From BMJ article, a Yale prof writes:
"Bearing in mind that the median US income is in the $30,000 range and taking a look at the below medians from a recent issue of Medical Economics, I say doctors in the US, at least earn too much. Likely a redistribution from procedurists to primary care would be useful, but the overall pie is very large. Doctors should be comfortable, not rich.
2005 Median Total Compensation
Invasive cardiology $400,000
Noninvasive cardiology $325,000
GI $300,000
Ortho $300,000
Urology $300,000
Ophthalmology $280,000
Dermatology $254,000
General Surgery $225,000
Nephrology $210,000
OB/GYN $210,000
Allergy $200,000
Endocrinology $185,000
Rheumatology $176,000
All Doctors $175,000
To put it another way: how many earn above $300,000 in income (after expenses and before taxes) per year:
Invasive Cardiology 75%
Non Invasive Cardiology 54%
Orthopedics 50%
Urology 50%
Ophthalmology 58%
Dermatology 54%
General Surgery 27%
Ob/Gyn 22%
All US physicians 21%
All Primary Care physicians 12%
Yet another perspective is comparison to other US wage earners in 2005: Cardiologists, Gastroenterologists, Ob/Gyn, Most Medical subspecialists earn at the 96-99th percentile of all US citizens. All physicians in aggregate earn at about the 95th percentile of all taxpayers. Even the 'lowly' primary care specialists earn above the 92nd percentile.
Clearly, nobody other than another physician would make the case, with a straight face, that US doctors need more reimbursement. Common rejoinders include indebtedness, hours of work, importance to society, delayed earnings and the need to recruit the best and brightest. Even worst case scenarios of over $200,000 in school debt equates to monthly payments of about $2,000 (say $25,000 per year for twenty years), hardly putting a dent in earnings. As to importance or hours of work, many jobs are 'important' and require dedication. How much to firemen, policemen, teachers make? How long until a PhD scientist reaches his or her full earnings potential? Should doctors strive to make as much as the most highly paid lawyers and most successful businessmen? Oughtn't they engage in their profession to heal the sick, find meaning in the magical, intimate moments that we are privileged to be a part of? Yes, doctors should be comfortable and be able to enjoy the fruits of their labors, but at some point we cross the line into unseemly economic stratospheres. People became doctors for generations without the expectation of becoming out and out wealthy. Those are the sort of people we should be recruiting, not those who expect to be rich.
Competing interests: None declared"
Also, apparently docs in Italy make ~$100,000 but have to pay 40% tax. Germany is ridiculously low in pay-- maybe 50K huge taxes. UK docs have like 50-60% tax (paid 100,000 pounds which is about $200,000), while Israel is about the same (net salary of 20-25K!!!). I think US docs are going to earn much much less in the mid-to far future.
I wouldn't be averse to a 20-30% pay cut spread out over 40 years caused by stopping indexing for inflation, especially if it allows more people to have coverage... but what is really concerning is that successive presidents have cut more like 7-10% a year (notwithstanding inflation) AND they've severely cut funding for teaching new med students and residents. I think Bush proposed eliminating all GRE funding in the next budget... That kind of cutting will have bad consequences...
