I am a physician and do not drive a luxury car or live in million dollar home. it would be a financial impossibility for me to do so if I ever wanted to retire. I drive a subaru and live in a 320,000 dollar home. while that is quite nice It certainly doesn't match what most people expect from physicians.
One point that is lost in this argument is the need to keep physician salaries high to keep entry in to the field very competitive. If salaries were to drop then you would find less desirable candidates entering the field. I would not want to be a patient of someone who became a physician because he/she couldn't get into a decent school or career and became a physician as a back up plan. There is just way to much to know with too little margin of error to not have the very best people in the field.
Woody, MD - 6 weeks ago
Agreed. I cannot sustain these hours away from my family and the debt. Goodbye IM, hello fellowship. I hope it gets better after three more years. If not, there will certainly be a more desirable cohort of patients in the subspecialty.
Ro - 6 weeks ago
The problem isn't the compensation, it's the debt incurred from overpriced tuition and expensive loan rates. The solution isn't to pay physicians more money (i.e. raise the cost of healthcare), the solution is to create affordable education.
I'd like to add that your numbers for high school teachers are way off. I am a high school English teacher and I spend 70-100 hours a week working for my students. I recently calculated my hourly wage based on an 80 hour work week for 26 weeks (183 contract days) and I came up with $20.67 per hour. However, if you factor in that during my vacations I spend at least half of that time planning, grading, and at conferences (often paid for with my own money) that calculation drops to $16.25 (not including non-refundable expenditures). Keep in mind, that figure doesn't take into account my California taxes. After taxes I make $12.50 per hour. I won't go into the calculations for loan payments but that would obviously drop my hourly even more significantly.
I don't want to make this a game of "I'm more victimized than you!" because that's just ridiculous. I just think your calculations for a teacher's income are a gross misrepresentation. As a teacher, I have no desire to get paid more. I just wish things weren't so expensive.
BIGP550 - 6 weeks ago
Tax code shoud've been redone plus partial loan repayment should be forgiven or / and forgiven
dbm - 4 months ago
@William- Teachers put in long days when they work. He isn't talking about professors at universities or even community colleges because they do make more money. He is talking about elementary and high school teachers. During the school year they may put in 9 hour days, occasionally 10, with their planning, teaching, and grading. At the same time, they get a summer vacation every year. They don't work for over 3 months of the year if you add in summer break, spring break, Christmas break, Thanksgiving break, and federal Holidays. So the salary they make is really only for about 9 months. Now if you calculate it out using nine months as a year instead of 12, you will see that they are compensated very well for their time. This isn't a knock on teachers at all, it's just that their training and time spent actually working is nowhere near that of a physician.
Joe - 7 months ago
Internal medicine is the epitome of work... They are constantly getting paged about their inpatients... New admits, problems with existing inpatients, and so on...
It's a real beat down. Very long hours.... Tied to a phone and a pager as well as work.
William - 1 year ago
Interesting analysis. It's fair to say that some doctors aren't paid enough. I certainly agree with that. A lot are paid enough. Some are paid too much.
A few comments:
I don't think it is correct to use median values to scale up to lifetime earnings if income is not normally distributed.
The hours worked per week is for physicians from many specialties. I doubt internal medicine doctors work the long hours on average that some other specialties do.
The pay you include for teachers includes teachers with post baccalaureate degrees - but you don't include any training costs or time investment in these degrees.
Teaching requires a daily significant investment of time outside of class. For many teachers, nearly 7 hours a day is active teaching, lesson planning, grading, etc takes many hours past that. I think to just declare the outside of work time investment 'equal' is a bit unfair. Most teachers I know put in at least 10-20 hours in outside of the normal work week.
Gallant2m - 1 year ago
I agree. many doctors are teachers in addition to being clinicians, researchers, scientists. So of course, they do deserve to be compensated more than teachers.
dbm - 1 year ago
@das- I see where you are coming from when you talk about families where one or both of the parents are doctors and therefore can afford to pay for the children to also go to medical school. Unfortunately that is a false claim. I know this because my wife is currently in medical school and she has quite a few classmates with doctor parents. Most of the students went through undergraduate with the help of parents but when it comes to medical school they get little or no help at all. Most parents even with the salary of a doctor can't afford to pay off their loans and pay the $75,000/year that it is costing my wife to go to school (this is including everything, tuition, living, transportation, etc.) One explanation I was given was that the parents helped get them to medical school, they needed to get themselves the rest of the way. If you make it through medical school you will have the means to pay off the loans, but it will take a long time to do it and a big chunk of money like was indicated in the article above. Again, the author isn't saying they don't make "a lot" of money, it is just deceiving as to how much they make. They make four times what a teacher makes but they put in 7 times the amount of training, 1.5 times the amount of hours/week, and borrow hundreds of thousands of dollars more.
As far as driving luxury cars and owning million dollar homes, that is because they do make more money. Nobody denies that, it is just that they are not compensated fairly per hour. They barely make more money an hour and if they did not work 60 hour weeks, they would not be able to afford those things. I know they don't get paid hourly, but you have to look at it like they do. They DO work 60 hours so when breaking down their salary it only comes out to a little more then teachers. They don't have the choice to only work 40 hours. Sorry if this next comment offends anybody, teachers especially, but doctors deserve to make a lot more then teachers. We need teachers, don't get me wrong, but they only work 30 some hours a week, they don't work nearly as many hours, have less loans, and less training. Fortunately doctors won't strike like teachers do because they understand our need for them. Again, we need educators, but they make enough money for what they do. Doctors are greatly underpaid and in a lot of cases under-appreciated as well.
@B- I agree the amount of training needs to come down, but like the article says, if you want competent doctors who know their stuff, the amount of training and schooling will never go down. They need that long to learn everything. I wish reading the article you would see that, and understand that they are not overpaid.
Das - 1 year ago
As with any interest-loan system, a reduction of principal at the beginning can make drastic changes over time. While the math makes sense for someone starting from scratch with no financial support from their family, I'm not sure thats the usual starting point for the aspiring doctor.
I'd like to see some exact statistics, but a lot of medical school students I know come from families of doctors... is a family that's already financially stable more likely to take on the expense of medical school for the younger generations? While you can certainly point to the cases where someone pulled themselves up by their own bootstraps as evidence that it's possible, the math won't hold true for physicians who didn't incur the expenses upfront and ensuing interest because they were financed by their families.
While you could make the same argument for teachers, the disparity relies largely on compounding interest over a long period of training with no income... you may find that there's a much wider gap between teachers and physicians than this specific case depicts.
As an anecdotal observation, I don't know many teachers who drive luxury cars and live in million dollar houses, but I know quite a few doctors who do... there must be some underlying explanation for what I believe most would consider a common observation.
B - 1 year ago
YES, doctors make too much money. But, they also have to do too much "training" and they pay way too much tuition. Both sides of the equation need to come down.
Your article is superb! I placed a link to it on one of my pages:
http://www.er-doctor.com/doctor_income.html
When I have time, I will discuss your article in one of my Question & Answer pages on that site. I'm now making a robotic chef so that I (or anyone else) can prepare food by using a touch screen on the device or any computer or phone with an Internet connection. A Facebook friend recently commented about how "physicians have been given so much by society." I wondered, GIVEN? I wasn't given anything; I paid dearly for it in many ways, as your article illustrates. I've worked as hard to get out of medicine as I did to get into it. If medicine was the dream job many laymen think it is, working that hard to get out of medicine makes as much sense as desperately seeking to free myself from the embrace of a beauty queen who wished to kiss me.
I am a physician and do not drive a luxury car or live in million dollar home. it would be a financial impossibility for me to do so if I ever wanted to retire. I drive a subaru and live in a 320,000 dollar home. while that is quite nice It certainly doesn't match what most people expect from physicians.
One point that is lost in this argument is the need to keep physician salaries high to keep entry in to the field very competitive. If salaries were to drop then you would find less desirable candidates entering the field. I would not want to be a patient of someone who became a physician because he/she couldn't get into a decent school or career and became a physician as a back up plan. There is just way to much to know with too little margin of error to not have the very best people in the field.
Agreed. I cannot sustain these hours away from my family and the debt. Goodbye IM, hello fellowship. I hope it gets better after three more years. If not, there will certainly be a more desirable cohort of patients in the subspecialty.
The problem isn't the compensation, it's the debt incurred from overpriced tuition and expensive loan rates. The solution isn't to pay physicians more money (i.e. raise the cost of healthcare), the solution is to create affordable education.
I'd like to add that your numbers for high school teachers are way off. I am a high school English teacher and I spend 70-100 hours a week working for my students. I recently calculated my hourly wage based on an 80 hour work week for 26 weeks (183 contract days) and I came up with $20.67 per hour. However, if you factor in that during my vacations I spend at least half of that time planning, grading, and at conferences (often paid for with my own money) that calculation drops to $16.25 (not including non-refundable expenditures). Keep in mind, that figure doesn't take into account my California taxes. After taxes I make $12.50 per hour. I won't go into the calculations for loan payments but that would obviously drop my hourly even more significantly.
I don't want to make this a game of "I'm more victimized than you!" because that's just ridiculous. I just think your calculations for a teacher's income are a gross misrepresentation. As a teacher, I have no desire to get paid more. I just wish things weren't so expensive.
Tax code shoud've been redone plus partial loan repayment should be forgiven or / and forgiven
@William- Teachers put in long days when they work. He isn't talking about professors at universities or even community colleges because they do make more money. He is talking about elementary and high school teachers. During the school year they may put in 9 hour days, occasionally 10, with their planning, teaching, and grading. At the same time, they get a summer vacation every year. They don't work for over 3 months of the year if you add in summer break, spring break, Christmas break, Thanksgiving break, and federal Holidays. So the salary they make is really only for about 9 months. Now if you calculate it out using nine months as a year instead of 12, you will see that they are compensated very well for their time. This isn't a knock on teachers at all, it's just that their training and time spent actually working is nowhere near that of a physician.
Internal medicine is the epitome of work... They are constantly getting paged about their inpatients... New admits, problems with existing inpatients, and so on...
It's a real beat down. Very long hours.... Tied to a phone and a pager as well as work.
Interesting analysis. It's fair to say that some doctors aren't paid enough. I certainly agree with that. A lot are paid enough. Some are paid too much.
A few comments:
I don't think it is correct to use median values to scale up to lifetime earnings if income is not normally distributed.
The hours worked per week is for physicians from many specialties. I doubt internal medicine doctors work the long hours on average that some other specialties do.
The pay you include for teachers includes teachers with post baccalaureate degrees - but you don't include any training costs or time investment in these degrees.
Teaching requires a daily significant investment of time outside of class. For many teachers, nearly 7 hours a day is active teaching, lesson planning, grading, etc takes many hours past that. I think to just declare the outside of work time investment 'equal' is a bit unfair. Most teachers I know put in at least 10-20 hours in outside of the normal work week.
I agree. many doctors are teachers in addition to being clinicians, researchers, scientists. So of course, they do deserve to be compensated more than teachers.
@das- I see where you are coming from when you talk about families where one or both of the parents are doctors and therefore can afford to pay for the children to also go to medical school. Unfortunately that is a false claim. I know this because my wife is currently in medical school and she has quite a few classmates with doctor parents. Most of the students went through undergraduate with the help of parents but when it comes to medical school they get little or no help at all. Most parents even with the salary of a doctor can't afford to pay off their loans and pay the $75,000/year that it is costing my wife to go to school (this is including everything, tuition, living, transportation, etc.) One explanation I was given was that the parents helped get them to medical school, they needed to get themselves the rest of the way. If you make it through medical school you will have the means to pay off the loans, but it will take a long time to do it and a big chunk of money like was indicated in the article above. Again, the author isn't saying they don't make "a lot" of money, it is just deceiving as to how much they make. They make four times what a teacher makes but they put in 7 times the amount of training, 1.5 times the amount of hours/week, and borrow hundreds of thousands of dollars more.
As far as driving luxury cars and owning million dollar homes, that is because they do make more money. Nobody denies that, it is just that they are not compensated fairly per hour. They barely make more money an hour and if they did not work 60 hour weeks, they would not be able to afford those things. I know they don't get paid hourly, but you have to look at it like they do. They DO work 60 hours so when breaking down their salary it only comes out to a little more then teachers. They don't have the choice to only work 40 hours. Sorry if this next comment offends anybody, teachers especially, but doctors deserve to make a lot more then teachers. We need teachers, don't get me wrong, but they only work 30 some hours a week, they don't work nearly as many hours, have less loans, and less training. Fortunately doctors won't strike like teachers do because they understand our need for them. Again, we need educators, but they make enough money for what they do. Doctors are greatly underpaid and in a lot of cases under-appreciated as well.
@B- I agree the amount of training needs to come down, but like the article says, if you want competent doctors who know their stuff, the amount of training and schooling will never go down. They need that long to learn everything. I wish reading the article you would see that, and understand that they are not overpaid.
As with any interest-loan system, a reduction of principal at the beginning can make drastic changes over time. While the math makes sense for someone starting from scratch with no financial support from their family, I'm not sure thats the usual starting point for the aspiring doctor.
I'd like to see some exact statistics, but a lot of medical school students I know come from families of doctors... is a family that's already financially stable more likely to take on the expense of medical school for the younger generations? While you can certainly point to the cases where someone pulled themselves up by their own bootstraps as evidence that it's possible, the math won't hold true for physicians who didn't incur the expenses upfront and ensuing interest because they were financed by their families.
While you could make the same argument for teachers, the disparity relies largely on compounding interest over a long period of training with no income... you may find that there's a much wider gap between teachers and physicians than this specific case depicts.
As an anecdotal observation, I don't know many teachers who drive luxury cars and live in million dollar houses, but I know quite a few doctors who do... there must be some underlying explanation for what I believe most would consider a common observation.
YES, doctors make too much money. But, they also have to do too much "training" and they pay way too much tuition. Both sides of the equation need to come down.
Your article is superb! I placed a link to it on one of my pages:
http://www.er-doctor.com/doctor_income.html
When I have time, I will discuss your article in one of my Question & Answer pages on that site. I'm now making a robotic chef so that I (or anyone else) can prepare food by using a touch screen on the device or any computer or phone with an Internet connection. A Facebook friend recently commented about how "physicians have been given so much by society." I wondered, GIVEN? I wasn't given anything; I paid dearly for it in many ways, as your article illustrates. I've worked as hard to get out of medicine as I did to get into it. If medicine was the dream job many laymen think it is, working that hard to get out of medicine makes as much sense as desperately seeking to free myself from the embrace of a beauty queen who wished to kiss me.