Was surfing the net the other day and found this at Forbes.com. According to the medical search and consulting firm Merritt Hawkins & Associates' 2010 Review of Physician Recruiting Incentives, the ten worst paying specialties are:
Emergency Medicine ($247,000)
Family Practice with Obstetrics ($200,000)
Internal Medicine ($191,000)
Family Practice ($175,000)
Now, I find it odd but not surprising, that half of the specialties on that list are currently experiencing shortages across the country. After all, how can you practice medicine, even medicine that’s your passion if it doesn’t pay even a living wage? (The figures above are gross income and don’t include the $60-100,000 a year malpractice insurance charges, clinical overhead, such as lab tests and new equipment, or the $140,000 in student loans the average medical student racks up.)
So how did we, as a nation and a society, end up paying the doctors we’re most in need of the least money? So little, in fact, that even the medical students across the country that have a passion for family or internal medicine end up in other specialties simply because they can’t afford to do anything else.
A lot of the problem comes directly from the AMA (American Medical Association) which sponsors a committee charged with deciding how much a doctor's time is worth in Relative Value Units (RVU’s). These RVU’s determine how much Medicare will pay a doctor for a procedure. They also determine, in a roundabout way, how much your insurance will pay, since insurance carries take their cue from Medicare when deciding how much to pay. Basically, the more difficult a procedure is, the more it’s worth. By their reckoning, intubating a patient is more valuable, monetarily at least, than face to face time with a patient in the office for a fifteen minute check-up even though the first takes much less time.
This system leaves physicians in primary care making half the money of specialists in a lot of cases. Not surprisingly, less money means less PCP’s, and we need those providers. Thanks to a not very well thought out new national healthcare plan, the demand for PCP’s is set to increase exponentially while the supply will only continue to decrease.
Something’s gonna have to give.