Why all the negative talk?

[SmallTownGuy]

I am just finishing up my family practice rotation with a doctor from my hometown. To be honest, I had not considered family medicine before the rotation, because everyone told me that the lifestyle was horrible and the money was even worse (not trying to troll, please read on).

The rotation, though, did not bear this out. The doctors at this clinic worked 8 to 5-6, Monday through Thursday. They did not take care of patients in the hospital, because there were hospitalists to do that. The practice is hospital owned, and they received a salary of about 130,000 a year.

Now, 130K for M-Th 8-5 does not sound like such a bad gig to me! Are these docs just lucky, is this not the normal arrangement? I mean, how is this lifestyle bad? Isn't M-F 8-5 what most people do? Is it just bad compared to derm?

---

Members don't see this ad.

 

[PACtoDOC]

I am just finishing up my family practice rotation with a doctor from my hometown. To be honest, I had not considered family medicine before the rotation, because everyone told me that the lifestyle was horrible and the money was even worse (not trying to troll, please read on).

The rotation, though, did not bear this out. The doctors at this clinic worked 8 to 5-6, Monday through Thursday. They did not take care of patients in the hospital, because there were hospitalists to do that. The practice is hospital owned, and they received a salary of about 130,000 a year.

Now, 130K for M-Th 8-5 does not sound like such a bad gig to me! Are these docs just lucky, is this not the normal arrangement? I mean, how is this lifestyle bad? Isn't M-F 8-5 what most people do? Is it just bad compared to derm?

This is completely the norm. Plus, there is opportunity to make a lot more. You witnessed the low end of family medicine.

 

[SmallTownGuy]

Thanks for the reply. I am just curious because whenever a discussion of primary care comes up, I am always told about the bad pay and lifestyle.

The pay part I guess I can understand. Family does make less compared to surgery and subspecialties. However, I would not call 130K "lousy pay" (like I have heard it refered to).

But, the lifestyle statements make no sense to me, and I think that we allow others to make such statements too often without calling them out on it. All the family docs I have worked with came in 8-5 M-F at the most, with an hour for lunch (usually free from a drug rep). Some worked for the hospital, and did not take call or go to the hospital. Another I worked for was not even on staff at any hospitals, he simply ran a same-day clinic and did lots of employment physicals and immunizations. He did not round on patients, etc. I have never seen the 12 hour days, frequent call, etc that all the people told me that I would. I question whether the people who say these things truly know what life is like after residency in private practice.

 

[iatrosB]

Thanks for the reply. I am just curious because whenever a discussion of primary care comes up, I am always told about the bad pay and lifestyle.

The pay part I guess I can understand. Family does make less compared to surgery and subspecialties. However, I would not call 130K "lousy pay" (like I have heard it refered to).

But, the lifestyle statements make no sense to me, and I think that we allow others to make such statements too often without calling them out on it. All the family docs I have worked with came in 8-5 M-F at the most, with an hour for lunch (usually free from a drug rep). Some worked for the hospital, and did not take call or go to the hospital. Another I worked for was not even on staff at any hospitals, he simply ran a same-day clinic and did lots of employment physicals and immunizations. He did not round on patients, etc. I have never seen the 12 hour days, frequent call, etc that all the people told me that I would. I question whether the people who say these things truly know what life is like after residency in private practice.

I think this comes from old school docs, especially the rural ones. I shadowed one not to long ago that worked 70+ a week between clinic, rounds, nursing home, ER... This dude was making serious bank though and he was a workoholic. FP is what you make of it, but it seems that the newer docs (in general) are pulling the 8-5 gig and doing just fine. I personally think its a great life and plenty of money, to each his own, some people like to work and have that consume their life.

 

[SmallTownGuy]

That is a good point, iatrosB. A lot of the students at my school that say things like this have doctors for mothers or fathers. So their view may be distorted by how much they work. I think that another thing that contributes to incorrect information is that a lot of them have not had any experience in private medicine. For example, many of them tell me that they do not want to do internal medicine (my probably specialty) because they do not like team rounds. They do not realise that many internists do strictly outpatient stuff, and the ones that do inpatient do not round with other doctors like we do in academics. Most also do not take overnight call at the hospital, they take call from home.

 

[JML MD]

SmallTownGuy, I am happy that you enjoyed your FM rotation and even happier that you are open to a career as a Family Medicine physician. Currently, I am a PGY-1 in Family Medicine. Your story is very similar to my own. Personally, I grew up in a large city where I had little knowledge of what Family Medicine was. During the first 3 years of medical school (until I did my FM rotation that is), all I heard about was how undesirable FM was and how the only people who go into FM were those that couldn't do anything else. I'd hear how over-worked and under-paid FM docs were.

A major reason for this misconception, as I addressed in the FP vs. Surgery post in this forum, is that major university-affiliated medical centers are incredibly specialist-driven. Plus, many of the specialists (especially the surgeons) look down on every specialty other than their own. By the time I did my FM rotation as a 3rd year, I was undecided as to what specialty I wanted to pursue, but the one thing I (thought I) knew was that I wasn't doing FM.

My FM rotation was amazing though.... I was actually quite taken by surprise! Never had I experienced the impact of patient continuity, and I truly enjoyed the incredible diversity FM offered. I learned that most FM docs were actually very intelligent -- you have to be to synthesize all the information a FM doc is responsible for knowing. Moreover, I saw how much the docs I worked with truly enjoyed what they did. The office I worked at was a group of 6 docs, each who worked 8a – 5p four days a week with no call and no hospital coverage; they each pulled in over $140,000/year too!

The beauty of FM is that you can really tailor your practice. Family Medicine may actually offer the most opportunity to personalize your practice/patients of any field. You can work as much or as little as you like, although your salary will obviously vary as a result. You can follow patients in the hospital or chose to simply see patients in an out-patient setting. You can even be a hospitalist. Some FM docs do OB; others work in solely in ERs. If you desire, you can focus on women's health or sports medicine, among other things. If procedures are your thing, many FM docs do tons of procedures, including EGDs and colonoscopies. Additionally, I personally believe that the long-term relationships you develop with your patients is the most rewarding aspect.

Clearly, not every specialty is for every person.... While some of my best friends went into radiology and anesthesiology, I'd likely be miserable doing that... just as they may have been doing FM. I think you need to listen to your feelings though rather than what many people tell you, because after all, you're the one (not them!) who has to do whatever field of medicine you chose for the rest of your life.

I don't know about you, but when I dreamed of becoming a doctor in my youth, I didn't dream of sitting in front of a microscope all day or looking at solely at skin for a living. There's certainly nothing wrong with that at all, but I personally saw myself being someone's doctor throughout the entire spectrum of their life and treating all kinds of diseases. Sadly though, many students chose their specialty based on money more than anything else, partly due to the high cost of medical school. Call me crazy, but I think that if all specialties paid the exact same, Family Medicine would be the most competitive field in medicine. While I am sure that there may be a debate about that statement, I am positive that FM would do MUCH better in the match!

Either way SmallTownGuy, do keep an open mind. FM is a wonderful field of medicine. Whatever field you do chose, I wish you the best in all you do!

Jason

 

[SmallTownGuy]

Thank you for that detailed response!

I am actually trying to choose between IM and FM. When I complete residency, I think that I will practice at a medium sized hospital practice, with a group of other primary care docs. I like the 8-5 regular hours, the variety. I would like to work in a outpatient setting. My preference is adult medicine, but also like peds and ob. I could give up the peds and Ob though.

Which do you think would be a better choice for me, IM or FM?

 

[dr_almondjoy_do]

Thank you for that detailed response!

I am actually trying to choose between IM and FM. When I complete residency, I think that I will practice at a medium sized hospital practice, with a group of other primary care docs. I like the 8-5 regular hours, the variety. I would like to work in a outpatient setting. My preference is adult medicine, but also like peds and ob. I could give up the peds and Ob though.

Which do you think would be a better choice for me, IM or FM?

Well if you could do without the OB, peds, and surgery, then you could do the IM. Especially if you like geriatrics, you will like the IM....

 

[SmallTownGuy]

Well if you could do without the OB, peds, and surgery, then you could do the IM. Especially if you like geriatrics, you will like the IM....

That is what I am thinking. IM seems to offer a lot of options in terms of practice settings, etc. I am the type that gets bored easily, so it may be the best fit.

 

[iatrosB]

That is what I am thinking. IM seems to offer a lot of options in terms of practice settings, etc. I am the type that gets bored easily, so it may be the best fit.

I personally think that FP has more practice opportunities. Most people would agree that it is the most flexible field in medicine (ER work, urgent care, outpatient, inpatient, hospitalist, cruise ship doctor, resort doctor...and the list goes on.

 

[Mike59]

Now, 130K for M-Th 8-5 does not sound like such a bad gig to me! Are these docs just lucky, is this not the normal arrangement? I mean, how is this lifestyle bad? Isn't M-F 8-5 what most people do? Is it just bad compared to derm?

I'm just finishing up an elective in community FP and I must say I have come across several reasons why FP can be considered undesireable by many.

The main reasons I think these docs are frustrated is the stranglehold insurance companies have on their ability to deliver patient care, order tests, get certain treatments, and most importantly lifestyle wise- they play insane games with reimbursements that make that $"100+k/yr" income an uncertain month-month game of chance and in FP the margin between getting paid and breaking even is very tight. It's hard to run a business/successful practice when you have no idea how much of this month's billings will "actually" come back to you, and often we're looking at 3-6 months after the patient visit (sometimes in the form of an expired check).

I was gung-ho on primary care until I did this elective and I must say I'm more uncertain about it now

 

[cooldreams]

hmm im guessing it is not as easy as just saying you no longer accept a certain insurance provider?

is there some national insurance provider black list that doctors can get a hold of and contribute to that do these games, you can then say, you do not accept any insurance from those providers. and it would be up to the providers themselves to get off the list with better performance?

if people cannot get medical treatment with a certain insurance provider, then they should go to a different one or ??

lots of questions i guess........

 

[raptor5]

hmm im guessing it is not as easy as just saying you no longer accept a certain insurance provider?

is there some national insurance provider black list that doctors can get a hold of and contribute to that do these games, you can then say, you do not accept any insurance from those providers. and it would be up to the providers themselves to get off the list with better performance?

if people cannot get medical treatment with a certain insurance provider, then they should go to a different one or ??

lots of questions i guess........

Probably but you have to watch out for anti-trust laws. For the same reason physicians can't get together and propose a reimbursement floor (lowest amount). This is partially why some areas have very large medical groups. It's not an antitrust violation unless you are monopolizing an area. Not real sure though b/c what if you are one of only a couple docs in a small town that does have HMO/PPO penetration.
There is a website that rates insurance companies in Texas. I used to have the website bookmarked but lost it some time ago.

 

[cooldreams]

Probably but you have to watch out to anti-trust laws. For the same reason physicians can't get together and propose a reimbursement floor (lowest amount). This is the reasoning for very large medical groups. It's not an antitrust violation unless you are monopolizing an area, not real sure though. There is a website that rates insurance companies in Texas. I used to have the website bookmarked but lost it some time ago.

i think ive seen the website you refer to. i dont think i trust it very much. if you follow the math then you find a number of errors. even so its particular rating of them down there at that time may have been ok, i think it has stopped being updated...

 

[gwyn779]

Thanks for the reply. I am just curious because whenever a discussion of primary care comes up, I am always told about the bad pay and lifestyle.

The pay part I guess I can understand. Family does make less compared to surgery and subspecialties. However, I would not call 130K "lousy pay" (like I have heard it refered to).

You hit on one of the problems with listening to people in medicine about certain things.....like the belief that $130k is "lousy pay." Similarly, that a resident's $40k salary is "nothing." It's only nothing when compared with people making $300k. It's still 1 1/2 times the average income in the US. It's more than paramedics or teachers make, for example. The problem is that many, though certainly not all, medical students have parents who are doctors and to them, a family income of $300k is normal. But whatever.....

As for lifestyle, because of the flexibility of FP, you can make it as good or bad as you want. Sure, rural docs who are the only ones in town are more likely to work long hours. Also, docs who do OB are more likely to work long hours, mainly because of the need to go deliver babies at 3 am. But if you're in a larger practice, those issues get minimized. If you only want to work 40 hours a week, there are more than enough opportunities to do so in family med.

 

[SmallTownGuy]

You hit on one of the problems with listening to people in medicine about certain things.....like the belief that $130k is "lousy pay." Similarly, that a resident's $40k salary is "nothing." It's only nothing when compared with people making $300k. It's still 1 1/2 times the average income in the US. It's more than paramedics or teachers make, for example. The problem is that many, though certainly not all, medical students have parents who are doctors and to them, a family income of $300k is normal. But whatever.....

As for lifestyle, because of the flexibility of FP, you can make it as good or bad as you want. Sure, rural docs who are the only ones in town are more likely to work long hours. Also, docs who do OB are more likely to work long hours, mainly because of the need to go deliver babies at 3 am. But if you're in a larger practice, those issues get minimized. If you only want to work 40 hours a week, there are more than enough opportunities to do so in family med.

THanks for the reply and keeping the discussion going. I remember I complained one time to my fiance about what I would be paid as a resident. She told me that as an assistant district attorney she would start out at 30,000 and looked at me like I was crazy.

 

[Apollyon]

I personally think that FP has more practice opportunities. Most people would agree that it is the most flexible field in medicine (ER work, urgent care, outpatient, inpatient, hospitalist, cruise ship doctor, resort doctor...and the list goes on.

Actually, one example - Carnival Cruise Lines will take EM, IM, or FP, but, if you're EM-boarded, you don't need ACLS. Here's the job posting - appears more EM-based than FP-based:

Ship's Physician

The ship's physician is responsible for the basic and emergency medical treatment of the guests and directly supervises the ship's nurses. The ship physician also serves as the emergency and primary care physician for all crew onboard. Physicians must hold valid registration in the United States, Canada, Australia, New Zealand, Ireland, South Africa, or European Union member country. Candidates must have completed a minimum of three years postgraduate training in internal medicine, family practice, or emergency medicine and be competent in emergency medicine with experience in orthopedic and minor surgical procedures. Current certification as an ACLS provider or its equivalent, unless board certified in emergency medicine. ATLS certificate and PALS certification helpful, but not mandatory. Experience and knowledge of the indications and contra-indications of fibrinolytic therapy and care of the patient before and after administration. Some experience or willingness to learn simple laboratory and x-ray procedures. Evidence of a positive mental attitude and an ability to work with people of different nationalities in a close intense environment, while providing effective leadership. Must be fluent in English. Candidate must pass a pre-employment physical examination and be deemed fit for duty at sea. Basic computer knowledge and proficiency is required.

 

[OnMyWayThere]

It seems that the low pay in FM comes from those docs who aren't really into the business aspect of a practice. A Family Practioner who is just hired won't make nearly as much as a newly hired Orthopedic Surgeon. However, it seems like a business saavy FP can make more than an Orthopod if s/he runs the practice in that way - with procedures, PA's, NPs, etc. A lot of my info comes from personal family experience as well as excellent posts by Pac2Doc (sorry if that's misspelled).

The big controversy that FP don't make as much anymore also stems from the fact that many FP's were making millions back in the days, but that is rarely the case anymore. That does not mean they cannot make money though - even compared to the highly competitive fields. If I don't fall in love with something during rotations, I will go into FP and tailor my practice to what I desire.

 

[FMbound]

I hear alot of surgeons complaining about reimbursement also. Seems like only the rare specialist can pull down millions any longer. Derm still pulls in the cash since many of their procedures are not reimburseable and patients must pay out of pocket.

 

[tinkerbelle]

Similarly, that a resident's $40k salary is "nothing." .... It's more than paramedics or teachers make, for example.

Actually, that's not true anymore. First year teachers make about 40k a year (in my area) for a lot less work

 

[CJMPre-Med]

You hit on one of the problems with listening to people in medicine about certain things.....like the belief that $130k is "lousy pay." Similarly, that a resident's $40k salary is "nothing." It's only nothing when compared with people making $300k. It's still 1 1/2 times the average income in the US. It's more than paramedics or teachers make, for example. The problem is that many, though certainly not all, medical students have parents who are doctors and to them, a family income of $300k is normal. But whatever.....

First off, nobody is saying that $130K isn't good money-- it's just a pittance for what a physician actually has to go through and what their job entails. If you want to believe that $130K for a physician is a "lot" of money, or that that's all you're (or they're) worth, I'd advise you to go to any HR department or consulting firm and ask them to perform a job analysis (which is an objective, standardized technique for assessing a job's required knowledge, skills, responsibilities, and utility and determining appropriate compensation levels for said jobs, be they routine jobs or managerial or professional positions), and see how much a physician-- ANY physician, even an FP-- is supposed to be paid. Hint: it's quite a bit more than $130K.


Perhaps you're fine with $130K, but to suggest that it's in any way proper for physicians to only be paid that much is silly imo, no offense. Based on the exact same standards, analyses, and procedures used to determine compensation for nearly every other job in the country, physicians are woefully underpaid. Woefully. As are many other jobs, of course (while many are overpaid, such as in the financial and administrative sectors), but none are as underpaid based on these objective standards as are physicians. It's a very sad state of affairs, really. A friend of mine (age 27) makes $125K in a marketing department, and all he has is a bachelor's, and not even from a particularly reputable institution. Yet doctors should be content with $130K? Come now...

 

[SmallTownGuy]

First off, nobody is saying that $130K isn't good money-- it's just a pittance for what a physician actually has to go through and what their job entails. If you want to believe that $130K for a physician is a "lot" of money, or that that's all you're (or they're) worth, I'd advise you to go to any HR department or consulting firm and ask them to perform a job analysis (which is an objective, standardized technique for assessing a job's required knowledge, skills, responsibilities, and utility and determining appropriate compensation levels for said jobs, be they routine jobs or managerial or professional positions), and see how much a physician-- ANY physician, even an FP-- is supposed to be paid. Hint: it's quite a bit more than $130K.


Perhaps you're fine with $130K, but to suggest that it's in any way proper for physicians to only be paid that much is silly imo, no offense. Based on the exact same standards, analyses, and procedures used to determine compensation for nearly every other job in the country, physicians are woefully underpaid. Woefully. As are many other jobs, of course (while many are overpaid, such as in the financial and administrative sectors), but none are as underpaid based on these objective standards as are physicians. It's a very sad state of affairs, really. A friend of mine (age 27) makes $125K in a marketing department, and all he has is a bachelor's, and not even from a particularly reputable institution. Yet doctors should be content with $130K? Come now...

Unfortunately, society does not use the criteria that you speak of when determining salaries. It is all about supply and demand, and how unique your skills are. That is why a professional basketball player (unique skills, not many people have the talent) will earn millions. I do agree that physicians, and most other professsions, are underpaid to a degree. The point of my post was: 1. that the lifestyle of a FP can be quite good, contrary to what I had been told, and 2. that 130,000 in the greater scheme of things is not so bad as to keep me from doing FP. To me, that is an acceptable income for a 40 hour work week.

 

[allendo]

Unfortunately, society does not use the criteria that you speak of when determining salaries. It is all about supply and demand, and how unique your skills are. That is why a professional basketball player (unique skills, not many people have the talent) will earn millions. I do agree that physicians, and most other professsions, are underpaid to a degree. The point of my post was: 1. that the lifestyle of a FP can be quite good, contrary to what I had been told, and 2. that 130,000 in the greater scheme of things is not so bad as to keep me from doing FP. To me, that is an acceptable income for a 40 hour work week.

I don't understand what you people are talking about!! I'm from a town of 32k and I know a family doc bringing home 24k a month! Clear money! I think these low salaries are in the cities. You know what move outside the city and set up business. Be nice, courteous, and let people know you care about them and your salary will be reflective of that. The only docs I've ever seen were FP and surgeons, not specialist

 

[SmallTownGuy]

I don't understand what you people are talking about!! I'm from a town of 32k and I know a family doc bringing home 24k a month! Clear money! I think these low salaries are in the cities. You know what move outside the city and set up business. Be nice, courteous, and let people know you care about them and your salary will be reflective of that. The only docs I've ever seen were FP and surgeons, not specialist

I agree. The doctors that I worked with (read the OP) made 130,000 for a 40 hour work week. This is probably a good estimate of what you should make, but the potential to make more always exists (everyone always "knows a guy" that does). My point was that 130,000 is not that bad, and that EVEN IF that was all I made, I would be fine with that.

 

[FMbound]

$130,000 annually is terrible pay for 40 hrs/week. I guess it's ok if you are doing exams only.

As a comparison, I received an email looking for board certified EM docs for $225 an hour. That equates to appx $350K annually for 160 hours per month (equivalent to four 40 hour weeks per month).

 

[SmallTownGuy]

$130,000 annually is terrible pay for 40 hrs/week. I guess it's ok if you are doing exams only.

As a comparison, I received an email looking for board certified EM docs for $225 an hour. That equates to appx $350K annually for 160 hours per month (equivalent to four 40 hour weeks per month).

Compared to a specialists salary, I agree that 130K is much less. Like I said, supply and demand. There is a shortage of EM docs. That is why they can demand more, but 225 per is over the average. The doctors that I worked with were part of a hospital owned practice. They did few procedures (occasional pap, etc). Basically they came in, saw about 15 patients each, and left. No call, no weekends. It may not be a EM salary, but I guarantee you these guys were not working as hard. Good enough for me to consider it.

 

[CJMPre-Med]

Unfortunately, society does not use the criteria that you speak of when determining salaries. It is all about supply and demand, and how unique your skills are. That is why a professional basketball player (unique skills, not many people have the talent) will earn millions. I do agree that physicians, and most other professsions, are underpaid to a degree. The point of my post was: 1. that the lifestyle of a FP can be quite good, contrary to what I had been told, and 2. that 130,000 in the greater scheme of things is not so bad as to keep me from doing FP. To me, that is an acceptable income for a 40 hour work week.

Unfortunately, you're mistaken-- these are the criteria that human resource departments and consulting firms the nation over use to set compensation levels for all sorts of positions, be they "normal" jobs, managerial, or professional. The remuneration levels for literally millions of jobs fall under their purview. Corporate and company lawyers, accountants, managers, administrators etc. are all compensated according to a roughly objective formula based on job analysis methods. Several types are common, but the gist of it is as seen in my previous post. I mean, what did you think human resource departments do? Consulting firms? Certainly this is not their sole function, but it's a pretty big aspect of it. Ever see a moderate-to-large company without an HR department? No, of course not. And do you know how many people businesses employ in the US? Quite a few. And this is how they determine compensation for most positions.


The particular examples you cite-- athletes, CEO's to a certain degree etc.-- are the exception, not the rule. Do some research. All I personally ask for is consistency. And it is neither consistent, nor intellectually honest, to state that physicians are only "slightly underpaid." Fact: they are dramatically underpaid. All of them. Any objective analysis will yield that same result.


But you're free to keep believing as you do even as people with far fewer skills, far less knowledge, far less time and money invested in becoming a professional, fewer responsibilities and obligations, and less value to society/organizations are compensated more adequately than you are. Be my guest. Economic injustice is not my cup of tea, though, nor would I ever bear it in silence. Nobody should, not just physicians.

 

[OnMyWayThere]

Good post

 

[PACtoDOC]

I don't understand what you people are talking about!! I'm from a town of 32k and I know a family doc bringing home 24k a month! Clear money! I think these low salaries are in the cities. You know what move outside the city and set up business. Be nice, courteous, and let people know you care about them and your salary will be reflective of that. The only docs I've ever seen were FP and surgeons, not specialist

This is the gospel truth! Even as a PA, without the title physician, I was able to be the most productive provider in my practice of 3 PA's and 3 docs. My gross billing working around 45-50 hours per week, averaging 25-30 patients per day was about 500K per year, and we collected nearly 400K of that. Now add in a bit of hospital work, and take away the title PA so that I am the doctor making that money (instead of making it for someone else as a PA), and you can see that it is very easy to make at least 250K per year after its all said and done. And as a physician, I figure I will hire a real good PA to be my small town partner, and then I will be a lot more educated in office procedures to add even more to the bottom line. My goal is to be making 300K per year by my 5th year out of residency, and then slowly taper down until I am working 2-3 days a week at age 55 while my partners who are younger and more energetic pick up the slack.

 

[cooldreams]

I don't understand what you people are talking about!! I'm from a town of 32k and I know a family doc bringing home 24k a month! Clear money! I think these low salaries are in the cities. You know what move outside the city and set up business. Be nice, courteous, and let people know you care about them and your salary will be reflective of that. The only docs I've ever seen were FP and surgeons, not specialist

Unfortunately, you're mistaken-- these are the criteria that human resource departments and consulting firms the nation over use to set compensation levels for all sorts of positions, be they "normal" jobs, managerial, or professional. The remuneration levels for literally millions of jobs fall under their purview. Corporate and company lawyers, accountants, managers, administrators etc. are all compensated according to a roughly objective formula based on job analysis methods. Several types are common, but the gist of it is as seen in my previous post. I mean, what did you think human resource departments do? Consulting firms? Certainly this is not their sole function, but it's a pretty big aspect of it. Ever see a moderate-to-large company without an HR department? No, of course not. And do you know how many people businesses employ in the US? Quite a few. And this is how they determine compensation for most positions.


The particular examples you cite-- athletes, CEO's to a certain degree etc.-- are the exception, not the rule. Do some research. All I personally ask for is consistency. And it is neither consistent, nor intellectually honest, to state that physicians are only "slightly underpaid." Fact: they are dramatically underpaid. All of them. Any objective analysis will yield that same result.


But you're free to keep believing as you do even as people with far fewer skills, far less knowledge, far less time and money invested in becoming a professional, fewer responsibilities and obligations, and less value to society/organizations are compensated more adequately than you are. Be my guest. Economic injustice is not my cup of tea, though, nor would I ever bear it in silence. Nobody should, not just physicians.

while i agree with you on this when there are others higher than you in control of your salary, a different case is presented when you run and are paid through your OWN business. since many of the small town FPs do operate their OWN business instead of big city groups, they do not operate under the premise you speak of, and thus the disparity as to why you both could be right is revealed.

 

[Sainttpk]

First off, nobody is saying that $130K isn't good money-- it's just a pittance for what a physician actually has to go through and what their job entails. ...

Its crazy how wealthy this nation has become, I have no problem with physicians making alot of money, but come on now stop the complaining already..

Try working the field as a mexican labourer in the intermountain west and you will see what making little money for much work entails. imagine getting up everyday at 5 am and getting off work everyday at 7pm while the sun beats on your back, and you make less then a dollar an hour, that my friend is a pittance for work.

 

[FMbound]

Try working the field as a mexican labourer in the intermountain west and you will see what making little money for much work entails. imagine getting up everyday at 5 am and getting off work everyday at 7pm while the sun beats on your back, and you make less then a dollar an hour, that my friend is a pittance for work.

Oh please. I haven't spent the last 8 years of my life working towards this goal in order to work in a field for nothing. And actually, I've had my share of crap jobs for minimum wage already.

 

[Sainttpk]

Oh please. I haven't spent the last 8 years of my life working towards this goal in order to work in a field for nothing. And actually, I've had my share of crap jobs for minimum wage already.

Im just trying to make a point, im not saying there is anything wrong with making money, all I am saying is that there are plenty of other jobs out there that do not get high wages so be happy with what you have. There are plenty of people in other professions who deserve high wages, but they dont get them. I.E. Police officers come to mind. Soo please please get off your high horse!

 

[crys20]

The diff IMO is that police officers most likely did not sacrifice nearly all of their 20s to get into their profession. I've worked harder than most people in college. I will work hard in medical school. I have lived apart from my SO for years due to us both pursuing medicine. I want some reimbursement

 

[doc05]

All the negative talk??

In part because so many people are from big cities/suburbs, when subspecialists are the norm. The typical academic medical center is the same way. Hence, people assume that FP's don't or can't do anything more than write referrals.

In part because salaries are comparatively low for the work involved. 130K for a 40 hour work week?? A typical ophthalmologist makes about 2x that, working roughly the same hours, and almost never has emergencies when "on-call." Most FP docs aren't working 40 hours/week anyway; it's usually substantially more than that.

And in part because of ego. Who wants to go into the "least competitive" specialty?

Choose the specialty that fits you best, and don't worry about the "negative talk."

 

[Sainttpk]

The diff IMO is that police officers most likely did not sacrifice nearly all of their 20s to get into their profession. I've worked harder than most people in college. I will work hard in medical school. I have lived apart from my SO for years due to us both pursuing medicine. I want some reimbursement

How about sacrificing your life on a daily basis? Ever been shot at before? stabbed? chased? Ever dealt with convincted sex offenders and criminals on a daily basis? Ever been in fear for your life? Just something to think about

 

[novacek88]

How about sacrificing your life on a daily basis? Ever been shot at before? stabbed? chased? Ever dealt with convincted sex offenders and criminals on a daily basis? Ever been in fear for your life? Just something to think about

Hard labor is not the same as studying. I know it's cliche to act like the janitor or construction worker or cop works so much harder than doctors but that's b.s. You can do hard labor jobs and think about something else while you do it. You can come home and not worry about boards, homework, studying etc. You don't have the stress of passing your exams on Monday morning. I know a lot of cops and they don't all work hard. Many of them were ex-jocks who didn't feel like studying and going to college so they became cop so they could feel empowered, cool and earn money right away..

I held a full time job for 5 years prior to medical school I averaged working 70-80 hours per week...no joke. I was well paid but I can tell you that studying for 30 hours a week is much much harder that working 80 hours a week in an office setting. In a job, you can get into a routine and you really don't have to think about things, That's just not the case with medical school and residency.

Reading and studying is by far more difficult. This is why most people can't become physicians or other academic fields. If it was easy, more people would do it. You think people don't want to earn 200K? If they could do it, many more people would become doctors but when they learn they have to go to school for 8 years and work as an indentured servant for another 3-8 years, many of them drop the idea and pursue real estate. It's their own damn fault that they are in jobs like that. No one forced them to choose hard labor jobs.

One of my best friends and colleagues was formerly in construction. He worked hard and the labor was hard on his body but he was far less stressed than he is now. However, he also mentioned having a lot of fun like bringing coolers out there and drinking and going to bars after work etc. I asked him what was harder and without a doubt, he says medical school was 10 X more difficult.

Ask yourself why people go into the jobs in the first place. It's not like these people were straight A students in high school that just chose to engage in a hard labor job. Many of them had no choice because their grades were lousy and they couldn't afford a scholarship and were not willing to take loans to go to college or even get into college by studying for the SAT. Many of these students were not interested in school to begin with. While they were skipping class, cheating off their smart friends and partying, us ambitious pre-meds were studying.

 

[doc05]

Hard labor is not the same as studying. I know it's cliche to act like the janitor or construction worker or cop works so much harder than doctors but that's b.s. You can do hard labor jobs and think about something else while you do it. You can come home and not worry about boards, homework, studying etc. You don't have the stress of passing your exams on Monday morning. I know a lot of cops and they don't all work hard. Many of them were ex-jocks who didn't feel like studying and going to college so they became cop so they could feel empowered, cool and earn money right away..

I held a full time job for 5 years prior to medical school I averaged working 70-80 hours per week...no joke. I was well paid but I can tell you that studying for 30 hours a week is much much harder that working 80 hours a week in an office setting. In a job, you can get into a routine and you really don't have to think about things, That's just not the case with medical school and residency.

Reading and studying is by far more difficult. This is why most people can't become physicians or other academic fields. If it was easy, more people would do it. You think people don't want to earn 200K? If they could do it, many more people would become doctors but when they learn they have to go to school for 8 years and work as an indentured servant for another 3-8 years, many of them drop the idea and pursue real estate. It's their own damn fault that they are in jobs like that. No one forced them to choose hard labor jobs.

One of my best friends and colleagues was formerly in construction. He worked hard and the labor was hard on his body but he was far less stressed than he is now. However, he also mentioned having a lot of fun like bringing coolers out there and drinking and going to bars after work etc. I asked him what was harder and without a doubt, he says medical school was 10 X more difficult.

Ask yourself why people go into the jobs in the first place. It's not like these people were straight A students in high school that just chose to engage in a hard labor job. Many of them had no choice because their grades were lousy and they couldn't afford a scholarship and were not willing to take loans to go to college or even get into college by studying for the SAT. Many of these students were not interested in school to begin with. While they were skipping class, cheating off their smart friends and partying, us ambitious pre-meds were studying.

Wow what a narcissist. Your attitude is why so many people dislike physicians. Think about what you're saying. Then think about how many of these "lesser" folk busted their asses building the cities and highways, making the cars, mining coal, harvesting crops, and doing every other blue-collar trade that made this country great.

Not everyone is cut out for medicine, but that doesn't mean they aren't working hard at their jobs. Now get off your high horse.

 

[novacek88]

Wow what a narcissist. Your attitude is why so many people dislike physicians. Think about what you're saying. Then think about how many of these "lesser" folk busted their asses building the cities and highways, making the cars, mining coal, harvesting crops, and doing every other blue-collar trade that made this country great.

Not everyone is cut out for medicine, but that doesn't mean they aren't working hard at their jobs. Now get off your high horse.

You of all people shouldn't accuse me of being a narcisist. Your hypocrisy is amusing. We could do a quick search and find a myriad of obnoxious and arrogant posts you have contributed over the years. Not everyone is willing to make the sacrafices to be a physician but I believe almost anyone is cut out for it if they put in the effort. And where in my post do I say that I don't value their contributions in life? I just take issue with anyone who tries to make doctors feel guilty for earning a lot of money. They deserve every penny they earn.

A lot of people hate physicians because they are arrogant and condescending to their patients. I'm very cool and relaxed with my patients. I don't think I'm better than a construction worker but yeah, I think I worked harder than they did to be where I am. And I know that many medical students feel the same way although they will never admit that because it's not politically correct to do so. Like others have said, we sacrafice so many years of our life not to mention going into 200+ K in debt and dealing with an insane amount of stress not to mention the increasing threat of malpractrice and bureacracy. I'm not going to feel guilty for earning a lot of money or desiring a lot of money so you can kiss my ....

 

[novacek88]

I don't think the compensations concerns most people in regards to FP. I agree with most of the members here that FP docs can rake it in. We all know the FP doc who earns close to 7 figures by hiring several PA's, NP's and seeing a large volume of patients. FP is what you make of it and how hard you want to work. It also depends on how ethical you are. Personally, I think it's a bit shady if you only spend 2-3 minutes with a patient just so you can see a larger volume of them.

But back to my point, I think the problem most have with FP is the respect factor. Many people want to feel like experts in one particular field and as an FP doc you are jack of all trades as opposed to an expert in one.The other complaint I have heard about FP is that most of their patients are not that ill or complicated. And if they do suffer from something that requires more knowledge in a particular field, they will be referred out. When I rotated during FP, it seemed like 90% of our patients were people who were not that sick and had not thought of buying OTC medication. They just saw us for the purpose of acquiring antibiotics and they were insistent that you prescribe them to them. And for the sake of pacifying our patients, we almost always did prescribe them antibiotics but half these people would have been okay with some tylenolol, bed rest and fluids. And then yes, there is the ego factor. Some people are afraid of being looked down upon for being an "ordinary" FP. That is sad because FP docs are some of the best I have ever worked with. Money and lifestyle in FP can be quite good, I think it's the respect/ego/job duty factors that turn people away from FP..

 

[novacek88]

Okay, I'll bite on this one. You truly are a narcisistic one aren't you? Something tells me you have never had to work hard a day in your life, or that you came from a family where no one had to work hard. If I am wrong about this, then it just proves that environment plays very little role in shaping one's values. I worked 80+ hour weeks for 4 years as a corpsman in the Marines, and got paid about 18K per year. I never received overtime in the Gulf War when I went several days without any appreciable sleep. Something tells me you were parking golf carts back at the country club while the rest of us blue collars were helping shape our future. And to contradict your opinion, I feel like medical school is one big vacation compared to those years. Its even been a vacation compared to my 45-50 hour weeks as a PA. And my wife who is a police officer would argue with you that her life is not worth more than 36K per year making sure the thugs on her beat don't beat down some whiner like yourself. Now go ahead with the threats of searching my old posts and trying to find some inconsistencies, but I will save you the trouble and tell you now that I am extremely consistent in the fact that I rarely but loudly let my opinion be known when someone so blatant as yourself attempts to make all physicians look like they have your values. Your values are unfortunately prevelant in medicine, but take it from me that physicians with attitudes like yours lose patients and referrals and eventually die really bitter and as alcoholics. I am sure we will be reading about you in the back of your state's physician discipline section of their medical journal.

You are right; you don't know a damn thing about me. And it's funny how arrogant and presumptuous people like yourself stereotype people like myself because you didn't like my tone. I have read your posts in the past and I would never see you as my physician. You have the military elitist attitude that I can't stand. You routinely attack those who have a different opinion from you. People like yourself think you are honorable when you are nothing more than condescending meatheads who feel they can bully people around. It's people like you who get divorced when your wife can't stand being around you because you are a control freak.

I'm Mexican and my father was an illegal immigrant. I was working on lawns with him since I was 6 years old in southern california I didn't get to participate in after school activities like football because I had to help him everyday. I didn't use my heritage or our lack of money early on as a scapegoat to do poorly in school. I would work my tail off with him and then come home and study until about 1 AM. I attended community college for two years so i could still help out my family despite the fact that I was admitted to several Ivy League schools. I eventually transferred to one of those schools. I took loans and made it happen. I got a corporate job out of college and worked my tail off there as well but my desire was to become a physician. Yeah, I know what it's like to work hard. Working on lawns isn't construction but it's physical labor nonetheless. A lof of the people I grew up with chose not to go to school because they thought it was too hard. Many of them become cops, fireman...you name it. As hard as working outside was, there is a sense of peace doing physical labor. It was much harder coming home and having to read and analyze information. The truth is school is not easy and it takes a huge sacrafice to excel academically. This is why a lot of people can't do it and settle on other jobs. I have been there and I know what I'm talking about.

 

[novacek88]

PACtoDOC

After much deliberation, I realize I have become jaded over the years. I think there is some truth to your labeling me a narcisist. I never treat people that way but I realize that maybe I did think I was better than some people. I realize that's not how I was raised and that's not the type of person I want to represent. I do apologize.

I only responded to the poster above in regards to compensation. If you read my previous post, I never criticized FP. In fact, I said many of the same things you did in regards to FP offering a great lifestyle and compensation. I too think it's ridiculous how some criticize the field. But I do think FP should be compensated more the services they provide. They work hard and they shouldn't be compensated less because they refer problems out. That is just my opinion.

A 130 K is a lot of money but for the amount of schooling, debt, stress and overall workload that is required to become a FP, I think they should be compensated more. When people refer to the individual who earns only 50K, I want to remind them that often times that person didn't undergo the same debt, large number of years of school, stress to etc. to get where he did. But I realize that I was wrong in stereotyping people and assuming all people who earn less than 50K didn't work as hard. My father worked his tail off and he earned far less than that. I felt horrible last night because I realized I had become something I strove not to become.

Again, I apologize to the forum and those I offended

Peace

 

[iatrosB]

Happens to the best of us hombre. I recommend following these guidelines to a happy and successful medical career.

1) Choose a field that you feel will make you happiest
2) Work hard to be the best physician you can be
3) Treat every patient as though they are your mother or father

Everything after that will fall into place, and you will be very content with the rest of your medical practice life. I work with almost one doctor a week or so that truly complains about how horrible their life is, and then they wonder why they are tied up in lawsuits, are on wife number 4, and have 5 kids for whom college will be paid for by them, and none of them want anything to do with their father. Enjoy every day as if it could be your last, and be an advocate for your family and your patients. In the end, its not who has the most money that wins. Have you ever thought about this; Which physician made more money....Von Recklinhausen, Virchow, Chvostek, or Rovzing? My guess is nobody really cares, because they are immortalized by their name and what they contributed to the world of medicine. When I die, I simply want my patients and their families to say that I cared about them and did my best to make them feel like their problems were important. Good luck, and I hope you find your way back home.

That is the best anyone could hope for Well said!