Doctors, Incomes, and Fancy Cars

moneyPeople look at the cars in the doctors’ parking lot to estimate MD income.  Most folks still think that doctors are loaded, and doctors generally like to be thought of as rich.
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This post looks at physician income, motivation, and public myths about what doctors get paid.
In a private medical system, if doctors don’t drive a Lexus or better, they must not be a good doctor.

In a publicly funded system, doctors should drive a Honda, otherwise we pay them too much!

Physician Income:

1. Physicians who work more, earn more.
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Most MDs do not receive a salary; they increase their earning by working longer hours.  Like any self-employed business person in a market that needs your services, time and energy are the only limits to earning.  No matter what you earn per hour, if you work 100 hour weeks, you will earn $$$$, too.
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2.  Physician income does not equal take-home pay.
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Most physicians hire staff, pay rent, lease equipment, and carry dozens of other expenses related to running a small business that eat up 35% of gross billings.
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3.  Physicians do not receive benefits.
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MDs pay for their own pension, medical, dental, vacation, etc.  Benefits typically cost 25% of income.
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4.  Physicians earn less than other professionals.
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With similar training and experience (or much less), professionals in other industries (law, dentistry, finance) earn more.
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5. Physicians don’t own all their bling.
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Physicians aren’t known for financial prudence or frugal living.  Fancy cars are often leased: one more payment to a stack of debt.

Physician Motivation:

1. Delayed gratification.
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After 12-15 years of University, many physicians think they’ve earned the right to spend.  After watching friends in other professions buy houses and raise families, physicians think they’ve earned the right to go deeper into debt with a fancy car.
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2. Societal expectation.
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Despite begrudging envy, non-physicians expect doctors to spend.  They look askance if MDs drive up in an old vehicle.  People need to see extravagance, any extravagance, to justify their firm conviction that physicians are loaded.
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3. Peer pressure.
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Very few docs resist dressing, spending, and living like their colleagues.

Summary

Physicians do very well and work very hard for it.  Anyone who trains for years and works hard can do as well, or better, in North America.  What’s holding you back?
(photo credit: asianweek.com)

Healthcare Big Data in 3 Easy Steps

big-data-iceberg1Big Data will change the way we practice, fund, and regulate medicine. Patients and clinicians need to know how this will impact them.
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This post asks “What is Big Data?“, “How Will It Help Healthcare?“, and “What Should We Watch out for?
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What is Big Data?
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We hear about it when giant companies collect every mouse click, or every second you spend on each website you visit.  Data sets balloon in size and complexity beyond what common computing can handle.

 
Now imagine collecting every bit of information to do with healthcare: labs, x-rays, clinic visits, public health data, billing data, payer databases, electronic medical records, pharmaceutical databases…everything.

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Just collecting it would be a nightmare; trying to make sense of it all at once seems impossible.
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Big Data tackles both.
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You could imagine it’s a giant vacuum and catalogue system for structured and unstructured data; anything an organization or industry might want. To learn more check out:  Big Data Revolution, McKinsey website, Wikipedia.

How Will It Impact Healthcare?

  • transparency improves
  • detailed information become available
  • accuracy sharpens
  • storage capacity expands
  • analytics improve quality, accountability, and decision-making for individuals and groups

What Should We Watch Out For?

  • privacy presents the biggest challenge
  • control by non-experts:  insurance companies, government
  • relevance – should be relevant to healthcare not general interest
  • improvement – not punitive
  • abuse:  people/governments/companies using data for personal gain; creating value only for themselves
  • confusing correlation with causation – data will show associations that might have no relation to causality
  • limits – Should we collect everything? Personal details?
  • overuse – Big Data is a sledgehammer that might be used for everything when simpler approaches would be more cost-effective (big data problems)

Big Data is here. How are we going to benefit patients with it?

Doctor Bashing in #TheGlobeandMail Re: Unemployed MDs

businessinsider.com
businessinsider.com

Mr. Picard makes it sound like presumptuous, young docs refuse to compromise their dreams and would rather be unemployed than work in rural towns: How poor HR planning leads to unemployed doctors – The Globe and Mail.

He’s wrong.

No doubt, some physicians would sooner be unemployed than work as the only specialist in a rural setting where they are on call 24-7.  But, most unemployed docs are surgeons who can’t get operating room time.

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If the system can’t pay for surgical suites, then surgeons can’t work, and patients will continue to suffer on waiting lists.

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Let’s work together to find system solutions to patient waits and unemployed physicians instead of distracting with gratuitous slams on doctors.