Doctors make too much money

[Anonymous]

My ex is a dual degree (DDS MD) OMFS surgeon. Until this year he had 4 practices and generally made over 2M per year until he recently sold one for 1.8 because now that he's in his late 50s now he wants to work only 4 days a week instead of 6. And travel. He's still got 3 practices to sell.

He's worth ~20M.f

I know the exact finances because we're still legally married and still file joint tax returns. I also saw 1.6 go straight into our joint checking after he used 200K to pay chunks off some of his real estate properties. He likes to invest in real estate.

He's probably the best in the mid-Atlantic region at what he does, but one of his classmates who has exactly the same skills and degrees who works in the UK does not have even close to the same earning power.

[Anonymous]

I think a lot of you are completely missing the opportunity cost to go into these different specialties. My wife is a liver/kidney/pancreas transplant surgeon and did 4 years of med school, 7 years of general surgery residency (5 years + 2 research years), and a 2 year transplant specific fellowship. 13 years after graduation with 9 of those years being paid very little.

Trust me, she would have made far more in other fields with how intelligent/driven she is, but she actually values helping her patients over $$$. This is just one example, but how is this worse than some random overworked investment banker or lawyer?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Doc here. I left clinical medicine because the salary was rather low given my options. If I have to miss out on my kids life and my own life, I also have to maximize hourly compensation. Now I make more money doing something else. The expense of healthcare is not because of the doctors.

What are you doing now? Want to know as one family member who is doctor also interested in leaving clinical medicine.

Not the PP, but a friend that did this went to work for a VC firm. Always more money in finance.

That said, physicians are work horses. They have to be present to make money. Lots of easier jobs that you can outsource, work remote, have flexibility, etc.

This part is true, my ex is the OMFS. If there are no surgeons to perform surgeries, the whole practice doesn't make money. I think over the 4 private practices he had up to 100 employees. Some are larger than others. He has different partners in each practice and associates sometimes stayed or left. Anyway, every time he decides to go on vacation with his girlfriend (who travels with him from office to office because of course she does) it impacts the practice bottom line. I gather that he's starting not to care so much anymore, though. His dad died at around the same age he is now and I think he's hit some sort of existential wall about that.

He's been approached by at least one of those practice management places that are trying to come in like HMOs ("You Do what you Do Best and We'll manage the Rest" type stuff) but his other partners wouldn't uniformly agree. He's the only one who was partner in all 4 so I'm pretty sure he just had his partnership bought out in the one place. He also established the practice he sold, like he bought the real estate 20 years ago in the form of a commercial space and fitted it out for surgical work. (I don't know if we still own that because we don't talk. I just see numbers.) For all I know he's still renting it back to the partners who still practice there.

He was also supposedly approached by a regional consolidated medical borg a bunch of years ago to buy all 4 practices for 100m (which would have been split among partners) which obviously never went through. I have almost no idea about the rest of that, except that it obviously didn't happen.

FWIW he's been so paranoid about his fingers for decades he won't so much as throw a ball with a kid.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Honestly, I have no complaints about my doctors and that includes their salaries. They work their a$$es off and have provided me and my family with great care.

+1 I actually think most doctors are massively underpaid compared to other professions when factoring in skill level, value of service they are providing, years/cost of education, work/life balance, etc

PCPs are underpaid. Radiologists, orthopedic surgeons, and anesthesiologists are ridiculously overpaid.

My OMFS ex has a CRNA on staff and last time he talked about it he said he paid her 400K. That could be up to 10 years ago that I heard that, though.

And the CRNA works only the most complicated surgeries. For stuff like wisdom teeth I think it's twilight anesthesia with CRNA supervision but I might be getting out of my depth here.

[Anonymous]

Anonymous wrote:I think a lot of you are completely missing the opportunity cost to go into these different specialties. My wife is a liver/kidney/pancreas transplant surgeon and did 4 years of med school, 7 years of general surgery residency (5 years + 2 research years), and a 2 year transplant specific fellowship. 13 years after graduation with 9 of those years being paid very little.

Trust me, she would have made far more in other fields with how intelligent/driven she is, but she actually values helping her patients over $$$. This is just one example, but how is this worse than some random overworked investment banker or lawyer?

If we all agree our healthcare costs are too high nationally, it makes sense we are more critical of provider salaries than IB salaries. Of course, maybe our costs aren’t too high, and this is just what it costs to have the kind of healthcare we want.

[Anonymous]

Anonymous wrote:I think a lot of you are completely missing the opportunity cost to go into these different specialties. My wife is a liver/kidney/pancreas transplant surgeon and did 4 years of med school, 7 years of general surgery residency (5 years + 2 research years), and a 2 year transplant specific fellowship. 13 years after graduation with 9 of those years being paid very little.

Trust me, she would have made far more in other fields with how intelligent/driven she is, but she actually values helping her patients over $$$. This is just one example, but how is this worse than some random overworked investment banker or lawyer?

Her colleagues abroad make far less and their patients have better outcomes in a better system. They could also go into banking or whatever. No career is “owed” outrageous pay.💰

[Anonymous]

Anonymous wrote:

Anonymous wrote:I think a lot of you are completely missing the opportunity cost to go into these different specialties. My wife is a liver/kidney/pancreas transplant surgeon and did 4 years of med school, 7 years of general surgery residency (5 years + 2 research years), and a 2 year transplant specific fellowship. 13 years after graduation with 9 of those years being paid very little.

Trust me, she would have made far more in other fields with how intelligent/driven she is, but she actually values helping her patients over $$$. This is just one example, but how is this worse than some random overworked investment banker or lawyer?

Her colleagues abroad make far less and their patients have better outcomes in a better system. They could also go into banking or whatever. No career is “owed” outrageous pay.💰

That is true but what is it in particular that leads people to post it here? Why not lawyers, insurance exs or tech bros? This is a constant refrain on here (that doctors make too much).

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think a lot of you are completely missing the opportunity cost to go into these different specialties. My wife is a liver/kidney/pancreas transplant surgeon and did 4 years of med school, 7 years of general surgery residency (5 years + 2 research years), and a 2 year transplant specific fellowship. 13 years after graduation with 9 of those years being paid very little.

Trust me, she would have made far more in other fields with how intelligent/driven she is, but she actually values helping her patients over $$$. This is just one example, but how is this worse than some random overworked investment banker or lawyer?

Her colleagues abroad make far less and their patients have better outcomes in a better system. They could also go into banking or whatever. No career is “owed” outrageous pay.💰

That is true but what is it in particular that leads people to post it here? Why not lawyers, insurance exs or tech bros? This is a constant refrain on here (that doctors make too much).

Because everyone goes to the doctor and we are all paying outrageous sums for insurance. And because we are all nerds we look at the insurance statement and see the doctor charged the insurance $800 for a 20 minute appointment. So we see the cost right in front of us, more than insurance executive pay or whatever else.

[Anonymous]

Anonymous wrote:I think a lot of you are completely missing the opportunity cost to go into these different specialties. My wife is a liver/kidney/pancreas transplant surgeon and did 4 years of med school, 7 years of general surgery residency (5 years + 2 research years), and a 2 year transplant specific fellowship. 13 years after graduation with 9 of those years being paid very little.

Trust me, she would have made far more in other fields with how intelligent/driven she is, but she actually values helping her patients over $$$. This is just one example, but how is this worse than some random overworked investment banker or lawyer?

And other physicians in the world don't have opportunity costs, yet make multiple fold less than US doctors even after accounting for PPP differences?

Healthcare in the US is a sham. We pay out the ass for it so evryone from doctors to insurance execs can make millions of dollars in the field. Meanwhile, itnis bankrupting our entite country and becoming less and less accessible for millions of our citizens. The entire scheme in the US needs to be flattened.First, by getting rid of all of the bloat, then normalizing salaries so that they're in line with the rest of the world.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I think a lot of you are completely missing the opportunity cost to go into these different specialties. My wife is a liver/kidney/pancreas transplant surgeon and did 4 years of med school, 7 years of general surgery residency (5 years + 2 research years), and a 2 year transplant specific fellowship. 13 years after graduation with 9 of those years being paid very little.

Trust me, she would have made far more in other fields with how intelligent/driven she is, but she actually values helping her patients over $$$. This is just one example, but how is this worse than some random overworked investment banker or lawyer?

And other physicians in the world don't have opportunity costs, yet make multiple fold less than US doctors even after accounting for PPP differences?

Healthcare in the US is a sham. We pay out the ass for it so evryone from doctors to insurance execs can make millions of dollars in the field. Meanwhile, itnis bankrupting our entite country and becoming less and less accessible for millions of our citizens. The entire scheme in the US needs to be flattened.First, by getting rid of all of the bloat, then normalizing salaries so that they're in line with the rest of the world.

DP but this should also include making medical school affordable and not just a career for rich elites- guess what, it also affects health outcomes negatively when most of the people who get to become doctors are people with extraordinary privilege.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think a lot of you are completely missing the opportunity cost to go into these different specialties. My wife is a liver/kidney/pancreas transplant surgeon and did 4 years of med school, 7 years of general surgery residency (5 years + 2 research years), and a 2 year transplant specific fellowship. 13 years after graduation with 9 of those years being paid very little.

Trust me, she would have made far more in other fields with how intelligent/driven she is, but she actually values helping her patients over $$$. This is just one example, but how is this worse than some random overworked investment banker or lawyer?

Her colleagues abroad make far less and their patients have better outcomes in a better system. They could also go into banking or whatever. No career is “owed” outrageous pay.💰

That is true but what is it in particular that leads people to post it here? Why not lawyers, insurance exs or tech bros? This is a constant refrain on here (that doctors make too much).

Because everyone goes to the doctor and we are all paying outrageous sums for insurance. And because we are all nerds we look at the insurance statement and see the doctor charged the insurance $800 for a 20 minute appointment. So we see the cost right in front of us, more than insurance executive pay or whatever else.

Then clearly you are smart enough to read the EOB and see they aren't actually getting paid that amount.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I think a lot of you are completely missing the opportunity cost to go into these different specialties. My wife is a liver/kidney/pancreas transplant surgeon and did 4 years of med school, 7 years of general surgery residency (5 years + 2 research years), and a 2 year transplant specific fellowship. 13 years after graduation with 9 of those years being paid very little.

Trust me, she would have made far more in other fields with how intelligent/driven she is, but she actually values helping her patients over $$$. This is just one example, but how is this worse than some random overworked investment banker or lawyer?

If we all agree our healthcare costs are too high nationally, it makes sense we are more critical of provider salaries than IB salaries. Of course, maybe our costs aren’t too high, and this is just what it costs to have the kind of healthcare we want.

There are a lot of examples elsewhere in the world showing we don't need to pay doctors ridiculous amounts to get high-quality care.

What is it about the US system that makes this so screwed up? It seems to be that the health care system doesn't act like a market nor does it act like a government program. If we had a national health care system, government funding would basically limit spending. Look at what we pay federal employees, for instance. If it worked like a market, individuals would be more price-conscious and go to cheaper doctors. But because much of the market works through insurance, and insurance is mostly paid for by employers, there isn't that much price sensitivity.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think a lot of you are completely missing the opportunity cost to go into these different specialties. My wife is a liver/kidney/pancreas transplant surgeon and did 4 years of med school, 7 years of general surgery residency (5 years + 2 research years), and a 2 year transplant specific fellowship. 13 years after graduation with 9 of those years being paid very little.

Trust me, she would have made far more in other fields with how intelligent/driven she is, but she actually values helping her patients over $$$. This is just one example, but how is this worse than some random overworked investment banker or lawyer?

Her colleagues abroad make far less and their patients have better outcomes in a better system. They could also go into banking or whatever. No career is “owed” outrageous pay.💰

That is true but what is it in particular that leads people to post it here? Why not lawyers, insurance exs or tech bros? This is a constant refrain on here (that doctors make too much).

Because everyone goes to the doctor and we are all paying outrageous sums for insurance. And because we are all nerds we look at the insurance statement and see the doctor charged the insurance $800 for a 20 minute appointment. So we see the cost right in front of us, more than insurance executive pay or whatever else.

Then clearly you are smart enough to read the EOB and see they aren't actually getting paid that amount.

DP, I know what reimbursement rates are. And once you set aside primary care physicians, a lot of them are absurd. It's not the office visits as much as it is procedures.

Though, I once broke my finger. The doctor spent literally two minutes with me, ultimately taping the finger to the next. It was reimbursed for approximately $500 as a surgical procedure. Besides that being an outrageous reimbursement rate for what was done, the doctor at urgent care where I started at never should have referred me to a hand surgeon for this.

[Anonymous]

Doctor pay doesn’t bother me. They often have a lot of expenses and it’s earnings so they pay taxes on it.

Insurance companies and corporate hospitals on the other hand… bother me very much.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think a lot of you are completely missing the opportunity cost to go into these different specialties. My wife is a liver/kidney/pancreas transplant surgeon and did 4 years of med school, 7 years of general surgery residency (5 years + 2 research years), and a 2 year transplant specific fellowship. 13 years after graduation with 9 of those years being paid very little.

Trust me, she would have made far more in other fields with how intelligent/driven she is, but she actually values helping her patients over $$$. This is just one example, but how is this worse than some random overworked investment banker or lawyer?

Her colleagues abroad make far less and their patients have better outcomes in a better system. They could also go into banking or whatever. No career is “owed” outrageous pay.💰

That is true but what is it in particular that leads people to post it here? Why not lawyers, insurance exs or tech bros? This is a constant refrain on here (that doctors make too much).

Because everyone goes to the doctor and we are all paying outrageous sums for insurance. And because we are all nerds we look at the insurance statement and see the doctor charged the insurance $800 for a 20 minute appointment. So we see the cost right in front of us, more than insurance executive pay or whatever else.

Then clearly you are smart enough to read the EOB and see they aren't actually getting paid that amount.

Actually it was for a pediatric specialist appointment and yes, the doctor was getting reimbursed that amount. And if I recall correctly the hospital was also getting reimbursed for a similarly outrageous amount.

One of my children has a rare condition and the insurance has paid out hundreds of thousands of dollars for her. I look at every statement and see the difference between the charge and the reimbursement rate.