Why is Anesthesiology median salary so high?

[FrontlineWarrior]

i am a medical student.

first of all, if you reduce salary to 75k a year, even if you paid for my loans i wouldn't go to medical school. smart people will do something else, and less qualified people will fill the wards.

second, if you open up medical school enrollment, there will be A LOT of complete idiots becoming doctors and severely endangering people's lives. even with difficult admission standards for medical school, there are several that slip through the cracks. these people are truly frightening. trust me, you do not want to open up admissions just to lower healthcare costs, because people will die. this "artificial" supply you speak of is not too different than initial quality control. and with only a 75k carrot at the end of the stick, the dropout rate will be very high. medical school and residency training is TOUGH. it is 7-13 YEARS of training AFTER COLLEGE. for what, 75k a year? would you do that? would anyone?

third, reducing physician salary will do almost nothing to lower the healthcare costs of this country. however, it WILL dramatically reduce the quality of physicians and thus healthcare. in the US there are about 600000 physicians. average salary is around 200k/yr. that totals 120 billion dollars. healthcare expendatures topped 1.6 TRILLION dollars. physician salary makes up about 7.5%. compare that to the ADMINISTRATIVE costs, which top 500 billion. this adds nothing to healthcare, yet takes up about ONE THIRD of all healthcare costs.

now you tell me, is it better to save 5% to keep physician salaries at 75k, and completely screw up the quality of your healthcare, or would you rather find ways to cut administrative costs and keep the quality of care similar?

 

[FrontlineWarrior]

i will also add that anesthesiology salaries are high because there is a shortage of anesthesiologists. several years ago there was a fear that certified registered nurse anesthetists (CRNAs) would take all the jobs, and/or reduce salaries to nurse levels. guess what happened? the number of US trained medical students entering the field of anesthesiology PLUMMETED, and all the talented students went elsewhere. now because of that, there is a shortage, salaries are up, and the quality of students entering the field is rising again. salaries these days are somewhat artificially elevated due to the shortage; many anesthesiologists earn a higher salary that some surgeons, and much more than those in primary care (family medicine, internal medicine, obstetrics, pediatrics).

the funny thing about anesthesia is that it's gotten very safe due to lots of adjustments in protocol and technology. so safe that many highly trained nurses can do a vast majority of the job that MD trained anesthesiologists do, though not all. so even though the number of applicants dropped, there is no evidence that quality of healthcare dropped. however you can't take this example and apply it to the rest of medicine because other fields do not have as many technological safeguards in place, but rather the safeguards in other fields are within the doctors themselves. anesthesiologists have big machines that let them know when things are wrong. surgeons rely on their training and instinct; not big machines.

 

[msparish]

Originally posted by: FrontlineWarrior
second, if you open up medical school enrollment, there will be A LOT of complete idiots becoming doctors and severely endangering people's lives. even with difficult admission standards for medical school, there are several that slip through the cracks. these people are truly frightening. trust me, you do not want to open up admissions just to lower healthcare costs, because people will die. this "artificial" supply you speak of is not too different than initial quality control.

Then why don't they just admit the smartest/highest achieving people in the first place? You don't have to be a genius to be a very good doctor. You do need to be a hard worker with above average intelligence.

Again, there are many, many rejected applicants who had higher GPAs and MCAT scores than many of those who were admitted to medical school. Sure, if you have a 4.0 and a 40+ you don't have much to worry about, but there are many people scoring 27's who don't get in while several who score 24 do. Med school admissions could be increased noticably without generating doctors who are any less knowledgable. On the other hand, would not argue that there are thousands of applicants every year who have no business in med school (trust me, I've met several).

My argument was to those claiming to let the free market decide. The free market cannot decide because there is an artificially limited supply. If the free market did decide, there is no way that an anesthesiologists salary would be 75k, but it would be somewhat lower than where it is today.

I agree with you that physician salaries are not the primary cause of high medical prices.

 

[FrontlineWarrior]

the reason for why admissions chooses those with lower scores is probably due to the fact that they got a lot of flack in the past for filling the schools with socially inept people who couldn't deal with the other aspects of healthcare. sure you could fill the schools with only those with very high gpas and MCAT scores. but would you want these people to be your doctor? i'm not sure i know the answer to that. most of medicine isn't like your typical computer desk job where you can sit alone and never interact with anyone. it's kind of like hiring a waitress; do you hire the one that serves the food the quickest or one that gets along with the customers too and delivers an overall satisfactory dining experience? like you said you don't have to be a genius to be a doctor. but there are some standards. not rigid standards, but standards. i personally don't think anyone with a 24 belongs in medical school but that's just my bias. if admissions committees see something about the applicant that outweighs the lower score then i guess they know more than i do. in any case, being able to filter through the wannabes early on with the core science requirements, then with the mcat, then with interviews, allows schools to be selective and choose the candidates they feel are most qualified. it's kinda beside the point to argue which aspects lead to better doctors. that's the admission committee's job. my concern is only that there is a choice, and that the talent pool is not diluted, without specifying what the specific talents are.

as for a "free market", would you want the medical profession being the same as the legal profession? there are tons of unaccredited law schools training mediocre lawyers. as long as they pass the bar they can practice law. many of them are completely incompetent, prey on fear and wreak havoc on society. there are great lawyers that charge millions, other who barely make 30k a year. the end result is that the quality of legal representation varies a lot and the richest get the best, poor get public defense attornies who don't give a damn.

now would you want medical professionals being trained at unaccredited schools, having only to pass a few tests to prescribe life altering medications and surgeries? doctors deal with people's lives. when a lawyer mismanages a case you usually don't die. when a doctor screws up, it's very very bad. right now the vast majority of doctors provide excellent health care in america. with a free market you will have snake oil people opening up shop on every corner providing terrible healthcare, leaving the good care only to those with enough money.

cliffs:
choice for admissions committees is good
reasons why people don't get in are various. you can have good scores and be a sociopath. you can be really nice and caring but dumb. point is to screen people out who are lacking in one or more areas.
admissions could be increased slightly more than now, but cannot a free for all.

 

[msparish]

Originally posted by: FrontlineWarrior
the reason for why admissions chooses those with lower scores is probably due to the fact that they got a lot of flack in the past for filling the schools with socially inept people who couldn't deal with the other aspects of healthcare. sure you could fill the schools with only those with very high gpas and MCAT scores. but would you want these people to be your doctor? i'm not sure i know the answer to that. most of medicine isn't like your typical computer desk job where you can sit alone and never interact with anyone. it's kind of like hiring a waitress; do you hire the one that serves the food the quickest or one that gets along with the customers too and delivers an overall satisfactory dining experience? like you said you don't have to be a genius to be a doctor. but there are some standards. not rigid standards, but standards. i personally don't think anyone with a 24 belongs in medical school but that's just my bias. if admissions committees see something about the applicant that outweighs the lower score then i guess they know more than i do. in any case, being able to filter through the wannabes early on with the core science requirements, then with the mcat, then with interviews, allows schools to be selective and choose the candidates they feel are most qualified. it's kinda beside the point to argue which aspects lead to better doctors. that's the admission committee's job. my concern is only that there is a choice, and that the talent pool is not diluted, without specifying what the specific talents are.

I agree with most of that. My points were just to counter the argument of "letting the market decide." I think med schools do a pretty good job of choosing the right people, although they do make some mistakes. My main point was that if the market is to decide, enrollment caps must be eliminated...which I believe is better than capping doctor salaries. Either way, there would be some brain drain.

 

[FrontlineWarrior]

also i should also note that enrollment caps for medical school is only part of the issue. the cost of medical education far exceeds the tuition that medical students pay. it is also expensive to train doctors in residencies. resident doctors earn about 50k, but it costs around 150k a year to train them. most of the money comes from uncle sam. so let's say we open up the medical training to a "free market." the question is, who will train all these doctors? as mentioned, training medical students costs more than the tuition by several fold. what kind of free market would voluntarily lose money, and at the same time flood their own market with potential competitors?

it is true that some hospitals gain financially from training residents, because the feds give about 150 per resident to train them, and resident salaries are only about 50k. but that money has to come from somewhere, and i doubt uncle sam will be thrilled about spending 150k a year to train any wannabe doc in the country.

the free market cannot sustain medical education, unless we are all trained through books only, or something ridiculous like that.

 

[BlueWeasel]

Given current health care costs, why would any hospital need govemment subsidies for resident training?

 

[OrganizedChaos]

simple answer? its scary fvcking work.

every patient you meet could be the end of your carear.

 

[FrontlineWarrior]

well, like i said, it costs money to train residents. academic hospitals obviously have clinical teaching as part of the job description for their physicians, and they are usually paid a salary. and they don't necessarily have problems taking profits of one area (e.g. surgery) and spending it on another (e.g. resident training), as pure financial gain is not the goal of academic centers. however, a lot of resident training also occurs at private hospitals, where there are private physicians with their own private patients, who do not have a fixed salary, but earn their own money, whether or not residents get trained. in this environment, it is much more difficult to offset the costs from one area to another, as the money will have to come from somewhere, i.e. from someone's own pocketbooks. i suppose the hospital administration could spend some money to train residents, but private hospitals are a business, made for profit. it is not in their interest to have residents intrude on private patients and private physicians so that they can take a financial loss.

btw i just looked up some stuff about govt subsidies, and apparently they were created in conjunction with medicare in order to increase the number of physicians and increase public access to healthcare.

http://www.physiciansnews.com/commentary/797dv.html

 

[Sukhoi]

I once woke up during major surgery on my leg. That anesthesiologist got paid too much.

 

[BUrassler]

Originally posted by: BlueWeasel
Given current health care costs, why would any hospital need govemment subsidies for resident training?

Hospitals are closing left and right because they are in the red ever year. Thats the amazing part.

 

[CFster]

The doctor that delivered out first child pays $85K a year in malpractice insurance. She said she wants to get out of the business.

 

[DivideBYZero]

Originally posted by: FelixDeKat

Originally posted by: alchemize
I wonder who'd be willing to put themselves under the gas of a 50K a year anesthesiologist? I got folks that work for me that make more than that and they can barely program.

50k was the first stab. Its 75k+ now. Programmers are paid too much too.

A regular Doctor in the UK that you go to when you have a sore throat or cock-rot can earn up to £250,000 depending on services they provide. This is Social care. They earn it in most cases.

To say an Anesthetists shouldn't earn more than roughly £50,000 seems a bit skewed when they are keeping a person alive while they have essential life saving invasive surgery.

You really don't understand the way the world works, so stop posting about it.

 

[PlatinumGold]

Originally posted by: DeathBUA
They essentially will monitor the patients vital signs and put them under and bring them back. They adminster drugs as necessary throughout an operation. If anything goes wrong, they tend to be solely responsible. Also an Anesthesiologist may watch over several CRNA's(essential a nurse trained in Anesthesia who performs the same tasks as an Anesthesiologist but is limited in scope of practice in most states because they are still 'only' a nurse) as well and they are also responsible for those patients.

it's also a situation of demand.

every hospital HAS to have some anesthesiologists on staff. so the hospital has to compete with pain centers and private practices.

 

[mrrman]

thats the field I wish I went into...

 

[Strk]

Originally posted by: Sukhoi
I once woke up during major surgery on my leg. That anesthesiologist got paid too much.

Seriously? Or was it an issue where you become consious but still "out?"

Oh, and before thinking of even approaching capping lawsuits and salaries, why not go after how malpractice insurance is handled? Right now, any lawsuit causes your rates to increase - regardless of the outcome (I.e. someone tries to make a quick buck off their doctor, but it turns out to be completely false, the rates still increase).

 

[JS80]

Originally posted by: FrontlineWarrior
the reason for why admissions chooses those with lower scores is probably due to the fact that they got a lot of flack in the past for filling the schools with socially inept people who couldn't deal with the other aspects of healthcare. sure you could fill the schools with only those with very high gpas and MCAT scores. but would you want these people to be your doctor? i'm not sure i know the answer to that. most of medicine isn't like your typical computer desk job where you can sit alone and never interact with anyone. it's kind of like hiring a waitress; do you hire the one that serves the food the quickest or one that gets along with the customers too and delivers an overall satisfactory dining experience? like you said you don't have to be a genius to be a doctor. but there are some standards. not rigid standards, but standards. i personally don't think anyone with a 24 belongs in medical school but that's just my bias. if admissions committees see something about the applicant that outweighs the lower score then i guess they know more than i do. in any case, being able to filter through the wannabes early on with the core science requirements, then with the mcat, then with interviews, allows schools to be selective and choose the candidates they feel are most qualified. it's kinda beside the point to argue which aspects lead to better doctors. that's the admission committee's job. my concern is only that there is a choice, and that the talent pool is not diluted, without specifying what the specific talents are.

as for a "free market", would you want the medical profession being the same as the legal profession? there are tons of unaccredited law schools training mediocre lawyers. as long as they pass the bar they can practice law. many of them are completely incompetent, prey on fear and wreak havoc on society. there are great lawyers that charge millions, other who barely make 30k a year. the end result is that the quality of legal representation varies a lot and the richest get the best, poor get public defense attornies who don't give a damn.

now would you want medical professionals being trained at unaccredited schools, having only to pass a few tests to prescribe life altering medications and surgeries? doctors deal with people's lives. when a lawyer mismanages a case you usually don't die. when a doctor screws up, it's very very bad. right now the vast majority of doctors provide excellent health care in america. with a free market you will have snake oil people opening up shop on every corner providing terrible healthcare, leaving the good care only to those with enough money.

cliffs:
choice for admissions committees is good
reasons why people don't get in are various. you can have good scores and be a sociopath. you can be really nice and caring but dumb. point is to screen people out who are lacking in one or more areas.
admissions could be increased slightly more than now, but cannot a free for all.

I would think you're a little biased. Don't tell me you need to be a genius to tell someone he has a cold and prescribe him antibiotics. There are plenty of physician jobs that people who get rejected from med schools can do. The problem is that the AMA has a monopoly on the supply of doctors, and it is not in their interest to increase the supply of doctors (even at the same ratio as the increase in population).

 

[Sukhoi]

Originally posted by: Strk

Originally posted by: Sukhoi
I once woke up during major surgery on my leg. That anesthesiologist got paid too much.

Seriously? Or was it an issue where you become consious but still "out?"

Yeah. The surgery it would have happened during was either the one when I was five or seven. Being that long ago it's possible I've had some super-realistic dream since then and believe it as truth, but I'm pretty sure it happened.

I remember waking up, opening my eyes, and looking around. That was physically all I could do as the rest of me was paralyzed from the anesthetic. I couldn't feel anything, though I could hear all the loud-ass (at least to me) beeping from the machines in the room. Then someone called out "he's awake!" and I conked back out soon after.

 

[FrontlineWarrior]

Originally posted by: JS80

Originally posted by: FrontlineWarrior
the reason for why admissions chooses those with lower scores is probably due to the fact that they got a lot of flack in the past for filling the schools with socially inept people who couldn't deal with the other aspects of healthcare. sure you could fill the schools with only those with very high gpas and MCAT scores. but would you want these people to be your doctor? i'm not sure i know the answer to that. most of medicine isn't like your typical computer desk job where you can sit alone and never interact with anyone. it's kind of like hiring a waitress; do you hire the one that serves the food the quickest or one that gets along with the customers too and delivers an overall satisfactory dining experience? like you said you don't have to be a genius to be a doctor. but there are some standards. not rigid standards, but standards. i personally don't think anyone with a 24 belongs in medical school but that's just my bias. if admissions committees see something about the applicant that outweighs the lower score then i guess they know more than i do. in any case, being able to filter through the wannabes early on with the core science requirements, then with the mcat, then with interviews, allows schools to be selective and choose the candidates they feel are most qualified. it's kinda beside the point to argue which aspects lead to better doctors. that's the admission committee's job. my concern is only that there is a choice, and that the talent pool is not diluted, without specifying what the specific talents are.

as for a "free market", would you want the medical profession being the same as the legal profession? there are tons of unaccredited law schools training mediocre lawyers. as long as they pass the bar they can practice law. many of them are completely incompetent, prey on fear and wreak havoc on society. there are great lawyers that charge millions, other who barely make 30k a year. the end result is that the quality of legal representation varies a lot and the richest get the best, poor get public defense attornies who don't give a damn.

now would you want medical professionals being trained at unaccredited schools, having only to pass a few tests to prescribe life altering medications and surgeries? doctors deal with people's lives. when a lawyer mismanages a case you usually don't die. when a doctor screws up, it's very very bad. right now the vast majority of doctors provide excellent health care in america. with a free market you will have snake oil people opening up shop on every corner providing terrible healthcare, leaving the good care only to those with enough money.

cliffs:
choice for admissions committees is good
reasons why people don't get in are various. you can have good scores and be a sociopath. you can be really nice and caring but dumb. point is to screen people out who are lacking in one or more areas.
admissions could be increased slightly more than now, but cannot a free for all.

I would think you're a little biased. Don't tell me you need to be a genius to tell someone he has a cold and prescribe him antibiotics. There are plenty of physician jobs that people who get rejected from med schools can do. The problem is that the AMA has a monopoly on the supply of doctors, and it is not in their interest to increase the supply of doctors (even at the same ratio as the increase in population).

sure, i'm biased. i did mention that a slight increase in enrollment is ok, and the AMA is increasing the number of spots and medical schools. my school is planning an increase of 10% this year alone.

no, you don't need a genius to tell someone who has a cold to take antibiotics, because 1) colds are viral, and antibiotics don't kill viruses, and 2) only a doctor or well trained nurse practioner is able to recognize signs and symptoms that may indicate something more serious going on.

anyone can tell someone with a chronic cough to take cough medicine. but only a doctor knows when that simple cough is a sign of acid reflux, a side effect of a blood pressure medicine, neck cancer, lung cancer, or something else more serious. we don't train for years and years to prescribe cough drops. we train to keep people safe and to recognize things that most others are completely oblivious to. many people, with a little training, can perform routine surgeries with as much skill as an average surgeon. but when things go wrong, who has the knowledge to know what to do? who has the pathophysiological knowledge to understand the situation and best strategize? who knows when surgery is appropriate, who can manage the post-op period? not simple-minded cutters with some hand-eye coordination, that's for sure.

the first step to gaining knowledge is knowing what you don't know. that is why many hotshots screw up patients badly. that is why doctors are needed, and quality control is paramount.

it is good to be cynical. it keeps people honest. all i'm saying is that there is more to the limited number of spots than the AMA trying to guarantee salary.

 

[PingSpike]

Originally posted by: FelixDeKat

Originally posted by: DeathBUA

Originally posted by: FelixDeKat

Originally posted by: Excelsior

Originally posted by: FelixDeKat
This is nothing more than specialized nursing, 50k max.

300k :roll:

Sarcasm, right?

No, and Ive raised it to 75k plus student debt reimbursement over time (tax free) and pooled risk insurance for all medical employees. If you want, you can also add an annual $1000 bonus for every year of service to a max of $30k.

The base of 75k will also be adjusted annually by the average annual inflation rate for the previous year as compiled and released by the Bureau of Labor Statistics.

My goal is affordable healthcare for all Americans. I think we can make this happen sooner than you might think.

Changing salaries is NOT the way to do it. Do a little research first. And you never answered my other question.

Getting salaries under control should be the first step. Clarify your previous question.

Creating an artificial salary cap on this one profession in a free market capitialist economy is an excellent way to drastically lower quality of care and create a mass exodus of healthcare professionals from the field.

 

[imported_KuJaX]

lol @ the people that say they should only be paid 75k-100k max. Obviously these people that said this are in the "25-40k bracket" and believe that 75k-100k is a rediculous amount of money to be made. The truth is that it is not. Do you know why you are only paid 25-40k at your current job? Because you don't have the elite skills that the people making more than 6 digits have.

If any topic should be discussed about lowering a salary of a person, it should be professional sports; especially basketball. Those goons make millions every month, and what do they really do for you? If only the "75k-100k max" would be applied to the NBA players.... this world would be a better place. Think about it, how many of the NBA people could make more than 25-40k on their own, if they wernt playing in the NBA? I would say maybe 1% of them, the rest would still be living in the ghetto, trying to learn how to rap. All joking aside, if the NBA commision and NBA team owners were smart, they would put a salary cap of around 250k per year per player. This would earn them (the management, owners, etc) a lot more money, while lowering seat prices. If you said "Take 250k or don't play" how many NBA players do you think would just flat out quit? Sure, there would be a few, but only the super stars, only because they could branch out and make a ton with their name/recognition. Yes, it would take a few years before the NBA would be at the growth it is at, but then instead of $200 lower bowl tickets, we would be paying $100 and the players would actually be playing for their life. Look at college basketball games vs NBA basketball games; college players have to try as hard as they can if they want to make a career in the basketball industry. NBA players are so much slower, because they have their contract for millions per year, they arent going to get fired anytime soon, and if they did, they would just go to a new team. What a terrible organization.

 

[FelixDeCat]

Originally posted by: KuJaX
lol @ the people that say they should only be paid 75k-100k max. Obviously these people that said this are in the "25-40k bracket" and believe that 75k-100k is a rediculous amount of money to be made. The truth is that it is not. Do you know why you are only paid 25-40k at your current job? Because you don't have the elite skills that the people making more than 6 digits have.

If any topic should be discussed about lowering a salary of a person, it should be professional sports; especially basketball. Those goons make millions every month, and what do they really do for you? If only the "75k-100k max" would be applied to the NBA players.... this world would be a better place. Think about it, how many of the NBA people could make more than 25-40k on their own, if they wernt playing in the NBA? I would say maybe 1% of them, the rest would still be living in the ghetto, trying to learn how to rap. All joking aside, if the NBA commision and NBA team owners were smart, they would put a salary cap of around 250k per year per player. This would earn them (the management, owners, etc) a lot more money, while lowering seat prices. If you said "Take 250k or don't play" how many NBA players do you think would just flat out quit? Sure, there would be a few, but only the super stars, only because they could branch out and make a ton with their name/recognition. Yes, it would take a few years before the NBA would be at the growth it is at, but then instead of $200 lower bowl tickets, we would be paying $100 and the players would actually be playing for their life. Look at college basketball games vs NBA basketball games; college players have to try as hard as they can if they want to make a career in the basketball industry. NBA players are so much slower, because they have their contract for millions per year, they arent going to get fired anytime soon, and if they did, they would just go to a new team. What a terrible organization.

Buts thats not what the point was. The point was lower healthcare costs through lower salaries for specialized "elite skilled" nurses like anesthesiologists.

 

[PingSpike]

I've said this before...if anything, most healthcare professionals are paid to little. Becoming a doctor only for the sake of making cash is a poor plan, there are much easier routes with less school to go that don't involve the potential to kill other people to make the same amount if not more money.

 

[BUrassler]

SUPER NURSES FTW!

 

[JS80]

Originally posted by: KuJaX
lol @ the people that say they should only be paid 75k-100k max. Obviously these people that said this are in the "25-40k bracket" and believe that 75k-100k is a rediculous amount of money to be made. The truth is that it is not. Do you know why you are only paid 25-40k at your current job? Because you don't have the elite skills that the people making more than 6 digits have.

If any topic should be discussed about lowering a salary of a person, it should be professional sports; especially basketball. Those goons make millions every month, and what do they really do for you? If only the "75k-100k max" would be applied to the NBA players.... this world would be a better place. Think about it, how many of the NBA people could make more than 25-40k on their own, if they wernt playing in the NBA? I would say maybe 1% of them, the rest would still be living in the ghetto, trying to learn how to rap. All joking aside, if the NBA commision and NBA team owners were smart, they would put a salary cap of around 250k per year per player. This would earn them (the management, owners, etc) a lot more money, while lowering seat prices. If you said "Take 250k or don't play" how many NBA players do you think would just flat out quit? Sure, there would be a few, but only the super stars, only because they could branch out and make a ton with their name/recognition. Yes, it would take a few years before the NBA would be at the growth it is at, but then instead of $200 lower bowl tickets, we would be paying $100 and the players would actually be playing for their life. Look at college basketball games vs NBA basketball games; college players have to try as hard as they can if they want to make a career in the basketball industry. NBA players are so much slower, because they have their contract for millions per year, they arent going to get fired anytime soon, and if they did, they would just go to a new team. What a terrible organization.

Uhh they tried that with Football. It was called the XFL. It failed fast.