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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]The disparity of pay among physicians is what is criminal. It's all part of a skewed reimbursement system that values procedures more than cognition and actually taking care of patients. And it incentives itself by just ensuring that more procedures are done, some unnecessarily because they pay so much. The technical skills and training to be a critical care doctor and a spine surgeon are not that different. And one doesn't work harder than the other. But one makes 5 times more. Or even 10 times more. It's ridiculous. And some of it is sour grapes, sure. But it's difficult when you see the same guy in the middle of the night and he makes orders of magnitude higher than you because of reimbursement schemes set up decades ago. When he's not working harder than you and didn't train any harder. Stupid. [/quote]

So you think neurosurgeons don't have more technical skills than a critical care doctor? I strongly disagree with you. Procedures and surgery require more skill and they get paid accordingly. Maybe you think a consult ending with a script is the same a a 7hr surgery.[/quote]

I think that surgery is an important skill. One that I think most competent surgeons could be trained to do. It is highly technical. I am not disputing that. But keeping an ICU full of 30 critically ill patients alive for 24 hours is a highly technical skill too. That requires years of training to be able to do well. Not everyone can do that either, including many of the orthopedic surgeons we give gobs of money to. If you've ever been in a hospital and seen an orthopedic surgeon take care of medically ill patients you would know that's the case. And if you think running an ICU is the equivalent of a &quot;consult ending with a script,&quot; then you don't know what the hell you're talking about. Just because it doesn't seem as cool on Grey's Anatomy doesn't mean that the thinking part of medicine is just as important or as difficult as the procedural part. 
[/quote]

Icu is definitely underpaid - ER docs can consult every service for admit, but command high (&gt;300/hr) salaries, whereas pure critical care guys (without pulm clinic or anesthesia time) might make 150/hr on a shift. Criminal? No. Market driven? Yes, and we need more of that in medicine.

Neurosurgeons are paid well for skill and rarity - they don't train many of them. Meanwhile, midlevels are taking over primary care, driving salaries down. The answer isn't to beg the govt for more cheese, it's to allow marlet forces in - and many of the &quot;direct primary care&quot; cash models have PCPs making 4-500k per year with zero call.

We need more salaries post on this thread. We also need less jealousy. Kudos to the spine surgeon making $1 mil a year - I couldn't deal with those patients. That guy had to kill it in Med school to get ortho, although spine is actually not a competitive fellowship out of ortho. Tons of unfilled spots.

Enjoy the 7 digits while you can - billing reimbursement under the regime is likely to decimate spine, and I wouldn't do it for $1 mil a year - who would do it for 300?[/quote]

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