Doctor's salaries going up and up..

[4dsc]

While AWOLbush BS's the rest of America about the tort reform, let be reminded that the primary reason health care costs are rising in this country is due to DOCTOR'S SALARIES!!

that's right folk, your good old doctor salaries made up over 45% of the total increase in health care cost of the past 4 years.. Listen to Thom hartmann talk about some day and you'll know..

http://www.diffenbaughassociates.com/newsletter/current.html#1

[BlueEyedSon]

1. The majority of increases are going to hospital corps and

insurance companies.

[BurgherHoldtheLies]

4. Exactly. BIG healthcare conglomerates and Insurance....

Docs, depending on specialty, don't make their income potential until after age 30 because being a physician requires MUCH more training than other professions. Residents make squat and have to take call for 24/36 or even longer shifts...How many people could, first get the grades/MCAT scores to get accepted into med school, and second, survive the grueling schedule of medical training and residency? By the way, I'm talking about MD training here, not chiropractic training.

[mainer]

2. B.S.!

From your own article:

"Overall, the increase for all physicians this year is expected to be 4-%, a slight improvement from last year's 3.7-%, says Rosanne Cioffe, director of reports at Oakland, NJ-based Hospital & Healthcare Compensation Service."


Check out:

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2004/10/14/BUGR28JFEN59.DTL

"One of the main culprits pushing up the cost of care in the United States is the expense of administering a plethora of complicated health plans. It has been estimated that any large health insurer in a midsize U.S. state spends more on administration than is spent on health administration in all Canada."

[GreenPartyVoter]

6. I think that the higher cost of education has to be factored in as well

------------------------------------------------------
Election reform can help save this country!
http://timeforachange.bluelemur.com/electionreform.htm

[Red State Rebel]

14. Daughter 's Med. School 1st Year - $35,000.00

It got more expensive there - calculate that and see how long it would take you to pay off over $250,000 in student loans. This was at UMKC School of Medicine, not an Ivy League school.

[Jacobin]

37. In my home town it would take an entire quarter of a year

for her to pay off all her student loans.

Waaaaay, too long, doncha think?

[Mayberry Machiavelli]

41. There are not many doctors making a million bucks a year.

It depends on the area, and specialty.

If you are in primary care: family practice, internal medicine, pediatrics, probably almost no one is making that kind of money unless they are a subspecialized proceduralist like a cardiologist, and even most of those aren't making that kind of scratch unless they are really in a plum practice in an area full of well insured patients.

[knitter4democracy]

45. I know for my husband, that's true

We owe about $175,000 in med school loans (that's $500 a month to just one lender if we want to take 30 years to pay it off, in other words), and he's making the going rate for general internists in the area straight out of residency. The going rate for our area is anywhere from $100-150K a year. The ones who make the serious money are the radiologists, pathologists, and specialized cardiologists, and that's because there aren't enough of them.

I agree that there's a real problem with salaries (although doctors always complain about it until you put back in their face), but that's not the real problem. Insurance companies are the real problem.

[MsTryska]

52. anasthesiologists too. nt

nt

[MsTryska]

51. And the higher costs of malpractice Insurance. nt

nt

[gulfcoastliberal]

22. Great example of private sector "efficiency" in health care

I bet the cost of administering medicare claims nationwide is also lower than the costs in that midsize state. This is something that needs to be regulated at the federal level.

[mainer]

3. Overall salaries went up 3 - 4%. M.D.'s increase was AVERAGE.

"If you're looking for a raise in 2004, don't dream too big because you might be disappointed. Salary experts are predicting increases of 3 percent to 4 percent on average. But before you plan a spending spree, consider two facts:


Companies aren't likely to divvy up that increase equally among all employees.


If you're lucky enough to get a raise, you may end up giving some of that money back in the form of higher health insurance costs.

For 2004, Salary.com is projecting salary increases of 3.6 percent to 3.8 percent, says Keith Fortier, director of compensation. There will also be a trend of companies offering performance-based variable pay plans, he adds. Bonuses for hourly workers will hit 6 percent, middle managers will see bonuses of 12 percent and top managers will receive 30 percent of their salary as a bonus, he predicts."



http://content.salary.monster.com/articles/salaries2004/

[leesa]

5. This is nonsense. Many physicians have taken a pay cut

since managed care destroyed the industry. Average 150,000 salary for what they do?? That's peanuts.

The health care industry is being destroyed by the greed of the insurance industry and the pharmaceutical companies.

[mainer]

7. If you dislike doctors so much, don't go to one.

Do your own appendectomy. Or get someone from the meat counter to cut out your brain tumor.

Yeah, doctors are overpaid! Let market forces prevail and find someone who'll do it for less.

[importDavid]

8. I totally disagree!

My wife Jane is a 35 year old Doctor of Osteopathy (DO).

She has her own (Family Practice / OB-GYN) practice here in the Kansas City area.

Back in Spring 1998 she finished medical school and joined a medical practice (which was run by two local hospitals) with 23 other doctors. Her salary was $135k/year. It was a good setup - with the office staff and back office handling all the background details like billing, payroll, insurance companies, referrals, etc...

In Spring 2002 that practice disbanded with 30-day notice, leaving all the doctors to fend for themselves. My wife and I found a location, made a business plan, approached a bank, got a $100k line of credit and became a self-sufficient solo practice overnight... well in theory anyway.

In the 34 months since that have elapsed since then we have yet to make a profit - we've been living off a "salary" for her of $55k/year - which is enough to get by but doesn't allow much in the way of extravagance.

We're a fully integrated paperless office that does everything on computer - which is handy for my wife since I'm a computer consultant and got it all set up for her.

We've had initiation by fire in all the background things the old practice handled - getting good employees and retaining them, handling payroll and accounts payable, patient scheduling, advertising and billing... which brings me to the big crux of the matter...

People do NOT realize that insurance companies are the problem. Each of the 180+ different insurance companies that we deal with on a daily basis *continually* change their rules and way that they will accept each and every patient visit claim.

This is the ONLY business that I know of that behaves like a formalized bartering system. We say to the patient "That's $80 for that level-2 office visit" (CPT code is 99213 if you're interested). The patient will probably have a co-pay for let's say $10, leaving a $70 balance for the insurance company to handle.

Each insurance company pays a different amount for each different code. Some will pay $20, some pay $60. Only one will pay the $70. That's the one you base your fee schedule on - you can only have one price for each given CPT code.

In addition, insurance companies seem to reject claims whenever they feel like it - and they take forever to pay. Consistent accounts receivable is a joke.

Malpractice insurance is the biggest clusterf**k in the system. My wife has never been sued, never had a claim against her, nada. The previous practice paid her malpractice insurance through the end of 2002. We don't even know how much that was.

Our current practice paid $4000 in 2003 for malpractice. In 2004 it was $18000. This year - and we only found out last week (and have to have it paid by Feb 1st) is $38500 - I have to take money out of our 401k for this! My wife is moving her licensure from Missouri to Kansas after this year. The premium in Kansas is only $3500.

I could go on and on... sorry about the rant and waste of bandwidth but doctors are NOT making money hand over fist in this country.

Canada and other socialized medicine countries have a much better system in place.

[gpandas]

10. makes me think of the...

"family farmer" bullshit. nobody is forcing any family to farm, and nobody is forcing your wife to be a doctor. thousands of people are waiting in line at med schools to become doctors. it seems curious to me that they are all so deluded to think it is a good career choice. the best solution to the problem is to stop the malpractice, an idea that doesn't appear in main street media. it is also amusing that the ama, the group that is staunchly republican and brag about having less government in our lives, supports me giving up my right to seek redress when wronged by an action of others, and eliminate trial by jury.

[hunter]

12. Yeah, I remember when the AMA was a political powerhouse...

...now they are a bunch of dusty old farts living in senior centers supported by the pharmaceutical companies.

I could write entire essays about what's wrong with medicine in the United States, and the AMA would be little more than a note of historical interest. But there are many on both sides who have ulterior motives when they parade the AMA around as their straw-man. Mind you, I do not like or support the AMA, but it is a waste of energy to bash them.

The first obstacle we have to overcome is the public perception that the United States has the best medical care in the world. For most people in this nation, those who are not fortunate to be in the right place at the right time, medical care in the United States is expensive and mediocre. Even people with money often get crappy or downright dangerous and inappropriate medical care.

The biggest problem is our spineless and impotent politicians. Every time they see that hard viagra enhanced dick of the pharmeceutical companies, and the fat wallets of the insurance industry, they close their eyes and drop their pants.

I could pick on the trial lawyers too, but that problem would go away if the rest of the system was not corrupt. The trial lawyers have the same relationship with the insurance industry as the DEA has with illegal drug industry. The more damage the little guys on the street are taking, the greater their profits.

(Wow, gpandas, this rant is not directed at you, your post just set me off...)

[gpandas]

13. i'm glad it set you off...

the more bull and hypocrisy of the health care industry that is exposed, the better the chance of solving the problems. this whole thing is incredible disinformation- like the war on drugs, or the war in iraq. keep telling lies and they will be accepted as fact. as i stated before, if being a doctor is such a bad deal, don't be a doctor.

[Donkeyboy75]

16. And if people don't consider it to be a good career,

then nobody will go through the crap to be a physician. And you'll have no redress because nobody will treat you. Yeah, you're right. That's a better system.

[gpandas]

20. there is no lack of candidates...

only a carefully managed number of openings in med schools. by restricting the openings, the ama has limited the number of physicians, resulting in higher pay for doctors. as dr. kildare, ben casey, and marcus welby have gone the way of all myth that is perpetrated upon the public, the practice of a physician has become increasingly impersonal, and quite naturally, more specialized. many of today's doctors are no more than exotic equipment operators. the "crap" that students put up with is just that-crap, intended to keep a level of demand for their services. i have thought for years that the ama is the most powerful union in the country.

[hunter]

25. Again, it's not the AMA limiting admissions...

Training doctors is simply another profession that is being "outsourced." Training new doctors is risky and very expensive. Let someone else do it...

Imagine you were on the board of some large university that didn't already have a medical school and you proposed a new medical school be opened. You would be shot down before the AMA ever caught wind of it.

The only way the number of seats in American Medical schools will be increased is if our politicians decide it must be done. But they won't do that. There are plenty of overseas graduates eager to come to the United States, and best of all they were trained on someone else's dollar...

At one time the AMA had the opportunity to become a "powerful union" but they rejected that because most of their fading membership was caught up in some 1950's fantasy world where doctors were still godly.

Most doctors today are disatisfied with their working conditions. So many foreign doctors come here for exactly the same reasons that other foreign workers come to here to take other unpleasant and stressful sorts of jobs. The average guy gutting turkeys on an assembly line probably hates his job as much as some doctors hate their jobs.

[mainer]

32. I believe a minority of doctors belong to the AMA

Most just aren't joiners. Young doctors in particular seem to feel that the AMA is irrelevant to their lives and careers.

[Mayberry Machiavelli]

43. You have the right idea. The AMA is just a lobby. There is no

requirement for physicians to join, only to be licensed in their state.

For almost all of my career I haven't been a member of the AMA.

It is mainly used as a straw man for doctor bashing around here.

[MsTryska]

54. No one is saying is stop malpractice

people are saying it ain't the doctors, it ain't the patients, it's the busybody in between - IE Insurance companies.

[flygal]

19. Welcome to DU!

I appreciate your post - very informative. I remember in '88 when my insurance switched to an HMO. You are so right about them using wrong codes to pay. I have spent so much friggin time on the phones trying to get bills paid. One even went to collections but we got it taken care of. I heard all the time from military wives that they just paid the bill rather than fight insurance after 6 months. Tricare was very good at that.
I hope things start going better for you guys. I have a friend who is an MD and for 10 years she said she lived paycheck to paycheck and worked a second job at night b/c of loans.

[AP]

24. Exactly. Corporatization has screwed EVERYONE who works for a living,

including doctors.

The tax code screws people who work for a living too.


And I'm extremely suspicision of people who try to create hysteria about ANYONE who works for a living getting paid too much. It's just smoke and mirrors so that people don't appreciate the real problem.

The problem in America today is certainly not that people who work hard to earn money are making more money than they deserve. It's that people who work really hard, take a lot of risks, and try to create value for society with their labor are not getting to keep a fair percentage of the wealth they create. It's getting taxed and given to Halliburton and it's getting poached by insurance companies and banks.

[hunter]

27. Exactly again...

In many corporate boardrooms workers are just another kind of meat.

You got chickens, and turkeys, and pork, and bacon, and fish, and whatever stuff is left over, you make generic hot dogs and dog food with. Out of the line and into the grinder...

[MsTryska]

53. Damn - 38,5? that's crazy....

your rant is bringing back bad memories of dealing with insurance when my dad was in Practice and we did his billing and transcription.


This was before HMOs became huge huge tho. They were just starting up. Back then most people had major medical.

of course the only people who really paid 100% with no hassle was Guardian. My mom used to love them.

[radwriter0555]

9. Even in countries like MEXICO qualifying students are educated for FREE...

so that costs for their education aren't passed on to the patients.

And trust me, I'd rather go to a doctor who got in the business for the compassion factor, than for the profit factor, so I'll take a mexican doctor over an american doctor anytime.

[MsAnthropy]

28. You go ahead and go to Mexico

I'd rather go to a doctor that had to pay for his education and has to meet stringent U.S. board certifying requirements. I bet if anyone you love ever got REALLY sick you'd be the first one calling the Mayo Clinic.

[MaryH]

11. most of the doctors that I have done real estate loans for are

making 16,000 a month - or there-a-bouts. That would be gross.

[knitter4democracy]

49. What kind of doctors are they, and where are you located?

I can tell you right now that my husband isn't making anywhere near that kind of money, and I don't know many internists who are. Superspecialized guys, okay . . . but not anyone in primary care.

Jeez--that would make paying off David's loans a hell of a lot easier. You try paying off $175K in ten years on less than $150K a year with two kids and all.

Btw, it's been my observation that very few doctors make it through the process anymore who don't enjoy what they're doing. If you're in it for the money, you won't last. You try working 120 hour work weeks for months, years, on end just for the chance that, maybe, just maybe, you'll make a lot of money years and years from now. You try telling family after family that their loved one just died underneath your hands for the money. You try dealing with a corrupt and nasty system every day just for the money. My husband may get cynical from time to time (darn narc seekers!), but he loves his patients and his job--it's not about the money.

[Donkeyboy75]

15. And they should go up.

To pay off the crushing debt they have after finishing med school. I'm sick and fucking tired of the attitude that physician greed is the cause of high health care costs. Read your own article.

[Cleita]

17. I don't renege doctors being well compensated.

After all they really have to be available to work 24/7. When my husband had to go to the emergency room at 2:30 A. M., the emergency room doctor had to call him in the middle of the night to find out how to treat him. So even though they may have time off to sleep, play golf and such, they often get a call at anytime, which indicates they must drop what they are doing and return to doctoring.

[MsAnthropy]

18. How embarrassing for you

that you don't even understand the article you are quoting. Do you even know any doctors? Doctors are NOT getting rich. The CEOs of healthcare companies are the ones making tens of millions of dollars and reducing quality of care by making decisions that should belong to doctors. After ten or twelve years of training and 90 hour weeks, I'd be really pissed if I was making only $150,000. Most doctors stay in it because they care, not because they're getting rich. I'm embarrassed for you that you would broadcast your ignorance of something you know nothing about.

[mtnsnake]

21. I think doctors earn every penny they get because

higher responsibility demands higher pay....and those guys have an enormous amount of responsibility. I wish it were that way in all professions, where people got paid according to the amount of responsibility they had.

There is no way in hell I'd ever wanna be a doctor. I can't imagine going what they have to go through on a day to day basis. Fuck that...I'd rather not be wealthy and be able to do what I want when I please, than be tied down to a demanding medical profession. No wonder their wives are so often alcoholics!!

[knitter4democracy]

50. We're not all alcoholics . . . .

I'm addicted to yarn, instead. But yeah, it's a pretty angry group. There's also a pretty severe divorce rate for many reasons. In our town, the doctors' wives introduce themselves to each other by their wife number (i.e., "Hi, I'm Dr. So-and-So's wife number three."). Pretty nasty.

It's hard for my husband to put our marriage and our kids first when he's got sick patients who need him to keep them from dying. I hated it when he was covering the ICU in residency--hard to get him to come home. He's good at running codes (iow, keeping people from dying when their hearts stop), and everyone made him feel like he couldn't leave or people would die. As his wife, I couldn't compete with bringing people back from the dead. I just couldn't--doing his chores at home and reading to our kids just wasn't as interesting. Thank goodness, he decided to go into a traditional practice instead of critical care.

[MsTryska]

55. Please stand by your man!

he's doing good work.



My Dad was a doctor, and the men in my mother's family were all military, so i guess the women in my family jsut know they have to go it alone for the sake of the greater good.


I've never understood wives (or husbands for that matter) being resentful of Doctors' and Soldiers' careers. (and police, firefighters and nurses too!)

[knitter4democracy]

57. It's easy to get angry when you feel like you're last on the list

I am very proud of my husband and highly recommend him to everyone (his residency peers always told me that he was the best there at the time, which he scoffs at), but it can be really hard to deal with the hours sometimes. I always tell me friends that doctors' wives are single moms with the occasional live-in husband. It's even more true for surgeons' wives and cardiologists' wives--those guys are never home. When David did his surgery rotation in med school, I dropped him off at 5:15 am and picked him up at 10:30 or so at night. If he was on call (every third night), I picked him up at 10:30 the next night--and they were sending him home early because he was the med student. It's the hours that really get ya.

[found object]

23. Solution: replace all general practitioners with technicians

Why spend all that time at med school just to push drugs?

[patrice]

26. It doesn't matter how good they are.

We've lost two people in my family to cancer. They were "thrown away" by the "health" system.

The rest of us have to produce results or loose our livelihood. Not doctors.

[MsAnthropy]

29. I'm sorry for your loss, patrice

but I don't believe they were "thrown away". You do a disservice to them and to the healthcare workers who tried to save them. The healthcare system cannot prevent all death and disease. Medicine is a continually evolving science. A hundred years ago people died of the flu. We are making progress. A debate on how much a doctor makes is truly irrelevant when it comes to developing the science and technology required to stop disease.

[hunter]

30. Sometimes asking for a cancer cure is a bit much...

The "results" that doctors are asked to "produce" are often quite extraordinary. It is also possible the "health system" failed them.

From your short response there is no way to tell. Have you talked to a lawyer? (There's another profession that gets no respect...)

[mainer]

31. I'm afraid that even the best doctors can't stop Death

If every patient's death is considered a medical failure, then there are no good doctors on this planet.

[Mayberry Machiavelli]

44. Are you saying because the cancer couldn't be cured, that the doctors

who took care of them shouldn't earn money for their services? :shrug:

[knitter4democracy]

58. I'm so very sorry such a terrible thing happened to you

I lost two very good friends within six months of each other to cancer, and I know how much I miss them to this day. I can't imagine dealing with that as family.

I also know that when one of my husband's patients dies, he racks his brain for weeks, trying to figure out if he could've done anything differently. I've also seen him cry after he lost a patient who'd become a friend. Chances are, there's at least one doctor who treated your family members who is still thinking about them and trying to apply any lessons he or she learned from that experience to his or her current patients. I know that can sound callous, but each patient is a chance to learn something new, and sometimes the hardest lessons are the best. I really doubt that every doctor involved in your loved ones' care threw them away and just didn't care. Doctors can only put off death for awhile--for some, it's a long while, and for others, it isn't. They never win against death, though, and that can be the hardest thing for a doctor to learn and face every day.

[Technocrat058]

33. More than the salaries!

If you notice doctors charge insurance companies more for their work than they would to the normal patient (in general). This, I think, is the main reason for the higher costs! Perhaps thats why medical care is cheaper in other countries (not because the level of education is less as some would have you believe)!

[MsAnthropy]

35. That's bull

[Technocrat058]

36. If I'm wrong then please prove me so!

I would welcome any counter proof to this argument, However, I would like to remind you that I used the term "Generally." Please though I welcome any differing evidence and argument.

[MsAnthropy]

38. Go back and read post #8

[Technocrat058]

39. I make an exception, and apologize for not explicitly stating!

I consider small business practices the exception for the medical economic system. The rules and regulations set forth, and changed, by the insurance companies are done with the intentions of dealing mainly with the "Corporate" hospitals (here I will use the broadest term for corporate). This is where the majority of "gradients" in patient billings occur. Again I apologize for not explicitly stating so I used the term "general" to allow for the case of post 8.

[hunter]

40. The insurance companies profit by their overall cash flow.

They make more money if they get eighty bucks from you and pass on sixty to the doctor than if they get forty bucks from you and pass on thirty to the doctor.

If you don't have insurance and you pay your doctor forty dollars directly there is much less overhead and no middleman to worry about.

The most glaring problem with all these economic arguments is that an unacceptable number of Americans simply do not have health insurance, mostly because they cannot afford it.

Governments (local, state, and federal) take care of people who don't have insurance, and tend to do it much more efficiently than the health insurance industry does. But this is partly because doctors will treat uninsured patients at a loss, and make up that loss out of the "extra" income they get from insured patients.

It is a stupid and grossly inefficient system, and everyone but the big "health care" corporations suffer for it.

[Technocrat058]

42. OK, I agree with your argument!

I agree that this is the case. My point was that the gradient, induced by the loss from insured patients, creates a higher cost for health care. Thus continuing the cycle, and making the health care system grossly inefficient, as you stated.

[MsTryska]

56. Of course.....

all doctors give a break to people who self-pay. (or all ethical doctors do i should say).


it's because Insurance doesn't pay them what they bill for their services, so doctor's inflate it to get a more reasonable adjustment.

[tk2kewl]

34. I don't begrudge doctors a good salary

medical school can be crazy expensive and it is a log road through school and internships before the payoff.

that being said i don't begrudge good salaries for cops and teachers either.

[okieinpain]

46. had a interesting argument with my liberal daughter. she thinks

that 250,000 for someone that is not supporting someone is more then enough. using herself as an example, she's of the opinion that 250k, would take care of burying her. I

I replied what if she doesn't die, she thinks that 250k would cover her medical bills. I told her she has a lot to learn, I wonder how many others are listening to bush and going "yeah, that makes sense".

[NC_Nurse]

47. Wow.

I'm amazed that you think 4% is a big raise.

I'm also amazed that you blame doctor's salaries for higher health care costs.

I just got home from busting my ass all day at the hospital...we spent the last hour trying to save a guy who was bleeding...I won't go into detail but let's just say it was not pretty.

Every day the docs and nurses I know work hard to save people with cancer, hepatitis, HIV, etc...risking exposure to infection, struggling to get coverage or help for indigent patients, taking care of prisoners, all sorts of things you dont' think about.

I'm glad is the doctors make a good living, I wish nurses were paid more. It takes a lot of people to save one person.

I'm disgusted by the ignorance of this post.

[Bread and Circus]

48. I think that's bullshit. Specialist income has went up a little...

and primary care not at all (adj for infl). Meanwhile, primary care
has had to work harder and see more patients to make the
same income.