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(Washington Post)   The latest degree that is quickly becoming a bad value: MD   (washingtonpost.com) divider line 123
    More: Interesting, Health Affairs, Aaron Schock, Balanced Budget Amendment, Medicine study  
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11909 clicks; posted to Main » on 15 Feb 2013 at 2:24 PM (2 years ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2013-02-15 08:19:32 PM  
Suddenly my OD is looking better
 
2013-02-15 09:18:49 PM  
Tommy Moo:
You can easily pay off $250k in debt in three years by living below your $300k salary, or you can pay it off over twenty years without feeling it. A $2000 monthly education bill isn't exactly bringing you hardship when you bring home $15,000 a month after taxes. Education repayment takes your $300k salary and reduces it to a $270k salary. Big whoop. They still make three times as much as PhDs.

And that's not even getting into the fact that the loans are easily forgiven by doing a few years of work in underprivileged areas. Plus I'm pretty sure loan interest is deferred when you're in residency.

If med school wasn't a sweet ass deal, there wouldn't be a million undergrads banging at the door every year.


Again, do the math.  Lifetime salary, minus expenses, divided by hours worked is comparable to many other doctorates and some trades.  Or you can just cherry pick your data, ignore all that and keep believing whatever you want.

I kinda have a feeling you will be going with choice 2.
 
2013-02-15 09:36:09 PM  
Tommy Moo:
Until some people no longer want to go to med school, doctors are overcompensated. The end-all-catch-all statistic is the number of applicants to med school. You can rationalize how much doctors are paid all you want, but as long as twice as many people are applying as there are positions, the social consensus is that the benefits of being a doctor outweigh the costs. In every other field people are saying "Screw this; it's not worth it." No one in the history of this nation has ever said "Screw med school. It's not worth 8 years to only be guaranteed 100% employment with a six figure salary." When that happens, the compensation will have balanced out with the cost of entry.

Ohwow.jpeg
That's a great idea.  Do you know who else is overpaid? Astronauts. I mean, look at how many applicants they have compared to the spots!  Lets put their salary at zero so we can thin out the numbers a little.  What? They are STILL getting too many applicants?  Ok, let have them pay us.  We'll keep raising the fee until the number of people applying equals the number of spots.  I would love to see Warren Buffett, some 92 year old Chinese mining tycoon and Prince Al-Waleed bin Talal on a 6 year trip to Mars.

Because that makes farking sense.
 
2013-02-15 09:58:02 PM  

BigLuca: I would love to see Warren Buffett, some 92 year old Chinese mining tycoon and Prince Al-Waleed bin Talal on a 6 year trip to Mars.


Actually, that would be awesome.

But seriously, have you ever met a med student that wasn't in it for the money, status, and sex with rock stars? Because I haven't. And I've been friends with/dated dozens of them.
 
2013-02-15 10:20:29 PM  

Tommy Moo: BigLuca: I would love to see Warren Buffett, some 92 year old Chinese mining tycoon and Prince Al-Waleed bin Talal on a 6 year trip to Mars.

Actually, that would be awesome.

But seriously, have you ever met a med student that wasn't in it for the money, status, and sex with rock stars? Because I haven't. And I've been friends with/dated dozens of them.


As a med student I can confirm this is true about 95% of the time.  I can't stand my classmates.
 
2013-02-15 10:35:04 PM  

Tommy Moo: BigLuca: I would love to see Warren Buffett, some 92 year old Chinese mining tycoon and Prince Al-Waleed bin Talal on a 6 year trip to Mars.

Actually, that would be awesome.

But seriously, have you ever met a med student that wasn't in it for the money, status, and sex with rock stars? Because I haven't. And I've been friends with/dated dozens of them.


Yeah, mostly true.  It really depends on the program though.  I was friends with people from Duke med; what a bunch of raging assholes, the lot of them.  I think you are more likely to find decent people in small state schools or osteopathic schools.  But even then it's a mix at best.
 
2013-02-15 10:51:54 PM  

amquelbettamin: Health care costs would go down a lot if all medicine was over the counter. Nothing like going to a doc to get a prescription for every ear infection


Over-the-counter antibiotics would be moronic.
 
2013-02-15 10:56:29 PM  

BigLuca: Tommy Moo: BigLuca: I would love to see Warren Buffett, some 92 year old Chinese mining tycoon and Prince Al-Waleed bin Talal on a 6 year trip to Mars.

Actually, that would be awesome.

But seriously, have you ever met a med student that wasn't in it for the money, status, and sex with rock stars? Because I haven't. And I've been friends with/dated dozens of them.

Yeah, mostly true.  It really depends on the program though.  I was friends with people from Duke med; what a bunch of raging assholes, the lot of them.  I think you are more likely to find decent people in small state schools or osteopathic schools.  But even then it's a mix at best.


One would think wouldn't they? I go to a Carib school and my classmates are still like this.  I guess because we're one of the most reputable schools down there they let even that inflate their egos like they're the skinniest kid at fat camp.  Jesus be humble people.  Bunch of narcissists.  There should be a better screening process for med school interviews and I'm not talking about grades.

To be fair, it's not just because of the money, status, and sex with rock stars.  Let's not forget those that are culturally forced into medicine, though that's another conversation altogether.
 
2013-02-15 11:25:52 PM  
CWeinerWV:
One would think wouldn't they? I go to a Carib school and my classmates are still like this.  I guess because we're one of the most reputable schools down there they let even that inflate their egos like they're the skinniest kid at fat camp.  Jesus be humble people.  Bunch of narcissists.  There should be a better screening process for med school interviews and I'm not talking about grades.

To be fair, it's not just because of the money, status, and sex with rock stars.  Let's not forget those that are culturally forced into medicine, though that's another conversation altogether.


I did a rotation with a group from Ross I think ... might've been SGU.  But yeah, they were as bad as the Duke people, which was surprising.  The problem is the interview process screens IN these types.  At some point people began to equate being an egotistical prick with confidence and then further decided that confidence was the most important trait in a doctor.  Try going through the interview process while being modest and self-effacing, or apply to some ortho residencies while wearing that personality.  Won't happen.   The culture of the medical field is weird ... and broken.

Although I do like my Sex with Rock Stars classes.  The Steven Tyler final was rough though.
 
2013-02-15 11:36:19 PM  
I started in veterinary medicine.  Harder to get into, curriculum just as hard as medicine not even including the fact that you have multiple animals to learn, same course of study, etc.  Half to a quarter of the salary with the same amount of debt.  Students were farking amazing people.  Fun to be around, loved what they were doing, no pissing contests over grades, no gunners pretending to ask questions to demonstrate their knowledge to the prof, etc.  Switched to med school, figured it would be similar.  Heck, thought the med students would be humble knowing the other half of their school (Ross and SGU have med and vet) were more academically qualified.  WRONG.
 
2013-02-15 11:54:17 PM  

pho75: As someone who is married to a doctor who will complete residency this year I can confirm that this article is full of shiat. Early retirment Early divorce and replacement by at least a decade younger trophy spouse, here I come.


I'm sorry but someone had to say it...
 
2013-02-16 12:02:00 AM  

CWeinerWV: I started in veterinary medicine.  Harder to get into, curriculum just as hard as medicine not even including the fact that you have multiple animals to learn, same course of study, etc.  Half to a quarter of the salary with the same amount of debt.  Students were farking amazing people.  Fun to be around, loved what they were doing, no pissing contests over grades, no gunners pretending to ask questions to demonstrate their knowledge to the prof, etc.  Switched to med school, figured it would be similar.  Heck, thought the med students would be humble knowing the other half of their school (Ross and SGU have med and vet) were more academically qualified.  WRONG.


I have almost they same story and experience.  I did pharmacy before.  Had a blast, learned a ton, loved the people.  Med school was a rude surprise.
 
2013-02-16 12:55:02 AM  

BigLuca: CWeinerWV: I started in veterinary medicine.  Harder to get into, curriculum just as hard as medicine not even including the fact that you have multiple animals to learn, same course of study, etc.  Half to a quarter of the salary with the same amount of debt.  Students were farking amazing people.  Fun to be around, loved what they were doing, no pissing contests over grades, no gunners pretending to ask questions to demonstrate their knowledge to the prof, etc.  Switched to med school, figured it would be similar.  Heck, thought the med students would be humble knowing the other half of their school (Ross and SGU have med and vet) were more academically qualified.  WRONG.

I have almost they same story and experience.  I did pharmacy before.  Had a blast, learned a ton, loved the people.  Med school was a rude surprise.


I like what you're about.  Consider yourself favorited.
 
2013-02-16 03:05:37 AM  

potterydove: So they're in the same boat as most other professions.  We have too many people with degrees and not enough skilled trades(wo)men.


And requiring a degree for an ENTRY level position doesnt help either,,,

Letting HR write the job posting and not letting the department verify before it goes out results in the wrong applicants for the job.
 
drp
2013-02-16 04:00:49 AM  
All you guys who think the cost-containing solution is fewer doctors and more midlevels (NPs, PAs, CRNAs, and so on) ...

When the day comes that your medical condition is evaluated by a NP and referred to a specialist PA who gets a CT read by a Radiology Technologist Assistant, who then sends you to a cost-effective Surgical Technician with his online "doctorate" to operate with the help of an independent unsupervised CRNA ...


You can indulge in some satisfaction that even more money will be saved when your autopsy is conducted by the Certified Registered Licensed Nurse Pathology Practictioner Helper Assistant.


In the end, you may get what you ask for.

/ and you'll deserve it
 
2013-02-16 05:21:09 AM  
And with doctors retiring so they won't have to deal with ObamaCare... Hrm.
 
2013-02-16 06:06:34 AM  
As someone who is going to a osteopathic school in the fall, this graph doesn't bother me in the least. Then again, I'm going HSPS through the Army to foot the $350,000 bill so I don't really fit the private loan-funded allopathic specialty mold. As of now Family Medicine appeals most to me as a future physician. My mind is open for other areas though, at least until I get to my clinical years.

Research has shown that the decrease in MD primary care providers is being matched by an increase in DO PCPs, along with a growth in physician extenders (not substitutes) like NP, DNP, PA, etc. That trend may not keep pace with the aging population though.
 
2013-02-16 10:26:03 AM  

alywa: What a horseshiat article.  According to this  http://www.statehealthfacts.org/comparemaptable.jsp?ind=434&cat=8  there were 17,300 US medical school graduates in 2011.  The chart in TFA clearly shows nearly 25,000 PGY-1 spots.  The increasing number of applicants is due to an influx of applications from foreign trained MDs.

Relatively few foreign MDs get spots compared to their US trained peers.  The ones that do are usually very good (though I've seen some bad ones, and often language barriers are tough). They are also usually filling in spots that went unfilled.  I knew absolutely 0 people from my US medical school class that didn't get a residency position.

The real issue isn't residency spots, it's medical school slots in the US.  Medical schools are very expensive to build / create.  Our current system is simply too small for our population.  With the boomer population at Medicare age, a much smaller Gen X and Millennial pool to pick from, and increasing sub specialization, there most definitely will be a shortage of US trained primary MDs.  Expect to see more foreign trained physicians and allied professionals (NP, PAs) in the primary care roles in the years to come.  Not necessarily a bad thing, but it is the way things are moving.


It's hard to justify 4 years of medical school

noitsnot: Tommy Moo: Bad for med students, good for us. This is hitting literally every field. Why shouldn't they share in the suffering? The single largest reason health care costs so much in this country is because of the outlandish salaries of doctors. Let's dump a glut of competent doctors on the market until the invisible hand finally does its job and lowers salaries down to the point where people will actually have to weight the costs vs. benefits of entering the field of medicine. Currently it's a no brainer: if you can get into med school, you go, because you are 100% guaranteed a life of Corvettes and naked underwear models.

Ding ding ding!  Yes - this!  Finally we are seeing some alternative mechanisms for healthcare happening (surgical centers, NPT's) and competition and benefit reform (MOAR PLEASE) are beating some sense into "the way it's always been done".

I talked to my anesthesiologist neighbor about internships and residency, how they work 12 hour shifts and isn't that a terrible and dangerous idea, given how it's been shown that performance drops and errors rise after about 5 hours of being on a shift.  His response was "It's not a problem because they're used to it."  Basically 1) That's how we always have done it, 2) Those studies don't apply because we are supermen


Only 12 hours? I know they have started cutting hours in residencies, but I have heard of 36 hour shifts on call.
 
2013-02-16 11:04:13 AM  
 

Snarfangel: pho75: TheOther: Living in Baltimore doesn't make you an MD.

That's a bit creepy, or a very lucky guess.

He may have seen it in your profile, but Occam's razor suggests he is a stalker.


Occam's razor suggests the good doctor did not marry hir for hir brains.

/ 'Maryland' was my first thought after 'bad value: MD'.
//now I want soup
///gratuitous third slashies
 
2013-02-16 11:06:20 AM  
CWeinerWV:
I like what you're about.  Consider yourself favorited.

Thanks man.  Ditto.  Nice to see some who doesn't need "We are the Champions" played whenever they walk in a room.
 
2013-02-16 11:40:24 AM  
I'm planning on running free clinics when I'm shortly done residency (or charging 1$ per visit if I'm legally required to charge something) for those who need it, so the blanket comments about doctors being greedy pigs amuse me greatly.
 
2013-02-16 12:04:59 PM  

Gijick: I'm planning on running free clinics when I'm shortly done residency (or charging 1$ per visit if I'm legally required to charge something) for those who need it, so the blanket comments about doctors being greedy pigs amuse me greatly.


Good on you. Having moved to a rural area and not having a doctor for the first couple of years I lived here, I wish more would do that or at least start a practice out in the boonies instead of focusing on cities. It's brutal finding a physician unless you're really in need here; I got lucky and found one in the nearby college town, so she sometimes has openings for patients because they rotate out after a couple of years.

Makes it awkward though when I'm too sick to come to school; I can't get a doctor's note because she's in the same town (as the school) and if I'm not going to school, I'm damn well not going to her either...
 
2013-02-16 02:45:20 PM  

Occam's Disposable Razor: PatoDeAgua: Occam's Disposable Razor:

"Artifical" limiting of med school spots is not necessarily an evil, profit driven thing. Nearly every resident I've spoken with agrees that the bottom 5-10% of their graduating class (the ones who failed courses and had to retake them or made it through by one lucky answer) are not physicians they would visit if they were sick. Most go so far as to say the school pushed these students through, and question whether they should be practicing at all. Then there are the students who can't get into a US school and go to the Carribean (where residency match rates can be truly scary).

Meh, went to a Caribbean medical school. matched into an incredibly competitive field, and am now chief resident.  Classes are the same, books are the same, USMLE is the same (and my school has higher average Step1 scores than US students), so your argument is highly unconvincing . . .

Maybe you hit a good school. If you did the work and got the scores, that's fantastic, but I personally know people from schools with 60-70% match rates. That's scary to me if I'm an incoming first year, no?

Once you've taken the Step and matched, you're on equal footing with anyone else. Please don't think I was attacking Carribean schools.

Do you disagree that you had classmates who weren't qualified to practice? I know I did.


Yea, I think everyone has classmates that are unqualified to practice, but residency tends to be a great equalizer - if you can't cut it in residency, you're not going to get a job...

But, I disagree with the tone of this thread, almost throughout it.  Its incredibly rare for doctors to make 300-K, and only sub-specialists make that.  Most docs make 200-K, or even less.  And when you combine that with the loss of income over the entire medical school and residency (which is a minimum of seven years, often quite longer), the rewards are so ridiculously low, that truly only idiots would go into medicine for money...
 
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