Anonymous
Post 06/30/2016 19:58     Subject: Re:S/O Doctors: post your salary and practice area
Anonymous wrote: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.


You sound really bitter. Should have researched compensation before deciding on a specialty.
Anonymous
Post 06/30/2016 12:47     Subject: Re:S/O Doctors: post your salary and practice area
Anonymous wrote:
Anonymous wrote:All of the MDs should make more than these overpaid attorneys running around here. Thinking of attorneys in large firms and independent financial regulatory agencies.


Doctors should be paid more. Hospitals and insurance companies should earn less.


I could not agree more. My husband is an ortho surgeon. His implant reps often make more than he does in a surgery. That is ridiculous. Pharmaceutical and insurance companies are the ones who need to make less.
Anonymous
Post 06/30/2016 12:10     Subject: Re:S/O Doctors: post your salary and practice area
Anonymous wrote:
Anonymous wrote:All of the MDs should make more than these overpaid attorneys running around here. Thinking of attorneys in large firms and independent financial regulatory agencies.


Doctors should be paid more. Hospitals and insurance companies should earn less.



+1000
Anonymous
Post 06/29/2016 21:38     Subject: Re:S/O Doctors: post your salary and practice area
I am a pediatric sub specialist. I was taking call every third night and weekend and would regularly get called into the hospital after hours to take care of sick patients. I did six years of post medical school training and do highly specialized work, but it isn't procedure heavy. Patient loads were heavy and there wasn't enough time to see everyone that needs to be seen in clinic because there simply weren't enough of us. I was doing work that literally less than 300 people in the country are trained to do. I was a relatively recent grad and my board certification number is in only in the triple digits, meaning that less than 1000 people have been certified in my field, ever.
So I'm working crazy hours, was always in the hospital, saw lots of patients and did highly technical things. There are a very small number of people who could do my job and my services were in high demand. Despite this, I was making less than $150K with six figure debt. And was being told that I wasn't seeing enough people to justify my salary. All because of a system that artificially kept down reimbursement based on a formula cooked up years ago.
It doesn't make sense from an economic, policy or societal perspective. And I got tired of seeing other people in the hospital night in and night out (because we were all taking the same crazy call) telling me thier high salaries were justified because they "worked so hard."
So I left. Even though I loved the work. I went to pharma. And I couldn't be happier. My lifestyle is better. I'm at home more. I have much less stress and I get paid significantly more.
And that's a tragedy. My colleagues are left to see even more patients and take even more call. And the patients suffer. And I was talented. I'm not trying to brag, but I was doing a lot more good for people then than I am now.
Our professional society is faced with a shortage and has regular meetings asking how to address it. The answer is so obvious. But the system prevents it from being implemented.

It truly is insane.
Anonymous
Post 06/29/2016 20:59     Subject: Re:S/O Doctors: post your salary and practice area
Anonymous wrote:All of the MDs should make more than these overpaid attorneys running around here. Thinking of attorneys in large firms and independent financial regulatory agencies.


Doctors should be paid more. Hospitals and insurance companies should earn less.
Anonymous
Post 06/29/2016 14:21     Subject: Re:S/O Doctors: post your salary and practice area
All of the MDs should make more than these overpaid attorneys running around here. Thinking of attorneys in large firms and independent financial regulatory agencies.
Anonymous
Post 06/29/2016 10:14     Subject: Re:S/O Doctors: post your salary and practice area
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:

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?


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.


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.

Anonymous
Post 06/29/2016 08:54     Subject: Re:S/O Doctors: post your salary and practice area
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:

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?


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.
Anonymous
Post 06/29/2016 08:40     Subject: Re:S/O Doctors: post your salary and practice area
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote: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.


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.


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 "consult ending with a script," 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.


My son had surgery as an infant and spent many days in the PICU. Surgeon billed 20k of our 250k total bill. PICU bill was way higher than surgery cost. Don't know how that cost gets broken up between hospital and physicians but the billings were astronomical. Thank goodness we had good insurance or we would be bankrupt.


I doubt that the ICU physician billed 20K. ICU care is expensive. The professional fee is only a small part of it. Although I'm sure that the ICU doc spent more time taking care of your son than the surgeon. I mean why compare what the surgeon billed to the rest of the hospitalization? Why not compare what the surgeon billed to what the ICU do billed? My guess is that because the surgeon's bill stuck out because it was so much larger than anything else. Also,
OR fees that don't go to the surgeon probably made up a chunk of those fees.
Anonymous
Post 06/29/2016 06:39     Subject: Re:S/O Doctors: post your salary and practice area
This thread needs to go on. The practice of not discussing and revealing salary information only benefits corporations and hospitals. This needs to serve as a guide for all job seekers, young and old.
Anonymous
Post 06/29/2016 01:32     Subject: Re:S/O Doctors: post your salary and practice area
Anonymous wrote:
Anonymous wrote:
Anonymous wrote: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.


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.


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 "consult ending with a script," 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.


My son had surgery as an infant and spent many days in the PICU. Surgeon billed 20k of our 250k total bill. PICU bill was way higher than surgery cost. Don't know how that cost gets broken up between hospital and physicians but the billings were astronomical. Thank goodness we had good insurance or we would be bankrupt.
Anonymous
Post 06/29/2016 01:11     Subject: Re:S/O Doctors: post your salary and practice area
Anonymous wrote:
Anonymous wrote:
Anonymous wrote: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.


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.


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 "consult ending with a script," 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.


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?
Anonymous
Post 06/28/2016 21:51     Subject: Re:S/O Doctors: post your salary and practice area
*isn't just as important.
Anonymous
Post 06/28/2016 21:49     Subject: Re:S/O Doctors: post your salary and practice area
Anonymous wrote:
Anonymous wrote: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.


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.


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 "consult ending with a script," 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.
Anonymous
Post 06/28/2016 21:01     Subject: Re:S/O Doctors: post your salary and practice area
Dam it stop this thread!!