Would any of you NOT want more money?

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Attila

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I was reading the 'declining salaries' thread and I was surprized by the the number of people arguing that medical compensation is adequate given the amount of debt we have and time invested in both work hours and reading time - regardless of whether compensation has or has not been declining.

Does anyone think that medical salarys are too high? Would you be opposed to an increase if one were somehow negotiated?

I'm a little surprized by this point of view and would like to understand it better. Personally, I consider myself to be a good doctor and I do my very best to maintain and improve the service I offer. But I've never thought of my medical skills as anything other than a marketable commodity. Is that wrong somehow?
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i think it would depend on what was given to the doctor in exchange for their accepting a lower salary. docs in countries with national healthcare systems make less, but also don't have to deal with a lot of the logistical crap american docs do. i also understand some european med students don't pay tuition, so that also would have value. i would be willing to accept less pay, but not without getting something in return. and i'm not going into primary care, where i think their poor compensation is part, but not all, of why med students are going into those fields less. i also would only accept less pay if i knew that money were staying in the hands of patients, not going into the hands of some middle-man (ie, Aetna shareholders). that would really piss me off.
 
mlw03 said:
i think it would depend on what was given to the doctor in exchange for their accepting a lower salary. docs in countries with national healthcare systems make less, but also don't have to deal with a lot of the logistical crap american docs do. i also understand some european med students don't pay tuition, so that also would have value. i would be willing to accept less pay, but not without getting something in return. and i'm not going into primary care, where i think their poor compensation is part, but not all, of why med students are going into those fields less. i also would only accept less pay if i knew that money were staying in the hands of patients, not going into the hands of some middle-man (ie, Aetna shareholders). that would really piss me off.
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Primary care lack of competitiveness is all about the money.
 
A lot of people are complaining about the declining salaries in primary care. I plan on going into primary care IM after I finish residency, and yes, I do believe that PCPs are underpaid compared other specialties. I think a lot of it stems from the fact that PCPs can't really bill extra for time spent educating and counselling patients, which is vry time consuming, and a big part of the field. That being said, I would much rather be an internist today, making less money than internists 10-15 years ago. Internists used to have an extremely busy schedule. They would have a full schedule of patients to see in the office everyday. Also, they would have to round on the patients in the hospital before and after clinic, and on the weekends and holidays. They would get calls from their patients at home, plus calls from the hospital regarding their inpatients. Nowadays, most Internists either focus only on outpatient medicine or on hospitalist medicine. If you choose to do office practice, you can basically work M-F 9-5, or whatever hours you choose. You can have an answering service for the patients who try and contact you. You get weekends and holidays off. If you practice in a group, you can have many more vacation days. If you are a hospitalist, you can have great hours, depending on where you work. You are salaried by the hospital and don't have to worry about running an office. So yes, in situations like these, I would be content making less money, if it meant doing less work.
 
Faebinder said:
Primary care lack of competitiveness is all about the money.
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on what do you base that opinion? other lifestyle factors and interest in that type of medicine are also extremely important, at least to me. i wouldn't do internal medicine even if it paid twice what it currently does, and that is due entirely to my lack of interest in practicing that kind of medicine. i have many friends and classmates who feel similarly about various primary care fields - it's NOT all about the money, not to a lot of us (I hope).
 
mlw03 said:
on what do you base that opinion? other lifestyle factors and interest in that type of medicine are also extremely important, at least to me. i wouldn't do internal medicine even if it paid twice what it currently does, and that is due entirely to my lack of interest in practicing that kind of medicine. i have many friends and classmates who feel similarly about various primary care fields - it's NOT all about the money, not to a lot of us (I hope).
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Alright.. lets assume you double the money of primary care to become something like what radiology makes...

Scroll over to the little poll in the thread here.... see how many people chose their specialty for money... you will notice it's almost 9%. Lets say that the people posting here are an approximation of real life population of applicants. Can you imagine 10% of the docs suddenly shifting to primary care? Lets say they split even... IM/FM/Ped. Lets take FM as an example. FM already takes like 10% of the applicants....suddenly they have 3% more people interested in it... that's 30% more.. Do you think 30% of FM is unmatched post match? It would become competitive. Heck lets say only half of that is interested in switching... the others insist on making money but being in a non-primary care specialty.... then it's 15%.... NRMP shows that last year FM filled 85.1% of its position in the match.... so that 15 percent would pretty much plug it and make FM competitive.

Apply this to Peds and IM.

You might say this is all based on a couple of assumptions... yes but the assumptions are valid estimations: 1) that that poll represents the population (since it was done anonymous), heck since we see results here some people might be too embarressed to tell the truth that money matters.... 2) and that half of those money interested people will want to switch to primary care (this assumption is actually an underestimation because not all the money making specialties are as good life-style wise as primary care.)

Questions? Arguments?
 
KentW said:
IMO, family medicine is the ultimate "lifestyle specialty." Too bad it's such a well-kept secret. ;)
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Well said O caffinated underdog! But I think pathology trumps FM when it comes to life style. heh.
 
Attila said:
I was reading the 'declining salaries' thread and I was surprized by the the number of people arguing that medical compensation is adequate given the amount of debt we have and time invested in both work hours and reading time - regardless of whether compensation has or has not been declining.

Does anyone think that medical salarys are too high? Would you be opposed to an increase if one were somehow negotiated?

I'm a little surprized by this point of view and would like to understand it better. Personally, I consider myself to be a good doctor and I do my very best to maintain and improve the service I offer. But I've never thought of my medical skills as anything other than a marketable commodity. Is that wrong somehow?
Click to expand...

You are very correct, but there are a lot of people that believe medicine is some kind of cult of which all members should sheepishly comply with all conditions of service. Like brainwashed cult members they want to sacrifice more and more to prove their genuine commitment. When I hear people say stuff like "nothing wrong with 40 hour shifts" or "I don't mind a paycut as long as I get to help people" I am not quick to assume they are saying it out of nobility, as I recognize it could easily be a manifestation of their inept perception of reality.
 
mlw03 said:
on what do you base that opinion? other lifestyle factors and interest in that type of medicine are also extremely important, at least to me. i wouldn't do internal medicine even if it paid twice what it currently does, and that is due entirely to my lack of interest in practicing that kind of medicine. i have many friends and classmates who feel similarly about various primary care fields - it's NOT all about the money, not to a lot of us (I hope).
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I am confused:confused: . What does "that kind of medicine" exactly mean?
 
dutchman said:
You are very correct, but there are a lot of people that believe medicine is some kind of cult of which all members should sheepishly comply with all conditions of service. Like brainwashed cult members they want to sacrifice more and more to prove their genuine commitment. When I hear people say stuff like "nothing wrong with 40 hour shifts" or "I don't mind a paycut as long as I get to help people" I am not quick to assume they are saying it out of nobility, as I recognize it could easily be a manifestation of their inept perception of reality.
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You have to understand that your interest in "that" kind of medicine depends highly on what your mentors in med school thought of "that" kind of medicine.

Allow me to show you exhibit A.

http://www.stfm.org/fmhub/fm2003/September/Campos-Outcalt.pdf

This article for example shows you that your perception of medicine is determined by what you hear in med school. You hear negative comments about Family Medicine... you stop wanting to practice "that" kind of medicine.

I got more if you want....

Check out this link.

Allow me to restate the obvious... it's all about the money... otherwise you wouldn't hear negative comments... and more people would be doing "that" kind of medicine.
 
Faebinder said:
You have to understand that your interest in "that" kind of medicine depends highly on what your mentors in med school thought of "that" kind of medicine.

Allow me to show you exhibit A.

http://www.stfm.org/fmhub/fm2003/September/Campos-Outcalt.pdf

This article for example shows you that your perception of medicine is determined by what you hear in med school. You hear negative comments about Family Medicine... you stop wanting to practice "that" kind of medicine.

I got more if you want....

Check out this link.

Allow me to restate the obvious... it's all about the money... otherwise you wouldn't hear negative comments... and more people would be doing "that" kind of medicine.
Click to expand...


interesting articles and comments, but i'm still going to have to respectfully disagree that it's not all about the money. it's also about the exposure to the field as a med student. example: at our school emergency med is an MSIII clerkship laden with procedures, good hours, and cool faculty, and at our school we have a very high percentage of students wanting EM. OB on the other hand kills us with hours, many of us never go super involved because the residents just wouldn't let us, and some of the faculty were downright scary, and not a ton of our students pick OB-gyn. i think the same applies to FM; at the outpatient clinic we do most of our FM at there are almost no pediatric or gyn cases. so our "exposure" to FM isn't what real FM is supposed to be, and i think influences student choices way more than the fact that all of our faculty are doing just fine financially and rarely leave the clinic past 5:15 in the evening. students notice these types of things, and they weigh such factors along with salary and interest in practicing that type of medicine for the rest of their careers.

the assumptions you make actually seem somewhat legit, although of course we'll never see if you're right since FM will never pull down what rads does. i guess we're going to have to agree to disagree on this topic.
 
the kind where you get paid the most money for the least effort.

that seems to be the trend anyway.
 
Whodathunkit said:
the kind where you get paid the most money for the least effort.
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Most of the so-called "lifestyle" specialties (gas, rads, EM, "easy" surgical subs like urology, ENT, etc.) still involve getting up at o-dark-thirty and working nights, weekends, and holidays on a regular basis. They're not easy. People in hospital-based fields also give up a lot of autonomy. This isn't always easy, either.

Whatever field you go into, plan on having to work. You'd best make sure you enjoy the work, 'cause if you don't, the money won't keep you happy for long.

Few things take as much effort as doing a job you dislike.
 
Whodathunkit said:
the kind where you get paid the most money for the least effort.

that seems to be the trend anyway.
Click to expand...

Touche'
touche.gif
 
KentW said:
Most of the so-called "lifestyle" specialties (gas, rads, EM, "easy" surgical subs like urology, ENT, etc.) still involve getting up at o-dark-thirty and working nights, weekends, and holidays on a regular basis. They're not easy. People in hospital-based fields also give up a lot of autonomy. This isn't always easy, either.

Whatever field you go into, plan on having to work. You'd best make sure you enjoy the work, 'cause if you don't, the money won't keep you happy for long.

Few things take as much effort as doing a job you dislike.
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KENT!!!
twak.gif
What do you think you're doing?
whoopin.gif
Stop making people think it's okay to come to primary care! We need to reduce supply...
rant.gif
 
KentW said:
Few things take as much effort as doing a job you dislike.
Click to expand...

You think garbagemen, janitors, and dishwashers truly enjoy their work. Ultimately, very few jobs that people do bring them personal satisfaction. And for those people that can't do(or afford) their dream job, work is a means to an end.

There's this one dude that posted a few days ago that he only works 3 days a week(12 hr shifts). I'm sure people are envying him about right now as he's likely getting paid more than the average 50-60hr/week primary care physician.
 
Whodathunkit said:
Ultimately, very few jobs that people do bring them personal satisfaction. And for those people that can't do(or afford) their dream job, work is a means to an end.
Click to expand...

You'll likely wind up exactly where you expect to be, so set your expectations accordingly.

There's this one dude that posted a few days ago that he only works 3 days a week(12 hr shifts). I'm sure people are envying him about right now as he's likely getting paid more than the average 50-60hr/week primary care physician.
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I think you're referring to Apollyon. No envy here.
 
aggernodi said:
Not that I'm opposed to higher salaries, but when the public sees rankings like this put out by the US Bureau of Labor Statistics:

http://www.bizjournals.com/specials/2006/0313/401_jobs.html

It's hard to find/get any sympathy.
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I find it very hard to believe that dentists (I am assuming that they are including orthodontists, endodontists, etc) are that far down the list. And when it says "teachers" are they implying that these are professors?
 
I think that it is totally natural for anyone to want the most possible income in their chosen profession. With today's debt involved with being a physician, Docs from other generations really have no way of empathizing with our situation.

I think that one aspect of EM that has sounded so good, even if in the back of my mind, is the opportunity to moonlight/teach/etc to bring in that needed extra $$ for the first few years while I try and tackle this debt.

Also, one has to consider that a doc with large debt, a family of three kids, and resides in an area of outrageous real estate prices will have a MUCH higher emphasis on income than a single doc that went to cheap school and/or comes from money.
 
dutchman said:
You are very correct, but there are a lot of people that believe medicine is some kind of cult of which all members should sheepishly comply with all conditions of service. Like brainwashed cult members they want to sacrifice more and more to prove their genuine commitment. When I hear people say stuff like "nothing wrong with 40 hour shifts" or "I don't mind a paycut as long as I get to help people" I am not quick to assume they are saying it out of nobility, as I recognize it could easily be a manifestation of their inept perception of reality.
Click to expand...

This is the most honest representation of the problems in medicine that I have ever seen written. Touche :)
 
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