BTW, another interesting thing - my hospital bill was over $142K but their "agreement" with BCBS gets them only $37K. Contractually I'm not responsible for the rest. If I didn't have insurance I'd be responsible for the full $142K. Bizarre.
It's not bizarre (as somebody else noted) but this is going to be the downfall of our health care system. Why do I say this? One reason: Doctors. Medical school costs keep going up and up and up, as does the corresponding debt levels of the graduates. Grads take on the debt because "doctors are rich and can afford to pay it off later." Not so fast. Money Magazine did an article on a young married couple, both of whom are doctors. They're fresh out of med school, and have $400k in combined student loan debt, as well as a $300k mortgage.
Is the allure (and perhaps promise) of great paying jobs going to be there for a high enough percentage of doctors to make it worth while? I doubt it. Medicine is a business. Hospitals exist to make a profit, as do insurance companies. Insurance companies are going to throw their weight around and drive down costs as low as possible. Correspondingly, this drops the revenue for the hospitals. Hospitals are forced to make up their costs from "private pay" patients, so they drive up the "retail" rate. But who are these private pay patients? They're either insolvent or they're rich. As the price of medicine goes up, it becomes cheaper for the rich to get medicine over seas. And we all know that the insolvent don't pay, and they *really* don't want to pay medical bills. So, worst case scenario is that the "retail" patients, who are supposedly charged lots of money, never pay a dime.
So basically, as the insurance companies squeeze hospitals, hospitals are going to be squeezing doctors. I just don't see the incentive to become a doctor anymore.
I'll just chime in since I am a doctor and just finished residency. You're basically right on. The amount of work to get through all the training and the associated stress (which comes from more directions that you can understand unless you go through it) is probably larger than any other profession,
in general. The compensation to physicians has generally gone down compared to inflation for the last 2-3 decades (there are some specialty specific exceptions but this largely holds true - especially for primary care doctors). Add to this tuitions that have far outpaced inflation over a similar period.
I, for instance, incurred almost $200,000 in debt to get through medical school alone (college was essentially free do to academic scholarships). I happen to live a very frugal life and did much better financially than many of my peers at my school that also don't have rich parents.
I also benefited from historically low student loan rates. Most of my debt was consolidated around 2.75%. Also, I was able to defer payments through residency which was absolutely necessary. I could have never made those payments on a resident salary and maintained any sort of life. If I had a family, game over without deferment. Students today do not have these benefits. Loan rates are much higher and rules are about to be put in place that will no longer qualify residents for deferment. You can start to see there is a looming problem for our present students who, on average, pay more for tuition than I did.
Most people don't realize it yet, but most US med school grads no longer go into primary care, in part because the compensation is poor. As a result, more and more the bottom of the barrel graduates are going into it...frequently these are foreign medical grads that barely speak English (to be fair some are quite good, but on the whole it is frightening how bad some are). Take this with the fact that fewer college grads are apply to medical school every year and quality is on the way down. To be a good doctor you have to be motivated, enjoy your job and bright.
There is less competition to get into medical school so it follows that the average med student is not quite as motivated and/or bright as in the past.
Fewer doctors today enjoy their job - surveys bare this out. One reason is that some students after 1-2 years discover medicine is not their thing. Ideally, these generally bright, hard working people would have the mobility to change careers to something that is more fitting. However, when someone is already $50-100,000 in the hole, frequently they feel trapped and forced to continue with something they don't enjoy. This happens *alot* nowadays. Its been one of the shockers of being in medicine. The common theme is 'I would have left after so many years but I could never afford to do that'. This leads to some apathetic doctors more interested in pulling a paycheck that caring for patients.
There are some complex problem here. In part, improved compensation would help. Finding ways to reduce tuition would help, too. I would actually argue compensation that more closely related to amount of training rather than specialty would help even more, but there is still a large discrepancy in how much physicians are trained vs amount payed compared to other fields.
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Topic: I can see how people get unknown medical DQs (Read 30224 times)