<p>Whoa. Thanks, Bayou. I’ll browse these tomorrow and write them up. Thanks!</p>
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<p>Is this a serious question? We just elected a Prez that promised to “spread the wealth around”, and that’s what he & Congress will do. :)</p>
<p>Your welcome, bdm. Hope it helps.</p>
<p>“We just elected a Prez that promised to “spread the wealth around”, and that’s what he & Congress will do.”</p>
<p>He’s also continuing the trend of driving this country straight into the ground. However now we just won’t be able to get decent healthcare on our way down.</p>
<p>I think it’s all relative. Physicians are used to having great benefits, lifestyle, and salary, and in ANY profession cuts to benefits, even if they are small, bring about a lot of opposition.</p>
<p>I think physicians have it pretty good. If you think about the pathway to become a professor, wannabe professors too have to do well in undergrad with strong ECs (with the added pressure of doing well in research), then go through grad school which can be pretty intense as well (in addition to lasting much longer than med school, sometimes more than med school+ residency combined), and then do, in some cases, multiple post-docs, and then FINALLY you can be an assistant professor (still have a long way to go to be a tenured associate professor. Then if you work harder, you can probably go on to be a full professor).</p>
<p>Most professors I know work 50+ hours a week, and they don’t get paid nearly as much as a physician does. You tend not to break the 50k a year margin until many years after undergrad, and even then it is rare for a professor to break 100k. You can bring out the “professors love what they do, they are essentially getting paid to do what they love” argument, but I think you should love your job as a physician as well. If you truly love caring for patients and working as a part of the most advanced medical regiment in the world, current healthcare reform should not really affect your decision, IMO.</p>
<p>EDIT: I realized I forgot to address the debt argument. But I believe becoming a professor has a lot of unique hurdles, such as the long road to tenure, the competitive nature of grant writing and the insecurity of keeping your lab afloat, etc. that medicine usually does not have. My overall point is being a physician is still a very attractive profession, even with small cuts, espcially when compared to other professions that require high levels of training and education as well (such as the path to becoming a professor).</p>
<p>Lollybo, your points are well taken, but I would offer the following in counterpoint:
You say that becoming a professor has many unique hurdles, but the same can be said for any profession or career. And it doesn’t directly address the debt issue. While PhD students typically receive tuition-free education as well as a yearly stipend during their (admittedly longer course of) education, medical students can rack up ridiculous amounts of debt during their 4 years.
There is also the legal climate in which physicians operate in this country (which is certainly not the case for many other positions, including professors).</p>
<p>And professors usually aren’t running their own university, while many physicians operate their own practice, which requires them to pay for many things: building space, staff, supplies, malpractice insurance, administrative costs, etc.</p>
<p>But perhaps the best justification for the high salaries given to physicians is the trust and large responsibilty inherent in their profession. I think you would want to pay the person you trust to manage your illnesses or to dig around in your brain or chest a salary commensurate with that responsibility.</p>
<p>And I wouldn’t call a 21% cut (like the one recently proposed) “small” - many primary care physicians have a hard time covering their own costs with medicare reimbursements as it is.</p>
<p>I think all of the points you brought up are legitimate, but I think my point needs clarifying.</p>
<p>I don’t know if salary cuts will happen at all, I think it is too early to tell. There’s this whole reduced Medicaid/Medicare compensation thing here, but I believe that (correct me if I am wrong) nobody really has a clear idea of how that would pan out for physician salaries. Also, I don’t think it is prudent for college pre-meds to be deterred from medicine right now, because it will be at least 7 years before any salary legislation affects them. 7 years is a long time for legislation to occur. </p>
<p>Also, this long time period creates two potential possibilities
a. the salary policy currently fails miserably, worsening America’s health care system crysis. Thus, congress would be forced to make changes in the opposite direction Or:
b. it’s successful and everybody is happy- the ideal option.
Both pathways would work. I view policy as dynamic and not set in stone- adjustments could be made to improve policy.</p>
<p>If you think primary care physicians should not have their pay cut, then I totally agree with you. If anything, primary care physicians need a pay raise. They are the ones working long hours and dealing with the most patients- they are in fact the “shock troopers” when anything goes wrong. Their hard work and large expanse of knowledge should be rewarded- and doing so will attract future primary care physicians, which our country is in need of right now.</p>
<p>If we are talking about specialist pay, I think currently they are paid too much. I agree specialists should be compensated for taking extra time to study a subject, but I believe specialist pay should be approached with the goldilocks method- pay has to be just right, not too high, not too low. Currently, it is too high, and many specialists have other benefits such as way fewer hours. This does not apply to all specialties of course, some like OBGYN have high numbers of lawsuits and should be compensated accordingly.</p>
<p>I agree the professor debate might be a wash- both professions have a lot of pros and cons. But to me, the path to becoming a Dr. wins out a little bit from a financial point of view alone, debt for 4 years and higher pay later on versus getting paid a living stipend for at least 4 years (many grad students take longer, some take 7+ years).</p>
<p>The point you made that hurt my original argument the most is the argument about such responsibilities like taking care of people, being sued, and having lives on your hands. Indeed, being a physician carries a huge responsibility, and should be compensated accordingly. But the very factors that cause these stressors can often bring much joy, such as the responsbilitiy of making people feel better and saving lives. In fact, these very factors are often the reason why people become professors in the first place.</p>
<p>I would like to bring up another profession as a comparison: Lawyers. Lawyers also have to deal with a stressful life with many stressors unique to the profession, and lawyers have pay that is substantially less than a physician’s pay. [PayScale</a> - Lawyer Starting Salaries, Average Salary for a Lawyer](<a href=“http://www.payscale.com/research/US/job=attorney_/_lawyer/salary]PayScale”>http://www.payscale.com/research/US/job=attorney_/_lawyer/salary) It is true they don’t have lives under their hands, but they are involved in deciding if someone is sentenced to life in prison/electric chair/bankruptcy/divorce/custody and other stressful issues. It is true not all lawyers deal with such stressful issues and large responsibilities, but neither do all physicians (radiology, etc). How bad are these stressors you might ask? If there is any objective measure, it is rate of depression, which is 3.6 times higher than the average person [Lawyers</a> With Depression:](<a href=“http://www.lawyerswithdepression.com/lawyersunhappy.asp]Lawyers”>http://www.lawyerswithdepression.com/lawyersunhappy.asp) Lawyers also have to deal with insane hours, debt from grad school, a long gruelling training process, etc. Basically, I’m saying compared to other high paying professions like law and academia, docs have it pretty good.</p>
<p>The difficult path to becoming a lawyer (don’t read if you already agree with me, but if you need further arguments to be convinced, here they are):
Being a lawyer is also a very long and hard road, one must excel as an undergrad with difficult classes and score in the top 90 percentiles on the LSAT. For med school, getting in is often a sign of relief- med students have a very low percentile of people who don’t become doctors. For the path to becoming a lawyer, getting into law school is no guarantee of getting a high paying job, or getting a job period. Most law schools have high attritions rates, just under 20 percent of law students drop out on average. Tuition is equally as high as for medical school, and even once you graduate, it is extremely hard to get a job unless you went to a top 15 law school (while for medicine, any med school will do for the most part). Additionally, many top law firms are cutting jobs by as much as 50%[law</a> firm recession, marketing, econonomic downturn](<a href=“http://www.lawmarketing.com/pages/articles.asp?Action=Article&ArticleCategoryID=58&ArticleID=850]law”>http://www.lawmarketing.com/pages/articles.asp?Action=Article&ArticleCategoryID=58&ArticleID=850)</p>
<p>lollybo:</p>
<p>your points are getting weaker. :)</p>
<p>With the University of Phoenix opening a law school, not to mention Podunk colleges everywhere (bcos they add prestige and are a cash cow), there are ZERO barriers to LS entry. Sure, you gotta pass the bar to practice, but in California you don’t even need to go to LS to sit for it. (Anyone with a few hundred dollars can pay the fee and take the bar in my State.) Heck, it doesn’t even require a 3.0 or *average/i] LSAT score for admission into (a fourth tier) LS. (See Thomas Cooley or Cal Western, the latter which claims a ~80% bar passage rate instate.)</p>
<p>Ditto for Phd’s. Colleges purposely admit waaaaay more candidates than will ever find a job. That includes podunk colleges as well as the Ivies. In fact, there is little barrier to entry in that field either. OTOH, engineering and biz profs can make really good money bcos the quantitative nature of their field is an automatic barrier to entry from all those humanities-social science majors.</p>
<p>wrt to docs: No med school grad walks out the door into Big Med and makes $160k. They become interns for a year – essentially indentured servants. Then, for specialists, they get to train for several years more. Perhpas BigMed starts in the early 30’s. The difference in this profession, and the others you mention, is barrier to entry.</p>
<p>Just like in business, few barriers to entry means that one cannot command a pricing premium.</p>
<p>I definitely agree with you, bluebayou, in that law schools are less selective than medical schools, and PhD programs as well. However, even when considering graduates from the TOP law schools are having a heck of a time finding a job in these situations. It is true that in med school the process is long and strenuous, but the process for graduating from a top law school is also intense, and imagine after doing that you can’t even get a job. See: <a href=“http://www.nytimes.com/2009/08/26/business/26lawyers.html[/url]”>http://www.nytimes.com/2009/08/26/business/26lawyers.html</a></p>
<p>According to all my pre-law friends, either stay in-state or go to a top 15 law school or else you have a very low chance of getting a job. In light of this, yes it is true a lot of law schools are a joke and admit anybody (an on-line law degree, ha! imagine an online medical degree!) it further adds to the pressure to get into a top law school.</p>
<p>Your discussion of barriers to entry is also important to note, thanks for bringing it up. However, when considering top law schools, I think it would be pointless to argue that the barriers to entry are low. Not quite med school, but see: [2009</a> Raw Data Law School Rankings : Acceptance Rate (Ascending)](<a href=“2020 Law School Rankings - Median LSAT Score (Low to High)”>2020 Law School Rankings - Acceptance Rate (Low to High)). Personally, I think the slightly higher acceptance rates is more than made up for by the insecurity of getting a job afterwards. </p>
<p>I would also argue that becoming a professor also has many barriers to entry, and IMO the financial benefits are much less than the benefits of becoming a doc.</p>
<p>Well. Finally. I just finished my 17,500 word analysis of the bill and feel much better equipped to answer questions on it. haha – that thing is really, REALLY complicated.</p>
<p>What do you think is the most significant beneficial addition of the bill? What do you think is the most significant harmful addition of the bill?</p>
<p>So believe it or not, the Cadillac tax might be the single most powerful way to keep costs down in the long-run. As more and more insurance plans try to avoid paying the Cadillac tax, it’ll push them to be more cost-conscious. And I think in spirit the bill has a lot of very good intentions.</p>
<p>The most harmful provision… well, there’s a lot of things that I think are very likely to backfire. The bottom line is that CBO projects insurance costs more than doubling within the next few years, with the cheapest plan costing about $12,000 a year thanks to the changes the law imposes. If that turns out to be the case, there’s going to be a very broad array of negative consequences associated with the bill. For one thing, the mandate is going to be virtually empty, since it has a hardship exemption built in if insurance costs more than 8% of your income. So the mandate doesn’t actually apply to anybody making less than $150,000 a year if that math plays out right. If that plays out as CBO is expecting, then you’re going to get a nightmare scenario of death spiraling. And you’re going to have to replace it with another system – quite possibly single payer.</p>