From: rtoptan@lucpum.it.luc.edu (Richard Z Toptani)
Subject: Re: Physician's Incomes
Organization: Loyola University Chicago
X-Newsreader: Tin 1.1 PL3
Date: Mon, 21 Dec 1992 17:07:32 GMT



Just had to respond to some of the various comments that have
been made in this thread...




> 120K is the average for all physicians.  Several specialties have averages
> over 200K and a few have averages over 300K.

This may be true, but keep in mind that the number of doctores who
make that kind of money is not very large and that those figures
are included in calculating the "average" of $120K. This means that
for all those docs making well over $120K, there must be just as
many making well under $120K as well!


----------------------------------------------


>> that same logic should mean
>>that Ph.D's should get even more than MD's because we go to scho
>>achool 6 to 7 years post B.S or B.A.  Unfortunately, this isn't the case

Not quite. 

Well, you also need to take into account residency training which is
an integral part of the medical education. One cannot obtain a licence
to practice solo medicine until one competes a residency and passes the
board certification requirements. The MINIMUM residency period is 3
years, which results in 7 years post-BS. Some residencies take as many
as 8 years, which means 12 years post-BS. 

In addition, PhD's do not have to pay the large malpractice premiums, or 
incur the massive educational debt that many medical students accumulate.
When I graduate from medical school, my educational loans will be
$150,000+. Most of the loans are market-rate variable-interest loans,
which compound pretty quickly. My estimated loan payments will be
around $2,000 a month, and maybe even more if interest rates rise!
I would also point out that this debt is entirely from medical
school. I paid off all of my undergrad loans before I started!

At 2k/month, that means that $24K/year (for 15 years!) will go to
paying off educational loans. This will take up around $36K in
pre-tax income to provide the $24K to make those payments.
Another $15-18K will go toward malpractice premiums. After subtracting
those two amounts, an average physician's income of $120,000 ends up
being pretty much equivalent to someone else in the work force earning
$66-69K. I hardly think that anyone could claim that this figure is
too high.

I can't speak for all future physicians, but I assure you that I did
not go into this field for the money. I find it difficult to believe
that anyone else would, either. There are many easier ways to make 
money than in medicine.

------------------------------------------


> studies show
> that even the best medical school students have essentially forgotten
> 90 to 95 percent of what was taught by the time they do an internship!
> Surely there must be quick and better ways to train neophyte physicians.

Speaking from first-hand experience, I can say that the problem is that
the training in medical school is not long enough! We essentially fly
through hugh quantities of material and then move on to the next topic,
with never a chance to look back. The rate of incoming information is so
rapid, that I would not be surprised if 90% of it is forgotten. 

In reality though, that 10% still represents a huge chunk of material
(10% of infinity is still infinity).  And the other 90%,
may not be availiable for immediate recall, and some might say it is
"forgotten", but I would submit that it is still there, laying dormant
awaiting further development during residency. It is amazing how quickly
some of the "forgotten" material comes back with just a quick reminder.

It is amazing how short a time is devoted to many essentially important
topics in medical school. If anything, the time needs to be lengthened
if we want to turn out quality physicians.

---------------------------------------

>I think
>that these computer industry jobs are equally demanding (50+ hrs a week) as
>those of normal physicians, and probably more stressful because of recent
>downsizings and daily changes in the technology and business goals.  I have
>several friends with MD wives that work less, have much less job stress, and
>earn much more than their husbands.

Well, these anecdotal accounts are all very nice, but they don't mean
very much. I could tell you about some of my friends in the computer
field who are making some really good money, and they don't work nearly
as hard or as long as most physicians I know.  I was a computer engineer
and worked for several years before quitting to go to medical school. I was
very good at what I did, I made an excellent living, and the work was a
piece of cake! Again, this is just another anecdotal accounting, but I
doubt that I will ever acheive the same standard of living as a physician
as I had as a computer engineer. Working 50 hours a week is nothing!
Residents frequently work 110-120 hours a week.

The stresses of downsizing are nothing when compared with the stresses
in making decisions that affect lives. Changing technology affects
medicine every bit as much as other discipline.

-----------------------------------

> It is not sour grapes, but a question of perennial demand and an
> AMA-regulated supply.  

Hardly. This is not the source of high health costs. The government says we
have an OVERSUPPLY of physicians and they are doing all they can to limit 
the numbers of new physicians. The AMA is trying too prevent them from doing
so.



--
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 Richard Z. Toptani  -   Loyola University Stritch School of Medicine
        EMAIL: rtoptan@orion.it.luc.edu
        SNAIL: 6700 S Brainard #402, Countryside IL 60525-4661
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