I was promised that FM would make less money in the future

[AntiKarateKid]

I'm an MS3 finishing my orientation week. On Friday some guy pitching the "future" of integrated and patient centered care was talking about all these ostensibly wonderful things that would happen like being able to have better interdisciplinary teams WITHOUT any hierarchy, pay for performance and publicly available "performance grades" for your clinic, same day appointments for patients but less paperwork for docs who get to leave by 5! He also kept emphasizing how the "big winners" in all this were nurses.

He went on and on for about an hour and at the end of the session, I asked him a few questions:

1. How is there a flattening of the hierarchy when I'm the one responsible and liable for the diagnosis?
2. Why is it right for there to be "no leaders" or "everyone is a leader" when I specifically chose to become a doc to take on the responsibility to be a leader. I struggled to get top marks in college, chose to train twice as long as nurses or PA's, and took on immensely more debt
3. How is it productive to tell future students thinking about primary care that they will take a pay hit on top of having to now be responsible for all these extra, almost utopian responsibilities and new ways to monitor and care for patients? Saying we'd get to "leave earlier" makes no difference seeing as how I could have chosen a job with better hours at the outset these days anyway since primary care docs are in short supply and have that power to choose.
4. I asked if theoretically the pay for FM was 200k right now, what kind of pay hit were we looking at and he said about 175k would be the new salary then. So a 25K hit.

He had hand wavey non-answers to them and said that "specialists" were going to be "next."

There's more I can't exactly recall since our class was tired by the end of the day but it all made me feel very resentful and may have been the tipping point that pushed me away from primary care. I feel like theres this "doctor privilige" that these people people expect us to smile and hand away. That prestige, leadership, and yes money to finally pay back loans and earn a living are being attacked and we're supposed to smile and pretend that we're no more educated than nurses or PA who are IMPORTANT but not the same as us.

I apologize if I insulted anyone or wasn't clear. I'm in a tossup between FM and another specialty but it seems like every new healthcare change that's being proposed is positioning itself to screw FM docs

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[smq123]

I'm an MS3 finishing my orientation week. On Friday some guy pitching the "future" of integrated and patient centered care was talking about all these ostensibly wonderful things that would happen like being able to have better interdisciplinary teams WITHOUT any hierarchy, pay for performance and publicly available "performance grades" for your clinic, same day appointments for patients but less paperwork for docs who get to leave by 5! He also kept emphasizing how the "big winners" in all this were nurses.

He went on and on for about an hour and at the end of the session, I asked him a few questions:

1. How is there a flattening of the hierarchy when I'm the one responsible and liable for the diagnosis?
2. Why is it right for there to be "no leaders" or "everyone is a leader" when I specifically chose to become a doc to take on the responsibility to be a leader. I struggled to get top marks in college, chose to train twice as long as nurses or PA's, and took on immensely more debt
3. How is it productive to tell future students thinking about primary care that they will take a pay hit on top of having to now be responsible for all these extra, almost utopian responsibilities and new ways to monitor and care for patients? Saying we'd get to "leave earlier" makes no difference seeing as how I could have chosen a job with better hours at the outset these days anyway since primary care docs are in short supply and have that power to choose.
4. I asked if theoretically the pay for FM was 200k right now, what kind of pay hit were we looking at and he said about 175k would be the new salary then. So a 25K hit.

He had hand wavey non-answers to them and said that "specialists" were going to be "next."

There's more I can't exactly recall since our class was tired by the end of the day but it all made me feel very resentful and may have been the tipping point that pushed me away from primary care. I feel like theres this "doctor privilige" that these people people expect us to smile and hand away. That prestige, leadership, and yes money to finally pay back loans and earn a living are being attacked and we're supposed to smile and pretend that we're no more educated than nurses or PA who are IMPORTANT but not the same as us.

I apologize if I insulted anyone or wasn't clear

Is there a question in all this? Or are you venting?

Who was this speaker? Was he a physician, insurance salesman, administrator, nurse?

Are you looking to go into primary care? What fields are you interested in?

 

[AntiKarateKid]

Is there a question in all this? Or are you venting?

Who was this speaker? Was he a physician, insurance salesman, administrator, nurse?

Are you looking to go into primary care? What fields are you interested in?

I apologize that I wasn't clear. I've edited the OP. I'm looking to decide between FM and another specialty but it seems like future changes to the system are positioned to burden us and decrease our earning power. Like I said, I can't remember if the guy was a doc but he said he was part of some organization in the healthcare industry. I can say though that he was working in many ways with the government and insurance companies looking to reform the healthcare system. I'll update if I remember.

 

[deleted87716]

Sorry, but the talk sounds like B.S. to me. It's exactly as you said, someone's idea of a utopian primary care delivery system, and trying to figure out how much money people might be able to earn in a made-up scenario is pointless. The income numbers he threw out were pulled straight out of his a$$, I guarantee it. That sort of talk has been going on since the 80's, when managed care started to become a thing.

 

[jl lin]

IDK, my primary care physician is incredibly busy. Hope he gets to take his vacation. He probably will, cause he works like a dog to get to it. He is doing quite well and will live very nicely after retirement.

 

[bronx43]

Lol, he's totally making up numbers...like straight up pulling them out of his a**.