My doctor basically just fired me

[iheartscience]

To springboard off the education tangent, what would be so bad with an iq based educational system? Are you afraid your child wouldn't succeed in that type of system? that's pretty much the basis of higher education. Regardless of iq or performance, children can be motivated to learn, whereas a sick cancer patient can't just be motivated to get better. I'm not saying that teachers are not necessary, because they absolutely are. but why is it that we are accepting of public employees like teachers and policemen and firefighters fighting for their right to an appropriate amount of pay and benefits for the work they do but not ok with when doctors and other healthcare professionals? they don't have a union fighting for their rights and if they do it is severely underrepresented. I don't see the general population being outraged when teachers demand more pay, like you say they do.

You don't? Then you really just haven't been paying attention. I don't mean that to be nasty, but it's been all over the news for the last several years. For some reason teachers have become the punching bag of the right. So have all public employees, for that matter.

ETA again: What would an appropriate amount of pay be for physicians, BTW? How much money would they need to be fairly compensated? The vast majority of physicians make many times over the salary of a teacher, policeman or firefighter.

ETA and an IQ based educational system would be rife with discrimination. IQ tests are made for white, middle class test takers. In fact, CA banned the use of IQ testing altogether for some time because they had such issues with discrimination, where non-white children were being put into special education classes at a much higher rate than white children based on population proportions. I took a class on tests and measures in undergrad, and the takeaway was that research shows that IQ tests are very flawed.

 

[iheartscience]

my humble opinion. most professions could list how they are overworked, under appreciated, spent years becoming educated or trained, had to obtain loans for their education and the list goes on. respect is due all but few get it. i personally feel that doctors have been well respected until the last few years. maybe they are going to have to accept what others already have. they are not immune any more than others. everything has gotten out of hand. it is time for reason. just something to think about.

most jobs bring something to the table. while doctors are important they would have a hard time doing their job without power, water, plumbers, nurses, janitors, store clerks, restaurant workers and the list goes on. many workers are on call 24/7. no one is above the other. at least, that is how i was raised. our country has many who feel entitled. that attitude is not what brought us to where we once were. hard work and pride in a job well done seem to me to be the things that helped this nation grow and prosper. i hope we all can do some self examination and get back to those values. sorry for the preachy sounding post but this is something i think of often.

No one said doctors were better or "above" others. But come on, do you really think a janitor, waiter, etc. should get paid the same as a doctor? How would that work exactly?

Doctors have plenty of specialized training, so I think it is fair that they make more money than say, a waiter without a college degree. But your tone here is pretty condescending towards janitors and waiters. They work just as hard for their money as a doctor does-maybe harder.

 

[Mico]

Before the whole community starts to argue of what job deserves what, I'd like to share an interesting article for your review: http://benbrownmd.wordpress.com/

A couple quotes if you don't want to click the link:

Physicians spend about 40,000 hours training and over $300,000 on their education, yet the amount of money they earn per hour is only a few dollars more than a high school teacher. Physicians spend over a decade of potential earning, saving and investing time training and taking on more debt, debt that isn’t tax deductible. When they finish training and finally have an income – they are taxed heavily and must repay their debt with what remains. The cost of tuition, the length of training and the U.S. tax code places physicians into a deceptive financial situation.

During residency, if one makes payments of $1,753 per month, or $21,037 per year, to pay off the accruing interest, thier debt will be still be $300,527 at the end of residency. However, they will have spent $63,111 over the course of a 3 year residency or $126,222 over the course of a 6 year residency to keep their debt from growing. Though paying off the interest during residency is the responsible thing to do; coming up with $21,037 each year from one’s net pay of $40,000 may be quite difficult.

Time spent training, student loan debt and the U.S. tax code makes the income of physicians deceiving. A board certified internal medicine physician who is married with 2 children, living in California and earning the median internist annual salary of $205,441 will be left with $140,939 after income taxes and $106,571 after student loan payments.7 This is assuming a federal Income tax rate of 28%, California state income tax rate of 6.6%, Social Security tax rate of 6.2% and Medicare tax rate of 1.45%. You can go to www.paycheckcity.com to get an idea of what one’s net pay would be for different incomes, states of residence, marital status, number of children, etc. Paying off a debt of $369,425 over 20 years at a 7% APR will require annual payments of $34,368. Those student loan payments will continue to consume about $34,000 of their net income for 20 years until they are finally paid off. What started off as $300,527 in student loan debt will end up costing $687,360. This debt that consumes one-fourth of their net income for 20 years wasn’t accrued because they bought a house they couldn’t afford – it is because they chose to become a physician.

Before this goes on, I want to clarify that kenny initially said this was a highly recommended doctor which he had to be put on a waitlist to even SEE initially. I conclude from this that this isn't a money hungry doctor but one whose patient's trust and actually RECOMMEND to others.

I can assure you, with my 80+ hour weeks, 50k wages, 2 deferred loans (FOR SCHOOL) - 3 currently in repayment, hand me down car and a life where I've had 8 days off in the past 2 months that I wouldn't be doing this if I didn't love this job and have a hope that I would be out of the negative from my school loans when I'm at least 40. How anyone say that I should put up with this because it's "just the way it is," and I should have "known it was like this," before going into the field is insulting. It's behavior such as this where it's EXPECTED someone will cater to another that brings up so much animosity and hate in our society, I don't know why PS is allowing this conversation to continue.

Before bashing an entire profession, one should attempt to understand it. I am taking most of these comments personally and feel sorry for those of you who haven't had positive experiences with doctors you can trust.

 

[rosetta]

Mico, it kind of makes you wonder why we ever sacrificed so much for so little, doesn't it?

I'm often asked by teachers, friends to talk about medicine as a profession to young minds. I'm afraid I no longer sugar the pill. I tell them the hard truth, how long they will work, how many significant moments in their families' lives they will miss, how much abuse they will take (I remember my days in the ER all too well!) and how respect for our profession is sadly eroded.

If they still want to go through with it, I'm supportive. However, it's not surprising that the less than rosy reality of it all does change a lot of minds. I'm sad that some brilliant minds I know will never be doctors, but I'm satisfied that they made a much more informed choice before embarking on a very hard journey. Truly, there is no other reason I stay working other than my commitment to my patients. Everything else has worn me down. Please try not to take the awful comments made by some on this thread personally though. As kenny says, people vary! And I say: having thick skin is really handy!

 

[pandabee]

You don't? Then you really just haven't been paying attention. I don't mean that to be nasty, but it's been all over the news for the last several years. For some reason teachers have become the punching bag of the right. So have all public employees, for that matter.

I should have worded that better. I have seen it in the news but it is not the same sort of outrage and general appallment that I am seeing here.

ETA again: What would an appropriate amount of pay be for physicians, BTW? How much money would they need to be fairly compensated? The vast majority of physicians make many times over the salary of a teacher, policeman or firefighter.

How do you really determine a proper amount of pay for people who save lives? Not saying this to be snarky, just putting that thought out there. Obviously policemen and firefighter and armed forces and the like are all in this category of "life savers"...do I think they deserve to be paid more than they are? Absolutely. However in regards to your point with the janitors: pay is not only determined by amount of work put into a person's career, but the expertise and knowledge required to perform said job.

ETA and an IQ based educational system would be rife with discrimination. IQ tests are made for white, middle class test takers. In fact, CA banned the use of IQ testing altogether for some time because they had such issues with discrimination, where non-white children were being put into special education classes at a much higher rate than white children based on population proportions. I took a class on tests and measures in undergrad, and the takeaway was that research shows that IQ tests are very flawed.

I am not sure I follow your argument for bringing up the IQ-driven education system earlier if it is so flawed.

I can assure you, with my 80+ hour weeks, 50k wages, 2 deferred loans (FOR SCHOOL) - 3 currently in repayment, hand me down car and a life where I've had 8 days off in the past 2 months that I wouldn't be doing this if I didn't love this job and have a hope that I would be out of the negative from my school loans when I'm at least 40. How anyone say that I should put up with this because it's "just the way it is," and I should have "known it was like this," before going into the field is insulting. It's behavior such as this where it's EXPECTED someone will cater to another that brings up so much animosity and hate in our society, I don't know why PS is allowing this conversation to continue.

Before bashing an entire profession, one should attempt to understand it. I am taking most of these comments personally and feel sorry for those of you who haven't had positive experiences with doctors you can trust.

As a fellow healthcare professional student, I have to echo this statement. There are always going to be those people who go into it "for the money" but in the long run those are not the people who succeed in their careers. I understand that this forum is considered a luxury forum...but just because you have the money to spend on these types of expenses, it does not mean that you are entitled to everything.

Back to the original post, the doctor in question is a doctor that came highly recommended. Either you decide that his services and time were worth it to you, or you don't and find another doctor. That is it. The rest of this debate just makes me angry enough to be compelled to make my points heard.

 

[wildcat03]

Before the whole community starts to argue of what job deserves what, I'd like to share an interesting article for your review: http://benbrownmd.wordpress.com/

A couple quotes if you don't want to click the link:

Physicians spend about 40,000 hours training and over $300,000 on their education, yet the amount of money they earn per hour is only a few dollars more than a high school teacher. Physicians spend over a decade of potential earning, saving and investing time training and taking on more debt, debt that isn’t tax deductible. When they finish training and finally have an income – they are taxed heavily and must repay their debt with what remains. The cost of tuition, the length of training and the U.S. tax code places physicians into a deceptive financial situation.

During residency, if one makes payments of $1,753 per month, or $21,037 per year, to pay off the accruing interest, thier debt will be still be $300,527 at the end of residency. However, they will have spent $63,111 over the course of a 3 year residency or $126,222 over the course of a 6 year residency to keep their debt from growing. Though paying off the interest during residency is the responsible thing to do; coming up with $21,037 each year from one’s net pay of $40,000 may be quite difficult.

Time spent training, student loan debt and the U.S. tax code makes the income of physicians deceiving. A board certified internal medicine physician who is married with 2 children, living in California and earning the median internist annual salary of $205,441 will be left with $140,939 after income taxes and $106,571 after student loan payments.7 This is assuming a federal Income tax rate of 28%, California state income tax rate of 6.6%, Social Security tax rate of 6.2% and Medicare tax rate of 1.45%. You can go to www.paycheckcity.com to get an idea of what one’s net pay would be for different incomes, states of residence, marital status, number of children, etc. Paying off a debt of $369,425 over 20 years at a 7% APR will require annual payments of $34,368. Those student loan payments will continue to consume about $34,000 of their net income for 20 years until they are finally paid off. What started off as $300,527 in student loan debt will end up costing $687,360. This debt that consumes one-fourth of their net income for 20 years wasn’t accrued because they bought a house they couldn’t afford – it is because they chose to become a physician.

Before this goes on, I want to clarify that kenny initially said this was a highly recommended doctor which he had to be put on a waitlist to even SEE initially. I conclude from this that this isn't a money hungry doctor but one whose patient's trust and actually RECOMMEND to others.

I can assure you, with my 80+ hour weeks, 50k wages, 2 deferred loans (FOR SCHOOL) - 3 currently in repayment, hand me down car and a life where I've had 8 days off in the past 2 months that I wouldn't be doing this if I didn't love this job and have a hope that I would be out of the negative from my school loans when I'm at least 40. How anyone say that I should put up with this because it's "just the way it is," and I should have "known it was like this," before going into the field is insulting. It's behavior such as this where it's EXPECTED someone will cater to another that brings up so much animosity and hate in our society, I don't know why PS is allowing this conversation to continue.

Before bashing an entire profession, one should attempt to understand it. I am taking most of these comments personally and feel sorry for those of you who haven't had positive experiences with doctors you can trust.

+1

Other things to keep in mind for those who think all doctors are evil money-grubbing jerks:

• Non-state supported med schools cost $65,000+ a year
• While interest rates on homes and cars are 3-5%, interest rates on students loans are 6.5-9%
• Doctors give up ALL of their earning potential during their early and mid-twenties, and earn only enough to get by during their late 20s and early thirties. The opportunity cost of becoming a doctor is high
• In any given day I am more likely to be sworn at, spat on, or assaulted than I am to have someone say, "Thank you" and mean it

 

[icekid]

Mico, it kind of makes you wonder why we ever sacrificed so much for so little, doesn't it?

Umm, yes! Like you, rosetta, I also (very) strongly discourage young potential doctors!


And I am going to have to disagree that janitors or servers work as hard as physicians. Certainly, these are demanding jobs in their own way. But taking care of critically ill (trying to die) patients for 24-30 hours is ridiculously demanding, exhausting, and stressful. While I've never been a full-time server, I did a bit during college and it just does not compare.

Wages? Sure doctors make more than teachers, policemen, and firefighters. And absolutely should, in my opinion. For all of the reasons that have already been stated. But then again... who wants intelligent doctors anyway?

 

[iheartscience]

You don't? Then you really just haven't been paying attention. I don't mean that to be nasty, but it's been all over the news for the last several years. For some reason teachers have become the punching bag of the right. So have all public employees, for that matter.

I should have worded that better. I have seen it in the news but it is not the same sort of outrage and general appallment that I am seeing here.

ETA again: What would an appropriate amount of pay be for physicians, BTW? How much money would they need to be fairly compensated? The vast majority of physicians make many times over the salary of a teacher, policeman or firefighter.

How do you really determine a proper amount of pay for people who save lives? Not saying this to be snarky, just putting that thought out there. Obviously policemen and firefighter and armed forces and the like are all in this category of "life savers"...do I think they deserve to be paid more than they are? Absolutely. However in regards to your point with the janitors: pay is not only determined by amount of work put into a person's career, but the expertise and knowledge required to perform said job.

ETA and an IQ based educational system would be rife with discrimination. IQ tests are made for white, middle class test takers. In fact, CA banned the use of IQ testing altogether for some time because they had such issues with discrimination, where non-white children were being put into special education classes at a much higher rate than white children based on population proportions. I took a class on tests and measures in undergrad, and the takeaway was that research shows that IQ tests are very flawed.

I am not sure I follow your argument for bringing up the IQ-driven education system earlier if it is so flawed.

I can assure you, with my 80+ hour weeks, 50k wages, 2 deferred loans (FOR SCHOOL) - 3 currently in repayment, hand me down car and a life where I've had 8 days off in the past 2 months that I wouldn't be doing this if I didn't love this job and have a hope that I would be out of the negative from my school loans when I'm at least 40. How anyone say that I should put up with this because it's "just the way it is," and I should have "known it was like this," before going into the field is insulting. It's behavior such as this where it's EXPECTED someone will cater to another that brings up so much animosity and hate in our society, I don't know why PS is allowing this conversation to continue.

Before bashing an entire profession, one should attempt to understand it. I am taking most of these comments personally and feel sorry for those of you who haven't had positive experiences with doctors you can trust.

As a fellow healthcare professional student, I have to echo this statement. There are always going to be those people who go into it "for the money" but in the long run those are not the people who succeed in their careers. I understand that this forum is considered a luxury forum...but just because you have the money to spend on these types of expenses, it does not mean that you are entitled to everything.

Back to the original post, the doctor in question is a doctor that came highly recommended. Either you decide that his services and time were worth it to you, or you don't and find another doctor. That is it. The rest of this debate just makes me angry enough to be compelled to make my points heard.

I am not the poster who brought that up-ksinger did. I just thought it was a good comparison.

And although I certainly think doctors save lives, I think your counter point of "how much is saving lives worth?" is pretty silly. It's priceless, so I guess you shouldn't even bother trying to pay them! We can never possibly pay them enough, so why try?!

And I specifically said that doctors should be paid more than janitors because of their years of training. I really am curious what the doctors think an appropriate level of pay is. $100k? $250k? $500k? More?

 

[Missy]

And although I certainly think doctors save lives, I think your counter point of "how much is saving lives worth?" is pretty silly. It's priceless, so I guess you shouldn't even bother trying to pay them! We can never possibly pay them enough, so why try?!

So it's all or nothing? I think that's pretty silly. You know, I have to echo the comments/feelings of icekid, Rosetta, Mico, wildcat, pandabee, etc. And I also discourage young people from going into healthcare these days. No need to be a martyr and after this PS conversation I feel even more strongly about not recommending the healthcare profession as a whole. Unless you like to be overworked, underpaid, under-appreciated and abused. Then it's perfect.
The hostility and attitude exhibited here towards people who go into medicine is astounding and disappointing.

(There are fields ofc within medicine that are still lucrative but for the most part they are fields dealing with cosmetic procedures for the rich and over served. Not for the under-served population which is what drew me to healthcare in the beginning.)

 

[iheartscience]

And although I certainly think doctors save lives, I think your counter point of "how much is saving lives worth?" is pretty silly. It's priceless, so I guess you shouldn't even bother trying to pay them! We can never possibly pay them enough, so why try?!

So it's all or nothing? I think that's pretty silly. You know, I have to echo the comments/feelings of icekid, Rosetta, Mico, wildcat, pandabee, etc. And I also discourage young people from going into healthcare these days. No need to be a martyr and after this PS conversation I feel even more strongly about not recommending the healthcare profession as a whole. Unless you like to be overworked, underpaid, under-appreciated and abused. Then it's perfect.
The hostility and attitude exhibited here towards people who go into medicine is astounding and disappointing.

(There are fields ofc within medicine that are still lucrative but for the most part they are fields dealing with cosmetic procedures for the rich and over served. Not for the under-served population which is what drew me to healthcare in the beginning.)

I was being facetious in response to the "Can you put a price on saving lives?" comment.

I'm not hostile in the least, and it doesn't seem like other posters are either. FWIW, I have a ton of friends in the healthcare profession and work with physicians and nurses myself on a daily basis.

 

[Missy]

It's disappointing to read how some PSers seem to think doctors go in it for the money and how they don't care about their patients and how they don't deserve to earn a good living. What about your friends who are in healthcare thing? Did they go into it with good intentions and to make a difference? Since you are friends with them it gives you an inside look at their motivation. What are your thoughts about their reasons?

I want to add I have seen my fair share of "bad" doctors. Absolutely. And that is upsetting on many different levels but especially because of all the trust we, as patients, give them to care for us and keep us/make us healthy. However, in every field you will find "bad apples" and it is up to us to decide if we want to remain in their care or move on. For whatever reason. We are free to do so (money notwithstanding).

 

[Autumnovember]

So some doctors don't go into the profession for the money at all, right?

Come on. I'm not saying every doctor does but I don't think its fair to say that it isn't at least a SMALL percentage of why most people choose the particular field.

Just thinking about when I was sitting in my very first class of nursing school and the professors asked each and every person why they chose the profession; almost EVERY single person included money in the list of reasons (and damn, are nurses underpaid). It doesn't mean its a bad thing but you can't just flat out say doctors didn't go into for the money aspect either.

 

[Mico]

Mico, it kind of makes you wonder why we ever sacrificed so much for so little, doesn't it?

It's just disheartening, that's all. Thank god my patients don't make me feel like this, I don't know what I would do with myself. The "system" on the other hand... that's another entity.

 

[sstephensid]

my humble opinion. most professions could list how they are overworked, under appreciated, spent years becoming educated or trained, had to obtain loans for their education and the list goes on. respect is due all but few get it. i personally feel that doctors have been well respected until the last few years. maybe they are going to have to accept what others already have. they are not immune any more than others. everything has gotten out of hand. it is time for reason. just something to think about.

most jobs bring something to the table. while doctors are important they would have a hard time doing their job without power, water, plumbers, nurses, janitors, store clerks, restaurant workers and the list goes on. many workers are on call 24/7. no one is above the other. at least, that is how i was raised. our country has many who feel entitled. that attitude is not what brought us to where we once were. hard work and pride in a job well done seem to me to be the things that helped this nation grow and prosper. i hope we all can do some self examination and get back to those values. sorry for the preachy sounding post but this is something i think of often.

No one said doctors were better or "above" others. But come on, do you really think a janitor, waiter, etc. should get paid the same as a doctor? How would that work exactly?

Doctors have plenty of specialized training, so I think it is fair that they make more money than say, a waiter without a college degree. But your tone here is pretty condescending towards janitors and waiters. They work just as hard for their money as a doctor does-maybe harder.

There is nothing wrong with being a janitor or waiter, but yes I think it is laughable to expect a physician's salary. I work as a secretary in a psychiatric hospital. I make the same as the housekeeper. (I know because the housekeeper on our unit was discussing her salary!) I can't and don't complain about my wages. I don't have a college education, but fortunately my husband makes 3-4x what I make or we couldn't have our lifestyle or anything close on my salary.

I KNOW about making crappy money. However, the thought of ME (or a janitor, waiter etc) making what the doctor makes or even half of what he makes, is ABSURD. Why would I deserve to make what he makes? If I had the desire or passion to make what he makes, I could become a doctor. I don't have the energy, desire, or probably the intelligence to do so.

 

[wildcat03]

So some doctors don't go into the profession for the money at all, right?

Come on. I'm not saying every doctor does but I don't think its fair to say that it isn't at least a SMALL percentage of why most people choose the particular field.

Just thinking about when I was sitting in my very first class of nursing school and the professors asked each and every person why they chose the profession; almost EVERY single person included money in the list of reasons (and damn, are nurses underpaid). It doesn't mean its a bad thing but you can't just flat out say doctors didn't go into for the money aspect either.

See, that's the big misperception about physicians - that there's money to be had. Sure, there are certain geographic areas that are known to be cash cows - but there's a reason they have to pay doctors a lot of money to work at those places and why those jobs are available year after year. And there are specialties that pay a lot, but the majority of physicians are not in those specialties. Mico provides a very nice summary of the cost of becoming a doctor. When student loan payments consume 35,000 worth of income AFTER taxes, the amount left is enough to (hopefully) buy a house, feed a family, put a little away for a rainy day and hopefully put some braces on kids and eventually send them off to college. (I did the math - for my student loans and that starting salary, I would be left with 5000/month assuming I put 10% in pre-tax retirement)

I made the decision to become a doctor when I was 17. I had a very sheltered middle class upbringing, and really had no concept of what doctors earned. I figured it out in my twenties, when I had already discovered my love of science and healthcare. I entered medical school thinking I had the best of both words - I was going to get to do what I loved and make a nice living at the same time. It's now 7 years and one month later. If I could give back my medical education and all the debt associated with it, and in return have my 7 years back, go back to a job that was 9-5, M-F I might just do it. Unfortunately, I have this pair of "golden handcuffs" (as my friends and I often refer to them) with "Sallie Mae" engraved on them. So I work my 80 hours a week, get my 4 days off a month, take my antidepressants and hold out the hope that when I finish residency in a year that it'll somehow be better.

So no, for me, it's not about the money. Other than the fact that I don't have any.

 

[crown1]

my humble opinion. most professions could list how they are overworked, under appreciated, spent years becoming educated or trained, had to obtain loans for their education and the list goes on. respect is due all but few get it. i personally feel that doctors have been well respected until the last few years. maybe they are going to have to accept what others already have. they are not immune any more than others. everything has gotten out of hand. it is time for reason. just something to think about.

most jobs bring something to the table. while doctors are important they would have a hard time doing their job without power, water, plumbers, nurses, janitors, store clerks, restaurant workers and the list goes on. many workers are on call 24/7. no one is above the other. at least, that is how i was raised. our country has many who feel entitled. that attitude is not what brought us to where we once were. hard work and pride in a job well done seem to me to be the things that helped this nation grow and prosper. i hope we all can do some self examination and get back to those values. sorry for the preachy sounding post but this is something i think of often.

No one said doctors were better or "above" others. But come on, do you really think a janitor, waiter, etc. should get paid the same as a doctor? How would that work exactly?

Doctors have plenty of specialized training, so I think it is fair that they make more money than say, a waiter without a college degree. But your tone here is pretty condescending towards janitors and waiters. They work just as hard for their money as a doctor does-maybe harder.

if my post is re-read i don't think i mentioned doctors salaries once.

 

[justginger]

I think a huge error being made in this discussion is laypeople grouping all doctors together. "Doctors vary" is the understatement of the year." in Australia, GPs do relatively little work to earn a pretty decent pay - I've been to a handful who knew less about drug interactions than I. There are good ones (I finally found one!), but many only had 6 years of training and know a little about a lot. The system here is set up to have them pass patients to specialists at the drop of a hat. I find myself resenting how much some of them expect to earn.

Specialists though? The registrars and consultants I work with? Some are worth their weight in gold. They're taking our calls at 3 am with no complaints, in the lab with us on the weekends, studying and learning constantly. They deserve every penny they get - all 35000000 of them/year!

 

[Ella]

Everyone please remember that disparaging comments about professions or people are not welcome on PS. Please keep the discussion without insults so it can remain open.

 

[jstarfireb]

Mico, it kind of makes you wonder why we ever sacrificed so much for so little, doesn't it?

Umm, yes! Like you, rosetta, I also (very) strongly discourage young potential doctors!

Count me in among the doctors who tell young hopefuls the gritty truth about our profession. My usual bottom line is "if you have a remote chance of being happy doing ANYTHING else in the world, do that instead." I've said it before and I'll say it again...the rewarding aspects of patient care are often overshadowed by the inhumane working conditions, and hazing environment during training. Not to mention that the title of MD comes with less respect and more disdain and scapegoating than it did in the past (as clearly evidenced by this thread). And I'm in a so-called "lifestyle" field; I have it easy in comparison to my surgical colleagues! We don't go into medicine FOR the money, but it helps to soften the blow of giving up the best years of your life, precious time with your loved ones, and hundreds of thousands of dollars to a profession that is often thankless. We're expected to be martyrs to the profession, and some are literally (suicide rates are disturbingly high among doctors). It's true that we're not the only people who work hard and deserve to be compensated fairly, but I don't know any other careers that require the intense sacrifice, both personally and financially, that medicine does. Nobody else puts up with the kind of working conditions we do. I like what I do and am highly committed to it, but I wouldn't go into medicine again given the choice.

Anyway, I guess I'm repeating myself, but these points are important enough to reiterate, and this is almost exactly what I tell people who are interested in medicine.

 

[Maria D]

I'm sorry that this thread has upset the members here that are medical professionals and I can totally understand how they could take some of the remarks personally even though I don't believe anyone meant for anything to be personal. I can't believe for a minute that someone would go through all that it takes to become a doctor JUST for the money. Why the hell for? There are far less grueling ways for an intelligent person with drive to make a lot more money. And make no mistake, the vast majority of people that become doctors are highly intelligent with abundant persistence and drive.

Yes, other professions are very worthy and important. I'm a high school math teacher myself and I'm told that this is oh so important. The U.S. lags in math/science performance, must have more and better teachers! But let's face it, it's a lot easier to become a teacher than a doctor. On top of that, while a crappy teacher is certainly a detriment to society, it's not a life and death matter. Do teachers deserve their level of pay? Undoubtedly, regardless of what morons who think we work "banker's hours" with summers off have to say. Should they get paid more? Absolutely if we want more people that can become high quality teachers to enter the field. I could not afford to be a teacher if I wasn't married to someone making a decent living. So what stops us as a society from paying teachers more? The fact that the money comes directly from the taxpayer's pocket. The barrier to entry for teaching stays low (relative to becoming a doctor) because it needs to stay low so that taxpayers can afford teachers.

And that's why I think the concierge practice hits a visceral nerve. It's quite a lot of money for the average person, certainly a heck of a lot more than the $55 per household tax increase that my town faced for the last budget -- and that increase caused quite a stir; people thought taxes should be lowered! It's not that we're just not used to paying it, it's that we really can't afford it *and* maintain the standard of living that we have now. For a married couple, it would be $3600; that's a vacation you won't be taking this year. So when we're being asked to help a doctor maintain his standard of living and some semblance of quality of life, we're asked to give up some of ours. It makes us feel like the doctor is saying that we're not as important as they are. At the meeting my mother's doctor held to explain the new practice, the patients were told that they would be getting a better quality of care for less than the cost of a couple of lattes each day. My mom came home and said "who can afford to go out for coffee every day? I'm a factory worker, not a doctor!"

Here's what it feels like for the average patient: You've been a good patient, kept all your appointments, didn't complain about the occasional long wait past appointment time because you rightly assumed that your doctor was saving someone's life somewhere, paid all your copays on time, followed your doctors orders and advice and truly liked your doctor. You thought your doctor liked you. But now you're being told that your doctor's practice is turning into a private country club that you can't afford to join. Not a private school that has financial aid packages that insure a diverse socio-economic student body but a private country club that people with more means than you will sign up for without a second thought. You thought you were living in a classless society when it came to medicine (you had this disillusion because you've always had health insurance) but now you found out you were wrong. It hurts.

 

[Missy]

Maria, thank you for your thoughtful post. Insightful and indeed there are no easy answers. I see both sides and it seems for now everyone loses. Except for the very wealthy. Not a good situation at all.

 

[iheartscience]

Everyone please remember that disparaging comments about professions or people are not welcome on PS. Please keep the discussion without insults so it can remain open.

Not trying to argue, Ella, but I'm really not seeing disparaging comments.

 

[iheartscience]

It's disappointing to read how some PSers seem to think doctors go in it for the money and how they don't care about their patients and how they don't deserve to earn a good living. What about your friends who are in healthcare thing? Did they go into it with good intentions and to make a difference? Since you are friends with them it gives you an inside look at their motivation. What are your thoughts about their reasons?

I want to add I have seen my fair share of "bad" doctors. Absolutely. And that is upsetting on many different levels but especially because of all the trust we, as patients, give them to care for us and keep us/make us healthy. However, in every field you will find "bad apples" and it is up to us to decide if we want to remain in their care or move on. For whatever reason. We are free to do so (money notwithstanding).

I never said doctors don't deserve to earn a good living, although I'm not sure about the use of the word "deserve." Sounds rather entitled, don't you think? I think doctors should be fairly compensated for their specialized training and knowledge. What I'm curious is what doctors think is fair compensation, but I haven't gotten an answer yet from the doctors posting. According to salary.com (caveat: no idea how reliable that site is) the average family practice doc makes $175,596 a year. Even with $35k/year in student loan repayment, that's a decent living.

As for my friends, I think some of them went into it to help people (one of them is in Sudan right now with Doctors Without Borders), and I think some of them went into it for the status. Doctors vary.

 

[ieatbugs]

Why do you feel entitled to less expensive healthcare when you appear to be able to afford concierge medicine if you so wished?

 

[Deia]

I hate to name specific countries but my friends are from Canada and England and they came here for surgery because the waiting list was too long in their country. (And I know of other people/situations where this happened though not firsthand). You decide what that means.

You have a choice here in UK...if you don't want to pay anything, then on the waiting list at the NHS you go. However, you can get private health insurance if you so wish and bypass all the waiting time etc. I have health insurance through my work and do not use the NHS. NHS is very good, it's not the perfect solution either, but if you are sick, and you need help, doctors/hospitals won't tell you to leave because you can't pay the bill, they will treat you. Your friends could have opted to pay for their surgeries themselves over here instead of going with NHS, so I am not sure why they went to the US for it, maybe there was a specialist doctor or something? Who knows Anyway my point is that you can bypass the public healthcare if you choose to self pay or if you have private health insurance. Most NHS doctors have private practices/conduct consultations at a private hospital.

 

[iheartscience]

Why do you feel entitled to less expensive healthcare when you appear to be able to afford concierge medicine if you so wished?

I actually believe health care is a human right, so I'll go beyond that and state that I think all U.S. citizens are entitled to FREE healthcare. (And yes, I realize that that free healthcare would need to be paid for with tax dollars, and would happily pay more taxes to guarantee that right to my fellow citizens.) That said, I'm lucky enough to have great health insurance and a lack of doctors who feel entitled to $1800 per patient for the privilege of seeing them.

Interesting that my posts seem to convey that I can afford $1800/year for concierge medicine, though. Why, I don't even make as much $ as a family practice doc.

 

[ieatbugs]

Why do you feel entitled to less expensive healthcare when you appear to be able to afford concierge medicine if you so wished?

I actually believe health care is a human right, so I'll go beyond that and state that I think all U.S. citizens are entitled to FREE healthcare. (And yes, I realize that that free healthcare would need to be paid for with tax dollars, and would happily pay more taxes to guarantee that right to my fellow citizens.) That said, I'm lucky enough to have great health insurance and a lack of doctors who feel entitled to $1800 per patient for the privilege of seeing them.

Interesting that my posts seem to convey that I can afford $1800/year for concierge medicine, though. Why, I don't even make as much $ as a family practice doc.

Sorry, the post was directly toward Kenny, and I'm basing my assumption on his large carat diamond collections.

Personally, I have 15k worth of work that I need done, that insurance won't cover, and I'm scrimping and saving just to hope to be able to afford the treatment in my lifetime. I think that those who CAN pay should pay. I'm trying to.

 

[wildcat03]

I never said doctors don't deserve to earn a good living, although I'm not sure about the use of the word "deserve." Sounds rather entitled, don't you think? I think doctors should be fairly compensated for their specialized training and knowledge. What I'm curious is what doctors think is fair compensation, but I haven't gotten an answer yet from the doctors posting. According to salary.com (caveat: no idea how reliable that site is) the average family practice doc makes $175,596 a year. Even with $35k/year in student loan repayment, that's a decent living.

As for my friends, I think some of them went into it to help people (one of them is in Sudan right now with Doctors Without Borders), and I think some of them went into it for the status. Doctors vary.

It's hard to pick a "number" that I think fairly compensates physicians, and I'm reluctant to throw one out there, because no matter how reasonable I think the amount is, someone is going to be aghast on here about how I could dare think that my time is worth that much money. There are a lot of variables that would be involved in helping me decide what number is "fair." Does the job offer good health insurance, good malpractice insurance, and a good way to save for retirement? Are my colleagues nice and kind or are they grumpy? Do the nurses, techs, and physicians at work interact with respect and kindness or do they cut eachother down? If the answer to all of those questions is that people are generally positive and kind, I would definitely sacrifice income for a more pleasant work environment.

I'm fairly certain the salary.com figure is WAY off. A median figure would be much more helpful, as there are numerous people who trained as family physicians who either now "specialize" or have lucrative side businesses in cosmetic and all-cash procedures such as Restalyne, Botox, etc. That skews the number so that it doesn't represent the income of the family physicians who are truly practicing family medicine.

Keep in mind that as far as income, physicians are very late starters. Most will not earn a "physician" paycheck until at least their 30th birthday, and some will not until their mid-30s. The opportunity cost involved in that is HUGE.

If you read my post (which I suspect you didn't based on your subsequent post) the take-home pay for a physician making 180,000 who pays 36000 a year in student loans and puts 10% away for retirement is somewhere around 5000/month after taxes. Bear in mind that student loan payments are only tax deductible for the first $2500 of interest paid yearly, so there is no tax benefit to paying down student loans. I don't know what fairly compensates me for years of unpaid and underpaid hard work and the opportunity cost of training until my early 30s, but I can tell you that 5000/month net pay does not - especially in the part of the country in which I live, which has an unreasonably high cost of living for what it provides.

 

[Dancing Fire]

[quote="thing2of2|


And I specifically said that doctors should be paid more than janitors because of their years of training. I really am curious what the doctors think an appropriate level of pay is. $100k? $250k? $500k? More?[/quote]


this was a few years ago.. a brain surgeon said he makes $500k but his cost for malpractice insurance was $300k.

 

[Loves Vintage]

I don't know. If I had an on-going health concern, I wanted excellent care and had the money, I would pay the yearly fee. Really, at this point, I would just be happy to have a doctor to go to. Seems the trend is to replace doctors with nurse practioners, and sorry, but it's not the same thing. I've been sick for weeks with a sinus infection, went to a nurse practioner at a clinic because it was EASY to just drop in to see her on my way to work. Three weeks later, after a phone call and another prescription from the APRN, and I'm still sick. Went to my doctor yesterday. He was confused by the antibiotic she prescribed, since it apparently is not the go-to medication for sinus infections (after the Z-pak, which is too strong for me), and then proceeded to prescribe ANOTHER antibiotic and the correct OTC medication for me. So, it's now 6 weeks into this sinus infection for me, and hmm, what's my point -- my point is, I'd rather see a doctor, so I can avoid this whole APRN hmm-let-me-try-this-one-maybe-it-will-work approach to medicine. No offense intended to any APRNs here, of course, but this is the second time I've tried to go the APRN route and just wound up sick for longer. Just my personal experience!

Anyway, the APRN told me that there is an apparent shortage of doctors here (CT), and they are trying to open more of these clinic with APRNs to reconcile the shortage. Not sure if that is accurate, or not, but I would prefer an adequate number of doctors, so yeah, I do think they should be adequately compensated, whatever that amount may be. I really have no issues with an excellent physician transitioning to a concierge practice. If people want to pay direct, let them.