I wonder if the person that wrote the article is himself or herself, a physician. I’d also like to know if the author knows how much money and investment it is just to go through the basic (heavily understated) 4 years of medical school? Maybe the author should have looked at that before writing the article and realized that it maybe why doctors will jump on the opportunity to make the money. That goes for law school and attorneys too.

veterinarian training is far less expensive than medical trainiing. After the 4 years of college, and 4 years of med school, there is additional 3-5 years of training.
for those years of my training I earned minimum wage,
which did not meet my living costs, so I had to borrow more.

Veterinarian training is expensive, med school training is much more expensive and takes more years.

vets can start practice once they graduate from vet school and can start earning a lving wage. physicians cannot earn a living wage for an additional 3-5 years.

vets charge cash for their services and set fees according to what the market bears. Physicians charge what insurers allow. vets provide essential services and often euthanize animals when their owners prefer that option ,rather than paying for a large medical bill. vets customarily euthanize animals that are homeless.

Physicians do not euthanize patients,homeless or not.

So Tina suggests $80,000. Would I have taken it when I was a senior in college with a degree in engineering (along with my pre-med requisite courses) . A lot depends upon the cost of the intervening 8-10 years. If I had to pay for med school plus living expenses for four years, then let that debt rise during residency it might not look so good. That is, it would appear that I would have been in my 40’s before the debt was erased. Then with half a career left, would have had to create a retirement savings, and save for my kids education. No, starting behind with debt and paying forward with future dollars just is not a winning combination.

Would $80,000 look acceptible if the other half of the socialized medicine deal was in place? namely, that education costs would be absorbed by the health care arm of the government. Sure looks a lot better. Schools would have many more potential applicants because people unwilling or unable to incur serious debt would suddenly be in the applicant pool.

Educational debt does produce undesired results in the market place. Since prices are fixed by third parties, supply and demand does not exist. Just because there is a need for more primary care practitioners does not meen that there will be increased reimbursement to entice students to these areas. Pediatrics and Family practice are the lowest paid specialties. Yet many students cannot affort to take a career where they will earn $80,000-$100,000. This is because the tax rate considers them high earners, and taxes them down to $55,000-$70,000. This is not enough to service the debt and interest on what is typical for this midwestern school (Washington univeristy) of $150,000. They would be completely priced out of any home market .

I have a decent home in a good neighborhood. My car is a 13 year old taurus. I joke with my 12 year old daughter that some day that car will be hers because she is not going to get the new Bimmer that her friends older siblings are driving around town. What I havn’t told her is that she gets my hand-me-down car only if I can get another one for myself; not a sure thing yet though.

ok tina, lets take it one paragraph at a time.

your right…. residents earn 30 -40,000 /year,
usually they work 70-90 hours/week providing patient care.
Usually they work in cities where costs are very high.

per hour residents earn minimum wage. Equivalently Working 80 hours/week at minimum wage yields 34,000/year.

Most med schools are private: most tuitions run @ 30,000-40 ,000/ year. If you are lucky you can get into a state medical school where tuition runs 15,000 /year.
If a vet worked 80 plus hours/week I think the income they would earn would exceed 65,000/year. Our vet charges us reasonable fees but if they must come in after 4:30pm or the weekend or holiday the charges triple.

Med school degrees MUST be followed by 3-5 years training.
Usually debt interest starts accruing by the third year post med school. No such thing as low interest stafford loans for med school.

Physician costs for tubal ligation or vasectomy is NOT 18,000. please call around…most physician fees are well under 2000.00 If covered by insurance the fee a physcian earns is a few hundred dollars.
Certainly costs would be cheaper if a physician did these procedures in the office, but medical legal risks make this impossible. Thus the costs go up when you start receiving fees for the oupatient facility and anesthesia fees. the physician performing the vasectomy or tubal ligation does not have any influence on fees set by facilites.

costs of procedures is determined by cost of doing business. I am not aware of any vets paying 20,000-50,000
dollars/year for malpractice insurance…unless its a high stakes feild like equiestrian vet medicine. OB/gyn often apy 40-80,000 /year for malpractice. more costs = higher fees.

the US population is 300 million. about 50 million do not have insurance (not 150 million as you state)

I agree 50 million is too many.
Millions of Americans are homless. Is this the doctors fault?. Millions of Americans are Jobless, is this the doctors fault? Millions are hard working people who cannot afford health insurance. Too bad the CEO of Blue cross earned 80 million dollars in Bonus pay. Is this the doctors fault.?

how many people die from cigarettes? is that doc’s fault?.
how many people die from obesity and lack of exercise, cell phone related car accidents ? alchohol car deaths….
how many people are murdered? people die from all sorts of reasons. are doc’s the cause?

it might be that lack of health insurance and death is a complex social problem that seems will only be addressed through
a massive national political change that will support socialized medicine, anti-poverty programs .

Many well respected American medical associations support socialized medicine, you might be shocked but I do support this as well. (Interesting that in Britain and Canada that costs of socialized medicine are so high that many lifesaving procdeures are not offered to patients over age 67. Most wealthy patients in Britian will pay for consulatants to oversee their care. also access to costly tests is severely restricted. Many people wait months to years to get an expesnive test done.)

Vets are better than doctors?
its kind of like saying your mom is better than mine and your school and religion is better than mine.
so be it… if that is your belief.

Pharmacogenetics is a new field, certainly in years to come will offer insights and therapies that are not available this decade. I look forward to any and all impovements in medicine.

but if you prefer please imgine doctors are malicious, money loving, uncaring individuals. You will probably see what you want.

“Vets charge 80 bucks for to spay a dog, drs charge 18,000 to spay a human.”

Actually, the bilateral tubal ligation procedure is reimbursed (CPT 58600) at between $350.00 and $400.00 (you can look it up yourself at cms.gov).

“On the high end the vet would charge me 600 to remove my dogs eye. I would guess a human eye removal would cost at least fifteen thousand or so”

Wrong again. For a simple enucleation (removing the eyeball only, and leaving the muscles behind, CPT 65101) CMS allows about $700.00. If the muscles are removed too (CPT 65110) it’s about $1200.00.

I don’t suppose your vet has to hire an army of personnel to file claims in order to collect the fees, either, nor do they provide you with a 90 day float on the bill. And I am certain that their liability premiums are much lower. Does the new vet earning 30-40K put in 100 hrs/week? Your vet can also sell you the medications you require, another source of revenue. Can your doctor? (Not in many states).

“If you don’t have insurance you can’t see a dr.”

I’ve never seen a sign on anyone’s door that read, “Uninsured patients are not welcome.” And by the way, I see uninsured patients all the time. I never turn them away. Doesn’t mean I don’t charge for my services, though.

Hey Matte,

Checked out the pages you mention.
I don’t think the vet page is a reliable source of info. They’d like you to pay 250 bucks but can’t normally do that. As you guys have noted I bet the market will not allow that. Maybe in NJ that happens though.

As for med school tuition, I noticed the last link had both private and public tuition. Public is between 11000 for UTSW up to 25000 or so. If you choose to go private or go out of state then you will have much more debt. If you can’t do that in your state, then part of planning for med school means managing the debt by moving and getting residency somewhere else. You make a choice about how much you spend. That really does put it back into the vet school tuition ballpark. However as I noted before the high malpractice rates invalidate the argument to some extent.

So I have a few questions….

If a hypochondriac is someone who imagines themselves to have an illness, what is the adjective to go along with that? Are you hypochondriacal? Help me here. I am searching for my identity.

Also DB this ones for you, Why is med school tuition so high? Where do the costs go and is high cost used as a way to screen applicants for true desire? Large loans are used to justify the large salaries.

The funniest thing happened today. Another recent hire walked in on my friend and I while we discussing some of the points you guys bring up (I really do listen ) She heard three sentances and said ” My doctors suck. My vet is a better dr than my dr. ” I am not lying, she really said this. We all face complicated medical issues and all three have seen the worst drs can dish out.

If we are so mislead and have totally the wrong idea about the medical field than you guys have a very serious PR problem on your hands. Us patients keep seeing the same things over and over again and you guys dismiss it, much like you do our health concerns.

Tina-
As for people going into medicine to make a lot of money, you can fuhgeddaboutit. I’m not saying that we would not have changed our career paths if the salary were $80K (your number), but if you take a typical college student, make his career path primarily motivated by money, and advise him, medicine would be very far down on the list (yes, above teaching, clergy, farming, but way below business, financial services, law). First, his odds of getting into med school are better than the 1/4 of my generation (mid fifties), but still against him. Then he has 4 years of med school that he will have to pay tuition in let’s say low 5 figures per year, plus, he is forgoing 4 years of mid 5 figures income during that time. Med school is 4 years of very hard work (think the equivalent of 24-30 semester hours of college work in the science track with labs for 2 years, then 2 years of clinical work at 80 hrs/week in the teaching hospital, and lots of homework after hours). Then you have the coveted MD after your name, and that’s when the real training starts. Another 3-7 years of 80 hour weeks, with 2 weeks/yr vacation if you’re lucky. Yes, the resident does get minimum wage or slightly higher during that time, generally equivalent to the hourly wage of the person who sweeps the floor around him. After the residency, he’s out looking for a job, his first real job in your early thirties. Depending on the market, his specialty, and his talent, he may really clean up, with a mid 6 figure income potential after a few years, but most of us max out somewhere between $150-250K for most of our careers. Your pediatrician and psychiatrist will be lower in some cases, your surgical specialists a bit more, but it’s hard work, long hours, and emotionally and physically difficult. If money is the motivation, it will not keep anyone going through all this. There are much more efficient and less trying ways of making money.

Your new hire who hates her docs is probably the kind of patient that we apologize about when we refer to our colleagues. A little perspective is in order. You say you have “complicated medical issues.” A century ago, people did not have complicated medical issues because one simple issue was survivable, but two simple issues or one complicated one meant you were gonna die. That’s why the average age of death in 1900 in the USA was 42 years. We’re such worthless jerks, dismissing your health concerns, that our profession and our allies have managed to double the average lifespan in the country in a century. Yeah, we need better PR. Give me a break! And please tell your new hire to stay the hell out of my office. With her attitude, I would be tempted to refer her to the vet for appropriate management.

tina, you make many comparisons about costs

some key points.
ER care…… is vastly more costly than a
office visit. ER care is costly for many reasons but hospitals set the rates for all radiology,lab, nursing services etc…. Most insurance plans have pre determined rates that doc’s can charge. check out the E/M
codes as set by medicare ( on the medicare webs sites) Most insurance pay only a few percent more than medicare.

Office visits are usually 80-170 dollars/visit. Office pregnancy test are charge is $21.00 not $168.00

you certainly are mis informed if you do not know that doctors fees are largely set by insurance payors.

The Hysterectomy was 18,000 $ but then you add the missing phrase…”complications”… complications can be very expensive to manage. If you take an average medical bill you will see line items for costs thst have nothing to do with the physician charges (E/M codes)

Do doc’s like complications?
No…most insurers , medical Boards, hospital reviewers and other doc’s look for doc’s with high complication rates. Doc’s try hard to avoid them.

Medical school costs…. Good luck moving out of state for one year and then applying to medical school. Most schools have serious road blocks to such dishonest behavior. Residency requirements when applying to state medical school are stricter than applying for college. also remember that obtaining a slot in a state supported medical school is harder becuase of the sheer number of bona fide residents who do apply… mainly for the cheaper tuition.

Unfortunately, if you look closely at the average tuition costs they far exceed the average vet costs.

also, vets can start practice immed post vet school. Physicians still are in minimum wage training for an average of 4 extra years.

it is unfortunate that medicaid is not universally accepted in all areas. You assume however that your experiences are universal and generalize your experiences to the medical field at large . This is a false genralization. In our area most practices are hospital owned and patients with medicaidd are never turned away. I seldomly make a referall to a specialist who does not provide care to patients who have medicaid. Geographic differences do exist. Many doc’s do free care on a daily basis, many times over. Your experiences , although true for you are not true in many areas of the country.

Tons of BMW’s in the parking lot…. there are also tons of honda civics, mini vans and clunkers. I certainly do see BMW’s in the parking lot. Many doc’s who have worked for decades do reward themselves with good cars.
My electrician has a mountain summer home? do I villify him for that.? One of my neighboors (retired accountant) lives in a beautiful lake side home. do I rebuke him. ?

Do you really make judgements based on parking lots?

many people choose medicine to make money. Of course they do, you cannot take make such a huge investment in years and money and not hope to make it worthwhile economically. In countries that have socialized medicine
med school costs are covered by taxpayers and so incomes are limited. Both systems have their drawbacks. Just log onto the British Health Service, there are lots of complaints by patients and doc’s. Tax rates in Britain per capita are much higher in Britain.

I too like my vet. Funny thing happened today,I saw admitted 6 patients to the hospital three nights ago.
All were new to me. 2 have no insurance and will never be able to pay. I have spent about many hours helping them the best I can. Once they leave the hospital they will see me in the office for follow-up probably at least two or three times. these patients are very greatful. Thats the PR I get constantly. all my colleagues do likewise.

In your words
” Us patients keep seeing the same things over and over again and you guys dismiss it, much like you do our health concerns.”
thats is as invalid as

” Us doctors keep seeing the same things over and over and you patients dismiss it, much like you do our work concerns”

you taught organic chemistry? I thought that course was VERY boring. I very much liked Philosphy and History courses, in fact many , many of my medical school classmates were not science majors and did and learned things that were not anything like organic chem. again your experiences are anecdotal and seem foreign to what my experiences were. Perhaps this illustrates the difficulty in taking personal experiences and proclaiming that to be “the truth”. My experiences are alsoanecdotal but I do know people have all sorts of motivations.

I do know doc’s are people, thus I assume doc’s have all sorts of motivations.

Like any profession, there are people driven by financial gain, and people in it for the love of the job. Doctors, lawyers, dentists and basketball players (yeah right) all apply. The medical/ health care industry will continue to see radical change – as the allure of going into medicine for the money is fast fading i.e med school costs surging,smaller pot of gold at the end of the rainbow, etc. Further, doctors, who in the past acted as the ultimate evangelists are now bad-mouthing the business. I smell trouble.

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Some clarifications for Tina.

Most of what you are talking about is hospital charges, which are horrendously high. Also, the $168 pregnancy test is kind of like the list price on a car. Very few pay that price unless you have no insurance. After adjustments from BC/BS it may be more like $20. If Medicaid, more like $5. (That’s why a lot of docs don’t like to take Medicaid as our costs for Medicaid are about the same. Medicaid just covers overhead, so we don’t make any money when we see Medicaid patients. We in effect see them for free).

As far as BMW’s at the hospital, those belong to the surgeons. Most of us primary care docs aren’t parked at the hospital (except outside of normal office hours). If you look at my office parking lot you’ll see that I drive a Civic, my partners – another civic, a subaru wagon with 120k miles, 2 used honda accords, and a jeep wrangler.

Most of the complainers are talking about surgeons & their incomes, not us primary care docs. Although admittedly many of us make about $120 to $150 thousand a year, which still is pretty good. I’m happy with our income range personally. But when you pencil it out it may not be adequate for today’s grads if they owe over $200,000 in eductaion debt which is very common these days. Plus they don’t start making any money until they’re 30, pretty lake if you’re married with kids.

Med school tuition is rising very fast due to funding cuts from the government. We’re on the axe every year (I teach at a residency like DB).

And maybe you’re looking at the wrong kind of doc. Ask around for recommendations and I’m sure you can find someone in your office who is happy with their primary care doc (Family or Internal Medicine.)

It’s time for nationalized healthcare.