Physician salaries in America - are they too high?

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As healthcare in this country continues to evolve, and perhaps moves towards a single payer for all system in the years ahead, what are your thoughts on how physician salaries factor into everyday healthcare costs?

Are they too high? Too low? Just right?

According to the Bureau of Labor Statistics from May 2015, physicians and surgeons in this country have a mean annual wage of $197,700 - http://www.bls.gov/oes/current/oes291069.htm

For surgeons specifically, the average is salary is $247,520 - http://www.bls.gov/oes/current/oes291067.htm

Under a single payer system, many believe that physician salaries would take needed a hit to provide cost savings for patients, upwards of a 30% - 40% drop in salary. Others cite the 4 years of college, 4 years of medical school, and 3-7 years of residency as too much training for physicians to incur such dramatic cuts to their salary, and that a single payer system would disincentivize the best and brightest from entering the field.

While it's difficult to say exactly how the continual evolution of the health insurance system in America will affect costs overall, do you feel that some of those potential savings should come at the expense of physician salaries?
 
I honestly don't believe you can pay Emergency Room doctors enough - they literally save lives on a daily basis. Surgeons as well.
 
I'd rather not physician, nor surgeon, salaries decrease. While there are plenty of stories out there about doctors that entered the field solely for the salary, the majority of doctors I've been to have been passionate about the field. With the amount of training required for the field, I can't bemoan them making a lot of money.

If the cost of entry was a bit lower, I might be able to see it--though I'm perfectly fine with surgical professionals continuing to make high wages, as in many cases that's not a skill that can be taught effectively; If you don't have the hands for it, you face an uphill battle to steady yourself.
 
Unless the govt start heavily subsidizing med schools, I don't mind the high salaries. Doctors are usually 300k plus in the hole after finally starting their careers.

We actually need more physicians since med school students find the specialities more attractive due to higher average salaries.

Although PA programs are helping close the gap in primary medicine.
 
Yes. We should focus on MD salary! But CEOs, hedge fund managers and financiers.. those gents couldn't be paid enough.

Someone working their tail off to save lives (and who usually carry massive student debt) should be paid. We need to stop valuing capital over skilled labor. It's easier to be poor and become an MD than it is to be poor and find yourself running a hedge fund.
 
Definitely not. People working in healthcare have an enormous amount of responsibility. In fact, I'd say some professionals are paid too little.
 
I'm totally fine with doctors making that much money. They basically give up nearly a decade of their life just to get there, and then they're responsible for people's wellbeing on a daily basis thereafter. I'd say, at that point, they've earned it.
 
Medical school is very expensive and takes a long time. I'd rather see other workers salaries increase rather than having Doctors salaries reduced.

Many doctors also have to pay high prices for individual Malpractice insurance because of bloated damage awards given out to patients that have horrible things happen to them. That is often not subtracted from the kinds of salary numbers that are listed in the OP.

In countries other than the USA if a doctor makes a mistake and causes something horrible to happen to someone, then that is a horrible thing, but it doesn't give them the right to collect huge multi-million dollar settlements from the collective insurance pool. I would say we should talk about this problem before we talk about Doctors salaries.
 
Salary is high because it's a difficult job to get into, so there is a smaller candidate pool. When you have fewer of a resource, it has higher value. Increase the candidate pool should bring down the cost as more people compete. Which is why college education needs to be reduced in price, to create the opportunity for more of a resource.

Or something like that.
 
It sounds reasonable, but there's the fact that the amount of doctors entering the field are literally artifically constrained definitely would help keep them high.

In theory the pay would go down with that gone, but so would the work hours, and you'd have more time with the doctor per patient.

NoblesseOblige said:
Salary is high because it's a difficult job to get into, so there is a smaller candidate pool. When you have fewer of a resource, it has higher value. Increase the candidate pool should bring down the cost as more people compete. Which is why college education needs to be reduced in price, to create the opportunity for more of a resource.

Or something like that.
Click to expand...

It wouldn't matter if college price was reduced in this case, the number of new doctors that can enter the field are carefully constrained purely by slot count.
 
Considering how much debt and time people spend to become doctors, the hours doctors spend on the job, and the amount of money they have to spend on insurance, I don't think it's too high.
 
I think we should talk about CEO salaries before we look at Doctor's. Doctor's are at least usually productive members of society and an essential cog in the machine.
 
The expense and lengthy time commitment of med school makes the salaries appropriate. I know it won't be a popular idea but I think there should be a level of doctor that requires less schooling and thus make less. Perhaps a 5 year program.
 
Physician salaries are a drop in the bucket.

When you have fifteen nurses in one wing on one shift and one physician looking over that wing, the physician's salary doesn't matter much.
 
I think the big key is reducing the length of time/tuition $$$ required to become a doctor. I have to imagine it can be streamlined significantly.

AI advancements should bring pretty big market pressure to change that in the next 20-50 years, I would imagine.
 
Doctors are paid a perfectly reasonable salary, all the insane graft, corruption and thievery that goes into the entire medical, pharmaceutical and insurance system is what makes medicine so expensive in the USA, not salaries.
 
considering they spend like 5 or more years making basically minimum wage as residents, I'd say they earned their money by the time they start collecting it
 
FyreWulff said:
It wouldn't matter if college price was reduced in this case, the number of new doctors that can enter the field are carefully constrained purely by slot count.
Click to expand...

It would still matter in that case. Even if you limit your slots to 1, if you get 10 people who qualify to fill it instead of 5, then you're more likely to find someone willing to take lesser pay.
 
SG-17 said:
I think we should talk about CEO salaries before we look at Doctor's. Doctor's are at least usually productive members of society and an essential cog in the machine.
Click to expand...
CEO salaries are already regulated. You need to look at total compensation, which include stocks and other bonuses.

That's what caused the discrepancy. This was a instance were regulation actually made it worse.
 
You are forgetting

1) The amount they have to spend to become trained doctors/surgeons.
2) The fact that they don't start making those large incomes till a later age.
3) The opportunity cost of 11-15 years of training (compared to 3-6 for most other graduates who don't do a PhD.)
4) Malpractice insurance costs.
 
There's a lot of literature on this worth looking into. A good starting place would be T.R. Reid's "The Healing of America."

The short answer is: Yeah, probably.

The long answer is: Within the broader context of the US healthcare industry, not really. The income of a physician is actually on the lower end of the spectrum – the way the system is set up in the US, specialists make significantly more.

At the risk of stating the obvious, there are systemic problems related principally to barriers to access in the US that allow prices to soar. The other side of this is that the US also tends to have an abundance of specialists; the downside is that most of us can't afford to access them.

As to whether a shift to a single-payer system SHOULD come out of the provider's salary? It's not really a normative issue: under a single-payer system, and with a less restrictive pharmaceutical import policy, prices would come down as a consequence of market forces. Although it's hard to determine the magnitude at which this would affect healthcare providers directly, it has potential to put some significant downward pressure on their income.
 
I am pretty sure that physicians salaries are not a significant factor in the cost of our healthcare.

Their decisions can be though.
 
Sulik2 said:
Doctors are paid a perfectly reasonable salary, all the insane graft, corruption and thievery that goes into the entire medical, pharmaceutical and insurance system is what makes medicine so expensive in the USA, not salaries.
Click to expand...

It's the corporate business side that makes it so expensive.

As another poster says, let's stop trying to cut salaries of front line workers that contribute to society and instead focus on the ridiculous amount bankers and corporations make.

Yay capitalism.
 
no, not at all. Of all the fields in the human work force, doctors are one of the most crucial and required fields we have. They literally keep us alive. They are the last people to see a salary cut.
 
NoblesseOblige said:
It would still matter in that case. Even if you limit your slots to 1, if you get 10 people who can fill it instead of 5, then you're more likely to find people willing to take lesser pay.
Click to expand...

But they're still going to have to work absurd hours and command a lot of money once overtime hits. IMO, all public service jobs (medical, fire, police) should go for more people on the roster than more hours per person. If I had my way overtime would be completely prohibited for those jobs, not because I don't want those people to not earn more money, but I think it's a little too tempting to burn your whole body down, mistakes start piling up, and you're just a husk at the end of it all.

But most of the real cost of healthcare is the adminstrative...
 
MrVargas said:
. I know it won't be a popular idea but I think there should be a level of doctor that requires less schooling and thus make less. Perhaps a 5 year program.
Click to expand...

They're called mid-levels, and are specifically either Nurse Practitioners or Physician Assistants. Schooling is a bit less than 5 years, and while they can perform certain procedures and prescribe certain medications, they don't have the autonomy (or the full depth of training) as a physician, and thus usually cannot work independently.
 
I really wanted to be a doctor when I was growing up, but that dream was shattered by my colorblindness. The sheer amount of schooling, residency, and debt acquired seemed daunting, but it seemed worth it in the long run. From my research on the subject, when I was younger, you had to work absurd 36 hour shifts, which seems dangerous for both the student and the patients. If anything, I don't think non specialized doctors make enough. Malpractice insurance is also a thing too, so that cuts into the money as well.
 
Maleficence said:
It's the corporate business side that makes it so expensive.

As another poster says, let's stop trying to cut salaries of front line workers that contribute to society and instead focus on the ridiculous amount bankers and corporations make.

Yay capitalism.
Click to expand...

Bankers are overpaid since their industry literally controls access to financing and capital, not only that but they write rules lol.

I have many banker friends they always joke about it.
 
The base pay of insurance executives, hospital executives and even hospital administrators often far outstrips doctors’ salaries, according to an analysis performed for The New York Times by Compdata Surveys: $584,000 on average for an insurance chief executive officer, $386,000 for a hospital C.E.O. and $237,000 for a hospital administrator, compared with $306,000 for a surgeon and $185,000 for a general doctor.

And those numbers almost certainly understate the payment gap, since top executives frequently earn the bulk of their income in nonsalary compensation. In a deal that is not unusual in the industry, Mark T. Bertolini, the chief executive of Aetna, earned a salary of about $977,000 in 2012 but a total compensation package of over $36 million, the bulk of it from stocks vested and options he exercised that year. Likewise, Ronald J. Del Mauro, a former president of Barnabas Health, a midsize health system in New Jersey, earned a salary of just $28,000 in 2012, the year he retired, but total compensation of $21.7 million.
Click to expand...
http://www.nytimes.com/2014/05/18/sunday-review/doctors-salaries-are-not-the-big-cost.html?_r=0
 
whatsinaname said:
You are forgetting

1) The amount they have to spend to become trained doctors/surgeons.
2) The fact that they don't start making those large incomes till a later age.
3) The opportunity cost of 11-15 years of training (compared to 3-6 for most other graduates who don't do a PhD.)
4) Malpractice insurance costs.
Click to expand...

If the government subsidized medical school tuition and implemented true torte reform, would you be comfortable with physicians making $100,000 or slightly less?
 
FyreWulff said:
But they're still going to have to work absurd hours and command a lot of money once overtime hits. IMO, all public service jobs (medical, fire, police) should go for more people on the roster than more hours per person. If I had my way overtime would be completely prohibited for those jobs, not because I don't want those people to not earn more money, but I think it's a little too tempting to burn your whole body down, mistakes start piling up, and you're just a husk at the end of it all.

But most of the real cost of healthcare is the adminstrative...
Click to expand...

I agree. I would rather there be 2 doctors working 40 hours at $100k than 1 doctor working 60 hours at $200k. But if I were to dedicate a decade of my life and a $300k investment into education then I would expect that $200k job. However if the schooling only cost $100k or whatever then I'd think the $100k job was a sweet deal and take it if it were offered.

I made all those numbers up for the sake of simplicity, I have no idea how accurate they are.
 
Short and sweet answer: Fuck no. They deserve their pay and then some, they save damn lives.

Who we should be doing a much better job of regulating are the suits in corporate America. When your compensation package guarantees you more money than all of your employees combined...shit is fucked. But hey let's cut the salary of those doctors because reasons.
 
whatsinaname said:
You are forgetting

1) The amount they have to spend to become trained doctors/surgeons.
2) The fact that they don't start making those large incomes till a later age.
3) The opportunity cost of 11-15 years of training (compared to 3-6 for most other graduates who don't do a PhD.)
4) Malpractice insurance costs.
Click to expand...

DING DING DING.

That above the rest.
 
Happy to see the responses in this thread. I think many are actually payed too little. The dedication, intelligence and time investment into becoming a physician cannot be understated, all to face declining reimbursement and loss of autonomy/encroachment compared to prior generations.

Overall, physician compensation has gone down in many fields, and stands to decline pretty much across the board. Seemingly arbitrary cuts to Medicare CMS reimbursement, as well as the pretty much guaranteed killing off of fee for service will lead to notable pay declines. Not to mention the gradual, widespread shift away from independent private practice.
 
First I think we need more Physician Assistants and Nurse Practitioners before looking at cutting salaries. These are great careers with good pay that don't get enough attention. The 2nd thing that needs to be looked at is reimbursement rates. Dermatologist and other practices that seemed to get payed a lot while doing little for actual health issues should be looked at before overall pay rates.
 
There is so much waste in the medical field, and so many obscene salaries. Going after the salary of individual practicing Doctors is not the way to go.
 
What I don't think has been mentioned yet is also the obscene hours physicians work. Many work double or triple shifts, while being on call the rest of the time.
 
Salaries are not even close to what a physician makes. When they sign a contract they get a base salary and have to hit what are called RVU's:

https://en.wikipedia.org/wiki/Relative_value_unit

And in many cases their value is based if they hit that number. Not higher, not lower: that number. To the hospital, the employed physician loses value if it's higher or lower.

So the physician gets a base and payment (and evaluation) based on RVU. Incidentally if you ever felt like cattle in a doctor's office, that's why.

Even after saying that: no. They do not get paid enough. These people sometimes work 30 hours a day to get generally screamed at by people.
 
Going after physicians and other healthcare professionals' salaries is wrong in my opinion. The real problem with healthcare costs comes from administrators, medical device manufacturers, insurance and pharmaceutical companies, etc. Doctors are really the one area where the cost is justified.
 
MrVargas said:
The expense and lengthy time commitment of med school makes the salaries appropriate. I know it won't be a popular idea but I think there should be a level of doctor that requires less schooling and thus make less. Perhaps a 5 year program.
Click to expand...

Technically they do have those "lesser" level providers in the forms of NP's and PA's I guess. My girlfriend is a PA, and makes really good money but she obviously is required to have a licensed Physician over see her work.
 
Your Entertainer said:
Overall, physician compensation has gone down in many fields, and stands to decline pretty much across the board. Seemingly arbitrary cuts to Medicare CMS reimbursement, as well as the pretty much guaranteed killing off of fee for service will lead to notable pay declines. Not to mention the gradual, widespread shift away from independent private practice.
Click to expand...

And if the government is the only entity providing reinbursements under a single payer system, what does that mean for physician salaries?

Would physicians simply stop working and move into other healthcare jobs? Would top students be dissuaded away from entering the field if they can make as much as a physician simply by obtaining a B.S in an engineering field?

What would the impact be on the overall healthcare system?
 
I'm more concerned with the cost of drugs than doctor's salaries. My stepson is going through cancer treatment and some of his drugs are tens of thousands of dollars per cycle.

Also there is a ton of behind the scenes redundancy and duplicate paperwork. There is a lot of fat that can be trimmed in hospitals and insurance companies.
 
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