It has always seemed to me that the medical education process is fundamentally broken. The long period of study/indentured servitude/ridiculous hours and level of debt seem to be unique to that profession.
Expecting sympathy and high compensation for that just seems wrong.
Well, if you think that 4 years of undergrad, 4 years of med school, an internship, a residency and much sacrifice of time and money during those 12+ years shouldn’t be part of the cost of medical training what’s your proposal for training medical doctors? You want the dope head who maintains a 2.1 GPA in _________ studies operating on your brain?
Right. Those are the only two possible options. :rolleyes:
It’s not sympathy or high compensation for the study. It’s high compensation for the study of and this may come as a shock, a marketable skill. Some skills are more valuable to society than others and this is reflected in compensation.
You can study twice as hard as a doctor in a worthless field and get paid to hand out fries. So it’s not directly related to study. That said, the opportunity cost being as high as it is and the skill being in demand means that doctors will have a price floor in order to pay the deferred costs, with interest, of their education.
No idea. But the private sector is relatively small in the UK, and quite a few of its doctors will also have NHS posts. Presumably on both counts incomes will be at least influenced by the NHS scales
Who said those were the only two options? The question is ludicrous in a capitalist society though. Without a government mandated wage floor, which physicians do not have, how can you ask if a particular class of non-government employees are overpaid? I exclude government employees since taxation to provide compensation is a power the private sector does not have. The private sector must satisfy “customers” not subjects.
Foregone income, time value of money, and higher taxes on time-compressed income.
There is not a wage floor but there are tremendous barriers to entry. The AMA acts as a guild which restricts the number of doctors entering the profession. This serves to artificially inflate doctors training costs and also doctors’ salaries.
If adding more doctors meant a 20% reduction in doctors’ takehome salaries that would save 6 billion dollars a year.
That’s the figure for an established general practitioner, like the GPs in my neighbourhood health centre. Hospital consultant specialists would be earning at least 50% more from the NHS, and there would be the possibility of more from managerial responsibilities or academic posts. By comparison, the most senior NHS national executive and clinical director posts are getting up to around £200k a year.
How is the AMA acting as a guild? Most doctors are not members of the AMA; degree-granting schools are accredited by the Liaison Committee on Medical Education, which is a joint program with the Association of American Medical Colleges. The number of medical students and graduates in the U.S. has been rising fairly steadily for years, and the American healthcare industry also employs many medical graduates from abroad.
Doctor training costs are high because it is very elaborate, lengthy training requiring lots of expensive equipment and highly-trained personnel, AND public financial support, particularly at the state level, has been declining for quite some time. For example, at the University of Kansas Medical School, state funding paid more than half the budget as recently as 12-15 years ago; now, it’s less than a third, and the percentage is expected to dwindle further. The school made up part of the difference by jacking up tuition, which meant students needed larger loans.
In the UK, for a six-year undergraduate medical degree (the norm here), the tuition fees max out at £9000 pa for the first four years, and then the subsequent years are funded by the NHS. So that’s about $52,000 I think. How does that compare with a typical US medic loan burden?
Here’s Oxford University’s funding page as an example
https://services.aamc.org/tsfreports/select.cfm?year_of_study=2016
US$20-60k/yr depending on whether you count fees. The lower end of that range is for a few state schools charging residents of that state.
That’s for four years after completing a four -year undergraduate degree.
By a couple of ways. As you say the AMA is half of the accreditation board that must accredit all medical colleges. Although the number of physicians is slowly increasing demand is also increasing as the population ages. Currently over half of all people applying to medical college are not accepted and the high wages in that field mean that if more colleges were accredited then more people would become doctors.
The other way they act as guild is to try to limit what nurse practitioners and others can legally do.
At the University of Kansas, the annual medical school tuition is $33,694.20 for Kansas residents and $59,655.90 of out-of-state students (cite–see p. 12 of pdf). At KU, medical school is four years (so, about $135,000), not including the four years of undergraduate work before applying for medical school, and not including living expenses, various fees, costs of textbooks, and miscellaneous.
As of 2014, the average American medical student graduates with about $183,000 of student loan debt.
I should have said an attending physician. The range for these doctors is between 80k and 200K depending on the cost of living.
Well there are also foreign medical school grads and osteopathic medicine schools iirc.
What role do you think nurse practitioners and others are qualified to do?
Some people would say that Kim Kardashian and Paris Hilton are overpaid despite our market economy.
Are those useful barriers to entry or just roadblocks set up to reduce the number of doctors?
I think that we can probably live with less qualified primary care physicians but those aren’t the ones drawing most of the money out of the system and frankly we have so many tiers of nursing professionals providing primary care that we probably don’t need to reduce the hurdle much.
Do you really think we are being too selective in choosing our brain surgeons and eyeball doctors?
We could save double that if we let medicare negotiate prices for drugs. There are probably areas where doctors are overpaid but as a whole they are not the ones sinking the boat.
From what I’ve seen most doctors dont finish all their schools and residencies until nearly age 28.
There are US doctors who make tons of money, but we tend to forget about all the interns and residents who are living in net poverty in exchange for the chance to maybe pay back student loans.
It’s kind of a fucked system, but IMO those who run this gauntlet and pay back their loans by mid-30s are getting fair compensation for their skills and opportunity cost.
ETA: Anyone who can give an otherwise healthy 5-year-old child a new heart is entitled to whatever the market can bear, IMO.