Why do dermatologists make so much?

[jillibean]

I really know very little about derm, but I am suprised that it pays so well. Do they really do many procedures? It seems like they would just prescribe skin creams, acne meds and remove the occasional mole (all things an FP could do). Anyone have more insight?

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[Matth52]

That is a really good question.

 

[braluk]

aside from real medical cases such as skin cancer (and even then, melanoma patients and such are referred to oncologists anyways), irregular moles, severe acne and such, vanity plays a big role in dermatology being such a lucrative job. Unlike plastic surgery, arguably another speciality that makes its money off of patients' vanity (disclaimer: im not saying all of plastic surgeons fit into this vanity category: reconstructive plastic surgery is much different then tummy tuck surgery and things of that nature) patients dont have to worry about any major surgeries, things are done pretty much in the office, there are rarely any malpractice lawsuits, and they have hours that are unlike any other speciality of the same income. The lifestyle is very much desired because so many more hours can be dedicated to family and such- whereas anotehr type of doctor might be in the hospital for 12-16 hours a day.

 

[CTtarheel]

It could be a supply/demand thing. In 2006 there were only 30 derm residency positions as opposed to nearly 5000 in internal medicine.

 

[jillibean]

aside from real medical cases such as skin cancer (and even then, melanoma patients and such are referred to oncologists anyways), irregular moles, severe acne and such, vanity plays a big role in dermatology being such a lucrative job. Unlike plastic surgery, arguably another speciality that makes its money off of patients' vanity (disclaimer: im not saying all of plastic surgeons fit into this vanity category: reconstructive plastic surgery is much different then tummy tuck surgery and things of that nature) patients dont have to worry about any major surgeries, things are done pretty much in the office, there are rarely any malpractice lawsuits, and they have hours that are unlike any other speciality of the same income. The lifestyle is very much desired because so many more hours can be dedicated to family and such- whereas anotehr type of doctor might be in the hospital for 12-16 hours a day.

I agree. However, physician salary websites (for whatever they are worth) say the average dermatologist with 3+ years exp. make around 310K, and I just don't get where that is coming from.

 

[braluk]

check this thread out

http://forums.studentdoctor.net/showthread.php?t=289836

 

[tangledupinblue]

lots of cash. and little dealing with insurance companies.

 

[potato51]

It could be a supply/demand thing. In 2006 there were only 30 derm residency positions as opposed to nearly 5000 in internal medicine.

Just 30? It's at least 250 nationwide.

 

[braluk]

It could be a supply/demand thing. In 2006 there were only 30 derm residency positions as opposed to nearly 5000 in internal medicine.

good point, a decent dermatologist could easily be booked for months. The fact that there are so few dermatologists around, and how many vain people and people with real skin illnesses there are around, leaves dermatologists with a never ending supply of patients, or $$$.

Imagine if we had only 50, oh i dont know, penis enlargement and breast implantologists in the United States and can only take on so many patients at once. These doctors wont have to wrory about having to put in 16 hours a day because patients' lives arent really at risk. AND, there are probably a bunch of people who are willing to wait for years to get a procedure done simply because we live in a society where image is everything. (after all, look at the profits of these dieting trends that play on people's vanities)

 

[Haemulon]

A family member of mine is a Dermatologist and there is much more to it than just prescribing some creams and treating acne/moles. Not being very well versed in the field, I do not want to try and list off all of the different types of things that they do, but I can say that it is very procedure-based. And procedures = money. Also, I have been very surprised to see many of the the various conditions that they get called in on for consults. Much more interesting than you may think. Plus, there is a lot of research opportunity and even sub-specialties such as derm-path. It is well worth investigating to learn more. Derm also has one of the best lifestyles for those that are family oriented. Which makes it particularly attractive to some.

 

[braluk]

I also wouldnt be surprised if patients after invasive surgery (ALOT of patients) goes to see a dermatologist to reduce the scarring post-op. Theres another market potential right there.

 

[Law2Doc]

It could be a supply/demand thing.

This is the answer. Only a small fraction of the dermatologists necessary are churned out each year, and that is not accidental. And most of their patients never get better permanently, and the vast majority don't die from their skin ailments, so it's a great repeat-business field.

 

[Haemulon]

I also wouldnt be surprised if patients after invasive surgery (ALOT of patients) goes to see a dermatologist to reduce the scarring post-op. Theres another market potential right there.

Or for disease processes secondary to primary indication for hospitalization. Or perhaps as manifestations of an underlying disease process, such as thrombocytopenic purpura, such as is brought on sometimes by HIV, or leukemia.

 

[TMP-SMX]

Hello... None of their patients get better. Any condition a person has can only go into remission. (Can come back if you go off of medication). So they require constant observation and treatment.

 

[masterMood]

This question is irrelevant as 99.999999% of you will not enter this coveted specialty.

I recommend improving your chances to 99.99999998% by eating a poop sandwich. Yes my friends, even the mystical powers of the poop sandwich cannot help one enter a dermatology position, though it can do wonders to medical school acceptance.

 

[Haemulon]

Hello... None of their patients get better. Any condition a person has can only go into remission. (Can come back if you go off of medication). So they require constant observation and treatment.

huh??

 

[Law2Doc]

huh??

It's accurate. Very few skin diseases for which people seek dermatology help, eg. eczema, psoriasis etc. are permanently cured.

 

[Compass]

Acne - High School Student's Nightmare, Dermatologist's Welfare.

Acne never goes away. You stress out at 38, you're going to get acne.

 

[QuantumMechanic]

Acne - High School Student's Nightmare, Dermatologist's Welfare.

Acne never goes away. You stress out at 38, you're going to get acne.

that's not really their bank though

 

[Law2Doc]

that's not really their bank though

recurring rashes are though.

 

[TSK]

I've been volunteering/shadowing in derm depts for over a year now. I'm now a research coordinator in a derm dept for my app year. There is such a HUGE misconception about what most derms do. The vast majority of patients' visits to a derm have NOTHING to do with vanity....unless of course seeking treatment for chronic leg wounds/ulcers, severe psoriasis and eczema, and a host of other disorders that the general public isn't familiar with makes one vain....

But, derm is so competitive b/c of the "lifestyle". Most only see patients a few days a week and you can choose to specialize in treating lower risk disordres like acne and rosacea. Good hours, good pay, if you can get the residency, why the hell not?

aside from real medical cases such as skin cancer (and even then, melanoma patients and such are referred to oncologists anyways), irregular moles, severe acne and such, vanity plays a big role in dermatology being such a lucrative job. Unlike plastic surgery, arguably another speciality that makes its money off of patients' vanity (disclaimer: im not saying all of plastic surgeons fit into this vanity category: reconstructive plastic surgery is much different then tummy tuck surgery and things of that nature) patients dont have to worry about any major surgeries, things are done pretty much in the office, there are rarely any malpractice lawsuits, and they have hours that are unlike any other speciality of the same income. The lifestyle is very much desired because so many more hours can be dedicated to family and such- whereas anotehr type of doctor might be in the hospital for 12-16 hours a day.

 

[Compass]

IF. I might consider it, if I get to choose my time (I love days off, but weekends are always too short for me )

 

[Law2Doc]

IF. I might consider it, if I get to choose my time (I love days off, but weekends are always too short for me )

It's sort of moot -- just a few percent of the top students in med school can even consider derm. Wait until you are honoring med school and have crushed the boards before spending much time dreaming of derm.

 

[ghip]

It's sort of moot -- just a few percent of the top students in med school can even consider derm. Wait until you are honoring med school and have crushed the boards before spending much time dreaming of derm.

Consider whatever you want. You're not going to honor med school and crush the boards unless you have some serious motivation to do that. Unless you have some sort of inferiority complex, it's not going to come from just wanting to kick everyone's ass.

 

[braluk]

the thing is, if you had the choice to, would you even want to do derm if you dont have the passion to do it? I dont know if I would be able to do something involving skin for the rest of the my life if my heart isnt into it. Granted the lifestyle and the money are ridiculously extravagant, but I certainly wouldnt love the profession. I guess then it just comes down to a matter of money vs. passion.

 

[Rafa]

the thing is, if you had the choice to, would you even want to do derm if you dont have the passion to do it?

Because the job can leave you with more than enough money and time to pursue your passions - wherever they may lie.

 

[Johnny_one_eye]

the thing is, if you had the choice to, would you even want to do derm if you dont have the passion to do it? I dont know if I would be able to do something involving skin for the rest of the my life if my heart isnt into it. Granted the lifestyle and the money are ridiculously extravagant, but I certainly wouldnt love the profession. I guess then it just comes down to a matter of money vs. passion.

agreed. i was hoping i wasn't the only one thinking about this.

 

[Johnny_one_eye]

Because the job can leave you with more than enough money and time to pursue your passions - wherever they may lie.

that sounds like a bad reason to become a dermatologist

 

[QuantumMechanic]

that sounds like a bad reason to become a dermatologist

OK, there's not a "higher calling" to be a derm (usually, there are only so many cases of people with truly handicapping skin diseases) its a job and its a nice one at that. Lots of people lack "passion" for their careers yet they do enjoy their jobs. Being a derm is probably pretty satisfying work, you're still a doctor and you are regarded as an "expert" at your work, and all the while you still have to keep up with advances in the field. heaven forbid that someone desires to earn good money while also having a liveable lifestyle: with that logic, I guess those trolls that say that we shouldnt let many females into med school are right

 

[spospo]

my parents think i should go into derm. my dad says to do it for the money/schedule. my mom thinks i should do it because i (in fact our entire family almost) have a very weird fascination with skin. i won't describe to you what this all includes, but trust me, it isn't normal (no, not creepy, just a little weird to most people). maybe this fascination could become a passion, but as of right now, i will leave residency dreams alone and focus on just getting in.

 

[Rafa]

that sounds like a bad reason to become a dermatologist

Newsflash: nearly everyone in the history of humanity who's ever had a job got the job to enable a life outside of the job. A dermatologist isn't a pope - s/he's allowed to do what she wants, when she wants, with all the money she makes, the moment she's off the clock.

 

[braluk]

you make a very good point, and granted if my step scores are ridiculousy high and i am offered a derm spot, i really dont know if i would accept the position. As kumar said in harold and kumar, just because you're hung like a moose doenst mean you should go into porno (when asked about perfect MCAT scores lol). Instead, he did what he wanted to do, and that was to blaze up and get the perfect burger lol. Bad teaching tool i know, but you get the idea.

 

[Dunce]

Hello... None of their patients get better. Any condition a person has can only go into remission. (Can come back if you go off of medication). So they require constant observation and treatment.

that is an incredibly foolish statement

 

[chitowndr]

i think very few of you (and i dont mean to be rude) have a real clue what a dermatologist does. The work is hard, and you can make an immense difference in yoru patient's quality of life. Further, they don't make quite as much money as you would imagine, as malpractice insurance is incredibly high. Dermatologists get sued all the time. Its a lot easier to be unhappy with your treatment when you can see that something didn't clear up on yoru skin, vs. something internal (etc..)

That being said, the lifestyle is great, but by no means luxurious. It's not a part time job...

EDIT - id also add that the derms i know (my dad included) enjoy the profession because of the long term patient contact. I know my dad has seen some of the same patients for over 20-30 years, and he enjoys watching people grow up, start families, etc...

 

[geogil]

I've been shadowing a good friend of mine who's a derm for a while. When I asked him how much longitudinal patient contact he has, he said that he generally sees people perhaps an max of 3 times, with only a few 'repeat customers'. As a consequence, he has a large patient base of people who see him a few times ever. To rebut the claims that most derm conditions are incurable, I think this is bunk. Since most of us are college age/older, do you all have the same acne you had 16? no. What about fungal conditions that are readily treatable? not all dermatological conditions are chronic like exzcema (however you spell that) or psoriasis. In fact, a lot his office visits are spent reassuring patients that their mole is benign.

Derm is quite procedural, lots of little biopsies and surguries, ergo the income. It's also quite a cerebral specialty, a lot like pathology (I'm not saying other docs are dumb, let's not go there). As far as malpractice, my friend said that the insurance is about middle of the road, lower than OB/GYN, higher than psychiatry.

 

[ghip]

That being said, the lifestyle is great, but by no means luxurious. It's not a part time job...

In point of fact, it's a lot easier to make the part time thing work as a dermatologist than it is in most specialties.

 

[Rafa]

http://residency.wustl.edu/medadmin...62353a93c5c35cb186256f850071bd86?OpenDocument

^ Avg 42h/week. The only other specs that come close are path and psych (41 and 44 respectively).

 

[Law2Doc]

Newsflash: nearly everyone in the history of humanity who's ever had a job got the job to enable a life outside of the job.

Sadly, you are going to meet many many people who have no life outside of their job. Moreso on the doctor route than a lot of others, given the level of committment involved. Yes it's a lame existence, but you will see this enough to know it's not "nearly everyone in the history of humanity".

 

[Law2Doc]

Consider whatever you want. You're not going to honor med school and crush the boards unless you have some serious motivation to do that. Unless you have some sort of inferiority complex, it's not going to come from just wanting to kick everyone's ass.

I have no idea if you are agreeing with me or not. I'm not telling anyone to expect to honor med school or crush the boards, just that if you want derm, that will be involved.

 

[TMP-SMX]

that is an incredibly foolish statement

I was making a point. Relax...

 

[island doc]

Dermatology is the single most competitive residency in medicine, hands down. The high salary and wonderful lifestyle combine to make it the most sought after specialty there is, and the caliber of those few selected to enter this most coveted specialty reflects that.

I recently attended a conference where one of the speakers was a dermatologist. His CV indicated that he graduated from a major university summa cum laude before attending an Ivy League medical school where he graduated with "highest honors". A long list of publications along the way...

In my residency I worked with a dermatologist who made hundreds of thousands of dollars a year working four days per week with no evenings, no weekends, no holidays, and no call. Three day weekend every single weekend.