LOL try again fly. My problem is with both sides. You only defend one.

Well there's a balance to be struck here, not because of this really:

But because it does take significantly more work to become those specialists, and these people have a skill set that is in high demand without much competition. If you lower the salaries significantly you'll create a new shortage. Notice this is the kind of thing a market does really well.

Now in my dream world I'd like to greatly change medical education, but that isn't going to happen, so we're admittedly left with a lot of bad options. The simplest one is to increase the amount of MDs graduating so much that there will always be someone willing to take a PCP job. The pay structures could definitely be tweaked though as well.

The actual residency of about half the specialists listed in that article are typically going to be way easier on you than a residency in IM/Peds/Family.

(Anesthesia, Radiology and Derm being the most glaring ones where you may get paid 2-3.5x a general internist after doing a significantly less grueling residency)

Training might be a year or two longer, but in order to make up 2-3 years of salary over the course of a 30 year career the specialist salary would only have to be marginally more, not the current rate of 2-3x the yearly salary of a generalist.

It may take more work to match into those programs, but thats almost entirely just because of the competition caused by the current financial situation of each specialty.

So what? I highly doubt you want to argue that specialists don't get more training on the whole than a PCP.
Obviously the current financial arrangements make it so that it's more profitable to get the extra training. That's also why people do it. Remove that incentive and you'll have a lot less neurosurgeons out there.

I didnt mention any surgeons in my post, but even if you axed neurosurgery salaries down to 300k or something, you would still easily fill up all the neurosurgery residency slots around the country.

Anyhow, my point is right now the lifetime earning of lets say an anesthesiologist is literally millions of dollars more than an internist. And the internist had a harder residency and is working more hours post residency, I don't see how an extra 1 year of an easier residency should be worth millions of dollars.

Sure thing. You're still missing the forest for the trees.

lol Obama is not that bad actually, imo
I mean with all the ******icans in congress and all.

At least he gave the patients some protection
and made it affordable to get healthcare.

Only poverty, global warming, evolution, gun laws and gravity
left now to join the mentally developed world.

and the msm propaganda & government surveillance, Obv.

What forest am I missing?

My position is that specialty salaries should be rebalanced such that specialists surpass generalists in total earnings maybe 15-20 years post-medschool, as it is now a lot of them are doing it less than 10 years post-medschool and then after a 30 year career they have made 4 times as much. You dont need nearly that much financial incentive to get people into specialties.

(The above numbers are mostly made up, but when internists are making like 180k and anesthesiologists/radiologists are pushing 300-500k you don't have to even do the math to see why we dont have enough internists and radiologists are moaning that the markets in big cities are saturated)

That specialists by and large do more training than non-specialists.
Yup. Now the problem becomes how the **** you ghana do this?

It would be fairly simple to calculate what % to cut reimbursement for different specialist procedures to bring their career earnings closer to (but still higher than) generalists. This would decrease to incentive to enter certain specialties and therefore increase the number of American grads going into generalist fields. Obviously I would rather just increase generalist salaries to closer to specialist salaries, but obviously isnt going to happen in a period of time where everyone is trying to figure out how to hold down costs. (Also will ultimately be important to expand residency slots, but I don't see the political will for that right now either)

The system is so screwed up right now, I think there are only like 2 of us in my AOA cohort who aren't entering one of the super high paying specialties, its kind of a shame that the majority of the highest performing students are funneled into certain specialties based on the mostly arbitrary process of how reimbursement is determined.

That seems like the kind of thing you can say you want to do but would be really hard to put into practice.

What are the net numbers after everything is paid I.e. Malpractice insurance. I would assume a propofol jockey's is higher than an internist's. But by the same margin?


I just looked it up and an anesthesiologist' insurance is about double. But double is only 11k more. So yeah specialists are banking. At least the ones I know. A prime example is the guy my mother worked for. He was a urologist and only saw Medicare patients 4 days a week. Did not do OR stuff and make around 400k a year. Of course this was around ten years ago so I am not sure if that would still be possible today or if it would be higher.

As far as I know, almost all salary numbers you see published are after malpractice insurance is accounted for. This is what I've been told by physicians I've worked with, but I have never actually looked into it myself so I can't gurantee its true.

A big part of this is that no one wants to look at dick all day.

That's not true at all.

for $400K, show me all of the penises

Just looking at dick is not even the biggest problem. I have a feeling the frequent prostate exams are a bigger disincentive. Despite that, last time I checked it was still more competitive than FP.

Urologists seem to be some of the most laid back and happiest physicians out there in my experience as a medstudent. Good balance of clinic and surgery, great hours and less call compared to other surgeons, and of course making like 600k doesnt hurt. Its also one of the most competitive fields in medicine, comparable with Derm/NeuroSurg/ENT/Plastics

Yeah in my sample size of 1, urologists are super laid back considering they are grabbing balls all day.

My GP does my "digital" prostate exam FWIW.

I guess it wasn't obvious but that post is not meant to be serious lol.

David Kennedy, hacking expert, said that gaining access to 70,000 personal records of Obamacare enrollees via HealthCare.gov took no time at all, and required nothing more than a standard browser to pull off.

Read more: http://dailycaller.com/2014/01/19/top-hacker-reveals-how-he-cracked-obamacare-site-in-under-4-minutes/#ixzz2r2a3WgdG

So does mine – but the time he did he was a little rough. I know lol. That night I had my first one of these things: http://en.wikipedia.org/wiki/Proctalgia_fugax. I figured it was just because something must've got impacted or something. But over four or five years since then I've had maybe a half a dozen more. They are incredibly painful.

Now I have a scary cougar doctor who tries to molest me – but at least her finger is very skinny.

Thanks, Obama

Cite or die

This is true in theory but is not happening in practice. Insurance companies are raising rates they charge employers to cover the increased risks they face with Obamacare. This was predicted and how insurance companies deal with increased risks.

Glad DKay quoted that riverman post. The smug arrogance while being completely wrong about all employer-sponsered complying with obamacare before obamacare is just too ****ing much. Should be requoted every time he talks down to anyone here.