Recently I have been reading a lot about physician’s salaries, a very heated and controversial topic, indeed. The central questions are, “How much money should a physician make?” or, “is medical school still worth it?” Answers vary widely – from frustrated medical students or starting physicians to soothing individuals who are trying to calm people down, appealing to people’s passion and compassion.

It is important to note that in a free market, payment is neither dependent on overall value/functionality for society nor an individual’s commitment or workload. Hollywood actors’ or NFL players’ value and functionality for society could be debated, for example, yet these individuals belong to the top 1% of the wealthiest Americans because of the demand for entertainment. Payment depends on supply and demand. Supply / demand = $. In the case of the doctor, one could say, individuals qualified / individuals demanded = $. However, the field is also greatly controlled by regulations from the government, such as medicare and medicaid. These programs are necessary to give poor or retired people coverage, but they do not offer as great of reimbursement rates as private insurance companies, which also cost more. The discrepancy between what specialists earn is huge. Generalists, like primary care or family medicine doctors, make half of what specialized doctors make and only a fifth of what neurosurgeons earn.

The Facts on Medical School Debt

Medical students go through a lot of financial stress to say the least. In addition to academic stress, tuition needs to be paid. Average medical school tuition in 2011 was about $40,000 per year, depending on the medical school. It could also be much higher. A friend of mine at Yale medical school had to have $500,000 in an escrow account prior to being fully admitted. If you’re not married or have a partner that can provide, you will also have to pay for living costs, so that will be an extra $10-20k per year. In any case, you have to pay for medical equipment (stethoscope, otoscope, sphygmomanometer, etc. – expensive!) and books each semester, which can add another $4,000 per year. The answer to all of this is student loans.

While average medical student debt is 200,000, it is not uncommon for medical students to be in debt for up $400,000 – 500,000 after medical school, depending on how lousy the interest rates are (private debt). Some students also still carry their undergraduate debt with them. It is understandable that doctors demand a fair and rewarding compensation for the risk they took.
Educational Debt

The great risk of studying Medicine

Needless to say, accumulated medical school debt can be a big let-down for aspiring physicians. Understandably, there needs to be enough compensation for all the hard work, sacrifice, and investment. Let’s not forget that if something goes wrong, a medical student’s life can be ruined. Certain diseases or disorders like multiple sclerosis often hit people in their twenties. Thus, with costs of living going up, as well as tuition rising, some students are considering other options like chemical engineering, law, etc. The outlook of medicine is not what it used to be.

To remain credible, I have to admit that I am a first-year medical student. Thus, I cannot speak of the sacrifices of professional doctors in the same way that an experienced and distinguished physician could. Currently, I am going to class 8 hours, attending a lab/meeting for an hour, and then studying at home for another 5 hours. That’s 14 hours of strenuous concentration and work.

Most of the doctors that I know personally work 12-hour-days, and some more than that. There are some who work less, on more manageable schedules, and there are some doctors who work even more. This commitment to a continually rigorous performance is often accepted only under one circumstance – if the price is right.

Conclusion

It’s important to look at the exact salaries, by specialty. CRNA salaries sometime surpass those of primary care doctors. This certainly is unfair and worrisome, and has something to do with the discrepancy between generalists and specialists. Specialists earn up to double the salary that generalists like primary care and family medicine physicians do. Thus, primary care physicians’ salaries could indeed be considered too low.

While the decline of primary care physicians being a direct result of our broken health care system, it is an issue of its own – and I find it relevant to this discussion. My conclusion is that depending on the specialty, salaries currently could be too low considering the great investment, at least for the primary care field.

One might complain, “If I don’t get to go to any of my sons baseball games, no longer have any social life, and have to go deeply into debt, then I need to be paid darn well!”. However, let’s not forget that people in other professions are missing their sons baseball games, too. This includes the average Joe that is slaving away at McDonalds AND Walmart, just to pay a $400,000 mortgage on a house that is now worth $100,000, or to pay his/her child’s medical bills.

Let’s all hope that the discrepancies of generalists & specialists will be addressed soon. Either way, I believe people should not choose a career or specialty because of money. Of course, one shouldn’t be unrealistic about the accumulating debt of medical school, but in order to be a thriving, effective, and relational doctor one should always follow the heart and see what “makes you come alive”. And let’s not hide the fact that job security for physicians is is one of the highest (if not the highest) – and compensation is still very good.