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May 1st, 2012
10:55 AM ET
Seriously? Doctors say they're underpaidAnthony Youn, M.D., is a plastic surgeon in metro Detroit. He is the author of “In Stitches,” a humorous memoir about growing up Asian American and becoming a doctor.
But many other physicians are not as satisfied - a recent study by Medscape revealed that 49% of doctors believe they're not fairly compensated. Of primary care physicians, this percentage increases to 54%. It’s no myth that doctors are some of the highest paid professionals in the country. So why are they complaining? It’s likely because of situations like Dr. Peterson’s. I was the on-call plastic surgery resident one night when a 42-year-old man - let’s call him Dave - was brought into the hospital at 3 a.m. He had fallen off a roof while intoxicated. Dave broke several bones in his face and shattered his lower leg. I stumbled out of bed and met Dr. Peterson in the ER, where we spent the next three hours assessing Dave’s injuries and repairing his lacerations. Five days later Dr. Peterson and I performed an eight-hour operation, reconstructing his broken facial bones and performing a muscle transfer to help heal his fractured legs. For the next two months, we visited Dave in the hospital each and every day, changing his bandages and making sure he healed properly. Not once did Dave thank Dr. Peterson for his care. Instead, Dave took more than $3,000 from him. Close scrutiny Quite possibly no other occupation in the country receives such attention regarding the income its members receive. And that’s not a new trend - more than 70% of respondents of a survey published in the 1985 American Journal of Public Health believed doctors were overpaid. The Medscape survey found the average physician compensation now ranges from a high of $315,000 for orthopedic surgeons to a low of $156,000 for pediatricians. Sounds pretty good right? Consider that physicians must complete at least four years of college, four years of medical school, and between three to eight years of residency training prior to becoming a real, practicing doctor. Many physicians don’t start earning “doctor-level” salaries until they are well into their 30s. A 2009 survey by U.S. News found the typical medical student graduated with $141,132 in debt. The graduates of some schools averaged more than $200,000 in loans. According to the Bureau of Labor Statistics, the average computer and information system manager earns $125,660 per year. The average lawyer makes $130,490 per year. Orthodontists take home $204,670. The New York Times recently reported the average base pay for managing directors at Morgan Stanley is $400,000. At Goldman Sachs, it’s $600,000. The average salary of an NFL player is $1.9 million. NBA players average $5.15 million per year. Just for putting a ball in a hoop. When you consider these numbers, the thought of pediatricians making $156,000 a year doesn’t seem unreasonable. They often see 50 patients per day, answer our calls at all hours, and keep our kids healthy. What about critical care physicians? They average $240,000 a year, but are responsible for keeping the sickest of us alive. One-quarter of critical care physicians spend more than 65 hours per week with their patients, not including time doing paperwork. Unlike most other professions, there is a ceiling to what most doctors can earn. Physician compensation is tightly controlled by the government and insurance companies. Medicine is also the only profession where its members are required to sometimes work for free. No return on investment Which brings us back to Dave. Three months later, I accompanied Dr. Peterson in his clinic to see Dave for a follow-up appointment. Dr. Peterson seemed a bit distracted. At the end of the visit I found out why. “I’m glad you’re doing so well, Dave,” said Dr. Peterson. “Yeah, I’m really happy with how things have turned out,” he replied. “So Dave, this is a little awkward for me, but I need to ask you something. Two weeks ago your insurance company sent you a check for $3,200 to forward to me for all my surgical and office fees.” “Yeah, so?” “Well, um,” Dr. Peterson stuttered. “We never received it from you.” “No, you didn’t. I cashed it and spent it.” “Dave, why would you do that?” “I figured you’re a rich doctor. I need the money more than you.” What do you think? Are doctors being underpaid? Tell us in the comments below. soundoff (15,183 Responses)« Previous 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 Next »Leave a Reply to Carey Fenske
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Full disclosure: I have no complaints about how much I make.
Interesting post – I'm a physician in Canada and make about $240,000 a year before taxes. I get taxed at 40% so you can do the math. Do I think physicians are underpaid? Good question. Let me start by saying that OF COURSE we get paid well. We probably get more that 99% of the population. For that, I'm truly grateful and therefore am hesitant to whine or complain. We generally make a good living. I however am not rich. I do not own a BMW or have gigantic house.I don't even own a car. I am still paying off a $100,000 student loan, trying to pay my mortgage and save for my childrens' education (as many people are). I guess the questions is should we get paid more? Well, most of us know that going into medicine isn't going to make you extremely wealthy. It will however afford you a comfortable life (in general). This comfortable life comes at a cost – long work hours,years in school, chronic stress, threat of malpractice, impact on family life, the pressure of making the sick better/preventing death etc etc. I am certainly not whining about it because that is what you sign up for. Do I think we should get paid more? On bad days, yes. When the hours are never-ending, when things go horribly wrong with patients, when patients want more from you and there's just no more to give – yes, I wish I got paid more. When the day is good, I don't think about it at all. If you want tons of money, medicine is not the way to go but it's better than many other jobs out there. To me, it is the best mix of having a meaningful profession in combination with some financial reward. Is it enough? It could be better but I'm not complaining....
Pithy!
You should complain! Skilled labor deserves more.
first lets address dave...why did the insurance company send the payment to dave? made out in dave's name? did they sue dave?
by all means...lets charge even more for medical care in america...god knows it is practically free. are you kidding me!!!!!!!!!
Yes & No? some doctors abuse the fee for services system. Most doctors are terrible businessmen. I believe we should have nationalized medicine, with doctors on a salary similar to the federeal GS system. Let doctors get paid the money they deserve, let them only be responsible for patient care, let the paper work be done by others. It is unfair that an infectious disease specialist makes 20% of the income of a surgeon. Doctors cannot survive if patients have to pay them. They now rely on Medicare, Medicaid, and insurance plans which dictate to them what they can charge. Use capitation for a compensation system. They should all make 200,000 to 600,000/yerar, depending on the quality of care they deliver, experience, and results.
The reason this article and these responses make everyone uneasy – because the very dialogue reeks of bickering instead of talking about how to forge real solutions, or even bringing up the problems.
1. Hats of to the healers out there, but people are getting sicker, and their ends of lives happen prematurely, and with terrible suffering by being sedated. Death is in our faces constantly, yet as an empire (yes, US), we have some of the worst standards of living and highest rates of diseases in the world?
2. I appreciate sanitation, but at what cost? Our systems inundated with chemical runoffs? Please correct me if I'm wrong here. As a person who tries to grow untainted food in a tainted world, I don't fret about my car, I fret about whether the soil is safe to plant in.
3. By defending what's yours you alienate all the people like myself who live in tiny houses and barely make ends meet day by day. You are defending your rung in the pyramid, justifying a system that cares more about money than care. Human beings respond to compassion and love; here's another cold case of shruggery.
I don't really care about your houses and cars, it turns me off and makes me unable to read this. I don't sympathize with your plight. I care about a man, let's call him Steven, whose mother was just diagnosed with breast cancer and has to decide whether she'll take your solutions of severe, long-term suffering and pain.
Yet another example of people yelling at each other without forging a dialogue or finding common ground in their humanity on this network. Let's pray that a shift in consciousness can really start accelerating this year. Peace, blessings, namaste.
@larry banal
Personally (as a doctor) that is the way I think it should work (insurance company should pay via the patient, not that the patient cashes the check and never pays the doctor). Somewhere about 40-50 years ago doctors started hiring people to take over being the middle men to deal with insurance companies. For good insurance companies it works quite nicely as doctors get paid quickly, directly and efficiently. Unfortunately only about 50% of insurance companies are "good". Many insurance companies delay payment for months.
The fact that doctors and hospitals (and other providers) deal directly with insurance has made insurance rules more arcane and self fulfilled the necessity of doctors employing a cadre of billing specialists. It has allowed insurance companies to negotiate quite variable discounts (which are different doctor to doctor, patient to patient for exactly the same service) which are often not discounts the patient/healthcare consumer actually sees but discounts to the amount the insurance company pays out (they still get the same premium).
I think costs would go down or at least become flat for a while IF the medical bill went in full to the patient who then was responsible for asking the insurance company for payment and was responsible for the difference. The small percentage of people with the money could pay the bill up front and get reimbursed. The rest of us could negotiate something with the provider after they submit the bills and perhaps make a small payment and say the rest is on the way when the check comes from the insurance company.
I know this sounds like just making the system more complex, but I believe when the patient does not really care about the entire cost of care (because currently it costs them $20 to see the doctor whether they have a broken arm and really do need help or if they simply keep going back repeatedly for colds and hangnails) there is little DISINCENTIVE for most middle class people (who can afford the $20 ... or even people on public insurance programs with no co-pay) to spend their insurance company's money for dumb stuff.
I also think our society in general in 2012 lacks savvy about health and cannot distinguish (even when told by their doctor repeatedly) between problems that are life/aging and significant health problems and way too many go to the doctor (worse yet to the ER) at the drop of a hat. I can't help with this one. Frankly this is a little bit how you were raised (my sister in law takes my Niece to the doctor literally every 2 weeks for basically colds and allergy/sinus problems) while my kids go only if it is clear they are really sick and not just sneezing because of hayfever. There is also an education component here but I don't think school health classes were ever designed to help with this, they are more about eating right, exercising, understanding some basic principles of disease and prevention, and the changes kids are experiencing as they are growing up.
Payment in medicine is all done through middlemen. The insurance is the middleman between the patient and their doctor. The doctor in turn has insurance specialists who deal with their side of things. Actual patient responsibility for the bill only happens when they don't have insurance (and most of that simply never gets paid).
Wow $150,000. Never came near it in 40 yrs. Work in area w many poor and Latinos w no insurane. Having worked my way up from poverty I understand plight of these pts and charge what I consider fair or no fee. No complaint but malpractice and all overhead rises. Also have many Medicare pts. I control all risk factors and save system money w reduced hospitalizations, and un necessary tests. But takes time. Quality care doesn't equal revenue. My income is poverty level. If we would socialize medicine it would be reasonable. The government is pain in a– deal w But they must follow their own rules . Insurers ( private businesses) don't. As I trained in Philly the criminals said if we get caught what we pay out is less than we keep. In forty years insurers and government has cheated me enough by non or denied payments that I could retire on that am out. Only in America is medicine a for profit business and Doctors have been reduced pawns.
I agree with this post and article. I think Drs deserve what they are paid. Do I think other professions such as teachers should be paid more...yes. I beat breast cancer almost 3 years ago at 42 years old that required many surgeries along with a mastecomy and reconstruction. I was very lucky to find an amazing surgeon and plastic surgeon. My surgeon called me once to tell me not worry because he had not gotten test results back. I would get calls at 7pm when I knew he had a family waiting for him at home. Through my journey, I saw the time and effort both of them put in to making their patients healthy. They get paid more than others but to me they deserve every penny they earned. As I said some people deserve more money and others such as people in the financial industry make more money than they should.
See this and quit your griping.
http://www.cnn.com/video/?hpt=hp_bn12#/video/health/2012/05/02/dnt-doctor-charges-five-dollars.ksdk This is a true doctor who cares about his patients. You all need to learn a bit more compassion and concern for your patients, then they might not complain about what you make. To many Doctors don't really care about us, we're just a number & dollar signs to them. Get over yourself.
I watched that also. He is incredible. But a Dr now days cannot aford to do what this man is currently doing.
Jill, I hope you get the quality care you deserve! You probably get it all free from the gov't anyway. You are obviously uneducated (don't lie!) and have a chip on your shoulder. I doubt that you've ever put in an honest day's work!
Linda, after reading some of the comments you have posted, I can only come to one conclusion. You are a b*itch!.
Only in medicine does the Public demand that you work for free and be perfect every time.
Physicians aren't machines. The greedy public thinks we should be.
@we're people too No doctor works for free if a doctor worked for free for a year he would be homeless. Your also not the only profession where perfection is expected 100% of the time. Is it ever okay for a welder on a bridge to do a crummy job and cause it to fall killing possibly hundreds? Your profession isn't the only one where a mistake could cost someones life, at least in yours a mistake will cost 1 persons life some people aren't as lucky and get paid far less.
Yes, a welder ought to be perfect; however, it's much easier for him to do a perfect job than it is for a doctor, who is working with tons of changing variables and uncertainty – he's often welding together a moving bridge with an eye-patch over one eye. Add to that the pressure of directly contributing to the patient's health. A welder on a failed bridge won't experience a driver fall off and die from the passenger's seat – a doctor will.
A physician has one of the most difficult and rewarding jobs out there. Considering how much the public pays bankers and lawyers for things that affect their quality of life, it's perfectly alright for people to support fair compensation for doctors who prolong, or save their very lives. Few jobs are comparable, and you should use the compassion argument for every other member of society if that's how you feel.
By your logic, lawyers, teachers, firefighters, bankers, and everyone else should work out of compassion just because they're a part of society. Absurd, this is.
The answer to this question is best done by asking another question. Is there an oversupply of doctors? Basic economics, the law of supply and demand, tells us that if doctors were overpaid, we would have too many of them. In contrast, if they are underpaid, we would have a shortage. There is your answer. SInce the supply of doctors is below the demand, they are underpaid. Once their pay is sufficient, there will be an equilibrium between supply and demand.
What something is worth and what you want it to be worth are not the same thing.
Sorry I think your Economics is backwards. No offense.
Southerner is right, common sense one would think, but that is lost on most people. They prefer to despise the wealthy.
The intrinsic laws of supply and demand don't apply to a market with a regulatory ceiling. Cartels of insurance vendors effectively regulate the pay for medical professionals, keeping compensation artificially low. There is no way to reach equilibrium because there is no way to increase the pay for doctors.
l
No, we despise wealthy whingers
You are wrong about this being a market based issue. Supply and demand aren't relevant. There are a limited number of slots in US medical schools and a limited number of slots in US residency programs. Presently, there is a "glut" of medical students. The school where I teach receives 10,000+ applications each year for 265 slots. There aren't enough US medical students (because there aren't enough US medical student slots) to fill all of the residency slots. On that note, international medical students fill the remaining slots.
There is a shortage of physicians in the US particularly in the inner city and in rural areas. Because of this shortage, many new medical schools are starting (see 2 in NJ, 1 in MI, FL, CO, etc.). This won't solve the physician shortage issues because it simply addresses the input. It does not address or increase the number residency slots. Residency is very expensive and the cost is largely bore by the US government. There aren't plans on increasing the investment in residencies so that more doctors are trained so the problem isn't likely to get better with time.
As you can see, market based theories don't apply in this case.
Dear Southern:
The only thing that sometimes mucks up markets is government intervention. the government forces people to purchase health insurance through their employers. That's what makes doctors overpaid.
@Kirstyloo
Medicine is not a free market in any sense. Your statistics about medical school applicants are a little skewed as with computer based applications these days it is easy for applicants to look at multiple schools. Your 285 spots are not the only options for those 10k. Admittedly, the number of doctors being trained has risen very slowly with time, but it has risen (at approximately the same rate as population growth).
While I'd like to say that suddenly flooding the market with doctors would drive prices down, I'm not sure it would work that way. Doctors salaries would go down, they would lay off "extra" employees (my practice employs several advice nurses, a Quality Nurse Manager, and multiple other back office people who do their best to help patients with billing questions, etc. - it would be a whole lot cheaper for me to have my receptionist tell the patient the doctor will call you back sometime in the next 24 hours, but patients hate that and often are unwilling to make an appointment if they have a problem and expect their questions answered for free over the phone).
The flip side of medicine is not a free market either. Insurance dictates what you can and can't bill. Go to a different doctor in a different clinic down the road and get exactly the same service and your insurance company will pay a different amount because of a different contract (and these doctors can't compare rates because that is illegal, it is collusion). So, basically doctors get as much as they can from the insurance company (and it usually isn't the doctors themselves negotiating this, it is a clinic manager), bill a little bit more than their best paying insurance company pays and then the insurance disallows the difference. If it were truly a free market, doctors would set the charge and bill the patient the difference that the insurance company didn't pay (beyond deductible / copay). If those charges were too much then patient's wouldn't decide not to go to the doctor for minor issues.
I watch patients to to urgent care all of the time for a sore throat, for a skin rash that has been there for months (and they could just mention it the next time they went to their regular doctor), or repeatedly go back to the doctor over and over for symptoms they have had thoroughly evaluated numerous times by multiple doctors and have been told they have something like irritable bowel syndrome that needs to have symptoms managed yet they keep making appointments and going back to the doctor repeatedly expecting to get a different answer. Many of these healthcare seeking behaviors are just ridiculous, but in 2012 in America people want on demand care even for stupid stuff (and even when they know it is stupid stuff) - somewhere that tells me that prices may not be high enough to deter those people.
I do realize that the number of applications versus seats number has some limitations. What doesn't are the national averages...the number total applicants versus the number of total seats. There are approximately 2.3-2.4 applications per every medical school seat. That number has been as high as 3 per seat about 3 decades ago. It dropped just below 2 per seat during the boom years around 2005 when potential physicians entered other careers instead of medicine because they could do better in those. As the economy soured, applications to medical schools increased. That being said, we have many more applicants than training slots available.
It is important to keep in mind the bottle neck of residency slots. They are tightly controlled, and my opinion they haven't kept pace the need for physicians.
In my opinion, US doctors are not underpaid. One only has to travel to a few countries around the world where doctors do not enjoy pay remotely close to what US doctors make. Are there some expenses early in their career sure, but most of the people going into this field are aware of what they're getting themselves into and should plan accordingly; their lack of planning shouldn't justify a higher salary.
Should doctor salary be capped? As an advocate of capitalism and free market economics I would say no, however, I wouldn't want doctors charging an even high price for their services than they currently do. Also, you don't have an idea of what procedures cost until after the procedure is completed, so it would be difficult to shop around for different doctors.
Not completely true on "you don't know what procedures will cost". The same could be true of taking your car to the mechanic or anyone who services mechanical devices (though they usually call you with an estimate which can be +/- a bit after the diagnosis is made). Most doctors can tell you exactly what their fee will be for the procedure. What they can't tell you is whether or not there will be a zero, small or large pathology cost (it depends on what is found), what the hospital will charge you for the use of their OR/procedure room/nurses, etc. and what your specific insurance company is going to pay, reject, drag their feet on, try to get you to pay, erroneously pay when they shouldn't, etc.
I do procedures every day. I can tell patients EXACTLY what their bill will be from me for X, Y and Z procedures (though I may get into a procedure and have to change from X to Y or Z depending on what is found). I also tell my patients that my bill isn't going to be the whole charge (usually it is about 20% of their entire charge for the procedure, the rest coming from the facility/hospital and pathology) and I am not going to sit down with their insurance benefits for an hour and go through the fine print with them .... they need to discuss with their insurance company if they want to have an idea of what their part will be.
i think that in general, this issue boils down to loan repayment. if you come out of medical school with $200K+ in debt (more if you are an out of state student) and you go into family medicine, your $80-$120K salary coming out of residency will barely keep you afloat, especially compared to a classmate whose ortho specialty will net him/her $350K starting salary after residency. but these two students have the same amount of debt to repay because med school costs what it costs regardless of what you'll make in the field afterwards.
personally, i think the system is backward. the government (medicare) currently subsidizes medical residencies which pays for residents' salaries across the country. why not, instead, have medicare cover medical school. 4 years of free tuition, courtesy of the government, and then if you want to pursue a higher-paid specialty (with multiple years of residency), you pay for that yourself or with loans. it's a way to equalize the system so that family medicine is a more palatable option – you would only pay for 1 year of post-graduate residency, rather than, say, the 8+ years it will take to become a neurosurgeon.
Uh that is a terrible idea and I would definitely not go to a physician with only 1 year of residency under their belt. Med students are dumb enough when it comes to clinical medicine but a 1 year family practice guy is going to be deadly to patients. Keep in mind FP is a 3 year residency
Bombs...I don't think that this poster suggested cutting residency. Only changing it to a single year of paid tuition.
Given that the vast majority of med students are hard workers and smart since they are at least in med school....they can only be as smart in clinical medicine as their attendings and teachers (you) provide them to be
This is a courageous aritcle to publish, as the anticipated outcry is inevitable.
Most people just cannot contemplate the stress and responsibility Physicians worth with, and hence think their salaries are unreasonable. Soldiers in a war, police in the line of duty, firefighters in a fire work in about a similar stress level, but not many other careers do. I applaud soldiers, police, and firefighters for working in life threatening situations which doctors do not, but I honestly do think the stress is similar and more constant for a physician.
But the most important point is this: it takes a very smart person to practice good medicine. Most people who can be physicians wouldn't be physicians if the pay wasn't there because they could just do something else with a lot less stress. I do not mean to say most physicians practice for the money, because most do not, but I also know that without that reward, the number of people entering medicine would plummit and thus society would suffer greatly.
Shoot if I earned just a fraction (per year) of what these Docs do, I wouldn't complain one bit. When you are used to earning less than 20k while supporting 2 kids, even 5k more per year sounds grand. 🙂
I should point out that many of the doctors I have seen over the years I beleive are in it for only the money or bring the added stress on themselves. The reason I say this is because too many times appointment times have been overbooked and the doctor barely has 5 minutes or less time to evaluate any situation, otherwise I'd get a "Make a follow up appointment in ____days." with same scenario.
Now mind you during a couple hospitalizations then those doctors were more caring, but the typical family physician types- No!
If you earn $20K a year, you obviously haven't put enough time or effort in training to enter into a more lucrative career, or you don't have the intelligence to practice in a highly skilled field. Look at all that time and $ you haven't spent–you got to start earning a lot earlier. Hence, average or below intelligence, or little effort applied, and no education above high school = $20K /year. Quit whining about how little you earn –they only hand out free, unearned money from the welfare lines. Why moan about people who do work hard to earn their money and then begrudge them that?
Most patients assume we are able to control who gets booked into our overbooked schedules, but that is generally dictated by the politics and quotas set forth by the hospital. Would I rather spend 15 minutes solid with a patient and another 15 minutes for notes and scripts and ordering appropriate tests? Sure. But when we are told that you need to see 50 patients a day in order to keep up with appointment demand so that, god forbid, you don't have to have long periods to get an appointment, it borders on impossible to run a quality clinic.
I would invite anyone to live the life of a doctor for a week and then see what your comments are about whether or not we earn our money. My guess is most would last a single morning.
Momw2kids – If being a physician is so easy and so well paying, why don't you join the profession?
MomW2kids, you've hit on the crux of the problem. Every patient would like to spend more than 5 minutes with their family physician, however they don't want to have to wait in the waiting room for their 2:00 appointment any longer than 15 minutes. The problem is if we all booked 30 minute slots to speak with our patients in an 8 hour day that would mean we're only seeing 15 patients (allowing 30 mins for a meal). This, of course, means that more and more people will complain that it takes 6 months to get an appointment to see their doctor.
I can't see the health care economy keeping up this pace. As someone said, $3 trillion a year can't last. It's not even possible. It's a big bubble that will burst and the question is, how far? Is $1 trillion Ok? That's still a great deal of money. It's a thousand billion dollars and that's if we chop the health care spending by two-thirds.
It has to go down (maybe not off a cliff, but close). I do fear doctors' salaries will suffer greatly.
I agree that health care is a bubble. But doctors salaries make up only about 7-8% of that $3 trillion. Since there is a shortage of doctors, basic economics will tell you their salaries won't go down without some kind of artificial cap. There is plenty of fat to trim in areas that are far less important. Administration costs (in hospitals and insurance companies) makes up for about 25-30% of health care cost. Some estimates say frivolous lawsuits, and more so the tendency over test to avoid them (defensive medicine), makes up about 10% and maybe much more of costs.
If there is a bubble that will burst it will be in private insurance companies, which are extremely bloated and actually require an unnecessary amount of most doctors' time that could be spent treating patients.
medschoolkid –
I believe doctors' salaries are tied to seeing patients who are willing to buy medicines, lab tests, elective surgeries, etc., etc.
The important part of the bubble that will pop in the doctors' collective face (and paycheck) is that patients will have less and less disposable income (because of other necessities, e.g., fuel, energy, food, etc.) and patients will invariably skip more and more doctor's appointments and choose not to have surgeries that can be delayed, skip lab testing, etc., etc. I think the young-set who are racked with finding employment will quit seeing doctors and dentists wholesale.
The boomers will simply slide into medicare which is threatening 30% cuts in physician reimbursements with more cuts to come.
You can't just "quit seeing doctors", not practically at least. In the long run by delaying treatment you will only incur more costs. Or die. Do you really think people won't cut back on other costs to the point that they are willing to die? Do you think a patient will turn down a critical operation because they don't want to pay for it?
And as for the medicare physician reimbursement cutbacks, the medicare system has already denied reimbursement to the level that many doctors are limiting the number of medicare patients or not seeing them at all. Medicare will have no choice but to pay close to the actual amount. Otherwise medicare patients won't get make appointments. Its not about greed, its about sustaining a business like any other.
I do not think people understand the physical and mental stress that physicians are subjected to on a daily basis. Work generally does not end at the practice or hospital, as weekends are many times dedicated to paperwork. In a residency, an 80 hour work week is the norm. Family life and relationships with spouses can be strained due to a ridiculous work schedule. Yes, you make good mone but you pay for it with your limited time and crazy lifestyle. Many times, you have the stress of being subjected to frivolous lawsuits. It is not as good as it is cracked up to be.
There is a lot of people pulling the same hours and stress for less money. Doctors do earn their money but when someone complains of not making enough money when they are in the 99% of earning professions it rubs everyone the wrong way.
Donnie, 99% of people don't train as long, work as hard, or pay as much for their training plus interest accrued on the loans as physicians do. Don't go to the doctor next time you're sick and you'll soon be willing to pay them what they're worth!
Oh Linda, I am so sorry. Nobody in the entire 99 percentile of professions could possible ever experience anything that only those that have gone to med school and a residency have. I guess that just leaves doctors and the holy spirit
I began working with doctors 9 months ago. Before that, I had a good opinion of them. Since that time, my estimation of them has dropped significantly. The childish behaviors – I was once a teacher – I found astounding. They would often leave the doctor's dining room worse than I ever saw children leave a cafeteria. We – as a society – have put doctors on a pedestal and it isn't working. Even as residents, they except to be treated as "special" instead of realizing that they are part of a medical team. I think we need to stop expecting doctors to work miracles and be perfect. We need to limit the awards on malpractice insurance and then expect doctors to act like people. They deserve respect but no more or less than anyone else.
so says a nurse assistant? 9 months and you are an expert of physicians eh? Cute.
The funny thing about a narcissistic individual who make comments like "so says a nurses assistant..." is that they are incapable of observing themselves and therefore cannot comprehend the fact that everyone else can and do.
I am finding these stats for other professionals somewhat inflated and those of the doctors deflated for the purposes of argument. The fact that he grouped Lawyers, Orthodontist, Computer Systems Engineers in with Professional Athletes is a bit asinine
My wife has a PhD in Biology. She was in grad school for 5 years, then got a job as postdoc in a research lab earning less than the techs who only have Bachelor degrees. She is now in her mid 30s and still not earning anywhere near what she could have if she started working right out of college. Her research focuses on a specific childhood disease, so she is definitely helping people live better lives. She loves her work and we aren't having any money problems, but to hear these doctors complain about money just makes me sick. They aren't the only people who spend a lot of time, money, and blood to get through grad school, and they certainly aren't the only people whose work helps the sick. Where do they think all those medications they prescribe come from?
I'm sure your wife works very hard and her work is greatly appreciated. But she is not subjected to the daily stress that doctors are. Nor is she on call and required to come to work at any time of night. She doesn't have to deal with all the BS insurance paperwork either.
Stress is subjective
Let me know when a researcher is pulling 80-100 hours a week for 30+ years. Then get back to me.
Actually Donnie stress is directly correlated to cortisol levels. It is not subjective, it simply occurs more at a baseline level in some people.
Great point, Yaya.....Medschoolkid, maybe Yaya's wife isn't subjected to the same daily stress by not having regular patient contact because she is in a lab or doing research, but how about those who got their Ph.D. in Psychology and do have direct patient contact, ARE on call being called in at all hours, do have similar liability risks, and still have to mess with all of the insurance garbage? Psychologists go to school for as long as some physicians and get significant LESS compensation than any physician in practice. Yet all of the focus is about physicians who feel unfairly compensated. You don't see an article on Psychologists complaining about their compensation. I think if asked, most people would say they would like to earn more and feel they deserve it!
Funny, I have seen my father (cardiac surgeon) preform several procedures like he was riding a bike but the man couldn't sit in front of a loan officer and ask for loan without having a panic attack. Probably because he was trained to do one and not the other. Its a parallel argument to hitting a baseball. One is trained to deal with a confronting obstacle and it becomes routine. Stress is completely subjective to environmental situations and mental make up.
Yaya, at least your wife can say she contributed her intelligence and skill toward a cure as opposed to crying about not profiting off of symptomatic treatment. Hmm kind of like Jonas Salk.
medschoolkid:
You are a really self-centered person. Do you not think that it's stressful to be a scientist? You have no control over the results of your work, but you will only ever make any real money if the results come out a certain way.
Being a PhD researcher is stessful and involves long hours! You people who say it is clearly less stressful than being a doctor have no idea. Getting a Postdoc position is hard, and then you are expected to work 10 hour days and my PI required a minimum of 4 hours on Saturday. If you do get a faculty position, you are working 80 hour weeks trying to do research, secure funding, teach courses, and prove you diserve tenur. Then when you get tenur you have to work 80 hour weeks to maintain funding, manage graduate students and postdocs, and teach. And what do you mean not being on call at night? I have had to drive to the lab at 1 am to meet time points that just wouldn't fit in a 10 hour day. PhD researchers certainly work hard and long hours.
Regardless of stress on the job (I know a lot of happy radiologists with a lower stress level than almost any PhD), other graduate programs in the arts and sciences do not have the same financial stresses as medical school. PhDs often are educated for FREE, and MOST get a stipend. They do not understand what it feels like to be buried in >$150,000 of debt. AND they make real pay after their education, they don't have a financial waiting period called resdiency/fellowship. Physicians need to be compensated for the costs of their education.
Doctors are not the only professionals who are forced to work for free. Attorneys can be ordered by a judge to take pro bono cases. Teachers often spend 20 hours per week of their own time planning and grading papers; they also typically spend a week or more of their own unpaid time prior to the beginning of the school year preparing classrooms and lessons.
One would also think that someone with 11 to 16 years of higher education would have a mastry of grammar and syntax. "Dr. Peterson is a plastic surgeon whom I worked with during my residency," should be, "Dr. Peterson is a plastic surgeon with whom I worked during my residency." Prepositions must be followed by objects.
Most people with a mastery of grammar and syntax know how to spell mastery. And grammar and syntax aren't exactly subjects in med school. Last time I had to suffer through grammar was in junior high.
What Dave did was unethical – period. The insurance company should have made out the check to the doctor or medical facility – so part of the culpability is theirs. Dave misappropriated that money, plain and simple. He did it on purpose, and he freely admitted it, the jerk. (BTW, isn't that referred to as "fraud"? I am retired and on a fixed income, I've had some (elective) minor PS and am trying to figure out how to afford a follow-up – I've been wrestling with it for a year now and I'm not sure it will happen. I'd be THRILLED if I had an insurance company hand me a check for those – or any other – medical expenses. I have excellent medical insurance that covers part of this expense, and it's still a challenge. Wake up "Dave" – your an idiot. That doctor should call an attorney. . .
These stories about doctor pay are so aggravating because of the inevitable onslaught of comments from people who just don't know the truth and base their perception of all doctors on their experience with a few. in particular the post about how doctors leave a dining room is ridiculous to factor into your perception of all doctors. to the poster complaining of only 5 minutes per visit with the doctor and being overbooked – this is an issue with the system and not a factor of doctors "being in it for the money." in order to keep up with the overhead of practices, doctors have to see more and more patients in a day with reimbursements being cut. patients show up late or no-show without canceling an appointment all the time. to factor this into scheduling, schedules are overbooked so to not risk seeing to few patients in a day to cover the overhead.
1. doctor pay is adequate if it were not for a few reasons:
a. having to pay for malpractice insurance in a country that will not accept tort reform (except for texas) – onus is on the doctors to protect themselves from litigious patients and lawyers all to ready to take a case
b. 3rd party profits (insurance companies) – these companies and medicare set doctor's payments. doctor's do not sit and decide how much they want to charge for visits, treatments etc. i'm talking about non-elective treatment
2. consider that the medical student who just graduated from medical school on loans of roughly $200,000. Now this medical student takes on his/her first paying job as a resident for at least 3 years at salary of $45,000 working more hours than most but has to defer the payments on those $200,000 loans while accruing interest on most of it. Also keep in mind, interest has been accruing since the first year of medical school. Interest rates are fixed at 6.8%. Now 7 years out, in their mid 30s, they can start paying off loans, start building a practice (not free), get their first home, start a family with the 150,000-200,000 they will now get. I think all of that is manageable. The concerning part is that there are a large number of people who think this is overpayment and want to cut this salary. Furthermore, a large majority want this group to be taxed even more than 40%. People who go into medicine, for the most part, would like to live comfortably while providing care to their patients.
Bottom line, if you give us tort reform, leniency on school loans, get rid of for-profit 3rd party organizations that serve as middle-men in health care access..i'll consider taking a pay cut but until then don't touch my salary that I have and continue to work hard for
well said.
Finally someone who can actually present facts and figures and isn't basing everything on opinion. All these people claim to think they know something about doctors but are drawing conclusions based only on the handful they've dealt with. This is clearly faulty logic.
Very well spelled out!
Their financial problems is their darn responsibility.
Over booking is also their problem and their greed. Do not tell me that it is because of patients canceling without notice. Most doctors will charge for that.
Caring for people should not be for profit. Our system (the worst in the world) is pure example of what you get.
Most people want to be a doctor for the MONEY, not because they care about healing patients or caring for them. So, you spent all that money for your education? that's your darn problem and you shouldn't be gauging your patients.
Doctors are NOT the whole problem of course. The entire health and medical systems (and governance of it) is just plain WRONG!!
Most people in medicine are in it to take care of people. Those who got into it for money are generally quite unhappy, because they soon realize that the money is not that great compared to the amount of sacrifice it takes to become a good doctor and to practice medicine.
The problem with this forum is that most of the anti-doctors posting are looking at it from a perspective of money first, just like the unhappy doctors who got into medicine for the money.
I love being a doctor and taking care of people. I couldn't see myself being happier doing something else. I hope that my kids will find a career, medicine or otherwise, that allows them to feel the same. I don't mind working hard. I expect to have be financially secure because of all of the sacrifices that I have made to get to where I am. I don't think that this is unreasonable, or "narcissistic" as some in this forum accuse all of us doctors as being.
I've heard sooo many people argue here that doctors are under "so much stress!!" –
If that's true, then what good are they? I mean seriously, I thought our medical schools weeded out these weaklings in the first place. Secondly, I thought that after "all of this training" and school, doctors would know what the blanky-blank they were doing, no matter what.
If doctors still feel "so much stress" after making it through the selection process and 12+ years of school, then one thing is for certain: the med school chose the WRONG PERSON!
If performing medicine, surgery, or what ever is stressing you out after all of the riggors of traininng, then get a clue: the job is beyond your natural capacity and somehow you squeeeeeked through anyway. You should resign yourself to picking weeds out of gardens instead.
Stress is stress, and doctors are truly under a lot of stress. Medical school weeds out people who struggle with handling the stress. The stress of saving someone's life is a great one, and it is always present. Doctors will always feel the stress that comes along with their job.
If that's the case, then I am certain the person and the profession are a mismatch.
If after a rigorous selction process and 12+ years of school and training a doctor still can't perform their job with aplomb and the greatest of ease, then they should NOT be performing medicine.
This notion that doctors are under so much stress and therefore should be financially compensated is bogus. These are the doctors that shouldn't be doctors and slipped through anyhow.
Are you serious? If you fire all the doctors who experience a great deal of stress day to day, you would fire 99% of them. That sounds like a great idea. Practicing medicine is ALWAYS a challenge.
Being a physician can be quite stressful and training to be one is stressful as well. I would know because I am one. Is it too much? Depends on who you are asking. I have days when I say, "god, this is too much" but most of the time, I don't notice how stressful it is. That's probably why we graduated from med school. Most of us have a capacity to just "deal with it". As a physician, we get used to the "above average" levels of stress. BUT, just because you get used to it, it doesn't mean that we don't feel it. And just because we chose this profession, it doesn't mean that we aren't allowed to feel it or at least complain about it from time to time. Again, I chose this job, I knew what I was getting into and generally, I am quite happy with my choice. For all of the "stress" it can bring, it brings me a lot more – satisfaction taking care of patients, intellectual stimulation and some money in my pocket. But doctors are not superhuman. Find me a doctor who says that their job isn't stressful and I'll tell you that they're lying. If I walked around saying, "this is so easy, no stress at all, everything is fine", there would be something wrong with me as a physician. I'd be a ROBOT! But to be honest...I kind of like the stress and pressure. Many doctors will say the same thing but there is a tipping point where it can be too much. At the end of the day, physicians are stressed and so are a lot of other people. As for pursuing a career in gardening, maybe....one day....but today I love being a doctor!
Have you ever had the direct responsibility of someone's child, mother, father, spouse, directly in your hands? Everyday?
Dr. C:
I think you described mothers.
Victor, I'm an oncologist and make critical decisions on my patients on a daily basis. Not every decision is stressful, but some people come in who are very sick and are challenging to take care of. I often worry about my patients when i go home. So yes, I freely admit that I can get stressed at work. I dont think my medical school chose poorly in me. I dont think my patients do either.
Medicine is not black and white. It is very much an art. If YOUR doctors are NEVER stressed, then they are practicing cookie cutter medicine where everyone is treated the same, no matter what. I'm pretty sure that's not what any of the doctor-haters on this forum want for the,selves or their loved ones! What kind of amazing genius are you that you don't get stressed ever in what you do?
As a faculty member at medical school, I've trained approximately 2500 medical students to date. Medical school is horribly stressful. Schools actually try to decrease the stress because it is thought to cause students to become less empathetic. In addition, it (and the whole profession) can have a destructive effect on the student and ultimately the physician. Physician's have higher rates of depression, suicide, alcoholism, and drug abuse than the general public.
As someone who has sat on medical school admissions committees and interviewed students for over 12 years, we try to identify caring, well-balanced, smart students. Overall, I thing that my school does a decent job of this. Please keep in mind that only about 5% of students don't complete medical school. Our accrediting agencies would become concerned if that number jumped to 10 or 15%.
Look at it this way. Everyone thinks they are underpaid. It all depends on the context. If your toilet is clogged and the crap is starting to run all over the floor, paying a plumber big bucks is not a issue.
Fresh out of med school, a new physician faces huge student debt and outrageously expensive malpractice insurance premiums. Their income may be high, but so is the cost of maintaining a practice.
If A-rod, Jeter, or any other sports notable has a bad day, a bad week, a bad month, or a bad season, no one cares. They still get their money, and JulieMS and Victor are more than happy to pay the ticket price to see them perform. However, if the physician unlucky enough to see them in the middle of the night makes the slightest error, JulieMS and Victor will be more than happy to sue for all that the malpractice carrier will allow, badmouth them on public blogs, and then make shortsighted and critical remarks about the care they received and how overpaid the treating doctor was.
It is a no win situation for the physician. The public expects physicians to bat 1000 every time a patient interaction occurs, yet they want to reimburse physicians on par with many other professions that are NOT held to the same level of accountability...not to mention the unequal years of sacrifice, training, level of stress, liability, etc. (already mentioned in some of the more well-written responses above).
Most of the critics here have no problem doling out top dollar for concert tickets, premium aged beef, cars, clothes, wine, jewelry, etc, but for the best health care in the world, they want it for free.
One day, when JulieMS and Victor (or one of their loved ones) requires some sort of emergent health care intervention, they might just realize the value having a qualified physician at their side.
Actually athletes are scrutinized on poor performance. To see this you only have to watch or read one of many mind numbing forms of media. With the exception of the elite most are dismissed pretty quick and won't make anything even close to the life time of salaries they amassed in 1-3 very short years. Maybe one day when socioeconomic class system crashes and all hell breaks loose, you'll remember you dedicated your life to the study and practice of medicine and not profiting from symptomatic treatment of illness.
I have attempting to post a blog for the past three days but it appears that I am being censored. Have had terrible experience with doctors and wanted to share them with other bloggers.
Dude I hear ya. Everything I try to post gets scraped
Let’s review some history and facts to help us grasp at the truth and to dispel myths and false medical propaganda:
1. Could nurses (or anyone in general) perform the activities that are now done by doctors?
A. Google the story of “The Blue Babies” that relates that it was a technician, a Black American that was classified as a janitor, who developed and trained doctors at John Hopkins hospital to do heart bypass surgery on Blue Babies.
B. There was a recent story on TV that related the success that a young doctor is having in constructing and running new hospitals in India. He does not look for doctors in medical schools. This doctor recruits young students from high schools and trains them to practice medicine. The success of this doctor in building and staffing new hospitals appears to be in his rational thinking which displays great humbleness. He is building more hospitals than any other organization. This doctor believes that others are just or more intelligent than he is.
So anyone that is trained can do what doctors are trained to do!
Exactly!!! Its all about the training, humility and the desire! These people weren't tapped by god.
Cruzer:
I really think that's how we need to go here in America. There is no law that says you have to have a degree to be a doctor. You only need to pass a test. I do not want to be asked to repay my doctor's $500,000.00 student loan. I would be happier if older doctors would take on young apprentices. If the apprentice can pass the test, then he/she can move up the ladder in the practice. That would be better.
You can train a monkey to operate, but what happens when things go wrong. What happens when that person doesn't have adequate education and 20 years of experience to save you because they were an apprentice, and you die from something completely preventable. Get a grip.
Dr. C:
A person who started as an apprentice has MORE experience than a person who started as a freshman in college. And why do you think that a doctor's apprentice could be a monkey? How weird.
While I strongly support the role of PAs and NPs in medicine, I don't think that you'd like the success rates on trained HSs. In India, the public accepts poor health outcomes better than the US.
And no, like it or not you can't practice medicine legally without one of those little $500,000 pieces of paper.
Colleges, medical schools, residency programs, and medical boards all serve to ensure that those who practice medicine are adequately trained and capable of providing standard of care medicine.
But you guys are right, we should abandon these processes and let Dr. Smith train an apprentice instead. As long as the apprentice can "pass a test" afterwards, it should be just fine.
Rather than crying over your so called lack of earnings, why don't you actually do something like become a political power and do something about the 3rd party inhibitors and the educational loan formats that are gouging all of us. Ha, I guess that wouldn't happen because if health care became a fair and efficient practice you'd would make even less money.
Let's say you have appendicitis. And let's say if left untreated you would die. And let's say there was no insurance, no medicaid, no medicare etc. What would you pay? What is that skill set that physician earned over 14 years of 80 hr work weeks worth to you at that moment? Is it worth more or less then the ability to throw a football 100 yards? Hit a baseball 33% of the time? I would suggest that the money that you as that sick patient would put on that is limitless.
Let's say you have cancer. Let's say it is incurable and you are going to die. And lets say that another human being has to come into your room and show you compassion, empathy, and tell you this horrible news. And then let's say that that person has to go do that 3 more times that day. What monetary value do you place on that as a patient, as a family member? How much should that person be compensated.
People who complain about Dr's salaries have no concept of the practice of medicine, nor do they understand the complex challenges Drs face everyday. Most of which would put the average person in the psych ward. These are often the same people who demand state of the art care at no cost to themselves when they get sick.
So I propose this system. You don't pay me anything at all, and I won't treat you for anything at all. Let me know how it works out for you.
OH!! So your contribution to humanity is healing and treatment of the sick BUT only if they pay you handsomely? Awesome philosophy! Its funny, because of all the things we humans have evolved to the practice of Medicine and the objective treatment of the sick is one that sort of transcends all the pretentious things we have created. It (Healing) in a way comes closes to godliness. A real life shepherd of men. Which I guess is the reasoning behind the ego, which in turn is the reasoning behind the desire for astronomical profits. Hi I (attempt) cure humans, bow to me and give me your riches.
Superman:
Let's say Otherman can perform the same services for less. What do you do with your empty waiting room then?
Otherman: Hard to Dr. shop when you have an emergent life-threatening condition.
Hey Dr. C. Enough with the extortion already. You find an office with a price sheet. That's where you go with your emergencies. You shop BEFORE the emergency occurs. Doesn't take that much intelligence.
Oh my.
Let's say that you're a doctor and do all of these things...then you leave. And a nurse is at the bedside is left to actually helping that person cope with that terminal diagnosis or caring for that patient with appendicitis...while you do what? Go home and open a bottle of Merlot while patting yourself on the back.
If a person works in the healthcare system and thinks that they're superman, literally doing all of this one handed, they're delusional. It takes a team of people to deliver adequate medical care to the seriously ill.
I have a great deal of respect for dedicated physicians. I roll my eyes at those who don't get that they're not doing this alone.
It is interesting to note that the article does not take the time to compare physician's salaries with the salaries of other healthcare providers. Long gone are the days where a doctor shows up with a black bag and administers the medications himself. In fact, with the exception of surgeons, many of today's doctors do not actually perform treatments or give medications. Rather, they direct a team of nurses, paramedics, and therapists whom are an essential part of the healthcare system. I guarantee, The two doctors in this article did not perform surgery on "Dave" by themselves. They worked in an operating room full of nurses, techs, and surgical assistants. None of these other providers make more than $100,000, and yet they often perform dangerous and physically strenuous tasks such as restraining combative patients, or lifting and moving obese patients, that doctors rarely, if ever, take on. Such tasks often lead to career-ending injuries (i.e. a paramedic with a bad back can no longer lift patients into the ambulance), and yet allied health are compensated at a far lower rate than physicians. This article, as with healthcare in general, is too physician centric. It takes a team to care for a patient; if salaries are to be discussed, let's discuss salaries for the entire team.
Doctors still bill independently even though you where treated by the team and sometimes not even seen by the Doctor
Doctors are so narcissistic I don't think they even know you exist. Ask them to share in the salary wealth and they'll come up with a 1000 reasons why allied health professionals don't deserve to eek a living.
Give them half a chance and doctors claim they do everything and they'll leave out the important fact that they had significant help.
It's all about them.
the team members are paid a set salary and get paid even if the doctor does not get paid so i'm not sure what your argument is other than the article that was written about physician payments not being about the ancillary staff. furthermore, in some cases the same ancillary staff wouldn't get their paycheck if the doctor doesn't get paid. i understand your concept of team, but if the doctor doesn't get paid, just wait for the trickle down effect
true.. healthcare is a team work; however, the leader in this team is the doctor, and without the doctor, there is no team. A doctor replace any of the team members; but none of the team members have enough knowledge or experience to replace what the doctor can do.
The ratiionale here seems to be, "Generals can't do anything without soldiers, so pay the generals the same amount as the privates." Or, "The business owner can't run a business without employees, so the employees should get the same compensation as the owner." Maybe you should work in a North Korean hospital.
I don't think that doctors are overpaid, having had my life saved by a great team.
My question is why did the insurance sent redneck Dave the check instead of sending it right to the doctor? My insurance paid the doctor directly minus any deductible, etc.
There is another type of insurance that pays a patient for their loss, rather than paying the doctor for services rendered. It's more expensive, and it usually only covers catastrophes.
Hmm... If one genuinely wants to demonstrate that physicians are underpaid, it's probably not the best idea to employ examples from the country's MOST grossly and undeservedly overpaid professions, such as managing directors at Morgan Stanley, NFL players, and so on. Unfortunately, one of the reasons a significant percentage of physicians believe they are underpaid is that too many of them are materially/financially motivated, in the FIRST place.
The symptomatic treatment of incurable conditions is the ultimate business. You never need to market, never need to worry about lack of customers, or the end of disease. Its the perfect most sound proof business model. The profit stream is endless, the only problem is there are too many cups in the river and the docs are mad.
That's right. The med students who think they're about to get rich have miscalculated. Wherever there is a gravy train, you will find a pack of dogs.
Instead of complaining about how much athletes make or entertainers people complain about how much doctors make, people who actually contribute to our society. Four years of college, medical school and residency and fellowships can equal to almost 20 years before you actually become "a practicing physician". Not to mention that this is America so you have to worry about people wanting to sue you because these days if there is something wrong with you or your baby it's the doctor's fault. One unfounded lawsuits can ruin your entire career. On top of that the amount of debt you are in once you graduate medical school is in the hundreds of thousands. I realize that the amount of money they are getting right now is high but if you put it in perspective they are definitely underpaid.
And arrogant.
I suspect doctors don't really contribute all that much. Other countries are using medical providers with much less "training" and a bit less education and their health care results are actually better than ours. Best of all, they are paid less than our doctors.
American doctors = lucrative profession (whine, whine, and say PAY ME)
Other doctors = noble profession (humbly get down to business and don't over-medicate/over-test patients)
I suspect 90% of what takes place in doctors' offices can be done quite competently by a Nurse Practicioner or Physician Assistant.
If done correctly, we could use a mix ratio of 85% NPs or PAs and 15% doctors (for surgery, ICU, and "life-saving" events).
It certainly would be cheaper for the rest of us "mere mortals" –
Who will take responsibility when an error is made? CRNP's and PA's don't. Ah, that's right a doctor does.
Have any of you ever made an appointment at a doctor's office? Have you ever noticed their business hours. Typically 3 days/week, 6 hours/day. Where did this claim of "working 80-100 hours per week" come from?
Because that Dr has 3 other offices and sees patients in the hospital before and after office hours. Get a grip
Nope. One-office doctors. Not hospital doctors. Private practices. Please do not hurl childish insults, dear.
Yes, there are regional practice differences. In my region, an academic physician usually works 60 hours/wk plus call every 3rd or 4th weekend which can add 8-16 hours to that week. A number of the female physicians I know work part-time as they raise small children. On that note, the receive less compensation too.
please try and not group the few doctors you may have seen with such hours and try and make a case that all doctors work these hours. just as you may see some doctors that may be nearing retirement with less hours, you may have doctors working upwards of 80 hours at the beginning of their careers. also, there are different types of doctors if you may have not noticed. surgeons for instance may have operating days on those days you think he/she is off golfing and therefore can't be in the office to take care of you when you want them to
Why do you meddlers insist on using such inaccurate verbiage?
Doctors are overpaid: Go to medical school, become a physician, then come talk to me about what you think you might know.
Because we are now conditioned to only speak about the "cost of Medicare", not for what it actually is being spent on: a great percentage of the money is being spent almost frivolously. "End of Life"care is taking huge amounts of the healthcare dollar. People are being treated with expensive hospitalizations, meds and procedures even when they can no longer speak, feed themselves, walk and ( not or) have purposeful movements. Yes, there should be a point, a formula, a board or a set of rules/calculations that determine how much should be spent and for how long. This has very little to do with the doctors' salaries, but, perhaps does have somethuing to do with their sense of hopelessness when they see hungry children, homeless families or unemployed people without the benefit of a program such as Medicare.
I am a relatively new physician and I've made some observations. The funny thing about being a physician is that income for many physicians has not kept pace with inflation. In fact, many physicians are paid less than physicians were paid 20-30 years ago for performing the SAME work. I currently make less than half of what one of my older partners was making at the same stage in his career 20 years ago without adjusting for inflation. Costs associated with providing care have continued to rise (rent, staff salaries, supplies etc.) but reimbursement, in many cases, has decreased. Physicians need to see more and more patients just to make ends meet and, yes, earn a good living. Unfortunately, seeing more patients means less time with patients which often leads to ordering expensive tests (CT scans etc.) instead of taking a good history from the patient which might make the test unnecessary.
I also find it amusing to read the posts about whether or not medicine is a stressful profession. One thing I am learning is that being a physician is very much the "practice" of medicine. The practice of medicine is stressful because there is rarely a black or white answer and the stakes can be quite high. Most of the older physicians I have spoken to limit their practice as they get older to avoid stressful situations. Many tell me the most important thing they have learned over the years is humility. It does not matter how much we train and prepare or how skillful and knowledgeable we are, we all have patients that have complications and die, even when we do everything correctly. Unfortunately, most of us have difficulty accepting that some things are out of our control.
Are physicians over or underpaid? Obviously, one's opinion on this depends on your income, experience with physicians, and career. As for me, my income is only a fraction of what many physicians in my specialty were making 20-30 years ago and there aren't many professions where your income not only doesn't keep pace with inflation but actually goes down over such a long period of time. Having said that, I do enjoy my profession.
Newsflash:
The median US income has not kept pace with inflation. Cause we're poor now. It think it's down 7% since 2008, WITHOUT adjusting for inflation. Doctor's pay has kept up much better than everyone else's.
Newsflash:
I referenced decades, not just the past 4 years. Physician income has decreased even during periods of economic growth, when "everyone else's" flourished.
Sorry, md, but I also make a lot less than people in my job used to make 20 years ago, indexed to inflation. Salaries in the US have not kept up with inflation since they started offshoring everyone's jobs in the 1970s. It is amazing that you haven't noticed that (but you only noticed it about your own pay).
What is your profession Doctors R Overpaid?
Doctors R overpaid id part of the flood.
He is parasitic in nature and only seeks to destroy. The flood can only be stopped using widespread sterilization.
Both of my parents are Family Physicians. I am very proud of BOTH of them, because they rose from the bottom of the economic system to NEAR the top. My father grew up in Syria working in the desert as a shephard. He always dreamed of helping his family get out of the poverty. He worked so hard that he earned the highest grade on a standardized test in the region!! To put the story short, the seemingly impossible dream became a reality to him. Immigrating to the U.S. brought many challenges. His so-called "friends" used his naivety against him. He always kept an open mind and walked miles every day with the huge Harrison's Internal Medicine text book!! He devoted his life to the CARE of people. that is the best gift anyone could give to the world, and he has done so much to help me. He has guided me onto the right path of love. He says I must be passionate with whatever I choose in life, and his choice was Medicine and People.
As soon as he is done his 9 hour shift, he drives all the way up to my college 2 hours away to see my soccer games. Then he would drive back down to make it to my little brother's basketball practice. By the time he would get home every night from his four children's various activities, it would be 10 pm. Then, he would clean and cook for the family, and FINALLY, read over all of his patient's files for that day. My mother, same story and extreme work ethic. When you grow up with limited resources, then every wish you make upon that one star on a brisk night counts! I know alot of people work hard in other occupations. I know alot of people stress. Ha, I stress every day as a Biology major!! I just hope people understand that some physicians really DO CARE about people. They live for their patients. They remember EVERYTHING about them. Trust me. You all are their life... haha well besides us( their children of course!) So, please respect the hardworking example I gave you all...
One reason why public thinks that doctors are overpaid is that they don't have an idea that doctor's fee is only a fraction of health care cost. CT scan was invented 30 years ago but the cost has not come done. Routine blood tests and IV gadgets cost more then what they used to be, Although they still do the same job.Some of us would like to spend 1000 dollars going to Mexico but when it comes to paying for doctor's bill, they become uneasy.A plumber coming to my house charges me 80 dollar an hour and if it is after hours it goes up to 150 dollars.A doctor is usually paid once for a day even though he attends to his patients for many hours.I pay check or cash to my plumber as soon as the job is done. A doctor has to hire a billing secretary to fight with insurance company to get the money 1 month later and some times the claims are rejected.
I'm not sure why i can't post, will try and split this up...
to the above poster cruser...
such a myopic view of reality. while i agree that if you teach someone to do a specific task or skill over and over again, that person can be proficient enough at that task. the practice of medicine does not read like a manual for your iPhone. the purpose of a residency training program is to provide said "apprenticeship" in the setting of evidence-based medicine with access to a wide range of pathology. if one was to train under a near-retirement physician alone in his/her private practice under a true apprenticeship, i can guarantee you he/she will not be my doctor. first of all, most of these doctors are grandfathered into not having to recertify their medical boards every 10 years. the vast majority of these doctors will not be up to date on the newest technologies/medicines available to patients.
Puzzling. You have such an ineffective understanding of the medical education system. Your ignorance is insidious and elegant.
I don't know how "Dave" here can call himself a decent human being. Yes, he may feel the doctor is overpaid, but that's just dishonest.
Are doctors overpaid? Maybe. But lawyer fees for being sued for malpractice are way overpriced. So is medical school. Along with all the (often unnecessary) tests doctors HAVE to give patients because they will be sued otherwise. Their skills are in high demand. Doctors are paid what people think they're worth. Health is one of the most valuable things we have. That someone has devoted their life to preserving it should merit a high paycheck. It's unfortunate that cosmetic plastic surgeons make a lot more than primary care physicians, who are actually a necessary part of society.
Dave is like the flood.
Dave only seeks to advance is own self interest.
The lay public is like the flood. Eager to consume all.
We have too many lawyers and not enough doctors. The worst doctor should make more money than the best lawyer. Doctors save lives & lawyers screw up lives.
I'm coming to my 12th hour of work tonight, I'm taking a five minute break to have a yogurt, because that is all I have time for. Unlike every other member of the team in the hospital, doctors do not have breaks built into the schedule and doctors do not get paid overtime. My husband is a lawyer and made 160,000 straight out of law school. My father is in business and makes 400,000. I am making 50,000 and I'm currently taking care of two hundred patients in the hospital right now. I've already "coded" two patients tonight. Your blood pressure rises just watching a code on House, think about what we do in real life. It's easy to say we get paid too much, but it's also crystal clear to us you have no appreciation for what we do. Two codes: one survived, one died, two code carts, 11 rounds of epi, 2 of nor epi, calcium gluconate, bicarb. I can't even fathom how much that cost. Yet the hospital will see none of that because the patients cannot pay because they have no money. But I'm more than happy to try to save your life. The doctors on the team are the least paid members of the team, per hour basis, that just tried to save your loved one. Call me narcissistic, but I'd like to argue that we're also the most important.
Your narcissism knows no bounds and it's built in somehow during education and residency. Arguably, unless you were standing right beside that patient (who lived) when they died, the most important person was the one who called you, otherwise, that patient would be as dead as my sidewalk, even though "YOU" "the Almighty" one, were on the next floor down. Same can be said for the person who make sure your crash cart was stocked with epi....what would you have used, a needle full of tap water.
The fact is, "critical" "live saving" steps in medicine involve people that aren't doctors and without them, the medical doctor profession would look like bumbling fools, standing there arguing about not having the right stuff on the crash cart, or not being told someone is in 'code-blue.' Meanwhile, back at the farm, people would be crashing left and right.
Most important: the poor smuck Ph.D.s and Pharm.D.s (both doctorate degrees) that designed the Epi and nor epinephrine in the first place. What would you have done without them? Pushed the coffee you were drinking?
I have an idea – give credit to the poor smuck electrical engineers that designed the EKG/monitors that told you the patient was in vtach! How else would you have known when to give the meds? Arguably these equipment designers were more important than you at the moment. In fact, their work lead to 100s of thousand of lives saved. Your involvement only lead to a relative few.
Doctors are so narcissistic it's uncanny. They'll spend their lives believing they saved heaven and earth, when in fact, they're mostly just technicians that use the technology and meds designed by others that didn't go to medical school.
But, hey, if they claim "most important" enough times, maybe we'll believe it one day. Not. I suspect a good set of nurses who have been to ACLS training year after year and assisted with codes 100s of times could have saved that patient without a medical doctor. Are you really suggesting the nurse couldn't? I've sat in on ACLS training and it's pretty by the numbers if you ask me (and I'm not a nurse).
As a former ICU nurse who oftentimes did mandatory overtime from anywhere from 12-16 hours, who laughs at the idea of 'breaks', I have only one question: How do you code someone by yourself? Did you actually do the compressions or did you stand there and watch the nursing staff rotate doing this for 45 minutes? Inject a drug? Heck, stock that cart? Did you drag the cart in there? Who hit the button in the first place? And if the patient died, did you clean the room, wrap the body, make sure that alll of their belongings made it to their famiily? Tell the family that the patient died? Contact the coronor and/or the mortuary? Push that gurney to the morgue? Break down the room and get ready for the next patient? Chart for the next two hours after your shift as to exactly what happened, who did what and why?
Oh wait, that wasn't you. That was the nursing staff in that unit. The code TEAM.
I have a great respect for the long hours that some doctors work, and their base pay when they're first starting. But I also know that your rate of pay is what a nurse can make for the entire length of her career, and never see anything better than that after decades. And they can do the above and so much more, all day, every day.
IEvery order you write, every good idea that you have, no matter how realistic or unrealistic, someone else has to carry out. From nurses, to respiratory therapists, to lab techs to those ultrasound techs, someone else iis going to make that happen for you. You are not alone, you have a team. And that team is going to work it's but off and be just as liable as you are if something goes wrong. Only the odds are high that the facility will give you a high priced lawyer and 'we' get to just figure that one out on our own.
You want stress? Be the person who is on the lower end of the food chain but gets to carry that responsibility, too.
I do feel your pain, and I have respect for your position, but it's incredibly myopic and more than a little self centered. You can't have a team of one person. The best that you can do by yourself is one person CPR.
Many people making these comments really don't have any idea of what it takes. The average take home pay for a medical visit is charged at around $75 paid by the Insurance at around $45 minus the copay the pt gave, after expenses the physicians take from that is around $25 minus taxes which leaves you with about $15 . that is for Primary Care. How many Mechanics would diagnose your car for that much less fix it. Would a Lawyer, Accountant,or other professional or construction worker do it? Besides that regular 8 hours of work at the office there is hospital rounds, paperwork, charts. Is the time being sacrifced from the family worth anything? Yes Drs are underpaid, and spcially Primary Care. No NP's and PAs do not have the same lavel of training expertiseor knowledge. Are the requirements to get into those schools the same as for MDs? Why did they not go to Medical School? One way to reduce the shortage of Physicians commin in the near future is to make pay more equel across the board for the different specialties and add added pay for diffferent procedures so that people will do what they like and do the best and not jst for the money. These Physicians can be assisted by the NPs and PAs for the less complicated cases.
Doctors drive up the cost of all health care by ordering far too many tests, both laboratory and x-ray, and by passing out too many drugs that the patient doesn't really need.
No matter what doctors are actually paid, they are responsible for sky-rocketing costs, because everytime a patient needs to be charged money, it's the medical doctor that ordered that service.
To some respect that's true. But, doctors aren't the drivers of thsoe requests for more tests. It only takes one patient going sour and having to explain to a jury why that $5000 test wasn't justified to make that doctor decide to order the test next time. And, don't get me started about the families, usually without any insurance, who want "everything" done for their terminally ill, irreversibly comatose great-grandfather except to be allowed to die with any peace or dignity. Those people are the ones who REALLY drive up the cost of medical care, which the rest of us have to pay for.
To some respect that's true?? How about to every respect? Doctors never take responsibility. Even in this case, they blame the patient and courts. Then follow it with the rare event of a financially broken family that wants to keep old fester alive for $1 million. Those examples are supposed to give justification for doctors ordering too many tests and medications and driving up our health care costs to three trillion dollars per year? Do you know how much three trillion dollars really is?
Doctors should know how much three trillion dollars is, because they are responsible for driving every dollar of it.....except bad outcomes, that's never their fault. Someone elses.
I wish it were as rare as your believe.
My 14-bed ICU has fourteen of these "rare" cases filling it up right now.
I don't believe doctors will ever give credit, because their narcissism is permanently implanted in them in medical school and residency (a transplantation, if you will).
They will always see themselves as singularly responsible for all good outcomes (" I did this," or, " I did that " ) and never responsible for bad outcomes ( with such statements as, " oh...well...there's only so much one can do " – supposedly, the patient died of either natural or self-inflicted causes, but never because the doctor messed up).
Doctors are trained to never admit mistakes, ever, especially if the patient is irrepairably harmed/killed. Doctors are also trained to take full credit for everything good.
THAT'S NARCISSISM of the malignant kind. It helps them grab up all the money for their salaries.
Actually, we doctors are trained that we all make mistakes, and encourage us to admit our mistakes as they happen. Particularly since studies have shown that if we do, we are less likely to get sued. In fact, in most medical schools, we study ethics as part of our training for four months.
However, there is some truth to the premise that "there is only so much we can do." The vast majority of medical problems I treat as a family physician are self-inflicted by the patient. They smoke, overeat, don't exercise, and demand inappropriate treatments. My job as a physician is to educate, advise, identify problems, and prescribe the appropriate treatment. Education and advisement is cheap, diagnosis and treatment is not.
If all of the patient's whom I've told to eat better, exercise, and quit smoking did as I advised, us doctors would have made a lot less money off of them over the following years.
What medical school did you attend that you are able to make the claims that you do? And that is not narcissism, it is merely a question to find out why you believe doctors are trained to never admit mistakes. I am finishing up medical school (not bragging) and can first hand tell you that physicians have taught me, the first thing you must do after making a mistake is go straight to the patient and their family to admit what has happened.
Most medical students come into medical school idealistic and wanting to help others. Fortunately, that's solved after year two, when we are lined up in the basement and implanted with our narcissism chip. From then on, it's only about us. All the time. Once in a while, a doctor starts caring about others again and is called back to have their narcissism chip switched out. This is a very hush-hush secret. How did you learn about it?
I hesitate to respond to a post that makes gross overgeneralizations of an entire profession – part of me thinks posting this might be pointless because when I hear a person say "all doctors..." or "all of these people...", I become very weary of the type of the person making that kind of argument. As a doctor, I have been right and wrong. I have been wrong many times. I think I 've been right as well. I help people who are ill but I do this with a team. I rely on nurses, social workers, researchers, pharmacists etc etc. I am open about my mistakes and clear with my patients when I don't know the answer. We can't know all of the answers and that is one if the reasons, I think, practicing medicine can really humble you. There are doctors who are narcissists, sure , but there are some incredibly caring ones out there as well. Please don't generalize your individual experience to the group of us. We're not as evil as you think!
We are all human beings and make mistakes. The only ethical thing to do when a mistake is identified is to promptly go and explain this to the patient. It has happened in my career and this is what I do as it is the only ethical path. All hospitals have ethics committees lead by a member of the medical staff to discuss complex issues as well. You really don't know much of what you speak unfortunately.
I think the point is you never see a doctor give credit to anyone on "the team" unless they are cornered like a rat in a trap and forced to extend credit and that especially includes salaries.
Narcissists, yes. Quick to take full credit, always and forever. There is one thing doctors love to hear more than anything else: "Doctor" – and that's because they love themselves and want admiration, praise, recognition, pay, etc., etc. Do doctors care if nurses, techs, pharmacists, or house-keeping get praised? No, of course not. Doctors wouldn't care about such silly things; they're too important.
Brian, you hit it square on the head! You've come up with the perfect description of the entire profession of physicians. Absolutely! 100%. I'm going to lobby Websters Dictionary and Wikipedia to change their change their description of doctors/physicians.
While your generalization may have some truths, I have to defend emergency medicine here. Nowhere else in medicine will you find greater teamwork! The docs in my company throw a party every year for all the ancillary staff, lead monthly collaborative case reviews so we can ALL learn from each others perspective roles, have an incentive program for all ancillary staff to reward certain QUALITY metrics, and have a recognition program to GIVE CREDIT to all those ancillary staff that we work with who DO GREAT THINGS! (we have a hard time picking just one person every month!). ER physicians have less ego (in general) than most specialties and ABSOLUTELY recognize that we cannot do our jobs without others! That extends to EMS personnel who bring patients to us. I have told patients directly on arrival (in front of the EMS worker)–"that guy just saved your life!". So while you may have had experiences that skew your opinion to an extreme view and generalization of physicians, realize there are many others including most ER physicians who absolutely recognize the value of the healthcare team.
I certainly have shared credit to my support staff when we have done a good job. However, I have yet to ever hear of a nurse taking the blame for his/her mistake. The doctor gets stuck with that. We had a patient who had a lab result come back that required immediate action. The lab phoned the result to the floor nurse, as they were supposed to. The nurse didn't tell anybody about the lab result and went home because her shift was ending. The patient died. When the lawsuit was filed, only doctors were defendents. The nurse in question had already moved on to her next hospital.
I hope you stop and praise every construction worker you meet for so graciously constructing the roads and bridges that will benefit you for years to come!
Brian has it all figured out! This debate is over! I've been following your posts and I'm thinking one of two things. 1. Poor, poor Brian. Sounds angry, bitter and prone to generalizing groups of people based on individual experience or 2. This gut just loves to stir the pot!
In all seriousness, I'm going to come to the defense of doctors. My father was very, very ill recently. He would not be here today without the care and expertise of his doctor. He had a great team but his doctor was exceptional. I don't care if this doc makes tons of money. Money well-spent, I say. I have my father here to prove it!
I suspect Brian is 90% correct, at least from my vantage. People don't see the whole picture behind the scenes and it's quite possible doctors like it that way, or at least they don't do anything to change the situation. In other words, if the doctors can take the credit for the "team" as you call it, they do.
What I don't see is a collective of doctors rising up to tell the health system, whether it is the large hospital center or the larger providers like Kaiser, that the ancillary medical professionals need salary increases, because without them, doctors wouldn't be able to do the life saving "miracles."
I've read Brian's and Doctors Are Overpaid's posts as well and they hit on a sore spot that is 90% true of doctors. Doctors do want you to believe they perform miracles singlehandedly. I see doctors here only attack, mock, and ridicule these two and others, like a couple of nurses, who post valid complaints here. The only anger I see here is from the doctors who don't like calling a spade a spade.
As a physician, I can honestly say the system is completely broken. Very few people know how much medical care costs because there is such a disconnect between charges and reimbursement for healthcare with significant delays in payment through a middleman. Physician charges are usually based on what Medicare has determined it will pay for an office visit (depending on complexity) or procedure. This is usually a multiple of what Medicare will pay (2-3 times). In other words, the physician can charge whatever they want but Medicare reimbursement is predetermined. Occasionally, an insurance will pay the whole amount of the physician charge which is why charges are inflated, but this is quite rare. Most insurance carriers will negotiate with physicians on payment and it is usually based on what Medicare pays (e.g. a insurance company may agree to pay a physician 120% of what Medicare pays). This is where it is much better to be part of a large group for better negotiating power with insurance companies. Typically, what happens is a patient sees a physician and a charge is generated. The charge is submitted to the insurance company and the insurance company is supposed to pay the appropriate reduced amount according to the contract. Payment is sometimes denied or incorrect (too low) which requires additional time, paperwork, and diligence on the part of the physician's staff. Payment frequently is not received for 30-90 days. In my experience, patients rarely know how much an office visit costs other than their co pay. As a patient, I am no different. And when patients do see bills, they frequently are amazed at the amounts and often assume they are physician bills. I recently operated on a gentleman and he stayed in the hospital one night. He brought a bill he received to a postop appointment for $41,000. He, half jokingly, told me I must be doing very well. In all honesty, I collected $600-700 approximately one month after the operation (for a charge of $1800-2000) which included all follow up visits and treatment for 90 days after his surgery. The remaining charges were hospital related and not for my services.
Are you at all concerned how much the nurses received from their contribution to this guy's care? Do you even know? Care?
As a nurse, I have never encountered a doctor who cared at all about the plight of nurses or anyone else in the hospital. The adage is always, "You should have gone to med school!" – That self-centeredness gets old.
It makes sense that doctors are paid a lot. They're highly trained, their days are long, they're under a large amount of stress, and there are high-risk consequences for failure. What I don't understand is why firefighters and soldiers aren't paid more, and why so many investment bankers are paid so much for doing so little.
It makes sense that doctors are paid a lot. They do everything single-handedly and are the only ones who went to school, and are the only ones who work long hours, shift work, and contribute to saving lives.
People all over the place would be falling down dead all the time if it weren't for doctors saving everyone everywhere. We would see at least 50 people die on every street every hour of the day if it weren't for doctors saving them.
I would certainly want everyone else in health care to make $3.15 per hour, just so doctors could make $150 per hour, because those nurses and techs don't lift a finger and in fact if it weren't for their incompetent dickering, the doctors could save many more lives.
It does make sense doctors make so much. I think everyone else everywhere sould pony up more money to give these poor doctors that sacrifice everything to save us all from dying all over the place. We should all shave off half our earning to provide these doctors another Mercedes Benze or two. I know I would have died five or six times this year alone if it weren't for several doctors saving me. I can't wait until they save me next year. That will be fun.