Why don't physicians work more regular hours?

[cge0]

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[CheA]

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[45408]

I think part of it is that kids in college don't necessarily know what it's like to have real bills that they have to pay without school loans. I live on $1800/mo now and it sucks. (Yes, I realize there are other people that have it worse.) You can't find a decent apartment in Philly for less than $750, maybe $650 if you're willing to go with a studio, maybe $600 if you're willing to have roommates. But then there's utilities/cable/internet on top of that so you're looking at another $100-150 or so a month. That's half my monthly income right there. Cell phone bill? I doubt you're paying less than $75/mo. It costs $40 even to fill up my super efficient little Corolla, which I have to do probably 3x a month. It adds up, kids. Not to mention my salary covers both me and my fiance most of the time because his work as a photographer is largely seasonal. I can't wait for him to go back into IT. My salary leaves very little space for enjoying life without feeling guilty for going out to dinner somewhere nice occasionally.

They'll learn when they're residents trying to make their avg $45K salary cover all this stuff and school loans. Better hope income based repayment is still around in 5 years.

Pffft, you don't need cable/Internet or a cell phone. You could also sell your Corolla for a much more economical bicycle. 😉

 

[NickNaylor]

Have you considered the possibility that some people stay idealistic (with a rational touch) even after they graduate from college?

If you cared to read my original post, I state that I have a research background. I'm well past college age, and have put in considerable time/money into pursuing medicine. None of the things that people complain about here is new to me.

Now, how many doctors do you see who can't put their children through college because they are still paying their educational loan? Since when does living in a rural area equate to not caring about your own life or salary? I never said anything about physicians needing to be paid less. Maybe you read too much newspaper comments and can't remember which claims got made where.

Since when did we start talking about wages or living conditions in the 3rd world countries? Did I miss something? I never said physicians get paid too much.

I have indeed considered that possibility, but there's a difference between rational and irrational idealism. In an irrationally ideal world, we all pursue our dreams, work in jobs that we're passionate about, and don't care about money. In the real world, we try and find jobs that offer the best compromise amongst these considerations.

And while you never outright said that physicians deserve to be paid less, I'm deducing from your comments that you very much believe that.

The comparisons to third world countries came up because wealth and wages are all relative. Again, you're all but implying in your posts that physicians should be happy to work for incomes that are lower than what they currently are because they should be pursuing their "passions." Of course to the average American, physicians should be happy with their $150k salary, and we should all be happy that we have the great honor of practicing in this noble profession for such a great salary. But by more or less implying that $150k is a salary no one should complain about, you're imposing your values and what you want out of life on everyone else. I'm not even disagreeing with you that $150k is a great salary. But you should be careful of implying that aspiring to earn more equates to greed and a lack of gratefulness on the part of college students.

I don't feel like I'm making some absurd conclusion here. Everything in your posts suggests that physician incomes should be reduced, and I'm not that only one that made that connection.

 

[Druggernaut]

So what are you suggesting? Physicians have to deal with some nasty patients and hence they deserve more money, more respect, more whatever than they currently enjoy, so that people like you would not be too scared to go into medicine?

I never said they deserve more money. I said they deserve to be paid well and ought to get some measure of respect. It's nothing to do with fear, since I'm not the 5'6" 110 pound female that he was threatening. It does make for an occasionally bad work environment, though, and unpleasant situations merit better pay and benefits. I don't begrudge the police for getting their pensions and early retirements. But mostly what I was saying was that many days there aren't enough of those warm and fuzzy moments to completely balance out the things that irritate you or make your skin crawl. That's where monetary compensation comes in.

Did your friends go to college for free?

Nope, those that completed their degrees finished with comparable levels of debt. The ones who steered clear of private univerisities have about 1/20th of what my medical school debt will be, and faced a significantly easier courseload. Job satisfaction doesn't wipe these concerns away.

I agree. I wouldn't do it if doctors got paid 40k. But the reality is, they get paid >150k.

From your initial post, I took you to mean that you were of the camp that doctors should only care about helping their patients, and they should sacrifice their personal and financial lives for the greater good. If that's not the case, I'm really not sure why we're discussing this. I'm not pushing for more money, and you're not clamoring for less. Copasetic.

 

[45408]

Okay. I agree residents don't have a choice on where they live DURING RESIDENCY. I have more sympathy for non-traditional students who will be near their 40's when residency is done, but no sympathy for straight-out-of-college applicants who will be 30 when they are done.

Because those of us who went right to med school don't have houses or families?

Poor people don't brag about living poor. They talk about how living modestly works when medicine-bound college kids don't think they will have a comfortable posh life on their >150k salary because they will be 200k in debt. I have no idea why little pieces of you die when you hear this, btw.

Who was talking about a $150K salary? We said $2K/month, remember?

As an example, when I graduate medical school, I'll have somewhere around $160k in debt (which includes interest on the loans that is capitalized). If I wanted to pay that back in 7 years, it would require monthly payments that are greater than $2,000. How am I supposed to do that on a monthly salary of $4,000 as a resident? So right there, that's 3-5 years where you can't make much headway on the debt unless you have a spouse that's supporting you.

Living on 2k/month? It might not be lush living, but it's not exactly poverty either. I can understand not wanting to live that way for 7 years though.

In a lot of the coastal big cities, 2k per month barely covers rent on a studio apartment, utilities, car insurance and gas, and your phone bill. And that's assuming we are talking about after tax dollars, which we aren't. And then there's pesky things like groceries. So yeah, that's going to have you living pretty badly. Also FYI, 2k/month is 24k/ year, which last I checked was in the ballpark of what we call the poverty level. So yeah, it is "exactly poverty".

Go live in a place where real estate is cheap. That's where they need more doctors anyway. I do just fine with my ~$1,500 after tax paycheck that I get 11 months of the year. I can even save ~$500 every month if I didn't eat out every day. Or if you can't do that, at least appreciate that there are people who cannot afford to live wherever they want to. Yes I'm single and don't have a family, but most people have both spouses make money these days.

If those are your primary concerns, why are you going into medicine? If you really have a passion for something (helping those in need, or even just doing something worthwhile as your job), all of these would be secondary concerns. People with passion don't choose their career after having gone through cost/benefit, sacrifice/6-figure-salary analysis based on their impeccable logic.

There it is, the guilt trip with a twist of Burnett's Law.

 

[CheA]

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[CheA]

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[CheA]

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[Iso4ane]

I don't see why the doctor should be held responsible for the populace's lack of empathy. I don't know what it's like to be a top 1% income earner. Empathy and common sense should be embraced, and doctors shouldn't be a political loop hole or target.

I'd also imagine doctors facing a 30% pay cut got severely annihilated by their financial obligations... It's silly to think they just stow away money because they make a grandiose amount. I'm sure at least someone's credit was tarnished by such a drastic pay cut, and lost more money than the face value of -30%. You can't play god with someone's financial situation. I've never heard of such a drastic change going over smoothly before in my life.

I hope you realize to be in the top one percent a household (one or two earners) would need to make only 250K.

 

[circulus vitios]

I want to stop but these great comments keep coming up.
Too many people today have this idea that being a professional in an urban area by the time they are 25 and retiring by the time they are 35 is the only true success. No, early 40s is a GREAT time to starting living the life you want to.

Status Pre-Medical

 

[Longshanks]

So how about this: My position is that physicians get paid adequate amount of money as it is now (more than adequate depending on specialty), and people should not be discouraged from pursuing medicine because of the fear of not being able to live a satisfying life due to educational debt. I for one am not worried about incurring 150k debt during medical school for I have seen people live satisfying lives on much more financially challenging conditions. I'm not contradicting myself, am I?

So since someone else made their life "satisfying" on more modest earnings means that everyone else should be satisfied with that, or accept that despite training for 8-15 years and incurring debt during that time, they shouldn't want more for being in a high demand service that requires advanced training and technical prowess? Or since you're not worried about being an indentured servant to your debt means we should take it in stride as well? I've seen people lead satisfying lives, from their perspective, while they're fat or addicted to illicit drugs, should we want or do the same just because they find it satisfying? What puts in you any position to totally infringe on another's liberty and freedom to say what salaries are fair and moral?

 

[circulus vitios]

So since someone else made their life "satisfying" on more modest earnings means that everyone else should be satisfied with that, or accept that despite training for 8-15 years and incurring debt during that time, they shouldn't want more for being in a high demand service that requires advanced training and technical prowess? Or since you're not worried about being an indentured servant to your debt means we should take it in stride as well? I've seen people lead satisfying lives, from their perspective, while they're fat or addicted to illicit drugs, should we want or do the same just because they find it satisfying? What puts in you any position to totally infringe on another's liberty and freedom to say what salaries are fair and moral?

The guy is either incorrigibly stupid or a master troll.

 

[Kaustikos]

I'm just gonna follow the Wesley Snipes rule of making $$. Avoid paying....

Move to another country and just chill there while still doing consults for patients in the US. I'll have a swiss account to transfer moneyz for said consults. Problem solved....

 

[MacVA]

Just wanted to say that it isn't difficult to live on a resident's salary IF you are single... And you make about $2,500 a month after taxes...

 

[NickNaylor]

So since someone else made their life "satisfying" on more modest earnings means that everyone else should be satisfied with that, or accept that despite training for 8-15 years and incurring debt during that time, they shouldn't want more for being in a high demand service that requires advanced training and technical prowess? Or since you're not worried about being an indentured servant to your debt means we should take it in stride as well? I've seen people lead satisfying lives, from their perspective, while they're fat or addicted to illicit drugs, should we want or do the same just because they find it satisfying? What puts in you any position to totally infringe on another's liberty and freedom to say what salaries are fair and moral?

This is a very good point.

CheA, I hope you understand that I'm not trying to troll you. Your attitude/perspective is just all-too-common in the public, which makes *****s that didn't graduate from college and living off state assistance somehow feel entitled to argue for diminishing physician salaries because THEY MAKE TOO MUCH!!111 Your perspective en masse could result in a very real move by politicians (through their control of Medicare and Medicaid, which serve as the benchmark by which private insurers base their reimbursement rates) to cut physician salaries "because they make too much." This is what concerns me. Take a look at the comments of an online NY Times article about healthcare reform to get an idea of what the uneducated public thinks about physician salaries.

I would like to think I'm not a greedy bastard. I'm just very, very concerned that people think it's ok to diminish the wages of another because, from their perspective, they make too much when they simply don't understand what's required to become a physician with respect to both time and cost. As a future physician that prospect makes me worry, and frankly I think it should make you worry as well.

 

[CheA]

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[45408]

Take a look at the comments of an online NY Times article about healthcare reform to get an idea of what the uneducated public thinks about physician salaries.

If they're reading NYT, then they're not even the uneducated ones. The HuffPo comments really pain me, and I can almost never stoop to the level of the Daily Kos.

 

[Quizlet04]

Big difference between research (PhD) professors and doctors (MD) is that the PhDs GOT PAID to go to school (to the tune of around 25K a year most likely) for around 5 years while the MDs and DOs PAID to go to school (up to 60K a year) for 4 years. They then made about the same amount of money doing post-doc work/residency. The MD/DO will pull ahead after residency but keep in mind that the doctor is now most likely in about 100K+ worth of debt (could be much more) while the PhD is probably sitting on very little to no educational debt. So yeah, young PhDs aren't feeling too bad.

I am speechless at your ignorance. Let's try a few weird things called facts. I have a PhD in neuroscience, as a background:

1) If your PhD is in clinical psych, you paid. If your PhD was in something non-science, you most likely paid. The rule of being paid is not universal.

2) After taxes, I made $1683 a month (22K/year before taxes). My salary only covered 10 months, so I effectively made about $1400 a month. This was in a major city where the rent for a studio apartment was 1000 a month. So that leaves 400/month for electricity, any phone, food, transportation, school supplies like textbooks or electronics, health insurance (mandatory), etc. Most of us took out loans, had jobs, or both.

So it's not free. It's not as expensive, but it's damn not free and the average PhD will not make as much as an MD, ever.

3) Most PhDs do not go on to tenured positions anymore. The field is so saturated (even mine) that most of us are adjuncts, aka slaves. The average salary of an adjunct is something like 3.5K a course, depending on where you live and the type of school. No benefits, no security, not even a goddamn office. You can teach a course for 6 years and a full-timer comes in, booting you out, and you get jack...not even unemployment.

So we go to school for 6 years and emerge either with some debt or no debt but no savings...and get stuck in jobs that are barely better than minimum wage.

Its always hard to compare the fields anyway because a lot of what research professors do is sit in their office all day and write grants/check up on grad students/SOMETIMES teach class (mostly on the younger guys)/go to department meetings.

Those are the absolute top tier of the department...like 4 people. At non-research institution (small, liberal-arts colleges), teachers have a 4/4 load. At a research institutions, it's probably 3/3.

Also, grant writing sucks ass in ways you can't imagine: most of your salary and those of your students depends on convincing the government that your research is worth it.

Plus you discount tenure like its nothing...having a basically guaranteed job for the duration of your stay at the university is nothing to sneeze at. Like you gave in your example, its usually the young guys who don't have tenure who work longer hours. There are professors who choose to keep working hard after they get tenure but there are some who barely keep their labs running too. Its basically about how much you want to keep your reputation up.

Tenured positions are VERY hard to come by nowadays. A lot of schools are heading towards adjunct or non-tenure labor. Those guaranteed salary days are over.

I've heard PhDs bitch about pay too at times...basically everyone in the world thinks they're overworked and underpaid. Sometimes its true, sometimes it isn't. There's a lot more opportunity for PhDs to work "regular hours" than MD/DOs though.

A PhD is a waste of time in most fields nowadays. After six years, you are absolutely worse off than if you went into another field.