The Demise of Primary Care Physicians

Here  is another article that quotes a starting salary of $150,000 for doctors right out of their residencies–there are areas of the country where young doctors can get employment at this salary level.   But note these doctors are saddled with  $100,000 to over $200,000 in medical school loans.  With this financial burden,  young doctors rarely even think of  “hanging a shingle,”  that is, opening their own practice, as was customary decades ago.    It is understandable why going into primary care is the choice of less than 5% of doctors completing their 3 year residencies.

I doubt the doctor in this article, who loses $9.00 everytime he gives a pneumonia shot to an elderly patient,  makes $150,000 a year.     The day of solo practitioners is  quickly fading away even in rural areas.  Right now in Texas half the primary care physicians practice solo or with one other doctor, but these practices are disappearing rapidly.    There is no year-end six figure bonus  for the 64 year old family doctor who gets up in the middle of the night to take care of his patient’s heart attack.

Daschle is now out of the picture, but I shudder to think who will be the Messiah’s next pick to “overhaul”  our healthcare system.   When I hear medical economists who advise Obama making statements that nurses can perform most of what a primary care doctor does,  I know the family doctors’ concerns are not going to be  a priority in an Obama administration.

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4 Responses to “The Demise of Primary Care Physicians”

  1. Jon Spiers Says:

    Most folks see only one part of the equation – the charges from a medical practice. They don’t have any understanding of the liabilities and overhead.

    Most (dare I say all?) politicians do not want the public to know that many of the very laws they enact to “protect” us end up costing practitioners so much that the very service the politicians wanted to protect are now too expensive!

    And while there is a uproar over a physician making $150,000 a year after racking up a quarter million in debt to get to practice medicine, no one seems to realize that the economics there are not favorable – medicine is fast becoming a losing financial proposition for practitioners.

    And ponder this – a first year resident in a major hospital program makes about a third of what a similarly experienced attorney makes in a major firm as a 1st year associate!

  2. Doc's Wife Says:

    Almost any doctor, fresh out of residency, is hard pressed to open a solo practice – it’s beyond their reach by design.

    It’s also misleading when we hear the “average” doctor carries $139,000 in student loans because about 20% carry no debt and 40% carry more than $250,000. One of the residents who was part of my care during the delivery of my child called himself the “million dollar man” – his student debt, when he was ready to be an attending OB/GYN, would be over $500,000 – when he added up the interest he’d pay on those loans, they topped $1-million! To be an OB/GYN! Student loans aren’t just the priciple – they’re also the interest over 10-20-30 years, and once a doc consolidates loans, they can’t reset the terms!

    Add in the years of study and apprenticeship (that is what residency is) and a doctor forfeit’s a good 8-10 years of earning time compared to their peers, a specialist forfeit’s 12-14 years before practicing…the higher starting salary does NOT overcome the lost income for at least a decade of their life, but people are going begrudge a doctor their pay because it’s six figures?

  3. politicaldoc Says:

    Thank you Jon & Doc’s Wife for your responses.

    Yes, a “graduating” resident may have much more that the average $200,000 debt. I went to medical school with a guy who went to Stanford undergrad and had $50,000 in undergraduate debt even before he racked up medical school loans, and that was over 25 years ago.

    There have been numerous studies through the years (when medical education debt load was less) that showed a high school graduate starting to work at age 18 as a plumber, electrician, or other vocation, was just as well off financially as a doctor in his 40’s. Starting a savings program at a young age with no educational debt pays off big with just Einstein’s “compound interest”.

    I read more and more each day from a variety of sources from primary care doctors in solo practice throwing in the towel. They do not make a six figure salary! These docs are taking out loans to make payroll! But everyone still thinks all doctors drive Jaguars and take 4 week European vacations—the truth is primary care doctors often do not make as much as NP’s and PA’s, who also have better benefits.

  4. politicaldoc Says:

    I forgot to add I saw a news piece on TV that had doctors who were in their residencies saying they would be almost 60 years old before all their education loans were paid off.

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