Thursday, January 3, 2008

Do Doctors Make Too Much Money - Volume II

I am truly amazed that the #1 most read post I have ever written was (read the link after!) "Do Doctors Make too Much Money?". Thousands of people from around the world have "googled" that phrase and found EverythingHealth. Every day there are several visits to that one old piece. I am amazed because I wouldn't have thought there was that much interest in Doctor's incomes. Apparently there is A LOT of interest and many have strong opinions if you read the comments.

I think some doctors are probably paid too much. But the other 99.99% deserve what they get or, if they are primary care physicians...they deserve A LOT more. The doctor group I know the most about is primary care and general Internal Medicine. I can tell you that, on average, these doctors are underpaid and overworked. Now don't write back and compare it to a teacher or a fireman and tell me how underpaid they are too. This is not a is a fact.

If you have been reading EverythingHealth or any number of other health blogs, you know that we are facing a huge primary care crisis in the U.S. because less than 15% of all doctors in training will chose this specialty due to low reimbursement and heavy workloads. Why should you care?

You should care because your body is complex and there is no textbook or computer that can replace the thinking, intuition and training of a doctor. You should care because you are getting older along with everyone else, and the body is less forgiving with age. The Happy Hospitalist an Internist who practices in a hospital setting, describes just another decision making day at the office.
It isn't worth much, unless it is you, or your mother or wife.

You should care about primary care because your average specialist (cardiologist, transplant surgeon, gynecologist, dermatologist, ophthalmologist, pathologist, ENT, orthopedic surgeon and on and on) is not going to concern themselve with the complexities of multi organ disease and granny's alzheimers. They are not going to follow up on that abnormal mammogram or care about your cholesterol level. They are not going to care if you can't sleep, pee or poop...unless it involves an expensive test or procedure. Specialists are trained to deal with one part of your body. That is what they are interested in and that is where their expertise resides.

A primary care Internist has broad knowledge about every organ you own. They think in a comprehensive way and form differential diagnoses that let them process information to come up with the best diagnosis, testing and plan. Some are gifted healers and bring even more to the table.

Many people who follow health care policy believe it may already be too late to save primary care medicine. At the very least we will have two tiers of medicine. Retainer or concierge practices that cater to the wealthy and nurse practitioners who deal with routine health matters. Emergency rooms will be filled with everyone else. Patients will shuffle from specialist to specialist with no coordination, and costs will soar. Then we will see if we paid them too much back in the "good ole' days".


The Happy Hospitalist said...

Nobody seems to get it or even care. We must all bring awareness in any way we can.


Ask Aunt B said...

I spoke to my friend, Board Chairman, for Orthopedics, here on Long Island, the other day. I asked him if he had enjoyed his life's work? He's probably in his late 60's and has been around. Our discussion, rounded out to Medicine is not what it was intended to be because of the ever increasing hold by insurance companies, who are the ones, who are really getting rich. I don't feel it should be this way. The money should go where it belongs but it is certainly a racket, isn't it? I work for Clare Crawford-Mason, in conjunction with CC-M Productions and we deal with these and similar medical issues. I've also been the patient and more than observant. I ask questions and I do realize more than not that the Doctors who should be paid are not the ones, grabbing the money. No, it should not be about money but dammit, the money's not going where it belongs. How many Dr.'s are taking less than payments for Medicaid patients? Thank God for the program but it, in itself is a statement as to the very fact that they must not feel these Dr.'s should be paid their worth. It is a sad commentary, is it not? Of course, I side with you ad could go on and on but I'm sure, I'm simply preaching to the choir.

Good luck in your life's work and I hope you don't lose sight of your true intention.

Excellent blog!

Rich said...

Here’s the way I see it, if docs want to make a lot of money they have to work real hard for it. This means long hours and stressful days. This kind of lifestyle is not sustainable without consequence. It will have an impact on their lives in one form or another. So if you ask me – doctors make what they earn and they earn it indeed.

DDx:dx said...

I think the reimbursement is a symptom, not the true nature of the problem. I think medicine has become a service commodity and not a calling. I think the value of care is measured in returns on investment, not compassion. And the true cost to all of us will not be in less primary care doctors to "care" for us, but in the deep cynicism engendered by the acceptance of selfishness.

K said...

Rich, I think the point here is that doctors, especially in primary care, are working hard and they still are getting pooped upon, both by low monetary compensation (thanks in large part to skyrocketing insurance costs) and to a lesser extent by increased patient needs and demands (know-it-all googling patients, myriad problems brought on by sedentary lifestyles, uninformed populace that thinks a Coke douche will stop a pregnancy, etc). Not to mention the fact that most doctors go through a whole helluva lot more (expensive) schooling than other professions, and so they've got expensive loan payments to make as well.

Now, I'll admit, I'm not a huge fan of paying a lot of money to a doctor in spite of the fact I think they do deserve to be fairly compensated for, oh, making sure I'm healthy and all, but I'm much, much less of a fan of paying a lot of money for insurance that doesn't actually cover what they imply it will, and when it does cover, only pays as little as it can get away with paying, while silently promising to raise rates later.

Essentially what I'm saying is, yeah, everyone including doctors should expect to work hard to get the big bucks, but doctors are already working hard, for the most part, and while I'm not a huge fan of high prices, I also get that they perform a valuable service and as such someone who goes into that often thankless profession should get some dang respect. An insurance executive, on the other hand, gets no such respect from me.

Anonymous said...

Why don't they require the hospitalists to follow up the patients? The hospitalists are expediting things for the hospital by getting the patients out of the hospital faster. That means they get them out as soon as it is safe, but not necessarily that the workups have been completed. If we don't have enough primary care, that stuff won't be followed. At least until there are enough primary care docs, the hospitalists should help out.

Toni Brayer MD said...

Hospitalists specialize in caring for patients that are in an acute care bed. They have neither the expertise nor the interest in seeing patients for follow up in an ambulatory office setting. They are busy enough with hospital patients and could not begin to handle the demands of primary care medicine. Following up on tests is just one small part of "doctoring". The ongoing treatment is best served by a doctor who knows the patient completely...not just the events of one hospitalization. Thanks

organiparadox said...

Many people do not see the difference between what a doctor is paid, and what is collected. I do not want anything less than a professional treating my children, and i am
thankful that doctors are paid well.However, I am not a doctor, and I do not make a lot of money, although I work very hard to offer services that doctors take advantage of. Recently, I took my son to the emergency room because he got his finger slammed in a door. They x-rayed it, drilled a hole into the nail, and put a band-aid on it. The bill was almost $1000. I did not have insurance. Can you blame me for being pissed?

Toni Brayer MD said...

Organiparadox: No, I don't blame you at all. The system is all screwed up. TB

Anonymous said...

Dr. Brayer-
I think you overstate the situation when you say that the hospitalists don't have the expertise to follow up admissions. Certainly they do. In fact, many of the hospitalists were practicing primary care physicians before they were hospitalists, no? I will accept the contention that they don't have the interest in following up.
However, if there is no primary care physician available to follow up the acute hospitalization issues, I believe they have established enough of a doctor-patient relationship that they should follow-up, as board certified internists and family practioners.
Respectfully sbmitted

Toni Brayer MD said...

Anon: I am not sure how a hospitalist would do post hospital follow up. Many patients go to skilled nursing facilities or need ongoing home care coordination. Most hospitalists don't have offices or facilities for out patient visits. Once the post discharge period has passed...what is the patient to do for ongoing medical care? The entire purpose of the hospitalist movement is to have doctors dedicated to the inpatient care.
If ongoing primary care is valuable to a society, it needs to be preserved and strengthened. Thank You for visiting and commenting.

Anonymous said...

Our local hospitalists rented space from the hospital to create a pre-surgical evaluation clinic. If the desire or need was there, and the only thing limiting was space, it could be done easily. They could rent space from other primary care practices, who I am sure would love the revenue.
Certainly local circumstances dictate space availability, but I believe that is the easiest problem to solve. Patients in SNF-even easier, group of patients in one setting, don't even need much office space really.
It is just a question of whether they will be forced to do it by local circumstances as primary care physicians become less and less available for follow up, and as people get increasingly upset about being discharged faster and faster. They used to have large primary care groups with one person designated per week to be the hospitalist. This would just be the reverse. I fully agree with you that ongoing medical care is a problem, but I believe it to be a distinct one. As long as there is someone to follow up the acute hospitalization, i don't think the hospitalists necessarily need to follow. But not making sure the pneumonia is better is an important issue, in my opinion.
On a separate but related topic, I personally believe it would be helpful for physicians to have some follow up of patients to maintain their diagnostic and therapeutic skills.

Yes we absolutely, positively need more primary care physicians. I disagree slightly with most of the people here-we don't need to necessarily pay them more, we need to make the job better for them. For many jobs, salary isn't the primary determinant of why people move on-it is the work conditions and lack of respect.

For those who think that more money would solve the issue, how much do you think is necessary? There are primary care physicians working in nice groups that make more than $200k. They just aren't in Chicago and San Francisco typically. What tradeoffs are you willing to make?

cardiodo said...

I am a doctor almost done with training and I have to comment here. We all lie in the bed we make so I don't want to come off like too much of a complainer, however, being a doctor certainely is a very long and hard road. I am 31 yrs old, have a mortgage of debt, still work 80 hrs a week and starting to feel much older because of it. Never go on any nice vacations. Government says I need to pay off my loans now which are over $1000 month when my salary is only $3000 month, so we go and moonlight to make extra money on our sparse days off- only for the government to take 50% of that money. We deal with patients that are ever more demanding- call at 1 in the morning for general questions about their meds that we must answer (imagine a lawyer doing that). Work 30 hr shifts, etc. You get the point. My point is, yes, when I am finally done I will make a nice income but people don't understand the opportunity cost- that is the cost of losing 10 years of investing, paying towards a home, retirement, etc; not to mention working your ass off during what should be a more fun part of your life. People also need to understand that your doctor does not make what comes on a medical bill- usually only a fraction of that if it is collected at all- hospitals, on average, only collect on 30% of what is billed for, and we don't operate in a capitalist health care system because insurance companies determine what is paid for, what services you get, and what we get reimbursed. At 31 I live in a crappy 3rd floor walk up- I wish people understood that and patients would stop assuming we live this dream life of fancy cars and exotic vacations- it only exists for few. Thank You

Anonymous said...

I am a 26 year old woman married to a 3rd year medical student at a major research university. I have to agree with the previous poster, my life is certainly not fabulous, nor do I expect it to be in the near future. So far my husband has studied away in undergrad, graduate school and now medical school to ensure high grades and increased learning opportunities. We were married in May, but unfortunatly after the wedding he had to study for 30 days straight, 10 hour days to take his first licensing exam. Now he is posted at a hospital 2 hours away while I work to bring in an income. Becoming a physician is not easy, by the time my husband is done with medical school he will be 28, residency 32-33. Meanwhile we have combined student loans of about $170,000, and we are lucky compared to some. When my husband started medical school I was skeptical of the type of people I would kids with entitlement issues, nerds with social problems, people who only cared about the eventual payoff. However, in my experience, I have only met hard working people wanting to do best for his/her patient. Many of these students have already run up debts of over $200,000, owing to out of state tuition and living costs over an 6-8 year period.

medaholic said...

Money is only one part of the issue. If people really want to fix physician salary, they also have to rework all the things associated with it. Medical training, length of education, resident hours and wages, billing, malpractice, etc etc.

If only throwing more money at it could fix the problem.

Anonymous said...

So, I have a question for cardiodo but anyone is welcome to take a crack at it. I understand that the opportunity costs are high however they are high for many professionals. Excluding those who have settled for mediocrity, how many people work 40-45hrs a week? I would assume not very many. Many professionals do go on to some form of grad and work many hours starting their careers. So you do invest 10+ years of your life working to become a doctor and yes you put forth a lot of effort, time, and money. However, I cant help but think long term. While you studied your brains out and worked crazy hours your friends got jobs out of undergrad making 40k-50k a year. Those friends probably started a family and started paying on a house and probably enjoyed a lot of their twenties. I would assume most of those friends worked 50hr-60hrs a week give or take a little(unless they worked for the gov or have no desire to climb the ladder). Now a doctor who specializes gets out of residency/fellowship has 150k+ of dept and has spent the last 10+yrs of their life working 20-30hrs more a week than their undergrad companion however he is now making what...250k-350k? Meanwhile your undergrad friends might be making 70-90k and that's if he put forth some effort? So your now 32-34ish and making serious cash, you pay off your school dept in a couple years, gain a little more experience and get to the place where you go work for some practice that allows you to work 9-5 5 days a week with an hour lunch still making 250k+ a year (a modest # for a specialist). Sure you may have to be on call or take a weekend shift every once in a while. Your probably mid to late 30s by this point and you start truly enjoying your life just like your undergrad companion did 15yrs ago. So by the age of 50 (not nearly retirement age) who made the best decision? And, how long did it take the doctor to catch up? What kind of vacation options and retirement resources will the two have? Prestige and recognition is worth something too! How about time off and freedom to go work almost anywhere in world?

If my point of view is obscured please correct.

(fyi, im not saying doctors, especially GPs, make more than they should it is a huge investment which most are not willing to make)

Anonymous said...

Nature abhores a vacuum, as such would exist if there were a gap between those that earn and deserve, and those that take what is not earned. Why then do unregulated industries produce obscene saleries for CEO's while medicare (government) regulated prices produce such greatly different saleries. Answer: people meet, know and think of doctors, see the bill of which the doctor only see's a small fraction. "how can they deserve so much money?" they wonder. It is popular (read fad) to assume that doctors make too much.

This error in perception will bite harder once the current administration has it's way with the lower paying specialties of medicine.

All I can say, is you better be ready to pay in cash if your kid needs to be seen by a pediatrician for anything personal. Good luck with that "care provider" at Walmart also.

If you are diabetic in need.. You're screwed my friend, but I'll still see ya.

Anonymous said...

To Anonymous of January 30, 2009 8:59pm who said "If you are diabetic in need.. You're screwed my friend, but I'll still see ya."

A diabetic would be screwed if they were insulin dependent and couldn't get a prescription or couldn't afford to pay for insulin or syringes, needles, and glucose testing supplies (which happens all the time). However, if a pre-diabetic, or type II diabetic patient wants to lower learn about diabetes and effectively manage their own health they ought go see a nurse or dietician.

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."

Terry K. said...

I absolutely believe doctors make too much money. I also think that doctors think they're smarter than everyone else, and that most doctors have poles up their asses. Many of us could have been doctors eventhough we didn't choose that path. I think the whole United States System is messed up, though. Insurance is too expensive. People with pre-existing conditions get raped monetarily (my sister who had breast cancer was paying $1500/month for health care--I mean, are you kidding me?). Drug companies are selling their wares, and even though a drug might cause a third eye, they're still selling it.

I hate that it's all about money. I think most doctors became doctors not because of a life calling, but because they saw dollar signs.

It's a huge racket. And it makes me sad and sick at the same time.

Anonymous said...

Gastro MD is one example of having a pole stuck up his ass, by the way.

Sorry you missed out on having friends and having to turn down so many invitations and being a loser in general. I hope you enjoy all of your money and prestige and respect in life. I automatically don't respect you. You have to earn my respect as a truly good, giving person. Just because you're a doctor means absolutely nothing to me. Lots of doctors I know, by the way, are prescription junkies.

guy said...

I'm with you Gastro MD.

As for Terry K and the latest Anonymous post, you guys represent all that is wrong with this world. You expect the people who have sacrificed the most to provide you with what you want for minimal reward. You might as well be begging on the street.

I am currently a PhD student in medical physics (basically studying the medical benefits of radiation). After I finish my degree I would like to attend medical school and eventually practice as a radiation oncologist. I'd consider it an honor to be able to cure someone of cancer.

When it comes to the issue of physicians salaries, people like Terry K and Anonymous make me ill. By the time I finish school and residency I will be 37 years old. I will have spent 19 years in school and training just for the opportunity to BEGIN saving lives. I will have sacrificed over a MILLION dollars in lost earnings before making the salary of a licensed physician. This is because I could make six figures immediately after finishing my PhD.

After such an enormous sacrifice in time and income, not to mention the grueling nature of medical school and residency, I EXPECT to make a lot of money. Why? Because while Terry K and Anonymous are sitting at home watching TV, I'll be learning how to save lives. While they are choosing what shitty beer to drink during their all night drinking binge, I'll be at home learning how to save lives.
When they get old and gray and sick, they'll eventually have to come to individuals like Gastro and me, people who studied their asses off, and ask us to cure them, perhaps to save their lives, and we will be there. We will provide.

The point is, Terry K, you should be GRATEFUL that there are men and women intelligent enough and motivated enough to accomplish the extremely difficult job of saving lives and curing disease. You say physicans think they are smarter than everyone else? They usually are. I can guarantee I'm smarter than you. But rather than being a lazy, worthless piece of shit, I've decided to dedicate my life to something more; something that greatly benefits humanity. My personal sacrifices will be society's gain. It will gain a damned good physician who knows what the hell he's doing; a physican who will save people's lives. If I do that, Terry K, I expect to be compensated for my efforts, just like you would at your job. The compensation should be on par with the skill set that I bring to the table, which is already substantial. You can call me an asshole but that doesn't change the nature of things. Doctors have sacrificed and busted their asses to get where they are. The rising costs of medical care are not caused by them. Stop expecting them to work for less than they're worth. That expectation is some of the purest evil in the world.

Gastro, MD said...

Terry K, I empathize with you. My mother has uncontrolled diabetes and cannot find affordable health insurance for the life of her. However, I disagree with your comment that we went into medicine because of dollar signs. I can guarantee you that not ONE individual from my graduating medical school of 145 had money as their top priority. I started medical school with close to 190 students. Many of those who placed money as their top priority failed or dropped out because they couldn't "hang" with the rigorous academic curriculum. I can tell you that I spent many, many nights crying because of the overwhelming amount of information one must learn in medical school and stress of board exams. I share this personal information freely because many of my colleagues have experienced the same thing. Those that place money as their top priority are weeded out quickly because they realize that spending over a decade of their life learning medicine simply is not worth it.

That being said, money DOES become an important factor once you are finished with your training. But after spending a decade of your life in debt, working for free, and making countless personal sacrifices, I feel I deserve to be paid. It doesn't help that many patients are also ungrateful, rude, and demanding, as evidenced by this forum.

To anonymous: please define "LOSER." If it means having a beautiful wife with 3 wonderful children, and having a secure job that I love and look forward to every day, then I am happy to be a loser.

Of course not all physicians love their jobs. Based on statistics, primary care doctors make up the overwhelming majority of this group. They are overworked and underpaid. They are not reimbursed for all of the phone calls or emails they must return from patients. Their work requires the greatest breadth of knowledge and practical intuition in the shortest allotted time period. Their patients are often grumpy, ungrateful, and angry that the doctor sees them in 5 minutes only to rush them out the door. They don't see the mound of paperwork that must be filled out afterwords, or the constant battle with insurance companies to get reimbursed because you forget to dot an "i". I used to work per diem as a hospitalist in California. MediCal would pay me $13 per day to take care of a patient in the intensive care unit on life-support with multi-organ failure. I can think of a million other ways to make $13 without going through the rigorous training.

And now the government wants to tax the wealthy to help cover the 1 trillion dollar estimate needed for universal healthcare? Here's my proposal: lose weight and you won't develop diabetes and hypertension. Quit smoking and you won't develop COPD. Quit drinking and you won't develop cirrhosis. There. I just saved the government ONE TRILLION dollars. But that plan would never work because Americans would have to take responsibility for their own choices and actions, which would be ludicrous.

Anonymous said...

I agree that medical school is difficult and expensive, and I believe that primary care physicians should be paid more while other specialists are probably getting too much.
Yet, I also have a grudge against some doctors because some definitely do have poles up their asses. My cousin had leg pain and a doctor turned him away, saying it was nothing more than tendonitis. Later, he came back complaining of chest pain... the doctor told him that he had a fractured rib. My cousin insisted that he did not. The doctor didn't listen to him. It turned out that the leg pain was due to a massive blood clot, which broke off and traveled to his lungs and almost killed him, all because of a physician who did listen to his patient because he had a big ego.
This is probably the kind of doctor guy, above, will become. By the way, my cousin had a genetic clotting factor (thankfully I don't) and was otherwise completely healthy.

I think that other professionals are underpaid in comparison to physicians. I happen to be studying software engineering, and while my schooling will not be as long as medical school + residency, it still involves consuming large amounts of seemingly arbitrary information, not to mention that good coding is something very few can do well. I think people in my area should be paid more money and respect. After all, look at the dependence of the medical industry (or any industry) on computer systems.

Anonymous said...

I am three years out of residency and I want to quit already. Patients look at me like I make too much money, I was accused just yesterday of driving a "fancy" car with a smirk from a patient. If you call a 6 year old hybrid that I purchased used and still am making payments on because I bought it during residency when my other car broke down "fancy" then, I don't even know how to respond. My friends always thinks it's funny I rarely buy clothes without coupons!
The long hours after residency, the lack of respect I get from patients, and the constant adding of more work and dealing with ever present threat of malpractice, I realize this job is just too stressful and not even worth what I'm getting paid. I'm actually considered to be one of the good ones, I get referrals from OR staff, nurses, and I see many of our own employees, and much of this is word of mouth. I'm getting more and more people sending in their friends to see me, but I'm exhausted, and I just can't keep up with it. When I back down and cut hours, I can't tell you how pissed off some patients are. New patients too because they can't get in to see me in what they consider a good time. I am truly sorry to all of you. I studied my booty off, only to get crushed by insurance companies and a work load I can't keep up with up.
Honestly, if things continue like this, more and more of my colleagues will leave this profession and what will you, the "consumer- who knows more than me-" do? Go to an NP? A PA? I quit going to NP's in second year of medical school because that's when I had already surpassed her knowledge base. Don't get me wrong, many are good and I would still recommend for basic routine care, but once you get into problems you're going to need someone else and all these generalists will be gone because they too finally had enough of the long hours, stupid phone calls at 2am (yes, some are true emergencies, but don't just call me to me you're bleeding at 20 weeks pregnant and then also tell me you are refusing to come to the hospital and can't I just diagnose over the phone??? NO, I CANNOT diagnose you without looking at you and your baby!)
Ok I've ranted enough. I agree with above posts- where has PERSONAL RESPONSIBILITY gone? People don't want to hear they need to exercise, lay off the McDonalds and LOSE WEIGHT. It truly would save this country trillions and save lives, but what do I know? I'm the dumb doctor with a pole up my booty, huh?

Anonymous said...

Few facts to remember:

The hardest part of med school is to get into one. (Reasons for this are complex but one of them sure is AMA goal of keeping the supply of doctors low to preserve high salaries). Getting a Phd in, say, organic chemistry is no easier then med school, however if you want the Phd you will eventually find a school that will educate you if you are qualified but that is not true in case you want to be a doctor.

Therefore, its not necessary true that one did not become doctor because of beer drinking, waisting time, etc. like few doctors/med students suggested above. While that may be the case for some its also true that there are qualified candidates who never got the chance to attend simply because the space is so limited.

Since you have been trough selection process you should know what I am talking about.

Anonymous said...

Some of the most hardworking people go into medicine 'primarily/secondarily' because of the money involved.

People who get left out will always bicker.

If AMA increases the number of doctors graduating from medical schools then quality of medical care in general is bound to suffer.

The standard of healthcare in USA is amazing compared to my country which is churning out doctors in thousands each year.

Your doctors have put in really a lot of effort to understand the complex bodies that god has made. This is unlike man made machines which can be understood from books. Patients are moody, irritable and thankless. They cannot be replaced just as you would replace an old car for a new one. There are bound to be mistakes. And the service doctors put in cannot be counted in money. Be thankful that AMA is not letting this happen.

If youngsters were joining medicine just because thay had a calling then there would be fewer than a hundred doctors graduating from American medical schools.

And for those suckers who did not choose medicine when they had a chance.....It is your own decision....The day doctors start getting payed lesser than a software programmer the more hardworking youngsters of your lot will definitely go into software programming or something more paying. I bet the present software programmer will be out of work when this happens.

Anonymous said...

I think prices are unreasonable. If you have a headache and a sniffly nose, go to the doctor, sit in her office for five minutes, see a nurse for seven, a doctor for three, she writes a prescription for antibiotics even though what you have is virus, please tell me why that should cost more than $15 dollars? Perhaps the doctor went to school for 15 years. So what? She has not provided you with the benefit of all that experience. The nurse probably made the decision. Yet you are paying doctor prices.

Not all medical care is the same, and not all of it deserves to be expensive. An X-ray and a cast? Come on, this procedure is like, what, 40 years old? Why should that be more than $50?

The Happy Hospitalist said...

anon. Why are you going to the doctor? Sounds like you don't need one. How much do you think an hour with the doctor should cost?

Sandy said...

I do think that doctors should be paid for their expertise. If they save my daughter's life they should be paid a nice sum, not my house, but maybe one year salary which is about $40,000. There you go, doc, my yearly salary that you just made in one day. Is that enough?

Anonymous said...

All the apologetics notwithstanding: if I take a Sunday drive through the neighborhoods in my town where the doctors live, I see enormous mansions sitting on 5-acre lots, pools in the backyards, and Escalades in the driveways. None of their children are in the grimy public school with my older kid; apparently they are all in the tony private school here. None of their small children are in day care with my younger kid; apparently none of those wives have to work like I do. Sorry if I sound bitter; it's just that reading about how doctors are just middle-class worker bees who are overworked and underpaid kind of sticks in my craw. said...

For my part one and all ought to look at it.