<p>I'm just curious about how the lives of doctors (in pretty much anything from salary, working hours, debt, etc) will differ if universal healthcare comes around. </p>
<p>Perhaps we should look at doctors lives in other countries?</p>
<p>Most likely working hours will drop across the board; salary will rise for some docs and drop for most; not sure about debt, but if I had to guess I’d suspect it’d drop too.</p>
<p>Perhaps malpractice payouts, and the corresponding insurance premiums, will also drop.</p>
<p>@ bluedevilmike: why would some salaries increase while others drop? I would think all would decrease. </p>
<p>I think this issue has the power to change the whole healthcare field. There will probably be more patients per doctor due to affordability.</p>
<p>Obama’s making a concerted push to get more doctors into primary care fields, so he’ll try to raise those salaries. It’s not a terrible idea, although I think there are better solutions to the crisis.</p>
<p>Okay, that makes more sense. I don’t think that’s a bad idea either…but we need doctors in all fields either way.</p>
<p>Has the de-professionalization of Pharmacy due to corporate dominance of the retail drug market made people less likely to become pharmacists?</p>
<p>I remember when being a pharmacist was equivalent to being a physician in pay and prestige. Individual druggists owned the drugstores, made big profits, and enjoyed significant social position.</p>
<p>Today there is no shortage of pharmacy school applicants because, while the profession is not what it used to be, it is still a good job with high, if not stratospheric, pay.</p>
<p>Maybe so many of our best and brightest don’t need to go to medical school and spend their careers tending to problems that could easily be handled by a nurse practicioner.</p>
<p>^ yeah, well, how is socialized medicine going to impact the salaries of pharmacists?</p>
<p>I have not heard anything that will reduce debt.
With the push to cut physician reimbursements, overall incomes are likely to drop. This will be even harder on those with higher debt.
They are talking about some increases in reimbursement rates for primary care docs relative to specialists, but it is unclear whether this will overcome the drop in overall physician pay.
Not likely to affect work hours in any direct way. Perhaps more insured people will mean more demand in some fields, but there are so many other factors at work, unclear what the effect will be.</p>
<p>“Universal” health care is actually a pretty vague concept. What happens to physicians lives depends on details that have yet to be worked out.</p>
<p>As noted, pharmacists were demoted from being largely independent professionals and small business people years ago to salaried employees of huge chains today. I do not recall pharmacy being comparable in pay or prestige to medicine, but it has certainly moved down on both since the independent pharmacies were forced out of the market.</p>
<p>All things being equal, I am sure there are people rethinking their interest in medicine. But things are not equal. For all the changes, no one is expecting to see mass layoffs among physicians, as there have been for lawyers and corporate executives. So medical school applications are up substantially over the last 5-10 years. This economic crisis hit so quickly that we will see how it and health care reform, if it happens, affects applications in the future.</p>
<p>I want to become a doctor, and the prospect of being a government employee does not tempt me whatsoever. Although I think in a way it may weed out the people who truly want to become doctors to help people and those who are in it mostly for cash (as of course pay would drop).</p>
<p>I certainly hope that this health care bill doesn’t pass. It will only cause more problems and government control. I really don’t see any upsides to it other than making sure illegal aliens have health insurance.</p>
<p>^ very true. because illegal immigrants are the only people in the US w/o healthcare. they are also the only population in the US who can’t afford it.</p>
<p>exactly. (10 char)</p>
<p>Yep, the millions of people without health insurance are all illegals. Illegal emergency department immigrants.</p>
<p>I know, right, mmmcdowe? All those wealthy people who decline to buy health insurance because they can afford to pay out of pocket costs? Yup, illegal. All those people who lose their jobs and then lose their health insurance? Why, they lost their American citizenship the moment they were fired. All those people whose employers do not offer health insurance? Totally illegal immigrants, dude.</p>
<p>The ignorance and callousness displayed by some posters here is astounding. Stay away from the profession of medicine, I beg of you.</p>
<p>forgive me if this is completely stupid, but, i mean even if universal health care passes, illegal immigrants still wouldn’t have free health care, correct? I mean, it would only be universal for all citizens? Please tell me I am not wrong?</p>
<p>The simple answer is that nobody knows.</p>
<p>On top of the ambiguity stemming from the fact that Obama has still not proposed anything concrete, “Health Care” is a very ambiguous term. Some would argue that illegal immigrants already get free “health care” thanks to a federal law known as EMTALA.</p>
<p>Most would say that “health care” is defined as health insurance of some kind – but how much care is it required to include? And, for that matter, what is it worth if doctors won’t accept it? Many physicians are now refusing to accept Medicaid. Do Medicaid-covered patients have “health care”?</p>
<p>If Obama does extend universal health “care”, does that just mean insurance, or does that have to include enough physicians to actually provide care?</p>
<p>
Working hours will drop once compensation is not directly related to productivity. Most docs in private practice are working long hours now to bolster income while it is possible; once the incremental compensation for additional work disappears, many docs will retire if they are able. (Don’t believe this? Ask any private practice doc how much longer he will have to work before retiring. Each one will be able to provide exact estimates based on likely economic scenarios).</p>
<p>Numerous studies have shown that physician productivity (and hours worked) once a hospital or HMO buys a practice. Our VA hospital system provides a preview of government run healthcare – VA docs work short hours and patients wait for care.</p>
<p>Obama has courted the AMA to lend legitimacy to his cause. The AMA, composed mainly of internists, does not represent the majority of docs in this country. Not surprisingly, the AMA supports increase in pay for primary care docs at the expense of compensation to specialists. So, yes, pay may increase for some and it will decrease for most.</p>
<p>Debt reduction and tort reform are the only carrots Obama can offer to docs. The government already has generous debt repayment programs for docs willing to commit to working in rural health clinics and other underserved areas. It is unlikely that medical student debt will change for the better. With rising interest rates necessitated by current government expenditures, that debt will weigh more heavily.</p>
<p>And finally, any docs fortunate enough to have an AGI over $280,000 may face a surcharge on income.</p>
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<p>No one knows what will happen to work hours for individual specialties, or overall. The increase in demand, if they get wider coverage, could increase hours for some docs, but not clear exactly who. There might be an increase in demand for primary care docs, and some more primary specialties.</p>
<p>I do not see any realistic chance that docs will all go on fixed salaries. That would require a complete government take over of the entire sector. There is no way that would get through Congress.</p>
<p>So docs will continue to be self employed, or in smaller or larger groups. There is nothing in the proposal that would change the fee for service system, so busier docs would make more than less industrious people in the same field.</p>
<p>They continue to ignore illegal immigrants although they represent a substantial cost for emergency care in many hospitals. They would not be covered under any plan I have heard seriously debated. They would continue to get care in the ER, but that is all. Most patients need more than that, and the uninsured do not get it.</p>
<p>It has definitely made me reconsider. But when I think about it, it’s what I want to do. If I get paid a huge salary, then badass, I’ll have my cake and eat it too. If I make a comfortable living doing what I enjoy, I’d be happy with that too. I’d rather work my ass off at something that’s enjoyable than stare at a computer screen all day and be bored to death and make 100k/yr more.</p>
<p>Although it does depend on what happens whether I continue to head towards medicine, or change the track to some sort of research (which wouldn’t be much different than a low paid doctor in terms of salary and work). I just hope we get some major details finalized before it comes time to apply to med school so I’ll at least have a fairly solid idea of what the future will be like.</p>
<p>I’d hate to be applying to med school right now with all the uncertainty.</p>
<p>If these uncertainties would steer someone away from medicine, then they probably should not apply. If health reform passes in anything resembling the current form, then further major changes are sure to come. The costs of expanding coverage without dealing with the cost drivers in the system will remain unsustainable. One way or another there will be more insurance company/federal government/purchasing coop control over physician practice. One way or another there will be more control over hospital practices, what treatments are approved for whom…</p>
<p>If the current plans pass as is, or are completely rejected, physician autonomy will go down, and incomes are nearly certain to go down as well.</p>