The “deceptive” income of physicians

One perennial topic of profuse internet discussion, ranting, and general circle-jerking among medical students, American medical students in particular, is the idea that doctors’ incomes are “deceptively” high, and that really, when you take all the cost and effort of training into account, physicians don’t really make any more money than [insert some other “humbler” profession of your choice]. This is a topic that pervaded blogs and forums back when I was a bright-eyed pre-med seeking advice for my med school applications, and it continues to be a popularly repeated topic now, as I near graduation. Most recently, this article has been making the rounds on reddit, and to be honest, I’m really sick of it. Yes, medical education is expensive. Yes, the training is long. Yes, you have to work hard. And no, you probably shouldn’t decide to go into medicine if money is your only objective. And I do think that we probably deserve the high salaries that we’ll eventually get. But what’s this need to compare ourselves to everyone from high school teachers to nurses in order to “prove” how much “worse” we have it?

We were the ones who, of our own free will, decided to put ourselves through this. Because, after careful consideration, we thought that it would be worth it. Few of us came into this blind. Most of us could have succeeded in any number of other potential professions. And if we really thought that it would have been better to become high school teachers, dentists, and nurses, we would have picked a different path. Can we really not just be happy with our career choices without trying to convince everyone else that we’re all a bunch of self-sacrificing martyrs who have dedicated our lives to the thankless service of humanity?

I think the real reason that these kinds of discussions keep happening is that we’re afraid. With all the recent talk about runaway healthcare costs and “bending the curve,” many members of the lay public have looked at doctors’ salaries as a potential place cut costs. And so we’ve become defensive. We’re afraid that by the end of our grueling training (and I do agree, as anyone who has done 24-hour call or worked an 80+-hour week will, that the training is grueling), after we’ve all worked so hard to be worth what we thought we’d be worth, that by then, our salaries will have been cut to pieces and the journey wouldn’t have been worth it at all anymore. So we make ridiculous claims about how we should have all just become high school teachers instead (since no one could ever accuse a humble high school teacher of making too much money), not because we actually believe it, but because we want to convince everyone else to sympathize with us. And somewhere, deep down, with the smallest tinge of guilt (because most of us did go into medicine, at least in part, because we had some selfless notion of wanting to “help people”), maybe we do wonder if doctors might just be a little tiny bit overpaid after all. But as soon as that thought surfaces, we drown it again in another wave of facts and figures and comparisons.

4 thoughts on “The “deceptive” income of physicians

  1. I was waitlisted (unofficially rejected) for medical school this past admissions cycle and I can honestly say I’m glad that’s how things turned out. I was so gung-ho about attending medical school just to protect my ego and of course get away from a certain someone, but I actually did some thinking about it and asked myself will I really be happy in medicine. I eventually figured out what I wanted in my life and also realized that I don’t really like how doctors think of themselves. (Some like to think they’re basically god/martyrs/things of that nature. I’m sure you’ve encountered colleagues that were a bit like that.)

    To put yourself through the rigors of medical school requires a lot of balls and the worst thing any person could do is to get into medicine simply because of monetary purposes.

    I understand why you would be sick of the discussions about “deceptive” income of physicians, and I agree with you wholeheartedly. They did after all put themselves (physicians) in that position; they chose medicine, now they have to deal with the system.

    I wonder… Could the shortage of physicians have anything to do with this dilemma? Or does the problem start from the beginning, where students start to apply to medical school? With the shortage of physicians, I wonder why medical schools don’t increase their seats for admission…

    • I think that self-confidence is more or less part of a doctor’s job description– patients want their doctors to be sure of themselves, especially where risky procedures or life-and-death decisions are concerned. From there, it may be a fine line between confidence and arrogance. Despite the stereotype, though, most of the doctors that I’ve interacted with have been not been full of themselves, and I certainly hope that I’ll be able to remain humble as I go through my training.

      Med schools have been making efforts to increase their enrollment– larger class sizes, new schools opening, etc. While medical schools certainly still are a bottle-neck, I think the bigger bottle neck is the number of residency positions, which has remained largely constant because residency programs rely on government funding. In the past, there weren’t enough US medical school graduates to fill all the training slots and the difference was made up by foreign graduates, who were willing to train at less desirable institutions or in less desirable specialties. With increasing US medical school enrollment, a greater proportion of residency spots are now being filled by US graduates, but the total number of physicians being trained (foreign and US graduates) is about the same.

  2. I can name people who think that high school teachers make too much money, and they draw a lot of comparisons to other higher professionals to “prove” it. No matter who you are, some people will think that you don’t deserve your pay.

    In all honesty, I think that good doctors certainly deserve, and should get their pay! I was told by a professor from Taiwan that in Taiwan, surgeons are not paid well, so the country does not have enough people willing to endure the years and years of training to become one.

    • The truth of the matter is that people are continuing to flock to medicine in droves, and many qualified med school applicants are turned away each year (I think something like half of all med school applicants fail to gain admission every year). Meanwhile, good public school teachers remain scarce, especially in math and science. So they can argue all they want about how overpaid teachers are and how underpaid doctors are, but it’s clear that people think medicine is a much more desirable career choice than teaching is, and it would be hard to believe that salary doesn’t play a role.

      My point wasn’t about whether or not doctors deserve their salaries–I think they probably do–, but about how we (med students and doctors alike) shouldn’t whine about how underpaid doctors are and how hard/long the training is, etc., etc. I hate how they try to paint this ridiculous picture of how saintly we all are to dedicate our lives to helping others for a mere $200k salary.

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