paradise_circus
Member
I don't want to belittle your responsibilities or cut your salary. Your work enjoys high reputations in the society. It's not like other doctorates in any other subject have to do less work.
Physician salaries in America - are they too high?
- Thread starter Pineapple
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I don't want to belittle your responsibilities or cut your salary. Your work enjoys high reputations in the society. It's not like other doctorates in any other subject have to do less work.
Iorv3th
Member
And "alternative medicine". Alternative doctors probably make just as much or more with less shit to worry about
My brother/SIL are MDs and I'm getting my PhD. No one I know works as much as them. Even during my crunch times, I still get to sit at a desk and read papers / work through equations *at my own pace*. I can get up and go for a walk if I want. I can browse GAF (just got out of a meeting so I decided to check up on here before I get back to work). My brother/SIL are on their feet *doing something* constantly in the hospital. It's non-stop. I could never do it.
As someone who actually got to sit in on a number of surgical procedures while in college (thanks to a surgical illustration class), I have absolutely zero problem with these men and women making the money they do. I saw a Whipple Procedure (or a Pancreaticoduodenectomy), which is an exceedingly complex surgery that involves removing a cancerous mass from the Pancreas. It takes something like six hours to perform and I just cannot wrap my head around how someone could ever learn to do that. These people honestly work miracles on a daily basis.
The insurance cost is the real killer. There's a lot of doctors that work insane hours too. If anything, doctors need to be paid more. Nurses, lpn and cna most definite need to be paid more. What they make is a damn joke.
I don't know, bro. Sometimes docs are on call. Pretty chill if you ask me. /s
UnemployedVillain
Member
In Germany is it typical to do a Masters AND a Phd, instead of just a Phd? Seems like a waste of 2 years
Particle Physicist
between a quark and a baryon
On call for me means I am at the hospital working for 30 hours. As an attending it basically means work from home, staff consults/admits over the phone with residents and come when needed. It's not what you think, it's definitely not chill. Movies/tv shows make it seem like something it really is not.
EDIT
Just realized /s meant sarcasm. Haha. My bad
I'm an MD in my second year of residency training in radiology. My residency will be 6 years long total. Here is how much I worked to get to where I am:
Undergrad was 5 years x 60 hours of studying per week + ~20 hours per week part time job.
Medical school was 4 years x 80 hours of studying per week.
Now as a resident I work between 60 and 80 hours per week and study at least an hour to two hours per night after work.
I am $160,000 in debt and that's below average. I currently earn $55,000 per year to work the hours I listed above as a resident. I'm married with a kid on the way. I will be 33 when I finish residency and fellowship.
As an attending physician I will work 60 hours per week to earn the salary that most people see online when they search salaries. There is no overtime pay for a physician.
Physician salaries make up less than 9% of the overall healthcare budget in the US. If you continue to lower physician salaries (because every year congress attempts to and is often successful at cutting physician reimbursements) all that will happen is continued demoralization of one of the most critical elements of healthcare delivery in this country with relatively little impact on overall cost.
Undergrad was 5 years x 60 hours of studying per week + ~20 hours per week part time job.
Medical school was 4 years x 80 hours of studying per week.
Now as a resident I work between 60 and 80 hours per week and study at least an hour to two hours per night after work.
I am $160,000 in debt and that's below average. I currently earn $55,000 per year to work the hours I listed above as a resident. I'm married with a kid on the way. I will be 33 when I finish residency and fellowship.
As an attending physician I will work 60 hours per week to earn the salary that most people see online when they search salaries. There is no overtime pay for a physician.
Physician salaries make up less than 9% of the overall healthcare budget in the US. If you continue to lower physician salaries (because every year congress attempts to and is often successful at cutting physician reimbursements) all that will happen is continued demoralization of one of the most critical elements of healthcare delivery in this country with relatively little impact on overall cost.
Oh man I hope you're kidding. I wish I made $500k when I get out of residency. Lmao, god that'd be great.
Your Entertainer
Member
Consider the nature of their work, and what it take in time, dedication and finances to get there. It's many years till they see the money, and at what cost? The lives of their friends and family passes them by while they're mired studying, accumulating debt. Residency earns very little per hour, and it can be as long as 7 years. Surgical residents make less than minimum wage when you calculate it.
PAs and NPs are fine if you have medical problems that are pretty cut and dried, but I've had problems in running up a ton in tests and hassle to try to figure out a mysterious problem that a specialist doctor could diagnose much quicker.
Reimbursement rates are a big problem, I've had two GYN docs retire from seeing patients because the reimbursement for typical procedures are so low, and the malpractice insurance costs skyrocketed (because people are more likely to sue if anything goes wrong during OB deliveries). It's really annoying because they want to provide women's health services, but the US makes it hard to maintain a practice or even downright legally impossible in the case of abortions.
shadowfall
Member
Medical education is long , hard and expensive. I have lot of respect for them. They also need to pay high insurance to avoid getting sued. They have every right to a high salary. Not only do these people do 12 hr/24 hr shifts - they freaking save lives.
Like other posters have said, I would rather cut salaries of those folks at Wall Street and Oil companies.
Like other posters have said, I would rather cut salaries of those folks at Wall Street and Oil companies.
smokeandmirrors
Banned
Make med school cheaper or free. Don't care about their high salaries.
Fuck useless CEOs and other deadweight who siphon off more wealth than they deserved fucking leeches
Fuck useless CEOs and other deadweight who siphon off more wealth than they deserved fucking leeches
Goldenroad
Member
Whatever it takes to attract the best and brightest students to the field of medicine.
Though, as a Canadian, I might say American physicians are over paid simply because you tend to steal away our best doctors. Of course that issue really boils down to, we don't pay our doctors enough, and we waste entirely too much money on redundant administrative costs.
Though, as a Canadian, I might say American physicians are over paid simply because you tend to steal away our best doctors. Of course that issue really boils down to, we don't pay our doctors enough, and we waste entirely too much money on redundant administrative costs.
Lol. Please, tell me what I do everyday as a resident since you're an expert.
You don't want someone willing to take less pay to be your doctor
There's enough barely competent MDs practicing as it is
Guy LeDouche
Banned
Certainly you need to have a personality that matches with the demands. Work life balance is out the goddamn window for ~8 years or so, but it gets better after residency. My wife is a 2nd year resident working toward a subspecialty that will allow her a more normal 9-5 lifestyle. Sure that's 6 years away (when she'll be done with fellowship) but then we'll have small children who will be able to grow up with both parents around.
You also need to tally in the running costs of being a physician.
Continuing Ed
Malpractice
Board and membership fees
If a physician owns their own office they have a ton of business costs
If a physician is not hospital employed then they are an independent contractor - so they pay full price for all of their own insurances - health, life, disability, malpractice, umbrella policy in case they get sued above their insurance coverage, no employer subsidies here
This is just off the top of my head. I'm sure if I gave it serious though, I could list half a dozen other things. There are a lot of things that need to be cut in the healthcare system. Physician and other provider salaries are not one of them.
Continuing Ed
Malpractice
Board and membership fees
If a physician owns their own office they have a ton of business costs
If a physician is not hospital employed then they are an independent contractor - so they pay full price for all of their own insurances - health, life, disability, malpractice, umbrella policy in case they get sued above their insurance coverage, no employer subsidies here
This is just off the top of my head. I'm sure if I gave it serious though, I could list half a dozen other things. There are a lot of things that need to be cut in the healthcare system. Physician and other provider salaries are not one of them.
Dr.Guru of Peru
played the long game
I doubt this very much. How is a machine going to intubate? Figure out why a patients ETCO2 is dropping or is suddenly hypotensive? Will the machines be putting in lines, spinals, etc. too?
I mean, its conceivable that we'll eventually have AI that can do all this. But the same is true about every single profession in the planet. I mean, sure some MDs do surgery, others push meds, while others sit at desks and read slides or images. But ultimately they get paid to make decisions. We'll have an AI that can be President when we have machines taking over these careers.
UnemployedVillain
Member
darkistheway
Member
I don't have a problem with doctors making that much.
The problem I have is the entitlement and arrogance 95% of them have.
The work they do is important but it is not particularly difficult (except surgeries).
I suspect advances in medical technology will soon begin to impact doctors and they may find their status dwindling (over the next 10-20 years)
The problem I have is the entitlement and arrogance 95% of them have.
The work they do is important but it is not particularly difficult (except surgeries).
I suspect advances in medical technology will soon begin to impact doctors and they may find their status dwindling (over the next 10-20 years)
Science is where the guys that didn't get into med school ended up (apologies to anyone that chose to do science)
andthebeatgoeson
Junior Member
There's some good evidence cost increases are due to administration department increases and not physician salaries. So, would love to see some of the suits disappear.
Doubt it. The decisions are not binary. You can break down some decisions but the overwhelming majority of both those specialities require intense training. A computer can't really help when the response by individual patients are varied by a large degree. 7 billion people in the world and I expect 7 billion different CT scans.
andthebeatgoeson
Junior Member
http://www.commonwealthfund.org/pub...rature/2014/sep/hospital-administrative-costs
Can't vouch for the website but I'll have to do more digging.
I am biased against the suits.
Didn't have time to read this:
http://www.ncbi.nlm.nih.gov/books/NBK53942/
Can't vouch for the website but I'll have to do more digging.
I am biased against the suits.
Didn't have time to read this:
http://www.ncbi.nlm.nih.gov/books/NBK53942/
Having spent most of my adult life researching what it takes to become a doctor and deciding whether to pursue it or not...
They are not paid enough.
You do realize they go through:
4 years of undergrad (securing at least a university honors level GPA to even have a fighting chance of being accepted to med school) + insane amounts of extra-curricular achievement and activities + 4 years of med school + yearly board exams + 3-7 years of residency + 1-4 years of fellowships before they even become independent physician practicioners?
And you take like $50k out in loans for every year of med school PLUS undergrad.
If you graduate high school at 18 and go the most efficient route, that means you get out of residency at 29 if you're lucky. Residency also pays badly $40-60k for working 80-100 hours a week? Unless you're derm or pathology or radiology lol)
These people basically don't get their careers settled until their mid to late 30s. At that point they have spent over a decade of their lives slaving over textbooks and getting little sleep, eating poorly and living in constant stress over exams, riddled with debt, with parts of their lives on hold for their profession. Divorces are common in medical training. And they're behind everyone else who has had a chance to save money for a home, a car, a family, etc.
They often work graveyard shifts and spend their time tirelessly caring for people's bodies and rarely are properly appreciated.
And even with that large salary comes huge malpractice insurance and taxes.
Some don't get to start paying their debt off until their late 30s and sure I guess, congrats, you get to enjoy being wealthy and comfortable at the ripe age of your early 40s, after your youth is behind you.
This isn't even mentioning the politics and stress and bullshit that comes with interviewing for residency, hospital politics, especially clinic politics that are owned by some corporation.
It's not a sacrifice most people would be willing to do, and honestly the least you could do is pay them well for trading their 20s and 30s in for learning how to save your life.
Sure, neurosurgeons make $700k.
But you become a neurosurgeon at like 33 at the earliest. And you get it from doing a residency (which you only got into by being one of the best medical student applicants in the country) that is literally at least 90 hours a week of learning how to perform BRAIN SURGERY. And then over half your money goes to malpractice insurance and taxes.
These are not every doctors experience. Hell, some doctors would do their career for free. That's usually why you don't survive this process unless you have some real passion for it. The financial/life trade-off is too high unless you are either extremely good at medicine or you live and breathe it as an enjoyed lifestyle.
They are not paid enough.
You do realize they go through:
4 years of undergrad (securing at least a university honors level GPA to even have a fighting chance of being accepted to med school) + insane amounts of extra-curricular achievement and activities + 4 years of med school + yearly board exams + 3-7 years of residency + 1-4 years of fellowships before they even become independent physician practicioners?
And you take like $50k out in loans for every year of med school PLUS undergrad.
If you graduate high school at 18 and go the most efficient route, that means you get out of residency at 29 if you're lucky. Residency also pays badly $40-60k for working 80-100 hours a week? Unless you're derm or pathology or radiology lol)
These people basically don't get their careers settled until their mid to late 30s. At that point they have spent over a decade of their lives slaving over textbooks and getting little sleep, eating poorly and living in constant stress over exams, riddled with debt, with parts of their lives on hold for their profession. Divorces are common in medical training. And they're behind everyone else who has had a chance to save money for a home, a car, a family, etc.
They often work graveyard shifts and spend their time tirelessly caring for people's bodies and rarely are properly appreciated.
And even with that large salary comes huge malpractice insurance and taxes.
Some don't get to start paying their debt off until their late 30s and sure I guess, congrats, you get to enjoy being wealthy and comfortable at the ripe age of your early 40s, after your youth is behind you.
This isn't even mentioning the politics and stress and bullshit that comes with interviewing for residency, hospital politics, especially clinic politics that are owned by some corporation.
It's not a sacrifice most people would be willing to do, and honestly the least you could do is pay them well for trading their 20s and 30s in for learning how to save your life.
Sure, neurosurgeons make $700k.
But you become a neurosurgeon at like 33 at the earliest. And you get it from doing a residency (which you only got into by being one of the best medical student applicants in the country) that is literally at least 90 hours a week of learning how to perform BRAIN SURGERY. And then over half your money goes to malpractice insurance and taxes.
These are not every doctors experience. Hell, some doctors would do their career for free. That's usually why you don't survive this process unless you have some real passion for it. The financial/life trade-off is too high unless you are either extremely good at medicine or you live and breathe it as an enjoyed lifestyle.
darkistheway
Member
In Canada, physicians are the second most expensive element of health care (behind hospitals). And that cost is rising.
I guarantee there are smart people out there looking for ways to decrease that cost.
Advances in computer technology will very likely help. For instance, algorithmic screening of medical images could reduce the need for as many specialists.
Tarkus
Member
Everyone always references neurosurgeons. Lololololol. Cardiothoracic surgeons are the gawds.
I'm dual training in Plastics/reconstruction and critical care. I want to work for MSF on the front lines. It's a hard life, the hours are terrible and the decisions you make can be from a spectrum of not killing a patient to not causing significant morbidity to actually saving them.
My system does not allow the suing/litigation for doctors but we do have formal complaint processes that can go all the way up to a tribunal.
Another hard thing I face is when to stop treating?
But let's not forget our nurses. They do the the brunt work as well while we tend to make the hard decisions. They tend to face a lot of the criticisms from the media and the families as well.
My system does not allow the suing/litigation for doctors but we do have formal complaint processes that can go all the way up to a tribunal.
Another hard thing I face is when to stop treating?
But let's not forget our nurses. They do the the brunt work as well while we tend to make the hard decisions. They tend to face a lot of the criticisms from the media and the families as well.
True. Damn do they make the money.
I say good for them. I don't think I could crack open rib cages of little children to fix them.
Tarkus
Member
Other than a JCAHO representative, the heart surgeon is the most respected person in the hospital.
Yeah I always got that impression. Physician gossip/culture is one of my odd interests despite me not actually being a med student...I guess I got fasincated during my research process for med school.
Derms make a shit ton of money because of the nature of their specialty. They are almost immune to many external pressures facing other specialties. They can charge whatever they want for lots of procedures because they're cosmetic and insurance won't cover it. Many work in private practice because they're usually not needed at hospitals, so they can resist the pressure of mega clinics and hospitals buying them out. My derm is amazing. Not only is he brilliant (Harvard derm residency), he formulates his own prescriptions and then sells them to his customers directly. He has his own acne formula, anti-aging formulas, etc. He offers a yearly membership to people who want cosmetic procedures. Can you imagine his wealth? One time I called to make an appointment but he was out for 3 months on vacation lol
What makes you think that?
Id be careful with the word "difficult"
It's not complex abstract or theoretical thought (like modeling fluid flow of the brain using advanced mathematics like a graduate biomedical engineer might do) but it's not trivial. It takes a lot of effort in learning to wield the knowledge of a doctor.
Dr.Guru of Peru
played the long game
The cost isn't rising. Physicians have seen a rise in their reimbursement over the last few years, but you have to take into context that there were cuts in the 1990s and early 2000s. These things tend to go in cycles, and some provinces have already started cutting back physician funding. The overall trend has been stable.
As you can see on page 44 (figure 17), physician funding as a percentage of total costs has been stable since the 1970s.
darkistheway
Member
Because I work in the field and I know what doctors do.
Granted. Which is why they are well-paid. But I am of the opinion that much of what doctors do is not difficult and would be able to be performed by other professionals. Nurse practitioners are an example.
Interesting. Thanks.
Also, much of the rising cost is probably related to the general increase in patient care costs due to population demographics.
Don't really agree with this at all. The depth and volume of training is not equal between MD's/DO's and NP's/PA's. Not to say that there aren't good NP's and PA's out there and that they have a place in the healthcare system, but there's a reason that the majority of them require physician backup.
I'm also wondering what field you work in if you honestly feel that what doctors do "is not difficult." Even the smartest physicians I've worked with would be the first people to tell you that what they do on a daily basis is not easy. One for the breadth of information that you have to know in the first place. Two for the amount of responsibility that it entails. Three for the stress that's brought about by hospital politics, malpractice, and the business side of medicine. Combine those elements (among others), and I have no clue how anyone can say with a straight face that "much of what doctors do is not difficult."
hockeypuck
Member
Which field of medicine do you work in and does it involve writing orders?
Edit: Actually, I want to ask you this: What do doctors do, since you know?
Agent Cooper
Member
My mom is an ER nurse and she doesn't get paid enough, I think. She is constantly working her ass off to assist doctors (and stop the few bad ones from killing patients) and picks up slack from the lazier nurses, while doing her own shit.
I think there needs to be a better way to make sure people aren't becoming nurses or doctors for a paycheck. I know lazy people from my high school who went into nursing programs who really honestly should not be nurses. I'm sure there's doctors who are the same.
The medical field is hard, man. There shouldn't be less pay for a job that hard. The people who work that hard deserve to have coworkers that help share the burden instead of making life worse.
That's the biggest problem I hear about, anyway.
I think there needs to be a better way to make sure people aren't becoming nurses or doctors for a paycheck. I know lazy people from my high school who went into nursing programs who really honestly should not be nurses. I'm sure there's doctors who are the same.
The medical field is hard, man. There shouldn't be less pay for a job that hard. The people who work that hard deserve to have coworkers that help share the burden instead of making life worse.
That's the biggest problem I hear about, anyway.
Dr.Guru of Peru
played the long game
Sorry, forgot the link:
https://www.cihi.ca/en/nhex_2014_report_en.pdf
Anyways, its very easy to say that you think a job looks easy from the outside. It's very different when you're the one making the calls.
darkistheway
Member
I work in medical lab science. I work in a tertiary care hospital lab and am in charge of quality control and method development.
I analyze a ton of data everyday. And I have formed an opinion that much of what physicians do would be amenable to automation (for lack of a better word).
What doctors do is apply their knowledge in a heuristic fashion and match signs and symptoms to treatment.
Their knowledge base is their most valuable asset. I personally don't see application of that knowledge as 'difficult.'
Certainly, acquiring it would be, for most people.
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