More readers join the conversation:
I suppose I should be moved to pity by the reader whose physician husband works 55 hours a week and “cracks the six-figure mark”, but somehow the tears don’t flow. I’m a US-trained scientist, working at a leading UK university. My training wasn’t as expensive as a medical training, but it lasted longer. I feel privileged to be able to earn a good living doing the work I do, though I earn less than any physician I know. Sure, I could be earning many times my current salary on Wall Street. So what? People may choose their careers at the margins based on earnings, but it’s only one of many factors.
I’m certain that there are some brilliant potential surgeons who would rather work in a bank if we cut surgeons’ salaries, but there are surely plenty of others who now don’t go into medicine because they can’t afford the upfront costs of the education, or they are frightened of the debt burden.
That’s why the proposal to combine a cut in salaries with government subsidy of medical education is so important. (My doctoral studies, and those of a large number of scientists, were paid for by fellowships.) Another reader suggests that only stupid people would practice medicine if their salaries were moved closer to that of an average person. This is where the experience of other countries becomes relevant, though your reader chooses to ignore it, and retreat into American exceptionalism. Does he or she think that there are no jobs in IT or finance in Europe? (I’m a little mystified by this readers claim that the physicians elsewhere are earning $60k, when hardly any number on the chart – which is nearly 10 years old anyway – is that low.) The GPs I have seen in the UK have seemed every bit as intelligent and well trained as those I’ve seen in the US. And it’s much easier to get an appointment.
The real point is, no one gets paid what they “deserve”, but what those who employ them need or want to pay them for their services. So why is it that medical consumers in the US are so much worse than their counterparts in other advanced economies at negotiating a good price for competent medical service?
Another is even less sympathetic:
Your reader wrote:
I was in school (paying tuition) or in training (earning $20-$30K per year) for 12 years after college and collecting more than $150K in debt at a public medical school while others my age and background were moving up in their careers, earning increasingly higher wages (some made millions in the Internet bubble), increasing their retirement nest egg, buying houses, etc. I made my first paycheck from “overpaid” reimbursement at the ripe age of 33.
Cry me a frickin’ river. I’m a teacher. My training period (student teaching) was beyond full time hours and paid $0 a year. In fact, I had to pay tuition for the privilege of working 70 hours a week for no pay. After completing my student teaching I found I was totally unemployable straight out of college – due to lack of experience – and had to embark on several years of substituting to burnish my resume. Last year I was lucky to spend most of the year in long-term substituting (jobs lasting more than a month, which pays more than regular substituting).
I made $10,500 last year. This year I am a first-year teacher with my own classroom, and I will make about $30k. If I max out my educational level, get rave performance reviews, and stay in the same school district for the next 20 years, I’ll max out at about $50k/year. All the while I’m required to spend more money on education to keep my teaching certificate current.
My path through college was slower because I had to work while going to school. Even still I have about $80k in student loans. I’m currently 35 and I will NEVER get the “overpaid” reimbursement paycheck this guy talks about.
I don’t particularly mind that my doctor’s overpaid, and I don’t expect sympathy for my low wages (I picked this career knowing what it entailed). But I’d rather my overpaid doctor not whine about the fact that he isn’t overpaid enough.
More perspective on the subject:
I’m a 30-year-old medical student and son of a highly-paid specialized physician. I am well aware of the opportunity costs involved in pursuing a career in medicine that your reader speaks of, and know well the debt burden faced by new physicians ($170,000 is the median indebtedness of medical school graduates). Assuming one has $25,000 in undergraduate debt (about the median), the monthly loan costs are about $2,250, or about $27,000 per year.
The median physician’s salary varies by specialty, but ranges from $350,000 (orthopedic surgery) to $150,000 (pediatrics) per year, after taxes, this is $250,000 to $115,000, respectively. This leaves you with an after-tax, after-loan income of $223,000 to $88,000 assuming a one-income household.
I didn’t decide to enter this field to make money. It is a privilege to be studying medicine, and a privilege to be present in those intimate moments that are often the most critical moments in a human life. The fact that I can do all of this, and still be in the top 95%-75% of all disposable incomes in this country is nothing short of a blessing. Physician incomes aren’t the sole or primary cause of inflated health spending, but it certainly is part of the picture. I’m quite honestly disgusted at the self righteousness with which this particular reader writes, and hope that I never lose sight of the privilege that I have been granted.
A doctor gets the last word:
Medicine is a very rewarding career. It pays fairly well. For most doctors, not enough to make it into the 1%, but pretty close. More importantly, it provides a lot of flexibility; you can get a job as a doctor nearly anywhere. A friend of mine from residency went to work in Hawaii; how many auto plant workers can say that? It has excellent job security. Though I am sure there must be unemployed doctors, that number is quite small. And it provides the opportunity to pursue a rewarding career.
On the other hand, it is a lot of work. It is a lot of work, being paid fairly little, during a long training period. It is a lot of nights away from family. It is not a low stress occupation. And although it pays comfortably, the upside financial reward is limited. There aren’t multi-million dollar bonuses for doctors. You aren’t going to take your company public and make a boatload from stock options.
Are doctors overpaid? I don’t know. I think we’re paid enough. I didn’t go into medicine for the money, but it wasn’t a disincentive, either. I’m happy with my choice, and I think most of your physician readers are too. Which suggests that we aren’t underpaid.
The Dish 