Are Doctors Worth Their Salaries?

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On my last post “Why Did I Become A Doctor” JF, of Pursuit of Happiness, asked me to specifically address my road to becoming a practicing physician as a means of justifying my paycheck. This is particularly dear to my heart because I know many people have made physicians out to be the enemy.

We are not the enemy.

Your primary care doctor is not the reason medical costs are so high. Instead look to pharmaceutical companies, medical supply companies, electronic health records, facility managers, CEOs, etc.

The CEO of Aetna made over $30 million in 2013. My income is a pittance compared to that.

But back to the question. Am I worth what I get paid?

Let me clarify:

I am not worth what I bill insurance companies. We both know that. BUT, they don’t pay me what I bill. It is a little dance we do.

Them: If you can see a patient for that much, surely you can do it for less!

Me: I need to bill more so you at least pay me what I need to cover my overhead and pay my staff and myself…

I am worth what I DO get, though.

After college, while everyone else was starting jobs, I was starting medical school. I lived for four years on loans.

My life was on hold.

My friends were buying their Mercedes convertibles while I was driving my rusty Dodge Shadow with the droopy ceiling and no AC (the fabric would slap my head as I drove with the windows down in the sweltering heat). They started having kids. I was dissecting dead people and learning how to stick my finger in someone else’s butt in a caring and compassionate way.

They started saving for retirement. I went further and further into debt. Over $100,000 in debt. In fact, I was in my thirties before I actually started making enough money to save for retirement.

Late nights studying gave way to working on the wards, trying to work harder and better than all of the other super smart, highly competitive students so I could get a few recommendation letters and get into a good residency program.

Residency was another beast entirely. I did get into a great program (a story that deserves it’s own post). Three years of 36 hour shifts back to back to back. Sleep deprivation. Depression. Self doubt. Self loathing. Gaining weight. Sexual harassment. Descrimination. Verbal abuse from attendings in the middle of the night and in the light of day. And then finally clawing my way out of the dark place and back into the light.

Every day, all through medical school and residency, my husband would say, “You can quit. It’s OK!” I would be curled up in a ball somewhere crying myself to sleep and chanting, “I am NOT a quitter! I am NOT a quitter! I am NOT a quitter!”

Why didn’t I just quit? That is my next post.

For now let me say my soul still feels bruised by what I experienced in residency. It made me into another human being entirely, a better one who was stronger and had found her voice, but the experience breaks some new physicians. It was awful.

If you are interested, here are some links to some experiences that I have already blogged about:

Lessons

The Power of Love

Giving Head

Gargoyle

My first five years of practice were better than residency, but I still worked hard from 6AM until 7 or 8 PM and spent many, many weekends doing rounds all day at the hospital or taking my turn running the Saturday clinic. I could often be found up in the middle of the night trying to keep someone alive when I still had a full day of clinic to look forward to the next day.

At this point I no longer do hospital work. That has been a breath of fresh air and a huge load off my back. But now I am a mom on top of working full time so my stress level is back up. Honestly, I always thought I would never have kids, that the job would be my life. So many female physicians wait until later in their lives to have kids because it is incredibly difficult to do it earlier with the work that is required for med school and residency. I may be a better mom for it on some level but I will also be the only mom at high school graduation sporting a walker.

So I do well financially but I still don’t have my convertible. Or a Mercedes. I drive a Honda, though I DO have functional air conditioning now. I am living well below my means. First so I could pay off my loans (so I can have the peace of no longer being a slave to my education), then to pay off my modest home (I have a place to live if something terrible happens like losing a limb or sustaining a brain injury and because you never know if/when you are going to get sued), saving for college for my kids (because they deserve a future, too), and now so I can catch up on saving for retirement because I would like to switch to volunteer/charity work before I am too obsolete to be useful.

The most important thing, however, is that I am not sure you want doctors who only make $40,000/year operating on you or prescribing your medications. You want the best, the brightest, attracted to this tough, demanding profession instead of opting to become an overpaid CEO lounging in their comfortable leather swivel chair in some high rise somewhere…

For patients, though, very little of any of this matters. I understand. It is about your suffering and your pocketbook and that is as it should be.

What I would like to see is free healthcare for all so patients don’t have worry about how they are going to afford their care. I would like to stop having to play guessing games with all of the damn insurance plans, fighting and fighting to get them to do the right thing. I would like CEO and executive salaries slashed. Do you know how many sick people could be helped for 30 million dollars? What single person deserves that kind of money? You don’t want to pay for a patient’s heart medication but you are paying your CEO millions?!?!?! This is my vision. It scares people. It scares me.

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88 thoughts on “Are Doctors Worth Their Salaries?

  1. I think the whole system of recompense for service is all messed up. Who knows what each person’s salary should be. All I do know is that when you have people dieing on the streets from the cold ( in Canada) and the nescessity for people to depend on food banks to survive, there is something very wrong with society. You have politicians making astronomical incomes with benefits and pensions that one can only dream of and they have allowed thing to be so miss managed that a lot of them belong in jail. You have CEOs of multinationals that make unbelievable salaries and they don’t even provide local employment. No wonder our youth are flaundering as well as a lot of other people.
    We are desparately in need of a societal overhaul.
    Leslie

    Liked by 3 people

  2. I think doctors ARE worth their salaries — not all of them, but most. It is a hard job, with literal life or death decisions made frequently. They need a high level of education, compassion, split-second decision-making ability and the memory of an elephant. The more I learn about medicine both as a patient and as a researcher, the more I appreciate the folks who go into medicine.

    The folks who are overpaid in my book are the MBAs. As a rule, they make nothing. They help no one. They drive up costs, of everything, outsource jobs, destroy functioning companies. They have no heart, no soul. Are you listening, Mitt?

    Liked by 1 person

  3. Locally the (big political) question is not about doctors but teachers with taxpayers questioning whether they are worth the $65 to $85K they get in our area. As you say, we don’t want teachers for our kids making minimum wage either. Each profession has it’s advantages and it’s pitfalls. I worked in a corporation so my salary was never questioned. Of course I worked in human resources and most people don’t have any use for that but they stopped short of telling me I was overpaid. The most important thing is to be doing what you love and it sounds like you are…at least most days. That’s the best we can ask for.

    Liked by 1 person

  4. Thank you for this one. and thank you for pushing through all the crap to get to where you are today. There are 4 doctors in my extended family, my sister who is an RN and we have a friend who is a pediatrician, so I have heard lots of similar stories like some of the ones you have shared here at family gatherings.. I don’t know how you do it sometimes. Those of you that have a caring heart have earned every cent that winds up in your bank account. ..just the malpractice insurance premiums are enough to choke a horse.

    Liked by 2 people

  5. Doc, you are worth every penny. Your compassion is amazing and this is what makes you a rich person indeed.
    PS I love the description of the roof slapping you in the head…. I had a car like that too.

    Liked by 2 people

  6. Wow, that post certainly opened my eyes even wider than they already were! I definitely think you are worth your salaries, without a doubt! You have worked like a Trojan to earn a halfway decent salary. It is so maddening that at CEO can earn so much but someone such as yourself who literally SAVES LIVES get a pittance in comparison!
    I am from the UK as you know, and our system is totally different, but no natter where a doctor is from, the work, hours. stress, and tears they put in, makes them worth every penny and more!

    Liked by 1 person

  7. Victo, this is a wonderful post! Many my friends are doctors and I know how hard they work and how many people they saved or cured (my wife, our children and myself included). I wrote several posts about doctors in my blog. I think that you deserve more gratitude and respect from everybody (and more money too).
    Please give a link to this post in https://closetoeighty.wordpress.com/2015/01/10/new-challenge-our-ways/ or add my link to this post. Thank you. Best to you!

    Like

  8. Knowledge is power – and this is what all professions use – and often abuse – when dealing with us ordinary folk.

    I find it hard to sympathise with my dentist’s study loans and practice overheads when he has a game farm, private plane, holiday homes, private schools for children, and more.

    It is also hard to justify my orthodontist’s charge of $2000 plus for an hour’s work – no complications, no special materials. There is no way to evaluate the quality of service beforehand and I have to rely on the referral of my dentist. So it’s not really a “free market” and there is little opportunity to “shop around”.

    So, medics, lawyers, plumbers may be worth every penny but don’t ask for sympathy!

    Liked by 1 person

  9. I just can’t even imagine people questioning your value to society. Speaking only from the one case of which I can talk as an expert, my own, having this couple pounds of flesh that I carry around inside my skull subjected to so much mistreatment at so early an age, there was every likelihood that I could have turned out to be one of those people that we read about far too often on the nightly news leaving swaths of destruction in their wake. But thanks to some individuals who I’m assuming quite likely went through hardships and grief very similar to what you’ve described above, and still somehow had enough compassion left in their hearts to take all my problems and pile them on top of their own, and after working with me for extended periods of time, handed to me a life to live simply because they thought I should be entitled to one also. I’m fifty-eight years old now, so I don’t know how many more years I have to enjoy this life they managed to salvage for me, but please, don’t ever ask me to put a price tag on it. Once again Doctor, I’m sorry you even have to put up with this kind of nonsense.

    Liked by 1 person

  10. Ahh Dodge shadow the chariot of the 80s. Hondas are great little to no maintenance! Regardless of profession there will always be those who spend out of means. Maybe dr Oz or plastic surgeons to the stars are rolling around in a Benz, but most are not.

    Liked by 1 person

  11. I have to say, I have never begrudged my doctor whatever it is he makes. And quite honestly, I don’t even know. I know in addition to his own costs, he has the responsibility of running his own practice, paying his own employees, he did hospital rounds for years, at two hospitals, in addition to ALWAYS being at his own practice. He also has a family. And when I go to his office? He knows who I am and what my history is. I know who to blame for the high cost of medical care. THE DAMN INSURANCE COMPANIES AND POLITICIANS. All bad things lead back to those two things. πŸ™‚ I have never understood putting doctors and nurses through hell. WHY do we want them to suffer while they learn? It makes no sense. Sleep deprivation and 36 hour shifts is begging for trouble.

    Liked by 1 person

  12. I can’t even imagine how hard it would have been. I lose one nights sleep and I don’t function well at all.
    I always wondered why docs are expected to work on little or no sleep constantly. Isn’t that dangerous for the patients even more so when they’re doing surgery?

    Liked by 2 people

  13. Everything has already been said, but thank you so much for sharing. While I have had some poor experiences with doctors (every profession has their bad apples, right?) I really do admire and respect them for their work. I respect the less ‘celebrated’ members of the medical team too, as theirs is often a very thankless task.

    Liked by 1 person

  14. You are so right. You deserve every cent. Your commitment is staggering. The effort to keep up is relentless. There is no way medicine is just a job. If the money wasted on CEOs went into health, care, we wouldn’t have a problem.

    Liked by 1 person

  15. The best doctors I’ve ever had were ones that did not accept insurance. (They offered the forms for me to submit to my own insurance company for reimbursement, but they only accepted cash up front.) I think without the headache of insurance, they were able to focus more on me or my children. And they also charged less than their competitors charged patients who didn’t have insurance. So, in essence, what I’m saying is, I don’t blame the doctor at all for charging so much. Then again, I understand that I’m paying for their education… and depending on how sick I am, I WANT them to have the best education possible. πŸ™‚ Personally, I think besides health insurance mumbo-jumbo, it’s also the increase in litigious people who try to sue their doctor and drive up the doctor’s med mal insurance that also causes medical costs to rise.

    Liked by 2 people

  16. It’s a similar situation with scientists. Before you start having enough money to raise a child, your ovaries stopp cooperating. All my friends have kids, some have bought a house, they go on holidays to all kinds of exotic places… While I work all night long, with a wage under the minimum, without a social life and so on. It will take me another 5 more years before I start earning enough to live their lives. I’ll be 33 when this starts and since they earn money since they’re 16 it will take me even more to catch up.

    Liked by 1 person

  17. I had a great GP in Cinci, that must have been in a mood one day because he chatted with me for about 10 minutest about insurance, mostly his. They were cranking up his rates again. He voiced similar things to what you’ve said. He quit practicing soon after.

    I’ve said it before, I don’t know why anyone would study to be a doctor any more. It ain’t Marcus Welby. I was horrified when I started doing billing for the podiatrist and had my hands on the reality. He accepted Medicaid (which, folks, in case you didn’t know, doctors don’t have to). There would be visits that lasted over 1/2 hour and he’d be lucky to get paid $12 for his time. Oh yes, you’d bill out at $60/15 mins for something, cross your fingers that some idjit who didn’t know a malleolus from a molar would deem it worthy, and the check would come and he’d receive $5. It cost him more for me to process all of that stuff than he made on a patient, and I was underpaid.

    A friend in California was an ob/gyn. She finally stopped doing that because of the malpractice and she’d never been sued. She became an admin for a blood bank.

    Liked by 1 person

    • Ob/gyn malpractice coverage is some of the most expensive. And yes, most people have no idea how the billing nightmare goes behind the scenes. Health imsurance costs have skyrocketed for most of my patients this year with sky high deductables and people are refusing care that they need as a result. It isn’t right.

      Liked by 2 people

      • Well, my most recent job was with the AHA and explaining health insurance to people… That was cringe-worthy most times. Also because the company provided health insurance I was not able to take advantage of the Exchange, where I would have qualified for help with deductibles. Instead, I had a $2000 yearly deductible, for one person, and this was NOT considered a catastrophic plan. Oy. Yes, we could go on and on in that discussion.

        Liked by 1 person

  18. Your blog makes me smile. I’m very glad you found me, or I found you, or however we came to be followers of each other. It’s sincerely a pleasure to read your words and gain insight into your life in medicine.

    Liked by 2 people

  19. My husband is pushing for us buying a house. I would feel better about that if I didn’t already have enormous law school debt with escalating payments, and/or we had better financial synchronicity. (We might be on our way there?)

    Sometimes I look at my salary and wonder how we don’t live better. The number seems so high as an abstraction. Then I break down where it all goes and it’s no longer quite as surprising. Child care alone takes a staggering chunk of that … and yet, while a childless version of me would already have crushed her debt, this me gets to read your words while snuggled up with a snoring five-year-old. I wouldn’t trade this different and lovelier (if messier) than expected life.

    Liked by 1 person

  20. Your descriptions of residency remind me of my brother’s experiences as a cadet in the Air Force Academy where the primary objective seemed to be to break you. If you survived the crucible, you were worthy to go on to become an officer….or maybe even a doctor.

    Liked by 2 people

  21. I love this post–especially the last paragraph (which I wholeheartedly agree with). I do believe that most doctors are worth their pay, especially after watching my daughter go through so many of things you described. Medical school seems like a four-year boot camp from what I’ve seen. It definitely changed my daughter for the better.

    Liked by 1 person

  22. Good doctors are worth every penny of what they can earn, although I know it’s not as much as we all think it is. I recall a visit with my favorite primary, a man about my own age. He had just gotten his tax returns from his accountant, and I overheard him telling his nurse about it in the next room. His salary was only about double what I made as a paid employee, and he had to pay his office and staff expenses out of that. And this guy worked something like 90 hours a week between hospital visits, office visits, paperwork, etc. He was one of those doctors that really cared about his patients as people, not just as income generators. Not too long after that, he gave up his practice and went to work for the VA, where he could have regular hours and a stable income, supposedly without the rest of the hassle. Another good doctor lost to the general public because of taxes, insurance guidelines, and government regulations.

    Liked by 1 person

    • The VA needs better physicians, so kudos to him for doing that instead of just quiting. I have the feeling that my patients often think I am taking home half a mil or more each year. Not even hardly. Overhead alone eats up half of what we take in as a practice.

      Like

  23. It scares me too…why can’t we just go back to before it started with CEO’s snarking the profits from health care? You are right…if it was simply the physician running the show like it used to be, medicine could be so much better! Once they figured out they could make money off of healthcare…they ruined the whole premise. I don’t know how you do it in this day and age. My utmost respect for your profession.

    Liked by 1 person

  24. Doctor, I would venture to say that medically trained physicians (especially a GP or PCP) are worth far MORE than you bill for. I have supported billers at independent offices and I have supported full billing services, and I don’t believe most patients would even begin to be able to understand what a physician goes through to get paid a FRACTION of what they billed for.
    Imagine starting a business where you only get a fraction of what you charge, if you get it at all, and when the corporation/state/federal agencies do pay, they dictate what you can charge someone who doesn’t want to use insurance.
    I worked with a doc who ran a Suboxone program. He had multiple patients who had insurance coverage for 10 tox screens per year (done in office), but the program requires 12. The patient wanted to pay out of pocket for the last two, but instead the doc was forced to send these patients to an outside lab charging 5x the amount…that is what is wrong with this system…1 small example anyway. Its why I advocate for family, general, and primary docs to explore the option of concierge/direct primary care. At least then the doc has a fighting chance. (I know doctor, broken record) πŸ™‚

    Liked by 1 person

  25. I’ve always wondered about the unhealthy lifestyles demanded of doctors in training. I’ve wondered if some have the compassion hardened out of them, or if some (not many) doctors are just hard to begin with. Thank goodness there are many who are still compassionate like you. It must be tough balancing act.

    Liked by 1 person

  26. Pingback: The Doctor’s Salary in the Philippines | Batang MD

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