Despite all the complaining that doctors do, this physician puts it in perspective
“Personally, I think we complain too much. All businesses have become more difficult in today’s economy. My brother-in-law – in management for an automobile company – has had to work out-of-state 10 days out of 12 for the past six months. A computer company downsizes its workforce and everyone left picks up the slack. A well-respected editor is let go when the company that acquired his publication decides his position is expendable. This is the reality of our modern day world. Yet it seems we believe that because we’re doctors, we should be immune.”
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{ 22 comments }
I think the fact is not that physicians complain but that it is in such an open forum. Medical care is one of the most regulated industries in the country; it is a matter of public interest and policy. I’m sorry but the “let-go” editor, his job isn’t of political concern.
Politics and policy are discussed in the open, in the media, in blogs. The fired editor complains just as much about the loss of his job as any physician about DTC drug ads or government regulation, however the editor’s audience consists of only his wife and kids because his complaints are narrow. Physician complaints deal with national issues and so are heard by a larger audience; as such it appears they complain more than the average white collar worker but they don’t.
Physicians complain incessantly and given the amount of money and influence they wield, it makes them whiners. I’m glad someone finally said it. These are people who won’t go into pediatrics because they will “only” make $120,000 per year and don’t even think about psychiatry where you might not even make 6 figures.
That’s a ridiculous comment above.
Your absolute statement, “These are people who won’t go into pediatrics because they will “only” make $120,000 per year and don’t even think about psychiatry where you might not even make 6 figures,” would mean there are no psychiatrists or pediatricians.
But if you look at match figures there is not a particularly small amount of highly qualified med students choosing pediatrics. It has it’s share of AOA and 90th percintile step 1 students applying.
So, you’re wrong.
Look some physicians choose a speciality based on more money but it’s certainly not a bigger percentage than the rest of the population. Business has become America’s most popular undergraduate major over the past decade. College kids want money and know being an I-Banker probably is going to lead to bigger wealth than the kid with the English major. But, it just shows that physicians are not abnormal in the number of them who seek out wealth making employment.
Can you tell which of the above are physicians? The point is that too many doctors seem to confuse the well-being of their personal finances with the well-being of the field of medicine.
Another post elsewhere comes to mind. A self-described 42 year old MD who retired from the practice of medicine because he had accumulated enough ‘assets’ to live comfortably and didn’t want to risk getting sued. Where is the dedication to his patients and to medicine?
The original post is right — there is a lot of whining going on out there, or maybe it’s just the whiners who have time to post. Speaking of which, it’s Sunday morning and I’m going to my office now — I was one of those business majors — and I sure am not retired at 42.
I wouldn’t question the early retired doc’s dedication as much as I would question society for letting this kind of frivolous lawsuit nonsense chase away the best and brightest from practicing medicine. Why should he risk losing his hard-earned financial assets to some ambualnce chaser trying to hit the lawsuit lottery?
Let’s just hope not too many docs are as smart as this guy. We need to keep the young guys out there practicing longer.
Anonymous is nothing if not consistent in his continued ranting without any factual basis. I think he may be in PR for the AMA or ATRA.
Money is not the main problem. Combining the money with the paperwork, regulations, lifestyle and stress resulting from combined responsibility and liability, THAT is the problem. You can be very passionate about medicine but after a while your life passes without you and passion is not enough to keep the boat floating.
I did not go to medical school thinking of money and considered my 120.000 salary very good. But when I started combining that with the 60 hours of weekly work, phone calls every night, constant stress, mountains of paperwork and the constant arguing with HMO’s and medicaid, I started having second thoughts about my life and medicine. I did not go to medical school for this BS.
You know, if you guys worked in en masse on the issues of paperwork, reimbursements, etc. the way you worked together on liability issues, you might accomplish something.
Or if you worked together against those health insurers who created most of your headaches. Which is difficult, admittedly. Once you start living a lifestyle and create the overhead both personally and professionally, it’s hard to wean off of it. In that respect, you’re no different from lawyers.
But it seems from reading the blogs of physicians who do drop out, once they survive the initial financial hurdles, they are happier. Or at least they complain less.
Just think : one single physician has to cover salaries for three other people AND be liable for their mistakes. There is a whole army of people out there who make a living from turning papers around. And another army who decides in which order the papers should be turned around. And everybody is concerned about how much health care costs ! I strongly believe this kind of practice is not sustainable anymore. At least, I am not going to sponsor this stupidity anymore. I can live easy with 80.000 instead of 120.000 and be again a normal human being doing the right thing.
“Anonymous is nothing if not consistent in his continued ranting without any factual basis. I think he may be in PR for the AMA or ATRA.”
What “factual basis” issue are you referring to?
I wouldn’t question the early retired doc’s dedication as much as I would question society for letting this kind of frivolous lawsuit nonsense chase away the best and brightest from practicing medicine. Why should he risk losing his hard-earned financial assets to some ambualnce chaser trying to hit the lawsuit lottery?
Bull’s eye.
“His hard earned financial assets”? Let’s see, it’s reasonable to assume he finished college at 22, med school at 26, a year of internship would make it 27, then residency, let’s say age 30 when he begins private practice. Then he builds a practice, pays off the educational debt we keep hearing about, pays all those malpractice insurance premiums and all the office paperpushers to deal with the insurance companies…and still nets enough after tax to retire at 42. Uh huh.
A little more math: to have say $60,000 pretax investment income on the accumulated assets currently earning (let’s be generous) 4%, the invested principal would have to be about $1.5 million. That principal would be after tax net of all the items listed in the preceding paragraph. To net $1.5 million in 12 years after expenses and taxes, the gross must have been enormous to net a simple average of $125,000 in cool excess cash each year, and after living expenses too.
No wonder medical costs are so high. I don’t hear about a lot of business owners or lawyers or anyone else who retire with that kind of piggy bank after 12 earning years.
The answer is, if you docs want to stack up this kind of cash in the mattress, then yes, you’re going to have to work very hard for it, just like regular people, and yes, you’re going to be held responsible for your mistakes, just like people in any other money making venture. You can’t have it both ways.
“No wonder medical costs are so high. I don’t hear about a lot of business owners or lawyers or anyone else who retire with that kind of piggy bank after 12 earning years.”
– Physicians’ income represents anywhere from 3-10% of medical expenditures, depending on what source you choose to believe. By contrast, administrative costs represent between 25-40% of national expenditures.
You wanna know why health care costs are so high? Look no further than the bureaucratic and legal systems.
Besides which, your “argument”– if it can be called that– doesn’t even make intuitive sense. Physician incomes are at their lowest levels in decades (fact), yet health care costs have skyrocketed as doc incomes have plummeted. Doesn’t exactly suggest a causal relationship, now, does it? Know what else has skyrocketed during that time? Administrative costs are up over 550% since 1995. Managers, middle-managers, execs, paper-pushers, myriad billing and documentation requirements necessitated by our current managed care and legal paradigms.
So go ahead and feel free to admit your error at any time, though I won’t be holding my breath.
According to US Labor Dept, the average US physician makes about 150k per year.
Is that a good salary? Yes.
Does that indicate they are being “overpaid”?
The term “overpaid” is meaningless unless you assume a socialist system a priori.
If you believe in capitalism, then people are worth whatever hte market will bear. Hence, baseball players make 10 million per year and doctors make 150k per year.
Deciding what jobs are “worth” is a slippery slope to deciding that everyone can live on 50k per year and creating a government that enforces flat wages across all industries.
“If you believe in capitalism, then people are worth whatever hte market will bear. Hence, baseball players make 10 million per year and doctors make 150k per year.”
– Not that I disagree with the rest of your post, but this is not entirely truthful. The system that physicians work under is by NO means a “market” system. Market systems– even fettered ones like the rest of our capitalist society operates under– do not feature third party payors and other proxy mechanisms. Doctors are in no way being paid “what the market will bear” currently, because there is very little of the free market dynamic in modern medicine.
“What “factual basis” issue are you referring to?”
The fact that you have no concept of payouts by insurers, how your insurer manages its money, how many cases would be affected by whatever version of “tort reform” you’re backing each day, the fact that you have no idea how much your insurer would have saved in the past, say, 5 years if that version had been in place, the fact that you have no idea how much of that would have been passed on to you.
You know, all the facts that one would normally need to reach the conclusion that capping damages for the weakest members of society will have any effect on whether you make $150K or $180K.
At least you don’t try to argue that tort reform is a societal benefit in terms of health care savings. I’ll give you that.
CJD
You sure do prove the point of Kevin’s original post.
You know, you don’t have to go into managed care. You could drop out. You just wouldn’t have the guaranteed pay.
You want to reduce the risks of lawsuits? Ignore your insurer and listen to the patients. They just want you to acknowledge them. Literally every med mal lawyer will tell you that the #1 complaint of every person who comes in to talk about a potential case is that they can’t get anyone to answer them.
Yet none of you talk about that solution. You’re so focused on trying to solve it in ways that have failed before.
But we are, you just need to translate it a little bit in your own language. That IS the point : examining the patient in ten minutes and filling huge amounts of paperwork in twenty is detrimental to patient-physician communication. The same applies for using a billing service (impersonal creature), secretary (poorly trained and medically illiterate very often) and any other middle-man. Physicians did not create this, although many people think that.
And yes, the solution is to ignore the insurance company completely and refuse to be part in any of them, including medicare.
Aren’t there blogs about physicians doing that very thing?
As to your other comment, you say the physicians didn’t create it, but what are they doing to combat it? I see ample press releases, organized action, etc. on tort reform. I see nothing but acquiescence on the other issues you mention.
Of course, there is the occasional class action on reimbursement rates. The irony of that is always noted, of course.
Go away for a few days and look at the blather that gets posted.
Okay, let’s try this one again. All the whining that gets done about how these poor poor docs just CAN’T make a decent living anymore — All I did was point out the dollars that had to have been made by one of them to retire comfy after only 12 years’ practice, and do ANY of you respond to the point? No!
Notice! The point is: you can’t moan about how you can’t make a decent living when you can retire so young and so wealthy.
Notice! The point is NOT that there’s anything wrong with making money, y’all. Just don’t make a pile of it and then complain how you’re being taken to the cleaners every day and have to have special legislation passed that protects you from your mistakes. Whence this sense of entitlement?
No, not all docs whine, not all are rich, not all are afraid of their mistakes, but those who do — you know who you are.
I think part of the problems is that medical care is less about helping people and more about business. Once you realize that, then you’re right, why complain. But when most clinical forms are designed around billing purposes and are almost always difficult to navigate for clinical purposes. And yes I can chose to treat a patient anyway that I want, but what good is that if they can’t afford the medication and insurance will not cover it. Plus I am still liable eventhough someone else is basically making treatment decisions, such as an insurance company. There do seem to be many barriers (insurance companies, paper work, increased number of patients leading to 15 min visits) that make it difficult to do the one things that I have sacrificed (family, children, financial debt – some friends of mine have greater than $150,000 debt from medical school)so much for, which is to help people live better quality of life. So, yes it would be nice to change the system, complaining will not do that, for many it is a coping strategy. It will be difficult to change the system because so many different people profit from it. Oh, and it’s not about retiring wealthy (though it helps not to have $150,000 debt) it’s about the personal cost. Divorces are common and much personal is sacraficed that is not made better by money. One married friend once said that his second wife hasn’t even been born yet. How true. The best thing is to take pride in what you do and try to do the right thing, eventhough there is much pressure externally and internally (sleep deprived, hungry, etccc) to not do so.
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