Doctor Salaries, A Problem Overseas Too

In a previous post (Physician Salaries on the Decline) I wrote about declining physician salaries and how that is bad for healthcare.

I recently found a post from a medical student in the U.K. The system is kind of different there. He talks about the salary a newly graduated doctor would make out of medical school. Here in the States, I’ve found some residency brochures that advertise paying their residents somewhere between $45,000 and $50,000 USD.

Anyways, the post talks about how the financial benefits of a career in medicine might not be enough to entice the “cream of the crop” into medicine. And, the author points out, wouldn’t you want the best and the brightest to be the ones taking care of you when you’re sick?

From the post:

Where would you want the brightest people in the country to work? Would you have them making you money as stockbrokers; defending you in court as lawyers; writing your next headline as journalists; or would you have them saving lives as doctors? Most people would rank their health as one of the most important aspects of their lives, but is medicine financially attractive enough to entice the cream of the crop? I am not sure. In financial terms medicine might not be the best choice for the bright young future of tomorrow.

The post is at sBMJ – Viewpoint: Deterred by the doctor’s salary?


Physician Salaries on the Decline

Related Posts: Doctor Salaries, A Problem Overseas Too

Sources: American Medical Association, American Medical Student Association, Center for Studying Health System Change, New York Times

Last year (2006) a story published in the New York Times reported something troubling. Physician salaries are on the decline.

the average physician’s net income declined 7 percent from 1995 to 2003, after adjusting for inflation, while incomes of lawyers and other professionals rose by 7 percent during the period.

Some people do not think that this decline is a problem at all. Even with the decline, physicians are still making a decent salary. They aren’t going hungry. Maybe they have to forego a brand new S-class, but doctors don’t live off of welfare. And with the ever-increasing costs of healthcare, physician salaries just don’t seem as important.

It is very important. This country is headed towards a severe physician shortage. New medical schools are opening up and existing schools are expanding their freshman class sizes in response. Producing more physicians each year is not enough. Physician salaries must increase as well.

The shortage we are expected to go through is in the primary care segment. As it is, the current state of healthcare encourages doctors to enter high-paying specialties. New graduates are not flocking to Pediatrics, Internal Medicine, and Family Practice. Take a survey of any freshman medical class in the country. Many will share their desire to go into radiology, surgery, orthopedics, plastics, or dermatology.

Why? Frankly, for most, it’s because that is where the money is. Those specialties are the quickest way to get out of the enormous debt incurred during medical training. According to the American Medical Student Association (AMSA), the median debt for students at a public medical school is over $119,000 while those that go to a private medical school will carry a median debt of nearly $150,000. On top of debt, physicians make approximately $48,000 during their years during residency — which lasts at least 3 years. It could take up to 8 years for a thoracic surgeon to complete his/her training.

The stereotype of a lawyer is someone whose focus is on the number of billable hours. On the other hand, the stereotype of a doctor is one of compassion for a patient. While stereotypes can be dangerous, it is possible that in some ways they may give us a glimmer of reality.

The kind of people that go into medicine are usually people who truly care about the health of their patients. It is not a career chosen solely based on financial reasons. Today’s medical students are aware of the huge costs of training and the low reimbursements from insurance, medicare, and medicaid.

But there are many people who would make excellent doctors. They have all the right qualities but choose to go into other fields. They are discouraged from pursuing a medical career by working doctors tired of rising costs of malpractice insurance, declining salaries, bureaucratic hassles, and long workweeks. A career in medicine just does not seem “worth” the time and effort (see AMA Response to declining physician salaries).

Declining physician salaries are a big problem. It’s a big problem for the medical community and a big problem for the patient. If they continue to fall more and more prospective medical students will decide not to go into medicine because it is not “worth” it. Medical school graduates will continue to avoid primary care for higher paying specialties. And doctors will continue to order diagnostic procedures that bring in more revenue.