Because it's a really difficult job that requires a lot of training. The question is not why doctors make that much, the question is why so many other people make so little.
A lot of training that you have to pay a lot of money to get, then more on the job training that you get paid (relative) peanuts for.
A lot of other countries have better support for people during these training periods, so the US equivalent takes on a lot more debt and a lot more risk to attain these higher salaries.
If the barriers to entry in the medical field were lower, the salaries would be as well.
I looked up salaries of Canadian doctors just to compare. Seems like the average is about $300,000 Canadian dollars or about $225,000 USD. So Canadian doctors make about 2/3rds of what they make across the border. That indicates its not necessarily all about training or difficulty.
It's a common problem in Canadian healthcare that workers leave to the US for a considerable pay bump, which is part of what the article talks about. Are American doctors just in it for the money?
Canadians in many fields make 2/3rds or less than their American counterparts.
Also, education is more subsidized in Canada.
Are American doctors just in it for the money?
This is a strange question. You think European or Canadian doctors are just more noble and selfless? They all take the best salary they can get, all other things being equal. But the US has a higher median income along with a convoluted medical system in which profits are unusually high, and doctors get a share of that.
Or is it related to the fact that the US health care system is a profiteering scam.
[“In general, U.S. physicians are making about 50 percent more than German physicians and about more than twice as much as U.K. physicians,” ]
The closest that I would say there is to profiteering is that the American medical education is a very long hazing ritual where the financial risk of not becoming a doctor falls on the students.
First of all, that's not a lot of money.
No. Really.
That's about $197,000 in 2000 dollars. $123,000 in 1985 dollars
Our idea of a comfortable salary largely depends on when you entered the workforce.
Now, adjusting for inflation we see that doctors are actually paid slightly better today than they were back then. HOWEVER, we also have to consider the skyrocketing cost of medical school and student loans.
Even if at the end of all the calculating doctors are actually making slightly more than that used to... that's a great thing, right? Shouldn't we all want salaries to trend upward in real buying power over time?
The ONLY scandal here is that all the rest of us have had our share of the wealth WE generate stolen from us.
Sure, people making more money is a good thing. Well, as long as it's distributed relatively equally. The issue that I personally take with their salary, especially when considering inflation (which most of us can't say the same) is the massive decrease in care. I don't think it's fair for doctors to make more and more money every year, while providing CONSIDERABLY less or worse care.
Doctors in most practice settings have very little control over the quality of care these days, believe it or not. Several factors converged. One was an unintended side effect of anti-kickback and anti-fraud laws like the Stark Law preventing ownership of healthcare facilities by the physicians who practice there to prevent the temptation to provide superfluous and unnecessary tests for the sake of extra billing money.
This opened to door to corporate ownership, and doctors gave up too much of their autonomy and control, becoming "mere" corporate employees like the rest of us. The corporations deliberately understaff and just push more and more and more patients onto doctors, nurses, respiratory therapists, everyone all across the board are being expected to take on more and more. Which of course degrades the quality of care.
It's the corporations keeping the excess profit generated, not the physicians. Physicians have finally started seeing what's going on and unionizing (at least up here in Massachusetts - University of Massachusetts and Mass General Brigham are both major hospital systems where resident doctors have unionized.) And it's the resident ("junior") doctors who are currently on strike in the UK.
Honestly, we need to get hospital ownership out of corporate hands and back into the hands of the providers who are motivated to take care of patients. We need to figure out better mechanisms for regulating fraud
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I see a lot of reference to Europe-based medical practices being thrown around with no context other than, "This number bigger," so I'm hoping to clarify a few points from my own experience:
For one, the M.D. path for an American student is longer than the bulk majority of European countries you're referencing. European medical training begins after high school graduation, while American students have to complete 4 years of undergrad first. Only then do they complete 4 years of medical school, followed by 3+ (in my case, 5) years of residency. Depending on specialty of practice, a fellowship of 1-3 years after residency might also be required.
That extra four years of undergrad had me starting med school with a baseline of $100k in student loan debt (public, in-state university) that continued to accrue interest while I trained.
Then there's the matter of medical school cost in the US. I went ahead and checked my loan account for you, even though it gives me an ulcer to look at. Just shy of $400k is how much I'll have to pay back for those four years of training. When added to my monthly payment for undergrad loans I anticipate paying about $5k per month in loan bills alone. Medical training in other countries is subsidized to the point of being free for those accepted into an M.D. program. The UK is a bit of an exception, but their average annual tuition is the equivalent of $13k per year and still way, way less than the requirement here. I'd happily take a lower salary if I could know there wasn't going to be a giant debt hanging over my head until I'm at retirement age.
There's also a big discussion to be had about not starting to save for retirement until you're in your early 30s, but I've already gotten a bit long-winded here. The point is this: The salaries are higher because we fully bear the cost of our own training up front--for longer--and are expected to pay it back ourselves.
Others have already made the point for me, but we're a small drop in the bucket if what you're truly worried about is the cost of healthcare in the country overall. For that, you need look no further than hospital CEO salaries, nightmarish insurance companies, and the ludicrous cost of medicines courtesy of pharma.
"guys it will take me like 5 years to pay off my med school debt" is not the argument you think it is.
Facts are, the ADA lobbies Congress to restrict residencies to artificially restrict the number of doctors and that is bad for everyone
I'm all for helping doctors pay for/removing costs for med school, but that's going to be meaningless without changing residency restrictions
Thank you for a reasonable take
They are incredibly useful.
They are incredibly useful in the UK and Germany also, where according to the article they make a lot less.
Now do insurance executives.
Why don't doctors make more?
