Where is the Uproar over Doctors Salaries?

Yes, the artificial scarcity of medical care has always bothered me. We could train more if we were of a mind to. It doesn't have to be 10 years. We don't have to put them on a rookie-scale contract in residency. We don't have to make their work-life balance so crappy. We don't have to make their education so expensive. We could reduce the personal costs being a doctor entails, make more of them, and pay each less. It really looks like an industry with a lot of dysfunction.

To be fair, it's the specialists that are making the big dollars, not the primary care doctors. I think specialists are over-compensated, where general practitioners maybe aren't so much.

I don't think I've ever seen Mr. Brightside be serious in a thread before.

I think this is dangerous ground. Individuals in the market place will put very high values on their own health, especially when it comes to specialists (which I think is an important element of the problem in the first place), because of the catastrophic risks involved. Public policy would put a lower price on the health of the population because individual deaths are not catastrophic to the health of the society. It's not that I think the current funding mechanism is good, but I wouldn't want a simple free market either.

 

Where is the uproar that Rocketman1981 makes more than the guy who performed the quadruple bypass on my father?

 

And the war on doctors continues.

 

I have a feeling you've never had to rely on a doctor to fix you or a loved one.

If nobody wants to put a price on the value of healthcare, they also shouldn't really be questioning those who are trained to deliver said healthcare... and I'm not talking about just any physician, but those who are board certified and adhere to the strictest of guideline/evidence-based care.

There's still a good % of students who get into medical school who still can't make it all the way through the needed requirements to become a full-fledged physician (board exams, years of residency, specialty board exams, state licensing, re-certification). Why are all those extra steps needed? Because they ensure you're getting the best training, in order to deliver the best patient care. Those board organizations don't care as much about the doctor as they care about the care patients receive.

Some may have the vision of wanting healthcare to be available on every street corner like the abundance of fast-food restaurants (that actually contributes to a lot of this country's health issues in relation to other countries)... but just like the food you get at those places, you'll end up getting what you paid for.

I'd prefer to continue to have highly trained/board certified physicians using standard of care techniques... vs. cookie cutter/non-qualified place-holders who should never have met the higher qualifications of becoming a physician in the first place.

And even if you open more med schools, or relax the requirements to get in, there are still much steeper hurdles each of these candidates has to get through... all of them put in place to ensure patient care/safety. You lessen those requirements, and you'll see the quality of healthcare patients receive dwindle.

 

Additionally, while people complain that its the lack of medical school spots "artificially" created by the AMA that leads to a potential shortage of doctors (and thus more demand/higher salaries)... many physicians would actually say that getting into medical school is the "easiest" part of becoming a doctor.

Just like pre-med students get weeded out in undergrad college, several aspiring-to-be physicians who actually get into med school never make it through the needed steps/exams to become a fully licensed/board certified doctor.

 

This ignores the reality that doctors in other countries receive excellent training at far lower costs with similar or better patient outcomes - it's not like our system is the only way to properly train medical professionals.

For an example, just look at PA schools - which manage to train people really, really well in just 3 years. PAs have to work under an MD, but they can handle the vast majority of day-to-day work that doctors currently do. If you trained more PAs, you could leave the MDs to only do the specialty work, but as it is, the training doesn't fit the job. On a side note, I believe the PA model is the future of medicine in this country to help combat cost escalations.

 

Of course they would - because physicians are a self-selected population of people that successfully got into med school.

 

By what measure are you saying they receive "excellent" training? If its just based on the health of those outside of this country, you have to factor in that people are healthier in other countries because they live healthier lives (they eat better, they walk more/better exercise, less stress)... not necessarily because they're receiving "better" healthcare. I would still always be reluctant to receive healthcare abroad, where standards/guidelines are not followed as strictly, nor are the board certification requirements nearly as stringent.

Sure, PA's are a needed part of the equation... but good luck getting a PA to fix you in the middle of the night on a weekend.

They do a great job of working the daytime shifts... but when it comes to after-hour care or weekend care (which if you add up the weekend hours + all after work hours... its actually = the majority of the week), they're nonexistent. They do populate most ER staffs now, though... if you go to an ER nowadays, chances are you're getting a PA.

Additionally, MD's with less challenging specialties require less training... much like PA's.

 

Just combating the argument that making more medical school spots available would alleviate the shortage... it wouldn't. Not as long as the same board requirements, years of training, and exams are needed. And like I said before, these are put in place not to limit the supply... but to ensure better patient care.

The American board systems don't care about how many doctors they have... as there could essentially be a 100% pass rate on their exams. They represent the patient, and care about what kind of doctor they'll be giving the board certification title to.

 

You're now comparing being a physician/healer to selling burgers... and how compensation models should be similarly structured.

I'm starting to question why you're getting paid anywhere close to what you're claiming, with such logic as that.

 

If your chef has poor training he's probably not going to kill you with the burger. You kind of seem oblivious to that distinction and why regulating medical training is important.

 

Which might also be an artificially high barrier to entry.

 

Fine... make more medical schools, but keep the same requirements within the school and post-medical school to become a fully-licensed physician (and again, those requirements put in place in order to ensure the best patient care).

You'll have an even higher med school drop-out rate, along with those who eventually decide to take extended leaves from residency or ultimately go into teaching/research (and not pt care).

I'm all for extending opportunities... but in the end, its still the smartest and hardest working that end up getting through all the requirements.

 

No... evidence based requirements to ensure high quality standards for patient care.

American board organizations exist on behalf of patients... not doctors.

 

As long as you admit to keep the current training requirements in place, I'm for more medical schools.

And while prospective lawyers take the LSATs and the BAR exam... prospective physicians will end up taking MCATS's, USMLE Steps I, II, III (three individual exams), have to go through a 3-7 year residency program post-school, and then have to sit for a one or two part specialty board exam (that could make or break their entire career if they don't pass).

Its not the same (physician vs. lawyer), even thought they're compensated similarly. And I know plenty of out of work lawyers having no clue what to do with their lives.