What do doctors earn in the US?

[Kirk W]

What do doctors earn in the US?

The compensation of physicians and surgeons in the United States reflects a complex landscape shaped by factors like specialty, geographic location, and demand.

According to the Bureau of Labor Statistics (BLS), approximately 816,900 Americans were working as physicians or surgeons as of May 2022. In 2022, the median annual wage for physicians and surgeons was $229,300, according to the BLS. This was nearly five times more than America's general median wage, which was $46,310.

[Chalkie]

OK, and.... what? To compare a doctor's salary to the general median wage is kind of an apples to oranges thing in my mind. The median wage accounts for wages across the entire spectrum of workers but how many of them require four years of college, preferably in a science heavy field, then have to pass a test to be considered for medical school, then spend four more years of college to earn a medical degree, and finally spend as many as seven years in a residency before you can go out on your own? Then when the doctor is out on his own he needs to rent office space, hire staff, pay insurance (this is a big one) all out of that salary. For what doctors do, I, personally, don't think they earn anywhere near enough. 

[Kirk W]

I would think that the numbers are personal income, net of job related expenses. But I don't know for sure. I didn't get the impression that the article was critical of doctor incomes, just stating facts.

These jobs require extensive education and training and are some of the most demanding positions in the workforce — they can be stressful and require long shifts or overtime.

The work is intense, but the professions are growing. The BLS estimates 24,200 new physician and surgeon jobs will open each year over the next decade as population growth, an aging population, increasing rates of chronic illnesses, and retirement create added demand for doctors. But the investment in training and time has a solid return; while salaries do vary by location and specialty, physicians are some of the most well-compensated healthcare practitioners, and the highest-earning Americans in general.

[lappir]

This is such a can of worms and I really shouldn't be helping anyone open it up. But here I go.

Maybe you have read this before, but Health Care is not what it used to be. Drs. also are not what the used to be. Patients are not people any more in the greatest sense of the word, but are a product. They are an item that generates income for many, many people now. It used to be the Dr. would treat the ill and be paid for his services, and yes I just used the male pronoun, because in the beginning only Men were allowed for the most part to be Drs. If you were a female and wanted to work in health care you could be a Nurse. 

Thankfully that has changed and either sex or pronoun can be what ever they want to be as long as they follow the rules the insurance companies set forth for appropriate billing and accept the payments they decide are best. 

Chalkie listed off several costs associated with a medical practice. Most of them are now taken care of by Hospitals and Clinics where many, many physicians are employed by such and they all receive a different Annual Salary no matter how many patients they see or the level of their expertise in the real sense of the word. An individual practitioner is a very rare being and most likely is only a specialist and often times does not accept insurance payments. He or She will give you a bill to turn into an insurance company, Medicare and maybe Medicaid, but it's on the patient to follow up on any reimbursements.  At least that's how I see it with some Drs. 

So I'm thinking about a Poll of how may of the participants on this forum have a:

"Personal Physician (PP)" currently?

Have any had a "PP" in the past? 

Consider the "Emergency Department" as their "Go To" health care. ?

Use the "Doc in the Box" Urgent Care facilities.?

And the big question is "If you were admitted to the Hospital, Would you expect to see your PP?"

That's all for today, but I will be following. PM me if you have specific questions. 

 

Rod

 

[sandsys]

13 minutes ago, lappir said:

So I'm thinking about a Poll of how may of the participants on this forum have a:

"Personal Physician (PP)" currently?

Have any had a "PP" in the past? 

Consider the "Emergency Department" as their "Go To" health care. ?

Use the "Doc in the Box" Urgent Care facilities.?

And the big question is "If you were admitted to the Hospital, Would you expect to see your PP?"

 

I have had the same personal physician for many years. She's younger than I am so I expect to have her through the rest of my life. 

I do go to urgent care occasionally but it is in the same system as my doctor--not a big box center.

All my recent hospital experiences have been outpatient so I've not seen my primary care doctor there but I would if I was admitted. And the hospital is also part of my care system so my doctor has access to my hospital records. I would also expect to see her if I'm admitted to the care facility that is part of our apartment complex even though it is not part of that system--she has already said she is familiar with it and I know staff there will consult with her.

I am one of the lucky ones.

Linda Sand

[Chalkie]

3 hours ago, lappir said:

This is such a can of worms and I really shouldn't be helping anyone open it up. But here I go.

Maybe you have read this before, but Health Care is not what it used to be. Drs. also are not what the used to be. Patients are not people any more in the greatest sense of the word, but are a product. They are an item that generates income for many, many people now. It used to be the Dr. would treat the ill and be paid for his services, and yes I just used the male pronoun, because in the beginning only Men were allowed for the most part to be Drs. If you were a female and wanted to work in health care you could be a Nurse. 

Thankfully that has changed and either sex or pronoun can be what ever they want to be as long as they follow the rules the insurance companies set forth for appropriate billing and accept the payments they decide are best. 

Chalkie listed off several costs associated with a medical practice. Most of them are now taken care of by Hospitals and Clinics where many, many physicians are employed by such and they all receive a different Annual Salary no matter how many patients they see or the level of their expertise in the real sense of the word. An individual practitioner is a very rare being and most likely is only a specialist and often times does not accept insurance payments. He or She will give you a bill to turn into an insurance company, Medicare and maybe Medicaid, but it's on the patient to follow up on any reimbursements.  At least that's how I see it with some Drs. 

So I'm thinking about a Poll of how may of the participants on this forum have a:

"Personal Physician (PP)" currently?

Have any had a "PP" in the past? 

Consider the "Emergency Department" as their "Go To" health care. ?

Use the "Doc in the Box" Urgent Care facilities.?

And the big question is "If you were admitted to the Hospital, Would you expect to see your PP?"

That's all for today, but I will be following. PM me if you have specific questions. 

 

Rod

 

It is indeed a can of worms. I have two cousins that are doctors and a brother-in-law that is the CEO of a hospital.

One cousin took the private practice route as a GP/Family doctor and still maintains that although they have grown to a group of 12 doctors. They are not affiliated with any particular hospital group, they do take most insurance and in some cases will still actually make house calls. He did quite taking OB patients several years ago as the malpractice insurance costs made it too costly.

The other cousin started out as a temporary/traveling doctor. He would fill in for doctors taking vacations or sabbaticals all over the country for 6 months and then would travel the world for 6 months. When he got the traveling out of his system he went back to school and got board certified as a trauma doctor and now works ER in a big city hospital with side gigs as a prison doctor. 

Clearly their expenses are different but so is their income.

The hospital CEO sees the side of medicine that has to balance all the salaries of doctors and staff against the income the hospital makes whether from private pay, insurance or Medicare/Medicaid and have money left over for everything else. At least he is not tasked with making a profit per se as it is a county owned and operated hospital in a rural area but the balance sheet has to stay mostly in the black. 

A poll would be interesting. If the definition of Primary Physician is the same PCM (Primary Care Manager) then yes, we have had one for a lot of years. It has not always been the same one as we were seen at a military facility for 30 years so obviously the doctors would rotate out. Now that we have moved we still have one in the medical organization that we patronize. In either case, we would not see that doctor if we were admitted to hospital as they had/have associated hospitalists that took over care in the hospital. 
 

Edited November 26, 2023 by Chalkie

[ms60ocb]

My primary doctor use to make Hospital visits and some other out of his primary office shifts. But as the health network expanded, he has kept to his office. Thus his hours has been reduced from 60-80 hours a week to 45-50 hours. Luckly that that been quite a pay raise.

Clay

[Kirk W]

15 hours ago, lappir said:

So I'm thinking about a Poll of how may of the participants on this forum have a:

It might be interesting to start a poll, which any forum member can do. 

Pam & I have the same Primary Care Physician, but I'm not sure what a Primary Care Manager is, if it is something different? As well as the PCP, in the past few years I have seen a pulmonologist one time for check up by referral, a cardiologist also once by referral (both due to my age and never having seen one), an orthopaedic spine surgeon once to check a back injury and a urologist for prostate surgery and now an annual follow-up. I also see dermatologist every 6 months to prevent a return of previous melanoma that was now 15+ years ago. My PCP also has a Nurse Practitioner who assists her and most patients alternate visits with 6 months between. It is interesting to note that the cost to my Medicare & Insurance is exactly the same no matter if I am seen by the PCP or her NP. 

A few years ago, I read an article that compared the total earnings by the age of 50, net of the cost of education, for a long list of different professions. I did an internet search but have not found it. As I remember the #1 profession for total income by age 50(net of education expenses) was a plumber and the highest medical profession was down about fifth or sixth. The nearest thing to that which I found was Top 25 Highest Paying Jobs in the World in 2023.

12 hours ago, Chalkie said:

I have two cousins that are doctors and a brother-in-law that is the CEO of a hospital.

I have 2 retired and 2 active nurses in the family and my wife was a health plan administrator many years ago, if that matters. I don't know that I consider doctors or anyone else over paid. I do know that medical costs are a problem today but I have no ideal how to change that.  What Are the Countries With the Best Healthcare?

Edited November 26, 2023 by Kirk W
repair a typo

[Chalkie]

PCP and PCM I think are the same, although I think the PCM tag may fit slightly better. Our PCM is not only the general/family practice doctor that we see for routine or non-urgent visits, he also is the "collection" point for the data from the various specialists we see. He makes sure we are seeing the right ones with the right skills, he is also the one that manages medications even if the original Rx was written by a specialist. All the doctors are tied together with a computer system that lets them see all the post visit notes of each other. The group we are with is very good compared to what I have read about others. 

As to ranking of countries' quality of healthcare, I think it is all about the source of data. US News & World Report will have a different listing from the WHO which will have a different listing than the one that Kirk referenced.

Edited November 26, 2023 by Chalkie

[Kirk W]

2 hours ago, Chalkie said:

Our PCM is not only the general/family practice doctor that we see for routine or non-urgent visits, he also is the "collection" point for the data from the various specialists we see.

That sounds a lot like the primary doctor in an HMO, where you must see the PCM for referral to any type of specialist? My primary care physician will sometimes refer us to a specialist but we have the option of choosing our own specialists and my not be involved at all. For instance, 15 1/2 years ago on a visit to my primary care physician, a family medicine practitioner, I asked about a mole on my left ear and was referred to a choice of 2 dermatologists. The one that I chose did a biopsy and then sent me to a specialist in Mohs surgery without any contact with our pcp. Since that time I have moved twice, changing PCP doctors each time but continued with the same dermatologist. Appointments with him are made without contact with my PCP and the same is true from my annual urologist follow-up. As I understand it, with the PCM those rechecks would need to be made via the PCM. 

Pam has the same PCP as I do, but she also has a gastroenterologist who she contacts directly when needed and the same is true for her orthopedic doctor. Thanks to electronic medical records, each of us have only 1 medical record which each of our doctors have access to and add to when we visit, even though they are not all in the same practice, via the EpicCare Link medical record system. 

[sandsys]

9 minutes ago, Kirk W said:

That sounds a lot like the primary doctor in an HMO, where you must see the PCM for referral to any type of specialist?

My doctor does the same as Chalkie's but my insurance is a PPO where referrals are not required. And the reports of those other doctors still go to my primary physician as long as they are part of the same record keeping system. I do get referrals from my doctor but they are not required.

Linda

[sandsys]

We have a former doctor in our family. He quit that profession when the cost of medical malpractice insurance got ridiculously high. He then became a special ed teacher as a cheaper way to serve people.

Linda

[lappir]

34 minutes ago, sandsys said:

We have a former doctor in our family. He quit that profession when the cost of medical malpractice insurance got ridiculously high. He then became a special ed teacher as a cheaper way to serve people.

Linda

Many years ago while working in South Florida, I worked with a few Drs. who would inform their patients that they did not have "Malpractice Insurance" for the reason of cost. I do not recall any patient refusing to have the procedure, but of course I'd hope they wouldn't have made it to the schedule if there was that possibility. The medical community called it going "Bare" at that time, not sure if that would be accepted today. 

My experiences with a PCP or PCM started as a Clinical office manager in a Family Practice office that was also a "Resident Physician" training location. That too was many years ago and I'm sure things have changed a lot. I had to contact the insurance companies to obtain "Authorization" from them to send patients to "Specialists". Sometimes it could be a very drawn out ordeal, especially in the early days of my working there. I soon became known by the reviewers and I also determined what needed to be said to have few issues in getting a referral. It was an interesting job, but the pay was disturbingly low and the office was always in the red. Not sure how that affected the Residents opinion of private practice, but it sure put me off wondering if needed supplies would actually be arriving when needed. 

Personally I have had little contact as a patient with the medical community. I'm sure that will change more as I get older. It's happened a couple times in 2023 already. I think I'm glad the year is about over. 

I've done some "Polls" before Kirk and I know you have too. I'm going to add one to this topic to see if people want one. 

[lappir]

54 minutes ago, sandsys said:

We have a former doctor in our family. He quit that profession when the cost of medical malpractice insurance got ridiculously high. He then became a special ed teacher as a cheaper way to serve people.

Linda

Ok, it's not working right now and I'm having to submit this twice. 

 

1Many years ago while working in South Florida, I worked with a few Drs. who would inform their patients that they did not have "Malpractice Insurance" for the reason of cost. I do not recall any patient refusing to have the procedure, but of course I'd hope they wouldn't have made it to the schedule if there was that possibility. The medical community called it going "Bare" at that time, not sure if that would be accepted today. 

My experiences with a PCP or PCM started as a Clinical office manager in a Family Practice office that was also a "Resident Physician" training location. That too was many years ago and I'm sure things have changed a lot. I had to contact the insurance companies to obtain "Authorization" from them to send patients to "Specialists". Sometimes it could be a very drawn out ordeal, especially in the early days of my working there. I soon became known by the reviewers and I also determined what needed to be said to have few issues in getting a referral. It was an interesting job, but the pay was disturbingly low and the office was always in the red. Not sure how that affected the Residents opinion of private practice, but it sure put me off wondering if needed supplies would actually be arriving when needed. 

Personally I have had little contact as a patient with the medical community. I'm sure that will change more as I get older. It's happened a couple times in 2023 already. I think I'm glad the year is about over. 

I've done some "Polls" before Kirk and I know you have too. I'm going to add one to this topic to see if people want one.   

Ok, it's not working right now and I'm having to submit this twice. 

[Ray,IN]

lappir is exactly right. For instance, The largest health care employer in Indiana is IU Health Inc.(not connected with Indiana University-a state run higher education institution).  They own/control most of the hospitals in the state and have hired doctors from private practice, and bought specialty practices, to consolidate health care in the state. This is touted as reducing expenses to the general public.

It is now very difficult to see specialists I've been seeing for many years. IU Health hires many Nurse Practitioners to see patients, who in turn make reports to the doctor specialists.

Meanwhile doctors they hired are leaving at an alarming rate to find jobs elsewhere due to the low pay they are receiving.  IU Health assigned me 3 different kidney specialists, I only saw one, one time. I never got a chance to see the other two, they left IU Health before my appt.

The most recent facts I've heard say IU Health now has a financial surplus of ~$12,000,000,000.

Edited November 27, 2023 by Ray,IN

[Chalkie]

5 hours ago, Kirk W said:

That sounds a lot like the primary doctor in an HMO, where you must see the PCM for referral to any type of specialist?

That is exactly what this is, an HMO. However, our doctor is pretty easy. If we think we want or need a specialist he is more than willing to provide the referral. 

[Kirk W]

9 minutes ago, Chalkie said:

That is exactly what this is, an HMO.

And mine coverage is original Medicare with a part G supplement, PPO and thus your Primary Care Manager, & my Primary Care Physician. 

Edited November 27, 2023 by Kirk W

[Dutch_12078]

My wife and I have shared the same PCP for a number of years now, and for the past few years even sharing most appointments. She works for a multiple clinic practice run by our nearest hospital. Our PCP is a gem that routinely goes above and beyond her normal duty requirements. She has responded to my patient portal messages after hours, on weekends, and once renewed a prescription for me while attending a friend's funeral. The only other doctors I was seeing at least annually before my first stroke were my dermatologist and my VA PCP in order to stay active in the system. Since the stroke, I'm also seeing a cardiologist and a neurologist regularly along with speech, occupational, and physical therapists. Shortly before my second stroke, I was given a preliminary diagnosis of Addison's Disease pending confirmation by an endocrinologist. Still waiting on that. Oh, and my Advantage Plan does not require referrals for most specialists.

[GlennWest]

wife and I are not traveling now. So we got a local physician together. He has his own practice. Told us we will never get a bill from him. If Medicare doesn't pay all he absorbs it. Nice to know. They are several to choose from here. A friend of ours recommended him. We are pleased so far. If we need a specialist he sets it up. My early life as a welder exposed me to asbestos so chest x-rays yearly is way of life.

[Vladimir]

On 11/26/2023 at 6:28 AM, Kirk W said:

I have 2 retired and 2 active nurses in the family and my wife was a health plan administrator many years ago, if that matters. I don't know that I consider doctors or anyone else over paid. I do know that medical costs are a problem today but I have no ideal how to change that.  What Are the Countries With the Best Healthcare?

I clicked on your link and found this.....

The measurements took into account how easily people can access care, administrative procedures and equity around this care, and the quality of healthcare outcomes.

The US came in 11th. 

BUT the headline "what are the countries with the best healthcare".....has nothing to do with the measurement criteria.

If I am a healthcare patient my criteria for the BEST HEALTHCARE......has NOTHING to do with " ........how easily people can access care, administrative procedures and equity around this care, and the quality of healthcare outcomes."

In all the countries I have had medical care, the US is by far the best. 

The criteria used in the study, has little to do with the healthcare people experience when they see a doctor.

The criteria used in the study, might be important from a national policy perspective on health care in the US concerning the relative access, administrative procedures, equity and healthcare outcomes. 

They are important issues, but not really related to the quality of healthcare individuals receive in their respective countries.