Yes, that's right, three years after med school.
I have 11 years of practice as a primary care Internist, and 12 as a Gastroenterologist. My life is definitely easier, and better paid, than it was as a primary care doc. Of course, I earned that by staying on in training extra years beyond what primary care folks do, and by the fact that my work involves higher-risk procedures, using much more expensive tools, with higher malpractice cost. And my knowledge of my field is deeper and more current compared to a primary care doc, who must cover a larger area of medical knowledge and so cannot go as deeply into any one area.
Having been both types of doc, I can tell you that it's not that specialists are overpaid, it's that PCPs are grossly underpaid. But if you want to rectify the underpayment of PCPs by underpaying specialists (a truly socialist idea) then be prepared to wait six weeks for your heart disease or colon cancer to be treated, because who wants to do all the extra training only to be paid as if they hadn't?
Socialism can only level down, not up, making shortages, not plenty.
I might add that it's simplistic to reduce the matter to money alone. The hassle factor of primary care practice has to be experienced to be believed. And that hassle factor has nothing to do with the nature of a PCP's work. It is imposed by--you guessed it-- government. The commercial ensurers, as the article states, follow Medicare's lead because they can get away with it.
If I could drop Medicare and all commercial insurance, and escape the incredibly intrusive and useless paprwork and regulatory burden imposed by them, I could go to a cash-only basis, cut my fees in half, and still increase my income. I am absolutely convinced that if Medicare never happened, we'd still have excellent quality of medical care in this country,it would be cheaper, and primary care would retain its place of honor in the field of medicine. As it is today, excellence in primary care is punished.
Nice, informative post, thanks.
Being completely uninformed about the realities of medical practice, I find myself asking, ''OK, why can't you do this?'' Not being a smartass, here -- I'd really like to know. Some sort of regulation? Ethical rules? I haven't a clue.
Would you please elabourate a bit? In layman's language, please ;^)
Benefits from the Social Security funds and Medicare have both been turned into a vast welfare program. If SS served only workers who've paid into the system, I don't think it would be in such trouble. Also, there's a lot of doctor fraud with Medicare and the SSA does not police this very well at all. Congress has created the SS mess, very deliberately.
Amen...Primary care IS punished, adn I encourage all the med students who train with me to avoid it like the plague! After 4-1/2 years of slapping myself in the head with the frozen fish, trying to make a go of it in an office that plays the stupid insurance game, I had had enough. I had been moonlighting > 100 hours per month in the Er to pay my bills, and just went there full-time, signing my half of the office over to my partner whom I could not convince to go cash-only. FP's and internists should do clinic-based, primary care work only if they are cash-only and free of insurance and hospital i.e. Medicare/Medicaid involvement.
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