md007,
You are making assumptions about me which simply have no merit based on my previous posts.
1. I do NOT consider myself underpaid. I am quite happy with both the financial and non-financial benefits of my practice, so I don't need to "reconsider", "lobby", or "move", but I will keep your handy advice in mind. I AM concerned about declining reimbursement and empathise with our pediatric and family practice colleagues who I DO feel are underpaid considering the amount of training they required compared to other fields. This whole thread was kicked off by asking whether people would still consider ortho if it paid $125K per year. At last count roughly 50% said "probably not" or "nope" so I am certainly not in a miniscule minority when it comes to this issue.
2. I, like yourself, am a huge proponent of the free market system. I think anyone in our society should be allowed to earn EXACTLY what the free market will bear, including physicians. I don't fault professional athletes, lawyers, business people, etc for earning fantastic salaries. I simply think physicians should be allowed to operate under the same rules. Physician reimbursement is but a FRACTION of the total cost of health care in this country. If a physician or group refuse inadequate insurance plans, I don't think they should be condemned by their colleagues as uncompassionate or only money driven. Your cute little example about the family having more money for a 3rd SUV or grandpa's new hip ignores the following fact: Physician reimbursement has fallen in the face of RISING, not FALLING health insurance premiums and INCREASING insurance company profits. I don't think that "physician greed" and "taking advantage of the system" can completely or even closely account for the rising cost of healthcare in our country. It is naive to assume so.
3. To put the STARK issue to rest. I am not PERSONALLY involved with any STARK issues. Our community needs at least two trauma trained orthopedists. The hospital has been trying for years to recruit. There are multiple reasons behind their failure - relatively poor state, undesireable location for many, relatively few natives pursue medical careers, etc. The hospital has been offering candidates a salary that, as I understand it, can't exceed a certain percentile of all traumatologists or they risk violating STARK laws. They would probably offer a million bucks a year, but can't without raising eyebrows. By md007's logic, the law of supply and demand would dictate a traumatologist could earn a million bucks a year in this particular market and should be allowed. But because that traumatologist happens to be a physician, he or she shouldn't be allowed to make that type of money. As a result, we have a shortage - and rest assured, it isn't just my perception. I am all for letting society "make the decision" on what physicians are worth, as long as it works both ways and the market is allowed "demand" when the "supply" is short. I am of the opinion it is conspiring insurance companies and beauracrats in charge of puble payors that unfairly tip the balance of power.
4. Enjoy 4th year of med school. It is now obvious where you are getting your idealistic view of the medical system - you haven't worked in it yet. You may want to resist being too critical of those who discuss financial issues surrounding medicine until you have been to the front line. This is just a stab in the dark, but you just may have a change of opinion in 5-6 years when you are practicing yourself.
5. I am really not getting emotional. In reality I am bored because the weather sucks and half of my patients have not shown up for clinic. You can presume about me what you wish - my motivations, my and my colleagues little schemes to bilk money from medicaid, whatever. I am simply defending those who consider financial issues in medicine, because when it comes down to it, EVERY physician has a price. While you may consider it shallow and uncaring to refuse to practice orthopedics for $200k per year, I bet that you yourself would not pursue it if you made $12k per year. How could that not also be considered shallow, greedy, and uncaring? Although the threshold may be different, rest assured, EVERYBODY has a price, even yourself.
