Should I be worried?

[HAZELLBOO]

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[maceo]

I recently turned 30 years old and I'm currently a Biochemistry major in Undergrad with hopes of being accepted to medical school in a few years.

I came across this awesome article titled, "Does Your Doctor Charge Too Much?" After reading the article, I am a bit worried that after working so hard to obtain an M.D., I won't be able to make ends meet and will become so frustrated with the politics in the medical industry that I won't want to practice anymore! (Change that to WTH). LOL I'm tempted to start slipping a $50 in my OBGYN's white coat pocket during future visits! Geeeez! lol

Here is the article.

http://ethicalhealthpartnerships.org/doctorfees.html

I really want to practice medicine as an Anesthesiologist one day and I am willing to work very hard to get there. However, I can't help but to be worried about my future after reading this article.

Would you M.D.s please read the article and give me your thoughts?

Thanks!

P.S. I guess I could have posted this in a general M.D. area, but I may have overlooked it.

let me put it to you this way, you will never be paid commensurate with the level of hardwork, dedication and expertise you have. NEVER. more over, I will venture to say it will become worse. You will be punching a clock, you wont be able to enjoy the freedom that doctors enjoyed in the past. The whole system is rigged so it can control you. you should be worried... more pre meds should be worried, and if premeds are worried maybe the government will be worried about the quality going into this important venture

 

[Daredevil]

let me put it to you this way, you will never be paid commensurate with the level of hardwork, dedication and expertise you have. NEVER. more over, I will venture to say it will become worse. You will be punching a clock, you wont be able to enjoy the freedom that doctors enjoyed in the past. The whole system is rigged so it can control you. you should be worried... more pre meds should be worried, and if premeds are worried maybe the government will be worried about the quality going into this important venture

can't agree with it more. 👍
My wife and I have over $400,000 in school loans (+ growing interests) to pay off and I wonder how long that will take. 👎

 

[igottaquestion]

can't agree with it more. 👍
My wife and I have over $400,000 in school loans (+ growing interests) to pay off and I wonder how long that will take. 👎

you're an attending with 2010 pay, with a consolidated interest rate below my locked-in 6.8%. it could be worse.

 

[aredoubleyou]

By the time you finish residency, everything will be different. Theres no way to know. Just don't jepordize your family's financial well-bieng for a dream to become a doctor...its not a sound financial decision.

 

[bronx43]

I recently turned 30 years old and I'm currently a Biochemistry major in Undergrad with hopes of being accepted to medical school in a few years.

I came across this awesome article titled, "Does Your Doctor Charge Too Much?" After reading the article, I am a bit worried that after working so hard to obtain an M.D., I won't be able to make ends meet and will become so frustrated with the politics in the medical industry that I won't want to practice anymore! (Change that to WTH). LOL I'm tempted to start slipping a $50 in my OBGYN's white coat pocket during future visits! Geeeez! lol

Here is the article.

http://ethicalhealthpartnerships.org/doctorfees.html

I really want to practice medicine as an Anesthesiologist one day and I am willing to work very hard to get there. However, I can't help but to be worried about my future after reading this article.

Would you M.D.s please read the article and give me your thoughts?

Thanks!

P.S. I guess I could have posted this in a general M.D. area, but I may have overlooked it.

It's one thing to be bitter about the changing landscape of health care in this country compared to the golden days of the 80s and 90s. It's entirely another to state that you're somehow afraid you can't make ends meet.
I don't know if you've ever had a job outside of medicine, but "not making ends meet" would be having 2 kids, a wife, a mortgage, and getting laid off. No matter how much reform is implemented between now and when you start practicing, physicians will always be well compensated compared to the rest of society. Loans are a big thorn in everyone's side, but it's not insurmountable with prudent financial planning, and should never place you in a position where you can't "make ends meet."
If you want to be a doctor, great. Maybe you can't afford a 4000 sq ft house in a gated community, or drive a couple of BMWs, but your kids won't starve.

 

[bronx43]

let me put it to you this way, you will never be paid commensurate with the level of hardwork, dedication and expertise you have. NEVER. more over, I will venture to say it will become worse. You will be punching a clock, you wont be able to enjoy the freedom that doctors enjoyed in the past. The whole system is rigged so it can control you. you should be worried... more pre meds should be worried, and if premeds are worried maybe the government will be worried about the quality going into this important venture

You'll never be paid commensurate with the level of hardwork, dedication, and expertise you have?
I don't know how you can back that statement up with anything other than your own sentiments about how much you think you should be paid.

 

[nlfru]

You'll never be paid commensurate with the level of hardwork, dedication, and expertise you have?
I don't know how you can back that statement up with anything other than your own sentiments about how much you think you should be paid.

I just love the altruism of medical students. Get back to us when you join the real world, have actual responsibility (not retractor holding or glacier speed skin suturing) and earn a real paycheck. Medical school is easy... residency is what makes you realize how much you actually sacrifice.

 

[sweetalkr]

miss about 6 christmas/thanksgivings with your family, about a dozen weddings , work a lot of weekends as a resident. come out almost 29, have no semblance of a normal life, all while your buddies have weekends off, 3 day weekends every other week, have hobbies (what is a hobby?) and read books for fun (people do that?), and STILL be struggling to make ends meet while looking for a job. find out the job market sucks, and to get a license to practice medicine costs 2000$ (with 1000$/2 year renewal for life), your board certs cost over 5000$, and those are just baseline costs to start working. then be an intern in the practice you join at 30, start from the bottom and work all holidays again, and still have no say in your practice..

you never get what you put in in medicine unless you have the guts and the situation that allows you to try and open your own clinic (pain) or practice. then it would have to be in a small town no one else will live in.

they didn't teach you this in med school?

 

[WholeLottaGame7]

I'm going to guess...all of the above.

It's going to suck for awhile, but at the end of the day you're going to be living comfortably.

 

[bronx43]

I just love the altruism of medical students. Get back to us when you join the real world, have actual responsibility (not retractor holding or glacier speed skin suturing) and earn a real paycheck. Medical school is easy... residency is what makes you realize how much you actually sacrifice.

That's great, man. Seriously. Good for you.

It still doesn't address the issue that you have no way of demonstrating you're actually underpaid. Whining about working hard and being paid less than you deserve is a ubiquitous phenomenon.

 

[durlvlbeacoo]

That's great, man. Seriously. Good for you.

It still doesn't address the issue that you have no way of demonstrating you're actually underpaid. Whining about working hard and being paid less than you deserve is a ubiquitous phenomenon.

I bet you're a huge fan of Obama. 👎

 

[bronx43]

I bet you're a huge fan of Obama. 👎

Can someone on this forum actually offer a valid argument, instead of these vague, unsubstantiated assumptions? If you claim that your pay is below what you deserve, then provide a well-supported argument for such. Whether or not I'm a big fan of Obama is irrelevant to the validity of your reasoning.

 

[pgg]

Can someone on this forum actually offer a valid argument,

Our nation is in the early stages of what certainly appears to be a long, painful slide into what will probably be a very unpleasant recalibration of our overall standard of living. No, we doctors won't starve or end up sleeping under a bridge.

The fact that we anesthesiologists aren't quite as ****ed as most of the rest of our fellow Americans doesn't make the sanctimonious premed/MS1234 wankers who drop in here every other week with their insight telling us we're in the top X% of US earners any less annoying.

Ya rly.

 

[bronx43]

Our nation is in the early stages of what certainly appears to be a long, painful slide into what will probably be a very unpleasant recalibration of our overall standard of living. No, we doctors won't starve or end up sleeping under a bridge.

The fact that we anesthesiologists aren't quite as ****ed as most of the rest of our fellow Americans doesn't make the sanctimonious premed/MS1234 wankers who drop in here every other week with their insight telling us we're in the top X% of US earners any less annoying.

Ya rly.

So, instead... the fact that you anesthesiologists aren't quite as ****ed as most of the rest of our fellow Americans makes it perfectly reasonable to complain that you aren't being paid accordingly, while not actually providing a coherent argument for such a belief.

Gotcha. Perfectly understood.

By the way, I entirely agree with your first sentence.

 

[VanDiemen]

Among my fellow med students, I've seen that the people who have the most anxiety/disappointment about future incomes are the children of wealthy physicians, who are realizing that they will actually be in a lower economic class than their parents. That especially goes for the ones who will be entering primary care fields.

 

[nlfru]

Can someone on this forum actually offer a valid argument, instead of these vague, unsubstantiated assumptions? If you claim that your pay is below what you deserve, then provide a well-supported argument for such. Whether or not I'm a big fan of Obama is irrelevant to the validity of your reasoning.

So here is a question for you. Where is YOUR valid, well-supported argument? Can you prove that anesthesiologists are NOT underpaid? So far, all I'm hearing is the OPINION of some left wing med student. Quoting facts about how much the rest of the population makes just does not cut it. The sacrfices that physicians make are well documented on every forum on SDN.

For what it's worth, I have no desire to drive a german luxury car or own a 4000 sq foot house.

 

[durlvlbeacoo]

Can someone on this forum actually offer a valid argument, instead of these vague, unsubstantiated assumptions? If you claim that your pay is below what you deserve, then provide a well-supported argument for such. Whether or not I'm a big fan of Obama is irrelevant to the validity of your reasoning.

Was I right? It sounds like I was right from your rebuttal. 👎

 

[cleansocks]

So, instead... the fact that you anesthesiologists aren't quite as ****ed as most of the rest of our fellow Americans makes it perfectly reasonable to complain that you aren't being paid accordingly, while not actually providing a coherent argument for such a belief.

Gotcha. Perfectly understood.

By the way, I entirely agree with your first sentence.

Our pay is reasonable now. The threat of reducing it further is what is worrisome to everyone. That will be disastrous for the following reasons:

1. Level of responsibility enormous compared with others. Shouldn't pay people with such huge responsibility less than the collective group feels is reasonable. People will be injured / die.

2. Requires high intelligence and incredible hard work to do it right. Reduction in pay -> less intelligent people -> mediocre medicine. People will be injured / die. This is compounded by the mediocrity already being created by the rise of mid-levels.

3. Alternatives for intelligent people abound. Why work this hard in what has become an under-respected field when we can make just as much / more elsewhere? Intrinsic interest takes us only so far. Working 60+ hours in real estate, wall st, pharma, medical devices, etc would make us more. You better compensate people adequately to prevent them from leaving.

4. Debt enormous compared with others. Kids going to very expensive schools is also something physicians will likely have to save for. 50% of revenue already taken by government. Legal insurance. Reduce our salaries further and these become stressful issues for people that contribute so positively to society. Doctors are living middle to upper middle class lives now. That is where they should be. I don't think society would disagree.

5. Level of stress enormous. Are you planning on becoming an anesthesiologist? It is stressful. More-so than you can imagine given where you are. Stress (ie financial) at home should be minimized when stress at work is so high.

6. Altruism enormous compared with others. Does not make sense to target physicians' salaries rather than pro sports players, investment bankers, etc We are targeted given the lack of understanding of what we do and our inability to form a large cohesive lobbying collective to fight for us politically.

7. Sacrifice much greater than others: youth, holidays, free time, less stress.

There. A bunch of arguments for you. Now don't be hypocritical. You need to tell us why you feel you can properly judge how much physicians should be compensated when you haven't worked as one yet.

 

[Frank Rizzo]

Among my fellow med students, I've seen that the people who have the most anxiety/disappointment about future incomes are the children of wealthy physicians, who are realizing that they will actually be in a lower economic class than their parents. That especially goes for the ones who will be entering primary care fields.

That's an interesting observation. As I was reading through some of these posts, I was wondering in the back of my mind who is paying for these outspoken med-students' education... Loans/themselves vs mommy and daddy.

In case anyone was wondering, I grew up in a very avg middle-class background: father worked two factory jobs while I was growing up so my mom could stay home at home with me and my sister. When my sister started school, mom went back to work and dad went down to one job.

No wealthy upbringing...

Just an appreciation for hard work...

That work ethic helped me excel in HS, college, medschool, residency, and now as a barely-one-year-under-my-belt attending. I continue to BUST MY ASS everyday.

Do I think I am reimbursed fairly at the present time for basically going balls out since THE EARLY 90's in order to get where i am RIGHT NOW... yeah, for the most part.

Do I think I WILL BE reimbursed fairly in the future for basically going balls out since THE EARLY 90's in order to get where i am RIGHT NOW... Nope.

No proof, no arguments backed up with facts, just a feeling. You'll learn this feeling soon enough when you're taking care of a pt in the SICU, or working your way through a difficult case... you don't have the test results to back you up, but you JUST KNOW something is not right. Call it the 'eyeball test' call it a 'gut feeling', call it whatever you want... YOU JUST KNOW!

So for Bronxy and some of the other medstudents that like to take the holier-than-thou approach , I'm sorry that your miffed by some of the attitudes on this site. Sorry I don't have a RANDOMIZED, DOUBLE-BLINDED, PLACEBO-CONTROLLED STUDY(thats the best, right?) to back up my thoughts. Sorry you're drinking the Kool-Aid blindly.

Come back when you're all done eating pizza lunches with whatever interest group is providing them that day. Come back when you're no longer wearing the short white coat. Come back when your decisions and mistakes are no longer being backed up by your attending's medical license. Come back when its YOUR LICNESE that is on the line when you decide to push Sux.

Let us know then if you think anesthesiologists are being over or under paid. I'll be curious as to what your response will be.

 

[HAZELLBOO]

Bronx, I'm sorry, but I have to ask... Did you actually read the article that I posted? I think it was a very valid argument, and the author present his case very well.

So, instead... the fact that you anesthesiologists aren't quite as ****ed as most of the rest of our fellow Americans makes it perfectly reasonable to complain that you aren't being paid accordingly, while not actually providing a coherent argument for such a belief.

Gotcha. Perfectly understood.

By the way, I entirely agree with your first sentence.

 

[HAZELLBOO]

I don't think Bronx read the article that I posted. If he did, I don't see how he could feel the way he does. Unless of course he totally disagrees with it.

I am interested in hearing more about your #6. (Inability to form a lobbying...) Why is that?

Our pay is reasonable now. The threat of reducing it further is what is worrisome to everyone. That will be disastrous for the following reasons:

1. Level of responsibility enormous compared with others. Shouldn't pay people with such huge responsibility less than the collective group feels is reasonable. People will be injured / die.

2. Requires high intelligence and incredible hard work to do it right. Reduction in pay -> less intelligent people -> mediocre medicine. People will be injured / die. This is compounded by the mediocrity already being created by the rise of mid-levels.

3. Alternatives for intelligent people abound. Why work this hard in what has become an under-respected field when we can make just as much / more elsewhere? Intrinsic interest takes us only so far. Working 60+ hours in real estate, wall st, pharma, medical devices, etc would make us more. You better compensate people adequately to prevent them from leaving.

4. Debt enormous compared with others. Kids going to very expensive schools is also something physicians will likely have to save for. 50% of revenue already taken by government. Legal insurance. Reduce our salaries further and these become stressful issues for people that contribute so positively to society. Doctors are living middle to upper middle class lives now. That is where they should be. I don't think society would disagree.

5. Level of stress enormous. Are you planning on becoming an anesthesiologist? It is stressful. More-so than you can imagine given where you are. Stress (ie financial) at home should be minimized when stress at work is so high.

6. Altruism enormous compared with others. Does not make sense to target physicians' salaries rather than pro sports players, investment bankers, etc We are targeted given the lack of understanding of what we do and our inability to form a large cohesive lobbying collective to fight for us politically.

7. Sacrifice much greater than others: youth, holidays, free time, less stress.

There. A bunch of arguments for you. Now don't be hypocritical. You need to tell us why you feel you can properly judge how much physicians should be compensated when you haven't worked as one yet.

 

[HAZELLBOO]

Bronx, I would like to add that I am not worried about my future financial well being because I come from wealth and want to enjoy the same luxuries of my imaginary wealthy family. I have been in the work force and taking care of myself since I was 18 years old. I had living expenses at the age of 18 that most of my friends didn't see until 25. I am worried because I know that this journey that I've decided to take will be a long and arduous process that will require a lot of dedication and hard work on my part. After reading the article, yes, I became a little worried, but that is because it sounds like I would be spending the next 10-12 years in school and training to enter a profession that would put me in the same boat that I was in earlier in life, just on a larger scale. By that I mean, yes I would have higher pay, but I would also have higher expenses, and very little time to enjoy what I have worked so hard to attain. Still, I want very much to take this journey and I will continue on. I just hope that things get better for Physicians in the future. In my opinion, they have the one of the most important jobs, aside from our police officers, teachers, and soldiers.

Also, Yes! I think that NBA Players making more than the people who treat them so that they can continue to play their game to make the millions; AND CEO's of health care companies making more than the people who treat their members is a JOKE!!! There, I said it!

One last thing. I think that Frank and the others are right - Perhaps you should humble yourself and admit that you are only a med student and "you don't know what you don't know." Think about that.

That's an interesting observation. As I was reading through some of these posts, I was wondering in the back of my mind who is paying for these outspoken med-students' education... Loans/themselves vs mommy and daddy.

In case anyone was wondering, I grew up in a very avg middle-class background: father worked two factory jobs while I was growing up so my mom could stay home at home with me and my sister. When my sister started school, mom went back to work and dad went down to one job.

No wealthy upbringing...

Just an appreciation for hard work...

That work ethic helped me excel in HS, college, medschool, residency, and now as a barely-one-year-under-my-belt attending. I continue to BUST MY ASS everyday.

Do I think I am reimbursed fairly at the present time for basically going balls out since THE EARLY 90's in order to get where i am RIGHT NOW... yeah, for the most part.

Do I think I WILL BE reimbursed fairly in the future for basically going balls out since THE EARLY 90's in order to get where i am RIGHT NOW... Nope.

No proof, no arguments backed up with facts, just a feeling. You'll learn this feeling soon enough when you're taking care of a pt in the SICU, or working your way through a difficult case... you don't have the test results to back you up, but you JUST KNOW something is not right. Call it the 'eyeball test' call it a 'gut feeling', call it whatever you want... YOU JUST KNOW!

So for Bronxy and some of the other medstudents that like to take the holier-than-thou approach , I'm sorry that your miffed by some of the attitudes on this site. Sorry I don't have a RANDOMIZED, DOUBLE-BLINDED, PLACEBO-CONTROLLED STUDY(thats the best, right?) to back up my thoughts. Sorry you're drinking the Kool-Aid blindly.

Come back when you're all done eating pizza lunches with whatever interest group is providing them that day. Come back when you're no longer wearing the short white coat. Come back when your decisions and mistakes are no longer being backed up by your attending's medical license. Come back when its YOUR LICNESE that is on the line when you decide to push Sux.

Let us know then if you think anesthesiologists are being over or under paid. I'll be curious as to what your response will be.

 

[HAZELLBOO]

No, I don't know if you've ever had a real job and expenses outside of schooling. I know exactly what it is to not be able to make ends meet. And it doesn't take having a wife, and kids to experience that. When I was 18 years old, I lived alone, 1,000 miles away from my imaginary wealthy family that you think I have. I did not have any children or a husband. I only made $8.80/hr., yet I still had montly rent for a very small 500 sq ft 1 bedroom apartment, a very used car, car insurance, utilies, a grocery bill, a gas bill, and every other living expense that people have today. Making ends meet has to do with the amount of money coming in verses the amount going out, not necessarily the number of mouths you have to feed.

I have a feeling that you are still young. One day you learn not to assume, and once again, that "You don't know what you don't know."

It's one thing to be bitter about the changing landscape of health care in this country compared to the golden days of the 80s and 90s. It's entirely another to state that you're somehow afraid you can't make ends meet.
I don't know if you've ever had a job outside of medicine, but "not making ends meet" would be having 2 kids, a wife, a mortgage, and getting laid off. No matter how much reform is implemented between now and when you start practicing, physicians will always be well compensated compared to the rest of society. Loans are a big thorn in everyone's side, but it's not insurmountable with prudent financial planning, and should never place you in a position where you can't "make ends meet."
If you want to be a doctor, great. Maybe you can't afford a 4000 sq ft house in a gated community, or drive a couple of BMWs, but your kids won't starve.

 

[bronx43]

Our pay is reasonable now. The threat of reducing it further is what is worrisome to everyone. That will be disastrous for the following reasons:

1. Level of responsibility enormous compared with others. Shouldn't pay people with such huge responsibility less than the collective group feels is reasonable. People will be injured / die.

2. Requires high intelligence and incredible hard work to do it right. Reduction in pay -> less intelligent people -> mediocre medicine. People will be injured / die. This is compounded by the mediocrity already being created by the rise of mid-levels.

3. Alternatives for intelligent people abound. Why work this hard in what has become an under-respected field when we can make just as much / more elsewhere? Intrinsic interest takes us only so far. Working 60+ hours in real estate, wall st, pharma, medical devices, etc would make us more. You better compensate people adequately to prevent them from leaving.

4. Debt enormous compared with others. Kids going to very expensive schools is also something physicians will likely have to save for. 50% of revenue already taken by government. Legal insurance. Reduce our salaries further and these become stressful issues for people that contribute so positively to society. Doctors are living middle to upper middle class lives now. That is where they should be. I don't think society would disagree.

5. Level of stress enormous. Are you planning on becoming an anesthesiologist? It is stressful. More-so than you can imagine given where you are. Stress (ie financial) at home should be minimized when stress at work is so high.

6. Altruism enormous compared with others. Does not make sense to target physicians' salaries rather than pro sports players, investment bankers, etc We are targeted given the lack of understanding of what we do and our inability to form a large cohesive lobbying collective to fight for us politically.

7. Sacrifice much greater than others: youth, holidays, free time, less stress.

There. A bunch of arguments for you. Now don't be hypocritical. You need to tell us why you feel you can properly judge how much physicians should be compensated when you haven't worked as one yet.

Wow. Such an inundation of replies, many of which are entirely incoherent, and show an utter lack of understanding for basic economics and how the world functions. I'll respond to this post, given the relatively level-headed thought process. And by the way, I have worked prior to medical school in a high stress/work hour industry (averaged 80-90 hours/week not including air travel). That fact isn't relevant in the least in a debate in this topic, but apparently you guys want arsenal for malicious assumptions and ad hominem attacks.

These points are all valid reasons for why you THINK you should be paid more than you do (or current do), but it's all irrelevant when taken into account how prices and costs are determined in the real world. The cost of a good or service is determined solely by a compromise between the most amount of money the employer/consumer is willing to pay, and the least amount of money the provider/employee is willing to receive. There is superfluous spending if the price point is set too high, and there is a lack of a good or service if the price point is set too low. Given these parameters, it's against common logic to accept that the current reimbursement rates for anesthesiologists is the actual equilibrium price point, simply because that amount of money isn't needed to retain their services, or the services of future anesthesiologists.
In fact, in the current medical system, price determination can almost entirely disregard practicing anesthesiologists (and many other lucrative specialties), because you guys simply have no alternative to maintain a similar income. If reimbursement rates were dropped so the median salary is $250k, it would be foolish to argue that there would be a mass exodus of MDAs into non-medical ventures. Therefore, the variable of higher concern is the steady influx of future practitioners. And even then, I think it's foolish to conclude that students would stop applying to medical schools simply because lucrative specialties are no longer making $350k+.
And no, not every medical student can make similar money on Wall Street. I've worked there, and I know exactly who can even get their foot in the door and who can't. If you didn't go to a top 10-15 national university, then you can forget about high paying finance or consulting jobs. And going by statistics alone, the vast majority of medical students and physicians didn't attend top universities. And real estate, pharm, medical devices? Haha, are you just throwing out random industries without having even a basic understanding of how they work?
And as far as your assessment that doctors should be middle to upper middle class, I entirely agree. I don't think anyone would disagree, either. However, there is still a difference between $350k and $250k - both of which are upper middle class.

Honestly, I expected an overall better understanding of the world by attendings, but the level of arguments made on this forum is amusing, to say the least. So far, pgg is the only one here who seems to know what he's talking about.

 

[bronx43]

I bet you're a huge fan of Obama. 👎

Actually, I'm not a huge fan of Obama. I think his health care reform bill beat around the bush far too much, and failed to bend the cost curve enough to correct unsustainable spending.
Like pgg said, consumption at this caliber by the US is unsustainable in the long run. People really need to understand that their standard of living was driven by a bubble for the past few decades, and the American way of life isn't the way it is supposed to be - especially given increasing globalization. There's no way around this, and whichever president is presiding over this downward slide is going to feel the pain from a largely ignorant public.
It honestly doesn't matter who is in office, there will be a relative contraction of American wealth - and that obviously includes American physicians.

 

[badgas]

Wow. Such an inundation of replies, many of which are entirely incoherent, and show an utter lack of understanding for basic economics and how the world functions. I'll respond to this post, given the relatively level-headed thought process. And by the way, I have worked prior to medical school in a high stress/work hour industry (averaged 80-90 hours/week not including air travel). That fact isn't relevant in the least in a debate in this topic, but apparently you guys want arsenal for malicious assumptions and ad hominem attacks.

These points are all valid reasons for why you THINK you should be paid more than you do (or current do), but it's all irrelevant when taken into account how prices and costs are determined in the real world. The cost of a good or service is determined solely by a compromise between the most amount of money the employer/consumer is willing to pay, and the least amount of money the provider/employee is willing to receive. There is superfluous spending if the price point is set too high, and there is a lack of a good or service if the price point is set too low. Given these parameters, it's against common logic to accept that the current reimbursement rates for anesthesiologists is the actual equilibrium price point, simply because that amount of money isn't needed to retain their services, or the services of future anesthesiologists.
In fact, in the current medical system, price determination can almost entirely disregard practicing anesthesiologists (and many other lucrative specialties), because you guys simply have no alternative to maintain a similar income. If reimbursement rates were dropped so the median salary is $250k, it would be foolish to argue that there would be a mass exodus of MDAs into non-medical ventures. Therefore, the variable of higher concern is the steady influx of future practitioners. And even then, I think it's foolish to conclude that students would stop applying to medical schools simply because lucrative specialties are no longer making $350k+.
And no, not every medical student can make similar money on Wall Street. I've worked there, and I know exactly who can even get their foot in the door and who can't. If you didn't go to a top 10-15 national university, then you can forget about high paying finance or consulting jobs. And going by statistics alone, the vast majority of medical students and physicians didn't attend top universities. And real estate, pharm, medical devices? Haha, are you just throwing out random industries without having even a basic understanding of how they work?
And as far as your assessment that doctors should be middle to upper middle class, I entirely agree. I don't think anyone would disagree, either. However, there is still a difference between $350k and $250k - both of which are upper middle class.

Honestly, I expected an overall better understanding of the world by attendings, but the level of arguments made on this forum is amusing, to say the least. So far, pgg is the only one here who seems to know what he's talking about.

Pgg definitely knows what he is talking about. I'm pretty sure he called you a "wanker." Pretty funny that is the only post you agree with.

 

[cleansocks]

Wow. Such an inundation of replies, many of which are entirely incoherent, and show an utter lack of understanding for basic economics and how the world functions. I'll respond to this post, given the relatively level-headed thought process. And by the way, I have worked prior to medical school in a high stress/work hour industry (averaged 80-90 hours/week not including air travel). That fact isn't relevant in the least in a debate in this topic, but apparently you guys want arsenal for malicious assumptions and ad hominem attacks.

These points are all valid reasons for why you THINK you should be paid more than you do (or current do), but it's all irrelevant when taken into account how prices and costs are determined in the real world. The cost of a good or service is determined solely by a compromise between the most amount of money the employer/consumer is willing to pay, and the least amount of money the provider/employee is willing to receive. There is superfluous spending if the price point is set too high, and there is a lack of a good or service if the price point is set too low. Given these parameters, it's against common logic to accept that the current reimbursement rates for anesthesiologists is the actual equilibrium price point, simply because that amount of money isn't needed to retain their services, or the services of future anesthesiologists.
In fact, in the current medical system, price determination can almost entirely disregard practicing anesthesiologists (and many other lucrative specialties), because you guys simply have no alternative to maintain a similar income. If reimbursement rates were dropped so the median salary is $250k, it would be foolish to argue that there would be a mass exodus of MDAs into non-medical ventures. Therefore, the variable of higher concern is the steady influx of future practitioners. And even then, I think it's foolish to conclude that students would stop applying to medical schools simply because lucrative specialties are no longer making $350k+.
And no, not every medical student can make similar money on Wall Street. I've worked there, and I know exactly who can even get their foot in the door and who can't. If you didn't go to a top 10-15 national university, then you can forget about high paying finance or consulting jobs. And going by statistics alone, the vast majority of medical students and physicians didn't attend top universities. And real estate, pharm, medical devices? Haha, are you just throwing out random industries without having even a basic understanding of how they work?
And as far as your assessment that doctors should be middle to upper middle class, I entirely agree. I don't think anyone would disagree, either. However, there is still a difference between $350k and $250k - both of which are upper middle class.

Honestly, I expected an overall better understanding of the world by attendings, but the level of arguments made on this forum is amusing, to say the least. So far, pgg is the only one here who seems to know what he's talking about.

I make my points as an economics major, an MBA, someone who has worked in the device industry (on the buy side), someone whose family is in real estate, and a current resident.

Your general treatise on economics 101 does not address many of the arguments I made (ie 5 out of the 7 points) - especially the following: people will die (more on ethics in a second). It does address my opinion that people would no longer want to be doctors. YOU believe people would continue to want to be doctors if salaries fell. I disagree. AND I feel better prepared to make this argument since I know how much sacrifice it takes to be a doctor. I think there are better alternatives for all current physicians, certainly myself, and certainly people considering becoming one.

Additionally, price point equilibrium determined by supply/demand models require the 5 intrinsic assumptions of an open market (google if you don't know them), none of which apply to healthcare. We have insurance companies, laws, politics, all of which corrupt this analysis of price point equilibrium. Healthcare is a more complicated analysis than 2 lemonade stands in close proximity on the beach competing with one another. Additionally, basic microeconomics, theory based entirely on rationality, utterly fails in light of the irrationality inherent to ETHICS.

Politics, ethics, law, and indeed propoganda determine price points in healthcare. Not supply/demand models.


FINALLY, and very importantly, please do not refer to us as "MDA's." I find it degrading for some reason.

 

[badgas]

Actually, I'm not a huge fan of Obama. I think his health care reform bill beat around the bush far too much, and failed to bend the cost curve enough to correct unsustainable spending. Like pgg said, consumption at this caliber by the US is unsustainable in the long run. People really need to understand that their standard of living was driven by a bubble for the past few decades, and the American way of life isn't the way it is supposed to be - especially given increasing globalization. There's no way around this, and whichever president is presiding over this downward slide is going to feel the pain from a largely ignorant public.
It honestly doesn't matter who is in office, there will be a relative contraction of American wealth - and that obviously includes American physicians.

Failed is an understatement. It is a 1 TRILLION dollar bill that makes things WORSE! No tort reform, no insurance company competition across states lines, etc.

 

[badgas]

This whole thing is getting a little troll-like. Even if Pelosi43 is not a troll, there is no use trying to debate with a know-it-all, arrogant, socialist MS1/2/3/4 "wanker."

 

[cleansocks]

"However, there is still a difference between $350k and $250k - both of which are upper middle class."

Please consider net profit rather than gross revenue before saying that a doctor making less revenue will still be upper middle class. As I said in a few of my arguments, many costs doctors face are EXORBITANT compared to the general population. 350K is a TON Of money for an ordinary person. But not for us with debt/kids with bright futures/insurance/other extreme overhead.

 

[cleansocks]

I don't think Bronx read the article that I posted. If he did, I don't see how he could feel the way he does. Unless of course he totally disagrees with it.

I am interested in hearing more about your #6. (Inability to form a lobbying...) Why is that?

I can provide you with general reasons: maybe people can expound upon them with specifics.

1. Divided ideals. Doctors can't agree on a fundamental point that most other industries can - more money is better. A large minority want universal healthcare which would degrade our income substantially.

2. Laws/ethics that prohibit us from forming a credible threat if things do not go as we like. (again, maybe someone else can provide specifics). For example, doctors can't just strike. Can you imagine?!

So we are forced to lobby in a divided fashion often against our own brethren who are politically inclined differently than ourselves without obvious recourse of we don't get what we want from politicians, law makers, and insurance companies.

 

[bronx43]

I make my points as an economics major, an MBA, someone who has worked in the device industry (on the buy side), someone whose family is in real estate, and a current resident.

Your general treatise on economics 101 does not address many of the arguments I made (ie 5 out of the 7 points) - especially the following: people will die (more on ethics in a second). It does address my opinion that people would no longer want to be doctors. YOU believe people would continue to want to be doctors if salaries fell. I disagree. AND I feel better prepared to make this argument since I know how much sacrifice it takes to be a doctor. I think there are better alternatives for all current physicians, certainly myself, and certainly people considering becoming one.

Additionally, price point equilibrium determined by supply/demand models require the 5 intrinsic assumptions of an open market (google if you don't know them), none of which apply to healthcare. We have insurance companies, laws, politics, all of which corrupt this analysis of price point equilibrium. Healthcare is a more complicated analysis than 2 lemonade stands in close proximity on the beach competing with one another. Additionally, basic microeconomics, theory based entirely on rationality, utterly fails in light of the irrationality inherent to ETHICS.

Politics, ethics, law, and indeed propoganda determine price points in healthcare. Not supply/demand models.


FINALLY, and very importantly, please do not refer to us as "MDA's." I find it degrading for some reason.

We'll just have to agree to disagree about whether or not students will enter medicine should lucrative specialties receive a hefty cut in reimbursement. For the vast majority of medical students, there aren't many options as far as propelling themselves into the top 1-5% of the income bracket. Compound that with the fact that medicine has unparalleled job security and what you have is still a very attractive profession for young undergrads. There might be a slight drop in incentive for top tier medical students who have the option of going into IB, HF, trading, consulting, etc, but I think that is far from enough to result in a statistically significant decrease in quality of health care.

And as for the fact that physician reimbursement rates aren't determined by a free market, I agree entirely. I'm sorry if I didn't make it as clear as I should have, but my addressing the set price points weren't in regards to how much physicians receive for their services. It was addressing the availability of future practitioners, given a price (income). The issue of whether or not medical services should be priced in a free market is a different argument altogether.

 

[HAZELLBOO]

.....

 

[HAZELLBOO]

"I think there are better alternatives for all current physicians, certainly myself, and certainly people considering becoming one."

Care to share, please?

I make my points as an economics major, an MBA, someone who has worked in the device industry (on the buy side), someone whose family is in real estate, and a current resident.

Your general treatise on economics 101 does not address many of the arguments I made (ie 5 out of the 7 points) - especially the following: people will die (more on ethics in a second). It does address my opinion that people would no longer want to be doctors. YOU believe people would continue to want to be doctors if salaries fell. I disagree. AND I feel better prepared to make this argument since I know how much sacrifice it takes to be a doctor. I think there are better alternatives for all current physicians, certainly myself, and certainly people considering becoming one.

Additionally, price point equilibrium determined by supply/demand models require the 5 intrinsic assumptions of an open market (google if you don't know them), none of which apply to healthcare. We have insurance companies, laws, politics, all of which corrupt this analysis of price point equilibrium. Healthcare is a more complicated analysis than 2 lemonade stands in close proximity on the beach competing with one another. Additionally, basic microeconomics, theory based entirely on rationality, utterly fails in light of the irrationality inherent to ETHICS.

Politics, ethics, law, and indeed propoganda determine price points in healthcare. Not supply/demand models.


FINALLY, and very importantly, please do not refer to us as "MDA's." I find it degrading for some reason.

 

[bronx43]

Pgg definitely knows what he is talking about. I'm pretty sure he called you a "wanker." Pretty funny that is the only post you agree with.

I said I agreed with his assessment of future American standard of living. As for his wanker comment, I choose to ignore it given there was no argument actually presented.

 

[bronx43]

"However, there is still a difference between $350k and $250k - both of which are upper middle class."

Please consider net profit rather than gross revenue before saying that a doctor making less revenue will still be upper middle class. As I said in a few of my arguments, many costs doctors face are EXORBITANT compared to the general population. 350K is a TON Of money for an ordinary person. But not for us with debt/kids with bright futures/insurance/other extreme overhead.

The only difference I can see between a physician and another member of the upper middle class is the opportunity cost and debt of medical school/residency. However, even given those liabilities, you would still be in the upper middle class. I'm not sure why only physicians have kids with bright futures.

 

[BLADEMDA]

"However, there is still a difference between $350k and $250k - both of which are upper middle class."

Please consider net profit rather than gross revenue before saying that a doctor making less revenue will still be upper middle class. As I said in a few of my arguments, many costs doctors face are EXORBITANT compared to the general population. 350K is a TON Of money for an ordinary person. But not for us with debt/kids with bright futures/insurance/other extreme overhead.

I doubt those who have never actually earned that amount or more will understand your post. Wait until you see what taxes, disability, 401K, Soc. Security, etc. do to a paycheck. Then, combine the "American Dream" lifestyle with 2+ kids, a pet plus a mortgage and I guarantee you won't feel like Obama's wealthy who needs to pay their "fair share."

The tax system is geared against the W-2 worker/earner so much so that "income earned" is a relative term as it regards salary. The ability to retain your money is how real wealth is accumulated in our society. The rich know this as does Obama.

 

[BLADEMDA]

The only difference I can see between a physician and another member of the upper middle class is the opportunity cost and debt of medical school/residency. However, even given those liabilities, you would still be in the upper middle class. I'm not sure why only physicians have kids with bright futures.

You seem like a nice kid. The real world of economics is vastly different than those presented in textbooks or internet discussion boards. My advice is be less concerned with absolute terms of W-2 wages and more with the money the govt. lets you keep in your pocket. Low expenses and a spouse who works plus keeps spending down is the crucial to success.

I am glad to see you interested in discussing the topic at this point of your career.

 

[Coastie]

American wealth only has to contract if we have commies like Maobama implementing policies which destroy our nation.

If we had a free-market, low-tax, freedom-oriented President, our wealth would only grow.

It's only when we lower ourselves to the standards of the other nations around the world that we limit our ability to increase our wealth.

Actually, I'm not a huge fan of Obama. I think his health care reform bill beat around the bush far too much, and failed to bend the cost curve enough to correct unsustainable spending.
Like pgg said, consumption at this caliber by the US is unsustainable in the long run. People really need to understand that their standard of living was driven by a bubble for the past few decades, and the American way of life isn't the way it is supposed to be - especially given increasing globalization. There's no way around this, and whichever president is presiding over this downward slide is going to feel the pain from a largely ignorant public.
It honestly doesn't matter who is in office, there will be a relative contraction of American wealth - and that obviously includes American physicians.

 

[durlvlbeacoo]

Physicians bill what they think their time is worth, just like everyone else in society, but only in medicine do the receivers of services get to determine how much they are going to pay AFTER they receive the services.

It's like going to a restaurant, eating a steak dinner, and paying $1.95.

 

[BLADEMDA]

Physicians bill what they think their time is worth, just like everyone else in society, but only in medicine do the receivers of services get to determine how much they are going to pay AFTER they receive the services.

It's like going to a restaurant, eating a steak dinner, and paying $1.95.

And you are protected by law from any additional bills incl tips.😉

 

[cleansocks]

"I think there are better alternatives for all current physicians, certainly myself, and certainly people considering becoming one."

Care to share, please?

Off the top of my head:
1. Expert witness testimony (VERY lucrative if done well and ethically)
2. Consulting from various standpoints
a. working for a consultant management firm (ie McKinsey)
b. joining the board of a early venture (having an MD on board makes any medically related project more substantial - it was a red flag when I didn't see an MD team member in a medical device's business plan)
c. joining a VC group or an angel investment group - even as a lowly medical student an medically oriented angel investment group HIRED me to analyze business plans, perform market research, etc. A board certified physician would be invaluable for this kind of work.
3. Research director or consultant for pharmaceutical companies
4. Hospital administration (ie CMO)
5. More I'm sure!

Getting these positions generally requires some extracurricular experience/time, but nothing that a physician can't manage to do if they put their mind to it and demonstrate as much dedication in these respects as they do clinically.

Moreover, anesthesiologists participate in almost every aspect of hospital-based medicine so they're one of the professions best suited to this kind of work.

 

[HAZELLBOO]

Thanks a lot! I'll get to work on Google!

Thanks everyone for your input!

Off the top of my head:
1. Expert witness testimony (VERY lucrative if done well and ethically)
2. Consulting from various standpoints
a. working for a consultant management firm (ie McKinsey)
b. joining the board of a early venture (having an MD on board makes any medically related project more substantial - it was a red flag when I didn't see an MD team member in a medical device's business plan)
c. joining a VC group or an angel investment group - even as a lowly medical student an medically oriented angel investment group HIRED me to analyze business plans, perform market research, etc. A board certified physician would be invaluable for this kind of work.
3. Research director or consultant for pharmaceutical companies
4. Hospital administration (ie CMO)
5. More I'm sure!

Getting these positions generally requires some extracurricular experience/time, but nothing that a physician can't manage to do if they put their mind to it and demonstrate as much dedication in these respects as they do clinically.

Moreover, anesthesiologists participate in almost every aspect of hospital-based medicine so they're one of the professions best suited to this kind of work.