patrick.net

bob2356 says

No, you just don't know anything about the economics of medical practice. There isn't any more "demand" in any given population. The same percentage of people get sick no matter what. What happens when there are too many doctors in an area is they boost the number of tests, referrals, and visits to keep up income. The missing part of your equation that you don't grasp is the cost of health care and what doctors earn isn't interlocked. Salaries are much lower in area's with lots of doctors even though costs are much higher.

You seem to be getting upset and contradicting yourself, while ignoring what I and others have posted. Obviously costs and net income are not the same thing, insurance distortions being a major reason for that. Equally obviously, demand and the number of doctor visits are also not the same thing, visits are usually counted as an intersection of supply and demand. In one sentence you say there isn't more demand, then in the same paragraph you acknowledge doctors inflate demand by ordering up more tests (which are subsidized by government and insurance, inflating demand). Please, switch to decaf, read a bit about economics, and come back when you can cite some links. You never acknowledge when you're wrong, and when it's proven quite obviously you say you don't want to see any more links. I will not indulge your hunger for ad hominem food fights, nor your thirst for source-free shouting matches, so if those are all you want then you'll have to direct your attention towards someone else. If you want to discuss intelligently then please cite some actual source links, and quote somebody who knows that the plural of area is areas, rather than endlessly embarrassing yourself with your own words. You might be able to make some good points, but it's impossible to know because you slip so frequently into sarcasm and you almost never cite any sources.

"Why shouldn't we have unlimited immigration of engineers and scientists?"

Because all this means is we get flooded with Asian tech workers with fake degrees (I know they're fake because my wife's friend is one and she told us matter of factly that they fake the diploma and work experience. She helped my wife do the same!!!)

Think about that the next time one of them is cutting open you or your loved one in an emergency room...

curious2 says

You seem to be getting upset and contradicting yourself, while ignoring what I and others have posted. Obviously costs and net income are not the same thing, insurance distortions being a major reason for that. In one sentence you say there isn't more demand, then in the same paragraph you acknowledge doctors inflate demand by ordering up more tests (which are subsidized by government and insurance, inflating demand

Patrick is moderator of this thread.).

I'm not the least bit upset. Are you actually a native english speaker? Ok, for the hair splitting amoung us I will rephrase it to say there isn't any more need, does that satisfy you? There isn't any more need, but because there are excess doctors PER CAPITA they create excess work to bill for. The excess supply of available doctors is creating the excess utilization not the other way around. Satisfied with that wording? There is no contradiction, and the article you keep citing says exactly the same thing. Try to remember that your original point was that if there were more doctors the cost of health care would fall yet here you are saying where there are more doctors the cost is higher. So which is it?

So why are costs so much lower in countries with 100% government paid for health care if government paid health care inflates demand? There should be unlimited demand in those countries as per your logic. This is not an ad hominem food fight just a simple question that keeps getting ignored.

curious2 says

You really don't seem to understand economi

Patrick is moderator of this thread.cs. Of course the areas with greatest demand (i.e., highest prices) attract the most supply. The supply is there because the demand is there. If you were a doctor choosing where to live and work, would you choose the place where you can make twice as much $, or half as much?

This is your quote correct? In your own convoluted way I think you are saying that doctors in high "demand" area's aka high health care cost area's aka area's where lots of doctors practice the doctors are making twice as much. Am I reading that correctly? I thought you said obviously "costs" (I am assuming you mean health care costs, it's not very clear) and net income were not the same thing above. I thought it was you who pointed out how much doctors could earn in Des Moines Which is it? Work on your own contradictions. Doctors earn considerably less money in area's with excess doctors than in area's with a shortage of doctors This is not an ad hominem food fight, just a simple statement of fact that contradicts your assertion that a shortage of doctors is driving the cost of health care.

bob2356 says

In your own convoluted way I think you are saying that doctors in high "demand" area's aka high health care cost area's aka area's where lots of doctors practice the doctors are making twice as much. Am I reading that correctly?

No. And you haven't cited any sources, nor learned to spell "areas".

bob2356 says

I thought it was you who pointed out how much doctors could earn in Des Moines Which is it?

That was Rin. A simple text search would have found it for you.

bob2356 says

Doctors earn considerably less money in area's with excess doctors than in area's with a shortage of doctors

If you were to spell "areas" correctly, that statement would be consistent with basic economics.

bob2356 says

your assertion that a shortage of doctors is driving the cost of health care.

I never asserted a shortage of doctors. But, it is also true that the AMA lobbies for licensing restrictions that constrict supply. Other factors also reduce supply, for example the insurance system that drives many doctors to retire early in frustration. That doesn't create a shortage per se but it does reduce supply, increasing prices.

bob2356 says

Are you actually a native english speaker?

Is that sarcasm again or another attempt to fish for ad hominem targets? You are the one who can't spell the plural "areas".

bob2356 says

The excess supply of available doctors is creating the excess utilization not the other way around. Satisfied with that wording?

No. A culture of entrepreneurial doctors taking advantage of artificially inflated demand by selling unnecessary and even harmful drugs and "services", while shielded from the consequences by "tort reform," is creating excess cost.

bob2356 says

So why are costs so much lower in countries with 100% government paid for health care if government paid health care inflates demand?

Finally, amid all of your sarcasm, you manage to ask an intelligent question that might lead to a useful result. If you did some research, you might find your answer. Those countries manage demand instead of merely subsidizing it, and they subsidize the supply of doctors with free education and in some instances lower barriers to entry. They also don't have the costs and distortions of profit-maximizing insurance companies. And they don't have DTC advertising of Rx drugs on TV driving demand. We have a lobby-driven lemon socialist system that maximizes revenues by victimizing patients, subsidizing everything from HFCS to dialysis while taxing vaccines. BTW, costs are even lower in Mexico, where most healthcare is not government paid.

I took a couple of days off for the hurricane and all hell breaks loose. curious2, thanks for the assist. Looks like you've got everything covered.

Ok, since there's already been a lot of upheaval, here's the Des Moines general medicine, GP, salary survey ...

(http://swz.salary.com/salarywizard/Physician-Family-Practice-Salary-Details-Des-Moines-IA.aspx?&hdcbxbonuse=on&isshowpiechart=false&isshowjobchart=false&isshowsalarydetailcharts=true&isshownextsteps=true&isshowcompanyfct=true&isshowaboutyou=true)

It's ~$171K/yr, not bad for a town where one can buy their home in a couple of years with that kind of salary. Certainly beats the $1M homes in Silicon Valley where one can work for years w/o being able to pay off the farm.

(http://homes.yahoo.com/Iowa/Des_Moines/1646-beaver-ave:fb53d6d435f93881515dd4b617b3156c)

and you can search around there, houses aren't expensive in the heartland.

Next for those who think that my IQ is low, I got an A- GPA in Applied Chemistry/Chemical Engineering, BS level, and a 34 MCAT score. I've taken quantitative courses in thermodynamics, transport phenomena, and reactor design/kinetics which are generally avoided by premeds trying to pad their GPA with 'soft' courses. I'm a jr partner at a hedge fund, having left pure engineering (then IT), for a monied profession. I'll be applying for medical school, once I've banked my first $2-3M, as I don't see being a money manager, as a meaningful profession, despite the high compensation. Yes, unlike others, I don't see money as the only goal in life. I don't mind working 3 days a week for $100K, which any moonlighting physician can do.

And yes, I'm aware that the MCAT isn't the USMLE and thus, only covers undergrad material in biology, general/organic chem, and gen physics, however, i don't believe that many normal science/engineering individuals, who score well on the MCAT, can't study courses which are based more upon memorization than quantitative problem solving like Anatomy, Physiology, Histology, Biochemistry, Embryology, Neuroanatomy, Pathology, Pharmacology, Microbiology, Immunology, etc, the 1st two years of medical school.

AMA-driven Limits on medical schools and thus medical students:

http://wallstreetpit.com/5769-the-medical-cartel-why-are-md-salaries-so-high/

Limits on residency, blamed on Medicare but also driven by AMA (which opposed the enactment of Medicare, and influences the funding):

http://thechart.blogs.cnn.com/2012/03/16/why-your-waiter-has-an-m-d/

Barriers to entry restrict supply and increase prices.

But, there are also larger problems in the medical-industrial complex. Hospital and insurance executives much more overpaid than doctors. Increasingly, doctors find they can no longer practice on their own, and can only work as employees of hospitals and large corporations. The corporations overcharge for their services, but the doctors get only a fraction of that.

EBGuy says

A PBS documentary I saw a couple of years ago showed doctors in Germany on strike. I'm assuming they make less than their US counterparts.

Does that mean they are getting paid less? I don't base my assumption just based on one incident. Oh, and I don't assume the doctors over there are getting paid more, just because they are driving a Porche.

Nobody says

When I got sick in Germany recently, a cost to visit doctor's office was less than $30 without the insurance. The copay for my health insurance was already at $20, so I didn't even bother claiming it. Now, I want to know why it costs so much even to see a doctor here in US.

Much of it is the insurance. In Germany, you went without insurance and paid the actual cost. In America, the insurance companies negotiated with providers (doctors and hospitals) to be "in network" and part of the deal was the provider had to charge triple to everyone "out of network," passing along the actual cost as an "in network" insurance "copay." It got worse from there, as insurers began buying providers (hospitals and large corporate practice groups) outright. It started out like advertising, then became more like the mafia: you pay protection money to your insurance company for the privilege of being protected from the overcharges they put on everyone else. If you pay your insurance premium to the Gambinos, then they won't whack you, but if you suffer an emergency somewhere and John Gotti's crew or some other out-of-network provider gets ahold of you, you still get whacked. The whole thing has become so complicated and secretive that you can't even get an honest price quote from a doctor anymore, and part of that is because 70% of them are now employees of corporations whose pricing is beyond the doctor's control or even knowledge. It took years for the system to get messed up the way it is, but it is the logical result of various factions pursuing their own self-interest and using government to lock everyone into it. If you actually want to understand it, you'd have to spend a very long time reading about it, and it seems you haven't even followed the links on this thread because your question about salaries is answered in charts just one click away from what you're reading now. People don't read widely enough, which is one of the reasons why they become so thoroughly trapped and manipulated.

CaptainShuddup says

My wife saw five Doctors in the last two months, and it was the Doctor in the Emergency room that diagnosed her underlying condition that the previous 4 missed.

I'm sorry to hear that and hope all is okay. There are lazy and incompetent doctors out there that don't care about their jobs at all, and could care less about people. That being said, there are many out there (my wife included), that really care about people and devote their lives to medicine in order to help people.

Rin says

Simple, doctors are overpaid

I met a neurosurgeon from Argentina that made the equivalent of $18,000 per year in US dollars. Does that sound more reasonable to you? minimum wage?

nw888 says

Rin says

Simple, doctors are overpaid

I met a neurosurgeon from Argentina that made the equivalent of $18,000 per year in US dollars. Does that sound more reasonable to you? minimum wage?

Well, a postdoc in biochemistry (post-PhD) earns $42K/yr, a physician's assistant avg is $90K/yr, senior chemical engineer is $110K/yr, pharmacist is $115K/yr, so there are plenty of examples of people, stateside, who're well educated and experienced, earning an array of regular incomes.

nw888 says

Rin says

You can earn over $200K, as a doctor, in places like Des Moines Iowa, nevermind the big coastal cities.

This is because no one wants to live there. The less desirable the city the more incentive needed to attract doctors. Some places are as high as $350K.

Ok, so now try to get an engineering job in Des Moines, at a pay rate, near any coastal city? Exactly, it doesn't exist. At most, one will be employed by Big Corn and probably at 50-60% of an east coast salary.

On the other hand, a new doctor can start off in Des Moines, pay off his loans in a few years, and then high tail it for Boston, afterwards. Wouldn't it be nice if we all had that option with our debts?

And yes, I'd live in Des Moines for a few years, if I had to borrow heavily for medical school.

Ok now it's spelled areas. Are you feeling better now? So can you answer a simple question? You haven't actually answered one yet.

"Of course the areas with greatest demand (i.e., highest prices) attract the most supply. The supply is there because the demand is there. If you were a doctor choosing where to live and work, would you choose the place where you can make twice as much $, or half as much"

So what does this mean? Of course? Twice as much what? Highest prices? Highest prices for what? I already asked if that was the highest cost of medical care per capita, the generally accepted benchmark worldwide for quantifying medical care. You said no that was the wrong reading, without any kind of explanation of the correct reading. Could you explain this convoluted statement in simple English for those of us that don't know how to spell area's. If I could relate your obscure terms to what is generally used by everyone else I could respond better.

curious2 says

bob2356 says

your assertion that a shortage of doctors is driving the cost of health care.

I never asserted a shortage of doctors. But, it is also true that the AMA lobbies for licensing restrictions that constrict supply. Other factors also reduce supply, for example the insurance system that drives many doctors to retire early in frustration. That doesn't create a shortage per se but it does reduce supply, increasing prices.

So you are saying a reduced supply to the point of increasing prices is NOT a shortage. That's not what they taught me in econ 101. Has the curriculum been revised?

PolishKnight says

"Why shouldn't we have unlimited immigration of engineers and scientists?"

Because all this means is we get flooded with Asian tech workers with fake degrees (I know they're fake because my wife's friend is one and she told us matter of factly that they fake the diploma and work experience. She helped my wife do the same!!!)

Think about that the next time one of them is cutting open you or your loved one in an emergency room...

That's what the interview process is for. My old boss used to put up post doc positions and get 200 fake applicants from China. It's pretty easy to spot. Anyone that hires one of them is a moron.

> The culture that promotes frivolous law suits will not go away. The malpractice insurance won't be any lower.

I wonder what percent of medical costs are used in some way because of the frivolous lawsuits. I have heard values anywhere from 4% to 25%.

>"In America, the insurance companies negotiated with providers (doctors and hospitals) to be "in network" and part of the deal was the provider had to charge triple to everyone "out of network," passing along the actual cost as an "in network" insurance "copay." It got worse from there,..."

curious2, you may be on to something.

the medical industry is a complete clusterf*ck and universal health care won't solve a thing. Most of the money that goes towards "health care" is actually paying for an endless trail of paperwork, approvals, referrals and other inefficient nonsense.

I'm not going to get into the payor system per se, since I agree it is messed up. And I'm sorry Capn shuddup had bad experiences. There are varying levels of quality in all professions.

However, OP clearly shows that he doesn't know what he doesn't know with his statement.

First off, physicians are not overpaid. In fact, GP's are grossly UNDERPAID for the amount of work they have to do. Shit, a mid level engineer at Google can make as much an FP in the midwest who sees dozens of patients a day and spends a good amount of time on the phone trying to get a couple bucks per visit from insurance.

OP, as for me, I get paid well and deserve every penny. Every single time I interact with patients, I deal with procedures which have the potential to KILL people. KILL them. Ask any of the parents whose children I've cared for, or patients on the brink of death from a heart attack or brain hemorrhage if I should be making what an engineer makes. This is lost on many laypeople and if you plan on getting into med school, you better get this fact through your typical engineer brain: People aren't Camry's or computer algorithms. Shit WILL happen and you're there to respond as best you can when it does and the responsibility falls on you. It's a level of stress that will be unmitigated throughout your career so don't fucking tell me a bunch of early 20 somethings sitting around bean bag chairs in Menlo park drinking overpriced Philz coffee, eating shitty new age "Asian" fusion food all the while trying how to exploit more of your personal information should be paid on par with physicians.

And don't give me that bullshit about PhDs. They live a charmed life. I dated one for a few months and her day started at about 9 and ended early afternoon. Are they smart? Yes. Brilliant? many are. But none of them are up at 3AM trying to save a 450# lady bleeding to death from a ruptured placenta.

Facebooksux says

But none of them are up at 3AM trying to save a 450# lady bleeding to death from a ruptured placenta.

When you know this is going to happen, that's when you show up to work dressed like this:

I could seriously see you not being a bit sympathetic for someone who ate them,selves to death like that.

It's hard. But even in those worst cases of self-inflicted illness, that's still probably someone's mom, daughter, wife, etc.

Facebooksux, comparing Google engineers or even hedge fund engineers { now re-labelled as quants/traders/money managers } isn't an appropriate comparison. For one, those jobs are geographically constricted and typically, it costs a lot more to live in Silicon Valley, Boston, or NYC over Des Moines Iowa where a nice 2 bedroom apartment is ~$650/month. And at the same time, these high mark up careers have tons of applicants. I believe if you wanted to move to Des Moines Iowa, as a physician, they'd welcome you with open arms. And true, ever since I'd left chemical engineering work, my routine 12+ hour days for pilot trials have gone down to 8-10 hours (IT related work) and now, with this hedge fund activity, it's even less at 8 hours (though I'm busy on weekends doing work for other persons) but at three times my prior engineering salaries. So I understand the expression, money for nothing, which is why I'll be leaving this field for medical school once I'm financially independent because it's not meaningful work, despite the fact that I'll be a millionaire doing it.

And finally, while I concur that emergency medicine/trauma doctors are the most stressed out workers, the avg GP doesn't work in the emergency room, all of the time. They work in regular clinics, where PAs carry out a lot of the patient interviewing, and then the MDs prepare to close out the cases, after a lot of the preliminary work is done. Yes, I have former engineering friends, who'd gone to medical school, and by planning their lives appropriately, they mostly live better lives than they did as engineers, where their hard work got them nowhere since MBAs control the work and compensation scale of science & engineering work. At the same time, just look at R&D cuts in DuPont, Dow, etc, and you'll see that it doesn't have much of a future. Of the engineers who'd made this switch, the only stressed out person was the one who'd gone into surgery. The others ... neurologists, dermatologists, GPs, and anesthesiologists, don't have the same dire conditions you've depicted. They like their jobs and appreciate their level of compensation for work expended.

bob2356 says

Could you explain this convoluted statement in simple English for those of us that don't know how to spell area's. If I could relate your obscure terms to what is generally used by everyone else I could respond better.

Bob, so far your responses (sarcasm, no sources) sound like you're looking for a Jersey Shore GTL sparring match, which you can watch on TV if you want. It isn't my taste, so I'm not going to play researcher to your bombast. In reply to your latest flurry of rhetorical questions, here is a question that might really help: who controls the Medicare billing codes and payment rates? What is the American ratio, in quantity and price, of specialists to primary care? How do the American ratios compare to other countries? If you care enough to take the time to research the answers to those questions, and post links, you might find the results edifying.

Rin says

I understand the expression, money for nothing, which is why I'll be leaving this field for medical school once I'm financially independent because it's not meaningful work, despite the fact that I'll be a millionaire doing it.

I wish you well in that. This thread has produced many interesting comments. I think the comparison to other science grads indicates that science is underpaid, and there doesn't seem to be much correlation between what is paid well (enlarging banks until they become TBTF, running an insurance company) and what is actually needed. Alas you may find the same even more true in medicine. The fee-for-service model, insurance distortions, and other factors tend to reward the most wasteful and even harmful allocations. I hope you will find a way to do good and make a living at the same time.

I am a doctor that was a grad student before medical student at a top university in a quantitive field. Medical school, especially the pre-clinical years kicked my ass. To think that a person with a 30 MCAT could just skip the preclinical years to the clinical rotation is absurd. There is a big difference between medical school, and other types of school. I used to think how easy it would be, but listen everyone in medical school is an A student with 30 on their MCAT's. Passing is the equivalent of getting an A in undergrad or grad school. Also, the cost of medical school is usually $50,000/year, and that cost has to be recouped with the loss of wages while you are in school training for close to a decade. Sometimes, I think if I had my job before med school I was able to put away a considerable amount of money, and would be in a surplus while right now I am still paying off debt.

Also, medicine has taken an incredible toll on my health and life. Not everyone can stay up every 4th night for years trying to save people. One can make more money in tech or other areas and have a more comfortable life. Medicine is not for the faint hearted. If you think you are up for it, then quit your bitching about doctoring, and get to it. I can assure you that your ideas will change after you go through the punishment that we have had to, and this isn't about some hazing process, but the demands of the profession.

There appears to be this notion that folks, who do graduate studies in let's say biomedical, electronics, and chemical engineering fields get to bed by 9PM and live the life. This is mostly false in any good program. On the whole, these former colleagues of mine were up until 11PM to 3AM, working on design problems, homework sets, labs, etc, all of the time. And the PhDs/postdocs, I'd worked with in applied chemistry, were in the facility from 9 AM to 11 PM, as a normal work week, with a break in there for lunch a/o dinner. Thus, I don't know what lazy folks you're talking about and their alleged charmed lives.

And next, in terms of the coursework for the first two years of medical school, did you fellows use a combination of mnemonics & Roman loci, to help memorize the data? Or did you expect that you'd be able to cram 12 textbooks in a year's time w/o any problems when you'd started? In addition, do you practice recall in intervals of 2 days-6 days-30 days, to help reverse the Ebbinghaus forgetting curve (http://en.wikipedia.org/wiki/Forgetting_curve)? You see, that's a memory rich curricula and there are ways of being prepared to be able to digest it. On the other foot, you can't cram/memorize for let's say, a Chemical Engineering Control's final, because you need can break the questions into their key components, find the hidden suppositions, develop the design methods, and finally, work out all the math in these steps.

" One can make more money in tech or other areas"

I'll say that one can only make more in finance a/o trading. And yes, a successful Futures Prop Trader is living the life. They typically have homes in the Hamptons and the Bahamas. In science/engineering fields, there's constant downward pressure on wages and the need to replace experienced persons with younger ones. If you haven't run into MBAs, then you don't know this. Today, thousands of DuPont (& Dow, & ATT, ...) engineers are out of a job and in a few years, you can add 4000 from NASA to that list.

As usual, most sound arguments here are being ignored by those too invested in their faulty opinions to listen to anyone else. So here is a simple solution for those who think Drs are overpaid. Don't visit them. Problem solved.

Rin says

And next, in terms of the coursework for the first two years of medical school, did you fellows use a combination of mnemonics & Roman loci, to help memorize the data? Or did you expect that you'd be able to cram 12 textbooks in a year's time w/o any problems when you'd started? In addition, do you practice recall in intervals of 2 days-6 days-30 days, to help reverse the Ebbinghaus forgetting curve (http://en.wikipedia.org/wiki/Forgetting_curve). You see, that's a memory rich curricula and there are ways of being prepared to be able to digest it. On the other foot, you can't cram/memorize for let's say, a Chemical Engineering Control's final, because you need can break the questions into their key components, find the hidden suppositions, develop the design methods, and finally, work out all the math in these steps.

Again, you simply have no idea about what you don't know.

I agree that in terms of pure intellectual power, theoretical physics, quantum mechanics or some esoteric field of math that any a few dozen people on earth really understand trump the first two years of medical school. Yes, there is a LOT of memorization involved and while I've forgotten a lot of the basic science material, I still remember all of it in terms of broad areas and principles. This is enough to help with non-emergent problem solving and diagnosis.

Also, you're never going to convince anyone who's done both grad school and med school that the former is anywhere near as taxing as the latter, so drop it. Like vonah said, about a month into med school you're going to STFU about how easy it is and how anyone with a 30 MCAT can do it.

Only the market can tell if doctors are overpaid or not. Since the profession is heavily regulated, we will never know.

Facebooksux says

Yes, there is a LOT of memorization involved and while I've forgotten a lot of the basic science material, I still remember all of it in terms of broad areas and principles. This is enough to help with non-emergent problem solving and diagnosis.

Also, you're never going to convince anyone who's done both grad school and med school that the former is anywhere near as taxing as the latter, so drop it. Like vonah said, about a month into med school you're going to STFU about how easy it is and how anyone with a 30 MCAT can do it.

I'm in my mid-30s and I still remember most of my undergraduate course in biology because I used the Ebbinghaus principle in improving long term recall. Thus, despite not having heard "Klinefelter syndrome" or "Okazaki fragments" in years, that information hasn't been forgotten. Realize, I only took the general biology as I was an Applied Chem/Chem Eng major. I used graduated recall interval and that's all I needed to get an 11 on the biology MCAT at the end of college.

Plus, I never said that it would be 'easy'. It would be work, like everything else which requires hard work, to master. So yes, perhaps those first two years worth of courses need to be spread out, over a wider stretch of time, for those working in industry but hey, since you're indicating that engineers have too much time to spare on weekends, for barbecues and/or gaming conventions, then perhaps this is a way of staying in top mental shape for medical school later? Ultimately, it's about getting the points on the exam and if one can get the numbers needed for either an Honors, High Pass, or Pass (MD style grading), then maybe that's all the data one needs to determine if this person is adequate to study for an MD?

vonah says

I can assure you that your ideas will change after you go through the punishment that we have had to, and this isn't about some hazing process, but the demands of the profession.

This is a significant issue, and I have to wonder about it. The "demands of the profession" in America seem to involve a lot more barriers to entry than in other countries, yet outcomes are not better here. I understand clinicians have worked hard and suffered and want to reap the rewards, but we seem to have a system designed to require people to overpay for "services" that they don't want or need, performed by over-educated professionals who are constrained by the "demands of the profession" to charge more than people in other countries would pay. By "over-educated," I mean in the sense Noam Chomsky would say, the most educated are the most indoctrinated. (Or as John Gotti would say, "over-educated and under-intelligent," meaning they're book smart but not street smart so they don't see what's really going on because it isn't taught in a textbook or graded on a final exam.) We have a medical academy bought by the Rockefellers and PhRMA, built on allopathy, that excels above all in generating $ not health. I hesitate to put it that way because clinicians might get defensive, but the numbers speak very loudly.

curious2 says

meaning they're book smart but not street smart so they don't see what's really going on because it isn't taught in a textbook or graded on a final exam.)

Book smart vs street smart is a problem, common throughout many over-educated fields, including other science and engineering specialties. In chemical engineering, a lot of non-linearities and anomalies, esp in multi-phasic conditions, exist and thus, they have design heuristics, which factor them in. End result, ppl believe in their tools and don't question or peer into their assumptions.

Buster says

most sound arguments here are being ignored by those too invested in their faulty opinions to listen to anyone else. So here is a simple solution ...

And there also appears to be this sort of aegis, where it's implausible for a bright, hardworking S&E person, to learn the basic sciences of the first 2 years of medical school, without having first enrolled in the program.

If this was the case, then why does Georgetown allow their Special Masters students, who sat in with the medical students, to transfer into the MD class in year number two, if this wasn't a possibility?

Here's that program, http://smp.georgetown.edu/coursedescriptions/132250.html

And likewise, if a one year masters program is adequate for future MD admissions, why can't this spread out to other S&E areas of study, but w/o having to spend excess tuition money?

Buster says

here is a simple solution for those who think Drs are overpaid. Don't visit them. Problem solved.

Not really. Federal law since 1951 prohibits buying Rx drugs without an Rx. (And don't even get me started on the "drug war" that prohibits cheap natural drugs while promoting fraudulently marketed overpriced Rx versions, e.g. OxyContin.) You can buy an assault rifle, but you can't buy contact lenses without an Rx. And, with mandatory insurance, you are required to overpay whether you visit or not.

People talk about Google engineers making $, but if you don't like Google you can always use ask.com or bing or Yahoo! Or you can search for information the old fashioned way, at the library. Google engineers help you find information more easily, but they don't prohibit you from getting the same information some other way. Imagine how much they might get paid if they could do that, and how people would feel about them.

If you think doctors make too much money, then consider a California highway patrol officer or the average police in California. Median wage of a cop is 130K + about 50K into their pension and the countless other benefits they receive, including their ability to retire at age 50. Look up http://www.sacbee.com/statepay/ and in the drop box look at california highway patrol to see their compensation if you think i am lying.
Not bad for only requiring a high school degree.

Why would anyone want to spend 4 years of undergraduate, 4 years of medical school and 5 years of residency to earn about the same amount, especially if you are 200k in debt after schooling and having to worry about all the malpractice lawsuits? Plus I dont think most doctors work 40 hours a week... 50-60 hours seems more the norm.

Oh btw if you think a doctor making 150k is too much, you may be surprised to see nurses making even more than that...

http://www.crnasalary.com/

Meccos says

Oh btw if you think a doctor making 150k is too much, you may be surprised to see nurses making even more than that...

http://www.crnasalary.com/

Those are nurse anesthesiologists and yes, it's a well paid specialty. The regular RNs, however, are clearly not in that bracket.

Physician anesthesiologists (MD holders), however, earn ~$337K with a salary spread between $250K and $450K, depending upon experience and location.

http://www1.salary.com/Anesthesiologist-salary.html

The two chemical engineers, I knew, who went into anesthesiology, never complained about their careers, once residency completed. ORs are scheduled, just like pilot plant trials, and the on-calls are twice per month, as a career average, after residency. And I knew non-engineers (other prior undergrad majors), who also went into this field. If you're willing to shoulder the responsibility of life support and pain management of a person in OR, then I can imagine it being a rewarding career.

And true, the lifestyle of the anesthesiologist resident is rough, prior to starting one's career. 80 hours is normal for those first three years.

BTW, both of these chemical engineers were at $65K-$80K per year prior to medical school, so again, it's not likely that one will earn a high salary in the old fashion, non-"dot-com/Web 2.0" tech vs being a doctor.

I don't understand why all the doctors who post here keep insisting that tech workers mainly earn like Microsoft engineers in the 80s, with huge stock options, or Google/Web2.0 engineers of today? In general, if you work in tech, as soon as you're in the $100K+ category, MBAs start to look for ways to get rid of you or send your R&D cost center to Asia.

Meccos says

Why would anyone want to spend 4 years of undergraduate, 4 years of medical school and 5 years of residency to earn about the same amount

In Massachusetts, once you add in 'details', almost every cop is over $100K. But think about this, one day, you may be staring down the barrel of a gun. Thus, there's a lot of competition and cronyism, to get into a nice suburban gig. But yes, that's a security job and one which is state mandated with great retirement benefits.

As for attending medical school, if you're a person who's good at studying and taking exams, could you name a better profession? Right now, new actuaries are not getting hired as before, as spreadsheet work is being slowly offshored and the established certified Actuarial Fellows don't want to share the wealth with newcomers. In the field of law, outside of Patents, few lawyers get hired by Big Law firms & seldom achieve a partner track. Thus, the options left are to either hang your own shingle (with zero experience), work as a paralegal (no partnership track), or hope for a govt gig. And MBAs in management consulting a/o finance, do not advance by virtue of exam taking skills. Those are BS artists, for the most part. Many persons with some academic bent, can be trained to perform in a health care like area and right now, our science and engineering graduates are best equipped, academically, to serve in ancillary health care areas.

Rin...

I realize how firm your beliefs are on this subject and there is likely nothing that anyone here can say to change your mind, nor do I really care so much to change your mind.

Rin says

I'm a jr partner at a hedge fund, having left pure engineering (then IT), for a monied profession. I'll be applying for medical school, once I've banked my first $2-3M, as I don't see being a money manager, as a meaningful profession, despite the high compensation.

If you truly think it is that easy to become a doctor and that doctors are paid way too much, then you should definitely apply to medical school, go to residency and work as a doctor. Please update us after you have done all these things and let us know if you feel the same. Ill be waiting for your post in another 8-12 years. I do find it odd though that you want to go to medical school as a second or even third career, while over 50% of physician regret going into medicine due to the difficulty of the lifestyle and bad compensation

PS. I hope you will really have saved 2-3 million before you apply since you will have lost about 10 years of earning potential and will rack up 200k in school costs.

Logically, I don't see that the crazy increases in health care costs can be attributed to doctors pay.

Because doctors made as much (more really if you adjust for inflation) 30 years ago than they do now.

I do think that the profit motive in general doesn't have a place in health care, at least not in the direct sense where more money is always made if you do more tests and more procedures.

marcus says

Logically, I don't see that the crazy increases in health care costs can be attributed to doctors pay.

Because doctors made as much (more really if you adjust for inflation) 30 years ago than they do now.

I do think that the profit motive in general doesn't have a place in health care, at least not in the direct sense where more money is always made if you do more tests and more procedures.

Marcus,

you are right. although costs in health care have risen, doctor pay has actually dropped, even without calculating inflation.

doctors in the US only make up about 8.5% of total healthcare costs, which is actually one of the lowest...