Hey Solomon,

CT scanners and other high tech imaging devices are extremely expensive. They cost many hundreds of thousands of dollars, sometimes even millions of dollars for the latest equipment. The list price on the latest hybrid PET/CT scanners from GE and Siemens is about $2.5 million dollars, and they typically do only 10-15 patients a day. Those machines have to be paid for out of patient charges.

The technologists who actually run the machine are themselves highly paid professionals, who get their salary whether or not the radiologist or hospital makes any money on the study. They get paid from patient charges.

Supplies like IV contrast and X-ray film are expensive. They are paid for out of patient charges.

Medical scanners have special rooms built for them, with things like lead shielding in the walls, reinforced flooring to support their weight, high-capacity air filtration and conditioning, computer rooms, laboratories, prep rooms, etc. Those things all cost money.

Then there’s the question of malpractice; radiologists are among the specialists who are sued most often, and their liability insurance premiums reflect it. That has to be paid for out of patient charges.

We haven’t even touched on taxes, building rents, or billing and accounting expenses, or any of the other expenses that go into running a medical practice.

If you think the radiologist pocketed $700 for reading your wife’s CT scan, you’re totally misinformed. If he is in a very well-run practice in an area with decent insurance reimbursements, he might have made a net profit of $50 or $60.

“Do you think I picked Pierce County by throwing a dart at a map of the US? I see no reason to assist someone who I believe to be lying, is anonymous, and who has insulted me.”

– Yet you saw fit to reply– civilly, mind you– and now for some inexplicable reason refuse to supply the link to the site you say you’ve found. Entirely predictable.

“Could you please identify your posts in the future with some consistent signature so that I can know before I respond that it is the same person who has been posting in this thread?”

– No, because when you make a claim, and it can be verified quite easily by simply PROVIDING A LINK, yet you refuse to do so, I owe you nothing.

If you continue to refuse to provide a link to this “Pierce County, Washington job analysis” which purportedly contradicts my assertions, then I will henceforth view as a fraud.

I find it amusing that you continue to dance around providing the link when we both know that if you had one, you would have just posted it and shut me up already. In fact, if you provide said link, I will not only apologize profusely for everything said in this thread and admit that it is in error, I will worship you as my god, Elliot. That’s right– my god.

Oh, and I only “insulted” you once in about 10 paragraphs of writing (“insulted” is in quotes because you’re now using that as an out in order to not provide a link to substantiate your claims, despite having no problem with it earlier). Conversely, every one of your posts is dripping with condescension, vitriol, or explicit/implicit insults against physicians. Seems a bit hypocritical on your part.

But I guess they don’t teach you tact or good manners in “economics” school. By the way, did I mention how incredibly valuable your contribution to society is? Economists: what the world needs more of.

Here is the short argument of why I believe physicians are most likely overpaid:

1. They are the highest paid profession in the US.
2. Every single medical school slot is filled each year.
3. When substitutes become available at a lower price, businesses and people move to those substitutes (i.e. nurse practioners).
4. The percentage of practicing physicians relative to graudated physicians is higher than the percentage of practicing lawyers, teachers, or nurses.

Finally, I actually did find one job analysis on the web from Pierce County, Washington. It failed to support your claim.

– Then you’ve never run a job analysis on a physician. I haven’t, but I asked the HR division I was working with over a summer internship to do so, and they reported that a PCP (pediatrician, FP etc.) was “valued” according to their analysis, at roughly $270K per year. They currently make ~$130-150K, for reference.

“In addition, most job analysis includes required education and licenses and places a certain value on those aspects as well as the functional description of the job. I would be interested if you can point me to an article that states what you have just stated”

– There is no article that states such. It is something they did for me as a personal favor, since I was working with this group for a couple of months last summer. You’d simply have to go have someone perform a job analysis for a physician to prove it to yourself, though I’m sure you’re in no hurry.

“Also, since many job analysis tend to find multiple job categories to be underpaid, I would want to see the evidence that physicians were more underpaid relative to the analysis than these other professions.”

– Oh, without question there are a great many professions which are underpaid. There are also many which are overpaid based on objective criteria; I mentioned this in my previous post. I’m not certain whether physicians are underpaid to a greater degree than, say, teachers, firefighters, or biochem PhD’s, sibce I’d have to see a job analysis run on them as well. All I know is that they (physicians) are underpaid; hence, statements which say that they are overpaid are false.

“My contention is that the market in this case is not anywhere near the ideal perfect competition that would allow me to conclude that physicians are fairly compensated”

– The “market” is certainly not ideal. However, this works both for (your “monopoly” contention) and against (our current proxy payor system) physicians; hence I’d tend to believe that they balance out. Again, and as you well know, medical care is incredibly inelastic. How much would someone be willing to pay for an appendectomy as their appendix is on the verge of rupturing? Or for a hip replacement? A triple-bypass? To retain the services of a plastic surgeon after they’ve had third degree burns?

Assuming we “de-monopolized” (I disagree that the present situation constitutes a “monopoly”, but that’s neither here nor there– any provider can perform any service; they simply can’t have the initials “M.D.” after their name. That does not constitute a monopoly). But anyway, if we demonopolized medicine in an attempt to have as close to a “market” situation as possible, we’d also have to get rid of the third-party payor system. People would have to pay out of pocket for their own care, as opposed to a proxy paying 40-70% of fair value. Further, physicians would also be allowed to unionize (which is currently verboten) and could set pricing for their services to reflect the inelastic nature of the services they provide.

Assuming all this, I’d be willing to wager that doctors come out making substantially more than they’re making now. Substantially more.

In general, the market sets pay and the market has set physician pay higher than any other profession. My contention is that the market in this case is not anywhere near the ideal perfect competition that would allow me to conclude that physicians are fairly compensated. On the one hand, physicians need to be smart, highly trained, work relatively long hours, and bear a great deal of indivdual responsibility which certainly justify a high level of compensation. On the other hand, the monopoly elements of physician services and the distorted broader market of healthcare in which they operate lead me to believe there is a good chance that they are not underpaid, but rather overpaid.

I’m sure “economists” are incredibly valuable, btw. That’s what we need more of… lol

As an “economist”, surely you’ve heard of the job analysis methods I speak of. HR departments and consulting firms use them all the time to set pay levels for various jobs ranging from common, to managerial, to professional. They use objective criteria of the sort I mentioned earlier. Any job analysis you run on a physician is going to show that they are grossly undercompensated, yet you refuse to admit this fact despite the weight of the evidence being against you.

Do yourself a favor. Go to a localcompany’s HR department, and ask them to perform a job analysis to determine compensation for a physician (any sort of doc– it doesn’t matter). What you’ll find is that they are paid only 50-70% of what they are objectively worth.

You arouse pity in me. Ooh, ooh, you’re an economist– you’re SO special. Spare me…

I’m not even a doctor, btw, nor a med student, nor an aspiring med student. Your arrogance and myopia is galling, however.

Physicians do provide a valuable service. They have to be smart; they need to be highly trained; and yes, you want a good/great one when you need one. On the other hand the structure that put them at the pinnacle of the US labor force is an accident of history and luck. Also, much of what they do does not require any special skill. Try to tell them that and watch the fur fly. I’ll sit right back and watch it fly right now.