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Vault Message Board: Health Care

Topic Name: life as a physician
Message Name: out of touch
Date Posted: 04/21/2001
In Reply To: I wish I could agree, but it's just not true. First of all, most professionals (outside of law, perhaps), do not come out with a quarter million dollars in loans when they are done with school and postgraduate training. So already docs are starting with pretty big debt. As for "big bucks", well, I suppose it depends on your perspective. Most generalists (pediatricians, internists) will earn somewhere in the mid $100s. Not too bad, until you figure in the monthly student loan payment, which may be a couple thousand bucks. Still better than lots of people, but not even close to what the typical consultant/ibanker/high-level exec makes. As for job security, that certainly used to be the case. Unfortunately, there are plenty of health systems who are letting docs go (look at Duke, who laid off several hundred a couple years ago). There are areas in the country that are underserved, so if you're willing to go very rural, you're set. Many of us aren't willing, or can't. There's a huge demand for obstetricians in Silicon Valley (a real doc shortage!)... Why? Well, obstetricians have to live within 30 minutes of the hospital. The median house cost in that 30 minute drive is $945K. The average starting salary for an obstetrician... $140K. Now, even without student loans, those number just don't add up. Stability? How about paycuts for every subspecialty over the past 5 years. As more people switch to managed care, the numbers go down even more. I'm a primary care doc in an urban center, and because of changes in my payor mix, my salary has DECREASED 15% each of the pasy 2 years. And I started around $140K. Not so great... And how about the fact that after a few years in practice, your salary is unlikely to increase more than the cost of living each year? Most people aren't satisfied with that. Again, I'm not saying no one should go into medicine. But it's not the same kind of career it was 20 years ago... and that's what you are describing to this kid who's gonna be entering the field in a decade!
Message: To think that doctors are being shortchanged in any way would suggest that you are out of touch with other professions and indeed out of touch with your own. Your salary is ceratinly no refelction of what a doctor should expect to earn in private practice. Due to the artificial regulation of doctors numbers, doctors find it relatively easily to open up shop privately and before long they are raking it in. A friend of mine, an opthalmologist, charges $900 to remove a cataract, a procedure that takes him about 10 minutes. There a mega bucks to be made in medicine. Go ahead lament the money your earning but I guarantee you, had you entered any other field you would have starved to death long ago! The fallacy that doctors don't make money is one promoted by the AMA so as to avoid anti-competitive scrutiny. The AMA is the strongest union in the world and should be illegal!

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