You know whats sad about going into derm

Discussion in 'Dermatology' started by ihatesurgery, Nov 19, 2005.

  1. ihatesurgery

    ihatesurgery Junior Member

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    If dermatologists were earning less than internists and peds only FMG's would apply to derm. Unfortunately, when reimbursements change in 3-5 years and "procedures" get less payment, guess who's going to end up depressed?
     
  2. darrvao777

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    Who are money-seeking people who got into medicine for that reason seeing as declining payment has been the general trend in most fields of medicine for 5+ years?

    Solid answer!
     
  3. ny skindoc

    ny skindoc Senior Member
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    The attraction of Derm is not primarily money.Its a "lifestyle" field with a low stress residency compared to other fields and regular work hours afterwards, and many fewer "hassels" than most specialties.Those who seek high $$ can do much better on average in rads,gas,surgical specialties.
    Derm does pay well for the time worked which is a plus,due to the volume patients seen.The actual pay for most basic procedures is not high and has like most other things in medicine long sice been cut.I agree that you need to practice that which interests you. Thats true for most Derms I'v met.I doubt they would switch into internal medicine even if it paid more.
     
  4. teaparty123

    teaparty123 Junior Member
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    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.
     
  5. ny skindoc

    ny skindoc Senior Member
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    Much of what you say is true.People have been talking about increasing payment for cognitive services for over 20 years.... they should be reimbursed at higher levels..Some kind of meltdown in medicine is coming but physician fees only account for around 10% in the escalation of health care costs .Sadly from what I have seen the only things most patients themselves are happy to pay out of pocket for are cosmetic services.
     
  6. novacek88

    novacek88 Senior Member
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    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.
     
  7. CatsandCradles

    CatsandCradles SDN Donor
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    Wow, that was quite a thought provoking post.
     
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  8. Unemployed

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    Derm is the dentist of medicine
     
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  9. Unemployed

    Unemployed Senior Member
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    Derm is the dentistry of medicine.
     
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  10. darrvao777

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    I gotta agree.

    Can't put a price on being able to go home at 5pm when your fellow colleagues are worrying about call and being able to stay awake at 2am

    The higher than average pay is just an added bonus!
     
  11. ny skindoc

    ny skindoc Senior Member
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    Endodontics is the dermatology of dentistry!
     
  12. SuperTrooper

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    huh?! If there were a "dermatology of dentistry" it would have to be orthodontics. Also, Derm is NOT the dentistry of medicine. Ophthalmology is the dentistry of medicine.
     
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  13. *ahem* ...and what do you mean by that? ;)

    Really -- I want to know!
     
  14. sjkpark

    sjkpark Senior Member
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    It depends on how you define "best medical care," individual vs. population etc.
     
  15. sjkpark

    sjkpark Senior Member
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    And colorectal surgeons are plumbers of medicine?

    And what's wrong with dentistry? We're just jealous because they've got the more pleasant end of the digestive tract.
     
  16. teaparty123

    teaparty123 Junior Member
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    Well its nice to see that you're so patriotic about your country but i hate to break the news to you that the U.S. is not the best country for medical care. Perhaps you mean in spending because we are the number one spending country in medical care in the world but we rank in the 20's for standard of care in the world and that's not surprising. Also since when are doctors in the U.S. superior to the rest of the world is it because they get paid the highest? well I would certainly trust an orthopedic surgeon in europe to take care of me because they have had adequate training like any other country and i wouldn't judge their skills because they get paid the same as a mailman. This is the attitue that will bring the U.S. system down that we can spend all the money on all expensive tests and procedures and charge the insurance comapnies like crazy and we will set the standard in the world. Insurance comapnies are reimbursing less and less, premiums are increasing everyday and the number of uninsured americans are sadly increasing. As a U.S. born and raised citizen i'm not saying that we have a horrible system but we have an unfair system where some specialists are way over paid and it will eventually hurt the system. I saw that you compared the surgical residency to FP. Lets not comapare apples and oranges but the unequality that even exists withing specialists; paychecks are similar in Derm and Surgery; hmmm thats a no brainer who worked their butts off for five years and get paid the same as one who dont undrestand what call means, that's only one example there are many unequalities not only between primary and specialist but within specialists..and we all know when there are a big gap between these groups somethings will change...And i'm not saying i'm in favour for a socilaist system either they have their own problems, yes there is no perfect system but when the gap of unequality increases..a crash or maybe a better change will happen, you maybe right it will take a while to happen. Sadly its all about the $$ and not the well of people.
     
  17. teaparty123

    teaparty123 Junior Member
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    and i forgot to mention...dentisry is definately a smart way to go if you like teeth.
     
  18. No, I meant how is ophthalmology the dentistry of medicine? What does that say about ophthalmology? I've heard the saying before, but have never figured it out.
     
  19. toofache32

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    Derm and Ophtho both seem pretty close to dentistry as far as hours and pay, maybe he meant Ophtho focuses on one small area of the body. I'm not sure.
     

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