I think @Mad Jack has a good idea... The system should be changed; people should ONLY purchase catastrophic insurance and have a HSA for routine stuff. Once that HSA has a certain amount of money you should no longer contribute into it; you contribute into it as it's being depleted... I think that might control the cost of healthcare...
How do we cover almost everyone and control cost then? You can go ahead and say people have to take responsibility for themselves, but we all know that it not going to be the case for some... Now there is no doubt that the system is failing BIG time... Do you have any idea you can share on how to cover most while controlling cost?
I hear you on the premiums. This is bull....
This is why I'm advocating for HSA+catastrophic insurance. Catastrophic plans usually have deductibles of $2,000-5,000/year, so unless you're having a medical catastrophe every few months. Because of this, your HSA shouldn't get knocked out entirely in one bad run of luck, as you'll hit your deductible and the catastrophic plan takes over.
I hope you get great coverage with that! Otherwise, not worth the lack of investment in bags and shooz.
I'd argue MGMA is way too high if you are talking academics. Source: my physician family members and friends, and all their contacts. In academics, getting some of those numbers if simply not possible. Exception: being very high level in some super academic position. ex. world famous chief/chairman of neurosurgery
Obviously. Academics is an entirely different animal and I have no idea what would ever possess someone to work for the slave wages that many academic appointments provide. MGMA and Medscape averages are pretty accurate for non-academic physicians that work jobs that pay something resembling real wages.
Not all academic practices pay poorly, and you don't have to be the chair to make a decent income. Make sure you understand what you're turning down before you dismiss academia entirely.
Dude, haha. It's "game, set, match."Game, match, set.
Suze Orman's show has some great advice for college grads, too. Of course, it could have also been a running typo.
This is why I'm saying employers contribute the money, not employees. It could easily be paid for by the money saved from not having to pay for comprehensive health care, and you aren't allowed to take money out of an HSA once it's in there, so they wouldn't have access to the money for anything but health care needs.
Just saying, "people will game whatever system you make, so let's keep the broken system we have" is quite defeatist. I'm not at all advocating the blue cross/blue shield system, as I'm advocating for a system of deferred HSA money and catastrophic coverage that kicks in after X number of dollars a year is spent on health care, regardless of whether it is inpatient or outpatient. There's no way to game it- patients have an incentive to visit the doctor because they can't touch their HSA money and it covers checkups and things anyway, so to them, the visit is free. Insurers can't skirt responsibility because the high deductible plan kicks in after any combination of HSA or out of pocket cash is spent that totals 5k or higher in a given plan year. It's very, very similar to the direct patient care model being utilized by some providers right now, in which employers pay for a wrap-around plan that covers everything not provided by the DPC providers, and the DPC providers are given a stipend to provide all other services- only I'm advocating for an HSA instead of a stipend to the DPC provider, because it allows the patient to control their choice of providers and services.
Money can make one like it for 15 years and then you can retire after making a ton of money...
Long time poster here under a different name, but here is an example of doing well:
I currently do very well for myself as an anesthesia attending. Two years ago I wasnt partner till most of the way through. Made 940 taxable income from the hospital. Last year will be better but dont have final numbers. Income at our group has been on the rise for the past 14 years. I firmly believe we have reached a peak for our income last year. Next year projected is >10% lower.
We take 9 weeks vacation, do 12-14 weekends per year. Payers is 45% commercial. Work ~65 hours a week average, some weeks 30, some weeks 100.
Beyond that, investment has been very good to me with a ~2-3 mil investment portfolio at 3.5 years out of residency. I honestly am waiting for a shoe to drop somewhere in my life.
Job was basically handed to me by an attending during training, with minimal to no effort, unlike the options I found when looking for myself of the following:
Hospital employee: Start and all future years hovering around 375, better hours, same vacation
Private group, more BFE: Start 280, 2 years to partner progressing to 450-550 partner depending on amount worked.
Private group urban: Start 180, 3 years to partner, progressing to 700 or so.
Private group urban: Start 225, 5 years to partner, progressing to 550 or so.
Private group urban: Every year 400.
Academic, clinician path: 350-370
A good friend in all MD model urban environment was making 750, group replaced by AMC 2 years ago with same docs having same job (now plus CRNAs) with the addition of more in house call and 2/3 the vacation for 350 MAX (earned a percent of max compensation based on very hard to meet metrics) I should note that he, and almost all the other good anesthesiologists left that practice. He was begged to come back by admin and AMC at a much better rate, but still not anywhere close to what he left. He stayed away. That hospital continues with the AMC, despite surgeons who at least tell me they are unhappy with anesthesia. Who knows what they say when I am not around.
I am doing my best to make hay while the sun is shining, and invest heavily during this point in my life. My family of 4 lives off <100k per year including debt repayment (delayed for aggressive investments) and insurances. Income is already showing signs it will begin a decline for my group, and within 5 years I expect my compensation to be 1/2 current, and that is without us being replaced by an AMC or anything like that. I do far better than any of my residency classmates financially, but also work more hours and work harder when I am there. If my comp was lower I would unequivocally work less, life is much more than money in the bank. I am stressed at work and feel wiped out when I get home many days. If I didnt love my job I would be a very miserable rich guy.
So yes, salaries have been very high in the past, and are currently very good IF you make certain sacrifices. Many are not willing to make those sacrifices. Even so, I expect the income to decline across the board at varying rates to a point where salaries are in the 2-450 range for most people. Still a great income, but not 7 figures. Most in America would actually kill for this type of salary, and I see guys complain about their low salaries or difficulty living on that, and I want to punch them.
Please do not forget that you are a very privileged person, and all these discussions about pay will only make others jealous when they find out someone has it better than them, and make the "public" who reads this forum only resent anesthesiologists more for reading it.
Oh, and on that note, the neurosurgeons I work with make as much as my total compensation in call stipends yearly, even if they never do a case
Money can make one like it for 15 years and then you can retire after making a ton of money...
You can read that post below from the GAS forum... It comes from this thread:
http://forums.studentdoctor.net/threads/7-figure-anesthesia-salaries.924608/
