Wow Way to be Put Off

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rainbowman

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I'm a premed, but I'm posting this here because I figure you guys would know more about this than in the premed forums.

So my uncle is an ENT who does well for himself in private practice. At a recent family dinner (which included friends too) the topic somehow changed to the touchy subject of money. Eek.

Anyway, what started the vitriol is not important, only the one comment someone at the table made directed at my uncle "Yeah well I'm not a rich doctor like you."

I mean, come on. The guy's an engineer-he's not exactly starving, but my uncle does outearn him nevertheless. This is a guy who's had no shortage of opportunities in his life, went to a good college, could have majored in anything he wanted, and chose engineering. This isn't a first amendment thing, it's just my opinion that if you have countless opportunities and choose something that doesn't pay very much, that's your choice and more power to you, but what right do you have to begrudge someone because they are a doctor and to support pay decreases for physicians. I'm sorry you made bad decisions career wise but that's your problem.

Know what I'm talking about? Any similar experiences?

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We've all been there... heard that kinda thing.

In that situation, you could easily just educate the other person. Most people don't know how long it takes, how little we make through residency, how much we have racked up in student loans, the fact that your ENT uncle probably works more hours a week than the engineer, and also point out what you mentioned... everyone has their own career choices to make, etc.
 
I'm a premed, but I'm posting this here because I figure you guys would know more about this than in the premed forums.

So my uncle is an ENT who does well for himself in private practice. At a recent family dinner (which included friends too) the topic somehow changed to the touchy subject of money. Eek.

Anyway, what started the vitriol is not important, only the one comment someone at the table made directed at my uncle "Yeah well I'm not a rich doctor like you."

I mean, come on. The guy's an engineer-he's not exactly starving, but my uncle does outearn him nevertheless. This is a guy who's had no shortage of opportunities in his life, went to a good college, could have majored in anything he wanted, and chose engineering. This isn't a first amendment thing, it's just my opinion that if you have countless opportunities and choose something that doesn't pay very much, that's your choice and more power to you, but what right do you have to begrudge someone because they are a doctor and to support pay decreases for physicians. I'm sorry you made bad decisions career wise but that's your problem.

Know what I'm talking about? Any similar experiences?

Yeah, well, tell this engineer guy that if your uncle's rich, he's earned it. He went through college, med school, at least 4-5 grueling years of residency, and is now practicing. Its not like his lucrative ENT practice was just handed to him, for the love of God. Besides, your uncle's earning his income by providing health care to others. Yeah, yeah, I know, engineers are important too and deserve a good income. I'm just saying that your uncle deserves whatever income he gets.
 
It's even funnier when the nurses say crap like that . . .
 
Add this to the fact that he came here with my father with nothing from Cuba. I found it borderline offensive
 
An acquaintance of my parents, upon learning that I am a physician, remarked off-handedly, "oh, well, you two are set for life then."

My parents just kind of looked at her with mouths agape. As if 1) I would make enough to support my parents indefinitely and 2) that I am somehow obligated to do so as a physician.

The assumptions were so ignorant that they were offensive. It still amazes me how little even intelligent people know about healthcare in this nation.
 
Just because I was having a bad day the other day, when a patient, presenting for some BS complaint I don't even remember anymore, said something about how nice it must be to be a rich doctor, I countered with the statement that the woman who took his BP when he checked in and went to school for 8 months to learn how to do that, makes about the same amount of money that I do (for whatever reason, the MAs get paid really well where I am right now). Talk about jaws hitting the floor.

I don't do that kind of thing for educational purposes anymore, it's strictly to make myself feel better. I'm over it (sort of). I made my bed and now I'll lie in it. I love what I do and, hopefully, someday I'll get paid reasonably well for doing it. Beats what my parents put up with.
 
Its hard not to want to correct people. I spent a lot of time doing so with my own family (I'm the only one in medicine)...despite being well educated, intelligent people they had no idea that:

a) medical school cost so much
b) residents were paid so little and worked such long hours
c) that there was a thing called fellowship which prevented me from getting a "real job" sooner!:laugh:

Of course, now they are rather nosy with regards to how much I make, which I am less interested in educating them about (because I'm sure, despite the above, they will still think its "too much").
 
I guess it's human nature to be jealous of what you cannot or did not achieve and to do anything in your power to belittle and even diminish it. If I wanted to make probably more money in at least as much time or probably faster I'd be pre-Goldman Sachs not pre-med. My uncle has pointed this out to me-he says he sees the attitude among his neighbors it's ok if a stockbroker makes in the mid 6 figures it's standard but if it's a doctor he must be a greedy crook. I guess the only cure for ignorance sometimes is a swift kick in the ass
 
I guess it's human nature to be jealous of what you cannot or did not achieve and to do anything in your power to belittle and even diminish it. If I wanted to make probably more money in at least as much time or probably faster I'd be pre-Goldman Sachs not pre-med. My uncle has pointed this out to me-he says he sees the attitude among his neighbors it's ok if a stockbroker makes in the mid 6 figures it's standard but if it's a doctor he must be a greedy crook. I guess the only cure for ignorance sometimes is a swift kick in the ass

I would be curious as to what individuals like this think that doctors should get paid when they arrive to the ER with an acute case of appendicitis bordering on rupture and you sit there haggling with them......"Oh, I'm sorry Mr. neighbour....you see I spent 4 years in undergrad, 4 in med. school, and 5 more in a surgical residency in order to be qualified to take out out that there appendix, while you were out making money, getting drunk and fat and enjoying life. Whats that? You think x amount of dollars is exorbitent for my unique expertise and skillset? No problems.....enjoy the peritonitis.....I'm late for my golf game...." Now if it wasn't for the liars..er...lawyers...that would be my precise response in such a scenario. Wishful thinking eh?
 
For everyone posting in this thread and in the "Doctors are So Overpaid" thread, I just have to say:

Clearly doctors do a ridiculously large amount of work, have a ridiculously large amount of debt, and go through a ridiculously large amount of torture in order to become doctors in the first place. BUT it is also clear that (most) doctors make a ridiculously large amount of money.

Don't you think that ideally doctors would make half the money, do half the work, endure half the torture, and accumulate half the debt???

Don't you think that people who want to reduce doctor salaries have maybe the right idea? If doctors didn't make so much money, maybe nobody would put up with the bullsh*t, and the system would change. As it stands, med students, residents, etc., are afraid to make waves because they don't want to miss out on the money that awaits. And once they're attendings, they don't want to change the system because they've already gone through the torture and think they deserve the payoff. :mad:

In other words, doctors who defend the ridiculous salaries have become complicit in their own torture and the torture of others. It seems to me that this pattern is both totally understandable and completely unhealthy.

Why have doctors (of all professionals) created that sort of system? And don't tell me it's not the doctors who've done it. Doctors (and nurses) are the backbone of the healthcare system, and it wouldn't be that way if doctors didn't allow (promote?) it.

I'm very curious to see the response to this post...:p
 
In other words, doctors who defend the ridiculous salaries have become complicit in their own torture and the torture of others.

It's not a bad thought and probably not totally wrong. But as a brand new intern who does defend high physician salaries, I'm not sure how I (or really any other physician) is complicit in their own torture. I mean, what other choice do I have but to go through the hell that is residency if I want to practice medicine some day? And if it were possible to limit work hours further when some day I'm an attending and responsible for residents, I would probably advocate that (I mean, not like forty hours a week, but I do think 70 hours a week is reasonable and I would limit call to q4 rather than q3).
 
In other words, doctors who defend the ridiculous salaries have become complicit in their own torture and the torture of others. It seems to me that this pattern is both totally understandable and completely unhealthy.

You assume that money is what drives the system, and I completely disagree. The system is designed to create a "us-versus-them" mentality, similar to a fraternity hazing ritual. The people who are attracted to medicine, though they may appreciate and even expect the money, are primarily driven by baser notions like meeting a challenge, getting ahead, being better and different. The system would not change, even if there were less money in it.

If you really want to change the system, make it "nicer" or with fewer hours, then the best way to do that is to lower the acceptance standards. Open a thousand new schools, make the average MCAT 23 to matriculate, set the minimum GPA at 2.7. If you can attract more mediocre students, they will be the best people to push for a more lenient system. Driven people will go to great lengths to become better. Mediocre people will shape the system to fit in with their lifestyle.
 
You assume that money is what drives the system, and I completely disagree. The system is designed to create a "us-versus-them" mentality, similar to a fraternity hazing ritual. The people who are attracted to medicine, though they may appreciate and even expect the money, are primarily driven by baser notions like meeting a challenge, getting ahead, being better and different. The system would not change, even if there were less money in it.

If you really want to change the system, make it "nicer" or with fewer hours, then the best way to do that is to lower the acceptance standards. Open a thousand new schools, make the average MCAT 23 to matriculate, set the minimum GPA at 2.7. If you can attract more mediocre students, they will be the best people to push for a more lenient system. Driven people will go to great lengths to become better. Mediocre people will shape the system to fit in with their lifestyle.

So, what I'm getting from this is that you think:

(1) Doctors are better than everyone else.

(2) Working long hours, getting next to no sleep, and being unappreciated and denigrated for years is what makes doctors better than everyone else.

(3) Trying to change your environment (rather than merely accepting it and changing yourself to fit in) is what weak, lazy people do.

Is it just me, or is that really, really sad? :cry:

Doctors aren't better than everyone else. Doctors are (or should be) smart, ethical, and dedicated. To the extent that doctors are smarter, more ethical, or more dedicated than others, it's despite the form of the training that they go through, not because of it. The best people in this world are those who try to make the world a better place--and of course those are people who would never claim to be "better." The fact that you call those people "mediocre"...well, I just don't know what to say.

The one thing you say that I agree with is that med school _should_ be easier to get into. Think about it: if there were twice as many doctors in the country, each doctor could work half as much for half the salary. Med school is way too exclusive. A lot of doctors had to apply two (or more) times to get in...and yet, they did get in eventually, so obviously they're qualified. And if the system wasn't so f*cked up, maybe more people would want to go into medicine. Of course, I'm not saying (as you were) that we should let people into med school who aren't qualified. But you can't tell me that everyone who's smart, ethical, and dedicated is willing to put up with med school and residency.

I like to think that people who are smart, ethical, dedicated, and who are interested in and good at medicine should become doctors. To the extent that you think that you have to be an egotistical gunner to be a good doc, we will just have to agree to disagree, I guess. :rolleyes:

Attitudes like yours are the cause of remarks like the one the OP posted about. If you think you're better than everyone, than you deserve whatever sarcastic comments people make about you. And believe me, they'll make them.

Here's hoping your post was sarcastic and I was just too dense to see it. :laugh:
 
It's not a bad thought and probably not totally wrong. But as a brand new intern who does defend high physician salaries, I'm not sure how I (or really any other physician) is complicit in their own torture. I mean, what other choice do I have but to go through the hell that is residency if I want to practice medicine some day? And if it were possible to limit work hours further when some day I'm an attending and responsible for residents, I would probably advocate that (I mean, not like forty hours a week, but I do think 70 hours a week is reasonable and I would limit call to q4 rather than q3).

I think in part that doctor salaries are so high because there are so few doctors. The scarcity of doctors BOTH keeps wages high (free market, right?) and keeps hours long.

But also, it's exactly what you said: Once you're a resident, you want to practice medicine so you go along with the system. You advocate high salaries because you deserve a high salary for putting up with it. And I don't disagree. But high salaries attract people who are willing to do anything to get the money. Because those people are willing to do anything for the money (think Survivor;)), everyone else has to fall into line or be left in the dust. If salaries were lower, those gunners who aren't actually interested in medicine (and probably won't be good doctors anyway) would go be stockbrokers or something.

Doctors, of all people, should know that people learn best, and make the best decisions, if they (for example) get enough sleep. So why are doctors the one profession in which nobody gets enough sleep? Because the profession is competitive instead of cooperative. And I think that one big reason is the big payout at the end.

long hours = people who deserve high salaries
people who deserve high salaries = high salaries
high salaries = super-competitive students
super-competitive students = long hours

It's a vicious cycle. I don't know the solution, I just think that stupid high salaries are part of the problem.
 
I think in part that doctor salaries are so high because there are so few doctors. The scarcity of doctors BOTH keeps wages high (free market, right?) and keeps hours long.

But also, it's exactly what you said: Once you're a resident, you want to practice medicine so you go along with the system. You advocate high salaries because you deserve a high salary for putting up with it. And I don't disagree. But high salaries attract people who are willing to do anything to get the money. Because those people are willing to do anything for the money (think Survivor;)), everyone else has to fall into line or be left in the dust. If salaries were lower, those gunners who aren't actually interested in medicine (and probably won't be good doctors anyway) would go be stockbrokers or something.

Doctors, of all people, should know that people learn best, and make the best decisions, if they (for example) get enough sleep. So why are doctors the one profession in which nobody gets enough sleep? Because the profession is competitive instead of cooperative. And I think that one big reason is the big payout at the end.

long hours = people who deserve high salaries
people who deserve high salaries = high salaries
high salaries = super-competitive students
super-competitive students = long hours

It's a vicious cycle. I don't know the solution, I just think that stupid high salaries are part of the problem.
\

Wages are high because of basic economics, as supply decreases $$$ increases. But I'm glad it's so competitive. I'm glad only the most intelligent, driven, and hardworking people are allowed to become physicians. I don't want 1000s of new schools to open and standards and therefore quality to fall to the point where doctors become like lawyers, a dime a dozen.

To a certain degree however, medicine is a labor of love. There are ways of making a good living rivaling that of a doctor or surpassing it that constitutes far fewer years of postgraduate education and training. I never went into medicine because I expected to be rich. I loved chemistry, I loved interacting with people. I don't care if doctor salaries fall, but I don't want them to fall to the point where the smart people realize the money is elsewhere and less qualified people realize hey I could be a doctor, it doesn't make money anymore but it's still the same egotrip, better than anything else I could do.

I don't expect to be rich, but I expect to be fairly compensated. By this I mean I don't expect to have a lavish lifestyle, but if after all my hard work I cannot afford a nice decent sized house in a nice, safe neighborhood, a safe and comfortable car, support a wife and a couple of kids and quality food on the table on a regular basis, then that is preposterous and I will find another field. I have made a significant time investment in becoming a doctor, but I was an econ major. It's called a sunk cost. If things get bad in healthcare I might as well find something else.
 
\

Wages are high because of basic economics, as supply decreases $$$ increases. But I'm glad it's so competitive. I'm glad only the most intelligent, driven, and hardworking people are allowed to become physicians. I don't want 1000s of new schools to open and standards and therefore quality to fall to the point where doctors become like lawyers, a dime a dozen.

First, I totally agree with you that doctors deserve to make a good living. My definition of "a good living" just doesn't require $200,000 a year, much less $500,000. Personally, I think $100,000 a year is a good living, but that's just me.

Second, I totally agree with you that doctors should only be intelligent and hardworking people. And I agree with you that wages are high because of the competitive nature of the field. I also agree that it'd suck if doctors were like lawyers. ;)

BUT I think doctor quality is already below what it should be because doctors are overworked and overstressed, and because many of them don't even like medicine. Personally, I don't want to be treated by a doctor who's just in it for the money. I want to be treated by someone who is interested in medicine. I also want to be treated by someone who slept more than three hours the night before and is alert & oriented. If that person is five IQ points lower, I don't care, because at least he or she isn't so tired that I'm going to get substandard care. Is that wrong?
 
First, I totally agree with you that doctors deserve to make a good living. My definition of "a good living" just doesn't require $200,000 a year, much less $500,000. Personally, I think $100,000 a year is a good living, but that's just me.

Second, I totally agree with you that doctors should only be intelligent and hardworking people. And I agree with you that wages are high because of the competitive nature of the field. I also agree that it'd suck if doctors were like lawyers. ;)

BUT I think doctor quality is already below what it should be because doctors are overworked and overstressed, and because many of them don't even like medicine. Personally, I don't want to be treated by a doctor who's just in it for the money. I want to be treated by someone who is interested in medicine. I also want to be treated by someone who slept more than three hours the night before and is alert & oriented. If that person is five IQ points lower, I don't care, because at least he or she isn't so tired that I'm going to get substandard care. Is that wrong?

OK I'm not trying to rouse feathers here. If a doctor is in it for the money or the status, as opposed to helping people that is a problem. But I think we should be careful. Pharmaceutical companies, one can say they are very greedy entities. But they have developed very important medications. If I swallow a pill and know it will ease my pain, I don't really care if the company cares about my own well-being or just the bottom line-as long as I get my fix-er, medication.:D. Maybe that's not what you're getting at, I don't know. But I'd rather get treated by a rude and egocentric person like Dr. House than a sweet, well-intentioned yet subpar physician.

I agree with you 100% on the overworked and overstressed. If you have a solution to that let me know.
 
For everyone posting in this thread and in the "Doctors are So Overpaid" thread, I just have to say:

Clearly doctors do a ridiculously large amount of work, have a ridiculously large amount of debt, and go through a ridiculously large amount of torture in order to become doctors in the first place. BUT it is also clear that (most) doctors make a ridiculously large amount of money.

Don't you think that ideally doctors would make half the money, do half the work, endure half the torture, and accumulate half the debt???

Don't you think that people who want to reduce doctor salaries have maybe the right idea? If doctors didn't make so much money, maybe nobody would put up with the bullsh*t, and the system would change. As it stands, med students, residents, etc., are afraid to make waves because they don't want to miss out on the money that awaits. And once they're attendings, they don't want to change the system because they've already gone through the torture and think they deserve the payoff. :mad:

In other words, doctors who defend the ridiculous salaries have become complicit in their own torture and the torture of others. It seems to me that this pattern is both totally understandable and completely unhealthy.

Why have doctors (of all professionals) created that sort of system? And don't tell me it's not the doctors who've done it. Doctors (and nurses) are the backbone of the healthcare system, and it wouldn't be that way if doctors didn't allow (promote?) it.

I'm very curious to see the response to this post...:p

So where in your wonderful self-hating picture do pharma, insurance companies and HMOs fit in. Do you know they are the only ones truly profiting from this system. Why not cut pharmacists and nurses' salaries while you are at it? Did you hear they have been experiencing exponential increases in pay with reduced workload?

I don't know exactly who you are or what you do, but if you just happen to be a doctor, do not for one second think that you are the "backbone of the healthcare system", not anymore buddy. The big boys have taken over, and you are just as much a spectator as anyone else. You can probably think of yourself as a rat eating the master's crumbs, and those crumbs are getting smaller as we speak.
 
So where in your wonderful self-hating picture do pharma, insurance companies and HMOs fit in. Do you know they are the only ones truly profiting from this system. Why not cut pharmacists and nurses’ salaries while you are at it? Did you hear they have been experiencing exponential increases in pay with reduced workload?

I don't know exactly who you are or what you do, but if you just happen to be a doctor, do not for one second think that you are the "backbone of the healthcare system", not anymore buddy. The big boys have taken over, and you are just as much a spectator as anyone else. You can probably look at yourself as a rat eating the master's crumbs, and those crumbs are getting smaller as we speak.

Oh, I couldn't agree with you more. Here's my point: HMOs and insurance companies are just a bunch of paper-pushers sitting on their @sses without doctors. Doctors could do fine without HMOs and insurance companies, but HMOs and insurance companies couldn't do **** without doctors. Who should have the power to treat patients? Doctors. Why do doctors let HMOs and insurance companies run the system? Because doctors are addicted to the money.

In short, the whole system is screwed up (I think you agree with me there), and all I'm saying is that doctor salaries are a piece of the puzzle.
 
Oh, I couldn't agree with you more. Here's my point: HMOs and insurance companies are just a bunch of paper-pushers sitting on their @sses without doctors. Doctors could do fine without HMOs and insurance companies, but HMOs and insurance companies couldn't do **** without doctors. Who should have the power to treat patients? Doctors. Why do doctors let HMOs and insurance companies run the system? Because doctors are addicted to the money.

In short, the whole system is screwed up (I think you agree with me there), and all I'm saying is that doctor salaries are a piece of the puzzle.

Really? Do you think the big boys (thats what I like to call them) will be slowed down if physicians took a paycut? I actually have an answer to that: NO, because physicians have taken a huge paycut and the big boys have gotten stronger, so go figure.
 
OK I'm not trying to rouse feathers here. If a doctor is in it for the money or the status, as opposed to helping people that is a problem. But I think we should be careful. Pharmaceutical companies, one can say they are very greedy entities. But they have developed very important medications. If I swallow a pill and know it will ease my pain, I don't really care if the company cares about my own well-being or just the bottom line-as long as I get my fix-er, medication.:D. Maybe that's not what you're getting at, I don't know. But I'd rather get treated by a rude and egocentric person like Dr. House than a sweet, well-intentioned yet subpar physician.

I agree with you 100% on the overworked and overstressed. If you have a solution to that let me know.

:laugh: No, I agree, people skills aren't the key to great doctoring. But a doctor has to at least care enough about treating a patient to listen to the complaint and take it seriously.

What I hate is when doctors don't care enough to think about the problem, and just throw meds around like they're candy. I had to deal with these doctors when I was a student and had to go to my school's student health center. I'm sure they were reasonably intelligent (they were doctors, after all), but they just didn't give a **** about treating patients, and the quality of care suffered greatly.

Wrt the overworked/overstressed thing...that's what I'm trying to figure out, yeah?

Anyway, sorry for hijacking this thread. It's been fun. :)
 
Really? Do you think the big boys (thats what I like to call them) will be slowed down if physicians took a paycut? I actually have an answer to that: NO, because physicians have taken a huge paycut and the big boys have gotten stronger, so go figure.

Well, obviously, a paycut by itself doesn't solve anything. I'm sorry if I gave you the impression that I meant that cutting doctor pay, without any other chnages, would solve the problem. I'm sure the big boys would love it if doctors worked for free. What I meant is that if the system is going to change, doctors have to be willing to take a paycut as a part of that change.
 
Attitudes like yours are the cause of remarks like the one the OP posted about. If you think you're better than everyone, than you deserve whatever sarcastic comments people make about you. And believe me, they'll make them.

Here's hoping your post was sarcastic and I was just too dense to see it. :laugh:

Not sarcastic, just describing the reality. The system was created by driven people who appreciate the challenge of a physically, mentally, and emotionally demanding environment. The system is perpetuated by the same type of people. I find it amusing that you would react with shock and disgust at my comments, when anyone with three minutes of clinical experience should immediately recognize the truth in it. Are you even in medicine, or is this one more drive-by starry-eyed premed contribution?
 
Not sarcastic, just describing the reality. The system was created by driven people who appreciate the challenge of a physically, mentally, and emotionally demanding environment. The system is perpetuated by the same type of people. I find it amusing that you would react with shock and disgust at my comments, when anyone with three minutes of clinical experience should immediately recognize the truth in it. Are you even in medicine, or is this one more drive-by starry-eyed premed contribution?

Well, in the interest of full disclosure, I guess I should admit that I'm not a medical professional. I am...wait for it...the wife of a resident. That is mainly the reason for my interest in medical culture. Well, there's also the fact that I am a consumer of healthcare on rare occasions. I'm also...*gasp*...a lawyer. :eek: So if you feel that doctors are better than other people, then you may want to disregard my posts as written by someone inferior to yourself.

I hope you will at least answer this question: Was I right that you were saying that doctors are actually better than other people??? Because it sounds like that is actually what you were saying. I think (and everyone should correct me if I'm wrong) that no amount of clinical experience, or experience of any kind, would make me believe that doctors are better than other people.

With respect to the "physically, mentally, and emotionally demanding environment": I appreciate a challenge too. Sometimes I like confrontation, or working all night, or hiking up a mountain. But the thing about ordinary challenges is that you get a chance to take a break and recover before being challenged again. When you are chronically sleep deprived and constantly on the spot, eat no nutritious food, barely exercise, never have time to see your family or enjoy your hobbies, and, on top of it all, have that much responsibility, that's not a "challenge." That's torture. It's not healthy. See http://www.ap.psychiatryonline.org/cgi/content/full/28/3/221
 
Well, obviously, a paycut by itself doesn't solve anything. I'm sorry if I gave you the impression that I meant that cutting doctor pay, without any other chnages, would solve the problem. I'm sure the big boys would love it if doctors worked for free. What I meant is that if the system is going to change, doctors have to be willing to take a paycut as a part of that change.

I am not going to argue past this point with you because I already know your type, but I guarantee that people like yourself that are in the business suggesting cuts in physician income as a solution to our healthcare crisis, do so for purely antagonistic reasons, and even if every American is covered today you will not be satisfied.

I had the opportunity to work with some doctors in Europe, and some of them laugh at the illiterate assumption that American doctors have a better deal than they do. A British GP earns 100-120K pounds, which is well over $200K. In the Netherlands, a surgeon pulls well over $200K (the average for US surgeons), and you know the best part, they don't work more than 40 hours a week (by law in some cases), they don't deal with the whole malpractice drama, and they have little to no med school debt. Even in these "model healthcare systems", there are still people like you asking them to take pay cut just for the sake of it, even when it is clear their income makes up an insignificant percentage of the total healthcare expenditure. I wonder if there is a psychologist around to explain this phenomenon.
 
I am not going to argue past this point with you because I already know your type, but I guarantee that people like yourself that are in the business suggesting cuts in physician income as a solution to our healthcare crisis, do so for purely antagonistic reasons, and even if every American is covered today you will not be satisfied.

I had the opportunity to work with some doctors in Europe, and some of them laugh at the illiterate assumption that American doctors have a better deal than they do. A British GP earns 100-120K pounds, which is well over $200K. In the Netherlands, a surgeon pulls well over $200K (the average for US surgeons), and you know the best part, they don’t work more than 40 hours a week (by law in some cases), they don't deal with the whole malpractice drama, and they have little to no med school debt. Even in these "model healthcare systems", there are still people like you asking them to take pay cut just for the sake of it, even when it is clear their income makes up an insignificant percentage of the total healthcare expenditure. I wonder if there is a psychologist around to explain this phenomenon.

Okay, well, feel free to not respond to this post if you really don't want to argue. I am nonetheless going to respond to clarify, in case others may have misunderstood my comments as well.

I am not suggesting doctor paycuts "just for the sake of it." I am suggesting doctor paycuts may be necessary as part of an effort to improve doctor quality of life. I did not suggest, nor do I believe, that cutting doctor pay will make healthcare affordable. I actually suggested that this country needs more doctors, so that each doctor doesn't have to work as much, and that realistically if that happens doctors will make less money. I suggested that that might not be a bad thing.

I'm not sure what you meant when you said you know my type, and I guess that will have to remain a mystery since you are not going to respond to this post. I would also like to say, just fyi, that "ignorant" and "illiterate" are actually different words with different meanings, and I believe you meant "ignorant." Unless you think that I can't read? I assure you that I can. :p

Finally, I too would value the input of a psychologist if one is lurking...:confused:
 
I am suggesting doctor paycuts may be necessary as part of an effort to improve doctor quality of life.

How in the hell do you figure that one?
 
I am not suggesting doctor paycuts "just for the sake of it." I am suggesting doctor paycuts may be necessary as part of an effort to improve doctor quality of life. I did not suggest, nor do I believe, that cutting doctor pay will make healthcare affordable. I actually suggested that this country needs more doctors, so that each doctor doesn't have to work as much, and that realistically if that happens doctors will make less money. I suggested that that might not be a bad thing.

The problem is not one of quality of life but of standard of care. To improve the former you have to sacrifice the latter, IMHO. People want their doctor to fix them and they want them to do it RIGHT NOW (and oh, by the way, they don't want to have to pay for it either).

If you cut physician salaries in half, as you're proposing, then you won't be able to recruit and retain people willing to maintain our current standard of care. Cut my salary in half and just see how likely I'll be to stay that extra hour to take care of a patient, or see that end-of-the-day walk-in, or take call to remove someone's appendix on Christmas morning.

And it's not just a matter of numbers. If you want people to cover weekends/holidays/after hours/nights, you have to pay them a disproportionate amount of money. So training twice the number of doctors isn't the answer it may seem, because not enough are going to be willing to work those god-awful hours for half the salary.

People can complain about high physican salaries all they want, but tell them that they'll have to wait a week longer to get ABX for their viral URI because the doctor doesn't work past 3pm and you'll really see them throw a sh*tfit.
 
People can complain about high physican salaries all they want, but tell them that they'll have to wait a week longer to get ABX for their viral URI because the doctor doesn't work past 3pm and you'll really see them throw a sh*tfit.


Not only that but all those doctors who are nearing retirement would just retire a bit sooner. All those people aspiring to be physicians would go into other fields (people think that we wouldn't be able to do anything else... please).

Also, nursing, pharmacy, PAs, NPs, etc and all other house staff pay continues to go up. At they start making more than MDs/DOs for working fewer hours, people will choose to go into those fields as opposed to being an MD/DO.

Pharmacists already easily start at 100k. CRNAs can easily make $150k+. A PA or NP making over 100k isnt out of the question, yet people want doctors to take the same amount of pay despite the fact that: we generally work longer hours, we have more school loans to pay off, we actually have to do a residency, our positions are more competitive... The list really goes on.

Now I'm not saying I'm unhappy with physician pay, but it probably could be a little better. What I do know is if everyone keeps trying to take a piece of the doctors pie (insurance companies, medicare, pharm companies, patients, etc) there won't be much pie left, and sure there will still be people who want to be doctors, but the quality of physicians will also go down.

I have a friend who's 24? maybe 25 who made $170k (incl. bonus) last year in investment banking. Thats with out even having gone to graduate school yet. Sure he works a lot of hours, but so do doctors. Sure he's intelligent, but so are doctors. I'm pretty confident in saying that almost anyone who is an MD today could do what he's doing (and not to take anything away from him). By the time he's in his 30's, he'll be pushing 7 figures or more easy. At that point, if he really wants to help people, he can simply donate a portion of his wages.
 
If doctors get further pounded in the ass, I'd like to see some legislation passed limiting the money med mal attorneys can take away. They should have their own 99% tax bracket. I'm glad that assclown John Edwards has no chance of being elected. Maybe he can sue his oncologists when his wife dies of breast cancer. When I think of how that ambulance chaser made his fortune, it makes me sick. I just hope that there is a God if for no other reason than to damn him to hell.
I don't care if #5 is a resident's wife, the thought of a lawyer saying what she is saying makes my stomach churn. If my father's a cardiologist can I do an angioplasty? And you say you're a resident's wife. Poor guy. I've heard enough about physician reimbursement, but to hear it from a blood traitor. Wow. I wish I had a desk job.
 
I-banker spreadsheet jockeys make over four times the amount of money as a resident. They also make in their mid twenties what attendings make in their 30s. I find that to be ridiculous. Considering that they will end up working the same amount of hours, yet the doctor will have to deal with:
Crushing debt from 8 years worth of schooling
Reams of paperwork
The stress of having lives at stake
Lawyers circling if he slips up (this prompts needless tests and procedures to cover one's ass just in case, IMO the real cause of skyrocketing healthcare costs).

Frankly, before asking us to take a pay cut, perhaps our lawyer friend should advocate trial lawyers taking a pay cut from their usual third of a verdict/settlement. Perhaps then they wouldn't have to push for such exorbitant numbers that send malpractice premiums flying.

Or what about the insurance companies? Perhaps they should actually pay what the doctor charges them? When a doctor charges $10 for a procedure and the insurance company gives them only $2, next time the doc will charge $50.

And perhaps the Insurance company execs should take pay cuts. Instead of paying out a combined $56 million dollars in BONUSES, which is what a mid-sized insurance company did earlier this year (from what I recall in Businessweek) including $25 mil to the CEO, perhaps they should put this into reducing premiums for both patients and doctors. An extra $25 mil will do a lot more than shaving a few thousand off of a doc's salary.

And finally, how in the hell does a RESIDENT's wife get off advocating that docs HALVE their salaries? Jeez woman, he makes less per hour than working fast food!
 
Personally, I think $100,000 a year is a good living, but that's just me.

Talk to me when you are staring down the barrel of $200K of debt (or more), you're finishing residency/fellowship at 32, and you have got exactly ZERO dollars invested in your retirement.
 
Talk to me when you are staring down the barrel of $200K of debt (or more), you're finishing residency/fellowship at 32, and you have got exactly ZERO dollars invested in your retirement.

Comments like the one you're replying to are what scare me about going into medicine. Everyone has the right to their own opinion, unfortunately this includes ignorant ones as well. Good thing I'm a finance major as a backup plan. I'm not going to work my ass off in college this upcoming year to get into medical school to bust more ass to get into the residency I want and bust more ass to keep up and get a good job only to have self-proclaimed economists and healthcare experts drive my earning potential into the ground. Money isn't everything you say? Of course it's not. There are plenty of ways to make money that don't involve 10+ years of medical training. But that's the point of college right? My parents aren't paying for me to go be an English major-they want me to do business or engineering or premed so I can actually become something. My dad keeps telling me to go to college to earn a good living above all else. "What you love to do is your hobby. You can't make a living as a writer (I like writing) but you can do it in your spare time. What you're good at, assuming it pays well, is your job." I tend to agree with him, although some are disgusted at this attitude. But he's right. If you go to college and don't get a job that pays you might as well collect garbage.
If I'm going to make $100K a year as a doctor as has been suggested I'll put my love of science and helping people aside, and take my finance degree and go to wall street.
 
And you say you're a resident's wife. Poor guy. I've heard enough about physician reimbursement, but to hear it from a blood traitor. Wow. I wish I had a desk job.

Did I just get called a "blood traitor"??? :laugh::laugh::laugh::scared:
 
Frankly, before asking us to take a pay cut, perhaps our lawyer friend should advocate trial lawyers taking a pay cut from their usual third of a verdict/settlement. Perhaps then they wouldn't have to push for such exorbitant numbers that send malpractice premiums flying.

I certainly agree that the legal system has problems. And a lot of lawyers make ridiculously large amounts of money for very little work. But I do think that the med mal problem is a symptom of a society in which when bad things happen to people they have no choice but to sue because they have huge bills that they simply cannot pay in any other way. I think med mal would almost totally disappear if there was another social support system. I don't think caps are the answer. Maybe percentage contingency fees should go, but you should keep in mind that those fees don't actually increase the amount of money doctors (and their insurance companies) pay. They decrease the amount of money the patient gets.

Or what about the insurance companies? Perhaps they should actually pay what the doctor charges them? When a doctor charges $10 for a procedure and the insurance company gives them only $2, next time the doc will charge $50.

Don't get me started on insurance companies. I think we should get rid of them alltogether. But, yes, to the extent that we have to have them, I agree that they should pay what doctors charge.

And perhaps the Insurance company execs should take pay cuts. Instead of paying out a combined $56 million dollars in BONUSES, which is what a mid-sized insurance company did earlier this year (from what I recall in Businessweek) including $25 mil to the CEO, perhaps they should put this into reducing premiums for both patients and doctors. An extra $25 mil will do a lot more than shaving a few thousand off of a doc's salary.

Well, as I said, I think the insurance company execs should be fired. But in lieu of firing them, yes, I agree with a very substantial paycut. Of course.

And finally, how in the hell does a RESIDENT's wife get off advocating that docs HALVE their salaries? Jeez woman, he makes less per hour than working fast food!

Well, yeah, I was actually not advocating cutting resident salaries. I'm not totally crazy (despite what some of you may think). In fact, I think it'd be great if residents made more money...and worked significantly less.

The thing that bothers me is when people who make $200k+ a year get so offended when others suggest a paycut. It is a LOT of money. If it doesn't seem like it to you, it sure does to most Americans. And I know the job sucks in a lot of ways, and I know that you (we) have a lot of debt. And I know that it's important that the medical profession attracts intelligent people. But it bothers me that so few doctors are willing to admit that $200k is a LOT of money.

Also, if you read my posts, you might have noticed that I was NOT and have NOT advocated doctor paycuts for the purpose of reducing healthcare costs. I've advocated doctor paycuts for the purpose of reducing doctor workloads. So to your response, that doctor paycuts won't solve the healthcare cost problem, I can only say: I agree.
 
Except that the vast majority of people that advocate physician paycuts say nothing about having them work less. Makes sense, they want their healthcare with no wait and no fee.

People already complain about how long it takes to get a doctor's appointment and how long they have to wait to see the doctor and how little time the doctor spends with them. Do you really think that's going to solve people's gripes?

Don't say there need to be more doctors, you can't just snap your fingers and create more spots and schools. It takes a pretty massive infrastructure to run a medical school and most existing schools are already busting at the seams. You need a huge, centralized patient volume to teach all of these new students and residents. An effort is being made, but it's just not easy. I know two schools are opening in Florida soon, but I'm not sure how many others are in the works.

The other option is to open the FMG floodgates, but that doesn't sound any better.
 
Why reduce doctor payouts if it does not lower healthcare costs? I'm glad you think that $200K is a lot of money, but not everybody shares your values. I don't need somebody to make value judgments; just like I don't need somebody to tell me I shouldn't look at porn. I follow my own value system. If you think your husband will make a ridiculous amount of money, then give some away. But doctor paycuts- speak for yourself. People like you frighten people like me about entering medicine. This is exactly what I was talking about when I started this thread
 
Don't say there need to be more doctors, you can't just snap your fingers and create more spots and schools. It takes a pretty massive infrastructure to run a medical school and most existing schools are already busting at the seams. You need a huge, centralized patient volume to teach all of these new students and residents. An effort is being made, but it's just not easy. I know two schools are opening in Florida soon, but I'm not sure how many others are in the works.

The other option is to open the FMG floodgates, but that doesn't sound any better.

Excellent point. Making doctors takes a lot of time and money. My point is that I think that an effort is NOT being made, because doctors want the profession to stay ultra-exclusive so that salaries can stay ultra-high, as evidenced by the response I got when I suggested less work for less pay. I don't think the problem can be solved overnight. I'm just saying that if you want change (and clearly many of you don't), you should try to be flexible in figuring out how to create the change.
 
Why reduce doctor payouts if it does not lower healthcare costs? I'm glad you think that $200K is a lot of money, but not everybody shares your values. I don't need somebody to make value judgments; just like I don't need somebody to tell me I shouldn't look at porn. I follow my own value system. If you think your husband will make a ridiculous amount of money, then give some away. But doctor paycuts- speak for yourself. People like you frighten people like me about entering medicine. This is exactly what I was talking about when I started this thread

You don't think that a salary in the the top two percent is a lot?:laugh:

I am, obviously, only speaking for myself. But maybe people like you shouldn't go into medicine. So I don't really mind if I'm frightening you away. If you don't take joy in what you do, no amount of money will make you happy. And if you do love what you do, you will be happy with an income in the top, say, ten percent. So go ahead and be a stockbroker if you think you can make more money at it...and good luck to you.;)
 
Excellent point. Making doctors takes a lot of time and money. My point is that I think that an effort is NOT being made, because doctors want the profession to stay ultra-exclusive so that salaries can stay ultra-high, as evidenced by the response I got when I suggested less work for less pay. I don't think the problem can be solved overnight. I'm just saying that if you want change (and clearly many of you don't), you should try to be flexible in figuring out how to create the change.

I don't entirely disagree, I just think there's more to it than what you're saying, as I'm sure you understand. I don't believe it's just a matter of work less and make less money. There has to be flexibility from more than just the doctor's side of it.

Most people want to know that after taking out huge student loans and several years of post-graduate schooling and training, they will have a more than comfortable living for themselves and their family on top of paying back all of those loans. If there was truly a movement to reduce physician work hours, and consequently their compensation, there would need to be a corresponding effort from the government and general public to reduce the cost of medical education. It has to be give and take, an effort from both sides.

I'm all for medicine being ultra-exclusive. I should hope people don't want to produce anything less than exceptional physicians. But I think you're wrong about there being no effort to produce more doctors. The AMA (I believe) asked all med schools that are capable to increase their enrollment by 10%. My class has 16 more people than the class ahead of me for this very reason. I named two medical schools that are starting soon, I'm pretty sure there's also one in Georgia, I believe, that's going to be starting up. But the increased enrollment needs to be applied to the physician shortage that has to be fixed before there's any effort to reduce workhours. But that's a much more difficult problem to fix, as those are regional and/or specialty-specific shortages.

I just don't understand people (not referring to you) who's only argument is "cut physician pay." I think they're stupid. I want any doctor I have to go see in the future to be well-compensated. I want his/her life outside of medicine to be as cush as possible, so s/he can completely focus on my issue. I don't want the surgeon taking out my appendix to have anything else on his mind.
 
I certainly agree that the legal system has problems. And a lot of lawyers make ridiculously large amounts of money for very little work. But I do think that the med mal problem is a symptom of a society in which when bad things happen to people they have no choice but to sue because they have huge bills that they simply cannot pay in any other way. I think med mal would almost totally disappear if there was another social support system. I don't think caps are the answer. Maybe percentage contingency fees should go, but you should keep in mind that those fees don't actually increase the amount of money doctors (and their insurance companies) pay. They decrease the amount of money the patient gets.

You're kidding right? There always be greedy/jealous people & people looking to make a quick and easy buck. I'm sure you know a ton, since you're a lawyer.

Don't get me started on insurance companies. I think we should get rid of them alltogether. But, yes, to the extent that we have to have them, I agree that they should pay what doctors charge.

While the insurance companies are poorly run, there are a few good ones out there. Eliminating insurance companies would:
1) have everything run through cash or medicare (horribly inefficient)
2) eliminate consumer choice
3) drastically increase the government's financial burden for medical costs and therefore increase taxes for everyone

Well, as I said, I think the insurance company execs should be fired. But in lieu of firing them, yes, I agree with a very substantial paycut. Of course.

If anything it's Wall St. thats driving all this madness. Insurance company exces do what they please in order to keep their investors happy. If they don't meet the numbers Wall St. has projected for their company, their stock price goes down. If their stock price goes down, all those shares they own and all those options that they own go down in value.

The thing that bothers me is when people who make $200k+ a year get so offended when others suggest a paycut. It is a LOT of money. If it doesn't seem like it to you, it sure does to most Americans. And I know the job sucks in a lot of ways, and I know that you (we) have a lot of debt. And I know that it's important that the medical profession attracts intelligent people. But it bothers me that so few doctors are willing to admit that $200k is a LOT of money.

Also, if you read my posts, you might have noticed that I was NOT and have NOT advocated doctor paycuts for the purpose of reducing healthcare costs. I've advocated doctor paycuts for the purpose of reducing doctor workloads. So to your response, that doctor paycuts won't solve the healthcare cost problem, I can only say: I agree.

200k is and can be a lot of money, but keep it mind it all depends on your point of reference. In the midwest, I'm sure its a ton of money, but if you are out on the coasts (esp. california, new york, some parts of florida) 200k can easily be spent, especially if you have a family to raise. Taxes, house payment, car payment, saving up for kids college, higher costs of living, saving/investing for your own future. God forbid we want to enjoy some of the finer things in life on the side.

We're doctors, we wouldn't/couldn't be if we didn't want to help people. That's part of the beauty of the system today. Those people that really are in medicine for the wrong reasons, or that don't want to be in medicine don't really make it through. At the end of the day, almost everyone who makes it through medical school and residency wants to help people. There are plenty of ways in this country to make more money and have an easier time doing it too.

BlazerMed said:
Don't say there need to be more doctors, you can't just snap your fingers and create more spots and schools. It takes a pretty massive infrastructure to run a medical school and most existing schools are already busting at the seams. You need a huge, centralized patient volume to teach all of these new students and residents. An effort is being made, but it's just not easy. I know two schools are opening in Florida soon, but I'm not sure how many others are in the works.

:thumbup: Not to mention the time.


rainbowman said:
If you think your husband will make a ridiculous amount of money, then give some away.

Who would you trust more to donate money to a good cause: a doctor, a wall street type, a lawyer, a CEO/CFO, an entertainer/athlete, etc?

Personally, I'd take the doctor every time.

People like you frighten people like me about entering medicine. This is exactly what I was talking about when I started this thread.

Yep exactly.

It's pretty asinine that people think they can go up to someone else (that's not their employee) and tell them they need a pay cut. Try telling your electrician (insert ANY profession of your choice here) he needs a pay cut. He'll walk right out the door and tell you to find someone else.
 
You don't think that a salary in the the top two percent is a lot?:laugh:

I am, obviously, only speaking for myself. But maybe people like you shouldn't go into medicine. So I don't really mind if I'm frightening you away. If you don't take joy in what you do, no amount of money will make you happy. And if you do love what you do, you will be happy with an income in the top, say, ten percent. So go ahead and be a stockbroker if you think you can make more money at it...and good luck to you.;)

You advocate pay cuts for physicians. Obviously you are not speaking for yourself. Among most specialties doctors can set their own hours, and work less or more within a certain range. So you are advocating lowering the ceiling on doctor hours. This isn't Europe, where God forbid someone should work more than 3 hours a day

People like me shouldn't go into medicine? Here we go again with value judgments. Well, since that's not coming from a doctor I'll take that with a grain of salt.

And I never said I don't take joy in what I do-or will do, since I'm a premed. I just don't need someone telling me, a future physician, how much money I should earn based on what they think is fair. This is someone who went to law school, three years of postgraduate education, talking down to premeds, med students, residents, and doctors alike who, when they have finished their education have 3 sometimes 4 times as many years of postgraduate training as you. I was an Eagle Scout. I volunteer in hospitals. I care about people. But medicine is a business. Becoming a doctor should not be tantamount to taking a vow of poverty.

Oh and a laugh after asking me a rhetorical question. Top 2 percent of the entire nation is what I believe that statistic represents. If it was top 2% of all people specific to my demographic-i.e. holding professional/graduate degrees with years of hands-on training, I would indeed be a greedy bastard. But it's not.

This argument has been made many times before, it's like atheists arguing with catholics and the like, the same things being repeated over and over. But I will say it again-get off your moral high horse. Please come down from your ivory tower, we're tired of shouting up at you.

I will be happy with an income in the top 10% if I enjoy what I do? Maybe for you. And maybe for me, but that's something for me to figure out. Let's just remember that opinions are not inherently right or wrong.
 
You're kidding right? There always be greedy/jealous people & people looking to make a quick and easy buck. I'm sure you know a ton, since you're a lawyer.

Sure there will be, but I, naively optimistic as I am, believe that most people don't sue because they're greedy. I'm sure a lot of people have bad outcomes and could sue but don't because they like their doctor. Anyway, I might actually support eliminating med mal as a cause of action if people had another way to cover them in case of emergency.

While the insurance companies are poorly run, there are a few good ones out there. Eliminating insurance companies would:
1) have everything run through cash or medicare (horribly inefficient)
2) eliminate consumer choice
3) drastically increase the government's financial burden for medical costs and therefore increase taxes for everyone

1) I'm sure there could be a more efficient system, if we could get enough support and funding.
2) Consumer choice? I got to choose between three insurance companies, each of which covered the same procedures, with slightly different premiums and copays. Consumer choice does not exist for the vast majority of us.
3) Yes, absolutely. Personally, I think it'd be worth it.

If anything it's Wall St. thats driving all this madness. Insurance company exces do what they please in order to keep their investors happy. If they don't meet the numbers Wall St. has projected for their company, their stock price goes down. If their stock price goes down, all those shares they own and all those options that they own go down in value.

:thumbup:

200k is and can be a lot of money, but keep it mind it all depends on your point of reference. In the midwest, I'm sure its a ton of money, but if you are out on the coasts (esp. california, new york, some parts of florida) 200k can easily be spent, especially if you have a family to raise. Taxes, house payment, car payment, saving up for kids college, higher costs of living, saving/investing for your own future. God forbid we want to enjoy some of the finer things in life on the side.

You're totally right. I was not thinking about those who live in NYC, etc. That is a very good point.

We're doctors, we wouldn't/couldn't be if we didn't want to help people. That's part of the beauty of the system today. Those people that really are in medicine for the wrong reasons, or that don't want to be in medicine don't really make it through. At the end of the day, almost everyone who makes it through medical school and residency wants to help people. There are plenty of ways in this country to make more money and have an easier time doing it too.



:thumbup: Not to mention the time.

I sure hope you're right.

Who would you trust more to donate money to a good cause: a doctor, a wall street type, a lawyer, a CEO/CFO, an entertainer/athlete, etc?

Personally, I'd take the doctor every time.

Personally, I'd prefer not to rely on others to donate money, whether they be doctors, lawyers, or anyone else. That said, you can bet your *ss that we will be donating a good portion of our money if ever we should have some.

It's pretty asinine that people think they can go up to someone else (that's not their employee) and tell them they need a pay cut. Try telling your electrician (insert ANY profession of your choice here) he needs a pay cut. He'll walk right out the door and tell you to find someone else.

Oh well, it was just a suggestion. The thing with other professions though, be it electricians or lawyers, is that you _can_ find someone else who _will_ charge a different amount. And most lawyers will definately work with you on the fees if your case is good enough.
 
Sure there will be, but I, naively optimistic as I am, believe that most people don't sue because they're greedy. I'm sure a lot of people have bad outcomes and could sue but don't because they like their doctor. Anyway, I might actually support eliminating med mal as a cause of action if people had another way to cover them in case of emergency.

If that is the case, please explain to me why every single doctor going into OB/GYN can expect to be sued at least once in their lifetime? And please don't say they're all bad doctors. In addition to the reasons listed above, I also forgot: the need to blame someone else for your own problems. I.e. the mother who smokes, does drugs, doesn't show up for her prenatal visits and has a child with deformities, turns around and sues her OB physician. Happens everyday in the US.


1) I'm sure there could be a more efficient system, if we could get enough support and funding.
2) Consumer choice? I got to choose between three insurance companies, each of which covered the same procedures, with slightly different premiums and copays. Consumer choice does not exist for the vast majority of us.
3) Yes, absolutely. Personally, I think it'd be worth it.

1) Yes and that probably would take years at the very minimum to even setup a system like that, but keep in mind that most things run on a large scale tend to be inefficient, and most things run by the US government tend to be inefficient. Now you're thinking that the US government can realistically run something on a large scale? :laugh:
2) Different insurance companies cover different diagnoses, charge different amounts, have different medications on formulary, etc. It comes down to more than just price, and plenty of consumers (when diagnosed with less common medical problems), will and do shop around for the insurance company best for them.
3) Take your pick: Canada, or nearly any European country would be a more suitable place for you. If there's one thing American's hate: its taxes.

I live in one of those towns thats consistently in the top 25 zip codes in the US as far as median salary, housing prices etc. Most people here are exceptionally educated, are smart enough to decide on the issues for themselves etc, but at the end of the day when it comes to it most people here (around 90%) would vote republican simply because of that: the taxes (and this is in California too... which is considered a blue state).


Instead of telling doctors they make too much, why not use that lawyer power to go after the crooks on Wall St?

You're totally right. I was not thinking about those who live in NYC, etc. That is a very good point.

Personally I'm not the type to live in a big city. I'd rather just live close to one, but a doctors salary compared to others in a larger city pales in comparison to those who are educated a similar amount, work similar hours, etc.

I sure hope you're right.

I'm guessing part of your frustration with medicine right now is that your husband's a resident and you see his frustration at times. You also see how much time he spends working/training, and any crap he has to take at the hospital. That in turn affects you indirectly, so you're reaching out to us in a means to discuss your situation.

If you think that by increasing the number of doctors in this country, reducing the work hours, and decreasing physician salary will lead to change for the better you're mistaken. There's plenty doctors have to go through even after completing residency (even if they work 40 hours a week) that they need to be prepared for: a patient losing his/her life, complications related to medicine, and patients who you simply can't treat with current therapies, etc. We're compassionate people, that's why we go into medicine. But if anything the training we go through keeps us in check, and prepares us for the situations I've just listed. A doctor has to be strong when everything around him/her really isn't.

No matter how many med schools there are in the US, how easy it is to get into med school, how little/how much doctors make, how many hours we work: we all will still face many of the above situations. The training might be more regulated now (as far as avg hours / week in residency), but the fraternity aspect of medicine will not change for a while, if ever.

Oh well, it was just a suggestion. The thing with other professions though, be it electricians or lawyers, is that you _can_ find someone else who _will_ charge a different amount. And most lawyers will definately work with you on the fees if your case is good enough.


You can also find a doctor who will charge a cheaper rate. You can find different doctors who accept different insurances. Now while you might be able to find them (in any profession), they're also more likely to be busier. They might not necessarily be better either. But a lot of what you implied and other people implied is that doctors as a whole need to take a pay cut. If you honestly think we make too much money: do it the American way --> vote with your pocketbook.

Stop contacting the services of any type of doctor. If we don't have enough patients, by market forces alone, our salaries will go down.

I personally think the people that the vast majority (95-99%+) of the people that work on Wall St are crooks. I will never pay or let any of them manage my money. Can I force other people to do the same? No. Will I tell anyone else that they should follow my footsteps? Nah.

You're a lawyer. I'm sure you've seen some things that would help break the naivety I sense in a lot of your posts. I don't know how much you've worked, what type of law you are specializing in, or if you are currently working. But I do feel like some of what you are saying applies to the real world, and is in part just a pipe dream.

Please don't take that personally. You seem like a good intentioned person, and I obviously don't know you aside from that.
 
Let me also add that over the last 10-15 years doctor's salaries have steadily declined. Inflation has also steadily gone up (about 3% / year depending on your source and how much you believe them).

1 + 2 = double whammy.

Very few other professions in the US can even make such a claim.

We're also starting to see the effects of this.

While I don't have a source, I wouldn't doubt doctors have also been gradually working more hours to compensate over that time period (while they still can't fully compensate for it as avg salaries have still gone down).

Med school applications / year continue to go down (especially if you consider the number of applications per capita). Are there less people that have the desire to help others? No. The opportunity cost for those going into/wanting to go into medicine just hasn't kept up.

Now we could potentially slash doctor salaries by a huge amount: but expect a much greater number of foreign medical grads to fill the ranks. Most people wouldn't want that either.
 
First, mgdsh, thank you for your consistently thoughtful responses.

If that is the case, please explain to me why every single doctor going into OB/GYN can expect to be sued at least once in their lifetime? And please don't say they're all bad doctors. In addition to the reasons listed above, I also forgot: the need to blame someone else for your own problems. I.e. the mother who smokes, does drugs, doesn't show up for her prenatal visits and has a child with deformities, turns around and sues her OB physician. Happens everyday in the US.

Well, like I said, that support network isn't there. If someone has a kid with profound disabilities, they're suddenly faced with the prospect of paying for a ton of medical bills, therapists, a nursing home, etc. There is simply no support network for the parents; they are overwhelmed, don't know where to turn, and so they go to a lawyer. And of course, doctors _do_ make mistakes. Good doctors make mistakes too, once in a while. And nurses make mistakes. But you're right that some (but not the majority of) litigation is based on greed or spite or some other improper motive.

1) Yes and that probably would take years at the very minimum to even setup a system like that, but keep in mind that most things run on a large scale tend to be inefficient, and most things run by the US government tend to be inefficient. Now you're thinking that the US government can realistically run something on a large scale? :laugh:
2) Different insurance companies cover different diagnoses, charge different amounts, have different medications on formulary, etc. It comes down to more than just price, and plenty of consumers (when diagnosed with less common medical problems), will and do shop around for the insurance company best for them.
3) Take your pick: Canada, or nearly any European country would be a more suitable place for you. If there's one thing American's hate: its taxes.

1) Yes, you're right. I think it could, if the right people were running it, which they aren't.
2) Well, I did a ton of research into my three choices, which took a long time, many calls to the insurance companies, etc., but I don't have any major medical issues. So maybe it's different in some cases.
3) Awww, but I like this country, heaven only knows why.

Instead of telling doctors they make too much, why not use that lawyer power to go after the crooks on Wall St?

Well, first of all, the crooks on Wall Street only steal from rich folk, and I don't mind that as much for some reason. Second, of course, is the fact that I like seeing my husband once in a while. I don't really care whether stockbrokers have time off. ;)

I'm guessing part of your frustration with medicine right now is that your husband's a resident and you see his frustration at times. You also see how much time he spends working/training, and any crap he has to take at the hospital. That in turn affects you indirectly, so you're reaching out to us in a means to discuss your situation.

Oh, absolutely.

If you think that by increasing the number of doctors in this country, reducing the work hours, and decreasing physician salary will lead to change for the better you're mistaken. There's plenty doctors have to go through even after completing residency (even if they work 40 hours a week) that they need to be prepared for: a patient losing his/her life, complications related to medicine, and patients who you simply can't treat with current therapies, etc. We're compassionate people, that's why we go into medicine. But if anything the training we go through keeps us in check, and prepares us for the situations I've just listed. A doctor has to be strong when everything around him/her really isn't.

Really? I think you're wrong that the training helps, actually. Well, no, I shouldn't go that far. I mean that the aspects of the training that I am talking about (lack of sleep, ridicule, poor diet, etc.) don't help with that. What does 80 hours a week prepare you for that you couldn't get in 60 hours a week? Other than sleeplessness? I think chronic stress is something that you should prepare for by trying to relax, rather than by putting yourself into more chronically stressful situations. The more stress you have (once you reach critical mass), the less efficient, healthy, intelligent, etc., you will be. How can that be good???

No matter how many med schools there are in the US, how easy it is to get into med school, how little/how much doctors make, how many hours we work: we all will still face many of the above situations. The training might be more regulated now (as far as avg hours / week in residency), but the fraternity aspect of medicine will not change for a while, if ever.

I know...what I am hoping for is that it will change in a while, rather than never. I'm not so foolish as to think it will change by tomorrow.

You can also find a doctor who will charge a cheaper rate. You can find different doctors who accept different insurances. Now while you might be able to find them (in any profession), they're also more likely to be busier. They might not necessarily be better either. But a lot of what you implied and other people implied is that doctors as a whole need to take a pay cut. If you honestly think we make too much money: do it the American way --> vote with your pocketbook.

Stop contacting the services of any type of doctor. If we don't have enough patients, by market forces alone, our salaries will go down.

Well...the thing about medicine of course is that everyone needs it. And its because of the fact that it's so heavily regulated that I can't take care of my medical needs without a doctor. If I need antibiotics, I can't just make them in my kitchen. :( Its a monopoly. Our government is _supposed_ to regulate monopolies because market forces cannot regulate them.

You're a lawyer. I'm sure you've seen some things that would help break the naivety I sense in a lot of your posts. I don't know how much you've worked, what type of law you are specializing in, or if you are currently working. But I do feel like some of what you are saying applies to the real world, and is in part just a pipe dream.

Please don't take that personally. You seem like a good intentioned person, and I obviously don't know you aside from that.

No, I admit that I'm hopelessly naive, and I'm afraid that will never change. When I see what I perceive to be a problem, I can't help but try to figure out ways to improve it. It's sad, really, because I am well aware that the majority of Americans either don't understand or don't care. Or both. Ah, well. :rolleyes:
 
Med school applications / year continue to go down (especially if you consider the number of applications per capita). Are there less people that have the desire to help others? No. The opportunity cost for those going into/wanting to go into medicine just hasn't kept up.

I have only anectdotal evidence for this, but I do believe that a number of well-qualified candidates choose not to go to med school because they simply don't want to work in that fraternal environment.
 
I have only anectdotal evidence for this, but I do believe that a number of well-qualified candidates choose not to go to med school because they simply don't want to work in that fraternal environment.

I don't doubt that there are some indeed.

If you don't mind me asking what field is your husband doing residency in? If I had to guess I'd say surgery.

Let me also add by saying that there are several other fields that have similar or worse environments:
- the military
- football (ANY level), you probably could add a lot of major sports in this category as well
- wall st. / investment banking
- i wouldn't put it past some law firms as well
 
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