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Why are people so angry about doctor salaries?

In a really engaging recent post, ER doc Edwin Leap (via GruntDoc) discusses why it seems that the general public is outraged at reports of the occasional specialist who makes $500,000 and yet do not flinch at the much larger salaries of football players, musicians, or media tycoons.

I posted a response to Dr. Leap’s blog post, explaining my take on why people are so angry. Let me know if you agree:

You are right that there is a lot of anger towards physicians – it is the collateral damage of the broken physician-patient relationship. When third parties (insurers) got between us, and reimbursement dwindled with drastic cuts in Medicare/Medicaid, physicians had to make up the difference in volume. When you see 30+ patients/day none of them feels as if they’ve had a valuable interaction with you. And the physician’s memory of each individual patient (and their psycho-social context) becomes dim.

When we lose the sacred, personal, physician patient relationship – we lose the best of what compassionate individualized medical care has to offer. This is why patients believe that a government sponsored system can give them the same level of care that they currently receive. I shudder at the idea of handing over medical decision making to a distant bureaucracy that only knows what’s right for a population, not for the individual. But if doctors continue to treat patients like a commodity, the patients are actually receiving nothing more than population-based care anyway. Quality care is personal, and the physician-patient relationship is a trusted bond that cannot be easily broken. We need to know our patients well so that we help them to make the best possible decisions for their personal situation. I believe that the IMP movement (see Gordon Moore’s work) – where PCPs use IT to drastically reduce overhead costs so they can afford to see fewer patients – is one of the best ways to improve healthcare quality.

As far as Emergency Medicine is concerned – we need to get the non-sick patients out of the ER and back to the PCPs. Easier said than done – but if the patients have a real relationship with their PCPs they’re less likely to substitute an ER doc inappropriately.

My 2 cents! 🙂

Patients are angry about physician salaries because they know instinctively that they are not getting the quality care that they are paying so much for… Moreover, the major cost causers (hospitals that cost shift unpaid bills to the uninsured and take large cuts for hospital administrator salaries, and for-profit insurance companies) don’t have a name and a face to the patient.  So docs take a double dose of anger on the nose, further damaging the already strained relationship.  We must go back to our roots – and support the personal doctor patient relationship that has been a pillar of American medicine.  Revolution Health can be our meeting place… the new digital medical home, supporting the old physician-patient team decision-making approach!This post originally appeared on Dr. Val’s blog at

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5 Responses to “Why are people so angry about doctor salaries?”

  1. Liz1000 says:

    I am not concerned at all about doctors salaries–as far as I am concerned, they deserve every penny. But I do resent the cursory or impersonal care you refer to. It also terrifies me, because I know it might be capturing only half the story, or even be wrong.

    It would be hard to get me to an ER short of something that was broken or seemed truly life threatening. But I have to say that the friendliest, most personal care I have received in the past five years has involved visits to a Sat am walk-in clinic at a nearby hospital, when I didn’t feel comfortable waiting until my doctor would be available on Monday.

    In one visit, I had returned Friday evening from a trek in the jungle, and while undressing I noticed a THING that had burrowed into my foot, that I could not remove with tweezers. Sat am I was off to the walkin clinic, surely unnecessarily worried, and received the kindest care from a doctor who cut the THING out (although it could not be identified because it came out in little pieces.) We joked about it, but she did not treat me like an bother. In the second case I fainted after giving blood Friday afternoon, and then was still faint Sat am. Again, I was given the kindest, most personal, thorough care from the attending, another physician with whom I obviously had no prior relationship. Neither was a life threatening situation, but I was treated with such respect–and good humor. I really wouldn’t mind if these physicians earned millions a year, although I’m sure that they don’t. I guess this illustrates your point–that it is respect, openness, and good doctoring that counts.

    But why is it so rare, and then it crops up where perhaps it might not be expected? The walkin clinic is surely doing something right!

  2. ValJonesMD says:

    Dear Liz, so glad you had some great experiences in the walk in clinic! Great doctoring still exists and there are pockets of it in many different settings. I think most docs could be great if they had a little more time to spend with their patients. I sure hope that Revolution’s efforts will result in freeing up docs from the paperwork and red tape that steals time away from patients. This is one of our long term goals. 🙂

  3. Anonymous says:

    I think people are upset about doctor’s salaries because they simply make too much money. I base that on a recent survey that states that American doctors make more than three times their nearest competitors (in Germany). We don’t have outcome that are three times as good. Medicine should not be a for profit enterprise, at least not in the majority. The fact is that an average anesthiologist working for, say, a Kaiser Permanente outpost in Sacramento, can easily clear a half million dollars annually only a few years after finishing their internship. Market forces aren’t allowed to work because the AMA is a powerful lobby dedicated to enriching its members no matter how much it damages the American economy. Any discussion about this leads to veiled threats about “quality of care” and the dangers of “socialized medicine.” I don’t see any Canadians flooding over our borders to escape the substandard care. I see Americans going over the border for cheaper drugs, and I see American insurance companies trying to convince the bargain seekers that the Canadian drugs are somehow bad. The anger at doctor’s salaries is entirely separate from questions of care. We are being gouged and we don’t have the political will to do anything about it.

  4. Anonymous says:

    I am currently a 3rd year medical student and would like to point out a few facts that are missing from the discussion regarding physician’s salaries. ? 1)? MD education costs are rising at a rate that is disproportionate to doctor’s salaries.? Many of the physicians who graduated even 10 years ago came out with, perhaps, $50,000 debt.? When I graduate, my debt, will be closer to $275,000.? This is only for 4 years of medical school and does not take into consideration the large debt that will accumulate during an average student’s 3-5 year residency program.? 2)? Most people think of a physician’s salary within the context of a 40, 50, or even 60 hour work-week.? Considering the current hours doctors are forced to work for numerous years, a physician’s hourly salary is small for any level of education let alone the level of training we have been forced to acquire for practicing in the US.? I’ll give you an example:? as a student, we are capped at an 80 hour work week.? This is TWO TIMES all full time work week for the average person, and we are only students.? It gets much worse in residency and for many years beyond.? 3)? Depending on the field, malpractice insurance takes a huge cut out of a physician’s salary.? The more insurance companies control the physician-patient relationship, the worse it is getting.?

    Practicing medicine is not like it used to be.? I don’t think many people realize how difficult and unrewarding the path of medicine can truly be.? One of the reasons I entered medicine was out of a general disgust for my own experiences as a patient, and out of a desire to ensure that others did not have the difficulties I had with receiving quality care.? Over the last 3 years, I have come to view medicine from a completely different perspective and have gained a great deal of empathy for practitioners as well as patients.? The majority of my classmates have entered this field because of a strong desire to help people;? We are frightened by the prospect of not being able to do so in the face of insurance companies, massive educational debt, and the fear of malpractice lawsuits.? Children may still grow up with a fantasy of what it is like to be a doctor, but those of us who have been exposed to the real world realize that the path to becoming a doctor, although necessary in order to provide care to those burdened by illness and disease, is far from glamerous.

    (Excuse any grammatical/spelling errors…I am currently post-24 hour work shift)

  5. ValJonesMD says:

    Thanks for your post – all good points.  We are in a time of crisis for sure… but medicine is a calling… glad you’re on the team! 

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