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Why is discussing compensation a taboo amongst physicians?

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  • #46
    Originally posted by Panscan View Post

    yet the good doc taking care of people compared to their average peer is doing way more good for society relative to their replacement than the fancy grant person(obviously you know my cynicism/opinion of academics and research in general).

    If your 2nd paragraph is true then I think the academic places have swung too far in favor of research instead of balancing it with clinical teaching/being good doctors(the real point of being a tertiary or quaternary center IMO). If all you value is people who write papers and get grants you're going to have a crappy hospital with crappy teachers who produce more crappy docs and it doesn't matter how much research you do (besides being ranked highly on some lists), people won't go there. It's like we have flipped 180 from the past where before if you were a good doc you could throw a scalpel or openly abuse people and that was fine, now you can do essentially 0 clinical work/ have 0 clinical interest but produce some grants and you're golden. Personally I don't really know why these people become physicians and not just PhDs. The increasing focus on research in residency in general to me is alarming with more and more residencies requiring research or having separate research tracks. Is the goal to train doctors or scientists? There's a difference.

    Unrelated, but I think the stuff about "medicine being a calling" is perpetuated by academics to a) justify their lower earnings relative to their peers b) enable them to lowball future grads. Our outlooks are very self-fulfilling so if you enter a low paying job (relatively) you're probably going to gravitate towards concepts that justify why its ok to make less. As I mentioned in another thread, I have begun to hear about residencies and fellowships requiring their trainees to sign non-competes. What exactly is the purpose of that if not to low-ball them once they graduate? I think this is wildly inappropriate.

    Another reason I think it's taboo is because physicians get paid a lot. Period. Obviously this requires a lot of schooling/significant loan burden/effort/higher hours than general public, but laypeople don't go into this depth of analysis when they hear a number. If a layperson makes X and a physician makes 4X, there is typically immediate jealously/resentment and the dots aren't connected regarding the fact that the doc may have been in school/training for multiple times as long, with significantly more debt, etc.
    Big time. The admins who helps schedule my patients may make as much as I do in fellowship , and other than call works about the same number of hours I do slightly less. But if she were to hear about how much I’ll be making in a few months, they would hate me forever, which is completely irrational given how much I’ve done to get where I am, but it’s a human feeling and there’s nothing doctors can do about it. Everyone feels like they work hard

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    • #47
      I don't think anyone is advocating for transparency with those who aren't physicians. I'd rather risk being considered a social dolt than chance end up making significantly less than a colleague doing the same job. I also don't want someone willing to accept a much lower salary which could diminish my value. This is an important topic and I believe the only one who financially benefits from secrecy is the employer.

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      • #48
        One issue I have seen with some docs - they want to know what the other docs in that group make but don't want to reveal what they make. Or ask around for other's starting salary but once they are hired, their mouths are tighter than a clam. I have become cynical after seeing both happen and now prefer silence.

        I have no problem with the compensation being published for the not-for- profit entities.

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        • #49
          Originally posted by Kamban View Post
          One issue I have seen with some docs - they want to know what the other docs in that group make but don't want to reveal what they make. Or ask around for other's starting salary but once they are hired, their mouths are tighter than a clam. I have become cynical after seeing both happen and now prefer silence.

          I have no problem with the compensation being published for the not-for- profit entities.
          Just a reminder (which I know you fully aware of), Not-for-profit is only an IRS tax classification. If tax exempt status gives everyone the right to financial data for an individual, that is perfectly fine. Reminds me of some deals. The hospital real estate is rented from PE (or a minority partnership) and all the physicians are for profit entities. The only not-for-profit piece is the hospital system (guaranteeing debt) and a staff that runs the building.

          Does "who you work for" mean no personal privacy? I guess you could say yes. Or no. Maybe tax returns public? Not advocating one way or the other.

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