Department of Labor stats. Go to their website.

“Big houses in your hometown? So what.”

Actually, that’s just an example. I’m not citing it as statistical proof. Only a physician takes anecdotal evidence and advocates policy changes like that.

“More unsubstantiated garbage numbers.”

Again, I’m not a physician. I don’t just take numbers that an insurer tells me and swallow them whole and regurgitate them. None of my numbers are fake. The world’s average income is $7,000 per year. If you make the AVERAGE US physician salary of $150,000 per year you are in the top .33% of the world:

http://globalrichlist.com/

http://hypertextbook.com/facts/2006/MateNagy.shtml

My point is not that you shouldn’t be well compensated, I think you should. You work very hard at a very demanding job. My point is simply that other people work very hard at very demanding jobs and get paid far less and they don’t have the financial opportunities to set themselves up for life if they manage their money correctly like you do. Their jobs physically break their bodies down, and they will never have high enough earnings to retire early, no matter how well they manage because so much of their income is eaten up by basic necessities. When gas doubles, it has a MAJOR effect on their lifestyle.

Appreciate what you have. If you want to modify your reimbursement scheme and make more, great. I encourage you to do it. But don’t incessantly whine about how bad you have it. Because you’re doing far, far better than the vast majority of the world.

How about a citation for starters. Nothing like throwing around dramatic numbers with nothing to back them up. Can you?

Any profession? MLB? Investment banking? Commodities trading? Dentistry? Commercial banking? Actuarial consulting?

Big houses in your hometown? So what. That seems to be the limits of many people’s experience: the guy with a big house in this little town, he’s the doctor. (We forget about the guy next door that owns a couple of McDonald’s stores, or the dentist across the street, or the senior VP from the bank, or the real estate company owner, or the owner of the quick-marts.)

>>”you are compensated better than 99.9% of the world on average.”

More unsubstantiated garbage numbers.

So I should just be grateful and shut up, eh? I think not.

I also paid more for the privilege of practicing medicine than 99.99% of the world–to paraphrase you. So your point is exactly what, that I shouldn’t be well compensated? That I shouldn’t seek a fair return on all my investment? You spew tough talk about managing money–with your fake numbers and all– well, seeking and getting a fair and reasonable ROI is just that, or is that kind of money management not the thing you approve of?

You’re paid better than any profession in the world, by 50%. What else do you want? Statues?

In my state’s capitol city, the local business magazine did a review of all the houses that sold for over $1 million, and who lived in them and what they did. The single largest profession? Doctors by a landslide. Most employed at the local university hospital.

In America we get compensated by money, and you are compensated better than 99.9% of the world on average. If you can’t manage your money, that’s your fault.

You’re absolutely right – though I assume you are referring to the comments. But it was the original poster who introduced the irrelevant comparison in the first place. That’s where he went wrong and alienated some readers. You can very effectively make the argument that primary physicians are underpaid and even discuss moonlighting in this context without resorting to these outlandish and, frankly, insulting analogies.

But there is something to say about unmet expectations. I don’t think there is any longer course of education nor a more expensive one, nor one where the opportunity cost is higher than in medicine. If you compare comparably qualified students, the medical student–resident doctor is deferring key life purchases like a home, a retirement fund and savings for education far longer than any other college-educated person. Snide and envious people will remark that they can go live in the kinds of houses their patients do, and maybe they should, but nobody wants to count the ten years of not being able to buy even that house, never mind the lost opportunity at equity gains and other forms of wealth accumulation most people take for granted. Nobody wants to consider the costs of accumulated student debt, or of capitalized unpaid interest or of lost opportunities to earn a salary large enough to contribute early in one’s working life to a retirement fund, when those contributions can do the most earning.

Trucking out stories of others’ hardships adds nothing to this discussion–it is irrelevant.

If we as a nation expect doctors to be available to us on terms of entrepreneurship–and we do–then we shouldn’t be surprised to find little service available where the means aren’t there to pay the costs of service, and that means no less than the costs of my forgone opportunities.

If no place wishes to recognize the value of those sacrifices, then we rightly deserve to be a nation with a shortage of doctors, with all that follows from that.

If more physicians lived within their means, they would be in a better position to say “NO” when faced with…..well, a lot of the things blogged here and elsewhere. And just walk away.

I’ve known some docs who hold contracts with the local health department or the local jail. Sidelines to full-time office medical practice. Part-time work that’s administrative and once-in-a-while physician backup of the nurses and other personnel working there full-time.

Having diverse revenue streams gives you the ability to say no to an insurance plan that gives you a hard time. You can survive the loss of revenue. You can enlist your patients affected, they can write the insurance plan, and this sometimes gets the insurance plan to to negotiating table. Or just plain walk away if they won’t budge.

I knew one big internal medicine practice that did a big portion of their business with one 800-lb gorilla of a regional HMO. Then the HMO went bankrupt, and the economic shock really hurt the medical practice. A lot of layoffs of nursing personnel and even junior physicians.

So I for one don’t like to see any particular insurance become dominant in my practice.

I think I am going to throw up with disgust and shame.

I earn near the bottom of the average PCP–and that is a big jump this year–I have been below the usual numbers by about 20% for several years.

And I am not whining. I am grateful that I had the chance to get a medical liscense and took it. Sure, I worked and paid for it, but I didn’t make myself and could have been born without the health or intelligience to do so, or my family might have needed my support in those years or a dozen other things out of my control might have thwarted me.

And I have had no problem living on 80% of the average of PCP’s. No problem at all. And I paid off my student loans and completely paid off my house in 5 years while I was at it. The loans weren’t a lot–that is true. My wife doesn’t work and yess we have kids. They went to private school part of the time and one is in an expensive private college.

It isn’t hard at all, I feel rich, and am flat out embarrassed to see colleges grubbing for sympathy and comparing themselves to semi-skilled retail workers.

The problem that I see with docs who make less than 200,000 a year is that live too large–spend too much money. They feel entitled to certain things that they just don’t need and sometimes can’t afford. I didn’t buy in the neighborhood they bought into.

I have no problem living on several times what Walmart clerks live on and don’t much respect for someone who does and no respect for someone who whines about it. Clearly someone who has never been poor and has no idea whatsoever. Maybe that is the problem. I grew up poor–really poor and even pinching pennies in medical school never seemed a burden or anything to complain about. Any doctor I know, given the grocery budget of the average non-college graduate to live on for a week would run out of food by Tuesday.

For people who moonlight to buy the luxuries to which they feel entitled to compare their “struggles” to people who moonlight to keep the family in a home and out of malnutrition is ridiculous and disgusting.

“Really? Even with the employee’s discount from Wal-Mart? Where is your proof of that?”

Well lets see here the average worker at Wal-Mart makes about 7.00 dollars an hour. Now it is also Wal-marts policy to keep as many workers as possible working part time, rather than pay them benefits. so their full time hrs start at 32 hours per week, which means most employees get scheduled 31.5 hrs per work and will be sent home early on Friday if that average has been exceeded, even if they were doing the company a favor by working over when someone called in.

But, just for the hell of it lets “pretend” they all work 40 hrs per work for 48 weeks per year at 7.00 per hour.

OMG, brace yourself, because their full time employees have now made some where around 13K a year. Now if they are making a house payment or paying rent, raising a couple kids, putting gasoline in a car and trying to pay utility bills, its quite easy to see they have more than enough money left to buy a computer. Or, maybe a bit of common sense might tell you otherwise?

Imagine if both grown ups in one family are both working full time at Wal-Mart? Goodness, they are making some where around 26K combined total yearly income. They ought to be damn ashamed of themselves for making that much money. Especially when you do a comparison and consider what they are making with what the poor physicians have to settle for. We are SO sorry for you!

I checked and you were right… I exaggerated about the tens of millions working class people in this country. It’s more like ten or twenty THOUSAND. My bad. And, as it turns out, most ARE building that nest egg with their second job, though it’s not to start their own business. Most want to retire by 50.