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Would You Pursue Your Med Dream If The Salary..

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Yes. But I'd have no reason or finance to go through rigorous training I'd probably do something else within the same current like psychology or write books on well being, or go to rural parts of rural places and make the most of Netter's Atlas lol... essentially I have nothing else that I would subject myself to as a permanent thing unless it were for rent/survival reasons..... maybe open a ski resort... Idk

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On ‎5‎/‎7‎/‎2017 at 3:39 PM, MountainAmoeba said:

I have to say, as a nurse I make over 100 000 a year. Easy. So no. Doctors definitely should be paid more than nurses. They deserve to be fairly compensated for the work they do. Do I think that SOME doctors are over paid. Absolutely, then they are usually the ones over worked.

 

If you are making over 500 000 a year, and have a huge waitlist, someone else should be taking a chunk of that and reducing wait times, but that simply isn't the case. There is a lot of kick back to that type of thinking. Then again, RN's push back against LPN's for the same reason. Even though we could have more bodies doing the work for the same money, people enjoy holding onto "their" turf.

 

All consider though, I think generally speaking physicians are worth their pay. I work with simply amazing Doctors that put their life into their practice, they deserve excellent compensation for the work they do.

Which docs are overpaid? ROADS?

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MD= 4 y + 2-6 y (FM or speciality)
Regular Ph.D road = 4 y(B.Sc) + 2 y (Master) + 4-7 yrs (Research/clinical Ph.D) 

MD = 220-350k+ 
Regular Ph.D = around 85-95k

The reason = numbers highly regulated by the government while having a lot of the peaks of solo practitioner.
If there was a real free-market = way more MDs, more competition, the average pay would be way lower and the population would be better served... IMO. 

And I'm almost certain that even if the average salary of a physician was cut by 30%, all the seats in Med school would still be taken. 
 


 

 

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59 minutes ago, Clapton said:

MD= 4 y + 2-6 y (FM or speciality)
Regular Ph.D road = 4 y(B.Sc) + 2 y (Master) + 4-7 yrs (Research/clinical Ph.D) 

MD = 220-350k+ 
Regular Ph.D = around 85-95k

The reason = numbers highly regulated by the government while having a lot of the peaks of solo practitioner.
If there was a real free-market = way more MDs, more competition, the average pay would be way lower and the population would be better served... IMO. 

And I'm almost certain that even if the average salary of a physician was cut by 30%, all the seats in Med school would still be taken. 
 


 

 

I don't even know what you mean by "regular PhD" though. That's not a job. Are you referring to professors?

If it was a real free market, in many cases the salaries could easily stay the same or increase in some cases.
I don't think comparing PhD's and MD's on the basis of training time makes a whole lot of sense either way, it's apples to oranges. Their roles are completely different. Even the salaries of people with PhD's can be drastically different based on the field of study and what their actual job is (e.g. professor vs. lab technician vs. pharmaceutical consultant). 

Why not compare to dentists? They have even shorter training time and make around the same as family doctors (maybe on average a bit less).

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1 hour ago, Monkey D. Luffy said:

 

I don't even know what you mean by "regular PhD" though. That's not a job. Are you referring to professors?

If it was a real free market, in many cases the salaries could easily stay the same or increase in some cases.
I don't think comparing PhD's and MD's on the basis of training time makes a whole lot of sense either way, it's apples to oranges. Their roles are completely different. Even the salaries of people with PhD's can be drastically different based on the field of study and what their actual job is (e.g. professor vs. lab technician vs. pharmaceutical consultant). 

Why not compare to dentists? They have even shorter training time and make around the same as family doctors (maybe on average a bit less).

I'm actually studying in Dentistry and with all the saturation (open gates from international students and the opening of new dental schools) the incomes are lower than before.

But on the bright side, with the strong competition, patients don't have to wait as much as before to see a dentist and most of the fees are way lower than before. 

When my grandfather was a young doctor, it was fairly frequent to give free-consultations and to do home-calls (because they needed more patients). The competition was stronger. Nowadays (in my province, I don't know if it's like this elsewhere), I have to wait in the cold winter snow outside of my clinic 2 hours before the opening just to see my FP. And sometimes, it's already full... If I remember correctly, the ratio of doctors in the EU is 3.4/1000. Here in Qc, family doctors have an average of 2500+ patients... And this week they decided to reduce 37 seats in medical school...

P.S I don't mind that physicians/dentists are making great money. The training can be gruesome and the level of responsibilities is high. My point is only that we are very privileged. I know lawyers who works very very hard and they don't make great money because their profession is way more prone to the free-market than we are. And I'm sure that people would still pursue medicine even if the money was not so great (my grandfather did and the money was not so great, but obviously greater than the average worker).

 

 

 

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2 hours ago, Clapton said:

MD= 4 y + 2-6 y (FM or speciality)
Regular Ph.D road = 4 y(B.Sc) + 2 y (Master) + 4-7 yrs (Research/clinical Ph.D) 

MD = 220-350k+ 
Regular Ph.D = around 85-95k

The reason = numbers highly regulated by the government while having a lot of the peaks of solo practitioner.
If there was a real free-market = way more MDs, more competition, the average pay would be way lower and the population would be better served... IMO. 

And I'm almost certain that even if the average salary of a physician was cut by 30%, all the seats in Med school would still be taken. 
 


 

 

You forgot 3-7 years of BSc/masters/reapplication/pre-med  for MD pathway. 

Canada is a Fee for service system( Most doctors are NOT salaried.), so the govt themselves limit doctor numbers to ensure overall provision of care is kept within budget. If you doubled the # of MDs, the govt would have to institute more restrictive daily caps on how many patients docs can see, or cut fees in half for the same amount of budget to be sustainable.

So the free-market argument doesn't really work because the govt themselves also benefits from the current system of control of provision.

As for dentistry - unlike medicine, for most cases its not the gov't that is funding the fees being reimbursed to dentists, it is private insurance or out of pocket, so the govt has less incentive to control the physician supply. 

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I don't think that the "reapplication process" should count as some sort of med schooling. Lots of people are accepted directly. And if not, nobody put a gun on your head to re-apply.

The govt would have to institute more restrictive daily caps only if the budget was to remain the same. Let's say that a routine examination is 65$. What would happen if they cut it in half ? In that situation, you could have twice the number of physicians for the same % of the budget. And I'm pretty sure that all the spot in med school would still be taken by young premeds.

There is almost an endless supply of premeds who wants to become doctors. This supply is inelastic because even if the money was not as good as it is, they would still pursue med school. On the other hand, there is a point where we won't need more doctors. On an economic standpoint, if the supply is higher than the demand, you could easily reduce the cost of the service without affecting the quality of cares.

 

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44 minutes ago, Clapton said:

I don't think that the "reapplication process" should count as some sort of med schooling. Lots of people are accepted directly. And if not, nobody put a gun on your head to re-apply.

The govt would have to institute more restrictive daily caps only if the budget was to remain the same. Let's say that a routine examination is 65$. What would happen if they cut it in half ? In that situation, you could have twice the number of physicians for the same % of the budget. And I'm pretty sure that all the spot in med school would still be taken by young premeds.

There is almost an endless supply of premeds who wants to become doctors. This supply is inelastic because even if the money was not as good as it is, they would still pursue med school. On the other hand, there is a point where we won't need more doctors. On an economic standpoint, if the supply is higher than the demand, you could easily reduce the cost of the service without affecting the quality of cares.

 

I guess I was more so speaking to the total time factor, i mean, similarly one could make the argument that people who slack/get unlucky in their PhD and take much longer than others shouldn't have that time counted towards the total schooling argument either.  

I agree, the government could do that, and you would still have people going into medicine. The issue is, what would be the point of making such a change? Since the total number of patients served would still be the same, all that changed is at an individual physician level they are seeing less of the total visits. This would likely change or cause a shift in practice styles though.  As well, you would also need to train those new physicians - can the residency system handle that? What about this new cost of training 2x as many doctors?  Sure you can supplement with foreign doctors perhaps, but definitely not all of the difference, at least not in the current legislative structure.

I'm not disagreeing with your argument at all, just providing some extra thoughts in the utility. At least in the current scenario of cost-control healthcare, the providers are somewhat happy to at least be getting paid decently in a resource strapped system.  If you were to artificially increase the supply of providers, without increasing the amount of funds, then it would change the field. Not necessarily a bad thing mind you.  Just not the current status quo.

 

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6 minutes ago, JohnGrisham said:

I guess I was more so speaking to the total time factor, i mean, similarly one could make the argument that people you slack in their PhD and take much longer than others shouldn't have that time counted towards the total schooling argument either.  

I agree, the government could do that, and you would still have people going into medicine. The issue is, what would be the point? Since the total number of patients served would still be the same, all that changed is at an individual physician level they are seeing less of the total visits. This would likely change or cause a shift in practice styles though.  As well, you would also need to train those new physicians - can the residency system handle that? What about this new cost of training 2x as many doctors?  Sure you can supplement with foreign doctors perhaps, but definitely not all of the difference, at least not in the current legislative structure.

I'm not disagreeing with your argument at all, just providing some extra thoughts in the utility. At least in the current scenario of cost-control healthcare, the providers are somewhat happy to at least be getting paid decently in a resource strapped system.  If you were to artificially increase the supply of providers, without increasing the amount of funds, then it would change the field. Not necessarily a bad thing mind you.  Just not the current status quo.

 

I agree.

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No. I want to maximize my impact on the world by going into either research or public health, and my crotch is that if both plans fall through I can still be a family doctor (and enjoy it) while donating impactful sums of money to charity. If the pay was low I'd rather go into public policy/work for a charity/social startup/highly lucrative job in business

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On 2017-08-08 at 2:01 PM, Clapton said:

MD= 4 y + 2-6 y (FM or speciality)
Regular Ph.D road = 4 y(B.Sc) + 2 y (Master) + 4-7 yrs (Research/clinical Ph.D) 

MD = 220-350k+ 
Regular Ph.D = around 85-95k

The reason = numbers highly regulated by the government while having a lot of the peaks of solo practitioner.
If there was a real free-market = way more MDs, more competition, the average pay would be way lower and the population would be better served... IMO. 

And I'm almost certain that even if the average salary of a physician was cut by 30%, all the seats in Med school would still be taken. 


While I follow your logic, I think it's a bit too simplistic. PhD's do not have the same accountability of human lives that MD's do. They also don't pull the hours and rigorous studying that MD's have to go through to become PI's/academics. Don't get me wrong, PhD's work SUPER hard, and I would even argue that some have it even harder than some medical specialties. Also, PhD usually make more than what you stated above. You also didn't account for all the benefits that they receive on top of their salary that MD's have to pay out of pocket for. Overlooking the benefits/perks included in the job, is one of the reasons that pathology is over looked as a medical speciality. 
 

On 2017-08-08 at 3:23 PM, Clapton said:

I'm actually studying in Dentistry and with all the saturation (open gates from international students and the opening of new dental schools) the incomes are lower than before.

But on the bright side, with the strong competition, patients don't have to wait as much as before to see a dentist and most of the fees are way lower than before. 

When my grandfather was a young doctor, it was fairly frequent to give free-consultations and to do home-calls (because they needed more patients). The competition was stronger. Nowadays (in my province, I don't know if it's like this elsewhere), I have to wait in the cold winter snow outside of my clinic 2 hours before the opening just to see my FP. And sometimes, it's already full... If I remember correctly, the ratio of doctors in the EU is 3.4/1000. Here in Qc, family doctors have an average of 2500+ patients... And this week they decided to reduce 37 seats in medical school...

P.S I don't mind that physicians/dentists are making great money. The training can be gruesome and the level of responsibilities is high. My point is only that we are very privileged. I know lawyers who works very very hard and they don't make great money because their profession is way more prone to the free-market than we are. And I'm sure that people would still pursue medicine even if the money was not so great (my grandfather did and the money was not so great, but obviously greater than the average worker).

When comparing MD's vs. DDS - it's a whole different can of worms. Compared to regular healthcare, the government has very little to do with the overall income of dentists. Yes, the prices for dentists are lower than what it used to be due to foreign grads, but that doesn't mean that it's more accessible than regular healthcare or that Canadians have great dental health because of it. I would actually bet money that Canadians who don't have dental health coverage (i.e. no company insurance or third party dental coverage) have worse dental health than citizens of other countries who have universal dental care covered via taxes (e.g. UK).

In addition, your argument about the free market and driving prices down in dentistry is the same argument for privatized healthcare vs. universal healthcare. From my understanding, in theory, if you introduced privatized healthcare (i.e. via insurance companies) you will have competitive pricing and patients will pay less for their healthcare vs paying for it via taxes due to insurance companies wanting more patients under their plan. The U.S. is a prime example of how privatized healthcare care isn't cost effective for the country or beneficial for the physicians or the patients in it.

But just an FYI, healthcare economics is not as simple as you and I are making it sound to be. If it were, every country would have a healthcare system that is just as effective and efficient as Apple or any other company producing consumer goods. I say this because 1) you think that increasing med school enrolment is the solution to increasing GP's, and I would agree with you to some degree and 2) I only partly agree with you, because I realized how complicated and ambiguous the health economics can be because of this one health economics graduate course I suffered through. Most of us, including my self, think that it's simple supply and demand. But it really is not that simple and there are wayyyy wayyyy more unpredictable variables in the equation than A (new med students) and B (family docs) that are consistently changing.

Disclaimer: I have a limited knowledge on health economics. I wish I knew more, but I'm afraid I'm not smart enough for that. However, I do know one thing: it's not as simple as anyone makes it out to be and if health economists read this thread, they'd be banging their heads on their desks. Health economists literally bang their heads every time they see the healthcare platforms any political party runs with because it's over-simplified and simply used to gain votes of a specific population. How do I know? I've sat through a whole semester of class with health economists doing their PhD's, yelling and cursing about how misinformed everyone not in the field is misinformed about health economics. 

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On 2016-11-01 at 4:21 PM, moneyking said:

was the average Canadian salary of $49,000?

No, but I would if my tuition was not $60000 per year. I am from low socio-economic background and I can probably handle this income based on my life experience. 

 

I highly doubt that many would pursue the career of medicine if the salary was merely $49000 and I can understand their situation. Medical career is very demanding and the journey is long. I see little to no reason for anyone pursuing medicine for $49000 after going through all the hurdles. Regardless, do not let greed affect your ability to demonstrate compassion and empathy in your medical career. 

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I would without hesitation. I think it's very important to recognize how doctors' high salary are becoming a challenge in establishing trust with the population and soon with patients and other health professionals. We can justify an above-average salary (around 100k) with the arguments raised above, but not that high a salary. Human beings are greedy in nature, it's normal, but it's not acceptable when it starts preventing us from delivering quality care that is as accessible as possible. 

The salary doctors defend right now cause our whole health system to be held hostage to the high fees we demand. I'm down anytime to see our paychecks cut in half so we can hire more doctors, other health professionals, improve our infrastructures and start having health prevention&promotion policies that finally have some meat in them. I would gladly drop the "self-employed" status, let them handle the retirement savings etc. and have a much lower salary. I'm in it for the hourly rate salary if it means I get to spend the time it takes with my patients. 

I would prefer anytime to be in the middle income bracket but wake up knowing I get to work in an environment that makes it easier and feasible for me to truly help my patients that require lots of follow-ups and longer consultation to finally target that behaviour change they need to not end up in the emergency with clogged up arteries and glycemia through the roof in a decade; to not have to enter a room and know that for 8 minutes I will probably give half-a**ed advices to an overwhelmed patient that probably wont have the motivation I should have helped him get to apply those changes. And not having to head to a sinking health system and try to patch it up with glue and paper.

Even though I can respect the idea that for some the salary is a very important component of the profession and that it is justified by the length of the program, the academic costs (which aren't high in Quebec, so I cant speak on this one) & de liability. But on a practical and ethical point of vue the idea of maintaining our salaries that high doesn't add up. And I tried to debate it the other way around, but it just doesn't hold up with our own deontology, not if the patient's wellbeing is our number one, sinequanone priority. 

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14 hours ago, HalfBaked said:

I would without hesitation. I think it's very important to recognize how doctors' high salary are becoming a challenge in establishing trust with the population and soon with patients and other health professionals. We can justify an above-average salary (around 100k) with the arguments raised above, but not that high a salary. Human beings are greedy in nature, it's normal, but it's not acceptable when it starts preventing us from delivering quality care that is as accessible as possible. 

The salary doctors defend right now cause our whole health system to be held hostage to the high fees we demand. I'm down anytime to see our paychecks cut in half so we can hire more doctors, other health professionals, improve our infrastructures and start having health prevention&promotion policies that finally have some meat in them. I would gladly drop the "self-employed" status, let them handle the retirement savings etc. and have a much lower salary. I'm in it for the hourly rate salary if it means I get to spend the time it takes with my patients. 

I would prefer anytime to be in the middle income bracket but wake up knowing I get to work in an environment that makes it easier and feasible for me to truly help my patients that require lots of follow-ups and longer consultation to finally target that behaviour change they need to not end up in the emergency with clogged up arteries and glycemia through the roof in a decade; to not have to enter a room and know that for 8 minutes I will probably give half-a**ed advices to an overwhelmed patient that probably wont have the motivation I should have helped him get to apply those changes. And not having to head to a sinking health system and try to patch it up with glue and paper.

Even though I can respect the idea that for some the salary is a very important component of the profession and that it is justified by the length of the program, the academic costs (which aren't high in Quebec, so I cant speak on this one) & de liability. But on a practical and ethical point of vue the idea of maintaining our salaries that high doesn't add up. And I tried to debate it the other way around, but it just doesn't hold up with our own deontology, not if the patient's wellbeing is our number one, sinequanone priority. 

Salary should depend on market value for services provided and should be properly relative to other health care providers. It's not fair to have doctors train for so long, work long hours, and carry huge responsibility to be paid 100k which you can make as a nurse in many cases. It is also a massive task to convert all of the private clinics we have out there into public clinics with the physicians all being placed on salary instead of fee for service. I think this is just not feasible.

And I think it's important to note that just by lowering what physicians make by half (which let's be honest here, we're not being realistic), you could train twice as many doctors. Physician income isn't only limiting factor here, there are real capacities in terms of medical school spaces. Medical schools and hospitals can only handle so many trainees in the current system.

There are other ways that time spent with patients can be maximized at the system level. These inefficiencies need to be addressed first, but of course doing that actually takes more work than just blanket reducing physician income, and so it's easy for politicians to fall back on the latter. We need to first properly integrate the EMR in the province (and country), streamline the way ER's and hospitals run so that patients are seen in a more efficient manner by all the relevant providers and that communication between these providers is seamless, discharge/transition notes on the system need to be made more accessible and user-friendly, etc.) The list just goes on and on if one takes the time to properly investigate. QI needs to have a much bigger role (and it is thankfully expanding). But the results from QI also need to be examined and distributed at higher levels (i.e. if a hospital does a local QI project that shows a change to their transition document system results in a reduction in patient wait times and improvement in outcomes, someone needs to take the time to see if it can be applied to other hospitals, and to implement that change). It's crazy how much small things like this in our increasingly complicated system can improve the patient experience, I've personally seen patients discharged over 3 months ago but a simple discharge note hasn't been done because the resident in charge of it was replaced by someone new as they moved onto a different rotation, but the system didn't notify the new resident. This is dangerous for the patient, but also extremely inefficient as it wastes more time and resources for future health care workers for that patient to have to go back and find out details about that discharge when this information should be readily available to them.

Addressing the above first properly, and then seeing where cuts need to be made to make the books balance  is the correct way to improve our health care system, not hire 1000 new bureaucrats with poorly defined roles and then point to the overworked emergency physician who makes 400k as the problem.

That's my 2 cents anyway.

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18 hours ago, HalfBaked said:

I would without hesitation. I think it's very important to recognize how doctors' high salary are becoming a challenge in establishing trust with the population and soon with patients and other health professionals. We can justify an above-average salary (around 100k) with the arguments raised above, but not that high a salary. Human beings are greedy in nature, it's normal, but it's not acceptable when it starts preventing us from delivering quality care that is as accessible as possible. 

The salary doctors defend right now cause our whole health system to be held hostage to the high fees we demand. I'm down anytime to see our paychecks cut in half so we can hire more doctors, other health professionals, improve our infrastructures and start having health prevention&promotion policies that finally have some meat in them. I would gladly drop the "self-employed" status, let them handle the retirement savings etc. and have a much lower salary. I'm in it for the hourly rate salary if it means I get to spend the time it takes with my patients. 

I would prefer anytime to be in the middle income bracket but wake up knowing I get to work in an environment that makes it easier and feasible for me to truly help my patients that require lots of follow-ups and longer consultation to finally target that behaviour change they need to not end up in the emergency with clogged up arteries and glycemia through the roof in a decade; to not have to enter a room and know that for 8 minutes I will probably give half-a**ed advices to an overwhelmed patient that probably wont have the motivation I should have helped him get to apply those changes. And not having to head to a sinking health system and try to patch it up with glue and paper.

Even though I can respect the idea that for some the salary is a very important component of the profession and that it is justified by the length of the program, the academic costs (which aren't high in Quebec, so I cant speak on this one) & de liability. But on a practical and ethical point of vue the idea of maintaining our salaries that high doesn't add up. And I tried to debate it the other way around, but it just doesn't hold up with our own deontology, not if the patient's wellbeing is our number one, sinequanone priority. 

May I ask where are you in your training? 

I think perspectives do change as you progress along in your training. It certainly has for me.

Ontario students have a student debt (Undergrad + Med school in Ontario) of more than $150,000 at the end of graduation. If the student also has a mortgage of $300,000, he/she can barely make ends meet with a PGY-1 salary.

Edited by ArchEnemy

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