The Epidemic of Disillusioned Doctors

We all know medicine has become a frustrating profession. But surveys show that a younger generation of doctors are more resilient to burnout

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Last week I was ready to quit medicine. I was seeing a new patient with diabetes, heart disease, anemia, hypertension, osteopenia, hypothyroidism, reflux, depression and pain in every part of her body. From a bag she produced 18 pill bottles — from about as many doctors — and piled them onto my desk. She pulled out a form from her job that needed to be filled out, plus a prior-approval form that her insurance company required, as well as a stack of photocopied records from the other doctors. She didn’t speak English, so we waded through her complicated medical history via a telephone interpreter. I don’t like to write while I am talking with a patient, but I couldn’t afford to fall behind in my documentation, so I typed madly into the 50 required fields of our electronic medical record while the patient recounted her complex medical history.

In the middle of this, the computer seized up, then turned a shade of gray that in an ICU would elicit the code team. I didn’t want to lose the interpreter on the phone, so I fiddled with the control-alt-delete buttons while I continued the interview, moving on to the refresh buttons, the escape buttons, finally squatting awkwardly under the desk to yank the on-off switch of the computer.

Forty-five minutes into our 15-minute visit, with an interpreter telephone in one ear translating back and forth into Bengali, my office phone in the other ear, on hold to tech support, my desk swimming with insurance forms, pill bottles, MRI reports, and mammogram referrals, the computer flashing ominous error messages, plus six more patients waiting outside, eight phone messages from yesterday still to return, I thought: “That’s it, I quit!”

(MORE: Bitter Pill: Why Medical Bills Are Killing Us)

It’s a thought that crosses the minds of the majority of doctors, it seems. Patients have more complex medical conditions, practices are much busier, insurance companies require more paperwork, administrative mandates multiply like rabbits, electronic medical records are more byzantine, support systems are fewer — and the 15-minute visit hasn’t gotten any longer.

A survey of more than 13,000 doctors by the Physicians Foundation found that more than two-thirds of them feel negatively about their profession. Too much paperwork and regulations, plus the burden of defensive medicine, are the strongest contributors to this bleak outlook. These erode the doctor-patient relationship and the clinical autonomy that doctors have always cherished. What once seemed a higher calling increasingly feels like an assembly-line job.

(MORE: Doctors Go Shopping: Price Comparisons Lead MDs to Lower Testing Costs)

What does this mean for patients? For those of you who’ve had trouble getting an appointment with your doctor, consider this: on average, American doctors spend more than 22% of their time on nonclinical paperwork. That’s the equivalent of 165,000 doctors idling with busy work instead of seeing patients.

Evidence is starting to accumulate that disillusioned and burned-out doctors make more errors and are more prone to substance abuse and depression. One American doctor takes his or her own life nearly every day — a rate that is much higher than in other professions.

It’s much harder for disillusioned doctors to muster empathy for their patients. This too is a danger. Patients of doctors who score lower on the empathy scale have worse clinical outcomes.

(MORE: An End to Medical-Billing Secrecy?)

Many of the things that ail the medical profession — sicker patients, convoluted insurance requirements — are not so easy to change. But some things are. Electronic medical records, if done smartly, could ease the paperwork burden. Team-based approaches involving nurses, social workers and care managers could distribute the workload in a way that is less taxing on the doctor and more beneficial for the patient.

The good news is that doctors are not a homogeneous bunch. The Physicians Foundation study found that female doctors were more optimistic about medicine than their male counterparts. Doctors under 40 were more satisfied than older doctors, suggesting that younger people in the profession are more used to these demands. Salaried doctors were happier than doctors in private practice. Primary-care doctors had higher morale than specialists.

The rate of women in medical schools has been increasing steadily such that women are about 50% of medical students. Primary-care fields — internal medicine, ob-gyn, pediatrics, family medicine — are already dominated by women. And the trend of medicine is toward the salaried model, with new “accountable-care organizations” placing primary care front and center.

(MORE: Why the Drugstore May Be the Last Place You Should Buy Prescription Drugs)

Putting this together, the newer generation of female, salaried, primary-care doctors have the most optimistic outlook on medicine. This bodes well for patients, whose doctors will increasingly fall into this category. Perhaps the current epidemic of physician disillusionment will abate as the new waves of doctors remake the face of medicine. This of course does not dismiss the shortcomings of medicine that frustrate doctors on a daily basis, but it does suggest that all is not dismal. To me, the most salient finding of the Physicians Foundation study was that when asked what was the most satisfying aspect of medical practice, the No. 1 answer was relationships with patients. This is what keeps us going even on the most trying of days.

When I finally ended the visit with my patient, we were both worn out. We’d made some headway, but there were more issues unresolved than resolved. However, the fact that we’d plowed through the morass together, however agonizingly, seemed to provide common ground. We smiled wearily at each other, but our parting handshake was solid. We were now in this together.

178 comments
AngerterMaria
AngerterMaria

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 Angerter Maria

AngerterMaria
AngerterMaria

Good day,

I just stumbled at this your post and I must say that I was in a similar situation some few months ago and I really needed some sort of loan to renovate some apartments my husband bought so we could renovate the buildings and put them up for rent, we searched and searched but no luck, I even got burnt sending about $4,500usd abroad to secure a loan, but was introduced to some sort of a private lender Mr Anderson Klint and i was skeptical at first because i had to contact them via email and i just did out of curiosity and was surprised when they replied that they could be of help, and could loan me $80,000usd i needed. I almost turned down the offer when I was asked to pay the sum of $480usd as an insurance fee to insure my lump sum loan of $80,000usd.I was told it was the only form of security they needed to secure the loan. My husband advised that i pay it because to him it made sense and if we were scammed like the other loan dealer he could manage it. I was asked to make the payment via western union and that really made me worried because something told me it wasn’t going to pull through, but i was shocked after i made the payment on 15th of SEPTEMBER 2014, I got my bank account wired with a transfer of $80,000usd which I cashed on 20th of SEPTEMBER 2014 and work is ongoing at our sites. I was given a 5 months grace to start paying back my first repayment which is spread over 10Years. It was later I understood why they needed to insure the money by me before letting me have it, in case I cant meet up to my obligation the insurance company takes up the liability to pay back. I am happy that by next week our project will be ready and we would start making our money and can start paying back my loan.Am so happy at last Mr Anderson Did it for family You can contact them via their email...andersonklintloancompany12@gmail.com, and I can assure you that there’s nothing to fear about, they will deliver like they did to me, but its just a suggestion/recommendation. God bless you.




 Angerter Maria

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boffo!
boffo!

Putting this together, the newer generation of female, salaried, primary-care doctors have the most optimistic outlook on medicine. This bodes well for patients, whose doctors will increasingly fall into this category. "


really? salaried female physicians are the answer? That works until said physician starts to get too busy, then what?? is she going fit more patients in? why? she is on salary.....there is no vested interest and in 3 years she moves on.. or the hospital moves her along for lack of prodcutivity. Basically making physicians cogs in a gigantic corporate wheel dominated by adminstators and insurance execs. Here is a thought, pay the private docs more, we have a vested interest we are going to try harder for our patients. getting paid for things that originally weren't reimbursed is a good start. This way we have more money for more staff and better infrastructure. ANd guess what we don't have the bargaining power of a large hospital so that small capital investment by payers can save them a lot of money You think that gorgeous tertiary care facility with big screen TV's and fountains in the lobby just happens magically, it's because they get 2-20x times more per procedure than a community practice that does the same thing.. if you want everyone salaried as physicians by large orgs, health care costs will continue to skyrocket, wait times will continue to rise and you can forget about having a doc for any signficant period of time. 


Also men aren't that bad dr. Ofri, especially young engaged men who have huge debt loads and young families to take care of, they are doing everything they can to be nice to the patients and make themselves available. In addition to that men have lower rates of suicide, depression and substance abuse compared to their female counterparts. We work longer hours and see more patients. Oh but we dont spend enough time??? please i don't feel like talking about the weather with my patients,and i don't really need to debate politics with them, don't mistake efficiency with lack of empathy.  

JudithBarnes
JudithBarnes

Seeing firsthand what is going on with EHR and Meaningful Use, here is my prediction. Many doctors will abandon their profession due to the healthcare mess. There will be a new Government program that will pay a young person's way to medical school in exchange for a contract to "serve their country" as a medical provider for X years. (Akin to the military.) "But don't worry, young doctor, everything is all computerized for you. We have a database of demographics, diagnosis, treatments and outcomes. You just put in the symptoms and voila! Instant treatment plan. We developed this system by paying good doctors stimulus money to provide us with their expert knowledge". "Oh, and Mister Patient? We have a record here that we told you to stop smoking on 2 separate occasions and you didn't quit smoking, so too bad.  You're not covered for lung cancer. "  

JudithBarnes
JudithBarnes

Realizing this, my company developed a simple to use, speech recognition based, fully certified EHR that puts a friendly, easy to use interface between the provider and their EHR. Too bad our company-paid health insurance and taxes have gone up so much for my employees that I can't afford to advertise our revolutionary software. Ugh. We are not a huge company so spending $100,000 on software development for ICD-10 and Meaningful Use Phase II has had a huge financial impact on our bottom line. The delay of ICD-10 is making it worse for EHR vendors. HELP You can see what we have at www.charttalk.net (please). 

zman3000
zman3000

Nice. By the way, the patients waiting in the office have written that you are scum on Angie's List, and the company that is paying you wants to know why your productivity is low. Your 45 minutes reimbursed about $140.00, and there are at least 5 people making an average of $20.00 in your office. You haven't paid your malpractice nor your rent, and the supplies cost you at least $5-10. You trained until you were at least 30 years old, and you are pulling in too little in salary to pay back your $200,000 in medical school debt. Expect the patient to call you at 3 AM, when she mistakenly takes the wrong medication because you didn't have a translator in your office. Nice job. 

I bet you are happy.



cilozanin
cilozanin

Gladly, you had more than 45 minutes to spend wtih your patient. Lack of time is one of the most annoying demands in medical practice.

EpikMani
EpikMani

Putting this together, the newer generation of female, salaried, primary-care doctors have the most optimistic outlook on medicine. This bodes well for patients, whose doctors will increasingly fall into this category. Perhaps the current epidemic of physician disillusionment will abate as the new waves of doctors remake the face of medicine.


Yet more feminism at work. *yawn*

gomerblog
gomerblog

More Physicians need to look at gomerblog.com!

JohnMorrison
JohnMorrison

Try being a teacher. We have a nation of dunderheads who have never set foot in a classroom other than during their school-time who think it's a "simple job." The ululate epithets and throw faeces at those of us who do the difficult job of making schools go.  Want to learn about disillusionment?  Try a school for a few days.

NancyBaumgartner
NancyBaumgartner

The concierge model seems to be an attractive way to practice.  I would gladly pay a doctor/practice of my choosing a reasonable monthly fee in exchange for services when I need them instead of the huge costs each month for insurance, now worse under Marxistcare.  I am low-maintenance (eat right, exercise, sauna, use holistic remedies when need be)- so it would be a really good deal for the both of us.  My understanding is that some doctors like this arrangement.

newbornatlantic
newbornatlantic

I'm a fresh-out-of-residency physician (Internal Medicine). Pretty much got sick of dealing with the current healthcare system while in residency. Have yet to start practicing. Mainly because I make double an IM physician's salary by tweeting (no joke). Physicians, if anything, are highly underpaid for the crap they deal with. Busting your ass 12 hours a day, 5-6 days a week, to deal with problems that are MASSIVELY preventative (Diabetes, Hypertension, Hypercholesterolemia) and only get paid 120K, only to slowly chip away at an enormous debt...


You're delusional if you try to defend that kind of lifestyle.  

Threehils
Threehils

What do you think a doctor SHOULD be paid, per hour? (salaries are just too convoluted). In the middle of the night, when you are dying (or at least feel like you are), how much, per hour, do you think that person, who knows how to fix your problem, to potentially save your life when you actually are dying, deserves to be paid. How much are you willing to pay to have someone at the other end who knows what they are doing, who has had the training, acquired the knowledge and skill necessary to accurately, safely and expediently, fix what ails you? 


Because that's why you come to the hospital in the middle of the night. You want to know exactly what's wrong, right now, and to have it instantly be all better. If you didn't care about those things, you would ask your Starbuck's barrista why you are short of breath, or your Walmart greeter why you chest hurts so bad, or the guy who cuts your lawn how to make the bleeding stop.  


So, what exactly IS the amount to pay for safe, accurate, and expedient care. I'm curious to hear the dollar amount, per hour, that this is worth to everyone.  

bdbrl
bdbrl

28 years old here. First year of residency. 260k in debt. I work 5-6 days a week, 13 hour days. Try to study another day. I have no pension, I never will. I will pay an exorbitant tax rate to help pay for the roads and healthcare of others. I have sacrificed the last decade of my life and have 3 more years. By the time I am out of debt, I will be approximately 43 years old. I could have worked for a union, the government or a company with a pension starting at 22 and retire at 65 with a huge pension and a lot less stress. I will likely work until the day I no longer can and then I'll hopefully teach. I would be stupid to be doing it for the money, but, as a resident in NYC at 28 yo I can't even afford to live in a 1 bedroom apt alone.

CSquared913
CSquared913

These comments are horrific.

I'm a board -certified Emergency Physician. I love my job. I love my patients. No, I'm not being sarcastic. I say this kindly, but the non-medical public will never understand the work and sacrifice a physician has went through. You can't, because you haven't lived it. It's not something that can be explained. Its not your fault that you don't understand, I can see where you're coming from. Sometimes physicians need to complain, but when your salary is well above average I can see why the general public gives zero sympathy. Honestly, I would probably feel the same way being on the other end, but I also feel the public is misinformed.

I make a lot of money, when you look at the number. So I can understand when someone who makes $30k a year will be quick to discriminate a physician or anyone making 6 figures. What people don't know, is where that $250k goes. As an example, I will break it down for you:

My monthly check is roughly $24,000. Before taxes. . . . When you make a certain amount of money, you get taxed. A lot. Way more than that 25-30% most Americans pay. Mine are 43%. Yes, I said 43%. It is what it is, I make the money so seems legit to tax. Now that I'm eligible to contribute to a 401k, my check is less. But let's just keep it simple.

$24,000 - 10,320= 13,680. This is usually the amount on my check. Seems awesome, and it would be for the general population who don't have the type of bills I have to pay.

I owe, at this present day, $225,000 for school loans. I started around $260-270k. My monthly payments are $3000. Sometimes I try to pay a few hundred dollars more since the interest is 7% (Thank you George W Bush). I have 8 years left woo hoo!

$13680 -3200= 10480.

House payment $2100. I have a 3 bedroom ranch. No mansion here. I live modestly.

$10,480- 2100= $8380

Disability Insurance $600/month. This is vital, because if anything ever happens to me where I'm incapable if working (I.e. accident, cancer, pregnancy) this will ensure me about 75% of my current income so I can continue to have a house and pay the government. $8380- 600= $7780.

Life Insurance $1000/month. This is also a partial investment, since I've lost out in the ability to invest for the past 13 years, hence why it is expensive, but absolutely worth it since I can cash it in when I'm like 70..

$7780-1000= $6780.

Investments aside from 401k and term life, $1000/month. Again, see above.

$6780-1000= $5780.

Utilities roughly $800/month. Give or take. Includes all the usual utilities plus garbage, ADT system, and lawn/snow removal.

$5780-800= $4980.

No car payment. I still have my car from medical school and residency: a Saturn. A new Audi Q5 would be nice, but I can't justify spending $60k on a car when I'm a half million dollars in the hole, and for now, I like having no car payment.

Car and home owners insurance is $100/month. The Saturn helped.

$4980-100= $4880.

Gas and groceries: My car takes roughly $65 to fill the tank. I do this at least once a week, since my group staffs 4 emergency departments in the city. We will remain keeping it simple, $65 x 4= $260/month. Groceries are about $100/week, or $400/month. I'm glad I don't have teenage boys in the house or I'm sure it would skyrocket.

$4880-660= $4220

I try to put $1-2k away in savings a month for that "rainy day", or when the furnace decides to die. Or anything in my house decides to die. Or the zombie apocalypse.

$4220-1500= $2720.

$2720. Crazy, huh?

There are miscellaneous mandatory expenses, like state license and DEA license renewal ($1000 total), and I have to earn so many continued educational hours a year to even be eligible to renew my medical license. These conferences can be anywhere between $2-5k yearly. Also not included are clothes and other stuff, but whatever you hopefully get the idea.

I am not complaining. I knew exactly what kind of financial debt I was getting into. I live comfortably without struggle, but I just wanted to give people an idea where all that money goes. I HAVE to make that type money to pay for the cost to continue to be a doctor. I can't imagine what family physicians go through, because they make less AND have a business/office to run, staff to pay, etc. So now that we are all educated, everyone needs to play nice in the sandbox and stop being nasty to eachother. Everyone has their own struggles, just on different levels.

anniexf
anniexf

Oh my word, these comments are ridiculous.  Please refrain from commenting if you haven't used a blue interpreter phone with a broken computer and a patient with multiple, vague medical complaints.  If you're not a doctor, you don't get it.  And you have no idea how it feels when you pour your heart and soul into helping a patient, often neglecting your own family, and then see comments about how "all doctors care about is the money".  If it wasn't hard, then everyone would do it.  Heck, *you* would be a doctor.  But give us some credit for the $250k that WE paid to work in a job that is completely underappreciated by people with ridiculous concepts about how we care only about ourselves and money.  I'm glad the article tries to have an optimistic tone, but physician burnout is rampant and 40% of medical students are burned out even before they start working.  It's not a good time to be a doctor.  Even a female in primary care.

jyjudomerejo
jyjudomerejo

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docstew
docstew

Interesting, "Danielle", most of my female colleagues/doctors work part-time.  Maybe this is why they are happier.  I'm not saying...I'm just saying...go figure.

SmurphLin
SmurphLin

I think this is probably something that has been happening for a long time. Either that, or there are more people going into this field than there were before, and this is resulting in a larger number leaving it as well. Whatever the case is, I feel like most people should get a family doctor they know and trust (like those at http://www.ipmsak.com/)

maxfabella103136@yahoo.com
maxfabella103136@yahoo.com

We can always get doctors from third world countries, and they  will  work. Starting from State prison,s and unserved areas,

like Native American reservations

armana
armana

As if other professions do not have similar work-related stress. If you can't handle stress as a doctor and quit, do not expect life will be easier in any other job. What a stupid elitist.

adnan7631
adnan7631

Ok, this article is rather stupid. 

It opens up with a terrible and depressing story that illustrates that the career of a doctor can kind of suck. It then goes on to mention that a huge percentage of doctors feel burnt out to the extent that patients are being affected and the doctor's are becoming suicidal. Then, it says that there will be more younger, female doctors and that will make everything better. 

WHAT. 

Is it possible that older people are more cynical about their professions because they have more experience and have less energy/ability to handle more work? If that is the case, then guess what, one day, all those young doctors will be old and cynical, too. 

Here's some other news. The percentage of older people is going up, with the 65+ age group about to expand extremely rapidly as the baby-boomers hit retirement age. Old people generally have a lot more medical problems than the rest of the populous. There aren't more medical schools opening up. They aren't taking more students. The work each doctor is going to face is only going to increase, and the stress with it. There needs to be more to address the problem than demographic changes. 

CalebMurdock
CalebMurdock

Someone sent me this note.  I can't find it here, so I am going to paste it and reply to it.

"As a current medical student, I am beyond offended at how misinformed Americans are about medical practice. In fact, I'm even more offended that medical professionals don't even know why MDs get paid more (but barely more than NPs or PAs). MDs have licenses that are much more prone to being lost, and a lot of the time they are the head of a healthcare team. If the team screws up, most of the time the MD gets the flak. There are always exceptions, but my RN and NP associates generally agree.Secondly, most primary care physicians don't make much more than an NP or PA, and a lot of them won't see their student loans paid off until they get closer to retirement."

I'm 62 and I've seen plenty of doctors in my life.  Most of them seemed pretty happy, and most of them (I've noticed) work part-time.  I've also seen the statistics that show that the average doctor makes around $200,000 (dentists, amazingly, make more).  Below, someone said that a doctor can leave school with $300,000 in debt.  That certainly must be a burden, but it is also true that if new doctors are making $100,000 or more, that can be paid off in ten years.  After that, they have a comfortable life.  The notion that doctors aren't making more than nurses is ridiculous.

I can imagine that seeing 20 patients in a day can be stressful, and the paperwork certainly isn't enjoyable, but then most jobs have their stressful aspects.

EricHoffer
EricHoffer

So, female MD's are the saviors??

Perhaps studies have shown a slightly higher level of 'optimism,' but in the long run they will not want to work as 'full time' as their male colleagues.  

Having children, cutting hours wanting to stay at home etc. will predominate.  I worked 20 yrs as a hospital RN. 

CalebMurdock
CalebMurdock

The visit described in the article is very unusual -- a non-English-speaking patient, a translator on the phone, a broken computer.  That isn't normal.

The problem is that doctors want to be wealthy.  I make $15,000 a year, and I have no sympathy for physicians making $250,000.  If your computer system doesn't work, you can afford to get it fixed!  Non-English-speaking patients should come with family members who can translate.

My last visit to the doctor lasted 30 minutes and cost me $120, and my doctor works for a charitable organization!  I make $10 an hour.  My doctor works part-time.

wkbansatz
wkbansatz

@CSquared913 The problem with your analysis is that among your "costs" is more than $2500/mo in savings and investments (not including your life insurance policy and your mortgage which are both types of investments) and more than $2500 in money left over for "miscellaneous mandatory expenses".  Do you realize you save (or at least your net worth increases by) about as much in a month as the median american family earns in a month?  Not understanding that is why you get zero sympathy, not because people don't understand how hard you work or why you "HAVE to make that kind of money".

vara411
vara411

@armana You're a moron without a clue. Have a nice day.

Carlangaman
Carlangaman

@CalebMurdock you are missing payments to rent or own your office space, paying nurses & secretaries, paying the computer record system, buying materials, paying electricity and all other bills, just paying the basic staff is hard, then pay someone to help you with taxes or wight the running of costs of the office.  You are also forgetting that the 300K in debt has a 7% to be paid in that 10 year bill, so it goes upwards to 400K just in the debt.  You have to do all this AFTER doing a 10-12 hr day.  Doing the right choices for patient health is no relaxing task, one always in the back of his/her mind is deciding if they did the right choice for your patients.  

The 'average' doctor does not make 200K, more 120-160K a year before all his costs.

aggiedoc
aggiedoc

@EricHoffer  A female nurse that disparages female doctors. Shocking. Never encountered that before. #sarcasm

bdholtzman
bdholtzman

@EricHoffer  Actually, factoring in time for and cost of education, unpaid time off for children and such, female physicians make less over a lifetime than a female physician's assistant. Recent study -Google it.

c7777
c7777

@CalebMurdock If you make $15,000 a year. For one your not as smart as your doctor. So your value is less than a doctor. Second you did not spend 12 years of your life not making any money to become a doctor. Therefore your doctor deserves to make substantially more than you. Frankly a doctors job as you said is a job. A job that makes them desirable and needed but non the less a job. In a capitalist which is what we are thy should be allowed to charge what ever they want AND if you can't afford it that is no ones problem but your own.    

adnan7631
adnan7631

@CalebMurdock 

The reason why you pay so much isn't because your doctor is ripping you off. It's because insurance companies suck. 

Doctors genuinely care about their patients. I'm a premed student and my dad's a doctor. We aren't swimming in cash. He works more than 40 hours a week, splitting time at two jobs (one which is an hour commute), and is very often on call (which means that anyone at the hospital can call him and ask him to come in, any time. That includes late at night).  The patients my dad sees are usually pretty poor. They often can't afford the expensive medication that they need to function. So, he requests sample pills and saves them for the patients who need them. For that, he is docked some pay, but it means some people can make it through their daily lives just a little bit longer. He sees upwards of 15 patients a day. Many don't have health insurance so they don't pay the hospital. My dad makes no money on these visits. Even more are on Medicare/Medicaid. He gets paid less than half the normal rate for those patients. Those are the sacrifices he and the hospital have to make to keep these people functional. My dad sees literally hundreds of patients in a month. It's his job to see those patients, no matter what, and make sure that they end up in a situation where their health is managed enough for them to get through the day, every day. 

Don't bash doctors. 

JeffieMD
JeffieMD

@CalebMurdock 

I am a recent graduate of the medical system. I am in primary care. If I am LUCKY, I will make $150,000 per year.the average physician doesn't make close to $200,000. I don't know where you got that number from. Hospitalists may make $175,000, family docs $150,000, pediatricians average $120,000. I am not doing this for the money. I have $250,000 in debt to pay off, that is accruing interest daily.  I have three more years as a resident making roughly $10 dollars per hour and having individuals lives in my hands with the decisions I make, or don't make. I work roughly 80-100 hours per week, double the hours of a normal full time employee and make the same amount of money as you. I don't know what it is you do for a living, but if you don't have patient's lives in your hands with the decisions you make, please don't make any comment about the money physicians make. 

There is no physician I know, who was in this solely for the money. Movie stars, athletes, are in this for the money. Everyone wants to say Doctors get paid too much. No one every comments on movie stars or athletes and their multi-million dollar contracts. This mentality makes me sick. Physicians save lives, athletes and movie stars make you happy for two hours. We should be making what they make. I don't think Doctor's can ever make enough money to counter the mental detriment we face and deal with. It takes a strong mind, and a stronger heart to do what we do. Please don't ever attempt to belittle my profession until you have been in our shoes. 

Here is a story for you. A man was driving at night and his car broke down. He looked up a number to a tow truck. The guy who answered said it would be about 40 minutes to get out there and would cost $250 dollars to tow his car. Since it was the middle of the night, the driver didn't think much of it and said okay. The tow truck man arrived and aked what the problem was. The driver said it was making a weird noise. The to truck man said to raise the hood. He looked at the car for about 5 minutes, went and grabbed a wrench, and banged on a pipe a few times. He told the driver to try and start the car. The driver did and it came to life. The driver said thank you and the tow truck man said, okay, that will be $250 dollars. The driver was outraged and said, WHAT? you only worked on my car for 5 minutes!! The tow truck man replied, $20 for the gas to get out here. $20 for the time I spent. The rest for knowing exactly what to do to get your car started. 

This is what physicians do. We train and learn and keep learning so that we can spend 5 minutes and know what is wrong. so we can examine your body and figure out what ails you. THIS is why we deserve to get the money we get, if not much much more!


CSquared913
CSquared913

There is no problem with the analysis. It's just data. I don't want sympathy. Im not complaining whatsoever. I knowingly chose my path aware of all consequences. As stated, I live comfortably, but I don't have a bed of $100 bills. I was just reiterating the fact that the general public, at least according to 90% of these posts, thinks doctors are just rolling in it. Some months, I can't save anything because of unforeseen expenses. I have to invest what I can because I'm getting a 15 year late start on investing, while everyone else has already been there done that. 15 years is a lot of catching up to do. I dont know how significantly different my investing would be compared to others, given the huge time gap. A mortgage is not an investment these days, and my term is not guaranteed for the potential it could make, say oh, if I die. I'm not really sure what point you are trying to make in your comment.

CalebMurdock
CalebMurdock

The doctors that I have known in my life (beyond interns in hospitals) did not work 12-hour days.  Furthermore, the $200,000 a year that doctors make (according to statistics) would be AFTER expenses.  Doctors are not poor.  I agree that our education system needs to be reformed, but that's another topic.  I make $15,000 a year, so you can see why I have little sympathy.

eva68
eva68

@JeffieMD@CalebMurdockI know this might sound odd, but we are trapped here. Your patients are TRAPPED I tell you. It isn't the rich people on here complaining about what you make, it's people who cannot afford $250.00 for 5 minutes. Afford it hell, we don't even have it. What's worse is that it is probably not the last $250 this month because there will be follow ups. How does a person do that on some of the salaries?

 I can appreciate what you say about the expertise being a deciding factor in pay. I just don't know how to pay you that. I likely will never be able to pay you that because I have too many health problems to address. I am a professional myself, not medical but still professional and I can't make enough money with all the carp in my way to take care of myself .
That is the conundrum isn't it? We are taught in school that if we study something we can charge a certain amount for it. We are worth it. The problem is, caviar might be worth it, a Ferrari might be worth it, and God knows our health is definitely worth it, but I don't have the money for any of those things at the going prices. So what's the point in teaching people to charge so much when there are really not very many people who can afford it? Enter insurance and the next nightmare paradigm begins.


CalebMurdock
CalebMurdock

@JeffieMD @CalebMurdock  

 I'm not swayed by anything you said.  You said that you can make only $150,000 a year -- well, that's wealthy.  And your story of the man being over-charged by the tow truck operator was pathetic.  If the tow-truck operator had any integrity, he would have charged a reasonable fee.  As for movie stars and athletes, I DO resent what they are paid.  On the other hand, athletics and acting are less secure careers than medicine.  As for making the same amount of money that I do, you are a resident and that is part of your education.  For whatever it is worth, I strongly support a law that would limit the hours of residents to 60 hours maximum with a minimum 12-hour break every day, and pay them more money.  As for your debt, when you start making $150,000 a year, you'll be able to pay the debt off in five to ten years.  You do, after all, have lots of experience living on a resident's meager salary, so you should be able to do that.  If you are like most people, however, you'll get a house and a Mercedes and you'll be paying off the debt for 20 years.

I agree that physicians should make an upper-middle-class income, but not upper-class -- they shouldn't be wealthy.  Tell your sob story to a teacher making $40,000 a year.  Teaching is as stressful as medicine, but no one is making teachers rich.

By the way, as an over-worked resident, you are a danger to your patients as you go lurching through your days on stimulants and other drugs to keep yourself awake.  That whole system needs to be changed.

GabrielSmith
GabrielSmith

@CSquared913  Although I only make $28,000, I must say I do have some sympathy, not too much because I feel pretty confident that one day you'll get that debt paid off and be a rich man.  However, I think that there are people in this world that do deserve to be rich; and an ER doctor who deals with kids in car accidents, burn victims, gunshot victims, etc. is certainly one of them.  These are certainly things I could never do.  So, the sympathy I feel does not so much come from the idea that you are currently struggling, but that there is anything that might discourage you or any other young doctor from doing something that is so special and vital to our society.  This work deserves to be heavily rewarded.


As long as a physician does not become overly greedy with his or her money, I say let them be highly paid.  We should not hate anyone just because they have more money than us. Wall Street CEO's who exploit the poor and show endless greed are one thing.  But good doctors who help people are another.

CalebMurdock
CalebMurdock

@NancyBaumgartner@CalebMurdock@vara411-- I don't know what you're talking about -- "inconvenient work"?  If doctors are unhappy, then their issues need to be addressed.  But the fact that some of them are unhappy doesn't mean that they automtically deserve to make six times the national median wage.  Most people are unhappy in their jobs, but we don't reward them with extra pay for it.

I think that there are solutions to all the problems that doctors face.  I think that medical educations should be subsidized by the government in order to reduce the doctor shortage.  I think that we need nurse practitioners who are trained to treat mild illnesses and/or diagose illnesses and refer patients to specialists.  I am in favor of subsidized malpractice insurance.  And I am in favor of such things as the sharing of medical equipment (such as CAT scanners) to reduce costs.  All I can tell you is this:  Medicine is too important for doctors to be part of the wealthy class and to charge fees that most people cannot afford.

NancyBaumgartner
NancyBaumgartner

@CalebMurdock @vara411 I trust you subjected yourself to roughly 10-12 years of rigorous education and training, and before that busted your...rump to earn top grades in high school so you could get into a great college and then med school?  If not- shut your  pie hole- you could have done what doctors do, but didn't.  Moreover, inconvenient work isn't the same as hard work. Something tells me your job's greatest challenge was inconvenience.

CalebMurdock
CalebMurdock

@vara411@CalebMurdockWhat I resent is that one person can work hard for 40 hours a week and make $20,000, while another person can work 40 hours a week and make $300,000 or $3,000,000.  I'm not saying that all salaries should be equal, but hard work should be rewarded with a living wage, and there should be less disparity in income.  As for me, I'm retired on just Social Security, never having made enough money to save up for my retirement.  Thank God for FDR or I'd be on the street.

vara411
vara411

@CalebMurdock Caleb, how much you make versus how much doctors make should not be your determining factor in doling out your "sympathy." If you don't like your lot, step away from your laptop, stop resenting those who EARN more than you, and do something more with your life. God speed.

CalebMurdock
CalebMurdock

@lhathorn1@CalebMurdock@JeffieMDWhat a sorry, pitiful person you are that you mock people who are poor instead of feeling any sympathy or looking for solutions.  We have a health-care crisis in this country fueled by an economic system that rewards the rich at the expense of the middle class and the poor -- and yet meaningless, empty statements like this one is how you respond.  What an awful person you are.  I certainly hope you're not a medical professional.

CalebMurdock
CalebMurdock

@DaMan21@CalebMurdock@JeffieMD I have a good example of what I'm talking about.  Last year in April I had a boil lanced at the hospital.  I first went to a private doctor to have it treated, but he wouldn't do it, saying that it had to be done in the emergency room (boils have been lanced by doctors for thousands of years, so this is already an example of how medical costs have become higher -- a simple office procedure now must be handled as an emergency).  Well, the whole procedure took a little less than an hour, and the total bill was around than $1,240.  The bill included a $490 charge for a lab test which my own doctor's office did for me later for $27.

What they were doing was charging me not only the value of my own treatment, but the value of treatments given to other patients which weren't paid.  Happily, the ACA will end such abuses.  I paid $500 and would not give them any more money, and now I have bad credit.

lhathorn1
lhathorn1

@CalebMurdock @JeffieMD  We seem to have neglected a great mind in our not recruiting Caleb into medicine and not letting him fix all our problems and concerns. He seems to know everything and seems to be willing to tell us all the secrets of the universe if we will only listen. Caleb, you seem to be a person who picked a career which didn't pay much and you resent everyone who makes more than you do. As was written above, maybe you should get off the computer and go do something productive. And if you ever have the nerve to say that kind of thing to your doctors in person, they may just kick you somewhere tender. 

DaMan21
DaMan21

@CalebMurdock @JeffieMD 

I think you under estimate the costs associated with your medical care.  A hospital is a hugely expensive building.  Think of how many people are working there: from the doctors and administrators, nurses, lab techs, nurse assistants, maintenance, food service, cleaning service. 

You are naive if you think you can go to an ER, be triaged by a trained medical professional, have labs xrays and tests run, be seen by a physician, have a procedure performed, all in a sterile and state of the art environment, and pay $20.  Lets not forget the other big cost: insurance.  You are paying for that too: both physician and hospitals spend huge sums on protecting themselves from lawyers.

My point is that the medical care you receive is expensive because there is a lot more going on than just the single procedure you had in the ER.

VictorManuelMonterroso
VictorManuelMonterroso

@JeffieMD @CalebMurdock

I agree with you completely. Although I completely disagree on the part that you wrote; 

"but educating children and saving children's lives are not equivalent. That is a ridiculous proposal."

To me both are noble profession and no one, not even a Doctor has a right to belittle teachers deeming them inferior since they do a good to society as you do, although they do not have that education you may have that gives you no right to say they are not the same. To me they are since they instruct the young and send them to the world in the hopes that they one day may serve society in whatever they deemed to be right.

I worked as a nursing assistant when I was 18, in nursing registries in different hospitals around the LA area and I must say doctors do get pay so little (that is why many nurses would always say that they would never marry doctors), and I also worked as a Unit Secretary in many departments from the ER to CSU and PACU. I only know that the ones (for the most part) that are in it for the money are many RNs from here and from other countries for example the Philippines that got in it for the money and they do not have the compassion that it is needed to take care of patients. I say this because this was my experience. Many Doctors would go to the units and had this I am better than thou attitude that sicken me, the ones that were more noble were the interns and young doctors (some just thought they were superior though).

After working 12 years as a nursing assistant/unit secretary and 2 years in medical billing/coding in Los Angeles County Dpt. of Mental Health. I became aware of where I wanted to be, and I am back in school and going into Psychiatry. But I do feel for you, the hours and the time, and the thankless days you guys/gals get is really bad. I hope you will be happy and all this that you are going through will help you attain the virtues of humility, compassion, and above all obedience to your calling.

Just be prepare for the many jaded nurses, the many horrid doctors, and the many days and nights that will come your way where you will leave crying from a day spend with horrid hospital workers.\

Good luck.



CalebMurdock
CalebMurdock

@JeffieMD @CalebMurdock 

I agree with you that law suits are out of control.  There are lots of reasons for that which I won't go into.  However, since you've mentioned it, I developed tinnitus from taking the drug Avandia for just two weeks.  I've now been living with tinnitus for 8 years, but I didn't sue anybody (though I thought of it).  Part of the reason doctors get sued so much is that medicine is still as much art as science, and patients don't often get well.

As for paperwork, that's part of your job which you need to get used to.  I'd like to point out that medicine wouldn't be regulated so much if there wasn't so much greed and other abuses.  I went to the emergency room in April to have a boil lanced.  It took an hour or less.  Doctor's charge:  $466.  Hospital's charge:  $732.  The hospital "kindly" cut my original bill of $1,464 in half because I was uninsured.  However, their bill included a charge of $989 for a lab test (a simple culture).  That's a test which labs normally charge $100 for, but which actually costs them less than $30 to conduct -- I know because I got the same test done two weeks later by the non-profit that provides my medical care, and they charged me $27.

Doctors, surgeons, hospitals, labs, equipment manufacturers, radiologists -- all of them are trying to get rich off of sick patients.  It's disgusting.  The whole business is awash with money.  That's why the government is stepping in.

As for you:  Stop complaining.  You've got it good.  However, I predict that you are going to have a miserable career because you will resent your patients and always feel deprived even though you aren't.

By the way, I treat my own doctors at the non-profit with dignity and respect, and I have told both of them that I thought they were the best doctors I had ever had.  I know they are both making ten times what I make, but I don't say anything.

JeffieMD
JeffieMD

@CalebMurdock Of note, the fear comes not from the practice of medicine, but did I DOCUMENT everything correctly. I am not afraid of my abilites as a physician, but doumentation can get tricky very quickly. My career should not be up in the air about something as trivial as proper documentation. 

JeffieMD
JeffieMD

@CalebMurdock  You are correct in your assumptions. I have painted a picture depicting myself as someone who is only concerned about making more money. My true concern lies with the government's infiltration into my ability to practice medicine. I now have to do so much more paperwork to get any kind of reimbursement. I have to have the EXACT phrasing or insurance companies will deny the claim I submit. I am being told I have to standardize my care when every patient is different. Some will require special tests that cost more. I may bill for a certain amount. Many physicians with patients who have copays will only actually get the copay and nothing more from the insurance company. I don't like the government controlling what tests can and should be ordered. These people did not go to school to learn medicine and have no concept of what is required, yet they make the laws dictating my career. 


I believe this also applies to teachers having to standardize education. Since our attempts to "bring up education" in this country have started, we have only fallen further behind. Teachers are getting jaded because they are not able to truly teach, but have to teach out fo a manuscript. Medicine is becoming the same way... and all of it hinders our ability to practice medicine, and to make any money in the attempt to do so. 


One thing I would also like to add, is that Physicians are one of the few professions that is constantly under the threat of a lawsuit, whether by the individual or by the government. This society is so litigious and practicing defensive medicine has become the norm. My other issue with medicine. Gone are the days when patients trusted their doctor and did as they said. Now they are looking to get a piece of the pie any way they can. Most lawyers don't help the situation either...

No other "high end profession" has the amount of risk associated with it. Lawyers don't have to worry near as much about being sued. Architects don't. Engineers don't. Stock brokers don't. Only physicians remain in a constant state of fear from being prosecuted, causing the use of defensive medicine, which is WAY more expensive. If there is a 10% chance this test could show something abnormal and I don't order it, and later it comes back the patient had the ailment, I am liable. I will most likely be sued, or attempt to be sued (still costing the physician lots of money and raising malpractice premiums) due to this. So I order the test to cover my ass. I shouldn't have to worry about this in my decisions or practicing of medicine. 

The money... I will be alright in the end. I know this. Even if I stay in primary pediatrics, I will do well enough to retire without a problem when it comes time for that. But the more the government attempts to control my ability to practice medicine, the more that "I will be alright" comes into jeopardy and the more I fear about how I will be doing in 15 years from now.





CalebMurdock
CalebMurdock

@JeffieMD @CalebMurdock  

First, you are forgetting that you are talking to someone who makes $15,000 a year and who never made more than $35,000 in any year in his entire life, so there is little chance that you are going to get sympathy from me.  Second, I checked on teachers' salaries before I made that comment above; k-12 teachers generally make in the 40's.  Third, I have looked up the statistics, and MD's make more than you are claiming -- and that's AFTER malpractice insurance, which is a business expense.

I'm sorry to say this, but I think you have the wrong attitude towards your profession.  Granted, you are in medical "boot camp" now, so I'm sure you are suffering.  But once you get out you have the potential to make a very comfortable and happy living for yourself.  Instead of looking ahead at the good things to come, you are grousing and complaining.

Now, as far as teachers are concerned, you are dead wrong.  Their influence on children is as important to the development of children as your abilities to treat illnesses are important to their health.  You consider doctors to be exceptionally important to society, so naturally you think you are worth whatever you are paid.  The problem is, our society is full of people who consider themselves to be exceptionally important, and they all think they deserve a huge salary.  In the mean time, globalization of the economy is making the rest of us poor.

Actually, the people I am REALLY angry at these days are dentists, not doctors.  Dentists in my part of the country have an average income of $280,000 (according to the ADA).  You can't get your teeth cleaned for less than $95, though the cleaning is always done by dental technicians who get paid $25 an hour or so.  If the dental technician can do four cleanings in three hours, the dental practice pulls in almost $400 and the technician makes $75.  It's a real rip-off.

JeffieMD
JeffieMD

@CalebMurdock @JeffieMD 

There is no way I will pay off my debt in 5-10 years. I know of only a select few physicians who have paid off their debt in 5-10 years. Those that are unable are not driving fancy cars or livign in huge houses. Your concept of what a physicians life is like is apparently very skewed. One of my preceptors is 50, still has $100,000 debt to pay off, drives a Taurus, and lives in a small 3 bedroom house with his wife and two children. He is by no means even upper middle class. 

You are correct I have experience living off of a resident's salary. You are not taking into account the malpractice insurance I will have to begin paying once I am out of residency. Many physicians have over $75,000 in malpractice insurance they have to pay. Throw on the compounding interest and most physicians are making a DENT in their debt after 10 years. 

Thank you for your concern regarding resident's hours. They cut it back to 80 hours recently, but job satisfaction is lower because more time is actually spent at the hospital. Less time with families because there is no post call ady after working a 28 hour shift. So residents are seeing their families less. 

In regards to teachers, I believe they also should be making much, much more money than they currently make. My sister, however, was making roughly $65,000 per year teaching second grade. Many college professors make $75,000 or more. So, as a pediatrician, I will be making just a LITTLE more than many teachers, after all insurance and my higher tax bracket takes out everything. 

BTW, no offense to teachers, but educating children and saving children's lives are not equivalent. That is a ridiculous proposal. I spend a much greater amount of my time learning what I have to, to perform medicine. I can graduate high school and be a substitute teacher. I can get an associates degree and teach elementary school. My sister has a master's in education and does very well for herself, granted it is a wealthy district and the teachers are compesated as such.