
How much money doctors actually make - atrudeau
http://www.businessinsider.com/how-much-money-doctors-make-2017-4
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aabajian
I'm a graduating medical student with a master's in computer science. In a lot
of ways CS is the polar opposite of medicine; one values derivation and
automation while the other emphasizes memorization and one-on-one
interactions.

Surprisingly, teamwork is one area where CS wins out. I've found that despite
the professed importance of the _healthcare team_ , healthcare often doesn't
function like a team at all. Doctors, nurses, PAs, patient care assistants,
administrative staff, can make or break your life by providing support or
creating obstacles. I think it's a result of a inherently tiered system with a
single person (e.g. the attending) on top who decides the treatment plan. In
CS you almost never have a single person who is overly-trained relative to
peers. Maybe you'll have a better developer, UI designer or manager, but none
of these attributes makes that person the sole decider. The pay structure in
medicine reflects its hierarchical system: software managers don't earn 10x
what software developer make, whereas attendings easily make 10x a nurse's
salary.

~~~
alpha_squared
> I'm a graduating medical student with a master's in computer science.

That's... actually really neat. What made you go for a graduate degree then on
to med school, if you don't mind me asking?

~~~
aabajian
I actually got my master's in the middle of medical school (I took a leave of
absence). My undergrad degree is in computer science as well. It's my long-
term goal to start a radiology informatics company.

~~~
alpha_squared
Thanks for answering! How do you feel among your peers? Performance-wise and
general understanding of topics? Is there no noticeable difference or do you
find that you're learning things from a different form of understanding?

Sorry for all the questions, I think it's fascinating when people wind up in a
very different field from one they've more formally studied in.

~~~
aabajian
Computer-science wise: I'm a rather good developer, according to my
supervisors. I'm quite comfortable with Java, Python and a bit of Swift. I
_love_ writing code, starting with BASIC when I was 11 years old.

Medicine-wise: I'm in the bottom quartile of my class. I'm terrible at sitting
there and studying. It's a completely different mind set. I did really poorly
on UMSLE Step 2 in particular; most med students do +20 points higher relative
to Step 1...I did 40 points _lower_. That test is entirely memorization, we're
talking memorizing immunization schedules for children, the screening
guidelines for low-dose CT, the warning signs of an acute abdomen, and so
on...

In terms of benefits, I'm much faster at research data analysis. I'm doing
imaging work and I can take a DICOM, convert it to NIfTI, run an algorithm in
Python or MATLAB, and dump the results in under and hour. That kind of stuff
is second-nature to me, but takes my fellow lab mates an indeterminate amount
of time. I've written a number of 20-line scripts for my classmates that do
basic stuff like vertical lookups in Excel and searching for files on the
filesystem. Really simple stuff that would take a person a long time by hand.

One more thing, the MCAT was a _blast_ for me. It was a wonderful test. It
emphasizes integration and application of what you've learned on novel
problems, very much like computer science. The USMLEs were hell. I got 98th
percentile on the MCAT; 40th percentile on the USMLE.

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westbywest
These data would be more informative, were they also paired with vocational
costs MDs also incur, usually unavoidably. Malpractice insurance, prep for
board exams, for example. Note that the latter can include having to travel to
conferences, or similar events, to stay current in the field, and there may
not always be an employer to reimburse such costs. Likewise, insurance rates
will vary between disciplines, eg. higher for radiology vs psychiatry.

~~~
Consultant32452
I don't really understand this. I'm a small business owner and all the
insurance, training costs, etc. are not money I make. Those are business
expenses. If you work for a big hospital or group, the employer pays for all
that. If you open a private practice, your business still pays for it. The
doctor and their practice are separate legal entities for a reason. The
doctor's salary comes AFTER all that stuff is paid for by the business. So you
don't subtract the cost of insurance from their salary.

~~~
nlarew
While this might be the case in many businesses, physicians generally pay
their own malpractice insurance (which can easily be more than $10k a year)
out of pocket. The litigious nature of the medical system as a whole in
America drives these costs way up and it makes a noticeable impact in not only
how much doctors take home but how they act to cover their asses from a
lawsuit.

Conference expenses and the like are still often covered by the group though
so that's at least something.

~~~
maxerickson
$10k doesn't seem so bad if you are billing at a rate of $2 million a year.

(Of course utilization isn't 100% and primary care doctors aren't billing at
that rate, but that's often the rate for a not particularly expensive
specialist visit)

~~~
Consultant32452
[http://www.aafp.org/news/practice-professional-
issues/201505...](http://www.aafp.org/news/practice-professional-
issues/20150513salaryreport.html)

>On average, primary care physicians overall -- and family physicians,
specifically -- earn $195,000 annually, compared with $284,000 for physicians
in other specialties

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gumby
Quite surprised Dermatology and Plastic Surgery aren't the top two. Those
specialities are almost unique in being the only remaining ones in which most
practitioners are _not_ in managed care programs so can and do charge what the
market will bear.

If you go to an oncology conference you see a lot of paper presentations and
poster sessions. If you go to the annual Derm conference there's a whole
"scene" in the corridors and the trade show floor is really little different
from the trade show floor of, say, a car show, or the AVN awards. Maybe GDC,
or maybe that's a bit over the top. If you aren't an unabashed fan of
capitalism (which I am), you'd likely call it crass.

One year I was walking the show floor and stopped to look at a display of
liposuction tubes -- it was beautifully laid out, like a cross between a bunch
of Cala Lilies and an pipe organ rank. The salesdroid came over and said only
two things: \- "Hello, Doctor! Do you do liposuction in your clinic?" (I shook
my head) \- "Well you can easily get an additional $3000/day from these
babies."

I'm also surprised radiologists score so high because a lot of the analysis
has been farmed out to India. And since that entailed a fully digital stack,
those Indian MDs are about to be the first physicians to be replaced with DL.
Perhaps the large number reflects a small residual 'n', or perhaps the
radiologists have been able to hang on even though part of the job is
outsourced -- presumably by them.

~~~
clavalle
>Those specialities are almost unique in being the only remaining ones in
which most practitioners are not in managed care programs so can and do charge
what the market will bear.

I think you've hit upon the reason. Turns out when the customer is paying
directly and feels the pinch directly the market will not bear as much.

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nickgrosvenor
It's funny that list almost seems like the pay scale should be inverted.

The most important doctors get paid the least and the least important doctors
get paid the most.

~~~
magic_beans
That logic also seems to be true in most major corporations...

~~~
rbcgerard
"important" might be one adjective, but typically less specialized, less
competitive, and more common

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qudat
This article is extremely misleading. Even though these salaries might be
high, they aren't adjusting for number of hours worked.

When we think of a typical "salaried" job, we think 40 hours/week. This is
almost certainly not the case, even for the cushiest physician specialties.

My girlfriend is a critical care physician about to enter attending-hood
working at a university hospital. She will be working a minimum of 50
hours/week and with all the administrative tasks she's being asked to do,
it'll probably be more like 60+.

Really we need to see hourly rates to get a better idea of what physicians
_actually_ make.

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plg
The doctors who live on my street drive Porsches, Mercedes-Benz and Audis. Two
docs on our street own multiple Porsches each (summer, winter, racing).

Maybe it's family money.

Then again maybe it's taxpayers paying their salaries.

(location: mid-sized city in Canada)

~~~
maxxxxx
German doctors have nice sports cars too. Same in the US.

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cocoa19
I've wondered why everyone and their moms are pushing people to study computer
science and STEM, but you don't see the same push for physicians.

~~~
ikeyany
Because it takes 0-4 years of schooling to get your foot in the STEM door, but
8-12 years of schooling for medicine. That pretty much bars access for anyone
interested in having money in their 20s/30s, and those without a strong
support system.

There is a reason why only those from affluent/foreign backgrounds go into
medicine. They're the only ones who can "afford" to not make money right out
of college.

~~~
cantankerous
Realistically, it takes 4 years to attempt to get your foot in the door at a
medical school unless you have pre-admittance or you're looking at a special
case like UMKC's 6-year program. Getting into an MD or a DO program isn't a
guaranteed thing. It's a substantial downside risk.

Also, you can have a STEM-based undergraduate education as your pre-med, even
math and computer science can count if you take the right additional
electives. The two aren't mutually exclusive. It's a good fallback if you bomb
out of getting into med school (or decide 3 years into ugrad that you don't
want to apply).

~~~
ikeyany
4 years of undergrad and 4 years of med school at least. And I agree that a
tech related bachelor's is a good idea for a med school backup.

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czbond
These pay scales are insane for the fact that doctors essentially just have to
show up. This doesn't even include management of others (aka Director roles,
etc). Just literally showing up.

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jboogie77
if you think all doctors do is "just show up", i'd be curious to know what you
think programmers do. Do they just "type stuff"?

~~~
czbond
I meant ... normally for a pay scale above $200k in the non-coastal areas,
someone has to manage staff, lead a team, run a business unit, and make
strategic decisions. Literally, doctors "do their specialty" \- no teams, no
'winning clients' and closing deals to bring in business. They don't have to
have any other skills but their specialty at those ranges.

~~~
Fomite
...I know a number of doctors who manage staff, lead teams, provide cost
justifications to their hospital's C-suite, and make strategic decisions.

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aanm1988
> Despite having the same training and experience as their white peers,
> physicians who identified as Asian, Latino, or black received significantly
> less

What does this mean? The averaged all doctors by race? They averaged by
profession and race then combined to form some sort of weighted average by
race?

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gingerbread-man
"We found that African American, Latino, and Pacific Islanders were more
likely to work in medically underserved areas than were white physicians
(adjusted odds ratio, 1.22-2.25; p < .05)." [1]

Though I'm sure bias has a part in the income disparity, I suspect it is less
so, relative to other professions, as the fees paid to doctors for each
procedure are broadly standardized. Individual doctors' choices of where to
practice and what kind of patients to serve may play a larger role. (IMHO,
this is a much better justification for affirmative-action programs than other
oft-cited justifications.)

[1]
[https://www.ncbi.nlm.nih.gov/pubmed/22708247](https://www.ncbi.nlm.nih.gov/pubmed/22708247)

