> But I'm pretty sure they make far more in the US than anywhere else in the world.
Yea, but the opportunity cost of getting there is huge. At graduation, most doctors are in the ballpark of $1MM behind where they'd be if they went straight into a professional career.
Also, doctor's salaries only account for 8% to 20% of total healthcare costs.
>> For one, doctors educational costs are astronomical in the U.S compared to other countries.
Doesn't this apply to all US educational costs (at the college level)? On the other hand doctors in the US seem to get paid a lot more than in, say, the UK.
> That's the goal!! Very high doctor pay is the number 1 cause of skyrocketing medical expenses.
Exactly! I can't think of any other country where doctors routinely make 15-20x minimum wage, and people become doctors predominantly to make a lot of money. In most countries, doctors make very good money, but not 15-20x minimum wage good. In Western Europe, for example, it's more of 5-8x minimum wage.
> but they do pay pretty mid-level on Physician salary. It's not a place you can clear $500k+.
That's the goal!!
Very high doctor pay is the number 1 cause of skyrocketing medical expenses.
The model should be coupled with them opening a lower cost university and training 10 times as many medical people as we do today. Along with better supply lowering prices, it also means a Doctor could have normal working hours, so would not need the insanely high salary they need to pay for all the stuff they don't have time to do themselves.
>> Doctors are already paid absurd salaries in the US
>To put it in context, when I finish all my training, I will owe over $600,000.
> It's not the doctors being "paid absurd salaries" that makes medical care in this country expensive. It's lawyers - malpractice insurance can take upwards of 25+% of your income - and it's insurance companies, who have shareholders they are responsible to, and it's hospital administration, whose positions keep multiplying.
It's a red herring. If you compare physician compensation in the UK to the US, the costs of medical education are made up within the first ten years. Yes, even after malpractice insurance. Hospital administrators are also wildly overpaid, but there just aren't as many of them. Physician compensation as compared to foreign doctors, which get the same or better results, is just too large a piece of the pie to brush under the rug by pointing at other problems.
> Doctors are well paid in the US but they are typically not rich.
What doctors do you know? My friends who are just getting out of residency and such are making a few hundred thousand a year. My college roommate’s father was an anesthesiologist making $800k/year.
Just because they don’t draw attention to themselves with ostentatious vehicles doesn’t mean they couldn’t afford to (the anesthesiologist only had a Porsche for each of his kids).
> Also because of massive student-debt loads - the average GP came out with like $250k even a few years ago. Someone's gotta pay that, and ultimately it's the patients.
I doubt that's the reason for high doctor wages. They will keep making a huge buck even if tuition is cut by 80% imo. The reason I'm saying this is that the market doesn't care how much debt you have from school: you can pay Harvard 240K to get an art degree, that's not going to make anyone pay you what doctors are earning. You can become unemployed with big debt as you graduate.
>have to earn very high pay to cover the (insane) cost of medical school and insurance.
Also opportunity cost for people capable to become physicians in the US have other options with competitive pay to quality of life at work ratio. Lots of ways to not spend one’s 20s memorizing stuff for step exams and then spend 26 to 30 being a slave during residency, and then maybe a fellowship or getting board certified, and at the end, you still have to deal with patients.
Alternatively, they could go for a job where they sit behind a computer and not deal with the general public and get to work from home when shit hits the fan.
> Probably close to half of doctors make less money than the average person working at FAANG.
I feel like comparing doctors as a whole to the subset of software engineers who are at FAANG is not really apt.
> delay any wages until 34
What?
Out of HS at 18, BS at 22, MD at 26.... then what? At least 2 years of residency (PGY1, 2) and you're 28. And then what are you doing for the next SIX years before you're earning wages? Uhhh.
> lower middle class life until 50 while paying of medical school debts
I work as a paramedic, and have multiple provider friends, from family practice, to EM to anesthesiology. While the anesthesiologist is 40 and already owns a book store, and multiple homes, none of the others are wallowing in the "lower middle class". You can pay a lot of student loans at the $300-350K EM residents make in this area.
> barely be in the top 10% after that
I think you're exaggerating on top of exaggeration.
The top 10% line would be at $86K/year.
Let's be more real. Public Health pays the lowest physician salary, averaging at $249K/year. That already puts you in the 2%.
Cruise on up the ladder and Gastro, Cardio, Ortho and Plastics all are north of $500K.
Yes, there is malpractice insurance, and it's not negligible (and some networks will provide allowances to providers for this). But it's also fairly linear to specialty and income, and often not as much as assumed. Obstetrics, as expected, is the highest, at ~$42K (with average salaries of $390K), family practice averages around $10K, and even my anesthesiologist friend is only paying around $13-15K/year.
> Compare Dr salaries to other countries. Doctors in the US make 2 to 10 times as much as other counties.
This is slightly unfair if you don't consider the cost and time of becoming a doctor. That is not to say that the AMA doesn't purposely enforce a shortage as an attempt to drive up wages, but many doctors spend the better part of a decade (or more) before they're really earning any reasonable amount, and they have large debts from paying for school.
> Start educating way way way more Doctors
Yes. But that will hurt those who are already doctors somewhat, so there's a strong incentive to limit the pool.
> encourage people to go to low cost universities (which do exist - but everyone wants "the best").
These don't really exist in any reasonable amounts. You also have to consider how much of a doctor's education is outside of a university. And it does make a difference which hospitals you have your rotations and residency at. If you want to be doing EM, you're not going to want to end up in some sleepy town in the midwest where the most that happens is some drunk dude needing his stomach pumped. If you want to end up being in a specific field, your choices tend to be relatively limited in where you can actually get the education and experience you need for that specialty.
Anyways, all that is mostly to say that the healthcare 'system' in the US is a clusterfuck for many interconnected (and entangled) reasons and there is no one simple issue to address.
> Maybe medical school prices would go down with additional scale.
It seems like a bit of a chicken and egg problem. Medical school is already so expensive that the salaries are necessary in order for newly minted doctors to have the same disposable income after loan payments that, say, a programmer or chemical engineer who's 7 years younger has (4 years medical school + 3 years residency minimum). Who would make the sacrifices necessary to become a doctor, taking out massive loans, only for an income that won't sustain them comfortably?
> there are doctors making $500k/year living paycheck to paycheck.
Can you provide a source for that please ?
Also, it would be interesting to find how much of their expenses are paying back their insanely high tuition-fees.
> Is grinding thru med school somewhat sacred? should they earn more than EEs? civil engineers? architects?
Everyone you mentioned should (and does in the US) earn more than 90k GBP. Nurses in the US (at least in California where they make 50-60$/h) earn the same as top pay grade specialty doctors in the UK according to that NHS payscale.
> yes, fixing noses or fake tits
No, there are many specialties which don't involve plastic surgery but make millions. Cardiologist, dermatologist, dentist, etc. Or if you're a surgeon and work at a big hospital, you can also make 500k+. All of these involve mitigating pain and suffering and saving lives.
Sorry you think plastic surgery is the only way to earn a good living in medicine.
> like almost everyone else. Newsflash - US is really expensive.
Compared to what, London? Amsterdam? Paris? The US isn't more expensive than anywhere else, and for a doctor working in the suburbs, it's way cheaper than any major city in Europe. Don't forget, health insurance for white collar workers in the US is cheap compared to their salary, and taxes are lower. Energy costs as well. And a 401k is a lot cheaper than paying progressive social security taxes that redistribute earnings.
At least the US doctor can afford a house, whereas the UK one will never buy one within an hour's drive of London in their lifetime.
> isnt that the main reason the salaries are so high?
It's because the NIH limits the amounts of medical residencies in the country, and to become a doctor with a license to practice, you must have completed residency somewhere. The amount of doctors in the US are kept at low numbers because of this.
> doctors dont automatically become millionaires collecting vintage cars or buying private planes
Yes, instead they make less than new grads working in literally any white collar field in the US, less than nurses in the US, and less than most blue collar trades in the US [1]. 91k GBP for the highest pay grade specialist doctor is just sad given how much training you need to become a specialist. That doctor could be making millions here in the US with their own practice.
GPs in the US (lowest paid specialty) get paid 2-3x what GPs get paid in the UK, according to the NHS payscales.
I think doctors working 80 hour residencies and grinding through med school deserve to get paid more, don't you think?
> The fact of the matter is that no other career path even comes close to the risk-adjusted lifetime financial remuneration of becoming a doctor
Does that stat include doctors who didn't place into residency. This year, 1 in 5 med school grads didn't get a residency. Some of them will match next year, but it's typically considered a one and done process. That something many older doctors tend to forget.
You basically go $1 million in debt (between tuition and lost wages) for a 1 in 5 chance of being a complete financial wreck with a mostly useless degree since you can't become licensed.
Once you've made it being a doctor can be great. However, the process of getting there is absolutely brutal.
> but most make way more than $300k after only a handful of years of experience.
'Eh, not really [1]. Most will wind up in the upper $100k region (most being in some form of primary care). Not after a handful of years, but 4+ yrs college, 4+ yrs medical school, then bare minimum 3 year residency (with most 4+), with each step an order of magnitude more difficult.
> most doctors are sons and daughters of rich folks
Many are, but since we're in the anecdata game, none of my friends were.
Not going to lose sleep over it, upper $100's is plenty to compensate for high debt in the long run. But to pretend its not extremely stressful for most is to be misinformed.
Lastly:
> 5 years of service in a shortage area
After spending the last 2 years in a qualifying region (though not for that purpose); topping off 12 yrs of post-high school with another 5 living somewhere you'd rather not be (to be polite) is no small feat. Thats 35 yrs old before you get a shot at living and working somewhere reasonable.
Yea, but the opportunity cost of getting there is huge. At graduation, most doctors are in the ballpark of $1MM behind where they'd be if they went straight into a professional career.
Also, doctor's salaries only account for 8% to 20% of total healthcare costs.
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