<p>How come doctors “fresh” from medical school make a lower salary compared to doctors with years of experience? Could it be that the demand for healthcare increases a little bit every year or/and the hospital decides to reward doctors with higher wages because they are more valuable? Moreover, why does a dentist’s wage increase, is it the reputation of the dental clinic or what?</p>
<p>Interns, residents and fellows are considered to still be in training. They are not autonomous and still require supervision/teaching/guidance of fully credentialed physicians, and the cover of that person’s malpractice (the person or persons with the “deepest pockets” - those who carry the most malpractice limits get sued even though they may have nothing to do with whatever the claim of the suit is, just because if you sue an intern - big deal - you may be able to get a couple hundred bucks out of him/her IF you win). Insurance companies control reimbursement, not determine care, but they are somewhat hand-in-hand. Insurance companies now for the most part will only pay what they are going to pay, if you have full staff privileges and are board certified, which requires completion of training and board exams, both written and for many specialties, oral board exams, with recertification. For specialties with less insured cases, like cosmetic surgeons, patients go with reputation, experience, past results not inexperience. Also, just because a patient is not insured or they don’t even pay your bill, don’t think they can’t sue you because they can.</p>
<p>Doctors with more experience and training tend to work more hours and operate complex surgeries and oversight of other staff members; thus, their pay increases. Is this true? In addition, a dentist makes more $$$ throughout more experience, because he/she 1)pays off some of the debt for the his/her practice, 2) develops more contacts with patients, 3) more people are educated, have higher incomes; thus, have better insurance coverage and healthcare plans, and 4) because more patients are satisfied and decide to receive treatments. What am I missing? Not counting inflation, why are dentists earning more throughout their entire career?</p>
<p>More experienced doctors most certainly do NOT work more hours; residents work truly ungodly hours, whereas for many specialties senior people need only perform procedures from time to time. Additionally, under many types of insurance plans, doctors are paid for the type of procedure performed or based on the patient’s diagnosis (these ‘DRG’s’ are used by Medicare), not their hours worked.</p>
<p>^^^^Great. Thank you for clearing that off. Does this apply to businesses (for instance MBA investment banker), and lawyers?</p>
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Doctors who have completed training, in general, do not make a salary independent of productivity and in general are not paid by hospitals (exceptions include VA hospitals, some county hospitals, and certain practice structures). Most doctors are paid by third party payors (insurance companies, medicare or medicaid), not by patients or hospitals. In most cases, all doctors on an insurance company provider panel are paid the same amount for the same service regardless of skill, reputation or even competence. Reimbursement per procedure or visit has decreased for most specialties over the past ten years.</p>
<p>Resident pay is set by the training institution and is partly paid by the government. Pay varies from $40K-50K. See the UCSF report detailing resident compensation which includes data on training programs around the country at <a href=“http://medschool.ucsf.edu/gme/residents/pdf/ResidentCompensation.pdf#search=“resident%20pay%20scale%20ucsf”[/url]”>http://medschool.ucsf.edu/gme/residents/pdf/ResidentCompensation.pdf#search=“resident%20pay%20scale%20ucsf”</a> .</p>
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Working more hours and performing more procedures typically increases billing. Experienced physicians with good reputations may enjoy a more effective referral base, but experience alone does not predict greater activity or greater intensity of activity.</p>
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<p>Residents liability insurance is covered by the liability umbrella of the training institution; most university medical centers are self insured. Keep in mind that a malpractice judgement against an intern or resident will result in a entry in National Practioner Data Bank (<a href=“http://bhpr.hrsa.gov/dqa/[/url]”>http://bhpr.hrsa.gov/dqa/</a>) a database which “identifies practitioners with a history of adverse actions and medical malpractice payments.”</p>