Salary of Doctors on Decline?

[McGillGrad]

You are missing the point.

It is not about declining salaries due to natural reasons. It is about declining salaries coupled with declining quality of care in order to create profit for HMO's who make money at the patient's expense.

If we made less while the quality of care increased, it would not be a problem. The problem is that the money we are losing is going to increase the MULTI-MILLION dollar executive salaries of HMO goons.

I never understand the regular complaints against declining physician reimbursement/earning rates. If you wanted to make money and be material successful why go into medicine? The brain power and effort of medical education could have been more efficiently applied to business ventures if this was your goal. Don't bother posting the responses about need to pay medical bills and about "compensation", I feel they hold little weight. No one begs us to go through the education and paying off loans is never impossible (perhaps it becomes so when one feels they are entitled to multiple "luxuries" as a professional)

---

Members don't see this ad.

 

[gungho]

Wonderful article.

I certainly support Dr. DeGroote's premises and thrust of his article-very well-written. However, I wonder about one of his points. In his calculation of the Cost Correction Factor, he takes into account "salaries" which I presume include physician salaries, but not bonuses. He then laments the low profit levels that accrue to his practice and wonders about the wisdom of a surgeon who would operate for such a low profit return. However, it would seem that if he has included salary in his calculation of costs, then he has already been paid, and the profit would then be part of the bonus as well as investment in the practice, etc. Again, I heartily endorse the intent of the article, just wondered about that possible discrepancy.

 

[Miami_med]

You are missing the point.

It is not about declining salaries due to natural reasons. It is about declining salaries coupled with declining quality of care in order to create profit for HMO's who make money at the patient's expense.

If we made less while the quality of care increased, it would not be a problem. The problem is that the money we are losing is going to increase the MULTI-MILLION dollar executive salaries of HMO goons.

I don't know about you, but I think the problem IS me losing money, regardless of whether the CEO makes money or not.

 

[simpler2]

I don't know about you, but I think the problem IS me losing money, regardless of whether the CEO makes money or not.

McGillGrad, apparently I'm not missing the point. Physicians I hear are complaining about their earning decline, not about the managed care roots of such declines. I would think those complaining of declining reimbursement/salary are glad to accept the evils of managed care b/c alternatives to free market medicine = even less money to physicians. I rarely hear those in favor of universal care complaining about managed care reducing their income, generally they are focused on overall waste of resources and diminished quality of our health care system.

 

[yaah]

The other problem is that as salaries decline, fewer qualified people aspire to enter the field and choose others. This is very unhealthy for the future of medicine as a profession, obviously.

 

[mdjobexchange]

Doctors do complain a lot about poor reimbursement. Dentists have done a much better job of dealing with poor reimbursement. Basically, they say that dental insurance is the patient's insurance and they charge for their services when rendered and the patient collects the pittance from the insurance company. Physicians would do much better if they behaved like dentists, which is basically what Dr. Degroote suggests.

The problem is that physicians are really in a bad spot in our society. We finish up training at an average age of 31 or 32 with piles of debt (average $130,000). Our society tells us that doctors are rich and should have a huge house, fancy car, and all kinds of gadgets. By age 35, most doctors are mired in debt and have to accept whatever crumbs the managed care companies wish to throw us.

It is going to take a major shift in physicians' attitudes to change this situation. If we can finish residency, rent a place to live, and save some money, we could potentially throw off the shackles of managed care. By having six months of living expenses in the bank, a doctor could tell an HMO to take their $350 bucks for a hernia repair and shove it.

Given the fact that most of us are going to live until 85, a few more years of Top Ramen would not be that bad....if the trade-off is independence. My wife and I are doing exactly that. She joined a very poorly run gynecology practice and we are saving every dime for her to start her own practice. Her partner is almost broke and will take whatever fee schedule an HMO shows her. They recently got an "expert" to look at their reimbursement and their insurance reimbursement was less than medicaid. Of course, she cheaped out and wouldn't pay the guy $300/hr to renegotiate them because she thought he was ripping her off.

 

[FutureeMD]

I never understand the regular complaints against declining physician reimbursement/earning rates. If you wanted to make money and be material successful why go into medicine? The brain power and effort of medical education could have been more efficiently applied to business ventures if this was your goal. Don't bother posting the responses about need to pay medical bills and about "compensation", I feel they hold little weight. No one begs us to go through the education and paying off loans is never impossible (perhaps it becomes so when one feels they are entitled to multiple "luxuries" as a professional)

I am only a pre med, but if your title of "missing the point" is talking about you missing the point, then I couldn't agree more. I think the point of the majority of post that I read here mainly shows frustrations concerning insurance companies making medicine no longer profitable. I understand being selfless and what not...but that don't pay the rent, your loans, nor does it feed your family.
At the end of the day, Doctors work hard and should be compensated accordingly without them having to go through relatively extreme measures. I think they already make enough sacrifices without needing to have their financial future jeopardized simply because insurance companies want more profit.
That is just my understanding of the issue.

 

[simpler2]

I am only a pre med, but if your title of "missing the point" is talking about you missing the point, then I couldn't agree more. I think the point of the majority of post that I read here mainly shows frustrations concerning insurance companies making medicine no longer profitable. I understand being selfless and what not...but that don't pay the rent, your loans, nor does it feed your family.
At the end of the day, Doctors work hard and should be compensated accordingly without them having to go through relatively extreme measures. I think they already make enough sacrifices without needing to have their financial future jeopardized simply because insurance companies want more profit.
That is just my understanding of the issue.

Read back to the previous response on how doctors choose the work they have to undergo. I would further say that it is a privilege, not a burden, to go through med training and become a physician.
Thanks for further clarifying the argument I was making, you have only begun your training and are already upset about declining income. I'm not saying that managed care is not destructive. I do think it is absurd when the wealthy complain about "paying the rent" or "feeding your family". I find this way of thinking absurd but more importantly disrespectful to the majority of the patient population (who really do have trouble paying rent, bills, or FEEDIng your family).
If you want to chase money, have fun, but please don't justify the endeavor by claiming hardship.

 

[FutureeMD]

Read back to the previous response on how doctors choose the work they have to undergo. I would further say that it is a privilege, not a burden, to go through med training and become a physician.
Thanks for further clarifying the argument I was making, you have only begun your training and are already upset about declining income. I'm not saying that managed care is not destructive. I do think it is absurd when the wealthy complain about "paying the rent" or "feeding your family". I find this way of thinking absurd but more importantly disrespectful to the majority of the patient population (who really do have trouble paying rent, bills, or FEEDIng your family).
If you want to chase money, have fun, but please don't justify the endeavor by claiming hardship.

I'm not upset about declining physician income, I don't need it. However, I am upset that physician's income are being chipped away for no particular reason that benefits the patient. If the decline in income led to better patient care, I'd be all up for it. But the truth is that it doesn't go towards better patient care. Pls correct me if I'm wrong. Finally, private prasctice medicine is at the end of the day a business, and it must stay afloat. So I don't blame those who are concerned about it.

 

[wanabdoc]

Again, is there any statistical evidence to prove that claim? A link would be great.

Here is what I found using data from the AMA at my medical school library (these numbers are inflation adjusted, pre-tax, post-expenses - insurance, office staff, etc)

Physician Salary trends


It is important to understand reimbursement rates and take home pay. Reimbursement rates may go down, but physician salaries could stay the same by seeint more patients, handing off some work to other practitioners, etc.

 

[Law2Doc]

Here is what I found using data from the AMA at my medical school library (these numbers are inflation adjusted, pre-tax, post-expenses - insurance, office staff, etc)

Physician Salary trends


It is important to understand reimbursement rates and take home pay. Reimbursement rates may go down, but physician salaries could stay the same by seeint more patients, handing off some work to other practitioners, etc.

As I pointed out to you on another thread, here is a NY Times article citing a study of the decline of physician salaries over the latter 8 years of your data. In the article the Chairman of the AMA seems to be agreeing the trend is down, not up. So your data may be skewing things by starting a decade too early. http://www.nytimes.com/2006/06/22/b...gin&adxnnlx=1196542865-DDQ7laJbXmKGjh4Qv7kkXA