Washington Post article on Physician Salaries

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So, now they are coming for our salaries too? The title of the article, “The average doctor in the U.S. makes $350,000 a year. Why?”, sounds like they think we are making too much.
 
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Wow --- "Polyakova and her collaborators find doctor pay consumes only 8.6 percent of overall health spending."

My first thought was, wow, that's a lot of administrative bloat. Then, thinking some more, it's more likely the mid-levels are eating up a significant % of spending that would have previously gone to docs.
 
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DrStephenStrange said:
So, now they are coming for our salaries too? The title of the article, “The average doctor in the U.S. makes $350,000 a year. Why?”, sounds like they think we are making too much.
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If you read the article, that’s not what they are point blank trying to say. They are showing the discrepancy in primary care vs. procedural field salaries. They even mentioned that doctors salary, as an aggregate, isn’t all that big a portion of healthcare consumption.
 
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Putkernerinthehall said:
Wow --- "Polyakova and her collaborators find doctor pay consumes only 8.6 percent of overall health spending."

My first thought was, wow, that's a lot of administrative bloat. Then, thinking some more, it's more likely the mid-levels are eating up a significant % of spending that would have previously gone to docs.
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I don’t know. I’ve never seen a breakdown of what percentage of spending goes to midlevels. Since we all bill the exact same way, I imagine their compensation is lumped into ours.
 
Cops in big cities like SF make like 175k a year these days with overtime. What do they think doctors should make?
 
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Ho0v-man said:
I don’t know. I’ve never seen a breakdown of what percentage of spending goes to midlevels. Since we all bill the exact same way, I imagine their compensation is lumped into ours.
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What? You mean billing for services is not identifiable between MD, NP, PA,. etc. ? I hope to heck the billing amounts aren't comparable. The customer shouldn't be charged the same amount for MD as they would be for a PA.
 
Putkernerinthehall said:
What? You mean billing for services is not identifiable between MD, NP, PA,. etc. ? I hope to heck the billing amounts aren't comparable. The customer shouldn't be charged the same amount for MD as they would be for a PA.
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Most of the time the patient doesn't even know who is treating them
 
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Putkernerinthehall said:
What? You mean billing for services is not identifiable between MD, NP, PA,. etc. ? I hope to heck the billing amounts aren't comparable. The customer shouldn't be charged the same amount for MD as they would be for a PA.
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In most states, the reimbursement is like 15% less for midlevels. But I’ve never seen an official breakdown of their reimbursement alone. So I assume it’s all lumped together until someone can prove otherwise. I think it’d be weird to single out physician reimbursement in these charts and bury midlevel reimbursement elsewhere.
 
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Ho0v-man said:
In most states, the reimbursement is like 15% less for midlevels. But I’ve never seen an official breakdown of their reimbursement alone. So I assume it’s all lumped together until someone can prove otherwise. I think it’d be weird to single out physician reimbursement in these charts and bury midlevel reimbursement elsewhere.
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Yeah, agree. If 8.6% of total costs are for both physicians and mid-levels, that's even more telling in terms of what some might consider low or non-value added services.
 
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SurfingDoctor said:
I guess. Liking kids as always a bad financial decision though in all aspects of life, whether that be treating them, or having them.
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Unfortunately, pediatrics is one of the lower paying specialties but they seem to be a happy specialty though.
 
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SurfingDoctor said:
Shockingly, money doesn’t equate happiness.

Who knew?!
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Me if I had money.
michael torpey crying GIF by paidoff
face crying GIF
 
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I think the problem is honestly less how much physicians make and more how physicians *talk* about how much they make. I've seen physicians unironically call $200k a year "poverty wages" and "no money" and ask how they could ever manage to live on that salary, and my gut reaction is "honestly? Much, much better than the vast majority of people." Even a lot of professions that are considered higher-earning, like engineering, often top out below $200k a year outside of very high COL areas. Calling a salary that is many times more than what the vast majority of people will make "unlivable poverty wages" isn't going to win you any sympathy--it's going to make you look like a greedy jerk.
 
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futureapppsy2 said:
I think the problem is honestly less how much physicians make and more how physicians *talk* about how much they make. I've seen physicians unironically call $200k a year "poverty wages" and "no money" and ask how they could ever manage to live on that salary, and my gut reaction is "honestly? Much, much better than the vast majority of people." Even a lot of professions that are considered higher-earning, like engineering, often top out below $200k a year outside of very high COL areas. Calling a salary that is many times more than what the vast majority of people will make "unlivable poverty wages" isn't going to win you any sympathy--it's going to make you look like a greedy jerk.
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We should be talking about how little teachers make more than anything.
 
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Just a gentle reminder that the Washington Post is owned by Amazon, who also coincidentally just opened their online clinic this month:
www.cnbc.com

Amazon rolls out its virtual health clinic nationwide

Amazon Clinic allows patients to connect with telemedicine providers to help receive treatment for common conditions such as acne and hair loss.
www.cnbc.com www.cnbc.com

Just another reason we should all be radicalized towards unionization. We are not viewed as an assert or source of revenue, we are a cost that needs to be cut as much as possible.
 
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Putkernerinthehall said:
You are so right. It's absolutely appalling.
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And baffling as they have large unions.

Here in CA the RN unions/lobbies are very successful and RNs are paid significantly more than those in others states and often have significantly lower patient ratios. Our rehab RNs are on 4:1 or 5:1 teams, whereas many in others states they are 8:1. Big difference between caring for 5 patients vs 8.

Yet our teachers here in CA are still paid abysmally. If children are our future (which they literally are), it seems like we should invest a bit in that future!

At some point perhaps physicians will unionize since we're shifting so dramatically towards being employees. The best time to have formed a union would've been back when the majority of us were still private practice/working for physician-owned practices. Had the AMA done a better job of advocating for physicians and showing them how they advocated, perhaps we could have avoided this large shift from physician-owned practices/solo practices to employed systems, where physician satisfaction (and patient care) have both declined. The happiest docs are the ones who work for themselves/physician-owned group. Plus those that work at the VA. And Mayo/Kaiser...
 
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Ho0v-man said:
In most states, the reimbursement is like 15% less for midlevels. But I’ve never seen an official breakdown of their reimbursement alone. So I assume it’s all lumped together until someone can prove otherwise. I think it’d be weird to single out physician reimbursement in these charts and bury midlevel reimbursement elsewhere.
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Yes only fifteen percent less. After all that education physicians have.
 
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futureapppsy2 said:
I think the problem is honestly less how much physicians make and more how physicians *talk* about how much they make. I've seen physicians unironically call $200k a year "poverty wages" and "no money" and ask how they could ever manage to live on that salary, and my gut reaction is "honestly? Much, much better than the vast majority of people." Even a lot of professions that are considered higher-earning, like engineering, often top out below $200k a year outside of very high COL areas. Calling a salary that is many times more than what the vast majority of people will make "unlivable poverty wages" isn't going to win you any sympathy--it's going to make you look like a greedy jerk.
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Yes but the opportunity cost of becoming a physician is very high. Engineering doesn't have as long of training. Lots more engineers churned out every year compared to physicians.
 
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The most interesting part of that article is the averages per specialty which must be the most accurate reported thus far as it is based on a massive sample size of actual data rather than every other survey which is self reported. Really reveals how much some specialties under report to keep the target off their back such as ophtho, pain, and derm.

The overall income percentiles seem absurd though, are 50% of middle age docs really earning over 630k? and 10% over 1.3 million? That seems way too high
 
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The public:

"WHY DO I HAVE TO WAIT 6 MONTHS TO SEE MY DOCTOR?"

Doctors are retiring, switching jobs, or cutting their hours due to burn-out from overwork, moral injury, antisocial/demanding/entitled/litigious/know-it-all patients, and administrative bloat.

"DOCTORS MAKE TOO MUCH!... Cut their pay and force them to work more!"
 
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pyrrion89 said:
The public:

"WHY DO I HAVE TO WAIT 6 MONTHS TO SEE MY DOCTOR?"

Doctors are retiring, switching jobs, or cutting their hours due to burn-out from overwork, moral injury, antisocial/demanding/entitled/litigious/know-it-all patients, and administrative bloat.

"DOCTORS MAKE TOO MUCH!... Cut their pay and force them to work more!"
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Live video of dude and their medical group partners making $1 million per year dealing with Botox-related burn out and moral injury…

1691629779901.gif
 
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futureapppsy2 said:
I think the problem is honestly less how much physicians make and more how physicians *talk* about how much they make. I've seen physicians unironically call $200k a year "poverty wages" and "no money" and ask how they could ever manage to live on that salary, and my gut reaction is "honestly? Much, much better than the vast majority of people." Even a lot of professions that are considered higher-earning, like engineering, often top out below $200k a year outside of very high COL areas. Calling a salary that is many times more than what the vast majority of people will make "unlivable poverty wages" isn't going to win you any sympathy--it's going to make you look like a greedy jerk.
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There is the problem of student loans. If I put an average salary of a family medicine specialist into the fed loan calculator with my predicted debt load, it tells me it is unlivable. People don't realize how much in debt physicians are, especially first-generation or medical students from low-income families. That drags down our take-home wages significantly if we include that with liability insurance, taxes, and CEC costs.
 
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SkyKing1996 said:
There is the problem of student loans. If I put an average salary of a family medicine specialist into the fed loan calculator with my predicted debt load, it tells me it is unlivable. People don't realize how much in debt physicians are, especially first-generation or medical students from low-income families. That drags down our take-home wages significantly if we include that with liability insurance, taxes, and CEC costs.
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What do you mean unlivable. Even with 500k in loans, fm doctors must make at least 200-250k which seems livable.
 
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EdgeTrimmer said:
Unfortunately, pediatrics is one of the lower paying specialties but they seem to be a happy specialty though.
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Most peds I've seen who aren't worried about low pay are either in a higher paying peds medical subspeciality or peds surgical subspecialty, or are married to a higher earning spouse and hence aren't the primary breadwinner.
 
voxveritatisetlucis said:
What do you mean unlivable. Even with 500k in loans, fm doctors must make at least 200-250k which seems livable.
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$500k loans on $200-250k salary is barely livable; if you want to pay that off that much you'll have to live like a resident for quite a few years after becoming an attending. At that debt to income ratio, it would be also worthwhile to go for PSLF (which is in no part guaranteed, especially if you're still many years away from making all 120 qualify8ing payments). And also $500k is extremely unusual for a USMD Grade. You would have to be borrowing 100% from a expensive undergrad or masters degree on top of med school, or have gone to a DO or Caribbean schools that charge crazy high tuition.

Also any decent primary care job nowadays outside the VA or academics should be able to get you in low $300k at least once you have good volume with a full panel.
 
HipiMochi said:
If you read the article, that’s not what they are point blank trying to say. They are showing the discrepancy in primary care vs. procedural field salaries. They even mentioned that doctors salary, as an aggregate, isn’t all that big a portion of healthcare consumption.
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After they bury it in a single paragraph towards the end of the article. Don't even get me started on the clickbait headline.

Residency also extends your education into your late 20s and beyond, cutting into your lifetime earning potential. And, as Abaluck’s students often point out, that long medical education also leads to astonishingly high student debt — an average of $246,000 as of 2017. But that debt almost vanishes against a physician’s still more-than-robust expected $10 million in lifetime income.
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A FM doc making $250k a year would have to work 40 years to make $10M.
 
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collegestud2013 said:
Most peds I've seen who aren't worried about low pay are either in a higher paying peds medical subspeciality or peds surgical subspecialty, or are married to a higher earning spouse and hence aren't the primary breadwinner.
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Ha… that’s an oxymoron. And I wish my wife made more.

In fact, I’m gonna go tell her you told me that she needs to pick up the slack cause she and the kids are financial dead weight…

BRB…
 
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SurfingDoctor said:
Ha… that’s an oxymoron. And I wish my wife made more.

In fact, I’m gonna go tell her you told me that she needs to pick up the slack cause she and the kids are financial dead weight…

BRB…
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Back…

Welp… that went as expected. Last time I listen to a college stud about relationship and financial advice.

 
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Just as an aside, kinda… back when I did general pediatrics, the highest billing code one could generate in the clinic was for foreign body extraction.

So…
Counsel a family on exercise, diet and taking Advair daily for asthma control and save the healthcare system tens of thousands of dollars… reimbursement nothing.

Take a sponge out of a toddlers nose… $$$$.

Granted this was almost 20 years ago, but that pretty much tells you all you need to know about healthcare in the US and why mid level replacement will prevail.
 
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SurfingDoctor said:
Just as an aside, kinda… back when I did general pediatrics, the highest billing code one could generate in the clinic was for foreign body extraction.

So…
Counsel a family on exercise, diet and taking Advair daily for asthma control and save the healthcare system tens of thousands of dollars… reimbursement nothing.

Take a sponge out of a toddlers nose… $$$$.

Granted this was almost 20 years ago, but that pretty much tells you all you need to know about healthcare in the US and why mid level replacement will prevail.
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ENT here. Can confirm - there’s lots more gold than just boogers in the nose!
 
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operaman said:
ENT here. Can confirm - there’s lots more gold than just boogers in the nose!
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Unfortunately... for better or worse... booger extraction doesn't require a lot.

I once had a senior attending (going on decade ago... they are now a medical school dean) tell me... "SurfingDoc, I can teach a monkey to do a procedure. What makes you better than a monkey?!"... (realizing we made monkeys astronauts in the 1940s... nearly 20 years before humans) "

I'm afraid most doctors can't answer that question... that's the rub which is mainly lost on most.
 
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SurfingDoctor said:
Just as an aside, kinda… back when I did general pediatrics, the highest billing code one could generate in the clinic was for foreign body extraction.

So…
Counsel a family on exercise, diet and taking Advair daily for asthma control and save the healthcare system tens of thousands of dollars… reimbursement nothing.

Take a sponge out of a toddlers nose… $$$$.

Granted this was almost 20 years ago, but that pretty much tells you all you need to know about healthcare in the US and why mid level replacement will prevail.
Click to expand...
But Peds GIs make much less than adult GIs.
 
MisfitOutlaw said:
Is prime earnings for physicians 40 to 55? I feel like its that for the gen pop, not physicians
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Prime is when you make partner and can work your a*s (typically before 40s) - then relax to count your golden eggs; unless u buy lambos, a vaca home, and somehow get yourself divorced - then prime will be your entire career - working for the man.
 
collegestud2013 said:
$500k loans on $200-250k salary is barely livable; if you want to pay that off that much you'll have to live like a resident for quite a few years after becoming an attending. At that debt to income ratio, it would be also worthwhile to go for PSLF (which is in no part guaranteed, especially if you're still many years away from making all 120 qualify8ing payments). And also $500k is extremely unusual for a USMD Grade. You would have to be borrowing 100% from a expensive undergrad or masters degree on top of med school, or have gone to a DO or Caribbean schools that charge crazy high tuition.

Also any decent primary care job nowadays outside the VA or academics should be able to get you in low $300k at least once you have good volume with a full panel.
Click to expand...
The principal will be closer to 380k for taking out loans for my US-based MD program, but the 7.5% to 8.5% interest rates are what would pushing it towards 500k by the time new students are attendings. 500k is extreme, but that is where some programs are at now. Those loan-forgiveness programs are going to be critical for anybody interested in primary care.
 
SkyKing1996 said:
The principal will be closer to 380k for taking out loans for my US-based MD program, but the 7.5% to 8.5% interest rates are what would pushing it towards 500k by the time new students are attendings. 500k is extreme, but that is where some programs are at now. Those loan-forgiveness programs are going to be critical for anybody interested in primary care.
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look into the SAVE act. My understanding is that it helps to defray interest accumulation as long as a set amount of money is paid during residency
 
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