Gleevec said:
Resident salaries are part of Medicare, so there is no way in hell Congress is going to take an entitlement program and increase the costs radically. So they are definitely not going to pay more than 40k, and 80k is never going to happen (unless we're talking hyperinflation).
The match is probably the best system out there, because it makes sure people dont clog up spots and it prevents the prior practice of forcing applicants to agree on positions. The match is actually quite resident-friendly.
Variation in salary between institutions and multiple matches? That would basically destroy the match system and create a ton of stress for students in more competitive specialties. A few applicants, especially in the smaller fields, would dominate a ton of slots until the last possible minute-- you think residencies are biased towards top 20 allo research schools now?
So basically I think the system is OK, we all know what we're getting into and things are much better than they were during the more corrupt pre-match days. One thing they could do is make the 30-40k a stipend instead of salary, and make it nontaxable. Residents as they are actually cost the system money, and by the time they are competent enough not to they graduate and go to fellowship or the field.
Youre not going to find too many people willing to pay residents more, because the costs will be passed down to consumers, who already view doctors as rich (which they are once they are out of residency). Case in point: Ive read numerous threads on SDN saying that 75-100k isnt enough to live off of for a couple, which is just plain ridiculous.
Basically, the system is pretty good as it is, and there is no feasible way to change it without possibly causing more harm. Also, it seems people have the assumption that you will get paid MORE if you are a better applicant for a residency position. This is not the case. Harvard and MGH know that a top student will go there for 20k a year instead of Podunk Hospital for 30k a year, so guess what Harvard is going to offer the top flight prospect? 20k, because they could easily get another top student to do the job.
So capitalism works both ways too.
just because congress or the consumer don't want to pay more, it does not mean they should not. If the public had their way, we'd work for free. Basically, all i am saying is that residents and doctors both get shafted because we are not united.
I can say the only reason we get paid so little isbecause we haven't done anything to stop it. The other day i went to the store to get a brace...i used to be able to get them for about 7 bucks. Now its 20. Its a monopoly. When you need a brace, you need one. If every store charges 20 for it, its not fair. Its not worth more than 5 bucks, but when you need it, you need it. I mean, if you have strep, they don't charge you 1500 bucks for antibiotics, but if they did, you'd still buy it. Insurance companies stop that from happening. However, an individual consumer does not have the same leverage a corportation has. So basically, stores fix the price artificially high on many products and in that way the consumer is forced to get them. In medicine, doctors can set the prices like stores do by withholding their service. I'm not greedy, but i mean that doctors should not be exploited.
What i am saying is that we need to capitalize on the monopoly we have on healthcare. No residents? No money generating teaching hospitals. Hell, alot less healthcare, period. I'm not saying we need to go all out and hurt the patients, our profession, and our reputations, but there needs to be an element of fairness. America is being run by corporations and the goverment and every day normal people are getting the shaft. Doctors need to find a way to shaft the goverment and insurance too, so we can get our fair share of the pie. I'm not saying we need ot be greedy, but minimum wage for an 80 hour week is bogus. Everyone learns when they come into an entry level job, but our pay is reduced unproportionally. I mean, as you go through residency, it barely goes up the inflation rate. Thats unfair. It should at least go up significantly every year, as the responsibility and talent needed does. A 5th year surgical resident working nearly 90 hours a week ought to make more than 50k.
If the goverment can spend 200 billion on a war thats going nowhere, they ought to be able to spend some on healthcare. If people can afford to do other things, they ought to pay for healthcare. Doctors are afforded a lot of power and that is a great responsibility. But if no one respects our power and decides to abuse us instead, should we just sit still? I don't believe we should.
I think we should fight for what is fair. There has to be a fair way to give doctors more money...not so we can all have yachts, but so we can live an extremely comfortable life that is worth the sacrifice of youth and the utilization of our natural and acquired talents. One should not have to wait till 40 to be upper middle class after spending over a decade working extremely hard while living near or below the poverty line.
if medicine keeps going south, all we'll have left is a few do gooders who'd work for free, a lot of stupid doctors (stupid because they'd never get into med school if "normal applicants" applied), and the vast majority of potential medical talent goes elsewhere.
There's no point in defending "the man", because he does not defend you.
