Monday, July 30, 2007

Do Doctors Make Too Much Money?


An article in the New York Times says the reason health care costs are so high in the United States is because doctors are paid too much. I saw that and my eyes bugged out. I just came home from a meeting with physicians and hospital administrators and the entire meeting was spent discussing the financial challenges physicians face in keeping their doors open to see patients. The goal of this meeting was to keep health services in that community so patients will have someone to care for them. Not a person in the room would agree that the doctors earn too much.

Physicians paid too much? Lets break that down. A doctor spends a minimum of 11 years in education and training after the age of 18. Many are in training for 15 or more years. They are living on student loans and contributing zero to their family's income until the residency years. At that time they earn less than minimum wage if you factor in the 80-100 hour workweek. When a doctor emerges from training (and believe me, there is less sex and fun than is portrayed on ER or Gross Anatomy) he/she averages $160K debt, is over 30 years old and is usually feeling older. For another view of training check out this surgeon's experience.

Let's face it, people do not choose a career in medicine to make money. The opportunities are much greater in business, law or computer programing. Policemen that work overtime make more money than primary care doctors. (Before you make comments...I also believe policemen are underpaid.) Some specialties are well paid and they should be. Frankly I WANT my neurosurgeon to be highly reimbursed because I want to believe she is the cream of the crop. In fact, I want all of my doctors to be the top notch and I want them all highly paid.

The range of the average American's physician pay is between $140 -350K. Many earn less and some earn more. Many doctors work several different jobs (nursing home director, clinical research trials, insurance reviewer) just to supplement their income from seeing patients.

Health care reform is not about lowering physician salaries. Professions that are highly skilled, require extensive training and commitment deserve to be paid at the highest levels of society. There is enough waste, duplication, greed, payola, and inefficiency in health care to cover all Americans AND pay physicians well.

So what do you think? Are physician's overpaid? What about you readers in the UK , Canada, France, Germany and Australia? Are American doctors spoiled?

370 comments:

1 – 200 of 370   Newer›   Newest»
Rich said...

I think it's an old myth about Doctors. Actually a lot of the doctors I meet these days are somewhat discouraged at the rate of pay when the day is done.

Some get into medicine for other reasons than for the money.

Actually I had this discussion with my son recently and told him if he wanted to make good money (for the amount of hours worked) NOT to go into medicine.

I think we in health care are over worked and undercompensated if anything.

Anonymous said...

My doctor has stopped taking any insurance and now makes me submit my own bills to the insurance company. Sometimes they pay part of it, sometimes they don't and it is hard to understand why. I hate doing this but I do understand and I feel lucky to have a doctor who listens and spends time with me. I do not think doctors are overpaid.

K said...

I think some doctors are overpaid, just like some lawyers are overpaid. Certainly doctors aren't benefiting from the increased hassle that is our byzantine healthcare/insurance system.

In my ideal world (well, part of it, anyway), doctors would have relatively comfortable lives, they wouldn't have to do that ridiculous "let's run you until you're so ragged you can barely recall your own name much less practice medicine responsibly" residency, and they'd get to do what they got into the field for - helping people.

Coach said...

Hate to say it, but I think many docs are way overpaid. But it's not their fault. Their costs are too high and I also think it takes too long to train them for what they actually do. Most diagnoses are done by blood, urine, stool tests or CAT, X-Ray, MRI. Most treatments are prescription meds. On a bet I could, in two years, train a smart college grad everything s/he need to know to be a specialist in any one of 20 medical specialties. I have an extended analysis of this exact situation I will post tomorrow at www.marksdailyapple.com

Evil HR Lady said...

Doctors do not make too much money. If anything, they are underpaid.

Mike said...

"Most diagnoses are done by blood, urine, stool tests or CAT, X-Ray, MRI"

WHAT THE F*&% ARE YOU TALKING ABOUT??? THATS what is driving up costs, running all those tests. We are looking to dial DOWN the tests, NOT increase them so some person trained for two years (as you recommend) can just order things because he's clueless.

My goodness, what is left to say? Spoken truly like someone who isn't a doctor.

Anonymous said...

Those who go to medical school are assuming the financial risk of training and ought to be the ones to reap the rewards as well. It is not a fair comparison to compare salaries with another country when their educational expenses are covered by the state, rather than the individual.
That being said, pay in the US is skewed by specialty in proportion to what is compensated by insurance. Procedurally heavy specialties are better compensated, which directly affects medical students' choices in careers (how could it not). Thus we end up with many more highly paid specialists and fewer primary care professionals willing to work for smaller paychecks (at least compared to their level of training and responsibility)

JD said...

Doctors don't make too much money. Insurance execs, pharmaceutical execs and marketing execs are the ones who are sucking off the health care dollars. And, coach, you are absolutely delusional if you think that tests are all that is needed for good medicine. We have too many tests, not enough thoughtful interaction. A CT scan that shows a "mass" is worthless without the differential diagnosis, biopsy, evaluation, plan of action and treatment, reevaluation and consideration of co-morbid conditions, not to mention communication with the patient. Can you teach that in a weekend course?

Rich said...

So if you lower physicians salaries the best and brightest would no longer want to get into medicine. Reminds me of politics the media makes it so undesireable for anyone with good sense to enter that arena

such.ire said...

Well, doctors in the US do make quite a bit more than their companions overseas (even in expensive countries like Britain). That's not necessarily a bad thing, but it does put it all in more perspective. Of course, doctors in the US are also happier, have a higher quality of life, and need to be compensated for a longer training time. But really, US doctors don't have it bad compared to the rest of the world. Take Britain, where two-thirds of NHS doctors regret their career choice.

But if you think about another profession in the US with similar costs, i.e. academia, doctors are actually quite highly paid. Academia requires between 5-8 years of grad school, and then around 5 years as a post-doc, with the average age that most people receive a tenure-track position being around 41, if they do at all. When one finally gets tenure (if at all), that's 47, and only then do you start making a decent salary (usually at most $100K, though at the top, top schools, one can make around $200K with an endowed chair), so that's a pretty harsh lifestyle there. Sure, they don't have medical school debt, but the biggest cost for any of these school-heavy positions is always the opportunity cost of giving up the salary of a lawyer or banker, and when you factor that in, doctors really do get paid a heck of a lot more than academics.

So, overall, doctors are quite heavily valued for their work, and are quite well compensated for their time. If they weren't, why would students keep joining? They're obviously heavily influenced by money (just look at the shortage of PCPs, and the overweight in specialization), and if there wasn't enough to make a decent wage, they wouldn't keep entering the system. Even if students, individually, have other motivations influencing them as well, there is no doubt that everyone weighs money as a factor for any career choice. And right now, the money problem (if it exists) isn't bad enough that students aren't becoming doctors (except in certain specialties, like family practice and general medicine).

I think it's mostly worth it, since I want to continue to have some of the best and brightest become doctors, but saying that doctors in general don't make enough money sounds a little....I dunno, like a bit of a stretch?

Toni Brayer MD said...

Very thoughtful,Such.ire. You make a good point that doctors ARE valued in our society overall.

Anonymous said...

I think actor and sports player are paid way to much...life is not fair just like our moms used to say. I see people get by on low pay ..struggling for simple stuff and then I take care of plastic surgery patients who are uberrich and it blows my mind the wealth they have.and the over abundance of crap they have..Its a argument that could go on forever...I guess.
The heathcare system is not just DRs they need to start a reality show so people could be educated on who really is messing with the people..I think people would be surprized...

Glyph said...

the point made about "academia" is not very valid, as there is no comparison in the years spent getting your masters/PHD and the years in residency. Pay is better, work hours are normal, and abuse is neglible for "academia" in training. Alot of smart people who might go into medicine are lured by the less rigerous time/work-intensive training, the increased freedom in work and research, and the promise of tenure offered to "academia". Remember that when you attempt to compare the two.

such.ire said...

I'm sorry, glyph, but you don't know what you're talking about.

Pay as a post-doc stinks (not to mention the precariousness of funding), with NIH guidelines setting starting year pay at around $37K, generally without health insurance benefits. It's pretty much the same as any first-year intern.

Hours worked...well, that depends on whether you want to publish or not. One has to think about what the all-powerful advisor wants, and generally, most of the post-docs I've seen in the course of seven different labs have all worked between 80-100 hours a week. That's not "normal work hours." It's about the same as what a lot of residents do. Now, there's a lot more variation, since post-docs get to (theoretically) set their own hours, but without pulling those hours, you won't get a tenure-track position. Post-docs and grad students both work on holidays, vacation only here or there when they can afford the time-loss (i.e. almost never).

And I don't know of any tenure-track assistant professor who doesn't pull in excess of 80 hours per week, if they hope to get tenure. While he was up for tenure, my dad literally lived and slept in the lab during the week that grants were due. He almost always worked from 8 AM to 8 PM, seven days a week, year round. So that's another 6 years of brutal workload, on top of 5 years or so years as a post-doc and 6-8 years of grad school.

As for abuse...well, considering that grad students and post-docs live or die based on the whim of their advisor, I'd say abuse is quite widespread. Generally, only 50% of graduate students get a PhD, only 50% from there get a good post-doc, only 50% from there get a tenure track position, and maybe a quarter of those get tenure. So all in all, maybe a little under 5% of incoming grad students can expect to succeed academically (there are other career options, of course). Consider that on a stress level of 0 (none) to 100 (level for having a spouse die), first year grad students, on average, experience stress above 300.

So don't try to belittle the academic lifestyle as being "easy." I don't belittle what med students have to slog through.

My point wasn't that academia is rougher than medicine (I don't think so), but that US doctors get paid more for comparable time spent training, because the people value what they do quite a bit.

zstar said...

The reason that doctors get paid what they do is due to the American Medical Associaton. By setting up barriers to entry such as limiting the number of medical school seats and increasing the time needed to get an MD, they ensured the sky high salaries of physicians. It's simple economics. If every qualified student who applied to Med school was admitted, physician salaries would be lower.

such.ire said...

Although there might be some of that, I think that plays less of a role than one might think. I once heard someone at the NEJM estimating that 50% of prospective students get into an accredited medical school somewhere (maybe not their top choices, but somewhere). So that's a lot. And that's just the MD track; there is also the OD track, which surely increases the numbers quite a bit, as OD degrees are (legitimately or not, I don't know) stereotyped to be easier to get than MDs.

Sure, some fall by the wayside, don't finish school, don't pass the board exams, don't make it through residency, etc., but by and large, I don't think the system weeds out quite the number of people one might think. The effect is real, of course, but there are also good reasons to keep the supply low (e.g. quality). I think the quality is worth the price.

Etotheipi said...

SUCH.IRE:
I totally agree that a womanist studies professor specializing in the effect of the Battle of Hastings on gender identity issues should DEFINITELY make as much as the ER doc who saves your life! Great point!

check out http://docsontheweb.blogspot.com/
for more sarcasm.

such.ire said...

Wow, you have absolutely no point to make whatsoever. Great job!

Your blog post, however, is a little less airheaded. Wish you'd posted a link to that instead, but that would actually contribute something, right?

Anonymous said...

It is such a myth that doctors are overworked and underpaid. Doctors are paid way too much. They just want to make you feel like you are indebted to them. Don't give me this crap that they work too much and don't get paid enough for their education. A college professor spends more time in school and works 70-90 hour weeks trying to balance finding solutions to the worlds problems AND trying to make teach and get paid 50-80 K a year. Why should doctors get paid anymore. Psychologists go to school just as long as doctors and get paid 70 K a year. I'm so tired of hearing that docs are underpaid....they are WAY over paid!!!

Anonymous said...

I hate how doctors try to do this to everyone. They didn't discover anything...they just memorize and produce. But we have to be indebted to them because they are in the business of saving lives. Every doctor should feel immoral unless they donate have of their income to charity.

Proud Doctor said...

To the anons above:
The next time you are facing a life threatening illness (yes, it can happen to anyone, anytime)think about the fact that the physician is caring for you 24/7 even if it is Christmas or his son's birthday!! His/her expertise and decisions may make the difference if you live or die and he is also dealing with all of the other caregivers, your obnoxious family, your cheap insurance company, the rehab facility, the home care nurses, and your pharmacy just to make sure you can live and go on feeling entitled yet another day.

Yes, you should feel greatful and indebted!

Mac said...

"It is such a myth that doctors are overworked and underpaid. Doctors are paid way too much. They just want to make you feel like you are indebted to them. Don't give me this crap that they work too much and don't get paid enough for their education. A college professor spends more time in school and works 70-90 hour weeks trying to balance finding solutions to the worlds problems AND trying to make teach and get paid 50-80 K a year. Why should doctors get paid anymore. Psychologists go to school just as long as doctors and get paid 70 K a year. I'm so tired of hearing that docs are underpaid....they are WAY over paid!!!"

Where to begin... I am not a doctor, nor a professor, nor a highly paid administrator. I am a student. A 32 year old with a desire to go into medicine. I have been exposed to some of life's harsher realities courtesy of the US Army, also exposed to more death than most will ever see through my 10 year employment as a mortician (family business). I have seen political injustice, moral fabrications to promote agendas, and plain greed. Unfortunately most people never mentally mature and open their eyes to see the world for what it is, they'd rather bicker about petty jealousies, fueled by greed and wicked corruptions. Envy seems to be another driving force, some may feel that they have not accomplished what they wanted to in life thus far, and must attack other professions. It is all irrelevant. I am a realist. There is only one truth, and truth is supported by fact, not emotion, or faith. To compare a doctor to a teacher is futile. Every job has its challenges. But to be a real doctor, that practices medicine, is an immense responsibility. The sacrifices that they have given to get to where they are today are amazing. When merit and ability become the driving force of the world, then we will progress as a species, but until then, we are no better mentally than we were 500 years ago. Why is it that a man can put a ball in a hoop, hit it with a stick, or throw it a long distance, and he is considered a hero to kids, yet he did it with steroids. Not only that he is paid millions a year to do so. So how much is your loved one worth? Is sports worth more than life? I'm afraid I have gone on a bit of a rant. Bottom line is, Doctors are not overpaid, if anything, they are underpaid for the education they have earned, they work to get the title they have and the constant struggle to stay on top of the ever changing world of medicine. If you want to attack something, go for the pharmaceutical corporations that destroyed America's faith in medicine with their greedy tactics of advertising and releasing under tested drugs into mainstream society. Just my thought for the day...

Anonymous said...

Its not OD, its DO, Doctor of Osteopathic Medicine. An OD is an optometrist. And no, its not easier to get into. Osteopathic medicine, as an organized body, has been around for 130 years. And YES, they are fully licensed physicians, able to specialize in any field, do surgery, and prescribe medication. Look it up: www.osteopathic.org

Anonymous said...

I know a recently trained Endocrinologist who was one year out of fellowship and quit b/c she had 6 month old twins and was paying the nanny more than her bring home salary starting out. Pretty crazy if you ask me after the 4yrs college, 4yrs medschool, and 6yrs postmedschool training that entailed. Apparently if you want to make decent money, work less hours, and not train too long be a nanny.

Anonymous said...

Everyone who thinks doctors make too much is definitely not a doctor him/herself.

First of all, I am not a doctor yet, however I am working towards becoming one. Do you know how much sacrifice I have to make in order to become a doctor? Friendship, relationship with people that love me the most, and constantly having to fight against oneself, and batting through the emotional tramas.
My point is, Doctors are paid what they get today is because they have gone through so much. Try yourself going through 4 yeards of undergrad, 4 years of med school, and 2 years of training.

The amount of time that one needs to put into studying is unimaginable. Doctors to some degree, are not just able to memorize things like some of you said, but truly to recall things, and apply what they learned.

joe said...

Try working as an ER doctor -- expose yourself to bleeding HIV positive patients and obnoxious drunks night after night. Have the government mandate that every person, regardless of their inability to pay, must be seen in the ER (that equals seeing one-third of your patients for free in many locations). If you think I get paid too much, do what I did to get here, and then try to do my job, beeootch.

Anonymous said...

all i know is i have busted my ass for the past year and half trying to finish prerequisites for medical school and that alone seems sufficient to me for a higher salary. and to all those "blue collar" workers out there who think the white collar doctors are overcharging, ive been there and can honestly say hard physical labor is much easier than trying to figure out the mechanisms for antibody diversity. people tend to forget that mental labor is just as hard if not harder than physical labor. to anyone that thinks doctors are overpaid, go try to maintain a 4.0 in all the medical school prereqs and i imagine you will probably reconsider your opinion...and this is all BEFORE medical school. you still have four years of medical school and a residency/fellowship to complete before you really even begin your career. i agree with most on here that doctors, if anything, are underpaid and people like coach should walk the walk instead of talking the talk. if anyone is overpaid in our society, its the athletes of professional sports...people that have everything in the world handed to them on a silver plate and still complain about not making enough...

Goodman said...

just came on this.
Income is all relative.

Quite frankly, almost everything said about doctors can be said about engineers.

Engineers are grossly underpaid. A few strike it rich when the company explodes. but most just go through the grind.

The key to the problem with the medical profession is that the education is artificial. It's really meant as a barrier to keep the number of doctors down and the profession in high regard. So spare everyone the 4 years undergrad, 4 years post grad, 2 years training speech. What matters is the job you do on graduation.

Imagine if Engineers did that. If every webpage had to be authored by a professional engineer :) Or if auto mechanics did that and every oil change had to be done by a professional mechanic.

I live in Ontario, and 90% of the time, I wouldn't mind just seeing a nurse or even a nurse practitioner. I don't think I need specialization of a doctor. Yet, that is not possible. Only doctors may treat patients here.

So yeah, if you want to know what doctors are truly worth, let people have some choice.

Surgeons = would keep their high level of pay.
Family doctors = pay would fall even further.

In Ontario for example, a family doctor makes at least 200k per year. They would drop to around 100k. Which makes more sense.

So specialists (not overpaid)
regular family doctors = overpaid.

Goodman said...

Just a general note.
What is 'deserved pay' and 'hard work'.

It's a bit ridiculous to compare pay of any normal profession to that of athletes, singers...

those are high risk, high failure, big payout jobs. 99.9% of people fail to achieve anything in those jobs. It's like playing the lottery. The same goes for CEOs. I'm an engineer. Let me just say, the last job i'd ever want is to be a CEO. These guys work like crazy.

I'd venture to guess, if you become a doctor, you're going to do well, regardless of your skill level.

A doctor said...

If anybody out there thinks doctors make too much, let them spend one year in a doctor's shoes, accepting the responsibility for discovering whatever ailment a patient has whether they are aware or unaware of the symptoms. After this is done, then treating the patient appropriately, and following up on this treatment. After this, your job is not done, you have to accept the responsibility for whatever you missed or treated inadequately. You even have to be potentially liable for things which were not your fault, but that a patient, lawyer, or jury perceives as your fault. After that year, I want you to be ready to lose your livelihood, home, and possessions for any error you might have made during that period, plus live with any guilt you have for harming a person, or not living up to your years of training.

Anonymous said...

So Goodman wants there to be less restrictions on who becomes a doctor? It is all artificial this selection process...

So Goodman wants any average Joe Schmoe to be responsible for his health. It would be okay for him if a less motivated, less conscientious person, less knowledgeable person, less quick-thinking person to be responsible for his family's care? In fact, his family's health is less worth barely $100,000 a year to "Goodman." The selection process for medical school is intense because you cannot risk having a "slacker" as a doctor. It has to be a person who is willing to be 100% every day at their job. A doctor makes hundreds of meaningful difficult decisions every day. How many decisions does your typical $100,000 a year engineer make in one day? The doctor also is responsible for the decisions and performance of his staff. You need top notch people for this position. Not even "above average" people will do.

Laughing said...

I think it is funny how the guy out of Ontario thinks he would be happy to see just a nurse or nurse practitioner instead of a family doctor.

Has Canada's healthcare system degenerated to the point that there is no difference in quality of a family doctor from a nurse practitioner? That's what you get when you don't pay doctors. In the U.S. a nurse practitioner can see you, but the ultimate responsibility is with the doctor. How many NPs would there be if they could be sued at the same rate as doctors and for the same amount? I'd say that job would not exist anymore.

Bazzilone said...

such.ire.....OMG, what it has a few problems then all of a sudden its trash.

http://news.bbc.co.uk/1/hi/health/208046.stm

Yeah you also forgot the changes to help doctors in their careers being rallyed to be pushed into action.

So tell me. Are we doing this?

Gavin B. said...

It is rather amusing to me that I stumbled across this forum tonight. I took a day off today in the hopes of finding my daughter a Nintendo Wii online. In the process I was distracted and caught up in reading the forums by high school and college kids fiercely debating the current video game consoles(xbox 360, playstation 3, and the Wii). Every poster on the forum had a favorite console and defended it even in the face of contrary evidence. There was mockery and the flexing of egos across the forum.
So here I am now on this forum. It is obvious that there are some well educated people on this forum, yet I can't help being amused at the similarity to what I was reading earlier today. It is a different topic by far and more sophisticated language is being used, but the antagonism and reactions to it are nearly identical. It is disheartening to see that even amongst the highly educated we are still prone to adolescent bickering.
Sorry to say it, but I am in agreement that doctors make too much money. Goodman's opinion are very similar to my own and I do believe that much of the training is artificial and unnecessary. Especially with a family physician. We are an intelligent society and many doctor visits I guarantee are people who have a very good idea of what is wrong with them and either need a doctors approval for a prescription or a test. Many of these tests are not even being done by the doctors themselves. I'm sure a significant amount is done by the nurse after approval and then sent to a lab where there is a good chance someone with a B.S. in biology is performing the test.
There is an assumption in here that is innaccurate and that is that a persons can be measured and payed by the amount of time they spend educating themselves. Many here seem to think that all doctors are good people simply because they went through all of this schooling. I guarantee there are financial driving forces in those training years. There was in the doctors I know. There are many people out there who have real problems and no back-up money for themself who are forced to work during those years that doctors are off doing their internships. Are these people lower than doctors? Someone referenced how they save lives. Well so do fireman and policeman and even lifeguards. I doubt you'll see lifeguards demanding higher salaries and then defending their high salaries on the basis of their saving lives. I've said enough.

crella said...

JD is right on the mark. How can, say, a 5-day prescription for Decadron cost $1100? Thank God for insurance.

I live in Japan. The health care system here of course has it's problems, but when I see my parent's insurance paperwork I am always astounded at how much the pharmaceutical companies can charge for drugs in the US vs. what they can charge for the same drugs in other countries.

Anonymous said...

We do not get paid too much. However it's not so much about the pay but about what citizens feel is important to them and then compensate appropriately. Going to a baseball game, for example, tactily supports the million plus salaries of players. The game itself does not impart health or contribute to the wellbeing of society in general. Physicians do contribute such. So we all must question ourselves and say "what's important to me that I would be happy to pay for?" If the answer is Britney Spears, then the average US citizen gets what they deserve: a crappy, dysfunctional healthcare system soon to exclude all but the very rich and very poor.

Anonymous said...

I am a primary care doctor.
I make $65.59/hour. Just got my first raise in 2 years: 59 cents.
I do not have health care coverage nor do I get retirement benefits. I work for a large, multi-state HMO.
I see 30 patients a day between 8:30 and 5pm. That averages about 5-10 minutes per patient. In that time, I must develop rapport, actively listen to your
concern(s), examine you, come up with my diagnosis, discuss with you the course of action, answer your questions, write prescriptions, order any tests that may be needed, discuss the risks and benefits of taking any medications, inform you so of when to come back, and finally, chart everything that took place during our visit, in case I am sued for not doing a complete and thorough evaluation. Some people think our job as physicians is trite because we end up diagnosing them with colds and allergies, but our real job is to make sure you don't have something more serious than that.
So, for those of you who think we make too much money, try carrying a physician's responsibility for one week. Then tell us how much our time is worth.

Medical Consumer / Patient said...

I don't mind a physician driving a Mercedes but not a new one every year for every driving member of their family. They deserve to live in a nice home but a 5,000 square foot home and a vacation home, no. I would like to see a base pay for physicians and a "bonus" that the patient decides on based on how they were treated. If the physician acted like a jerk, they get nothing. If they take the time to really care for their patient AKA medical consumer they get the bonus.

Anonymous said...

reading this forum has been mindboggling! I am a physician, and to get here I busted my butt to get into the top public institution in this country, did a masters degree, followed by medical school, and four years of training in TWO specialties...and now have over $300K in loans to pay for all that education. You think doctors buy a new car every year? Have a beautiful home AND a vacation home? Are you kidding me? I will likely never be able to afford a home of my own, seeing that at even paying more than my medical school debt at a higher level every month, I won't pay it off until I'm 59!!! And I do not even own a car!

Do you people ever think of all those years of not having any income, paying exorbitant fees for liscensure, board exams, supplies, medical society memberships, malpractice insurance, etc...not to mention all of the costs of running an office for those in private practice?!! I have only within the last few years paid off credit card debt accumulated thoughout all of those years of having a ZERO income, and only now, in my mid-30's am starting to save for my retirement (which at this rate, will likely be in my 70's). So until then, my fate is to do a thorough exam on every patient that has even the most minute complaint, not just to tell a patient that they have something benign, but yes, like the previous entry said, to assure the patient that they don't have something that is life-threatening. For the sacrifices I and other physicians have made -- socially, financially, mentally -- the public should be grateful and should make sure that those that care for them (including teachers, firefighters, policemen) are well-paid

Anonymous said...

My girlfriend is currently in her intern residency year. I can tell you first hand doctors are way under paid for what they do. I'm an engineer and have been working in industry for 8 years. I'm a hard working, money saving, life living person.

Think about this... She will be 40 before she catches up to me financially, and is working way harder than I've ever had to. For me, 4 years of Electrical Engineering, masters paid for by employer, and 8 years of earned income. I've been able to save for retirement, save for a house, and still live a good life. Now look at her life. 4 years undergrad, 4 years med school with 200k in debt currently. Now she works 80+hrs at the hospital, not including all the extra time she puts in researching patients at home late at night. She gets 4 days off a month, and every 4 days works a 30hrs shift with typically 0-3 hrs of sleep. She has deferred payment on her loans until after residency, and is still just barely getting by with the money she's paid (basically makes $9.50/hr). Drives a beater car. When she is finished in 2 more long years, I'd estimate she'll have 350k in total debt that she has to pay back with interest on a several 30 year loans. 350K is more that most houses. She'll be 31 years old, no saving, no retirement savings, no house, but a huge amount of debt with $2200 in monthly payments.

What has she given up... She sees her family twice a month, friends maybe once a month for a couple hours, we see each other 4 times per week and she has to sleep 70% of the time. I've been through engineering school with no help, worked two jobs (40hrs/wk), pulled to many all nighters. I thought I had a rough life. Now I know better. Most people don't become doctors to make millions, and at some point life has to have worth. A person should be allowed to live.

Now then... add all that to the all the dangers of working in the hospital. AIDS/HIV and everything else you can catch. A rubber glove breaks, and you panic until you know your safe. Then there is all the stress of making the right decisions, 100s a day.

She has never complained about working the long hours, never not put in the extra hours to figure out someones medical problems. I think she looks at it and believes someday it will all be worth it. Personally I don't see it, she is suffering way more than she will ever recoup with money.

One last point... all doctors are not created the same. I believe most doctors are hard working professional who truly want to help and make a difference. There are the top 1% in intelligence, top 1% in drive, and top 1% in personal self sacrifice. Those doctors deserve ever penny they make, and need more. There is a percentage of doctors who get through med school and residency, and do a half ass job, only want the money, and don't truly care about the people they should be helping. Those doctors get people killed. There is a reason why it's so hard to get into med school, people demand the best when they are the ones who are directly in need of care. A previous poster wanted to let more people into med school, I'm guessing you are either a malpractice lawyer or a person who doesn't care about your family. Which on is it?

Somehow doctors needs to be compensated for all their hard work, accrued debt, life sacrifices, dangers in the job. Not everyone can be an engineer or get through engineering school or become a professor in whatever, and way less are capable of being a doctor let alone a good one.

Just my thoughts.

Anonymous said...

This is very interesting. My wife is also a doctor. She has said for years that doctors are overpaid. She thought that doctors should be hired based on their love of the field, and not on their desire to make money. Then the system would work better. She liked the idea of universal health care That was all before she went through residency. Now she no longer thinks that doctors are overpaid. It is long hours, and between debt repayment, malpractice insurance, and the hours she puts in, I wouldn't call it great pay.

Some of the doctors she works with want to quit, but can't afford to because they have built up so much debt. Once you go to med school, there is no turning back. It is like a black hole. You give up time with family among many other things, and you get very little in return for a long time.

My wife has an md and a phd. The phd was far easier than the md (although she has a lot of pride in her phd work).

I am a business man, and although I am paid on a risk / reward ratio, I must say that I would never trade my job for hers. I would never have made it through residency. 6 days straight, with a 30 hour straight shift is not something everybody is fit to do. And when she lost her first patient, it was devistating. Obviously, it was bound to happen sooner or later, but when it finally did, it wasn't easy. And in general it is hard for her to not be sad some days when she comes home, although she tries to leave work at work. But it is emotional and can be difficult.

Doctors make more money for a reason. Even in countries where medicine is socialized, doctors make more money than average. I don't know why it is this way (as there are many underpaid occupations out there - like EMTs, and there are many overpaid occupations - like longshoremen). I guess it all boils down to supply and demand. If people demand the best, whether it is an athlete or a doctor, then the worker gets paid more.

My personal feeling is that med-school should be free, and doctors could then be paid less money, but at least start with no debt to worry about.

Anonymous said...

I read, with great interest, the various comments regarding physicians and income. I was compelled to chime in, with a perspective that may be offensive to some.

I do not know if doctors "make too much money." I can say, that as a physician for the past 27 years, my income has slowly declined. As an emergency physician I have made anywhere from 80 to 100 dollars an hour most of my professional life. I have no equity -- I have been a so-called "worker bee", employed by those who know little or nothing about clinical medicine.

In my career, I have been exposed to a psychotic shooting up our ED, several needle stick incidents (one via a syringe left on a stretcher by a careless nurse), an increasing workload with burgeoning protocols, rules and regulatons which consume more time than the actual care of the patient, staph infections, pulmonary tuberculosis contracted from a patient, 12 to 14 hours of nonstop work with only a two minute "lunch break" (guzzling down a container of juice while simultaneously relieving myself) and "systems dysfunction" so profound as to literally drive me right out of clinical medicine.

I know of few other "professions" in which workers are expected to work in a frenzied environment for 12 hours without a break. Add to this a CT scanner which breaks down, no beds available in the hospital requiring transfer of patients to other facilities (most of which also have no available beds), and intolerable layers of documents and charts which must be completed, all while managing an emergency department full of sick or dying individuals (with one physician in a "single coverage" ED).

It is no wonder why many physicians are actively seeking alternatives to clinical practice. As a profession, we have committed slow suicide.

Anonymous said...

I know doctors who do indeed work a 24 hour shift. However, they are then OFF for the next 3 days and, in addition, get a few hours sleep during the shift. They work a total of 40 hours during the week. The doctors always through the 24 hour shift in your face, but never tell you (unless you call them on it) that they only work 40 hours a week. I don't believe they should be working a 24 hour shift--I wouldn't be able to do my job on so little sleep. That tells me either the doctor's job is cookbook medicine (what else could it possibly be on so little sleep) or what they are doing is unethical (i.e., practicing medicine with so little sleep). I suspect the job is easy enough that they can do it on no sleep--like I said, I wouldn't be able to do my job.

Doctors are complainers. If they had to work in the real-world (where there is real competition), they would shut their mouths and run back to their old jobs.

Anonymous said...

I agree with the post above that states doctors "didn't discover anything...they just memorize and produce. But we have to be indebted to them because they are in the business of saving lives."

In every other profession, the big money goes to the creative thinkers. From what I see, doctors merely deliver what other people create.

Anonymous said...

It seems to me that most doctors live very high lifestyles--they just feel they deserve it. The doctors who claim they can't make a living are often times making $150K - $200K per year. To them, these salaries are so low they threaten to quit.

To the doctor above who is making $250K per year and threatening to quit--I say GOOD RIDDANCE. Maybe you should adjust your lifestyle to be more in line with the common person--you are NOT A GOD who deserves to have it all!!!

Anonymous said...

Just an FYI, public interest lawyer's starting salaries are at about $40,000.

Anonymous said...

By far, the most difficult aspects of a career in medicine are the intangibles that are lost. Family, friends,time, and self are sacrificed to a greater degree than in MOST (not all) other professions. This is the heaviest burden, most often carried by the ones we love most. For those who cannot relate to the magnitude of this sacrifice, I offer the following:

I am a third year medical student.

I make $0 per year.

I have been making $0 per year for seven years now.

I will not see positive income until internship and residency. where I will be making slightly more than minimum wage.

So, if you sum this up:
12 years of school on $90,000 in earnings.

Doctors make a whopping $7,500/yr during training.

If I had started a career after my B.S., I would probably be making $50,000/yr. My alter ego would have made $400,000 by the time I finish residency.

Coulda made - did make= -$310,000

Plus $180,000 in loans=
$490,000 in the hole.

Avg physician salary= $140,000

So, in order to catch up to the amount I could have made had I not entered medical school, I would have to put away $4,336 every month @ 6.75% interest for 15 years. (37% of salary). Add to this the cost of practicing healthcare.

By the time I am caught up to my alter ego who did not go to med school, I will be 45 years old.

At 45 yrs old, after all this, I think I will have earned a good paycheck.

Most people going into medicine are aware of this. Money is not the driving force. There are far easier ways to make greenbacks.

The biggest payday in medicine comes at the end of the day when you look in the mirror.

Anonymous said...

I use to think doctors were overpaid, until one saved my wife's life.

Anonymous said...

One post above states that the Avg physician salary is $140,000. That may be true for a primary care doctor, who I agree should be paid more. However, I know specialists who clock in-out 9 am to 5 pm and are paid upwards of $400,000 per year plus production bonuses.

In fact, the average base salary for a urologist increased from $320,000 in 2006 to $400,000 in 2007--that's an average increase in BASE salary of $80,000 in one year. Keep in mind that the urologist also receives production bonuses on top of that. In addition, malpractice insurance is typically paid by the hospital for which the physician works.

The specialists salaries need to be cut substantially and, possibly, redistributed to primary care doctors.

In the March 2008 issue of Consumer Reports, it is noted that hospital and physician fees are, by far, the BIGGEST contributor to runaway health care inflation.

David said...

Every career has its benefits and drawbacks. Medicine, engineering, academia, professional atheletics, etc. One could poke a hole in each option and say that those people make too much money for what they do, or have to go through, or for how much they have given up. As well one could look at the options over time and find out who makes more money by the time they are 50. Conversely one could look at each option and argue (as easily as the opposing view) that "they" don't make enough considering what they do, or have to go through, or considering the cost of living in any given portion of society.

Comments have been made since the first one in July '07 regarding each option, and in some respects, everybody has a good point.

I think that the important thing to realize is that within each career option, there are gradients. Some doctors live very difficult lives and make very modest amounts of money throughout their career, and others find a niche that yields sizable monetary rewards. The same could be said for most careers...and the reward or difficulty may be in another form (time, stress, recognition, working environment, etc.).

I think that it would behoove most people who have participated in this blog to step back and read about, visit or even try to live in the shoes of others. There is no question that live can be VERY hard, no matter what you do.

Do doctors make too much money? Maybe in some cases, others no, and even another set may deserve (however you want to qualify "deserve") more.

What is the concern? I think that people are pretty upset about how much they pay for health care. I think that is most certainly a justifiable feeling. Why does health care cost so much!? Well, it is probably one of the most complex problems that our society faces. It is intertwined in the history of how the system, how we got to a reimbursement system with health "coverage" instead of insurance, HIPPA, etc.(reaching out to all involved parties...government, insurance, hospitals, academics, pharma/biotech/agents, med devices, etc....most importantly the patient).

It is also intertwined in motivations. Companies spend a lot and take a lot of risk to develop products (always some gradient in how much reward is deserved for their risk of course), insurance companies take a lot of risk as well. Doctors CAN live a very hard life and not make a lot of money.

In the end, there are a few truths (I think).

1) It is a business. Across the board, all parties involved...it is a business and people are looking to make money. Whether it is for profit to fund something, or for personal gain, or simply to sustain themselves or an organization, it is a business. Even if the government were to setup a single payer system, it is still a business even for the government.

2) When the system is disfunctional in any way, it is the patient who suffers. If the doctors make too little, the quality of physicians is likely to decline and the patient will suffer. If the doctor makes too much, it cost too much and people aren't cared for. And one could continue through all of the parties involve and how they provide something important, but it's not always perfect and in the end, the patients suffer.

It is a tremendously convoluted issue and one that I recommend you read several books on the topic before you way in.

In the end, in a lot of circumstances, people feel that they are not getting what they pay for. The inefficiency and places where people are trying to make money are throughout. Do we make it all controlled by the government? Well, maybe that idea has some merit, but think about this...when was the last time you dealt with a government organization that was TRULY streamlined, run well and hassle minimized? I haven't encountered one. I don't necessarilly fault the people who work there, but I don't think that I would want my wellbeing, what healthcare/doctors/medicines/procedures/test are available to me when I need them, what was paid for and what was not dictated by the government with complete omnipotence. Plus, any changes necessary may take a long time to pass through the red tape.

That is a scary senario to me.

Regardless of what I think though, it is a tremendously complex problem. So...do doctors make too much money? I don't think so, but the frustration that leads to this question is probably better applied to the healthcare system as a whole.

Anonymous said...

My father is an OB/GYN. I can tell you right now, no matter what he gets paid, he is underpaid. These guys are machines. As to people who believe physicians only memorize...
Jeez, about 99.99999% of the population can only regurgitate.
The .00001% that don't either make a lot more, or do not care about wealth.

"didn't discover anything...they just memorize and produce."

What have you discovered lately?

Ed said...

"they just memorize"...

What is wrong with memorization?
To memorize is the beginning of learning and education.
Think about it... If you cannot memorize, then you cannot learn. If you cannot learn, then you cannot discover.

If all physicians only memorized, then who do you think writes/publishes these medical books, journals and peer reviews? Who do you think facilitates clinical medical research? Who do you think pushes medical advancement in our society?
Look at most of the clinical research papers at pubMED. Most of the dedicated researchers have "M.D." following their names.

Do you really believe that the world's scientific/medical discoveries were uncovered by people who
went hours, days, months, years without studying, researching, and yes... memorizing?

For god sakes, even Einstein memorized.

Anonymous said...

It may be true that "Most of the dedicated researchers have "M.D." following their names." However, that does not necessarily mean most M.D.'s do research.

In fact, I would venture to say that most M.D.'s actually do NOT do research. Furthermore, my experience has shown me that most M.D.'s do not read scientific studies--they only read journal articles which interpret the studies for them.

Specialists working a 40 hour week have plenty of time to read actual scientific studies. Instead, I see most doctors using their free time for fun activities (like vacations, shopping, etc).

Reading merely journal articles (and not the actual scientific studies) is dangerous. I have caught more than one doctor in mistatement of facts from inaccurate journal articles. I have shown the actual studies to the doctors who said they never would have known. THEY SHOULD HAVE KNOWN. That is their job to know. We as patients DESERVE MORE FROM THE OVERPAID DOCTORS WHO SPEND THEIR FREE TIME SHOPPING AND VACATIONING.

Anonymous said...

David said: "So...do doctors make too much money? I don't think so ...."

Primary care doctors probably don't make too much money. On the other hand, most specialists probably make way too much money.

That sets up an incentive system that does not help the patient.

Anonymous said...

I do not think that a doctor is overpaid. If we truly believed that doctors are so overpaid, why are we not all doctors.... I have a great respect for anyone that can manage to make it through that much schooling. I thought at one time I wanted to be a doctor, in fact I went to college with the intent of being a doctor, but after a 4 year degree I was ready to be finished with school.

People that believe doctors are overpaid are not thinking about all the sacrifices (youth, money they could have made, time with family and friends) the doctors they see have made in their lifes to get to where they are. The doctor was still in school and for the most part struggling to get by, while we were all making a life for ourselves. People are getting married, buying houses, and making money all around them, while they are stuck in a classroom learning things that will hopefully someday save our lifes. I believe some doctors should make more than they do. I know that for me, my youth, time with my family, and chance to start a life, was worth more than a big payout in 6 more years.

I believe I made the right choice by stopping at a 4 year degree. I am 24 now and currently work in the energy sector making around $200k per year. You are always going to find some job where people make more than you think they should, but if you truly look at what someone like a doctor has been through to get there, I think they are more than deserving of their pay. If they were truly so overpaid like I said before, we would all be doctors.

CanadianDoc said...

Let me start my comment by announcing my biases. First of all, I am a family medicine trained physician in Canada coming in on his second year in practice. Therefore, I tend to sympathize with those comments regarding the workload of doctors as they are entirely similar to my own experiences and those of many of my colleagues. My comments are a bit of a potpourri; my hope is to give my opinion and maybe provide a bit of education with regards to the above comments by various posters.

One gentleman from Ontario commented that family doctors should be paid on the order of $100,000. My thoughts are that this could be a suitable arrangement if the following conditions were given:

1. The overhead for the practice (rent, office supplies, secretarial and supports service etc.) were paid for by the government. Please realize that overhead often costs a family doctor anywhere from 30-40% depending practice locale and scope of practice. So when you say that a family physician makes $200,000 please be aware that the take net income is about $130,000 which I do admit is still an above average income.

2. That some form of capitation were imposed... most professions charge on a per contract (job) or deliverable system. For a physician, this quota should be measured in patient encounters or numbers of patients held within a practice (with carte blanche number of visits for those patients only). No further service beyond these obligations should be expected.

Currently, we have a fee-for-service model where a physician bills per encounter which incentivizes the seeing of more patients; maximums are in place to discourage a doctor seeing an unsafe volume of patients per day just for anyone who may think that doctors in Canada churn through a 100 patients per day.

As for the whole issue of overpayment or underpayment, let me argue this from an economic standpoint. When selecting a career, we look at the duties, responsibilities, training, sacrifices, personal preference among many factors. For many of us, income is a major factor and so it should be as income dictates the material quality of life that we ultimately have.

Let us say we live in an alternate universe where doctors make $50,000 per year given the same education requirements, training and professional duties. Of course, if I became an engineer I could make $60,000 per year. Or if I got my MBA I could make $75,000 with promotion potential. Or I could be a teacher, make $50,000, face a different set of challenges (if that fit in with my personal preference) and have more regular hours with weekends and summers usually free. I have top grades in high school / undergraduate university, which one should I pick?

So all my A-student classmates are vying for the MBA or engineering. Who fills the void for being a doctor? The B-students? The C-students? I have not used organic chemistry or biology in almost a decade... these were prequisites for medical school... why? Because it ultimately was a competition. Marks are a measure of other qualities beyond intelligence (my opinion... we can debate this point). They indicate discipline, determination, work-ethic, desire, ambition. Everything that I would hope most people would want as part of their doctor's fundamental personal framework.

The high income for doctors are in place to try to attract those individuals who, in society's opinion, would fulfill this role in society most suitably. In Canada, there is a limit on the number of students admitted to medical school per year. In my year, there were approximately 16,000 applicant for approx 1600 spots. When you have so few medical school spots, the schools have a duty to be selective. Forget intelligence for a second. Presuming what I said about grades are true, would you rather have an A-student or a B-student for your doctor?

I do not know if I am overpaid or underpaid. I provide a service that the government has deemed to be worth a certain amount and my fiduciary duty to my patients and the Hippocratic Oath dictates the rest... of course I have always been a maximalist and that has not changed in regards to the care of my patients. I do know that I am exhausted both mentally and physically (I walk the length of our hospital multiple times per day, sometimes responding to emergent situations) at the end of the day. I do know that six years post-undergraduate training were required to earn my qualifications... six very tough years.

I would hope that most people would not begrudge me my income given the number of hoops that I had to jump through to become a doctor and the ongoing daily duty that I have to my patients who are ill and in need of my abilities. Maybe a bit of empathy on the part of those who are claiming that doctors are overpaid could be in order.

Anonymous said...

Overpaid? Don't know.

But from what I can see, the poor who can't afford to pay the MONEY are left to die.

Once upon a time, people studied medicine to CURE others. Nowadays, the patient who can't afford the medical expense is simply left to die.
Even if there are some support from the government etc, usually the patient can't get the best possible treatment.

It's kind of sad because doctors were once a very respected profession. Nowadays (some of them) will only serve you if you can pay what they want.

---------------------
I'm from New Zealand, where the doctors are trying to get government to pay them more by refusing to work (go on strike) / leave the health system. The doctors here do get paid A LOT, the top in the country.

Well, everyone need money to live. I guess that's life.
Too bad for the poor. Feel sad for them.

Anonymous said...

I'm the poster above.

I didn't mean to blame the doctors for not saving the poor. The medical expense (machine, pharmaceutical etc) are obviously very very costly too. So the doctors shouldn't take the blame for it.

I'm just no happy with the doctors who went on strike in this country when they are already making top money. And we have a huge list of patient waiting to be saved.

Goodman said...

Goodman back. Found this old thread.

Let me just clarify.
No I do not think your average family doctor needs to go through 7+ years of training to do their job. You can tell after high school who is a very capable person. Combine that with some tests and you should be able to straight into medicine, just as you can go straight into engineering.

In many countries this is the case.

Do that and it would be fair to pay a family doctor 100K or so.

Given the current educational requirements and the like, yeah it would be crazy to pay doctors only 100K. But again, that's the choice of the medical associations to boost their requirements. This is like doctors complaining about things THEY regulate themselves.

Who on Earth decides that residency should be 100 hour weeks? The doctors themselves do that. That's the irony. I gain no comfort at all knowing my doctor can be put through that kind of torture. I don't want my doctor working more than 40 hours a week. I want them fresh.

Do you your pilot trained to fly 100 hours a week, or do you prefer you pilot stays fresh in his/job and makes proper use of the co-pilot?


Of course any advanced medical degree should be paid amazingly well. i have no problem with a neurosurgeon being paid 400K or even 1 million dollars a year.

Hope that clears it up. Yes, for the record, changes in Ontario have allowed me to see a nurse practitioner. They have one at my local health group. You know what? I love it. I dare say, she's better than at least 2 of the doctors there. I actually request to see her instead of the regular doctors.

Anonymous said...

it's hilarious that this is even being discussed....the only people who don't understand how grossly underpaid MD's are simply have a massive misunderstanding of current US markets/politics/medicine.

Just look at what's being discussed here:

http://dealbook.blogs.nytimes.com/2007/03/19/are-first-year-lawyers-overpaid/

whether or not it's "overpaying" for first year law grads to get 160,000...


Everyone who's either a JD or MD student, or who has these kinds of friends knows that the MD is simply in an entirely different UNIVERSE in terms of rigor.

Look at how much grads from elite MBA programs make on average...170,000 starting...


HAHA GET REAL PEOPLE!!!!

Anonymous said...

To the poster above:

I would at first glance see that lawyers seem overpaid, but, in reality, many lawyers do not obtain that sort of salary. The ones that do get 160k are mostly corporate lawyers who have to cut through the intense competition. I am not saying they are as competitive as that of the doctor, but it is indeed something to examine.

Now, those that do not get into corporate law may be taking in under 100K, and that's after 3 years of law school which may run debt up to 150k. What is more ridiculous is that many lawyers may even make 50K and below; those that are interested in public interest, and those that cannot find a better job. In addition, the ceiling for lawyers, I feel, are not as high as doctors. Doctors may specialize or open a private practice, and lawyers can do the same, but to my knowledge, they are not compensated as much as doctors.

I am not saying doctors are overpaid, but I think using lawyers ' salaries to say that doctors are underpaid is impertinent.

Anonymous said...

I am a lawyer at a large firm in a major city. My wife is a specialist doctor. I work much, much longer hours for less money than my wife. Therefore, my salary/hour is a FRACTION of my wife's salary/hour.

I have seen reports that show the AVERAGE pay/hour for lawyers is significantly LESS than the AVERAGE pay/hour for doctors. However, I have often times heard doctors compare the AVERAGE salaries of doctors against a few highly-paid lawyers--that is NOT an apples to apples comparison.

Anonymous said...

Anybody who thinks doctors make too much money has
a. no knowledge other than that fed to them by the pot-stirring sensationalist fact-deficient media.
b. should go see a spiritualist for the latest non-effective treatments for cancer
c. ask an attorney to biopsy their brain tumor

Anonymous said...

I like the last post. People think that doctors are overpaid should just care for themselves even on their death bed. Solution is great because if my service or servitude is overrated than don't show up. If you are so smart, then deal with it on your own and don't get the government involved when you fail like the housing market. Americans pay for novelty (ex: sports, music) but not what matters. Well, you deserve your misery.

I feel more and more that I should leave medicine because I am disrespected.

Anonymous said...

Prior post states:

"People think that doctors are overpaid should just care for themselves even on their death bed. Solution is great because if my service or servitude is overrated than don't show up. If you are so smart, then deal with it on your own and don't get the government involved when you fail like the housing market. Americans pay for novelty (ex: sports, music) but not what matters. Well, you deserve your misery.

I feel more and more that I should leave medicine because I am disrespected."

You are EXACTLY the type of person who SHOULD get out of medicine. Based on the comments in your post, it strikes me that the reason you went into medicine was MONEY--not to help people. Please get out, we would be better off without you.

Anonymous said...

"Americans pay for novelty (ex: sports, music) but not what matters."

I frequently hear this argument from doctors, but not from other professionals (e.g., accountants, lawyers, etc). Doctors seem to have a GOD-COMPLEX. Why don't they compare themselves to other professionals (e.g., accountants, lawyers, etc) instead of professional sports/music players?

The doctor above who said this should get out of medicine and try to become a professional sports or music player. There is infinitely MORE COMPETITION to become a professional sports/music player than to become a physician. I wonder how successful he/she would be in either of those professions? But I think he/she should try!!!

Anonymous said...

Yes, a lot of doctors have god complexes. It's beaten into them in school and training as justification for the craptastic treatment they get there. It's hazing, pure and simple.

That doesn't mean they don't deserve hefty remuneration for what they do. They do.

There's not nearly as much fat to cut in doctor pay in the US (especially if you're talking about front-line primary doctors) as there is in insurance bureaucracy. Inefficiency in that area is a huge contributor to the fucked up state of the health care system in the US right now.

I highly recommend that those interested in this topic watch this FrontLine that aired a few months ago: http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

It's an interesting comparison of the US "system" with that of other first world nations, every single one of which actually makes sure that health care is provided to *all* of its citizens. Different countries have made different tradeoffs, and it's interesting to see what some of those are, and how they work.

Anonymous said...

Several people have said doctors deserve their pay because of the length of time it takes to go through training, and the sacrifices they make in terms of family time, sleep, retirement savings, debt accumulation, etc.

So others have proposed a solution: give them less training! They don't need it!

That's fine, as long as we also take away the right to sue them when they miss an uncommon diagnosis because they never saw a case like that in their shortened residency programs.

Like it or not, doctors have people's lives in their hands, and most people take it so much for granted that they don't even realize it. Consider the life expectancy now compared to 100 years ago.

If we could stop caring that they do their jobs well - meaning we take away the right to sue for missed diagnoses or wrong orders - that would cut back on their high malpractice insurance costs, and then we could cut their pay accordingly.

Who wants to be first to send a child with vague malaise to a poorly trained FP, only to find that leukemia went undetected for a long time?

Anonymous said...

Obviously all of you all who say that doctors are overpaid do not know what the hell you are talking about. My husband is in medical school and we will come out with over $150,000 dollars in debt! You will never know the sacrifices that we as a family have made so that he can be properly trained in saving lives. Yeah, right now we are on food stamps and are constantly worrying about money. My husband maybe gets four hours of sleep a night. When he is not in the hospital, he is studying.Last night he was studying until six in the morning. There is no other profession in the world that requires this type of training and sacrifices. Hello people, your lives are in the hands of these men and women who have literally sacrificed their own lives for medicine. And no one goes into it for money. The thought of money does not get you through a minimum of seven years of training, endless debt, and a sacrifice of relationships.I know that in a few years my son will probably be asking me why his father lives at the hospital and why he isn't home for Christmas. I would like to see any one of you be in his shoes for one minute. We will be paying about $4,500 a month in loan repayment for who knows how many years. People always complain about how much a doctor makes until one saves their or a loved one's life.

Anonymous said...

Which brings me to the question of how can anyone live making NO money during all those countless hours of schooling?

It seems to me that doctors are priviledged to begin with because in the real world that would not be an option.

Anonymous said...

Are you kidding me? We are living by making NO money by taking out student loans for living expenses, which we will be spending years paying back. My husband grew up in foster care and has no help from family members. Uh, we live in the real world. We count every single dollar we have, and I watch children at home to bring in a little income while raising our son. Nothing has ever been handed to my husband.

Anonymous said...

The only privilege my husband has had is that he has worked his ass off to get to where he is. Daddy and mommy do not pay his tuition, rent, or anything else.

Anonymous said...

I come from a family with a long tradition of working in the medical field. We've had nurses, paramedics, all kinds of physicians, several surgeons...and I'm going into neurology myself (currently majoring in biochemistry, considering a transfer to a college with a neuroscience major).

Medicine is definitely not an easy career to get into, and the Average Joe seems to be widely ignorant of how much time and money it actually takes to even try to become a doctor.

Also, has no one ever heard of malpractice insurance...? Some hospitals cover the costs, but a lot of times, the doctors have to pay for it out of their own income. It goes up every time a doctor is sued, too, whether they win the case or not.

I was considering neurosurgery until I found out that the average neurosurgeon works at least 70 hours a week, even after residency, and it's either "the most sued" or "one of the most sued" specialties in medicine, due to the thousands of things that can go wrong when cutting up peoples' brains. OB/GYN's are also up there, so a lot of the larger salaries go to covering the cost of malpractice insurance.

It also takes about eleven years to become a 'regular' neurosurgeon, counting four years of medical school, and a sub-specialty would take even longer.

I don't know a single person who went into the medical field for money. Besides, the specialties that make the HUGE bucks (like orthopedic surgeons, neurosurgeons, some kinds of cardiovascular surgeons, etc.) generally have very competitive residencies.

You have to be really good to get in--they're not going to let some punk who barely graduated from medical school sail through and eventually operate on someone's brain/heart/joints/etc.. They take the best because if they take anything less, they're risking future patients' lives and chancing tons of future lawsuits. 'Lawsuit' is not a word anyone working in a hospital wants to hear.

That's why, the more delicate and demanding the specialty is, the bigger the paycheck is. Generally.

The large incomes aren't just a pat on the back for completing the hell of residency. It's a compensation for the huge demands (mental, temporal, financial, and sometimes physical) placed on physicians.

Besides, the people I know who're in the medical field are in it to help others, not themselves.

The real money in a hospital is in the people on the business end, who're actually running things.

The ones at my mom's hospital decided this year to give themselves $20,000 bonuses and cut most of the surgeons' paychecks back by at least 10 grand to 'pay for recent construction costs.'

My family's finances are barely breaking even this year; we almost couldn't afford our house payments, but my mom's boss/supervisor/whatever just bought himself a helicopter.

That is what I call 'being overpaid.'

Doctors have to be good to be paid well, and in some specialties, it doesn't matter how amazing the physician is, they won't make much money.

In fact, there are nurses that make more money than some physicians--optometrists vs. RN's and NP's, for example?.

There are jobs in just about every field that make more money than physicians, actually.

Some physicians are highly paid, and some just-as-skilled and hard-working physicians aren't, but nothing in this world is perfect. We just expect our doctors to be.

As the anonymous above me said, they work their asses off to meet our expectations.

Anonymous said...

as a wife of doctor who has worked for many, many years he is underpaid. would a plumber come to my house for 40$ listen to me cry and worry about me? would any of you stick your hand inside of someone and fix their heart for 300$ and worry about being sued

Anonymous said...

Whatever.

I don't think having the option to not make money so you can go to school forever (kids go to school too) means you are extraordinarily intelligent, gifted, or whatever.

Also, nobody expects Dr.s to be perfect. In fact, many of us feel that going to a doc is worthless because they're wrong so often and most likely aren't going to fix anything. I don't know of any other profession where you're allowed to screw up royally ALL the freakin time, get away with it, and then be rewarded for it.

I think if you can make "doctor money" you should quit whining like a baby and be happy about it.

Can you tell I have a problem with doctors? I hope that didn't sound angry. LOL!

Anonymous said...

Doctors are overpaid, plain and simple. Moreover, because the cost of tuition in med school remains spectacularly high, only students with "family money" ever gain access. Thus, a good portion of "educated" doctors and physicians are great morons. Morons with the luck of family money. I never went to med school, but I've been treating myself for 10 years, including stitches and homeopathic medicine, and I'm much healthier for it

Anonymous said...

I know several doctors who are specialists. All they talk about are vacations. None of these specialists works more than 40 hrs/wk and they are paid ~$500K/yr.

I can't comment on primary care doctors, but the many specialists I know don't work hard, always seem to be going on vacation, and are grossly OVERPAID.

Anonymous said...

The next time one of you jerks get in a car accident, cancer, the flu, a broken bone or anything else, keep your butt at home and diagnose and fix yourself since you seem to have so many problems with doctors. If you all can't stand them so much, then don't use their services. Simple as that.

Anonymous said...

Wow, you think that you can be a moron and successfully get through medical school, the boards, and residency? Read a page from a Step 1 practice book and tell me if you still think doctors are morons. As I stated earlier, my husband is at a top 10 medical school and grew up in FOSTER care. I sincerely hope that you will be able to go trough the rest of your life without the help of a doctor. Now, if you will excuse me, I need to go plan our future vacations!

Anonymous said...

I had surgery and required a spinal anesthesia--I was numb from the waist down but completely coherent during the entire surgery.

During the surgery, the anesthesiologist talked incessently about one vacation after another. Then, he went on to complain about the "long" hours. After sympathizing with him, I learned that he works 4 - 10 hour days a week.

I don't understand how he has the right to complain. I am a professional, went through a lot of schooling, have worked long hours (not 40 hours/work week and not 4 days/week) for 15 years, and have a LOT of stress in my job. Oh, and by the way, I am paid a fraction of that anesthesiologist.

Doctors need to stop giving us this attitude that they work harder than anyone else. There are a lot of people we would miss if they weren't around to do their jobs (not just doctors).

Doctors are paid handsomely to do a job. They need to stop complaining and do their job. At the same time, they need to get rid of the attitude of entitlement and stop acting like they should be paid big money just because they went to school and passed tests.

Graduating from school and passing tests just gives doctors the right to WORK LONG HOURS and then be paid a lot of money for working those long hours!!!

Anonymous said...

I'm sure you and everyone else has a lot of stress at their job. But do you know the level of stress an anesthesiologist has? Seriously, look up what in entails. The slip of a hand during surgery can KILL someone. Doctors are under the stress of having a person's life in their hands everyday that they are at their job. Now, if you had that level of stress, you would probably want a long vacation too. And why would you lump all doctors into the same category? Just because you came across one complaining about needing a vacation (which he has the right to do!)doesn't mean that they are all like that. So now they all have a since of entitlement? Stop generalizing.

Anonymous said...

The ones who seem to have the sense of entitlement are all those complaining about how much money doctors make and how they go on vacations and blah blah blah. You all seem to feel entitled to bitch and moan when you have no idea what these men and women go through. For the most part, doctors have dedicated their lives to improve and lengthen the lives of others.

GregD said...

I wanted to be a doctor upon leaving high-school. I had the mind but not the discipline to make it through school, so I would say that the workload is heavy and means sacrifice in a number of areas that most people are not ready for. Thus, I believe that many doctors are dedicated, smart, and giving persons who have invested a lot to become what they are professionally, from a long way back in their lives. This kind of sacrifice does deserve to be rewarded. But how much?

The best way to answer this question is to throw out some hypothetical numbers.

Lets say that a doctor makes $125,000 a year, do the math:

$125000-$25000 taxes-$30000 insurance=$70000 a year

Basically, this is a very good rate of pay, even in most urban areas (except big cities like NY, but salaries go up there with expense).

Many doctors I know working general p's salaries do not work 70 hour weeks, 50, maybe 60, but not 70 or 80. If you took $70,000 a year and divided it by 60 hours/week you get $22.00 per hour take home pay. That is pretty high, but many business owners, lawyers, engineers, etc. make a lot more.

The proper question to ask at this point is "Is the average medical doctor worth as much as these folks?" It depends...not every business owner serves as an essential supplier in our economy, not every engineer is as able to plan projects as others, certainly not every lawyer is worth their fees, and not every doctor serves a critical position in saving or extending lives. The same is true for almost every other occupation...worth is based on market value. Trouble is, there is no way to regulate commercial industries or professions in a market economy--they charge what they want to.

Anonymous said...

"I don't know of any other profession where you're allowed to screw up royally ALL the freakin time, get away with it, and then be rewarded for it."

Been to a baseball game recently? Batting .400 consistently through your career will get you into the baseball hall of fame, right? Not to mention a multi-million dollar/year contract. How would you feel if your surgeon had a 60% chance of killing you on the operating table? 'It's okay. He's just in a bit of a slump right now...'

The point is that lives are at stake. Maybe it's grandiose to compare physicians to pop culture stars. Maybe it's irrelevant. But you (Anonymous #?) brought up the question of where else one is allowed to screw up so badly, and I thought I'd bring up an example of a place where not only are people expected to screw up a majority of the time, but are highly rewarded for it.

I find it amazing that people are willing to pay $200/seat for baseball tickets on a regular basis but eschew health insurance, and then show up tearfully in the ED when something goes wrong. I think one of the reasons people seem to care so much about physician compensation is that they forget how much they value their lives in this heavily consumer-driven society, where they'll take out installment plans to pay for HDTVs they can't actually afford, but change doctors and fragment their own health care when the co-pay goes from $10 to $20/office visit.

-Jess, medical student

Anonymous said...

Poster above stated:

"The ones who seem to have the sense of entitlement are all those complaining about how much money doctors make and how they go on vacations and blah blah blah. You all seem to feel entitled to bitch and moan when you have no idea what these men and women go through. For the most part, doctors have dedicated their lives to improve and lengthen the lives of others."

My response follows:

Doctors are not the only people who work hard and have stressful jobs. There are a lot of other professionals toiling away on a daily basis working 60 hrs/wk in high stress jobs with 2 weeks vacation/yr.

I DON'T believe ALL doctors are overpaid. I do believe a vast majority of SPECIALISTS are grossly overpaid. I personally know several doctors. The SPECIALISTS tend to work short hours--they call 35 hrs/wk full time (and punch in and out like a grocery store clerk and never do any work once they leave for the day) for $300,000 - $400,000 per year. These same doctors tend to take 5-6 weeks vacation each year--they talk a lot about what their next vacation is going to be.

These same doctors then go on to say how they like being a doctor because they like helping people. However, whenever there is any talk of Medicare cuts (like earlier this year), they become belligerent and say things to me such as "I won't be able to earn a living" or "I'll be living in poverty" if Medicare reimbursements are cut 10%. I am appauled and disgusted by such statements. Doctors (e.g., specialists) who talk like that are only in medicine for MONEY.

Maybe instead of complaining about possible reductions in their income, these SPECIALISTS could start working 60 hour work weeks (like other professionals who went to a lot of schooling and have stressful jobs) for the same money they are currently making. I think 2-3 weeks of vacation each year is sufficient for professionals who are being paid $300K - $400K each year.

dosi-do said...

As someone who works in the radiation oncology field, I know how much some of our RadOncs make, and trust me, if they came out of school with the average $160K of debt as another poster described it would take VERY little time for them to make up that ground. Also, my wife handles investments in a small, somewhat exclusive firm. They don't have time to mess around with people that don't have money. Many of their wealthiest clients are physicians, so I get really tired of hearing the sob stories of how doctors are just getting by like the rest of us when I'm constantly hearing of exotic vacations and private schools for the rich kids and the new Jag parked out front etc.

I'm not saying doctors don't deserve it for all they go through. For God's sake, I've seen them nearly lose their freaking minds before taking their boards. However, I do get tired of the constant poor-mouthing I hear from physicians. Honestly, who do you guys think you're kidding?

Anonymous said...

"We as patients DESERVE MORE FROM THE OVERPAID DOCTORS WHO SPEND THEIR FREE TIME SHOPPING AND VACATIONING."

What? seriously? do you spend your free time working? alot of doctors do, just because when you see them out they are shopping or whatever doesnt mean they don't have work they are doing in their off hours.

I'm all for keeping up with current medical info but to expect one person to be able to know everything about the ever changing medical field is crazy. also, some doctors are just more dedicated than others. But that can be said for any profession.

For as long as I can remember I wanted to go into the medicine. it wasnt about the money but yeah, I'd like to be able to make a good living doing it after spending 8+ years in school for it. If money wasn't a factor my love for science would be a hobby not a profession and I certainly wouldnt go $300k into debt for a hobby.

I think it's human nature to focus on the negative experiences and its difficult to have a positive experience when visiting a doctor becasue you're usually there because something is wrong. The pain of whatever you're going through can sometimes make the situation much worse than it is and blame is placed on the doctors because they are suppose to "fix" you.

Anonymous said...

Copletely wrong, nowhere in the world they get well paid for time and sacrifice , they do during their works and night duties. And also the risks they take...

other professionals (dentisits,pharmacists, bioanalysts, imaging specialists etc)of medicine make more money with less time and better life style.

Remember that, about 50 years back a physcician was also a pharmacist, nurse, analyst and everything to do with sickness. And now the physcician is still here with all the responsabilies and no income.

ADVICE FOR THE STUDENTS --: DONT STUDY MEDICINE...INSTEAD STUDY othe health specialties where you can make money, enjoy the life, no risks, sleep home everyday and work less time.

Anonymous said...

I have an MD and a PhD degree, and I can tell you the PhD life was awesome– 40-50 hours a week, weekends off. Being a doctor is a completely different world. I work 90-110 hours a week (I’m a surgeon), and I don’t have a choice, I don’t get more than 2 weeks vacation a year, and when I am at work I am working 100 times harder than I ever did during my PhD years. 4 yrs college + 4 yrs med school + 4 yrs PhD + 7 yrs surgery residency + 2 yrs fellowship = TWENTY ONE YEARS. The most I’ve ever made is $65,000 per year. I went into medicine because I loved science and a challenge, and not for the money, and I can tell you if I had done if for the money, I would have quit this career long ago. My brother is in the marines (who make almost nothing), and he has a house and property, whereas I have trained for 20 years and I still rent, and I own a car that's 15 years old.

Secondly, the health care system is way overloaded (as evidenced by the number of hours I work). People should do their research before commenting on the pay of doctors and surgeons. First of all, physician pay is less than 5% of health care costs. Secondly, the reason physicians in the US get paid more than other countries is because doctors in the US work almost twice the hours on average than in other countries (which is part of the reason wait times in the US are miniscule compared to other countries). If pay is regulated for physicians, I can guarantee physicians will do more to regulate their lifestyles, and good health care will be in severely short supply.

Also, if you think socialized medicine will decrease how much you pay for healthcare, think again. If you are an average american making $40k a year, you will all of a sudden be paying not only for your care, but subsidizing the care of millions of people who sit on their butts all day with their diabetes, COPD, vascular disease, renal failure, obesity, etc. About 10% of people use up 90% of healthcare costs and resources. So distributing costs will only make the average person pay more out of their pocket for healthcare.

Also doctors in foreign countries go right into med school from high school, and tuition is paid for them! US doctors spend years more studying medicine and science, and go into extreme debt to do so, and by the time they finish training they have worked more hours than most people have worked by the time they retire.

Rich Wood said...

Wow, there are a lot of comments. I feel like I'm just adding a a penny in an ocean. I'm in medical school right now, and I figure I'll graduate with $200 000 in debt, unless I get accepted to the Air force HPSP scholarship I applied for.

I think it is very important to recognize that doctors have spent AT LEAST, and I mean AT LEAST, 11 years without making a income greater than minimum wage. There needs to be compensation for all that lost time that other are using to climb the corporate ladder.

Doctors ARE underpaid. I don't think the patients or physicians are happy that insurance companies are skimming the cream off money that should go back to the patient and the physician, and the nurse, the PA, and anyone else involved in the delivery of health care.

dev said...

Well, I've been an RN for the past 24 years and as I see it, rising healthcare costs has much to do with unreimbursed services . . . also rising malpractice insurance - lawyer fees, etc.

However, I must say that my personal observations are that many doctors really aren't putting in the 40-60 hr work weeks (after residency). Many doctors work 4 day weeks from 9-5 with a 1-2 hour lunch each day. Nights and weekend call is shared with other specialists, usually amounting to 1-2 weekends per month and 1 or 2 nights on call per week at the most. In larger hospitals with so called "hospitalists", hours are sporadic but generally no clinic/office hours are worked.

To me, it's pretty easy to understand why many people point to doctors as being the cause of high healthcare costs when so many doctors live in ostentatious homes, vacation every few months at exotic locations, own a 2nd home or a few condos, drive a Lexus, and so forth. Lots of other professions require a lot of schooling and do important work for the advancement of society . . . yet it seems salaries are disproportionately high for physicians.

I've also observed an attitude change amongst the young people of society (teens and college-age kids) where they describe doctors as "being loaded" . . . many of this generation seem motivated to become doctors as a way to becoming extremeley wealthy rather than for any humanitarian reason.

One last thought, public perception about doctors being over paid may be progated by the little time many practitioners actually spend with their patients within the hospital setting. This is especially true with obstetrics . . . In many cases, a labor and delivery nurse gives all the care and the patient sees their doctor for the first time at the hospital only when the baby is actually coming out!! One last example, one of the biggest physician bills a patient will get is from the radiologist or the anesthesiologist and many a patient has never met the one and can't remember the other!!

Anonymous said...

To the surgeon above who states the he/she's ever made is $65,000 per year, rents a house, and drives a 15 year old car after twenty-years of training: I AM SHOCKED !!!

I have NEVER heard of a surgeon making so little money. There HAS to be more to the story!!!

Anonymous said...

In the UK, doctors are paid less because they have to go through less. All they need to go thru is a 5-year Bachelor's program to get an MBBS, the American equivalent of an MD, which takes twice as long.

med student said...

If doctors made $100k, barely anyone would become doctors.

Going hundreds of thousands of dollars in debt, not having any social life during your 20's, struggling through 8 years of the most academically competitive and intense education and emerging at the top, and another 4-7 years of 90/hr weeks at minimum wage-- it is just not worth it for an hourly wage that equals the plumbers union. Not to mention there is not even a retirement.

Anonymous said...

Earlier post said: "If doctors made $100k, barely anyone would become doctors."

I agree. However, I do think that $250K per year for 40 hour work weeks and 4 weeks vacation each year would be sufficient.

Too many doctors that perform procedures are paid upwards of $500K per year for 40 hour work weeks and 4-6 weeks vacation each year. This is what needs to be eliminated.

Doctors don't seem to understand that other professionals in this country work just as hard for a lot less money--without complaining!!!

Anonymous said...

Regarding specialists pay vs. primary care doctors pay over the last decade, see

http://thecenturyfoundation.typepad.com/photos/uncategorized/2008/10/01/compensationtrends.jpg

Money is only part of the equation. The specialists I know work very short hours (8 hours/day), short work weeks (4 days/week), with loads of vacation time each year (4-6 weeks).

In addition, I know a dermatologist who is considering being trained to perform laser hair removal treatments "because it is easy work (that does not require much skill) for huge money."

Anonymous said...

no one can really comment on this unless they are a doctor or know one personally. come work with me (a neurosurgeon) during a typical week and see what i see and do what i do. most people couldn't hack it. specialists are paid well because the job they do requires more education and has greater risk. also there are less specialists out there. there is a higher demand for their services and thus the higher pay. my typical work work is 80-100 hours. i am on call in my single practitoner practice 24 hours a day, seven days a week. i see patients in my office 6 days a week. yeah, i make a fantastic living but i work my tail off for it. i never see my family and missed my kids growing up. was it worth it? probably not.

Anonymous said...

I do personally know several specialists.

One gastroenterologist I know at a nationally respected hospital has told me he has about 30 minutes of free time between every patient. He spends that time chatting (gossiping) with drug reps. In addition, he works about a 40 hour week and takes several weeks vacation every year. In 2006, average income for gastroenterologist was over $400 K/yr.

I also know a radiologist who has 6 weeks vacation. He doesn't seem to work very long hours the weeks he is not on vacation (probably about a 40 hr work week). Avg income is about $445 K/yr.

An anesthesiologist I know was always complaining about how early he had to be at work (6 am). At first I was sympathetic when he told me he had to work long days. It turns out, however, that it was his choice to work 4 ten hour days a week (he leaves by 4 pm every day). He has 4 wks vacation per year. Avg income is about $365 K/yr.

The anesthesiologist I know recommended a friend of his when I needed surgery. He told me, however, that the FIRST question I needed to ask was if the anesthesiologist he was recommending was going to be on vacation that week--it turned out he was vacationing, so I had to choose another anesthesiologist. I don't know of any other profession where the FIRST question a client needs to ask is if the professional will be on vacation. From what I see (from the physicians that I personally know), specialists take much more vacation time, have much higher incomes, and work much shorter hours than any other professional.

Another specialist I know works exactly 35 hrs/wk (with Fridays off and 4 wks vacation) and calls that "full time" for well over $300 K/yr.

More than one of these specialists (who I personally know) has told me once they learned their job, they don't really need to learn new skills. Then expect to keep doing the same tasks (which become routine after a couple years) until they retire.

The neurosurgeon who posted above could have a very different lifestyle (for probably the same or more income) if he went to work in a group practice or for a hospital.

Anonymous said...

You are stupid to even post this.
Doctors study for 10 years if anything it is too little money.

Lizned said...

Doctors pay is secondary to the time spend with a patient. The national average of 11 minutes does not allow them sufficient time to make a intelligent evaluaton of that patient.
Typically a patient waits for a month or two for a appointment, drives 60 miles to see the doctor or specialist, waits a hour in the waiting room after filling out pages of usless family history charts, then is transferred to a little cage with no literature. After waiting there for a while, a assistant/nurse comes in and discusses your problems and basically gets to know you. Then she/he leaves the room for another 15-30 minutes and then the specialist comes in and announces his presence. After receiving secondary information from his assistant/nurse he quickly prescribes a few medications and tells you to make another follow up appointment.

I have seen 6 SPECIALIST in the past year and none have cured or helped cure anything......they run a few dozen expensive test and then finally refer you to another SPECIALIST.

Yes, as senior citizen.....we are treated like a assembly line, but we always pay before we leave .

Anonymous said...

To anonymous who said:

"You are stupid to even post this."


Nice response--you don't sound too bright youself. Obviously, my comments must have struck a nerve with you.

Anonymous said...

I'm currently in medical school and I feel family practice doctors are underpaid, while the others are about where they should be

I've read some of the posts here and it is a little bit frustrating to see the anymosity towards doctors. Doctor's should get paid what they get if not more for the unique and DIFFICULT services they provide to the public. The sacfrifices we make and the risks that we take are profound

Right now I plan on being $150,000 in debt after I graduate medical school, I will be 29. My wife lives in a different state because she can't get a job in the area I go to school. If she stayed with me I would be $200,000 in debt. I haven't bought anything much more than food for the past 2 years. My wife and I didn't go on a honeymoon. I drive a beater of a car. My friends are all buying houses, having kids, going on vacations, visiting family and friends while I worry about if I'm going to pass this class. I also wonder if I become a family practice doc how I will pay off my debt.

I haven't even mentioned the emotional sacrifices we make. I worry more nights than not if I will make a good doctor. Will I miss something somebody else would've seen that may lead to somebody DYING. What will it be like to tell somebody they have 3 months to live. What will it be like to tell a 40 year old married couple that her spouse died on the operating table. What will it be like to tell my wife and kids daddy has to work on christmas or sorry son I can't go to your basketball game tonight. Everybody makes sacrifices, but doctors certainly make there fair share.

All this said it seems worth it that I made this choice. I'm not complaining, but informing because I knew fully well that this is what my life would be like, but I just want those that think it is a breeze to become a doctor or that we've gone through little hardship is simply false.

Lastly the guy that said you could learn everything in a summer or whatever is BS. You could learn 80% of what a family doctor does, but you will make a crappy doctor that will get his ass sued and kill a handful of patients too. It takes years and years to learn the other 20% and that is what medical school and residency are for. Unfortunately, medicine isn't you've got a staph infection here is your antibiotic. You have to consider which staph it is, what drugs will work, what are the complications of staph, if the staph got into their blood is it going to cause endocarditis or maybe a renal abscess. This is just one of the many many instances where you need to know much more than what you may think. Add to that you have to not only treat, but explain to patients what every last infection, genetic defect, etc means. This adds to the expansive amount of material doctors not only learn, but must recall. If a patient asks hey doc, why is my lyme disease not getting better despite taking antibiotics, you need to give a correct response.

Doctors are very underapppreciated these days. I will be the first to admit that I thought being a doctor would be easy, I mean webmd has everything. BOY was I WRONG!!!
Medicine is much much more expansive than it ever was before and it is only getting more expansive.

I will leave this statement that we got from our professor. It is the obscure things, the miniscule things that make doctors doctors. Anybody can diagnose a broken leg, but not everybody can see what looks like 2 completely irrelevant things and put them together to form a correct diagnosis.

That is my 2 cents!

Anonymous said...

To the medical student above--if you become a specialist, you will be able to pay off your debt in about 2-3 years. Then, you can continue raking-in a $350K-$500K annual salaray for the remaining 27 years of your career.

I agree with what you said "not everybody can see what looks like 2 completely irrelevant things and put them together to form a correct diagnosis." Unfortunately, I know very few doctors who actually put in the effort required to do this. I know a good number of doctors who work at nationally recognized medical institutions, and their attitude is "if it's not in the textbook, refer the patient to someone else." They don't put in the sweat and hard work required to put 2 obscure facts together to make the right diagnosis--they are more interested in planning their next vacation.

Anonymous said...

In Europe docs make less than half the AVERAGE salary of a US certified physician, with a considerably higher cost of living in some countries...and yet people want to study medicine no matter what. So please drop the argument that no one would go into medicine if pays were slashed...

Anonymous said...

I'm an ER doc. Listen, you all can keep arguing over how much we should be paid and whether or not my stress or training is greater than your stress or training, etc, etc, and how much that is all worth. All of which I find quite humorous. And European medicine... where should I start? Forget about it. You be the philosopher. And when you come in my emergency department and need life saving treatment; I will continue to treat you like I would my own family. I will continue to work at my absolute capacity. I will do everything to save you regardless of your color, creed, SES, guilty, not guilty, male, female, fat, skinny, ugly, beautiful, crazy, sane, powerful, powerless, or whether you think I should be compensated better or worse than I am. We are not trained to play in the political arena. We are not trained to philosophize. We are trained to help you when you can no longer help yourself. You can decide how much that safety net is worth to our United States society as a whole. In the meantime, I will be in the trauma bay, meeting people at the absolute worse time in their lives. Its all glamour. Brad Pit has nothing on me. (wink)

Toni Brayer MD said...

As the author of this post, I enjoy reading the years of comments and it is a subject that lives on and on.

I must say I do think Anon, Nov23,2008 is sexier than Brad Pitt.(Or at least makes a sexy compelling argument). A smart physician, dedicated to his/her patients health, working nights, weekends and holidays is PRICELESS.

Anonymous said...

Toni Brayer said: A smart physician, dedicated to his/her patients health, working nights, weekends and holidays is PRICELESS.

If only they really did this. One doctor I know demands more money for working nights. Then, in addition, he demands the next 3 days off. I think he should take either the extra pay OR the 3 days off--NOT BOTH.

Anonymous said...

DO programs are much easier to get into compared to MD programs... who are you kidding. Just look at the average mcat/gpa of the incoming students.

Anonymous said...

i hope those of you that complain get a life threatening illness...since drs are so stupid i guess youll treat yourself

Anonymous said...

Who said "drs are so stupid"?

I simply feel doctors who perform many procedures (which happens to include a lot of specialits) are grossly overpaid in terms of money, vacation days/weeks, and short work hours. Actually, I think these "proceduralists" must be pretty bright to have been able to convince everyone they are worth the money they are paid.

I have been following recent news stories about primary care doctors (and non-proceduralist specialists) that are starting to question why they are paid much less than their colleagues who perform lots of procedures. The primary care physicians are starting to demand higher salaries (which they probably deserve). These higher salaries are going to impact the inflated salaries of the "proceduralist" specialist doctors.

I think the patients and primary care doctors have been the stupid ones for accepting the specialists salaries all these years without question.

Change is 'a coming. Those who work hard need to be rewarded (i.e., the primary care doctors), while those who vacation half their careers away (i.e., the specialists) need a good dose of reality.

medaholic said...

This is a complicated question. I believe most people will agree that primary care doctors are being underpaid, especially for the essential service they provide that isn't so easy to quantify. How can you measure the health care dollars we'll save from preventative measures?

Also, by paying PCP's more, perhaps there will be an increase of students choosing to go into such specialties.

If possible, it would be interesting to set up a poll on this post, just to see where people stand.

Anonymous said...

I am 28, have 250k in debt between educational and living expenses from medical school (I went to my state school too), no savings, currently earn <$10/hour while literally making life/death decisions everyday and learning as much as possible so when I finish training at age 33 I will be comfortable with "routine" cases and have some clue what to do when things go really bad.

At this time my engineering and computer science friends (I was a mechanical engineer) are making around 100k, work 40-45 hours/week, and never work nights, weekends, holidays, 30 hour shifts...

I believe procedurally oriented fields are reimbursed about right. Call me crazy but I think someone who can crack my chest open and replumb my heart or in general slice me open, fix what ails me and put me back together again deserves every penny they make and more.

Non procedure heavy fields (all of primary care and the bulk of physicians) are woefully underpaid. Your doctor doesn't spend that much time with you because if they did, they would go out of business. It is the current nature of third-party payers. If I did primary care I would be well into my 40s before I broke even financially with my engineering friends The direct costs and opportunity costs are high. That doesn't count the lifestyle during medical school, residency, and for most docs post-training practice.

If you want to see more/better primary care physicians, double the reimbursement rates. Currently your best and brightest medical students are going into fields where they can get reimbursed fairly and have a life when they are finished training. Odds are your dermatologist was a much, much better student then your family med doc (or your general surgeon for that matter).
All of this really got to me today after I had two patients at our county hospital make quips about me making too much. I could hardly control laughing. This coming from patients not paying a penny for their healthcare yet can somehow afford to smoke, drink, do drugs, wear designer clothing, have a nicer cell phone then me and I am sure have cable TV.

Physician salary is a pretty small piece of the health care pie and will continue to shrink as most docs don't have the gonads to stand up for themselves against the government and insurance companies. Ask your doctor, most likely he makes the same amount as he did 10-15 years ago yet works more now.

How much are you willing to pay for the expertise of someone who can fix you when you are deathly ill or help keep you from becoming sick in the first place?

Anonymous said...

Regarding the statement "Ask your doctor, most likely he makes the same amount as he did 10-15 years ago yet works more now", my response is that just saying something does not make it true.

See http://www.healthbeatblog.org/2008/10/primary-care-do.html#more. Although Internal Medicine drs may only make about 30% more than a decade ago, dermatologists make about 200% and gastroenterologist make about 180%more than a decade ago.

I'm not sure about you, but I don't believe a dermatologist's avg salary in 2006 of ~$350K is justified for procedures that often times include removing warts, etc.

Most of the specialists I know are more concerned with their own lifestyle than with working long hours to solve the difficult cases.

Although some engineers may be making $100k, I do not believe the AVERAGE salary of an engineer is anywhere near the AVERAGE salary of any doctor.

If you don't like medicine, you shouldn't have gone into it. It sounds like you wanted more money than you were making as Mechanical Engineer--you could always go back to that. Somehow, I have a hard time believing you were making $100k for 40-45 hours/week, and never working nights, weekends, or holidays.

Anonymous said...

"Regarding the statement "Ask your doctor, most likely he makes the same amount as he did 10-15 years ago yet works more now", my response is that just saying something does not make it true.

See http://www.healthbeatblog.org/2008/10/primary-care-do.html#more. Although Internal Medicine drs may only make about 30% more than a decade ago, dermatologists make about 200% and gastroenterologist make about 180%more than a decade ago."

** Be careful with salary surveys, they are rarely all that accurate in medicine. My info is anecdotal for sure, but I don't believe it is far off. Every year physicians have to lobby for medicare/medicaid to not CUT reimbursement, much less keep up with inflation**



"I'm not sure about you, but I don't believe a dermatologist's avg salary in 2006 of ~$350K is justified for procedures that often times include removing warts, etc."

** They absolutely deserve every penny. Sure, wart removal is easy and simple. However, are you sure that is a wart though and not a squamous cell carcinoma? Things aren't always cut and dry. Dermatologist make their money by volume. They see a LOT of patients. Acne and warts are good for paying the bills so they can spend more time with patients who have skin cancer and a whole host of odd ball inflammatory skin disorders (dermatologist make some crazy diagnoses). Once again, they have had 12 years of education/training post high school so they can make the hard calls that nobody else can. They deserve their pay.**



"Most of the specialists I know are more concerned with their own lifestyle than with working long hours to solve the difficult cases."

**Do you like to work all the time? Are you every concerned with your vacation or pay? Do you like to see your family? Doctors are human too. Sure, there are some lazy ones that don't care about their work and just want to go home and make their money, but that is the exception. Most want to do the best they can at work and still see their wife and kids as much as possible (few are privileged enough to do so)**



"Although some engineers may be making $100k, I do not believe the AVERAGE salary of an engineer is anywhere near the AVERAGE salary of any doctor."

**I never said the average salary of a doctor was close the the average salary of a physician. I clearly stated that my friends from undergrad are all making ~100k right now. It is about opportunity costs.

Docs will rack up 250k in debt during 4 years of medical school while the engineer is going from 60k to 100k in salary over that time, saving, compounding, and not living in a library or hospital. Then, during residency the doc gets to work 80 hours/week (often more, but don't tell anyone as it is offically against work hour rules that cap at 80) making 45k all while interest on the debt keeps building and the engineer is making at least twice as much and working half the hours. Then, when they finish residency the primary care doc gets to start at 110-140k, not that much more then their counterpart who has been earning and saving for 7 years without the debt and hours. It is all about opportunity costs. Specialists actually make enough to make it worthwhile, primary care does not.

I went to a top engineering school, so maybe the average engineer is slightly lower, but the concept remains the same.**



"If you don't like medicine, you shouldn't have gone into it. It sounds like you wanted more money than you were making as Mechanical Engineer--you could always go back to that. Somehow, I have a hard time believing you were making $100k for 40-45 hours/week, and never working nights, weekends, or holidays."

** I never worked as a full time engineer. Once again, all my friends from undergrad are making 100k +/- 10k working 40-45 hours/week, never working nights, weekends, or holidays.

I was a mechanical engineering major who decided that engineering wouldn't be fulfilling enough, picked up a neuroscience degree on top the engineering and went to medical school. I only ever did summer internships as an ME. I love medicine. I never said I didn't. I'm very excited to be training in a field that lets me work with other physicians to make difficult diagnoses, use cutting edge technology, and have a huge impact on patient care (I am a radiology resident and plan on either doing interventional or neurointerventional radiology). I couldn't imagine doing anything else with my life.

That said, I reserve the right to be payed fairly for my training and expertise when the time comes. Physicians are too quick to play the role of a martyr and not stand up for themselves.**

Anonymous said...

I don't think it's the doctors complaining about being overpaid. Sure, everyone would like to make more money. That's human nature. And I certainly believe that a physician who is working countless hours, SAVING LIVES should be compensated accordingly. However, this is not a fight started by physicians wanting more money. This is about YOU people complaining and whining. This is one part ignorance and one part jealousy. YOU are ignorant to think that physicians work an ordinary job and should be paid an ordinary wage. YOU are jealous because everyone secretly wishes they could be a doctor. Let's admit it..the white coat, the knowledge, and hey if you are good looking that's just the icing on the cake!! So stop your jealous rant and get over it. Physicians worked their asses off to be where they are and they deserve every penny and then some because they have to put up with noncompliant, ungrateful, ignorant people such as YOU!!!!!!!!!!!

Anonymous said...

I'm a doctor, and I do well. I worked very hard to become a specialist and perform procedures relatively few people can do. To accomplish this required a certain degree of talent, but no more so than my friends. However, it required an enormous amount of work and dedication, absolutely monopolizing my time for approximately 13-14 years. I don't think someone who has not been through it can understand it. Perhaps investment bankers, young lawyers at top firms putting in 100 hours a week. And that time is lost to me. A chunk of life, essentially gone. It took time from my very understanding wife, kids, family. I don't regret it at all. I do well. I am not rich and probably won't be, but no complaints. I would do it again, because I like what I do, at the end of the day I have helped people rather than shuffle paper, even though that activity that has made some of my close friends extremely wealthy. You can make of it what you will, but I don't think I'm overpaid. I would do it for free, but I don't think I'm overpaid. I paid for my expertise in full. There are relatively few people who do what I can do. If I charged 10 times as much people would still come to me.Since a good amount of what I achieved was purely due to my putting in a tremendous amount of effort, I think it's rude to suggest we make too much money. I don't think anyone makes too much money. I don't believe I have the right to determine what other people should make. Just concentrate on your own finances.

Anonymous said...

This is a continuation of the last comment. Internists and especially pediatricians make very little money. They should be paid more.

Anonymous said...

Regarding the statement "Be careful with salary surveys, they are rarely all that accurate in medicine. My info is anecdotal for sure, but I don't believe it is far off. Every year physicians have to lobby for medicare/medicaid to not CUT reimbursement, much less keep up with inflation"

**I trust salary surveys from the Century Foundation infinitely more than your (biased) anecdotal evidence. If we are going to rely on anecdotal evidence, I will tell you that every specialist I know lives in a very expensive home and drives very expensive cars--while working very SHORT HOURS. What makes your anecdotal evidence any more valid than mine? I know I am not a doctor, but I am capable of thinking.

In addition, why are physicians lobbying for medicare/medicaid to not CUT reimbursement? I thought physicians are not money-oriented people. Every specialist I know spends money like it's water, and then turns around and tells me how he/she doesn't need a lot of money to be happy--that it's just "icing on the cake." If these specialists had their income trimmed down to where it should be (about 1/3 of where it is now), I have little doubt they would turn into even bigger martyrs complaining about how they cannot maintain their lifestyles and, therefore, need more money. It's ALL ABOUT MONEY WITH DOCTORS.

Regarding the statement "They absolutely deserve every penny. Sure, wart removal is easy and simple. However, are you sure that is a wart though and not a squamous cell carcinoma? Things aren't always cut and dry. Dermatologist make their money by volume. They see a LOT of patients. Acne and warts are good for paying the bills so they can spend more time with patients who have skin cancer and a whole host of odd ball inflammatory skin disorders (dermatologist make some crazy diagnoses). Once again, they have had 12 years of education/training post high school so they can make the hard calls that nobody else can. They deserve their pay."

**I know several dermatologists very well. The salary surveys show they make huge money. The dermatologists themselves have told me such things as "my job could be done very well by a nurse practioner." That statement says it all. Why isn't the easy work pushed down to lower cost providers (e.g., nurse practioners) and the hard, difficult cases saved for the highly-trained, highly-paid dermatologists? That is what happens in a free-market (e.g., accounting, law, etc). Accountants and lawyers also graduate with large loans, but you don't hear them running to the government and lobbying for higher pay--instead, they simply WORK HARDER THAN ANY SPECIALIST DOCTOR I KNOW. Instead of lobbying Washington for higher reimbursements, why don't doctors who are working 35 hrs/wk for >$350K/yr (with 4-6 wks vacation) simply work harder for lower pay--wouldn't that help the patient more? That way, the patient would pay less and not have to wait 6 months to see a specialist.

Regarding the statement "**Do you like to work all the time? Are you every concerned with your vacation or pay? Do you like to see your family? Doctors are human too. Sure, there are some lazy ones that don't care about their work and just want to go home and make their money, but that is the exception. Most want to do the best they can at work and still see their wife and kids as much as possible (few are privileged enough to do so)"

No, I don't like to work all the time--however, I HAVE NO CHOICE. If I am not working, I do not get paid--I don't get 4-6 wks vacation a year, nor am I able to call 35 hrs/wk "full time." I am a professional who has to work ~60 hrs/wk and am LUCKY to get 2 full wks vacation a year. The free-market in which I work does not permit me to have the entitled attitude of the many specialist doctors I know.

I could go on and on.

You say "I am a radiology resident and plan on either doing interventional or neurointerventional radiology." That is one of the most OVERPAID specialties--no wonder you are defending the specialists. I can't wait for the overseas radiologist to read films for 1/10 of the price and provide superior quality.

Anonymous said...

I don't think doctors are paid too much as I think doctors should get paid whatever supply and demand dictates, but I do think many of them complain too much.

I am semiconductor engineer. I definitely had the grades and ability to go into medicine, but I knew that it wasn't a good fit for me as I prefer dealing with machines instead of people. All of my friends that did go into medicine really did seem to do it for the right reasons.

Anyways, I just wanted to say that I and many of the engineers that I work with (at least in our group) work at least 55 hours a week (often 60 or 65), work tons of Saturdays, work most holidays (including both of my kids first Christmases), often work night rotations, and miss many important family events. I have also worked many 20 hour stretches when a critical piece of equipment goes down. I have to make dozens of important decisions a day too. Although nobody's life is on the line for those decisions, it isn't unheard of for a simple mistake to cost the company a million dollars. I get paid about 75k a year which doesn't go too far where I live. I'm not complaining though because I like what I do, I didn't have to go through nearly as many years of school (although I really liked school), and I also know that a lot of other people would love to be in my situation.

Then what about comparing that to those who are serving in the armed forces. They didn't have to work their butts off to get good grades through school or anything, but you can't say that what they often have to do isn't tough. My brother is in the military and has been shot at and has seen friends killed. Talk about a bad day at the office. Those guys often pull crazy long shifts under a great deal of pressure. They go months without seeing their wives (or husbands- not to be chauvinist) and kids and do all that for about 30k per year.

So I don't have a problem with how much doctors get paid (often primary care physicians aren't paid enough), but please just stop the bitching. Maybe being an MD isn't what it once was, but it is better than many alternatives.

Anonymous said...

One other thing - Doctors don't have to worry about whether their entire industry will be outsourced in 10 years or not. (Although, admittedly, they do have to worry about the possibility of medicine becoming socialized.)

Anonymous said...

I have one last thing to add. My wife is a software engineer and previously work for EA. Don't even get me started on that. She was at work all the time and literally had to sleep on the floor sometimes when a deadline was coming up. She was pulling 80+ hours a week there. She didn't get paid very well for that either. Not everyone can write code like that; you have to be pretty smart. She got burned out eventually though and I guess that is nice that engineers have the luxury of throwing in the towel when we get burned out whereas doctors don't have the option due to high student loan debt. So I'm not saying engineering is harder by any means, I'm just saying that there are other smart people out there that work long and hard hours besides doctors.

Anonymous said...

Hey, life isn't fair. For someone to be on top, another has to be on the bottom. If you want to be a doc, go for it. Enjoy all the perks you can squeeze out of this life. If you're one of the whiners, get with the program or shut the hell up. Welcome to America!!!

Anonymous said...

Tsk tsk tsk, where do I begin.

Firstly, it's asinine to associate the concept that "hard-working" = "useful work". I've actually dropped out of medical school simply because of the retarded system and the rote memorization involved. Who ever said doctors are smart is either 1) a doctor or 2) a dumbass.

Furthermore, let's look at the in-efficiency of the medical system.

1. Feel something wrong
2. Call Doctor get appointment in a week
3. Doctor thinks its x, but not sure, gives you some pills
4. Feeling worse, re call doctor
5. Repeat #3 and #4 until Doctor really figures out what's going on.
6. Get billed $500 for the 7 appointments.

"Professionals" are the real inefficiencies of society. I'd say replace every lawyer and doctor with an engineer and society would be a million times better.

Anonymous said...

Regarding the post "Firstly, it's asinine to associate the concept that "hard-working" = "useful work". I've actually dropped out of medical school simply because of the retarded system and the rote memorization involved. Who ever said doctors are smart is either 1) a doctor or 2) a dumbass."

I say--VERY WELL SAID, and I COMPLETELY AGREE. None of the doctors I know socially seems to be very good at THINKING his/her way through new situations.

My experiences have shown me that doctors are always looking for someone else to do their thinking for them--they always want a checklist to follow. They are told from the first day of medical school that they are the "chosen ones" and that no one else could possibly be as smart as they are. Consequently, they have come to believe that running through checklists is "hard work" that should be compensated handsomely. Doctors seem to believe that no one else in society works as hard as they do. I have showed some doctors what I do for a living (as a professional), which involves figuring out concepts that neither I nor anyone else has ever dealt with before. The doctors have told me they never deal with such situations--after a few years, they have seen everything there is to see.

Regarding the post "Hey, life isn't fair. For someone to be on top, another has to be on the bottom. If you want to be a doc, go for it. Enjoy all the perks you can squeeze out of this life."

I say--that would be all well and good if medicine was a free market. It's not. Consequently, there are no market forces keeping US doctors (particularly specialists), or their pay, in check.

Anonymous said...

Wow so much hatred for docs here. It's funny, I think people talk big until they are the ones that actually get sick. Then they fly to hopkins, penn, harvard, and why? To have access to these technicians who are all the same? Nothing more than glorified car mechanics running simple algorithms, and who are incapable of critical thinking? A good doctor has 2 main qualities: 1.An excellent memory 2. The ability to analyze a problem. My undergrad degree is in bioengineering from MIT, so I am fully aware of the way engineers like to think of themselves as great thinkers. But comparing the ability brainpower I dealt with in college vs what I've seen in med school, residency, and beyond, there is no comparison. The people going into medicine are really the smartest, and we as a society should be happy about that. If we get paid a little more so be it, it's a small drop in the bucket compared to the CEO of Aetna giving himself a 400 million dollar bonus in 2006. After all, how would you feel knowing that the anesthesiologist putting the mask over your face chose medicine because he couldn't get into law?

Anonymous said...

I actually did go into medicine for the money. I'm smart, I always have been, I went to magnet high school that required me to score in the 95th percentile on my sats in the 6th grade, and the rest of my education is just as impressive including training at ivy league institutions. I could make money in business, but why wouldn't you want someone as smart as me in medicine? I've diagnosed things in patients that I know would have been missed by someone with a weaker memory, or someone not capable of connecting the dots as quickly as I can. If you paid me 150K a year along with 200K in med school debt, I would say you're f'ing crazy, and I'd go into investment banking. The money attracts the brains, its that simple.

Anonymous said...

We always seem to hear the argument that the best and the brightest are in medicine. It simply is NOT true.

Funny how it always seems to be the doctors that are telling us that they are the best. The ones I know are not that impressive.

I have no problem with the best and brightest doctors (at hopkins, harvard, etc) making good money. The problem is that each and every doctor is making the good money (even for practicing run-of-the-mill, repetitive medicine). That's shameful.

Anonymous said...

im a doctor and i make a billion dollars

Anonymous said...

To the dr. who said "i make a billion dollars," I say:

You must be a specialist who performs procedures. If you are a primary care dr., I don't believe you make a billion dollars.

Anonymous said...

I just had a quad bypass. I'm an Engineer who lost his job along with the entire group. No medical insurance, no job and a heart attack. The Heart Surgeon charged 6 grand for 4 hrs work, and packed his bill to 12 grand. Other Doctors packed it to a total of 30 grand. The hospital charged 100 grand for the OR, equipment and whatever else they can throw in. Since I have no job and owe 130 grand I have bad credit. Since I have bad credit I cannot get another job in my field. Debt prison. It seems like the hospital makes the most money. Six grand is very reasonable for somebody to crack my chest. I lived near a medical school and knew a few students. They were there for the money. Many had prior careers which would not pay and said so. I'm alive thanks to the Doctor. My job went to India. I wish I was employed an the time. There is big money in procedures, pills etc and very little money in cures. The business class determines where R&D money is spent and cures are not in the best interest of profits.

Anonymous said...

I am a 35 year old physician. I gave up a decade of my life when all my friends were traveling and making good money to sit in libraries and lectures and hospitals. I worked for 5 years at Johns Hopkins doing research, writing papers, giving presentations, and teaching incredibly bright students. I won a teaching award, edited a major textbook, directed teaching conferences, and grew a lot as a person.

During the course of my training and career dealing with patients, I have been cursed at routinely, punched in the face, spit on more times than I can count, bled on to the point that I could wring blood out of my clothes multiple times, and not uncommonly attempted to help patients who were telling me to F%$#* off and that I was just a hack who didn't know what I was doing. I made an average of $150,000 a year, lived in a two-bedroom apartment and was drowning in debt.

How did I rectify this? I went overseas to a wealthy Gulf nation, made triple my salary for a year, paid off my debts, moved back to the US, and now practice in a sleepy town with nice people/patients.

I miss my residents/students and the intellectual thrill of academic medicine, but not the clinical side. It was abusive, psychologically destructive, financially suicidal, and incompatible with any sort of family life. It also was incredibly demoralizing to attempt to help people who treated you so poorly.

Even though I have only been out of my residency for 7 years, I am actively searching for ways to make money outside of clinical medicine so I can leave full-time clinical work. I still would like to practice medicine, but only as a side venture-- not full time. It just is not worth it.

I have dozens and dozens of friends who are physicians who would leave clinical medicine in a snap if they could figure out how to do it. The problem with American medical training-- along with the heavy debt load-- is that it actually trains physicians too narrowly. We take very bright students and give them great depth in medicine but not much else.They don't really know how to do much more than what they are already doing, and find it very difficult to branch into other fields when they get burned out on medicine.

For those who say American physicians are paid too much, well, you will probably be able to put your theory to the test soon. With what's going on in the economy these days and the serious talks of nationalizing healthcare, I suspect that doctors will be paid less and less in the coming years.

When this happens, you will see more and more people leaving medicine or practicing overseas. Americans have very high expectations for their healthcare-- they want it fast, cheap, perfect (and with excellent outcomes 100% of the time), and delivered with a smile. My advice for all the critical authors of these posts? You will probably be able to get your doctor's salary lowered in the next few years, but don't be angry when he/she expects you to lower your expectations as well.

For my colleagues in the medical profession I would simply say, "hang in there." You are an incredibly talented group and there will always be a place for you if you are good at your trade. An American MD is highly regarded throughout the world, even if it is taken for granted here at home. As the economics of healthcare begins to shift, I would strongly encourage you to begin to seek employment outside the US. It might seem inconvenient, but I guarantee your patients won't see you as a "glorified mechanic." You will be held in high esteem and appreciated (and thanked repeatedly). The world is changing, but the good news is that individuals with talent can now take those talents where they are most valued. You have skills that are in high demand around the world-- as the US economy stagnates, take adventage of this opportunity and go someplace where you will feel like you didn't waste your time/life with all your training.

Anyway, this has been an interesting read. I know no matter what I say the critics will not be answered, but at this point I don't really care. I am phasing out of clinical medicine and have the contacts and knowledge to practice most places in the world if I ever want to get back into it full time. I also have the assurance of knowing that I can take care of my family and friends if they ever need my help.

One more thing...

I sense two issues with these complaints about doctors' salaries: one is pure jealousy, the other is frustration oer the cost of healthcare.

For those who are frustrated with costs, I would suggest looking into medical tourism (google it). You can travel overseas and be treated for a lower cost at a usually decent hospital. The standards are not as high as the US and the doctors are sometimes a little less experiences/qualified, but who cares? These guys are just rote memorizers, mechanics without creative thinking, etc... Put your money where you r mouth is aget your healthcare somewhere else-- you aren't a victim (especially all you hard working professionals who work just as hard as docs but with less pay).

For those of you who are just mad that you don't have a doctor's life/salary, get over it. If it's any consolation, the vast majority of physicians will end up paying most of their salaries in taxes to cover your mortgage/financial stimulus anyway.

Anonymous said...

Anonymous said:

"I am a 35 year old physician. I gave up a decade of my life when all my friends were traveling and making good money to sit in libraries and lectures and hospitals."

I say: Get over it. Do you realize most other professionals do the same thing you did? Why are YOU entitled to receive more than anyone else in return? This is the God-complex of the US doctor.

Anonymous said:

"It also was incredibly demoralizing to attempt to help people who treated you so poorly."

I say: Get over it. Try working with clients in my profession.

Anonymous said:

"The problem with American medical training ... is that it actually trains physicians too narrowly."

I say: I agree--US doctors don't know how to think.

Anonymous said:

"I am actively searching for ways to make money outside of clinical medicine so I can leave full-time clinical work."

I say: I suspect you will never leave clinical medicine since you will quickly realize medicine is easy money. You don't realize everyone has to work hard for money--you just think you shouldn't have to. I suspect you feel you have already put in your hard work (school and residency) and, therefore, you deserve to be able to coast for the next 30 years. All professionals have had to work hard to get where they are.

Anonymous said:

"get over it. If it's any consolation, the vast majority of physicians will end up paying most of their salaries in taxes to cover your mortgage/financial stimulus anyway."

I say: Get over it. Individuals with higher incomes pay higher taxes. I don't believe you will be paying MOST of your salary in taxes. A lot of people (including me) are going to be paying to cover the mortgage/financial stimulus--not just doctors.

John said...

I'm entering medical school next fall at the age of 28. I left a 6 figure income to dive into this monster of a goal. Think about this for a moment.

Under most circumstances, A potential MD must excel in high school as to enter a decent university to complete their undergrad. So high school excellence and dedication is the typical starting point for most who become a physician.

Next comes the 4, and more often than not, 5 years of undergrad. These 5 years aren't filled with much more than early mornings and long nights studying. I live on and stick to the 7am-7pm 7 days a weeks policy. That's a 84 hour work week folks. Those are my hours of intense operation. Most of my serious peers, the ones who actually made it in or will make it, have similar schedules. The first 3 years of med school will require similar hours.

I should be studying right now... Biochem and immunology exam coming up.

Effectively none of the serious MD prospects I know can hold down a relationship with these hours, unless it happens to be with someone who is working towards the same goals.

Of the 1-2 thousand applicants of the school that I'm entering, 156 get in. The competition is stiff. The people who make it aren't necessarily the most talented of the crowd, but they are almost always the hardest working and most dedicated people I have ever come across.

The average age of medical school admittance is 24. That means the average age of graduation is 28, and residency probably starting at age 28-29. Next comes 3-8 years of residency, depending on specialty. That means your physician didn't start making the supposed "debatable" compensation on at the average age of 32 to 37, depending on their specific specialty.

Not too long ago regulations were put in place so that no resident can work any more than 80 hours a week. Most older MD's you come across didn't have the luxury of a 80 hour work week. Also depending on specialty and program, your typical resident probably makes about 45K per year at that 80 hours per week, all the while dealing with an average of $160K in school loans.

So lets add things up and even forget about high school.
Undergrad: 80 hours per week * 16 weeks per/semester * 2 semesters per year (most of us do summers as well) * 4.5 years average = 11520 Hours. This doesn't include research, volunteer, or clinical experience time, which occurs on our "time off".

I cant be sure of med school hours because I'm not absolutely sure of rotation hours, but I think that its safe to assume at least the same number of hours, bringing us to a total or 23040 hours, not including the extra stuff that goes into the mix. Lets theoretically compensate each hour with $10. This becomes over $230K. Add an additional 160K for school debt and we have almost 400K.

Those of us who make it are dedicated to the profession and we all sacrifice much more than our time to meet these goals. If you ask me, we're all nuts to take that sort of beating to see our dreams become reality so many years after its initial conception.

There's more than one light that shines at the end of the tunnel for us, but one of them is that we might pay off our debt before age 45, and perhaps have a lifestyle that affords us to send our kids to a nice school. Ofter uncle Sam gets paid 33-35%, maybe there will be a little to cover the occasional much needed vacation.

I don't blame people for thinking physicians compensation is high, but I also don't think these people know any physicians or the masochistic and expensive path that helped realized their goal.

-John

John said...

In addition, "high" physician compensation has little to do with the high cost of providing health care. Health care is NOT a substitution for a healthy lifestyle. It is a finite resource that is all too commonly wasted by our Americanized McLife philosophies. I recently saw a T-shirt that said; "When is somebody going to do something about how fat I am", and it unfortunately fitting.

Instead of healthy living practices, including proper diet and physical activity that goes beyond the walk to our cars, we prefer our expensive designer drugs to lower our cholesterol and blood pressure.

I recently read that the US spends what I think was around 20 billion a year on statins, and that in most of these cases the high cholesterol that the statin was prescribed for could be taken care of with proper diet and exercise. Don't worry about the fried foods and inactivity kids, thats what doctors and lipitor are for.

Health insurance is more or less a capitalized system of socialized health care. If I lead an unhealthy lifestyle you're premium goes up in response to my personal and social negligence. It all comes out of the same pot and we all bear responsibility for the total cost of doing business, and "we the people" must share the blame. It's so much easier to point fingers though...

Anonymous said...

Wow. What a lot of anger on this site. I'm guessing a lot of this either stems from people who don't make as much as physicians, or people that were mis-treated by physicians. Let me give you an example of mistreatment!

I'm 29 years old. I'm in my final year of residency in internal medicine. Next year, I'll be starting a 3 year fellowship in gastroenterology.

I despise most of the patients I see in my continuity care clinic. Why? Here's why. The other day, I had a 450 pound morbidly obese man walk into my clinic with a TWO PAGE laundry list of problems that he demanded be addressed THIS clinic visit because he did not want to make another trip. I scanned the list for about 10 seconds: 1) back pain, knee pain, hip pain, uncontrolled diabetes, hypertension, dyslipidemia, congestive heart failure, decreased libidio, erectile dysfunction, etc etc etc.

I handed the list back to him and I said, "Sir, I've got the perfect cure for you." His eyes perked up and his scowl lightened as he began to show a glimmer of hope. "Really! Doc, that's great! What is it?"

I looked squarely at him and said, "You need to lose weight."

His scowl returned ten-fold and he said, "F*CK YOU, DOC. How do you know that I haven't tried to lose weight? I was BORN with this condition. I EAT LESS THAN ANYBODY I KNOW. I follow a STRICT 1500 calorie diet per day, and I STILL can't lose weight!"

I smiled politely at him and replied, "Sir, if you eat 1500 calories/day and still weigh 450 pounds, there is absolutely NOTHING I can do to help you. Good bye."

What is my point? The doctors on this forum are smiling because they understand that obesity is really a simple equation: consume more than you expend = weight gain.

Now of course this story is a huge exaggeration (literally and figuratively) of the average patient. And don't get me wrong, there are MANY patients that I am absolutely thrilled to see, and will sorely miss them as my residency winds down. But far too many patients walk into my clinic not willing to accept the consequences that they've reaped upon themselves. Then, they go around finding someone else to blame, ie the doctor.

Why did I choose gastroenterology? Why did some of the brightest kids in my medical school class pick specialties such as radiology, anesthesiology, plastics, derm, ENT, urology, etc etc etc. Why do more than 50% of internal medicine residents specialize in rheumatology, endocrinology, ID, allergy, pulmonary, critical care, etc. Because they don't want to take care of your ass anymore, that's why.

Being a primary care physician is REALLY REALLY REALLY hard work. You have to critically think every medical condition, make diagnoses on the fly using the vast amount of information you've stored in your brain, and formulate treatment decisions that can potentially harm if not kill a patient.

What used to be a satisfying job in the past, has turned to regret and remorse. As insurance premiums skyrocket and more and more people become uninsured, and as physician reimbursements plummet, you try to squeeze more patients into an already packed day to make the same dollar amount you did before. The result: unhappy customers.

Believe me folks, if I could see 10 patients a day (an hour per patient), I'd be the most popular doc in town. I think I'm a damn good physician (as evidenced by winning just about every major award my residency had to offer, in addition to getting into one of the most competitive fellowships). And I'd be perfectly happy doing primary care. The problem is, my rate would be $500 an hour. Yes, that IS what I think I deserve. At that rate, I'd be more than happy to service your every need. Shoot, I'd even clip your toenails if you ask nicely enough.

Unfortunately, insurance companies dictate what we are paid. Imagine going to get your oil changed, and they quote you at $50. You say, "Tell you what, chap. I'll pay you $25." They'd tell you to get lost!

Yes, there are certain specialities that I think make exorbitant and obnoxious sums of money. A radiologist once complained to me that medicare only pays him $2 to read a chest x-ray. If I was paid $2 to read every chest x-ray during my residency, I'd have bought a nice house by now.

Then again, the "best and brightest" of the best and brightest often get into specialties like radiology, which have high income / relatively low work hours ratio. So I have no complaints. They've earned it.

The problem with our healthcare is that doctors ARE NOT overpaid. We are incomprehensibly underpaid. And don't throw the argument at me that teachers, policemen, artists, blah blah are also underpaid. Because they are, I'm not disagreeing with that fact. But the title of this post is "Do Doctors Make Too Much Money?" So let's stick to that subject.

Anonymous said...

Statements such as "the 'best and brightest' of the best and brightest often get into specialties" are often made by the specialists themselves--as if it is an indisputable fact.

My experience with the specialists I know on a personal level is that they are NOT the best and the brightest. Instead, they seem to be people who have learned to do one or two tasks very well. Outside of that comfort zone, they are not very good at thinking their way through problems.

Most people (even non-doctors) tend to become good at repetitive tasks. However, specialist physicians seem to be the lucky few who are handsomely compensated for repetitive type work that doesn't require thinking one's way through new situations. These specialists typically see situations they have seen hundreds of times before in other patients. These are the ones who call themselves "the best and the brightest."

We the public are footing the bill for these bloated specialist salaries.

Kristina said...

This is a difficult question. Are doctors overpaid. No I don't think so. I really think that GP's are incredibly underpaid for what they do. To the people who say that doctors (especially Gp's) don't do much but diagnose you with a cold or flu, well you know what, why don't you just not go to a doctor and treat yourself. And when you get something serious like cancer, see how that self-medication and home treatment works for you then.

People don't realize what it takes to become a doctor. They think that doctors just whine, bitch and complain about not getting enough money and blah blah blah. Fact of the matter is that a doctor is responsible for people's lives. People tend not to value doctors until their loved one is saved by a doctor. People like neurosurgeons get paid a crapload because of the work they do. These specialists run such a high risk in some of the things they do and are so commonly sued that of course they'll be compensated. Anesthesiologists get paid a lot because guess what, they need to give the correct amount of anesthesia. Too little and its ineffective and you'll sue them for malpractice, too much and you'll die and then your family will sue them for malpractice. It's a double-edged sword.

Specialists make a lot of money because of what they do. Specialists go to school longer for their field of study. For example, your family doctor could believe there is something wrong with your heart. Would you rather have him who only has general training with the heart treat you, or would you have a Cardiologist, someone who has extensive knowledge of the heart treat you for something like this. They are equally as important so people who just hate specialists, give me a break. Doctors are involved in saving people's lives and doing well. My dad's GP believed there could have been something wrong with his heart sent him to a cardiologist. That cardiologist worked his butt off to do everything possible for my dad and saved his life. I hope to be a cardiologist one day and do the same for someone else. So please don't lump all of these people together. Are there individuals who are specialists that take advantage of their pay and complain, sure of course there are. Just like there are CEO's who complain about their workload and payment there will always be the bad examples, but by lumping them all together into one generalized category is just ignorant. I find it insulting that I haven't even become a specialist and people will already be taking these views about me before they even know me and the way that I would probably practice. Believe me i'm not getting into this for the money. I'm constantly worrying about whether this is a good decision and whether it is really worth the time, effort and debt i'll be in, but I want to make a difference and try to save people so these are the sacrificies I will make and those are the sacrifices other doctors have made.

-Kristina (future MD :])

Anonymous said...

Kristina said:

"Fact of the matter is that a doctor is responsible for people's lives."

I say: A lot of other people's jobs require them to be responsible for people's lives. Stop being so (overly) impressed with yourself.

Kristina said:

"Anesthesiologists get paid a lot because guess what, they need to give the correct amount of anesthesia. Too little and its ineffective and you'll sue them for malpractice, too much and you'll die and then your family will sue them for malpractice. It's a double-edged sword."

I say: Guess what, anesthesiologists follow a cookbook formula for determining how much anesthesia to use. The formula is based on the patient's weight, age, condition, etc. It's not that difficult--there's not that much thinking involved.

Kristina said:

"That cardiologist worked his butt off to do everything possible for my dad and saved his life."

I say: I bet after working his butt off, the cardiologist took a 2 week vacation. I bet the cardiologist takes many, many 2 week vacations during the year. I know many specialists personally, and they consider "working their butt off" to mean working a 40 hour work week. They may choose to work that 40 hours over only 3 days and, therefore, they have some long days. The specialists love to tell you about their "long days" when they are "working off their butt," but they conveniently forget to tell you that they only work a 40 hour week and take 6 weeks vacation a year. Stop being so (overly) impressed with yourself.

Kristina said:

"Believe me i'm not getting into this for the money. I'm constantly worrying about whether this is a good decision and whether it is really worth the time, effort and debt i'll be in...."

I say: Believe me, if you live within your means, you will be out of debt in about 3 years--not a bad return. Then, for the next 25 years of your career, you will mounting higher and higher sums of money in your bank account. Stop playing the martyr.

If the American public knew what poor value they get for their health care dollar, they would despise doctors--particularly specialists. It's because of the double-talk from people like Kristina that the American public actually believes doctors (and particularly specialists) earn the money they are paid.

The president has talked about the "crushing cost of health care." As soon as people begin to understand how much money they are paying and how little they get in return, they will begin demanding cost control in health care. Once that happens, I suspect the doctors "who are not in it for the money" will leave the profession quickly.

Engineer said...

I don't get how doctors are anything but overpaid. All this talk about saving lives, what could you have saved if not for the engineers who designed all the fancy equipments that helped your work. A simple technical glitch and that life that you labored hours to sacrifice would be lost. If doctors mess up they only lose one life but when engineers mess up millions of lives are lost. How is that not an important job and yet many of us make only 70 grand with years of experience. Just like doctors engineers are important to society. We also take difficult classes and undergo difficult training. I can assure anyone that our undergraduate careeer was infinitely more stressful than any undergraduate's was. Also, how long do you think we can depend on fossil fuels. Who's going to develop alternative sources of energy? Doctors. We don't even get the recognition we deserve. We are often featured as oddballs and there is not a single television show that features the work we do. Yet everything is about Doctors and Doctors. There are many people who live healthy lives up to 40 and 50 in developing countries without doctors but how many people can live without technology. All doctors do is make their job look so hard that they need to be paid so much to do it. However the immense breakthrough that engineers have made will stop soon and then people will realize who they really need to be paying.

Buy Avodart said...

Excellent post.I think doctors do not make too much money.

Anonymous said...

The largest contributor to the "crushing cost of health care" is physician fees.

For example, as noted above in this thread, the average base salary for a urologist increased from $320,000 in 2006 to $400,000 in 2007--that's an average increase in BASE salary of $80,000 in one year. Keep in mind that the urologist also receives production bonuses on top of that. In addition, malpractice insurance is typically paid by the hospital for which the physician works. On top of that, he works a 40 hour week and takes 4-6 weeks vacation each year.

Buy Avodart said...

Nice blog.I hate doing this but I do understand and I feel lucky to have a doctor who listens and spends time with me. I do not think doctors are overpaid.

Anonymous said...

Last report I saw, orthopedic surgerons had the best salary. Guess what the largest majority of med school applications were for? Orthopedic surgery. End of story. Dumb kids in it for the money.

Anonymous said...

"End of story. Dumb kids in it for the money."

Well said.

Anonymous said...

Buy Avodart said:

I hate doing this but I do understand and I feel lucky to have a doctor who listens and spends time with me. I do not think doctors are overpaid.

I say: I bet you have no idea how much money you are paying to see that doctor. By the time a family pays health insurance premiums (both the family's portion and the employer's portion, which is lost income to the family), payment into Medicare, and out of pocket expenses such as co-payments and deductibles, that family is typically paying more than $20K per year.

We should demand better value for our health care dollars. We should be able to get quality health care for a fraction of the price outlined above.

Anonymous said...

Our Priorities are really bleeped! up.
My doctor who has to save my skin makes 1/100th of what my favorite basketball player makes (but then the basketball player must be able to put a ball into a metal circle. So maybe there is justice.) Or,
Maybe it is just that we as humans are stupid idiots that have no ability to recognize value?
I for one will not buy a product that is overpriced. That is why I don't buy GM cars or sports or music tickets, or
Ipods or microsoft software,or ? You get the idea. There are alternatives.Price is not important - value IS

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Anonymous said...

Funny discussion. I really enjoyed all the comments.

Here is what's missing...

Uncle Sam doesn't go through any training and all taxes (Fed, State, City/Local, Sales, Real Estate, etc.) take 50% of all high paying jobs.

Uncle Bank goes on to take 8-10% or more in interest.

How hard is Uncle Sam working? How hard is Mega Bank working?

Doctors aren't the smart ones.

The smart ones are the wives.

No, not the 1st wives that struggled with them through Med school and residency - that one usually doesn't make it.

It's the ones that follow and are off driving the Lexus, getting massages, shopping and generally spending the $300k+ income while the nanny watches the kids and maid cleans the big house.

She's the one that didn't go to medical school, didn't sacrifice, enjoyed her youth and is off boffing the pool boy while the doctor is working.

Now that's what I call smart. ;-)

Anonymous said...

Here's my perspective from the veterinary side of things (I'm about to graduate from veterinary school). First, I want to make it clear that despite my passion for my profession, I in no way think that providing veterinary services has the same value as providing medical services for humans. I realize that saving a human life is more important than saving that of a cat's. Which is why we (justifiably) make so much less. But still:
My classmates incur the same debtload ($160,000 just from the 4 years of graduate school) as most medical students, have put in the same sacrifices - the same college pre-req courses, the same 80 hour/week rotations in school, including being on call and working 30 hour shifts....but we make an average of $60-80k/year after graduation with little room for pay raises unless you are one of the select few to own your own practice or specialize, in which case you still max out at $100-150k.
We perform the same difficult procedures (advanced laparoscopic surgeries, managing patients with multiple chronic illnesses, etc), which requires the same amount of intelligence, dedication, and high level analytical thinking as our human counterparts, not to mention that we have to know how to do all of this on multiple species with completely different physiologies, none of whom can tell us where they hurt. We, too, sacrifice almost all of our personal relationships, sleep, hobbies, etc, to pursue our careers. Granted, we do not have to do residencies after our 8 years of schooling, although those that choose to work the same hours for the same crappy pay ($35k/year) for three years only to make $125k at the end.
I'm not complaining: I have no regrets about choosing my career, I love what I do, I feel that I make a difference, I'm constantly intellectually challenged. For me, this makes the fact that I will be working 60 hour weeks and paying 20% of my 70k/year income towards my loans for the next 30 years acceptable.
I'm just saying this for all the bloggers who claim that only stupid incompetent people would become doctors if they made less pay. Most of my classmates were valedictorians in high school, went to top colleges, and could have picked much more lucrative careers. If we got paid for the difficulty of what we do (remember that veterinary school is actually much harder to get into than medical school with a 10-15% acceptance rate overall), like some others suggested, I don't think that anyone would argue that we would make as much as human physicians.
I realize that our salaries are dictated by supply and demand (no one would pay $200 for an office visit for their cat), which is completely fair. Again, I'm not saying that our services are as valuable as human M.Ds. Just pointing out that there are other professions that are just as difficult, requiring just as many sacrifices, but without the financial rewards...and yet each year there are still a thousand applicants for a hundred positions in veterinary schools around the country.

Anonymous said...

I do not believe that doctors necessarily make a vulgar amount of money. Few do but most don't. As an MD/PhD, I can attest to this fact. However, one thing that I do dislike is the God-complex that most of my colleagues seem to harbor. It is a myth that doctors are the repository of all wisdom. Far from it. Also, getting an A in a course does not make one a genius. Sir Isaac Newton was a C student and yet made great contributions to physics and calculus. Smart people are found in every field including medicine.
I do believe that the medical education in the US needs to be overhauled both in terms of content and cost. Spending 100hrs per week as a resident does not guarantee that one would be a good physician. Most of the anger directed toward doctors needs to be pointed at a failed health care system. So for a recap, doctors are not necessarily geniuses, nor does getting an A makes a person smart. However, doctors like other professionals render valuable services and deserved just compensation. Lastly, our system needs to be reformed so that physicians are not saddled with huge debts for life and patients are not over-burdened with unaffordable health care costs. May that day come.

Anonymous said...

Teachers are grossly underpaid. People working in the financial district are grossly overpaid. Professional athletes are paid just about right. Doctors fall between the financials and the professional athletes.

I've been a high school AP english teacher for 30 years, and I retire at the end of this year, not exactly on my terms, but with a "golden handshake."

We all need medical care, and the older we get, the more obvious this becomes. Yet, the problem with our country is that nobody wants to pay for it. We feel that it is our RIGHT to medical care, and therefore, it should be FREE.

I am 55 years old. I was told by my doctor (who I can no longer afford) that I am dying of cirrhosis. You see, I've been a closet alcoholic for 20 years. My doctor told me that I needed a liver transplant, but he said that it would cost over a million dollars. Without insurance, this would be impossible. At first, I scorned the millions who were fortunate to have health insurance, and wondered why I too wasn't given a fair chance to watch my grandchildren grow up.

Then realization hit me. I'm an alcoholic. I did this to myself. I have the right to health insurance as much as I have the right to drink myself to death. We all make choices in our lives. Yet, very few of us are willing to accept the consequences. Everday, I look at all of the obese children in my class and realize that we are waging a losing war. Forget the war in Iraq. We need to make lifestyle changes NOW.

Back to the subject of "Do Doctors Make Too Much Money?" My primary care doctor makes $180,000. His wife is a stay-at-home mom that is into crafts. My doctor drives a honda accord. I feel shameful that I drive a Lexus. All three of his children attend private schools. They live in upper-class suburbia. My doctor tells me that he still pays $2100/month for his medical school loans (for 30 years!). My own mortgage isn't even that much. Yet, it appears that he lives comfortably. Good for him. He deserves it. At first, I was filled with hatred, and wanted to blame him for not diagnosing me with cirrhosis earlier. Then, I realized I had been blaming others my entire life, and for once, I needed to own up to the decisions I had made in my life.

There are some posts here that say that some specialities make $400,000. Those salaries sound inflated. I hope those doctors are saving a lot of lives. As for me, I hope I can catch a few more LA Dodgers games, drink a few more beers, and maybe get an autograph from Manny Ramirez before my time here on earth is done.

jaded doc said...

Very interesting conversation.
I must comment on those that think that doctors work 40 hours a week and take lots of 2 week vacations. As an anesthesiologist, I often work 50 to 70 hours a week, and have to work 1-2 weekends a month. I go to work at 6:00 am and come home anywhere between 3-10 pm. When "on call" that can mean working 24 hours straight with little to no sleep. Emergencies and babies don't happen from 9-5 every day. You will find that the operating rooms and ER's are open 24-7. We are one of the few specialties that have to have an MD in hospital for 24 hours 7 days a week.

To anonymous who said, "anesthesiologists follow a cookbook formula for determining how much anesthesia to use. The formula is based on the patient's weight, age, condition, etc. It's not that difficult--there's not that much thinking involved" Sounds like a computer program can run the anesthetic in the OR. I invite you to have your next operation and anesthetic run by a computer. Would it notice that you were having a complication such as a pulmonary embolus or would it recognize an allergic reaction? How would it resuscitate you when there was too much bleeding? Would the program be able to place your epidural or how to manage the airway if you had a throat tumor or cervical spine damage? Would you let a computer take care of your mother when she goes in for heart surgery?
The statement is preposterous because every patient is different, processes the drugs differently and reacts to the medicines differently. The anesthetic has to be tailored to each patient with regards to their medical problems and to the type of surgery they are having. There is no formula.
Obviously, I am an anesthesiologist, and I take exception to the above comment. I refuse to feel guilty over what I get paid, because if I don't make a mistake and do everything right, I can still get sued and will lose 90% of the time.
I very much enjoy taking care of patients and soothing them and their families on one of the most stressful days of their lives.

As for the comparison to teachers and PHd's, I do believe that they are absolutely are underpaid, especially when you realize that they shape and mold future generations. However, the consequences of an error at work is NOT the same as making an error with a patient. Why do you think pilots make so much money? Maybe we should pay them less as well. Have a nice flight...

The other comment I have is about medicare and the government's influence on the business practice of medicine. Imagine you have a restaurant and when it's time for the customer to pay the bill, half the people stiff you on the bill. Then, the government informs you a significant percentage of the rest of the paying customers only have to give you 20-30 cents on the dollar.

Finally, I want to say that I do believe that medicine is very costly, but it allows us to have the best medicine out there. If we were to follow socialized medicine models elsewhere, be ready for long, long waits to be seen by less competent people. Oh, and be ready to be told "no" for certain procedures and treatments. If you think there are lots of mistakes in medicine now, try substituting the top 10 percent of academic performers out for those less than stellar achievers and see what happens.

So in answer to the question, "Do doctors make too much money?" Some do, most do not. In light of the fact that peoples health and lives are at stake, in addition to the enormous investment of time, effort and money (in wages lost over 11-18 YEARS of higher education) to become a physician, NO they do not make too much money. The fact of the matter is that MD compensation IS going down and will continue to go down, so it's kinda moot anyway.

Anonymous said...

I have worked in the billing offices of physicians for the past 30 years. Let me tell you, doctors make BANK!!! The last group I worked for, the head guy took home over $800,000 per year, as a Gynocologist. He works 4 days per week, no call, no weekends. The most junior member in the group started out (fresh out of school) with a salary of $204,000 per year, working 4.5 days per week, and one weekend of call per month. Not bad. My daughter began her career with a salary of $300,000 per year (fresh out of school); she's a pedicatrician. 9-5 work week, and one call weekend per month. All of the persons I've listed work in small towns with populations under 35,000 people. I shudder to think what the BIG WHIGS are making!

It took me 30 years to get to the top of my field. I obtained a Master's Degree, was a single mother of three, worked full time, sacrificed, etc. My salary pales in comparison at $100,000 per year. 60 hour work weeks, evening meetings 2 to 3 times per week, forget having weekends off (too much work), and no vacations. At least no vacations that last more than 3 consecutive business days. So, yes, many, many, many physicians ARE OVERPAID. Yes, they sacrificed, but so have many of the rest of us.

As a commercial airline pilot, my husband has more lives in his hands (300) at one time than any medical doctor, and it has been said that HE is overpaid! His salary got cut 49% two years ago, and he lost his entire retirement package.

I was told, "It's ALL about the money!" by one of the last doctors I worked for (in a 'Christian' practice). I'm sure some get into the medical field for altruistic reasons, but I beleive they are quickly jaded by the vast amount of money to be made. I'm sorry, but I have no sympathy for the overpaid ones. Yes, I know there are struggling doctors making $75,000 per year. But you know what, if they moved in with a group, or moved to a larger city, they could also get a piece of the BIG pie.

Anonymous said...

The post above states: "Yes, they sacrificed, but so have many of the rest of us."

I cannot agree more. EVERY specialist doctor I know vacations 1/2 of their career away. Then, they have the audacity to complain about how much they work. It makes me want to vomit to know my hard-earned money finds its way into these do-nothing doctors paychecks.

A LOT of people in this country have had a lot of rigorous education and work a lot harder than doctors.

The doctors I know are very good when talking GENERALITIES (e.g., telling me how "hard" they work). However, when pressed for SPECIFICS (e.g., asking how may hour per work they actually work and/or how many weeks of vacation they take each year), they become visibly annoyed (as if I don't even have a right to ask such questions). When I finally get answers, I am disgusted to find out how the doctors actually misportray their lives to me (and the rest of society).

Anonymous said...

"As a commercial airline pilot, my husband has more lives in his hands (300) at one time than any medical doctor, and it has been said that HE is overpaid! His salary got cut 49% two years ago, and he lost his entire retirement package."

I cannot agree more. Doctors are completely out of touch with reality. They have no idea how overpaid they are.

When will the American public wake up and start demanding good value for the health care dollars we pay?

Anonymous said...

I am a physician, graduated in 1998 from JHU Med. Back when I was graduating, and today, the majority of graduating students choose their specialty mainly based on salary and/or lifestyle. Most highly-ranked students choose these specialists. Change the highest paying fields and students will go towards THOSE fields. Nothing wrong with that - this is America and everyone has the right to do whatever they want. I do however resent the assertion by medical students and specialists that money isn't the MAIN reason. I'm an intelligent adult, I can figure it out, just be honest with me and spare me your sanctimonious BS about how "patient care" was the major choice behind your decisions

Anonymous said...

Doctors = human mechanics...instead of fixing cars, they fix people.

AMA = Dr. union. Doctors get paid a lot not because of price determined by free market, but because restricted labor supply with artificial bar set. They determine what's good enough, but who is making sure AMA is right?

Rebuttles for Dr. biased world views:

"We have 12 years of school after high school, so we must get paid for all the education".
If your janitor went and spent 12 years at phD in Janitorial services at a degree mill, would you pay your janitor $500k/year? Years of education should not determine salary or value of your services. Nowadays even teachers need Masters to get a job that pays $40-50K/year.

"We are the smartest"....so thought ibankers....intelligence is not exclusive of greed. If not checked, they will abuse others for $$$.

"We save lives"...they simply apply knowledge with fine motor skills. The real credit and $ should go to those who came up with the cure, pill, procedure by THINKING not the applicators of the knowledge. Who created the technology Dr. uses, invented the magic pill they subscribe, etc.? Doctors used to but no longer create knowledge more so than nurses.

"We work hard/long hours/never see family/etc."
More than the soldiers in Iraq who get paid $30k/year? How about young women working 12hr days7 days a week in gov run factories? Again, hard work does not entitle you high salary. You cannot dig a hole in the middle of the desert 12 hours a day for no purpose and demand payment.

"We do this to help others"
Thats what all they say in Med school applications. Only few are truely passionate (want to cure disease of someone in the family), others purely do it for money and respect. If you really want to serve others, go work for NGO in Africa. This is classic "1% goes to charity to justify my greed" thinking of the rich.

"Only few have my skills to perform cures"
Who restricted to just few? Who set the bar so high? Most profitable businesses are MONOPOLIES....such as only XYZ Dr. in town. Aritificial limit to supply of labor not due to market demand. Don't you know why diamonds are so expensive although there are plenty in the world? AMA = DeBeers

NOBODY is entitled. Let the free market decide the price. Capitalism is best at determining fair value when you don't have unions controlling supply of labor or politicians chery picking winners or greedy monopolies eliminating competition.
For 99% all medical services in US, much cheaper Dr. in UK, France, Japan, etc. can do the same. Let top 1% do into R&D to actually invent new cures and the rest get paid what they deserve...

Dr. salaries are the next bubble to pop.

Anonymous said...

Doctor license protection in this country is preventing them from facing negative effects of globalization private workers have faced in the last 10 years. Doctors do not have to worry about their jobs outsourced, constant layoffs, industry changes devasting their skill sets built up over long careers, due to supposedly unlimited demand for humans to stay alive.

HMO stocks are way down. HMO will figure out a way to drive down doctor's wages, by outsourcing non-critical services. We also need to introduce more competition amongst Dr. ranks. How come Doctors don't feel the unemployment while enjoying $500K salaries workgin 40 hour weeks? Sounds like whiners of diminishing industries of UAW(overpaid nobrainer work) and pilots union (overpaid flying bus drivers) In the long run, easy money reverts back to norm most times with sudden push back to reality of extreme stress.

Possible scenarios are:
A) Old people will opt to die past 60, and young will leaern to live with disease than go into medical bankruptcy.

b) Government will regulate with lower salary for Drs with Medicare, Medicaid. Not everyone need the best care, 90% quality care at half the price will suffice.

c) Everyone will rush to get into cush job of MD causing extreme competition into entry (more education, more applicants to Med Schools) making the whole effort too much of a sacrifice.

d) HMO/business will outsource many services where it is cheaper for similar quality. Your xrays viewed in India and radiologist just confirms the Indian Dr.'s findings. Basically US Drs. become managers of foreign Drs.

e) Technical breakthroughs in new machines, tools, drugs, etc. will lower overall demand for medical care and automate many non-thinking skills Drs. get paid for. You don't need a Dr. when a nurse can do it with idiot proof machine. Telesurgery by doctors in India will do the same surgery via internet.

f) people will get care elsewhere. Are US doctors 5X better than Canadian doctors to justify their cost?

Next time you go see your doctor ask if he/she will recommend their kids to get into medicine.

Anonymous said...

One question . . . for those of you who think physicians make too much, how much (per hour take home pay) do you think it would be appropriate for a family physician to make?

Anonymous said...

I am a female family physician who has definitely become regretful about my career decision over time. I truly didn't go into medicine for the money (or I would have selected a specialty other than family medicine). I had planned to work in the Peace Corps or the National Health Service; however, marriage and an attempt at stability changed these plans.

Although I did not go into medicine for the money, now that I am an "adult" and my job is the main source of income for our family, the financial part has become much more important as a matter of necessity. I have been in my own medical practice for 12 years. In the first 3-5 years my income did increase. However, each year after this my income has decreased. My income was 25% less per hour than the physician assistant who worked for me. I couldn't afford to keep her because what she was bringing in wasn't covering her costs. My last 2 paychecks were less than my office manager’s paychecks.

I see what I charge and find it hard to pay this price for my own health care. Unfortunately insurance reimbursement is decreasing and my overhead is so ridiculously expensive and is rising much more than the rate of inflation. My best reimbursing insurance company has paid me 14% less for many of my most frequent codes this year than what I was paid last year. There is nothing I can do about it other than stop taking that particular insurance. If I were to do this I would feel I was abandoning my patients.
High overhead costs are due to multiple factors including governmental and insurance regulations, exponentially increasing costs of vaccines (for which I pay thousands of dollars per month) and other supplies that are frequently not completely reimbursed by insurance companies or are unpaid by the patient. I have implemented an electronic health record 2 years ago and will be paying off the loans for this for the next few years. When initially implementing this I didn’t take home a paycheck for 3 months and almost needed to take out a loan to pay my staff and other office bills. I have needed to hire more staff for preauthorization of certain tests and referrals and to help with the billing to appeal denials and clean up the AR (even though electronic records are supposed to “decrease” staffing costs). We have always drawn blood in our office as a courtesy for our patients; however Medicare doesn’t reimburse for this. Some other insurance companies reimburse $3. After time spent by my receptionist, nurse, and biller, I am definitely paying to provide this service. We are asked to maintain registries for diabetes and other chronic medical conditions in order to provide better quality of care. We are also asked to enter immunization data into the state registry (requiring more staff time due to double entry.) Patients expect me to return phone calls free of charge and often call hoping to get treatment over the phone free of charge. I spend several hours each day returning calls. We are not reimbursed for any of these extra requirements. If I were mass producing and selling a product I may be able to absorb these costs; however, as a single person only “selling” my time, I cannot do more than what I currently am doing.

You may be wondering about living within my means, I drive a 2002 Ford Explorer and live in a basic ranch style house that I am embarrassed having people over to see. I rarely purchase clothes (and am embarrassed to say that I have some clothes that are over 15 years old). I usually go on a single 2 week vacation each year with a few days off around the holidays and sometimes take a week off for continuing education.

Initially I absolutely loved medical school and residency. I loved my patient interactions. I loved the science. I loved the challenge of solving a “mystery”. I have always worked hard and expected that at some point there would be “gratification” at the end of the “delayed gratification”. I completed school, got married, and began residency. My husband and I did start a family. Unfortunately I have missed most of their childhood because I have been working so many hours. I provided OB services and was on call 24-7, unless I was physically out of town. I missed many Christmas and Thanksgiving holidays with my family. My husband took the traditional role of “mom”, shuttled around the kids, helped with their school work, cooked, helped coach sports. He was the one to develop relationships with them while I left for work before they were up and came home to possibly spend 30 minutes with them before they went to bed. At times I wouldn’t see them for several days in a row. Due to my older age at starting a family I did have trouble conceiving and after multiple losses decided not to try again. Additionally if I was never home it seemed selfish to have another child. I have been chronically sleep deprived, have struggled with depression and other health issues due to the stress related to my job. Looking back on these sacrifices, the current financial frustrations, and the burden of the multitude of regulations, if I could do it all over again I would choose another career path . . . even if it were for less pay. I can never get back my daughter and son’s childhood and I would prefer my health and happiness to what I have now. I would change careers now but don’t know how to do anything else and don’t have the resources to go back to school. I still love the medical part of what I do, but the rest is not worth the effort. I am definitely underpaid.

Anonymous said...

I am a female family physician who has definitely become regretful about my career decision over time. I truly didn't go into medicine for the money (or I would have selected a specialty other than family medicine). I had planned to work in the Peace Corps or the National Health Service; however, marriage and an attempt at stability changed these plans.

Although I did not go into medicine for the money, now that I am an "adult" and my job is the main source of income for our family, the financial part has become much more important as a matter of necessity. I have been in my own medical practice for 12 years. In the first 3-5 years my income did increase. However, each year after this my income has decreased. My income was 25% less per hour than the physician assistant who worked for me. I couldn't afford to keep her because what she was bringing in wasn't covering her costs. My last 2 paychecks were less than my office manager’s paychecks.

I see what I charge and find it hard to pay this price for my own health care. Unfortunately insurance reimbursement is decreasing and my overhead is so ridiculously expensive and is rising much more than the rate of inflation. My best reimbursing insurance company has paid me 14% less for many of my most frequent codes this year than what I was paid last year. There is nothing I can do about it other than stop taking that particular insurance. If I were to do this I would feel I was abandoning my patients.
High overhead costs are due to multiple factors including governmental and insurance regulations, exponentially increasing costs of vaccines (for which I pay thousands of dollars per month) and other supplies that are frequently not completely reimbursed by insurance companies or are unpaid by the patient. I have implemented an electronic health record 2 years ago and will be paying off the loans for this for the next few years. When initially implementing this I didn’t take home a paycheck for 3 months and almost needed to take out a loan to pay my staff and other office bills. I have needed to hire more staff for preauthorization of certain tests and referrals and to help with the billing to appeal denials and clean up the AR (even though electronic records are supposed to “decrease” staffing costs). We have always drawn blood in our office as a courtesy for our patients; however Medicare doesn’t reimburse for this. Some other insurance companies reimburse $3. After time spent by my receptionist, nurse, and biller, I am definitely paying to provide this service. We are asked to maintain registries for diabetes and other chronic medical conditions in order to provide better quality of care. We are also asked to enter immunization data into the state registry (requiring more staff time due to double entry.) Patients expect me to return phone calls free of charge and often call hoping to get treatment over the phone free of charge. I spend several hours each day returning calls. We are not reimbursed for any of these extra requirements. If I were mass producing and selling a product I may be able to absorb these costs; however, as a single person only “selling” my time, I cannot do more than what I currently am doing.

You may be wondering about living within my means, I drive a 2002 Ford Explorer and live in a basic ranch style house that I am embarrassed having people over to see. I rarely purchase clothes (and am embarrassed to say that I have some clothes that are over 15 years old). I usually go on a single 2 week vacation each year with a few days off around the holidays and sometimes take a week off for continuing education.

Initially I absolutely loved medical school and residency. I loved my patient interactions. I loved the science. I loved the challenge of solving a “mystery”. I have always worked hard and expected that at some point there would be “gratification” at the end of the “delayed gratification”. I completed school, got married, and began residency. My husband and I did start a family. Unfortunately I have missed most of their childhood because I have been working so many hours. I provided OB services and was on call 24-7, unless I was physically out of town. I missed many Christmas and Thanksgiving holidays with my family. My husband took the traditional role of “mom”, shuttled around the kids, helped with their school work, cooked, helped coach sports. He was the one to develop relationships with them while I left for work before they were up and came home to possibly spend 30 minutes with them before they went to bed. At times I wouldn’t see them for several days in a row. Due to my older age at starting a family I did have trouble conceiving and after multiple losses decided not to try again. Additionally if I was never home it seemed selfish to have another child. I have been chronically sleep deprived, have struggled with depression and other health issues due to the stress related to my job. Looking back on these sacrifices, the current financial frustrations, and the burden of the multitude of regulations, if I could do it all over again I would choose another career path . . . even if it were for less pay. I can never get back my daughter and son’s childhood and I would prefer my health and happiness to what I have now. I would change careers now but don’t know how to do anything else and don’t have the resources to go back to school. I still love the medical part of what I do, but the rest is not worth the effort. I am definitely underpaid.

Anonymous said...

One question . . . for those of you who think physicians make too much, how much (per hour take home pay) do you think it would be appropriate for a family physician to make?

Anonymous said...

Regarding family physician salaries, my gripe is with the SPECIALISTS who are raking in $300K - $400K per year working 35-40 hrs per week, and taking 6 weeks vacation per year. I rarely (if ever) see these specialists working evening, weekends, or holidays. I know many specialists on a personal level, and this is what I have seen over the years with my own two eyes. These specialists generally have very entitled attitudes.

From what I know of family physicians, they are probably underpaid. The specialists are robbing us blind.

Anonymous said...

Do people on here REALLY think most docs make 500k working 40 hours/week and taking weeks upon weeks of vacation? Most make under 200k, work 60-80 hours per week and take 3-4 weeks off a year. You can't make judgements based on outliers. You may as well complain about lawyer salaries by only looking at your neighbor who makes 300k/year and ignore the fact that the average is aroune 70k.

Training length DOES determine pay to an extent. It is about replacement costs and how much you need something done (supply/demand).

A person above made a comment about sending a janitor to school for 12 years. The thing is, I can find someone willing and able to do the same job for 25k/year with 15 minutes of training.

A school teacher takes 4 years to train, but at the end of the day a lot of people are able and willing to do it. The demand is high, but the supply is higher. They will make more then the janitor since most people wouldn't be willing to put in the time without an increas in pay.

An engineer takes 4 years to train, but most high school grads aren't capable of handling the math and physics even if they are willing. Industry really needs them and it is more rare for someone to have both the ability and desire to train so they command a higher salary then the school teacher.

A PhD will take around 8 years to train. It takes quite a bit of ability and will to do so. The thing is, the market is small. Mapping out some obscure gene or working on a math theorem that only a few dozen people in the world will understand just isn't something that many employers will need.

It takes 11-16 years after high school to train a physician. You need someone of above average intelligence, but more importantly someone willing to put in the time. There aren't that many people willing to invest that much time and money so salaries will have to be higher to get someone to do the work. The demand is high because it is life and death and everyone gets sick...the supply is low because not very many smart people are willing to put in the time to do the job.

If it is so easy to roll around in money as a doctor then why don't YOU (anyone who thinks they are "overpaid" for a "cush" job) go do it? Seems silly to not take advantage of such "easy money"...right? Nobody is stopping you.

Anonymous said...

Someone mentioned "fair market".

If you are having a heart attack, what would you be willing to pay for a cardiologist to stent open your coronary arteries?

If you had a brain tumor, how much would you be willing to pay for a neurosurgeon to take it out?

How much would you be willing to pay a pathologist to tell you if that lump in your breast is cancer or not?

If your child was hit by a bus, how much would you be willing to pay a trauma surgeon to save his life?

I doubt anyone would really want a doctor to charge what they theoretically could in a true free market. Be glad they are willing to work for far, far less then you would be willing to pay. Decrease payments much more and you may have a hard time finding any doc at all.

Anonymous said...

Anonymous said: Do people on here REALLY think most docs make 500k working 40 hours/week and taking weeks upon weeks of vacation? Most make under 200k, work 60-80 hours per week and take 3-4 weeks off a year. You can't make judgements based on outliers.

Answer: YES, I absolutely think (and KNOW) that SPECIALISTS make $300K - $400k per year for 40 hour work weeks with 6-8 weeks vacation each year. If any SPECIALIST is making less than $200k per year, it is because he/she chooses to.

Primary care drs are the ones making less than $200k per year and may (or may not) be working long hours.

Anonymous said...

Here's a good link that seems pretty spot-on in terms of the average doctor's salaries. http://www.forbes.com/2009/05/04/america-best-paying-leadership-careers-jobs.html

As for the person on this site who's favorite thing to do appears to cut and paste quotes, then offer rebuttals with: "get over it." I really feel sorry for you. I understand that your hatred for physicians probably stems from a bad experience with one, and there is nothing I can do to alleviate that. However, I would be willing to be that a lot of it stems from poor communication skills because the physician is from India, or China, or some other part of the world where English was obviously not their first language. Do you ever wonder WHY there is an ever-increasing number of foreign graduates coming to the states to practice medicine, especially primary care positions? Because American graduates just don't want to do the job anymore.

I've had dozens of friends whose parents were physicians. And the parents tell their kids specifically NOT to pursue medicine. They say that what used to be a rewarding job has turned into a nightmare, dominated by greedy insurance companies, snake-oil salesman drug industries, and vindictive patients. And reading the sentiment on this site confirms that patients obviously dislike their doctors and don't feel like their salary of $175000 a year warrants their training. And so I can't wait until universal healthcare becomes a reality in this country. Because the quality of healthcare will deteriorate even more, and more US born physicians will leave the field, and eventually, we will be like the UK, where 60% of their physician work-force is made up of graduates from other countries because of the low-pay.

Anonymous said...

What a load of B.S. and hyperbole.

A major problem is that primary care physicians make much less than specialty physicians. Lower the specialty salary. How can you justify a radiologist making 500000 a year? Does his output equal that much? No. Impossible. That is why there is major outsourcing. A high school teacher must go through six years of schooling and is paid much less than a doctor. Anyone can be a doctor. Above a certain level, we all have the physical tools, it is just the drive that separates us. The high salaries are from the AMA that has a monopoly on the medical licenses. Off with their heads!

Anonymous said...

hi how are you i am not a doctor but if anyone say doctor get pay to much this person is just stupid because a basketball player get millions of dollar a year why this stupid don't realize that then to see doctor who try to give people a better life think about that what a basketball player do for people other than put ball in a basket nothing else and pay them millions compare to doctor who save your life just think about that

Anonymous said...

Most Doctors are glorified mechanics. Doctors are overpaid. Researchers in the field of medicine (MD PHD doctors included) are the ones that make real impact to our lifes. However, they earn comparatively modest salaries. Doctors however, present the usual sanctimouns argument that they are serving community and saving lifes.

Surprisingly researchers don’t complain about their rather relatively low incomes because they are actually doing for the love of the field.

From my experience and many others Doctors are NOT very intelligent they seriously lack problem solving skills. By and large they only rely on experience and retrieval from their memory bank. Much such function can be computerized. Doctors say they deserve high salaries because they went to school for 10-12 years after high school. Well most Physicists, Engineers, Chemists that are in research have gone to school for the same duration if not more. I give credit to the research Biologists, Chemists, Physicsts, Biomedical and Electrical and Computer Engineers that are making real difference to the human life. They work extremely hard in their respective fields. Doctors are simply mechanical agents for delivery of what the researchers have invented and found so the arrogance of a most Doctors is baffling I guess it stems from repetitive nature of the hard work.

bewildered said...

Can somebody PLEASE throw out a number that you think doctors SHOULD be paid? Everybody seems to think that doctors are overpaid, but I haven't heard how much money is justifiable.

There's a post above by an engineer who lost his job, then complained about how the cardiothoracic surgeon who did his quadruple bypass surgery made $6000. Is your life worth less than $6000? By the way, my brother-in-law is a cardiothoracic surgeon. He makes $900 for a single-vessel bypass heart surgery from MediCare. Look up the rates on google if you'd like. NINE-HUNDRED DOLLARS. To save your life. Please also remember that the $900 also goes to cover 90 days of post-operative follow-up clinic visits, and also includes any visits to the operating room again if any post-operative complications occur. That's pretty ridiculous if you ask me. $900. I made $900 the other day playing no-limit texas-holdem poker at a casino.

Goodman said...

"Can somebody PLEASE throw out a number that you think doctors SHOULD be paid?"

I think that's the point. We have the wonderful thing called the free market that determines how much people should be paid. If you value a doctor's work, feel free to pay them $1000 dollars an hour. I don't. I would rather see a nurse practitioner for most things. The problem with doctors is they don't let the market work. That's all I ask. Let me see the practitioner I want to see.

hello said...

To the post above: What do you mean doctors don't let the free market work? Doctors are paid by insurance companies that pay them based off of what Medicare pays. Therefore, the government is essentially dictating how much doctors are being paid. THAT is completely opposite of what a free market is.

Anonymous said...

Here is an interesting article about how much specialists are paid (and who sets their pay):

Who Decides How Much Specialists Are Paid?

See http://www.healthbeatblog.org/2008/01/who-decides-how.html

The article was too long to post here, so I only provided the link.

Gastro, MD said...

Somebody posted a question about "who made the better choice, the physician who starts working at 32 and makes 150K, or the guy who graduates at 22 and starts making 40K.

I would have to say the physician made the better choice.

But i'm also biased. I'm a physician. I made my choice early on and I've stuck with it. And that's essentially what this entire conversation can be boiled down to. We all make choices in life. In highschool, I had the choice of smoking pot. I didn't. In college, I had the choice of going out friday and saturday nights, hitting the bars and picking up girls. OR, I could stay home and study. Guess what i chose to do? Now these are obviously incredibly simplistic examples, but I've made it simple so that everyone will understand why I chose medicine. Yes, I wanted money, prestige, respect in life. Yes, I also found disease fascinating, and healing even more satisfying. And so I've made the choices that I felt were necessary for me to get to my destination.

So why attack me? Is it because you've made decisions in your life that you are not happy with? If money was so important to everyone, then everybody should have made the choices that would have put them in position to become a doctor, or lawyer, or an investment banker. The list goes on and on. Do you think Kobe Bryant became the best player in the game because he was a dreamer? No, it's because he shot 1000 shots every day one summer, then 2000 every day the following summer. He turned down invitation after invitation by his friends because in his mind, he wasn't just gonna play in the NBA, he was gonna be the greatest player ever.

So PLEASE, look at yourself and the choices you have made before you start doing what Americans seem to do best: "point your finger at everyone except yourself."

Mirra said...

To the "Proud Doctor" who said we should be grateful: You are paid for your job, so why should I be grateful? If you are truly available 24/7 and miss your son's birthday for your clients, then you are really in medicine for the right reason. You are the doctor I would like to see. However, I am no more grateful for this than I am for any other professional or non-professional I pay to do work for me.
My reality is that I have never met a physician who was available 24/7. If anything I have observed physicians who couldn't be bothered and made statements like "Can you cut your symptom list short, I will miss my tee time". My favourite was a cancer patient at our retirement residence (I work with elders) who was greeted by a physician who told him he had cancer. When the gentleman wanted to ask a few questions the physician cut him off and told him that he was meeting friends for drinks and did not have time. So, NO, I am not grateful. And part of a physician's job SHOULD BE treating people with dignity, respect and patience. If your colleagues cannot manage that they they should go into research and avoid contact with people. Sadly, medicine appears to be changing and students and physicians alike appear to think it is a cash machine. I really, really do not think most people go into medicine because they care.
Again, if you are really available 24/7 and at least try to smile despite missing your son's birthday party, I am glad you are a physician. The more I meet most physicians, the more I lose faith in them all.
Mirra

Gewanda said...
This comment has been removed by the author.
Anonymous said...

Many doctors are just so full of themselves. Justifying high salaries with the value of body organs?! How many doctors are really saving lives everyday? And seriously, anyone can save a life. The Sears delivery man finding a gas leak can save my life. And I've actually never known anyone who believed their doctor saved their life. That seems to be yet another attempt at doctors to act like God. Since you go through so much schooling, give credit to the authors of your books, professors...hmmm maybe even GOD.

I think like any profession, some are overpaid and some underpaid. To think an ENTIRE profession is over or underpaid is just ignorance. Of course we don't want just anyone diagnosing or giving us anesthesia but we don't want just anyone to fix our cars or build our homes either. This applies to any trained profession, not just doctors so get over yourselves!

And yes, when we are in bad situations we will pay anything for it to be fixed. So yes make money off of bad things happening to me that are out of my control. Can you imagine a firefighter charging thousands to save me from a burning building? When is it ever okay to excessively charge people for something they NEED to live? At least people have the reasonble option of not seeing basketball games or not having a personal nanny. But we all require medical treatment at some point.

NOTE TO DOCTORS: PLEASE STOP ASKING FOLKS TO CALL YOU "DR. SMITH" WHEN YOU ARE NOT AT WORK AND NOT THEIR DOCTOR. JUST BE HAPPY SOMEONE HAS SHOWN YOU RESPECT BY CALLING YOU MR. OR MRS.

Anonymous said...

I am surprised at the weakness of many arguments on this thread. Doctors are isolated in their field of ultimate job security and don't grasp intangibles like risk.

For the sake of this argument I am going to focus on family practicians. This is because they encompass the majority of doctors and because I don't want another bleeding heart story from an emergency room doctor on this thread.

Doctors in Canada and I presume in the states work 40 hours a week. Sorry to say, but this is nothing. I will tell you the story of my parents who owned a business so you can put it in perspective. My parents each studied for 5 years to earn an honors engineering degree. Doctors studied 3 years more only because of the flawed med school system in Canada and the US that forces you to first earn a bachelor's degree. In Australia you can go to med school directly from high school and get your degree in 5 years.

This system was created by universities that had basic understanding of labor market economics and kept the supply of doctors very low so they could keep salaries artificially high. I am sure many of the people who didn't make the cut were also very qualified individuals. Perhaps missing the mark by a couple of percentage points? Would they really decrease the total value of doctors by that much? Or would they provide more affordable and ready healthcare to people that need it? In a sense there is a monopoly on the production of doctors by universities. This couses a pricing for doctors that is below optimal consumption for the society. Anybody that has taken any economics courses would know what I am talking about. That's enough of that.

Please stop complaining about sacrifice blah blah blah, because you do not know the meaning. I have a friend who's father is a family practician and he spends plenty of time with his three children, has short work days, and goes on vacation to different parts of the world every year. To many doctors ignorant of the labor market and other available jobs the 8 hours a day Monday to Friday is the is an ultimate sacrifice.
My parents who also went to school for 5 years (more like the time that doctors should be going to school for) aren't quite as fortunate. They work 65+ hours a week and haven't been on vacation since god knows when. No weekends. When I was growing up I didn't get to see them that much. And the stress and anxiety from work was always brought home. They are highly skilled professionals and are regarded as some of the best in their field. When times were good, they make around 100,000 each. But when times are bad they make 30,000. With a lot more family, emotional, mental strain than any family practician. Please, to even compare it is an insult to people that work hard. They went to school, they paid their bills, they work their f-n asses off right now as well. And still have a lot of risk in their job. And make significantly less than family practicians.

To any ignorant fool about to say that they are also underpaid please save your breath. Their salary is correctly market priced. Doctors salary is not. It is artificially created by allowing few people through med school and making it necessary to have a bachelor's degree first. So please, put your salaries into perspective and consider how likely it is for a doctor to ever be fired. Don't compare your salaries to that of professional athletes or singers, because they truly are the few individuals in the world that can do what they do and their salaries are market priced (based on the demand for sporting events and types of music). The supply of doctors is not market based, but made artificially low so that salaries can remain high. Please get that through your head and stop complaining. The only arguments I am seeing from you are qualitative. I could give you well-written heartwrenching paragraphs about the difficulties of any job. This is pointless. Look at the quantitative data and compare. Please and thank you.

Anonymous said...

GASTRO MD makes a good point, about 3 posts up.

I hate complainers. People that complain about their jobs, their relationships, their problems, etc etc. The list goes on forever. To the doctor that complains about their salary, get another job! To the anonymous posters who complain that doctors make too much money, go become a doctor!

GASTRO MD says that we all make choices in our life that we need to learn to live with. I agree. the problem with americans is that we refuse to own up to our actions. We are ALWAYS looking to blame somebody else. ALWAYS. QUIT BLAMING OTHER PEOPLE, YOU IDIOTS. IF AMERICANS WOULD JUST LEARN TO BLAME THEMSELVES, MAYBE WE WOULDN'T BE SUCH A SH*TTY COUNTRY!

Minghuan said...

While I agree the process of training a doctor is one of the harshest and self sacrificing processes, the pay for doctors in the US is still overpaid. I'm sure most doctors do care about medicine and helping people more than their paycheck, but why do organizations such as the AMA continue to go against any policy that might affect their salary in a negative way.

And to the people that say doctors need to be paid this much to weed out the potentially bad and unqualified doctors, explain to me why doctors in other industrialized nations are paid much less however have the same effect with around the same life expectancies. In fact living in Japan previously, the doctors there are paid decently however much less than their american counterparts, yet their healthcare is phenomenal and life expectancy is higher than here.

Anonymous said...

Minghuan said "And to the people that say doctors need to be paid this much to weed out the potentially bad and unqualified doctors, explain to me why doctors in other industrialized nations are paid much less however have the same effect with around the same life expectancies. In fact living in Japan previously, the doctors there are paid decently however much less than their american counterparts, yet their healthcare is phenomenal and life expectancy is higher than here."

I COMPLETLY AGREE. Paying US doctors less would simply weed out the ones that are primarily in it for the money. We would all be better off by getting rid of those US doctors (who are, for the most part, specialists). US primary care doctors don't seem to be paid enough to be in it for the money.

sunny said...

First of all, majority of medical students in my class are here for the money and status. Most wont be quick to say that but eventually admit it after you get to know them better.

I believe doctors are being overpaid, especially in the united states. All doctors are making 6 digits, from family doctors to neurosurgeons.

Here is how I view it:
Would you rather have doctors who are in the field for the money and status? For these doctors, at the end of the day, its about how much money they collect than treating you. These are the type of doctors that could care less about you, and i'm sure every poster here has personal experience with them.

If anything, i think we should pay less to our doctors. Therefore, those that stick around are those who are in medicine because they genuinely want to help people.

Another point I would like to get across is the medical education expenses. The main poster explained its okay for doctors to receive 6 digit salaries because they have given up their time and are in huge debt $100,000-200,000.
Okay, fair enough. I say, fix the problem by not increasing their salary but lowering the cost of medical education and provide lower interest medical loans. It is cheaper to pay for a medical students tuition for 4 years than paying them six digits salary a year until retirement. This should be something the government should hop on into.

Anonymous said...

if people improve their eating habits, become more active, and practice a healthier lifestyle, would it drop healthcare costs and doctor salaries. It may not be a simple matter of supply and demand! But I’m sure it would have an effect. Simply lowering salaries may not be practical “who wants to make less!!” but if the number of people requiring costly medical attention drops, it may have an impact on healthcare costs and MD salaries

Anonymous said...

Im sorry to say but some people, actually many, people do go into medicine just for the money. However, they are not aware of the hardship and tribulations that come ahead of them. They also do it because of family greed, traditions and prestiege. I'm an undergrad Biochem major and I take a lot of science classes, in fact ALL, with premed students and ALOT of them are in it for the money. I don't think you realize this for sure until you are a premed wanting to become a doctor for the money or have been around these types of people or environment for a long time, like me. I think a lot of scientists would agree with me.

Anonymous said...

To every body out there who is saying that many proffesionals work just as much as doctors and make less do they have the weight of someones life on their shoulders if they mess up will someone die i was recently in the hospital for appendicitis my appendix had ruptured and pieces had adhered to my kidneys and other organs the surgeon had to remove all of the pieces of the appendix and parts of the kidney and other organs using a remote controlled knife shoved through three holes in my stomach
i was in the hospital for 3 weeks i was on dozens of meds the total cost was 20 grand 20 grand to pay the 5 people who did my surgery the 10 nurses who watched me the hundreds of tests i had to have plus materials to sterilize the or and my room and utilities all in all i would gladly pay 20 grand to have my life saved

Anonymous said...

The following is a chart showing median earnings of physicians who have spent more than 3 years in their specialty from http://www.bls.gov/oco/ocos074.htm#earnings a government website
Anesthesiology $321,686
Surgery: General $282,504
Obstetrics/gynecology $247,348
Psychiatry: General $180,000
Internal medicine $166,420
Pediatrics: General $161,331
Family practice $156,010
So for all of you idiots who keep saying Anesthesiologist make 500,000 and go on vacations a ton you are blatantly wrong and do you know why they make more than you, because when you were smoking dope they were working there asses off so now that you are welding car parts for failing car manufacturers and they are making 6 figures you are whining like a bitch
and to all the engineers who keep saying we are the ones who make everything doctors do possible and if we make a mistake millions die
you are not as important as you think most tests in medicine are based on chemistry and biology and if you make a mistake you have a chance to go fix it but if say a surgeon messes up and cuts an artery in someones brain he doesnt have a chance to go back and fix it

Jim M said...

I am a retired executive who has two accomplished kids--one is a teacher with a Masters degree and a Son who is a surgeon. Both are very talented and have worked very hard in their careers. I would say both are underpaid. It is obvious why one can see how teachers are underpaid but the discussion is about Doctors. Anyone who thinks becoming a surgeon is an easy task in braindead--to become a surgeon not only requires a significant amount of money and skill. Go beat on the NFL, NBA, MBL, they are saving lives and you still go pay a lot of money to watch them---many who are role models for your children. THINK!!! We need great Teachers and Doctors!!!

Anonymous said...

A doctor is paid what you believe he is worth.

If you don't like him or don't believe him, go to another doctor. You want to complain there is lack of supply of doctors? Ok, let's get the less qualified people into the field so you get treated by those people. Nice logic. US isn't the only country who are selective about who can actually become a doctor. Every country i know does that. Why? because not everyone can.

Money is part of EVERYONE's equation! doctors, lawyers...xxx. People want doctors to purely work of "honor", "prestige"...are smoking too much xxx. Last time I checked, everyone working for a doctors office wants to get paid their worth. You think anyone give a doctor a discount working for him just because he try to save lives? You think the landlord give a doctor a discount because he help others?

Doctors like any other professionals get paid what the society believe they are worth. You can change that but you'll also change who goes into the field. Unless you reward people for going through rigors of a professional, people aren't going into that profession. Guess what...supply and demand....it automatically drives up the cost again....

simple supply and demand

Anonymous said...

I find it repulsive that people judge all physicians based on one or two experiences with a bad doctor. Until you become a doctor, don't tell anyone you know what it means to be one and don't say you know what they should be paid. Go, study, throw your life into your career, and be a doctor. Then tell me how much you should get paid. There are bad cops, bad lawyers, bad government officials but no one says all of them are lazy and bad. And it's hilarious that people think doctors work 40 hours a week. WAKE UP! Everyone in my family is a doctor, aunts, parents, uncles, grand parents, and they all work non stop 80+ hr/wk and they deserve everything they are paid. Their jobs are extremely stressful - this isn't similar to being a pilot (while important as well), who flies healthy people who willingly take a risk. These are surgeons, cardiologists, radiologist who help sick people, who are already already at risk.

On top of that, no one is entitled to free health care. When you need a kidney transplant, you'll be glad you paid for insurance. What I see are people who have no idea what it entails to be a doctor, who have no understanding of how the health care system is run, and who have never seen doctors save lives in heinous circumstances.

There will always be mistakes - true. That's with everything. But doctors cannot be charity cases themselves. How can you help someone when you yourself need help? They are grossly underpaid in my opinion.

Anonymous said...

teachers, pilots, engineers, and policemen should all be paid more as well. they are all important. but this does not mean doctors are overpaid. it just means other professions are underpaid. and believe me, the wealthiest doctors get 50% taken from them in taxes - so what you take as 400 000 k is really 200 000k, which if youre living in NYC is nothing for a shitload of work.

ER Tech said...

I get the impression that the people on here that think doctors are overpaid are:

1. Unhappy with their job
2. Recently laid off
3. Having a rough time in this economy
4. Think they are entitled to free health care

I can empathize with 2 and 3, and kind of 1. But I am sick of people coming in everyday to the ER who think its their God given right to get free health care. They don't seem to get that I, an ER tech, have to bust my @$$ to get them the care they need. The ER nurse needs to break her back to make sure the patient isn't in pain. Manufacturers worked days and nights to come up with products that would save their lives. And most importantly, the doctor who went through 4 years of college, 4 years of medical school, and at least 3 years of residency before he earned a penny that didn't go to his monstrous student debt just so he can make an educated medical plan of action for a sick patient. They just think it should be free because they're entitled as a human being or something. And when its not, they go after easy targets: doctors with "high" salaries. Salaries that they earned every penny of.

Anonymous said...

Unless you have worked through medical school, struggled through your residency and are actually a physician, it is impossible to intelligently comment on this topic.

Going to medical school is like trying to drink water from an open fire hydrant with a straw.

Oh, and be able to regurgitate all of your knowledge at the drop of a hat during the tail end of a twenty-five hour shift in an operating room with a patient who will die if your manual dexterity falters even the slightest bit.

Anonymous said...

Dear proud doctors,
kindly be gracious enough to accept a humble tribute to your genius from a stupid stupid math PhD.

I don't think doctors are overpaid; if anything, they should be paid at least 10 times of what they get right now.

Why do I think that way? Because, as you can see, doctors here have all struggled hard through medical school. In other words, they have all done something DIFFICULT.

On the other hand, I, for instance, did math because it came easy to me. When I was doing my undergrad, I picked math because it seemed easy. I didn't have to memorize. I just had to understand. Ditto when I was doing my PhD. PhD was a breeze. I only had to read a few books, come up with my own ideas, prove to my professor that it was meaningful, get it published ... and bang... I had my diploma!

You could hardly say that about an MD. Med students have to read countless volumes of data and regurgitate it on demand.

On top of that, the brilliant MDs have to suppress all those great new ideas that must be popping into their heads all the time. The MDs hardly get time to pursue those ideas and publish them.

So, dear MDs, please accept my humble tribute and keep memorizing and regurgitating for the benefit of humanity, all for the modest sums of money that society can offer in gratitude.

Anonymous said...

I find an interesting attitude difference between the world of math (where I work) and the world of medicine.

When I was becoming a mathematician, we were constantly told that you do not deserve to become a mathematician unless you find it easy. In fact, we were shit scared of admitting that anything was difficult for fear of looking bad in front of the professors and in fact scared of even admitting to ourselves that things were, on occasion, difficult.

Finding things difficult was seen as a sign of being unworthy and stupid.

Medical doctors, on the other hand, seem to be perfectly fine with admitting upfront that medicine is hard.

Anonymous said...

Anonymous said "Medical doctors, on the other hand, seem to be perfectly fine with admitting upfront that medicine is hard."

I can't tell you how many doctors tell me how "hard" they work and what "long hours" they work. They also tell me it is becoming harder and harder to even "earn a living" in medicine--they're telling their kids to go into different fields. Then, I come to find out they consider 35 hrs/wk full time (and they clock in/out 35 hrs like a grocery store clerk). The doctors always seem to be out watering their lawns when I get home at 7 pm or 8 pm. In addition, they get 4-6 wks vacation a year. The only compensation they get for this "hard work" and "long hours" is about $400K per year.

JHC said...

"It is such a myth that doctors are overworked and underpaid. Doctors are paid way too much. They just want to make you feel like you are indebted to them. Don't give me this crap that they work too much and don't get paid enough for their education. A college professor spends more time in school and works 70-90 hour weeks trying to balance finding solutions to the worlds problems AND trying to make teach and get paid 50-80 K a year. Why should doctors get paid anymore. Psychologists go to school just as long as doctors and get paid 70 K a year. I'm so tired of hearing that docs are underpaid....they are WAY over paid!!!"

It is obscene to attempt to compare doctors with teachers. Does a professor have to go in over night to perform an emergency angioplasty (or 2)? Does a professor have to assume huge liability to do what they do - with the risk of losing everything? Does a professor have to be in the hospital frequently on weekends and holidays? Does the professor have to face the stress of someone's immediate medical crisis?

Moreover, you cannot possibly think it is rational to compare the training process of a psychologist versus a psychiatrist, for example. Just starting with the entry requirements reflects a HUGE disparity.

Doctors SHOULD be one of the highest paid professional career choices in this country. NO OTHER CAREER CHOICE requires what being a doctor requires.

Primary care doctors are great, but remember, they can REFER the risks to the specialists. They should not be paid the same as a neurosurgeon, because the neurosurgeon trains longer and assumes much higher risks. Primary care doctors can spend their on-call time on the golf course because they do not have to round on patients in the hospitals. Whereas, a cardiologist has to round on inpatients on the weekends, for example.

JHC said...

The notion that doctors are profiting from "people's organs" as was suggested above is also crazy. Doctors SHOULD be allowed to profit from their training, skills and services. They're not making money on "lives", they're providing a service which they took over a decade to learn in most cases, and that is what they should be allowed to profit from.

I have found so many of these posts filled with clueless people. I am a critical care nurse and I know what doctors go through and what doing their jobs requires. The people here who are so clueless, are also the ones who believe they can use WebMD to diagnose their problems.

larryarms said...

such.ire ... you can't compare a Phd with an MD. all the Phd's I know not only went to grad school free, but got PAID!

Anonymous said...

All the (specialist) MD's I know starting out making ~$400k/yr. It's not too hard to pay off a $100k loan over a relatively short period of time when you are raking in big money.

All the specialist MD's I know live in very high cost neighborhoods, send their kids to expensive private schools ($15k/yr - $20k/yr per child), work ~40 hrs/wk, take 4-6 wks vacation a year (and use those vacation weeks to travel to high-price, exotic places), etc. Living that lifestyle tells me the specialist MDs' couldn't have had that much trouble paying off their loans.

Aren't MD's supposed to be in medicine because "they like helping people"? It seems to me the specialist MD's only like helping other people when it will result in building-up their own bank account balances.

This is just my opinion, but it is based on what I see over, and over, and over, and over, etc.

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