The 10%=20% pay cut

This is spot on and it is time people realize that you (the physician) are the last one to be paid. Reimbursement cuts come right off the top; overhead never sleeps and continues to grow. The only quibble I have is that many physicians do have overhead greater than 50%. I that case, the pay cut is greater than 20%, and lest you ignore inflation, your year-over-year pay cut in inflation adjusted dollars is probably closer to 30%.