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Inflation=Physician Pay Cut

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  • Hawkeye225
    replied
    Originally posted by AR View Post

    Ok, but how was your annual income in 2020 vs 2010. Was it higher in 2020 because of the increased amount of work that you did? Obviously, you were making fewer $/hr in 2020 vs 2010. That's clear.
    No. Overall 6% lower in 2020 (likely more than 6% next year) than 2010 income not factoring in the increased days worked.

    To be clear, I am speaking of a full time partner's salary of which I was one for many years. I'm now part time as I finish up my career but I'm only referencing full parter's salary. I'm clarifying this since some here know that I'm part time now.

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  • wideopenspaces
    replied
    Originally posted by AR View Post

    In my experience, VA jobs are absolutely fantastic for the amount of work you are expected to do. I have a friend who does what I do. He makes about 35% of what I make (including value of benefits), but does about 20-25% of the work. So in a way he is getting paid more than I am. Of course in absolute terms there is no real way for him to make more than that within the VA system. So he moonlights outside the VA one day a week. He makes almost as much from moonlighting as he does from his full-time VA salary.
    I think it's specialty dependent. In psychiatry where I am, the VA pays the same or better as everywhere else in town. Workload in outpatient at the VA is very similar as outpatient at the university. I see slightly fewer patients per week but they are sicker so it evens out. I think in other specialties the VA workload is much less than what you'd see in the community.

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  • AR
    replied
    Originally posted by Hawkeye225 View Post

    That is correct. Working more days and making less/shift. Perhaps it's in part the part of the country we live in. Seriously though, I believe that there was one year when one of our contracts went up 1-2% but all others have gradually decreased.
    Ok, but how was your annual income in 2020 vs 2010. Was it higher in 2020 because of the increased amount of work that you did? Obviously, you were making fewer $/hr in 2020 vs 2010. That's clear.

    Leave a comment:


  • Hawkeye225
    replied
    Originally posted by AR View Post

    Interesting. I know zero. Maybe you folks aren't the unicorns I thought.

    The fact that you had to do a "calculation" tells me that you are not working the same number of shifts. Is that right? Are you working more now?
    That is correct. Working more days and making less/shift. Perhaps it's in part the part of the country we live in. Seriously though, I believe that there was one year when one of our contracts went up 1-2% but all others have gradually decreased.

    Leave a comment:


  • AR
    replied
    Originally posted by Hawkeye225 View Post

    Absolutely. Virtually every single physician that I know.

    Edit: Just did the calculation. 18% less/shift currently than about 10 years ago.
    Interesting. I know zero. Maybe you folks aren't the unicorns I thought.

    The fact that you had to do a "calculation" tells me that you are not working the same number of shifts. Is that right? Are you working more now?

    Leave a comment:


  • Hawkeye225
    replied
    Originally posted by AR View Post
    I certainly understand the above sentiment, but is anyone here who has worked for 10 years actually making less in nominal terms now than what they were making 10 years ago (assuming full-time work during the entire period). Finding someone like that is almost finding a unicorn. Sure everyone will tell you that they're working harder now, and I don't doubt this is the case for many. However, the reality is that no one outside of other docs is going to take any of this bellyaching seriously if pretty much everyone is making more money than they used to (whatever the reason may be).
    Absolutely. Virtually every single physician that I know.

    Edit: Just did the calculation. 18% less/shift currently than about 10 years ago.

    Leave a comment:


  • AR
    replied
    I certainly understand the above sentiment, but is anyone here who has worked for 10 years actually making less in nominal terms now than what they were making 10 years ago (assuming full-time work during the entire period). Finding someone like that is almost finding a unicorn. Sure everyone will tell you that they're working harder now, and I don't doubt this is the case for many. However, the reality is that no one outside of other docs is going to take any of this bellyaching seriously if pretty much everyone is making more money than they used to (whatever the reason may be).

    Leave a comment:


  • Hawkeye225
    replied
    Raise? That's a word I've never seen while in a long career in medicine. Would someone be polite enough to explain what this is in the English language?

    Leave a comment:


  • Cubicle
    replied
    There are Medicaid plans that have not given a single penny of increase for either E&M or procedures since 2016.

    But yet multiple insurance request my charts every month for "Medicare Risk Adjustment" so they can get more money. When I demand payment they refuse.

    Leave a comment:


  • nephron
    replied
    The real problem with inflation is that doctors are so dependent on government reimbursement rates which are continually subject to deflation pressures from lawmakers that they will never be able to keep up. Any amount of inflation means higher salaries for secretaries, techs, and nursing staff while reimbursement rates are moving in the opposite direction. Our salary is completely dependent on the profit margin between costs and reimbursement rates.

    Leave a comment:


  • pysibal
    replied
    I have been hassled about productivity before by an non-MD in administration.

    I have so far successfully refrained from asking him how many RVUs he made last quarter, and following up by asking him to provide a single metric to justify his utility.

    This RVU system is bogus in so many ways. So much value is not captured. I hear about hospitalists covering night call for patients admitted for elective surgeries (getting calls, but rarely something that generates a billable note), hospitalists required to work the transfer center for a full day (no notes/RVUs), subspecialist neurologists who spend 60-90 minutes with patients and order massive amounts of expensive labs and imaging (little RVU value, but feeds other aspect of hospital) who are then whined at about their "productivity."

    Leave a comment:


  • abds
    replied
    Originally posted by FIREshrink View Post

    My admin jobs have not seen any pay increases any time recently, I make more per hour seeing patients.

    Since I started almost two decades ago, the pay rate for one of my admin jobs went from $100 to $125 per hour.
    Meanwhile the CEO at one of our hospitals (large system) makes $4.3M. There are 5 additional non-physician administrators who make 7 figures.

    Leave a comment:


  • Sundance
    replied
    Originally posted by FIREshrink View Post

    My admin jobs have not seen any pay increases any time recently, I make more per hour seeing patients.

    Since I started almost two decades ago, the pay rate for one of my admin jobs went from $100 to $125 per hour.
    Funny that you think the admin pay you get has anything to do with the type of annual raises your hospital administrators are getting.

    Leave a comment:


  • FIREshrink
    replied
    Originally posted by abds View Post

    This is of course true, however with Medicare part A premiums increasing 6% and part B premiums and deductibles increasing 15%, which the federal government is blaming partially on inflation/increased cost of care (and partially on increased utilization), the question remains where that money is going? I assure you there are plenty of high-earning administrators at hospitals and nursing facilities that are getting cost of living raises. The fact that conversion rates have remained stable for the past 20 years while Medicare premiums have risen and inflation totals something like 60%, is obscene.

    Obviously we need a better lobby. Perhaps all these physician bloggers can divert some of their side-gig attention that way.
    My admin jobs have not seen any pay increases any time recently, I make more per hour seeing patients.

    Since I started almost two decades ago, the pay rate for one of my admin jobs went from $100 to $125 per hour.

    Leave a comment:


  • ENT Doc
    replied
    Originally posted by Hoopoe View Post

    Contract to allow us to work the ER. Stipend is negligible, mainly to cover some admin meetings. The rest is based on collections from patient care.
    You use the PFS and in no way the OPPS payment system?

    Leave a comment:

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