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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous] Icu is definitely underpaid - ER docs can consult every service for admit, but command high (>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 "direct primary care" 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] Medicine is rarely market driven. As you said, if it were PCP's in some places would be earning a lot more. It's all circular. Certain specialties and procedures reimburse more for arbitrary reasons set up long ago. Those specialties become competitive because the reimburse at a higher rate. Hospitals don't pay people based on market forces they compensate based on how they are reimbursed. I have some friends that are in pediatric subspecialties. They trained for 6+ years, are incredibly smart, and work hard. That in and of itself doesn't mean they should be paid more. BUT, there is a shortage of docs in these fields, I know one that literally covers 5 states. months long waiting list and full clinics. And these specialists are super rare as well. Under any other system, these people's salaries would increase to get more people into the field. But since reimbursement is kept arbitrarily low, no one will pay an increased salary. It's crazy. And this happen all the time. Which leads us with a glut of specialists who need to do more and more (sometimes unnecessary) procedures to justify their high salaries and not enough doctors who would actually make the population healthier in the long run. [/quote] I disagree with some of your argument, but you have my wholehearted agreement that Peds sub specialists are under paid. This is what happens when the government inserts itself into a private industry. It's only going to worsen under Obamacare. I do not recommend medicine as a career path for those who ask me. It is about to go the way of law in terms of high loan burden and lack of opportunities. [/quote]
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