teaparty123 said:
This is a great thread because this is not only true for derm but for any speciality. There is a direct correlation between $$ and competitiveness of residency and people always say we went into medicine to help people. if that was true we should all get the same salary. Medicine in Amercica is all about the money. Is it fair that any primary doc gets half as much as a specialist. Say FP, Peds or IM work hard if not harder than Derm, GAS, rad docs but get paid half their check and worse hours on top of that just because the specialist did one or two years more residency or scored 10 more points on their boards. So its not a fair world and the system will not sustain itself when this uneven distribution is happening.for example when i visited czech republic an orthopedic surgeon got the same paycheck as a mailman. Once the insurance companies collapse in US which will happen, you will get paid what people can afford and then non of this huge gap in salary and prestiege will exist between primary and specialist.
I think that's a little Orwellelian. The truth is the best medical care in the world is still practiced in the United States. It's no secret that European royalty prefer to be treated in the United States as opposed to their own physicians. It may not be a fair system but human beings are motivated by competition and greed. We have seen what happens to communist and socialist countries when there is no incentive to provide higher quality work. Competition is what has led to developments and achievements in this country.
And for all the "sky is falling" crap, physicians salaries have increased over the years. It hasn't risen with the rate of inflation as other fields. But if it had, can you imagine how sick some of these physicians would be paid, we are talking in the million dollar range. I remember in the early 80's when many physicians were earning more than proffessional athletes. What's funny is I heard some of the same arguments that are being made now 7 years ago. Not much has changed since then. In 1999, people were saying medicine would be socialized by 2005. Woops, guess they were wong!
And yes, I think it's fair that these specialists earn more. They sacrafice more of their personal life and mental health to be at the top of their class. They spend additional years of training. And they often have more responsibility. No offense, but the responsibility a radiologist has is considerable since many primary care physicians rely on their diagnosis to treat patients. i think they deserve their income. The same applies to a surgeon. Let's be honest 3 years of FP residency can't compare to the sheer hell that a general surgeon endures for 5 years. You can't tell me all residencies are equal.
My wife and I were discussing a very similar issue at an academic hospital. It's unfair that the attendings get paid similar if not equal salaries in most cases. The pediatric cardiologists and the NICU physicians bill more for the hospital and work twice as many hours than the dermatologists, allergists and rheum attendings yet they were paid the same wages. Guess what happened. Recently, the hospital changed it's policy and will now pay according to hours worked and patients being seen. All of these derm, rheum and allergy attendings started working longer hours and seeing more patients for the same income they were receiving when they were sitting on their butt or taking afternoons off. When they had no incentive to work, they didn't.
If an orthopedic surgeon is being paid the same as a mailman, then you will see the calibre and quality of orthopedic surgeons in that country drop considerably. I would never want to have my hip replaced by one of those surgeons and neither would you. Again maybe this is why foreign dignitaries hypocritically get treated in the United States instead of their own physicians. I bet you didn't know that.
Everthying in this country is run by large corporations and organizations with a lot of money. Medicine is no different from a wealthy organization that has self interests with well paid lobbyists on capital hill. Do you really think the 2 million or so physicians in this country would simply allow their income to collapse and allow a meltdown to occur. It's one thing to lose some reimbursement but it's another thing to have completely socialized medicine. It won't happen in our lifetime.