Physicians: "We are the new factory workers"

This article was from six years ago:

Lots of patients fork over nothing but a co-pay, the mandatory cash outlay that can be as low as $10, or even $2. “What do you value a physician at if you pay $2?” asks Stracher, who says that sometimes, for that amount, patients blithely skip even bringing along money. For two bucks, patients sometimes don’t show up. Or they get the idea that — guess what? — doctors are only worth a few dollars. Fox recalls a patient with a $10 co-pay. She had a small tumor in a lymph node and wanted a second opinion on surgery. She was upset and nervous, and Fox spent more than 30 minutes calming and examining her. In the end, he assured her, she didn’t need surgery. “That’s the best $10 I ever spent,” she gushed, leaving Fox nonplussed. To the patient, he thought, “that’s what I’m worth.”

Things have gotten worse since.

Comments

Anonymous
And the world’s whiniest profession goes to a new low. The average factory worker makes less than 1/3 the average physician, and the physician doesn’t have to worry about his industry packing up and moving to Thailand.
Get over yourselves.
pulling the wagon
1:53
Here you go again with your tireless, clueless argument.
The average factory worker didn’t deprive himself while those with drive and ambition studied, invested 200K in their education, and subjected themselves to slavery of residency in lifes prime years.
Get over your jealousy and sense of entitlement to others hard work
Anonymous
Slavery? Be serious. More overwrought nonsense. $200,000!!! And at 4% too! How do you overcome?
Where’s MLK when you need him to help you with your plight?
Mike
Anon 1:53… what factory worker has to play 20k or more per year for malpractice? when was the last time a factory worker got sued for not ordering an unnecessary CT scan? What factory worker went to school for 8 years, took endless licensure exams, paid thousands for licenses and test fees, took out 150,000 in loans, paid thousands per month in rent/electricity etc to run an office and hire a biller? What factory worker worked 110 hour weeks during residency for no overtime? What factory worker risks going to jail for writing too many narcotic prescriptions to fat idiots like Rush Limnaugh?
Is being a doctor not a job that is any diiferent to you than a factory worker? Do factory wrokers not complain about theri jobs? I’m sure you would begrudge them also.
Get a life.
Anonymous
Mike, what you’re saying about overhead is all well and good, but we’re talking salary – and the average physician’s salary, money made over and above expenses including malpractice, is $150,000. How many factory workers make that?
Again, lots of people work hard, some *gasp* even harder than physicians. And they don’t get paid near as much. Again, get over yourselves and stop whining.
Mike
So thats your argument. Because the salary is 150K or whatever bogus number you pull out of the air, we shouldn’t balk at being compared to factory workers. How many factory workers could do what a doctor does? Answer that one. Maybe 1 percent. So I dont give a damn how hard their having it. Because they can’t do what we do. So where does that leave you, anon, when you need a doctor?
Anonymous
Who’s paying only 4%? I;d like to know – where do I sign up?
I pay more than $1500 monthly in student loan payments. This in after tax dollars, or about 2100 in pre tax dollars. So $25,200 yearly off the top of my “salary”. Now I am a self employed internist, I do not make $150,000 (not nearly). After accounting for my loans and time “lost” on education, most PAs doing primary care net more than I do, at about 90K/yr salary, 2 years of post-bacc education (5 years less than mine), and minimal student loan debt.
Soon, I will need a good Internist, and there will be none. It’s not worth it. Those that really want to do primary care will be PAs or NPs, other will go onto something else. The investment in time/effort/money is too great for someone bright enough to pass the IM boards every ten years.
Anonymous
I love it. People whining because someone else whines.
I wonder if 1:53 is CJD. He is the famous one with the laborious and repetitive “150K” schtick concerning physicians.
Michael Rack, MD
Also deducted from the hypothetical $150,000 for self-employed physicians is the self-employment tax – Medicare and the employer half of social security- approximately $10,000 that an employed person wouldn’t have to pay.
Anonymous
Stop your whining. You’re not the only people in America who work hard. You’re just among the most well paid who work hard.
If you feel like you’re not appreciated, go trying being an actual factory worker for awhile and then report back to us on how difficult it is and how underappreciated you are.
Anonymous
By the way, the $150K is the Dept. of Labor’s number, not mine. You surgeons actually do much better on average – $250K
night shift
“If you feel like you’re not appreciated, go trying being an actual factory worker for awhile and then report back to us on how difficult it is and how underappreciated you are.”
brilliant suggestion CJD. Do you assume doctors have never done anything else? On the path through school to became an ER doc factory worker I: painted campground latrines, cut timber, bucked and stacked hay, butchered beef, cleaned test tubes, taught JR high kids. Yeah these were tough jobs, but not a tenth as demanding, risky, stressful, hard as what I do now.
Richard
Being a Canadian medical student, I can’t speak towards the state of physician compensation in the United States.
But here in Canada, while it is true that physician billing varies widely across specialties (radiologists make a lot, family docs and paeds make much less), the assumption that doctors get paid a lot is quite inaccurate.
Sure, a family doc may bill $200000 a year. But once you take out overhead, the lack of a pension and any benefits package, and health insurance and professional fees, you’re left with a lot less. Then consider that family doctors usually work well in excess of 40 hours a week, and have put in at least 6 years of medical education and an average of $120000 of student debt. Suddenly it doesn’t seem all that rosey.
And certainly surgical specialties bill more (Canadian average is over $300000), but I haven’t met any surgeons (except for dermatologists, ENT, and opthamologists) that work less than 70 hours a week even at the age of 40. Not to mention being on call…
I graduated as a mechanical engineer before going into medical school. Trust me, with 4 year head start on making $, much less student debt, the current state of oil prices and the retiring baby boomers, I would’ve made a LOT more money staying in engineering.
Call me crazy, but taking some of the brightest minds in your society, giving them enormous responsibility, very high stress and long hours, and then paying them worse than most other professionals doesn’t really make all that much sense to me.
Details here:
http://www.cmaj.ca/cgi/reprint/170/5/776.pdf
Anonymous
mike, yeah, you would think with all that education Doctors would be real smart. But, read what you wrote and then tell us who the smart folks are.
And you guys are absolutely, without a doubt, the whinniest profession there is.
Anonymous
Night Shift…I am LMAO at you and cannot stop! So before you became a doctor,….. you were, a butcher, a farmer, a painter, A jr high school teacher, AND a lab technician? Let guess here, you taught school during the day with weekends and evenings off, then you hurried to the meat mrk and did some butchering in the evenings. On the weekends you went into the hospital and worked as a lab technician, and during the summer when you wern’t teaching school you were a farmer. Where did you find time to study? When did you attend med school? How did you have any hrs at all to work 100+ hr weeks in residency?
Now if you want to change your mind and become a factory worker, go to Protor and Gamble. After a few years you can make almost 100k yearly. You will get alot of respect, and after 20 years you should have just about a million dollars in profit sharing.
Anonymous
Why don’t you all go into software R&D instead? Face it, you don’t really want to work at a factory.
But if you are good, with an MS in CS you could make about 100K yearly after 10 or so years. Maybe more, if you change jobs often. Around 1999-2001 you could have made a lot more, but salaries have fallen a lot since then. Some time in early 2000s companies in Sillicon Valley were firing people making 100K only to hire them back at 70K for the same job.
Of course, you’ll also be working long hours, sometime weekends just to meet insane schedules, not getting paid for extra hours at all (most high skilled white color workers are “exempt” from overtime pay in case you don’t know), worry every year about evaluations, worry about your company’s earnings – “below expectations” often translates to no raises and sometimes translates into layoffs. Unhappy? No worry, there are some folks in India and China who are just as good as you are can do your work for a fraction of your salary. If you are lucky you can get 2-4% increase a year raises, if you are not lucky you can go for a couple of years with no raises at all. Who cares about inflation if there are people in other countries who can do your job for $500 a month.
But look on the bright side. Nobody will ever sue you for malpractice. There may be other types of stress – when you cannot figure out why some little thing doesn’t work and the deadline was yesterday.
Forgetting CS, you could probably change jobs without changing fields. How about just going into research? You have an MD, you could probably get a PhD and just do research. For some reason, most of you choose an MD over MD-PhD, was it only because you wanted to help people?
Anonymous
I think the flaw in the argument here is the choice of “factory worker” as the Average Joe profession to set doctors against. I think this is wrong because “factory workers” have largely been able to organize labor unions, which can barter on their behalf for benefits, while the average retail/service employee (a much better, more modern job for Average Joe) cannot.
Despite your onerous overhead, malpractice, etc. you doctors all manage to pay dues to your professional associations, which work and lobby to your benefit. Walmart employees, on the other hand, cannot organize and fight for their rights.
There was no guarantee with your medical degree that you’d be able to cash in off the pain and suffering of others (I apologize, providing care). So welcome to the economy the rest of us live in, where going to college and getting a degree now means you can be a supervisor instead of a cashier when you end up having to work at Target.
Anonymous
When was the last time a supervisors pay was cut because of an act of Congress?
When was the last time the Target supervisor had thirty customers in one day insist that he break the law and every ethical code so that his illness would qualify for FMLA or state disability?
When was the last time the Target supervisor had to inform someone that their family member was dead, or a patient that his time was near?
When was the last time the Target supervisor was out 20K (out of pocket) to ensure that their liability carrier was doing right by him?
When was the last time the Target supervisor decided to forgo his pay so that he could meet the payroll for his employees?
When was the last time the people who pay the Target supervisors paycheck decided that they had paid him too much and demanded a refund for overpayment over the last three years?
It’s ok. You non-physicians are allowed to ignore the FACTS that are part of a physicians daily existence, as long as it furthers your argument, complaint, etc. Which begs one question: If doctors discussing (whining in your parlance) medical care, health care policy, and so forth bothers you so much, why do you read KevinMD (or other medical blogs)?
Anonymous
If the govt. is cutting your pay, stop doing govt. work. If you don’t want to be subject to EMTALA, don’t take govt. money.
When was the last time a target supervisor made $200K a year? With great reward comes great responsibility.
Don’t make a conscious choice and then expect everyone to feel bad for you.
Anonymous
If the govt. is cutting your pay, stop doing govt. work.
Just about every insurer ties their rates to medicare. The only “choice” today is to try to go concierge (not much of a choice).
When I was able to make a real “choice” this was not the case. There were no HMOs nor managed care plans, etc.
Don’t make a conscious choice and then expect everyone to feel bad for you.
How do you feel about abortion?
Anonymous
When was the last time a supervisors pay was cut because of an act of Congress?

When was the last time a doctor lost a job because of outsourcing or was asked to train his replacements from another country? Or had 50% cut in salary because of the stock market crash?
Every profession has its pros and cons. While it is true that most of us non-doctors don’t know a thing about your problems, you don’t have a clue about other fields. Like when you say that other people are paid by the hour (hello? most white-color workers aren’t) or are guaranteed the inflation-based increases (only unionized workers are guaranteed anything) or get overtime pay (most professionals on a yearly salary don’t).
If you don’t like it, you could do something else. You could do research, for example. Less money but less stress too; or maybe a different kind of stress. Freedom of choice.
Anonymous
If you don’t like it, you could do something else.
You are also free to get your care from a naturopath, spiritual healer, shaman, or medium… oh, wait a minute – you would never want to pay their non-government controlled, non-insurance payable rates, now would you?
Anonymous
You are also free to get your care from a naturopath, spiritual healer, shaman, or medium… oh, wait a minute – you would never want to pay their non-government controlled, non-insurance payable rates, now would you?

This was a non-sequitur. What does someone’s freedom to go to a doctor or not has to do with whether you better off or not than factory workers? Since you have no clue of who I am or anybody else on this board is you don’t know what we want to pay or not. No need to get personal.
Absolutely, if you didn’t take insurance I’d either have to pay out of pocket, find a doctor who takes my insurance, go to witch doctors, die, whatever. So if you don’t want to take insurance – don’t. If you loose your patients as a result and go out of business – it is your problem. You take or don’t take medicare based on what is convenient for you at this moment. You also have a professional organization who can lobby on your behalf. Don’t like your job – find another one. Go into IT where the risk of law suits are virtually non-existent and see if it makes the job stress-free.
Do you have a right to complain? Sure. Most of us complain about our jobs, about how bad business means no raises for us but a 20% raise for a CEO. Just don’t talk about other professions as if you know anything about them.
Anonymous
Just don’t talk about other professions as if you know anything about them.
The height of hypocrisy among comments on this blog.

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Physicians: "We are the new factory workers"

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