The challenge in the US is that the best and brightest increasingly have no interest in entering the medical profession. The debt, crazy years of minimum income, all to let an insurance company admin dictate your every move and while more and more physicians become a labor pool for PE healthcare tracked with metrics fit for warehouse workers (edit: and that’s not OK in a warehouse either). All to earn a decent income but no longer the top of the market. A decent mid-level developer or tech executive makes more than nearly all physicians. No sane top performing talent would dive head first into that mess.
There are exceptions of course but when my brother was considering medical school he visited about 10 different top physicians to seek input and advice and nearly all said if given a Time Machine they wouldn’t do it all over again. That was a real wake up call.
If you go into medicine as a business entrepreneur and build a successful medical business then there’s opportunities for one to still taste some of the glory of the medical profession that once was. Outside that it’s basically a reasonably well paid life of indentured servitude. Yes you’re “helping people” but that only carries you so far which is why so many just burn out and leave.
Massive reform is needed but the powers that be between the AMA and insurance companies seem unlikely to let that change happen unless it’s forced on them by Congress, and that too seems unlikely for now. Something more alike to an apprenticeship model where one grows up from EMT, to nurse, to physician fits the current business model much better than trying to preserve the old world “Officer vs enlisted” model where folks enter the profession directly as officers (physicians).
"decent mid-level developer or tech executive makes more than nearly all physicians"
That's no where near true for a mid level developer or most tech execs or most senior developers. If you exclude faangs a top developer doesn't make as much as a doctor.
It is unfortunately true. Sr/Staff making a tech salary outearns all but the most specialized doctors. Even if you exclude FAANG that's true (other companies have to offer FAANG salaries to get FAANG talent).
You have to be living in a VHCOL to get that, but if you make >$300k TC you are outearning most doctors.
> You have to be living in a VHCOL to get that, but if you make >$300k TC you are outearning most doctors.
Damn really? Years ago I saw a post of someone asking for advice. They had been offered two positions on in SF at ~$500,000 another in Minnesota at $300,000. Granted they were an anesthesiologist, but a few years back I met a doctor in a bar (lol) and they were telling me you can clear half a million as a GP if you're willing to work in rural states with a big shortage.
ER docs, of whom I know many in my town, with a median city household income of $79K, median home price of $529K, are all in a range of $300-500K. Anesthesiology, $600K+.
> Anesthesiology, $600K+.
Good $DEITY. To me that one number explains the entire state of the USA's health system. An anaesthesiologist is a life and death job, but it isn't a complex one compared to say an air traffic controller. In a competitive market, the amount paid to both wouldn't be too much different.
There must be one mother of a guild protecting anaesthesiologists supply in the USA. Where I live, the governments (ie the people who are supposed to represent the other 99.999% of people who aren't anaesthesiologists) ruthlessly crush such behaviour in any profession that lets it become a real problem. We've fired most airline pilots and imported them, live without electricity for a while, imported doctors from anywhere and everywhere until the medical admission boards got the hint.
The USA really needs to get itself a decent democracy, where the pollies actually represent the people who elected them.
From <a href="https://www.ilr.cornell.edu/scheinman-institute/blog/healthcare-insights/healthcare-insights-how-medical-debt-crushing-100-million-americans" rel="nofollow">https://www.ilr.cornell.edu/scheinman-institute/blog/healthc... :
> as many as 66.5% of people who file for bankruptcy blame medical bills as the primary cause.
That doesn't happen in most countries. If most Americans are happy with their health care coverage, I'd say most Americans don't know what good health coverage looks like.
Even the LLM's are bitten by this. I was discussing what sort of capital was needed for retirement, and I asked how about $X million. The LLM's reply was "that doesn't work if you get an expensive medical emergency". I scratched my head for a bit, then prompted: "reminder: I don't live in the USA". The LLM then apologised for it's mistake, and we moved on.
cmiles8 · · focus · HN ↗
There are exceptions of course but when my brother was considering medical school he visited about 10 different top physicians to seek input and advice and nearly all said if given a Time Machine they wouldn’t do it all over again. That was a real wake up call.
If you go into medicine as a business entrepreneur and build a successful medical business then there’s opportunities for one to still taste some of the glory of the medical profession that once was. Outside that it’s basically a reasonably well paid life of indentured servitude. Yes you’re “helping people” but that only carries you so far which is why so many just burn out and leave.
Massive reform is needed but the powers that be between the AMA and insurance companies seem unlikely to let that change happen unless it’s forced on them by Congress, and that too seems unlikely for now. Something more alike to an apprenticeship model where one grows up from EMT, to nurse, to physician fits the current business model much better than trying to preserve the old world “Officer vs enlisted” model where folks enter the profession directly as officers (physicians).
ipaddr · · focus · HN ↗
That's no where near true for a mid level developer or most tech execs or most senior developers. If you exclude faangs a top developer doesn't make as much as a doctor.
SR2Z · · focus · HN ↗
You have to be living in a VHCOL to get that, but if you make >$300k TC you are outearning most doctors.
the__alchemist · · focus · HN ↗
yilomap · · focus · HN ↗
Damn really? Years ago I saw a post of someone asking for advice. They had been offered two positions on in SF at ~$500,000 another in Minnesota at $300,000. Granted they were an anesthesiologist, but a few years back I met a doctor in a bar (lol) and they were telling me you can clear half a million as a GP if you're willing to work in rural states with a big shortage.
FireBeyond · · focus · HN ↗
rstuart4133 · · focus · HN ↗
There must be one mother of a guild protecting anaesthesiologists supply in the USA. Where I live, the governments (ie the people who are supposed to represent the other 99.999% of people who aren't anaesthesiologists) ruthlessly crush such behaviour in any profession that lets it become a real problem. We've fired most airline pilots and imported them, live without electricity for a while, imported doctors from anywhere and everywhere until the medical admission boards got the hint.
The USA really needs to get itself a decent democracy, where the pollies actually represent the people who elected them.
SR2Z · · focus · HN ↗
If you are complaining and what "the people" want, you have to understand that they are actually pretty well taken care of in the US.
rstuart4133 · · focus · HN ↗
> as many as 66.5% of people who file for bankruptcy blame medical bills as the primary cause.
That doesn't happen in most countries. If most Americans are happy with their health care coverage, I'd say most Americans don't know what good health coverage looks like.
Even the LLM's are bitten by this. I was discussing what sort of capital was needed for retirement, and I asked how about $X million. The LLM's reply was "that doesn't work if you get an expensive medical emergency". I scratched my head for a bit, then prompted: "reminder: I don't live in the USA". The LLM then apologised for it's mistake, and we moved on.