jasonInNy

Given recent developments in the health care reform, many primary care doctors worry that while their pay may increase 8-10%, their workload will increase about 30% with ever increasing paperwork from Uncle Sam. (Increase demand + stable supply equal huge rises in pay for Primary care but also disproportional increases in more work).

On the other hand, Specializations such as Cardiology and Onconology will experience drastic pay cuts. Medicare plan to slash some basic bread and butter procedures of Cardiology and Oncology by 42% and 24% respectively.

Is there a specialty that will be relatively unaffected in the next 10-20 years? I want a reasonable specialty without all that beaurucratic stuff and a STABLE pay that the Government can't cut.

ALL INFORMATION IS DIRECTLY SUPPORTED BY WSJ.

Thoughts and advice please.

thank you.

mmmcdowe

^Chill

OP, worry about it in medical school (which will be at a time when you will also being see whether or not these pay cuts actually happen. My thoughts are there won't be anything as significant as you are worried about without some serious benefits (lowered malpractice insurance prices, benefits, etc).

However, you have already hit the nail on the head when you said that medicare is looking to cut fees. Simply go into a specialty with less medicare coverage, meaning luxury medicine such as a lot of plastic surgery and dermatology.

jasonInNy

lol lets see how please Capitol hill will be when all the decent doctors go into Cosmetic surgery.

Anyways, Medicare has already lowered rates for Card and Onc. Type in Health care reform on WSJ. This stuff is no longer just floating around in congress, it is reality.

afan

The economic effects on individual specialties are hard to predict when there is not even a consensus bill. You have years to worry about this. For now the decision is whether to go to medical school at all. Once you decide to do that, let things play out for a few years, and make your decision in 3rd year.

mmmcdowe

A disproportionate number of the most brilliant doctors already go into derm, it hasn't been noticed by capitol hill yet apparently.

Princess'Dad

It is way too soon for you to worry about type of doc. First you need to get in.

Work for a VA for salary.

Colleges00701

get in first dude...

jasonInNy

I need to worry about whether I should or should not apply to PLME or HPME. If i make the commitment and get accepted, it is 100% guarantee that Ill become a doctor.

On the other hand, If the pay is gonna be cut with increase workloads and paperwork, time to look at other careers.


I stress this point for those who think cuts are still being debated: CUTS FOR CARDIOLOGY AND ONCOLOGY ARE ALREADY IN PLACE IN MEDICARE.

shades_children

You ought to forget about being a doctor if your primary concern is the money. There are better and faster ways to make money.

jasonInNy

Please^^^

Money isnt everything. As I said, increased workload and paperwork are not fun.


P.S please name faster and easier ways to make money.

afan

Even if you go to a combined program
1. you do not need to pick your specialty now
2. You can always quit and just get a college degree if you change your mind about medicine

"please name faster and easier ways to make money"

Assuming here you want to capitalize on academic ability, rather than, say, starting a small business:

Law school. Essentially everyone who applies gets in somewhere (there are way too many law schools). But if you restrict consideration to people who have the academic ability and work habits of premeds then you find of group of people who go to highly ranked law schools and then have chances at lucrative big law firms. You do not have to become a partner at Milbank Tweed to make much more money than most doctors.

Accounting. All the same comments. Excellent income potential. Much shorter time to real earnings than medicine.

Dentistry. Shorter time commitment to get there than for medicine. Your income depends in part on your ability to build a practice, but it can be substantial. Perhaps less glamorous than many areas of medicine, but lucrative.

Business. With or without business school. Particularly in finance. Highly competitive, but the potential financial rewards are astronomical.

bluedevilmike

I'll overlook the irony here and simply answer the question.

http://talk.collegeconfidential.com/...2-post108.html

jasonInNy

BDM,
thats interesting. I am just curious as too how Neurosurgeon bag 400-500k a year yet only are worth 700-800k.

But uh, what specialties have manageable hours, decent/stable pay, and relatively high malpractice? I think i can bypass malpractice suits by hanging a "Will countersue" sign on clinic.

bluedevilmike

Well, the specialties like that are derm, radiology, etc. (Unless you're being sarcastic, your idea for avoiding malpractice is sheer idiocy.)

But (1) those are the specialties most likely to be targeted in health care reform and (2) those are really, really hard to get into. So difficult that you shouldn't go to medical school purely for the purpose of doing that.

The math is actually quite simple. Neurosurgeons make, say, $400K per year. But they've had to wait 17 years to get there. That $400K is a lot less than it seems, because you've had to forego seventeen years worth of income. Seventeen years' worth of income is a lot, even if you're only making an auto mechanic's salary. (Making, say, $50,000 a year is $850K of raw income for 17 years. And then when you start considering that money can be invested... well, you're looking at something upwards of $1.2M.)

So the number is low because they've had to give up so much in order to get there.

shades_children

This thread reminded me of something from my neurology rotation. My attending on that rotation was awesome and would answer my questions on just about everything, from neurology to picking a residency to dealing with debt.

My attending had just finished her neurology residency in June. She's married to someone who I assume is about the same age as her (more on this later). She graduated from Columbia P&S with about $110k in debt.

I learned from her that brand-new neurology attendings at my hospital start at $75k. If you've got one year of fellowship under your belt, your salary rises to $100k. Since she just finished residency, she clearly had no fellowship training, so I took that to mean that she made about $75k.

I also learned from her during the course of some random conversation that her husband is a vice president at Citigroup. One of my friends who works in finance told me that someone like that would be in his early thirties, which is about the same age as my attending. I have no idea how much a vice president at Citigroup makes, but I'm guessing it sure ain't $75k. In fact, I'm willing to bet that he makes significantly more - my attending wore the biggest diamond engagement ring I've ever seen in person.

So here are two people who are married to each other and about the same age. One made enough several years ago to buy his then-fiancee a massive diamond ring. The other, after 4 years of college, 4 years of medical school, and 4 years of residency, currently makes $75k and is repaying $110k in debt.

If your goal is money, who do you think has the better deal?

(Granted, if my attending had entered private practice and not worked at an academic hospital, she would be making more. That being said, there's nothing she could do, with her education and background, to make as much as I assume her husband does.)