This has been a topic that has continued to pop up over decades, and I feel that it will have increasing relevance given the high chance of a president who will push for medicare-for-all within the next 4-8 years.
Countless articles have poked at physician salaries as a target for healthcare reform:
OK. Let's look at some facts:
- Doctors in America do certainly have a higher salary on average than doctors in other wealthy countries
- None of these articles / "hot-takes" factor into account that in comparison to doctors in other wealthy countries, American doctors:
-Take on enormous debt. Median debt according to the AAMC after graduating medical school is $200,000. 21% of private medical school graduates have over $300,000 in debt. Most of this debt is at the government unsubsidized graduate loan rate, which for my graduating class was around 6%. This puts US doctors at an incredible disadvantage financially early on in life. A separate discussion could be had discussing why doctors should pay 6% on their debt – it's likely that our repayment rate is much higher than other graduate students, which could be interpreted to mean that we should have much lower interest rates.
-Undergo more training on average in terms of hours and years than many doctors in other countries (when you take into account that American doctors, unlike other doctors in many wealthy countries, must obtain a bachelor's degree, MD, and complete residency)
-This has a huge effect on our ability to accrue financial capital in our 20s and 30s, which has a compounding, negative effect on our financial capital due to basic rules of economics
-American doctors work more hours on average than many comparators. I was unable to find accurate $/hour figures, but anecdotally I've met Western European doctors who work 35-40 hours per week
-Comparators do not face the same medical-legal landscape as American doctors
-Burn-out for American doctors is higher due to many factors, not the least of which is patient satisfaction as a driver for numerous metrics in American health care. As an aside, I strongly feel that legislation to disrupt the medical-legal climate and incentivize moving away from patient satisfaction as a driver in healthcare are crucial elements to address in our broken system.
I'm seriously concerned that our profession is at risk. I don't think American doctors are overpaid currently. What are your thoughts? Who are the candidates in the current primary cycle who might understand these angles? Are there any major articles that have been published in the mainstream to shed light on to these issues?
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