| Topic Name: |
life as a physician |
| Message Name: |
Accuracy Please! |
| Date Posted: |
04/28/2001 |
| In Reply To: |
The actions of the AMA are notoriously anti-competitive. The barriers to entry are often arbitrary and do not reflect ability. In Australia, where I'm from, to get in to certain specialties you have to wait for a practicioner to either retire or die. I think that more doctors would alleviate the shortage crisis and ensure that, through competition, medical service improves.
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| Message: |
Please use facts to support your comments. You seem to have a warped understanding of the medical profession, as well as the AMA.
First of all, the AMA has nothing to do with the requirements to practice medicine in Australia. In America, the AMA does not control the physician licensure process. To become licensed in the U.S., you must pass licensing exams (taken in 3 parts over several years) and complete a year in an accreditted residency program (although virtually all docs now train for an additional three to eight years after medical school). The National Board of Medical Examiners prepares the examinations, the AMA does not. The American Association of Medical Colleges and the Liason Committee on Medical Education are the main determinents of medical education requirements, although the 125 U.S. medical schools generally maintain their own admission standards.
Residency programs are accreditted by Residency Review Committees to ensure that standards are being met...otherwise the program will go on probation or be closed down. The federal government is the main driver in the amount of physicians being trained in the U.S., as Medicare foots the bill for much of the training expenses.
Of course, not all MDs are competent, some bad apples slip through. And some applicants that would make great MDs don't make the cut. However, the current process is fairly effective.
As for physician incomes, the AMA conducts an annual survey of physician incomes and releases it to the media. These survey results are very consistent with the results of other compensation surveys independent of the AMA. There is no conspiracy.
Primary care physicians earn an average of about $135,000. Starting out, a physician may make significantly less than that.
Physicins also work more hours than most other professions, roughly 60 hours a week on average. Also, physicians in many fields have little control over their schedule. If a patient needs your help, you may need to go to the hospital or office, even at 3 AM on a Sunday.
In addition, the opportunity cost of medical school and residency training is enormous. The average student debtload is now at about $100,000 and growing at aobut 6% a year. The opportunity cost of 7 to 12 years of education rather than working is enormous, especially when adjusted for net present value. In addition, the training process is extremely rigorous, leaving little time for other pursuits during those years. For example, the average surgery resident works roughly 100 hours a week.
Physicians also have considerable continuing medical education requirements. Physicians must spend many hours and dollars continually taking courses and going to conferences to maintain their certification.
Physicians have much higher liability exposure than other professions. OB/GYNs, for example, pay an average malpractice premium of about $100,000 a year. Physicians also work in one of the most dangerous professions, as there is high risk of infectious disease exposure, violence, and contaminated blood needlesticks.
Physicians work in one the most stressful occupations. Your patients will die, and you will question whether you could have done anything differently.
There are many, many rewards in becoming a physician. For some people, it is probably the most gratifying and fulfilling profession there is. Most physicians are aware of the advantages and disadvantages of the profession, and are very satisfied with their choice.
However, it is absurd to propose that a person become a physician for financial reasons. With all the effort and sacrifices needed, the payoff will be much higher in other fields, such as investment banking or consulting.
I am an MD/MBA student. I have all of my options in front of me, and there is no question that I will be a much wealthier man if I entered the business world. However, I plan to become a clinician, for many reasons, not of them financial.
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