Inflation=Physician Pay Cut

[Ekanive23]

Hello,
just curious how many of y’all are getting raises to offset inflation? I haven’t heard of many people getting this, and cuts more likely than raises. They are giving us a raise because we lost a retirement vehicle snd was announced before inflation took off.

my concern is, COLA salary adjustments don’t happen and doctors as a whole are making less money because of stagnant wages during this time.

all the best,
Eddie

[ENT Doc]

From the ACS:

[Tangler]

ENT doc, Sorry for my ignorance, what is the conversion factor in the graph? ACS = American College of Surgeons?

[Nysoz]

https://bulletin.facs.org/2019/09/medicare-physician-payment-on-the-decline-its-not-your-imagination/

[Dusn]

This has been happening for decades.

[CordMcNally]

It's difficult to give those with high income inflation adjusted raises, especially physicians. There's always pressure to lower reimbursement and adjusting physician wages strictly on inflation can really wreck a budget.

[JBME]

why limit this to physicians? inflation=paycut for everyone

[Tim]

Anecdotally, compensation adjustments always lag inflation. By definition, it is a lagging adjustment, if at all. Playing catch up.
Inflation benefits assets not compensation.

[Dusn]

why limit this to physicians? inflation=paycut for everyone

With the incredible job market right now many people should be able to switch to a higher paying job right now that keeps up with or surpasses inflation (at least my relatives in tech certainly have). That being said, employed doctors might consider this strategy as well.

[HikingDO]

Hello,
just curious how many of y’all are getting raises to offset inflation?

I’m going to show this post to my employers and see how long it takes them to laugh.

[ENT Doc]

ENT doc, Sorry for my ignorance, what is the conversion factor in the graph? ACS = American College of Surgeons?

It’s the CF applied to the end of the physician fee schedule formula.

Yes, ACS = American College of Surgeons

[abds]

It's difficult to give those with high income inflation adjusted raises, especially physicians. There's always pressure to lower reimbursement and adjusting physician wages strictly on inflation can really wreck a budget.

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.

[CordMcNally]

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.

Most physicians don't control their own purse strings and not giving rich doctors raises is easy to do. The general public doesn't view hospital administrators as rich although many decent-sized hospital administrators make more than some/many physicians. Most nursing administration jobs may not be on par with physician compensation but the amount of work per dollar that gets done is minimal. But again, it's easy to give these white coat administration 'heroes' raises and let them continue in a cush role.

[Tim]

With the incredible job market right now many people should be able to switch to a higher paying job right now that keeps up with or surpasses inflation (at least my relatives in tech certainly have). That being said, employed doctors might consider this strategy as well.

The contracts for physicians are much more akin to employment contracts for C-suite executives than the normal employed individuals. The vast majority of employees do not even have a contract that has a required notice of resignation period.
The policies and pandemic have seemed to create an environment for upward wage pressures. Seems to be cyclical. The energy industry for example is not participating.
Feel free to assume that that the wage opportunities are NOT transient. I personally feel like these opportunities will be transient. Policy proposals are already on the table,
unlimited import for work visas etc. I agree with the "right now" description of the job market for segments. Just don't count on it lasting.

[abds]

Most physicians don't control their own purse strings and not giving rich doctors raises is easy to do. The general public doesn't view hospital administrators as rich although many decent-sized hospital administrators make more than some/many physicians. Most nursing administration jobs may not be on par with physician compensation but the amount of work per dollar that gets done is minimal. But again, it's easy to give these white coat administration 'heroes' raises and let them continue in a cush role.

I don’t disagree with this at all. It’s easy to not pay physicians more.

And maybe increasing the conversion factor wouldn’t get passed on to employed physicians anyway and the hospital administrators will simply get bigger bonuses. However in private practice it’s a big deal. If small increases would have even been half inflation, my partners and I would make up to 30% more money for the same work.

People (public and politicians) complain about fee for service because it incentivizes physicians to see more people and do more procedures, ie spend less time on each patient, but we’re making less money for the work we do every year. So it’s absolutely the natural progression to try to do more work in the same amount of time just to maintain income. I know everyone on this forum knows this, I guess I’m just venting. In 20 years, if the system exists like it does, and Medicare is still paying $35/wRVU, it’ll be hard to continue to do what a lot of us do.