's or anything like that unless we are AOA. This (EDIT) allows even those at the bottom to still "bash" PCP.

I am kind of sick of it and am just reaching out for ways to give PCP more credit.

You actually believe your dean of your medical school when he says your school doesn't rank you in your Dean's Letter?

 

[DermViser]

A lot of assumptions here. Why don't you think that doctors are underpaid as opposed to overpaid? Do you even know how much money they make? How this money comes to them and where it gets spent? How about the breakdown of how healthcare dollars are actually spent? Why not pay pcps more without cutting into specialists salaries? Do you think that there is only so much money in a zero sum game?

It's painfully obvious that the only things you know about the business side of medicine is what you read in the news

I wouldn't give her that much credit.