why the drop in compensation

To control costs is the simplest answer, compounded by increasing operational expenses -- we are taking hits on both side of the equation. Medicare sets the pace with private insurers quick to follow. There is no relief on the horizon that I can see -- people talk about "political will", and there is absolutely no societal sentiment to increase physician pay / medical costs. I believe that it is only going to get worse -- there simply are not enough dollars in the system to cover the costs associated with the care of an aging, obese, whiny, needy baby boom population....

 

Please when arguing these points with outsiders point out that physicians make up 6% of the healthcare expense in the United States.

 

Expenses, equipment costs and liability insurance is going up at the same time as reimbursements from insurance companies are going down. Some physicians are dealing with this by working longer hours, but you can only do that with so many hours. The trend is unlikely to reverse in the near term.

 

The cost of medicine has increased. People who would have died 50 years ago can now go on 20 different medications and live for another 15 years. All this costs money. Doctors are squeezed for money because the cost of doing medicine has increased.