Comments on: What happens if you lower physician salaries? http://www.kevinmd.com/blog/2007/07/what-happens-if-you-lower-physician.html medical blog Sun, 22 Nov 2009 14:15:05 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Anonymous http://www.kevinmd.com/blog/2007/07/what-happens-if-you-lower-physician.html/comment-page-1#comment-110137 Anonymous Sat, 22 Aug 2009 06:41:46 +0000 http://clients.emmense.com/kevinmd/2007/07/what-happens-if-you-lower-physician-salaries.html#comment-110137 I agree that there is no free market in medical field. I was told by a specialist that they can maintain high salary simply because American Medical Association restricts number of residency. Experienced foreign Dr. have to go through residency in US too. This way, supply was cut even for those foreign Dr. Everybody knows Murrphy's, law 20% shortage leads to 80% salary increase. As for the brightest, Dr is largely a practice not an inventor, and the training needs a lot of memory. I would say, a lot of people do not have the gift to be a mathatician, but they can be a Doctor. I agree that there is no free market in medical field. I was told by a specialist that they can maintain high salary simply because American Medical Association restricts number of residency. Experienced foreign Dr. have to go through residency in US too. This way, supply was cut even for those foreign Dr. Everybody knows Murrphy’s, law 20% shortage leads to 80% salary increase. As for the brightest, Dr is largely a practice not an inventor, and the training needs a lot of memory. I would say, a lot of people do not have the gift to be a mathatician, but they can be a Doctor.

]]> By: Breckenridge http://www.kevinmd.com/blog/2007/07/what-happens-if-you-lower-physician.html/comment-page-1#comment-90115 Breckenridge Fri, 06 Mar 2009 08:36:00 +0000 http://clients.emmense.com/kevinmd/2007/07/what-happens-if-you-lower-physician-salaries.html#comment-90115 Bottom line: If you ask a doctor if he's paid too much, the answer is no. If you ask a non-doctor, the answer is yes. Bottom line: If you ask a doctor if he’s paid too much, the answer is no. If you ask a non-doctor, the answer is yes.

]]> By: Anonymous http://www.kevinmd.com/blog/2007/07/what-happens-if-you-lower-physician.html/comment-page-1#comment-87949 Anonymous Thu, 06 Nov 2008 05:23:00 +0000 http://clients.emmense.com/kevinmd/2007/07/what-happens-if-you-lower-physician-salaries.html#comment-87949 I'm was an engineer and am now a second year med student. Medicine is much more difficult than I ever imagined. It is not only memorizing things, but the ability to recall things years later. In my year and a half I feel like I've learned a different language and learned about every genetic disease, infectious disease, anatomical structure, and the ability to divulge into nauseating detail all of these things. It is a massive bear that isn't and cannot be appreciated until you go through it. IT IS A MEATGRINDER THAT NEVER ENDS. I enjoy it though, I guess I enjoy stabbing myself over and over again. <br/><br/>Joking aside I love my choice and really haven't regretted it one bit. Family docs are underpaid and vastly underappreciated. They are the ones that make a difference in many peoples lives that nobody notices. Everybody sees their job as the webmd job, but it is far more difficult than simply googling webmd.<br/><br/>Doctors have earned there pay. It is not only a difficult job, but a job that had many sacrifices to get to. Sacrifices only family and friends ever see! I’m was an engineer and am now a second year med student. Medicine is much more difficult than I ever imagined. It is not only memorizing things, but the ability to recall things years later. In my year and a half I feel like I’ve learned a different language and learned about every genetic disease, infectious disease, anatomical structure, and the ability to divulge into nauseating detail all of these things. It is a massive bear that isn’t and cannot be appreciated until you go through it. IT IS A MEATGRINDER THAT NEVER ENDS. I enjoy it though, I guess I enjoy stabbing myself over and over again.

Joking aside I love my choice and really haven’t regretted it one bit. Family docs are underpaid and vastly underappreciated. They are the ones that make a difference in many peoples lives that nobody notices. Everybody sees their job as the webmd job, but it is far more difficult than simply googling webmd.

Doctors have earned there pay. It is not only a difficult job, but a job that had many sacrifices to get to. Sacrifices only family and friends ever see!

]]> By: Gabriel http://www.kevinmd.com/blog/2007/07/what-happens-if-you-lower-physician.html/comment-page-1#comment-85557 Gabriel Mon, 12 May 2008 23:42:00 +0000 http://clients.emmense.com/kevinmd/2007/07/what-happens-if-you-lower-physician-salaries.html#comment-85557 Physician should make as much as they need to make. They are simply too important for the community. Please don't play around with their salaries. they study hard, so pay them well Physician should make as much as they need to make. They are simply too important for the community. Please don’t play around with their salaries. they study hard, so pay them well

]]> By: Anonymous http://www.kevinmd.com/blog/2007/07/what-happens-if-you-lower-physician.html/comment-page-1#comment-83767 Anonymous Wed, 20 Feb 2008 12:23:00 +0000 http://clients.emmense.com/kevinmd/2007/07/what-happens-if-you-lower-physician-salaries.html#comment-83767 I get the feeling that this blog is being read by disgruntled doctors who "get it' already, and a couple of uninformed intellectuals who just want to argue. Doctors cannot be compared to anyone else. <br/>I am an OBGYN private practice. I take insurance plans because to not do so would cause economic ruin. There are 4 major plans in our area and they completely saturate the market. To not take one would mean 25% loss of market share. People are not able to foot the bill for a delivery or surgery out of network. Therefore one takes the plans. Let me inform you on something else.<br/>RVU's- relative value units are how insurance companies look at our worth. It is an insidious system often arbitrary, but nonetheless, it is how they do it.<br/>The avereage reimbursement from an insurance company for all doctors is $65 per RVU. For Medicare it is $55. Even worse for medicaid it is $45. <br/>TMA the texas medical association has done research and found that the business model that would be most efficient and viable requires $75 per RVU. All insurance companies know this. The government knows this. Doctors need to know it, and so does the public. Today, one of my nurses complained because she had made an appt with an internal medicine doctor and then forgot. He sent her a bill for $25 for missing the appointment. She was mad at him. She thought that was unfair. I told her to expect more of the same as practices try to stay viable. I also reminded her that when he went to the ER at two in the morning to take care of her hypertensive crisis, that he couldn't charge any extra than if she had come into the hospital at 2 in the afternoon. Doctors should not accept any 3rd party service. They should go back to fee for service, and let the economy decide.<br/>The current system makes all doctors earn the same money from an insurance company,medicare,medicaid, whether they are good or bad doctors.<br/>Foreign trained doctors usually go to the less desirable residency programs that were not filled with US trained physicians. They are taken so as to fill the slots of the residency and create cheap labor for a hospital system. Supervision is a problem with that system. As a general rule they are not as well trained, have cultural issues, and ethics that often clashes with patients. I get the feeling that this blog is being read by disgruntled doctors who “get it’ already, and a couple of uninformed intellectuals who just want to argue. Doctors cannot be compared to anyone else.
I am an OBGYN private practice. I take insurance plans because to not do so would cause economic ruin. There are 4 major plans in our area and they completely saturate the market. To not take one would mean 25% loss of market share. People are not able to foot the bill for a delivery or surgery out of network. Therefore one takes the plans. Let me inform you on something else.
RVU’s- relative value units are how insurance companies look at our worth. It is an insidious system often arbitrary, but nonetheless, it is how they do it.
The avereage reimbursement from an insurance company for all doctors is $65 per RVU. For Medicare it is $55. Even worse for medicaid it is $45.
TMA the texas medical association has done research and found that the business model that would be most efficient and viable requires $75 per RVU. All insurance companies know this. The government knows this. Doctors need to know it, and so does the public. Today, one of my nurses complained because she had made an appt with an internal medicine doctor and then forgot. He sent her a bill for $25 for missing the appointment. She was mad at him. She thought that was unfair. I told her to expect more of the same as practices try to stay viable. I also reminded her that when he went to the ER at two in the morning to take care of her hypertensive crisis, that he couldn’t charge any extra than if she had come into the hospital at 2 in the afternoon. Doctors should not accept any 3rd party service. They should go back to fee for service, and let the economy decide.
The current system makes all doctors earn the same money from an insurance company,medicare,medicaid, whether they are good or bad doctors.
Foreign trained doctors usually go to the less desirable residency programs that were not filled with US trained physicians. They are taken so as to fill the slots of the residency and create cheap labor for a hospital system. Supervision is a problem with that system. As a general rule they are not as well trained, have cultural issues, and ethics that often clashes with patients.

]]> By: Anonymous http://www.kevinmd.com/blog/2007/07/what-happens-if-you-lower-physician.html/comment-page-1#comment-81830 Anonymous Sun, 18 Nov 2007 20:04:00 +0000 http://clients.emmense.com/kevinmd/2007/07/what-happens-if-you-lower-physician-salaries.html#comment-81830 In the Soviet Union there were lots of doctors, they didn't earn a lot compared to others, and there was less training. But I don't recall service quality in that particular area of the economy being bad. As for your guys argument of doctor pay, I think there is some middle ground. I think some doctors are overpaid (dermatoligists, family doctors, psychiatrists, among others), and some are not - surgeons, if they are good surgeons, do require special skills which not everyone can be trained. And some, such as neurosurgeons also require highly above-average intelligence, which compounds the salary. So, I think some are overpaid, bevause of restricted supply but others at least fairly paid or even underpaid esp. given the training and hours involved. In the Soviet Union there were lots of doctors, they didn’t earn a lot compared to others, and there was less training. But I don’t recall service quality in that particular area of the economy being bad. As for your guys argument of doctor pay, I think there is some middle ground. I think some doctors are overpaid (dermatoligists, family doctors, psychiatrists, among others), and some are not – surgeons, if they are good surgeons, do require special skills which not everyone can be trained. And some, such as neurosurgeons also require highly above-average intelligence, which compounds the salary. So, I think some are overpaid, bevause of restricted supply but others at least fairly paid or even underpaid esp. given the training and hours involved.

]]> By: Anonymous http://www.kevinmd.com/blog/2007/07/what-happens-if-you-lower-physician.html/comment-page-1#comment-78594 Anonymous Sat, 04 Aug 2007 14:25:00 +0000 http://clients.emmense.com/kevinmd/2007/07/what-happens-if-you-lower-physician-salaries.html#comment-78594 Pay less but think you are going to get more and better? Sorry, but an hour is still an hour, and when you are talking highly skilled labor, that is not a reasonable expectation.<br/><br/>Those who post thinking that you will make the equivalent in capable physicians with shorter training on back-of-the-matchbook type schools are fooling themselves. That might work for training truck drivers or computer technicians--and even then, that is debatable--but it won't work for medical doctors. If the idea had any legs, for-profit "universities" would be clamoring for the chance to open medical schools. But they aren't, and those entities would be the best equipped to do an educational program on the stripped-down-ugly-but-works model. Sorry, medical school is long and expensive because there is a lot to teach and the environment requires much more than a bunch of cheap night school rental classrooms and some home study materials. Pay less but think you are going to get more and better? Sorry, but an hour is still an hour, and when you are talking highly skilled labor, that is not a reasonable expectation.

Those who post thinking that you will make the equivalent in capable physicians with shorter training on back-of-the-matchbook type schools are fooling themselves. That might work for training truck drivers or computer technicians–and even then, that is debatable–but it won’t work for medical doctors. If the idea had any legs, for-profit “universities” would be clamoring for the chance to open medical schools. But they aren’t, and those entities would be the best equipped to do an educational program on the stripped-down-ugly-but-works model. Sorry, medical school is long and expensive because there is a lot to teach and the environment requires much more than a bunch of cheap night school rental classrooms and some home study materials.

]]> By: Anonymous http://www.kevinmd.com/blog/2007/07/what-happens-if-you-lower-physician.html/comment-page-1#comment-78558 Anonymous Fri, 03 Aug 2007 03:01:00 +0000 http://clients.emmense.com/kevinmd/2007/07/what-happens-if-you-lower-physician-salaries.html#comment-78558 By the end of my residency, I was able to estimate the hours that I had put into acquiring the skills that I was now setting out to sell. Counting medical school, it amounted to the amount of time that a state employee had put into the job in this state at after 20 years of full-time service, considering their vacations and sick-leave. And that doesn't count the pension they have been earning. Teachers in this state can retire in 20 years.<br/><br/>My health was damaged, I had missed my youth, and had put in nearly a lifetime of working hours crammed into a few years. I don't regret it--it was my decision, but I did it with the assumption that I would be living in a free society where I then rent that experience out at a fair rate. That is what someone is doing when they pay a fee--renting a little piece of that. I had to buy it.<br/><br/>Overpaid? My accountant with a bachelors degree charges more than I do. By the end of my residency, I was able to estimate the hours that I had put into acquiring the skills that I was now setting out to sell. Counting medical school, it amounted to the amount of time that a state employee had put into the job in this state at after 20 years of full-time service, considering their vacations and sick-leave. And that doesn’t count the pension they have been earning. Teachers in this state can retire in 20 years.

My health was damaged, I had missed my youth, and had put in nearly a lifetime of working hours crammed into a few years. I don’t regret it–it was my decision, but I did it with the assumption that I would be living in a free society where I then rent that experience out at a fair rate. That is what someone is doing when they pay a fee–renting a little piece of that. I had to buy it.

Overpaid? My accountant with a bachelors degree charges more than I do.

]]> By: Anonymous http://www.kevinmd.com/blog/2007/07/what-happens-if-you-lower-physician.html/comment-page-1#comment-78515 Anonymous Thu, 02 Aug 2007 01:41:00 +0000 http://clients.emmense.com/kevinmd/2007/07/what-happens-if-you-lower-physician-salaries.html#comment-78515 There were many in my med school that were as dumb as rocks and somehow made it through. Some probably should not have made it through. I would hate to think that standards would be lowered. There were many in my med school that were as dumb as rocks and somehow made it through. Some probably should not have made it through. I would hate to think that standards would be lowered.

]]> By: Anonymous http://www.kevinmd.com/blog/2007/07/what-happens-if-you-lower-physician.html/comment-page-1#comment-78513 Anonymous Thu, 02 Aug 2007 00:57:00 +0000 http://clients.emmense.com/kevinmd/2007/07/what-happens-if-you-lower-physician-salaries.html#comment-78513 what is this "best and brightest. BS"???. first most of the people who go to medical school are GOOD Students. but they dont have any clinical knowledge or vast understanding of medicine until they get to their 3rd year of school. when i was in high school... there were quite a few students who were high in our class. they did not all go into medicine. (4 of us did). in fact its not the best person from high school who does well in a medical program. usually its a very dedicated person who knows what he/she wants to do. as a previous post noted.. it takes years until you feel competant in a clinical setting. there are just so many variations in disease and the disease process. certainly physicians deserve to be well compensated... imagine your feeling being a patient and not understanding your condition or having high medical needs.. you want someone who is not only competant but also dedicated and able to help. we are looking for competant physicians.. it takes years of training to get people to the point that they can effectively treat some of the complicated disease processes that are out there. residency length is to make competant physicians. what is this “best and brightest. BS”???. first most of the people who go to medical school are GOOD Students. but they dont have any clinical knowledge or vast understanding of medicine until they get to their 3rd year of school. when i was in high school… there were quite a few students who were high in our class. they did not all go into medicine. (4 of us did). in fact its not the best person from high school who does well in a medical program. usually its a very dedicated person who knows what he/she wants to do. as a previous post noted.. it takes years until you feel competant in a clinical setting. there are just so many variations in disease and the disease process. certainly physicians deserve to be well compensated… imagine your feeling being a patient and not understanding your condition or having high medical needs.. you want someone who is not only competant but also dedicated and able to help. we are looking for competant physicians.. it takes years of training to get people to the point that they can effectively treat some of the complicated disease processes that are out there. residency length is to make competant physicians.

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