Sat Jun 25, 2016, 05:54 PM

Young Docs Shun Primary Care

How often do you see a PA instead of an MD? I guess the most succinct part of this article is this:

"In 2015, the average primary doc made $195,000 — which, from my perspective, is a lot. But the average orthopedic surgeon made $421,000. Now, if you think about going through four years of college, then four grueling years of medical school, then three to six years of soul-crushing residency and coming out well into adulthood with a mountain of debt — while all your friends have retirement accounts, and be looking at a salary that's potentially only a third of what someone who goes into a subspecialty can expect to make? Well, that would make anyone think twice," said Mitra in the Pulse.

So, it makes one wonder what the future will hold, especially small communities throughout the nation. A single small hospital or clinic and who is there to tend to the patients. Is there a cure? I'd sure like to see one appear.

Story with a video @

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Reply Young Docs Shun Primary Care (Original post)
sargentodiaz Jun 2016 OP
safestuffer Jun 2016 #1
His Daughter Jun 2016 #2
Currentsitguy Jun 2016 #3

Response to sargentodiaz (Original post)

Sat Jun 25, 2016, 06:57 PM

1. Doctors will go where there is demand for their services.

What we will probably see is a proliferation of less expensive medical degrees taking over primary care, in the form of RN's who defer to a limited number MD's or specialists on staff when needed.

There is a lot of money in surgery and specialized practices, as long as there is demand those with higher debt loads and costlier educations will seek to offset those costs with the highest paying job they are qualified for.

Lower education costs, and you will see a proliferation of new talent, and a subsequent lowering of salaries/costs as competition works through the health care market.

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Response to safestuffer (Reply #1)

Sat Jun 25, 2016, 07:49 PM

2. Welcome to the future of medicine. It is a mixed blessing

Much of it has to do the business side of things. Very very painful. Running a family practice is gureling and not particularly profitable.

Hospitals and such know that while they need people like me, for every major trauma, there are lots of skinned knees and sniffles. Nurse practitioners can do that just as well as an MD. They are much cheaper too.

Speaking as a doc, it is much easier to be an employee, get paid by the hour, go home at the end of shift, and not have to worry about billings, payment rates, etc. BTW, the averages cited are low for California. We are the highest paid hourly workers I know.

I would love to see medicine reorganized from the ground floor. Refocus and redefine roles, and increase salaries at some levels. For example in most facilities, the patient sees more of a CNA than any other level of care. This is particularly true in long term care facilities. CNAs are paid McWages and often can make considerably more money going to work in retail or as a waitress. The turn over is fierce, and patients get hurt because of it.

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Response to sargentodiaz (Original post)

Mon Jun 27, 2016, 01:24 PM

3. Forgiveness

Of all or some of the crushing debt in exchange for a commitment for some term of time to a rural or underserved area might go some way to addressing that.

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