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:
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.