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Who makes more: U.S. or foreign docs?

Doctor with money in pocket

TEXT OF INTERVIEW

Bill Radke: After a long wait, the Senate Finance Committee could actually vote this week
on a health-care bill. Yesterday, the Congressional Budget Office said the latest bill is not only budget-neutral, it would actually reduce the federal deficit. The cost of health care is the subject of today's Marketplace Globalist Quiz, with our quizmaster Stephan Richter of TheGlobalist.com. Good morning, Stephan.

Stephan Richter: Good morning Bill. Are you ready?

Radke: Let's do it!

Richter: All right, you know that Congress is having to wrangle a lot over the details of health-care reform, which is a key priority for this fall and it's all about lowering costs, or so one would hope.

Radke: Yes.

Richter: So I'm going to ask you this: How much do American doctors earn in comparison to other doctors in rich countries? Is it about the same? Are American doctors earning twice as much as those in other countries? Four times as much? Or let's say, 10 percent less, which would of course be good news.

Radke: That's not good news for doctors.

Richter: But for all of us consumers -- and there are a few more of those -- and ultimately we spend so much on health care that something's got to give, one would hope.

Radke: Let's see, we hear so much about the cost of medical care, all the high-tech testing we do. I say American doctors earn four times as much as anyone else.

Richter: Actually it's twice as much. And that is compared to countries like Switzerland and France, other sort of very rich countries. There the specialists make, on average, $130,000-150,000 a year. In the U.S., the average specialist gets $230,000. That's quite a lot of dough.

Radke: And for some perspective here, Stephan, do you know how much American doctors make compared to their patients?

Richter: Yes, and there your original guess of four times is almost on target. U.S. doctors make about five times more than their patients -- that is their specialists, of course, which are the ones that really put us out of whack with regards to our health-care costs across the nation. General practitioners, which are in short supply according to many people, are quite underpaid are in line with global averages so there's not much of a need for reform on that particular front.

Radke: OK Stephan, thank you. Can I put my shirt on now?

Richter: Please do.

Radke: Stephan Richter is publisher and editor-in-chief of TheGlobalist.com -- the daily online magazine on the global economy, politics and culture. Thanks.

Richter: Always a pleasure to be with you.

About the author

Stephan Richter is the publisher and editor-in-chief of The Globalist, a daily online magazine on the global economy, politics and culture.
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This story is long past but still has legs, according to me. I am a spouse of a female orthopedic surgeon. I have dated my wife since her Engineering undergraduate. My wife completed Medical School 9 years ago and I finished my MBA 9 years ago. If we tally up my earnings versus my wife's, I beat her hands down. For those lawyers or MBA's out there that think they have it hard... you have not clue what you are talking about. I have worked in Banking and Software for 14 years. These industries require long hours but some of those hours are sucking up to your boss at the bar after work or playing golf with clients. My wife has had three pregnancies to go along with her 15 years of post secondary education. There are no words to describe the level of effort that it took my wife to get to where she is today and for anyone that is not in this profession to say "I want to trade spots" is absolutely nuts.

For FedUp. The primary issue you have is that your doctors likely work for a network, that network bills you extraordinarily high fees but the doctor actually sees a fraction of those fees. Your primary issue should be with Health Networks and how they lobby insurance companies to raise their fees, not the surgeons that save your wife after she wasn't wearing her seatbelt in a car accident. Your anger is misguided and you should do more research before you decide to lash out at a particular profession.

We shouldn't get paid double the salary? Ok lets think about this, say we get paid half the salary, while everyone else has paid their debts by like age 35, we will still being paying off our debts by the time our children head off to college. You can't compare America's doctors to Europe's doctors. It's crazy, call me when they start to work 80 hours a week, practically nonstop, without 2 month paid vactions, there's just too many differences to even compare the two. Ha! When retirement age comes around, I'll be lucky if I even have savings! Thank you to all the Americans who hate us for being overpaid. Come talk to me when your 65 and we'll compare our savings.

This "quiz" above was shoddy journalism, at best, on the part of both Marketplace and Mr. Stephan Richter. Conveniently for Mr. Richter, it appears impossible to send him an email through his site, The Globalist. As mentioned correctly in the other posts, there was no mention of the cost of a physician and subspecialist education or malpractice costs. Also, there was no mention of the primary role that pharmaceuticals and technology play in the unsustainable costs of health care in this country. So, instead of tackling the larger issues at play (i.e. the 800 pound gorilla in the room), people choose to focus their attention on the low hanging fruit, which is M.D./D.O. salaries. To not even mention the other side of the story is not journalism, but propaganda.

*FAIL* This was such a load of crap. How can you compare salaries without comparing the cost to educate/train/practice? I sure don't think Sallie Mae's gonna forget about the money I owe her just because Mr. Richter can't be bothered to even mention it in his analysis. Does everyone else have to work for free or is it just physicians?

I was very disturbed to hear your report, as it is clearly biased and only presents part of the picture. My college and medical school training left me with $195,000 in debt. I finally finished my training at age 30, and I never made more than $22,000 as a resident in training. All my debt was "deferred" until after my residency, but all the time it was accumulating interest. So at age 31, I finally was making "alot of money", actually only $90,000 the first year. I paid on my loans all the way until I was 46 years old, before I finally could actually SAVE any of the money. Up until then, it was like I had TWO mortgages. Every extra penny went to debt on my education. When I turned 46, I got together with my 3 brothers, all business degree graduates, and we compared where we were. I finally had all the debt paid off, had "just a mortgage" like everyone else, including them. However, all 3 of my brothers had earned well OVER ONE MILLION by then, and had not had anywhere near the onerous debt load. They all had at least several hundred thousand in savings (the lowest was $380,000), compared to me- having NO SAVINGS at all. So now, I'm 51 and on full time faculty at a medical school. I make $161,000 gross, including my 401K deferred money. So I have been able to start saving, but I'm 22 years behind all of my peers as well as my brothers. Also, I have worked a minimum 70 hour work week the entire time, and that does not count my call at night. I do love my work, in spite of the malpractice costs, increasing paperwork, increased "hassle" of insurance, etc. But, at this point in time, I will be doing extremely well to catch up to my peers by age 65. Early retirement for me is a pipe dream!!! If you look at the situation, I couldn't accumulate anything until I was 46 years of age. So go ahead, "stick it" to the doctors. Just don't complain when you are sick at 2:30 AM and need a well trained MD, but get bumbling idiot instead because all the "smart" students went into business, law, etc. We are already having a decline in the applicant numbers to medical schools, and the quality is also down somewhat from 10 years ago. When one of my nephews talked with me about medicine versus other careers, I advised him to look at anther profession. He is in law, finished with only $25,000 in debt and is already making over $95,000, and he's been out only two years. He will have the debt paid off next year, at age 27!!! Smart kid!!!! So this report only present part of the real picture.

Marketplace lost credibility by giving airtime to a SIG under the ruse of a “quiz”. They should have indicated they were endorsing a specific agenda as an editorial rather than pretend it was “news”.
Most physicians bring to the table the work ethic, years of hard work and sacrifice, intellect, and commitment to ongoing education that encapsulates the highest ideals or our society.
Mr. Richter has little insight into the cost (or value) of a US medical education or the costs associated with maintaining medical certification. He also forgets who bore those costs.

This interview exchange on a well-respected news program was poorly executed. Mr. Richter should have compared apples to apples. The misinformation projected only fuels the already misled, such as "Fed Up" from Atlanta, GA.

I echo all the sentiments already expressed by my colleagues regarding debt and work hours. I earned $10-15/hour during residency, while deferring my $200,000 in student loans. I borrowed only enough to pay my med school tuition plus $12,000 per year to cover living expenses. Mr. Richter should adjust his analysis to account for salaries during 3-7 years of residency training.

My husband and I read an article about residents in New Zealand going on strike because they were earning $65,000/year and working 60 hours/week. We just laughed. Wouldn't those conditions be wonderful!

I have lived very frugally in order that I may care for people. "Fed Up" claims that all professions encounter these same hardships; that's just wrong. Lawyers and businessmen transition directly from schooling to decent salaries. Furthermore, lawyers and businessmen go to work every day to make loads of money for themselves. I go to work every day to take care of people. On my current gross income of $33,000 per year in Los Angeles, I'm sure not making much money!

Much about my job is very rewarding. Nevertheless, if I could rewind, I'm not sure I would do it over again. People like "Fed Up" reinforce that feeling.

I'm sure there are bad physicians out there. But most of us sacrifice greatly in order that we may serve people.

There is more to physician income than annual salary. Richter fails to weigh the cost of practicing medicine in the US compared to a foreign country.

The difference in student loan debt, malpractice cost, and hours worked between physicians in the US and their European colleagues sheds a different light on the higher overall salaries of US doctors.

Consider that some of our nation's brightest men and women give up 8-12 years of earning opportunity and life in their 20's and take on about 200K student loan debt prior to starting their first 'real' job. The lost earning potential, heavy debt burden, malpractice costs, and 60 hour work weeks completely justify and explain the salary differential between US docs and their counterparts across the pond.

Physician salary accounts for only a small percentage of overall healthcare costs compared to pharmaceutical, insurance, and administration cost.
Physician pay is an easy but inaccurate scapegoat for rising healthcare costs.

I'm disappointed that "Marketplace" failed to mention these important market factors in the story.

i'm not a doctor nor in health care. that was an extremely misleading article. what was the point?

Almost 2 days after I heard this story, I'm still saddened, and frankly, angry. I thoroughly agree with many of my colleagues above that because of educational and opportunities costs of our schooling and training, US and foreign doctor incomes are not comparable. Furthermore, fear of frivolous malpractice suits, as well as malpractice costs, require higher reimbursements. Lastly, all doctors in the US that I know far exceed the 36 hour/week rule imposed in many European countries.

I originally decided to pursue medicine after working in indigent health care as a volunteer. I felt women needed more compassion than what I saw some receive. I never expected to get rich, just to make a living helping people. I naively thought that, instead of working the insane hours of most doctors, I could simply work less for less pay. Instead, I run around like crazy, 60-80 hours a week, because my patients need to be seen. I am not self-aggrandizing, I just don't think they should wait 3 months to be seen by a doctor. Sadly, because of my student loans, I can't afford to work solely in indigent care. I certainly don't make $230K/year, even though I'm in a private practice.

The most maddening part of the whole story was the conclusion: reducing physician salaries will significantly change health care costs. It is painfully obvious to anyone in the medical care system that the vast majority of money is tied up in insurance companies. Although I am dubious of a completely government run system, government inefficiencies would probably still be less than insurance company profits and executive salaries. Unfortunately, because insurance companies are smart and getting in on the deal, we may be looking at insurance company profits and government inefficiencies combined. Almost makes me wish I spoke French.

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