Have You Met a Poor Doctor?

I haven’t. No, I’m not including the residents and fellows who, while they may have an MD or DO behind their names, suffer from significantly negative net worths because of the very medical education that earned them the honor of “Doctor” in the first place (myself included). I am talking about attending physicians who are at varying stages in their careers. I have never met a poor doctor and I don’t believe I ever will. Let me explain.

The Setup:

As the editor of Future Proof, MD, I like to read, especially on financial topics that may impact physicians. Through my readings, I’ve experienced a sense of “doom-and-gloom” from many of my peers — see 63% of Docs Are Pessimistic About Their Job Future, And More Survey Results. My overall gestalt is that medical trainees today anticipate their financial futures to be worse off than physicians today and those who have gone before us. The reasons cited are varied, but the common denominator is decreasing reimbursements. The prediction being that in the environment of cost containment, the total reimbursement provided by third party payers (Medicare and Medicaid being the largest) will eventually reach a plateau and perhaps even decline. So no matter how you slice the pie, eventually your slice will get smaller. Recently, I had a medical student reader who wrote wondering if he will be “poor” which is simply absurd.

Defining “Poor”

The words “poor” and “poverty” can be used in many contexts. I want to focus on the definition of financial poverty. For example, if you are a physician working full-time, thrice-divorced, drives a $125,000 car yet complains about living from paycheck-to-paycheck, you are “poor” in your decision making but not financially poor. Luckily for us, there is an actual definition of financially poor — courtesy of the US census bureau. Here are the poverty thresholds for 2015:

According to a recent report, physicians currently earn between $204,000-$443,000 a year depending on specialty. As you can see, unless you simply enjoy playing the victim, no physician who practices clinical medicine will even come close to being “poor”.

Predicting the Future.

There are many reasons why physicians of America feel under siege: We emerge from medical school with the title of MD — Much Debt. Decreasing reimbursements and increasing malpractice costs hit us hard financially. Government bureaucracy and corporate medicine make us feel less in charge of our medical decision making. Mid-level providers and physician-extenders are on the doorstep of practicing independently of physician supervision.

And of course, the very patients we interact with on a daily basis also have a big impact on our perception of job satisfaction (See Why You Should NOT Treat Patients Like Family).

Despite these headwinds, I believe physicians will continue to occupy a privileged rung on the American socioeconomic ladder. For one, physicians have always enjoyed a high income throughout history (see A Brief History of Physician Remuneration). Two, it takes an enormous level of trust for someone to agree to take a nap and wake up without their gallbladder. We have a natural tendency to associate quality with price, therefore, as a patient, I want my physician to be well compensated. Most importantly, healthcare is a marketplace. Like any other marketplace, if physicians cannot make ends meet, these hardworking men and women will exit medicine and enter another profession. The resultant shortage will necessitate an increase in wages and benefits. So med students, residents and fellows, temper your expectations. You may not make the kind of money to buy your own private island, but you will never be poor.

Thoughts and comments? Reach out to me at http://futureproofmd.com/.