In April, Medicare spewed out some schismatic physician-payment numbers. The blast of decontextualized data said that one ophthalmologist received $12 million in payments. Another 4,000 physicians took in over $1 million in 2012 just from Medicare Part B. The New York Times' number generator let readers type in a doctor's name and get a dollar amount. In a lot of cases, physicians came off looking seriously flush with cash.
Those numbers and the accompanying "Go to medical school, you can make more than Lebron" implications were misleading in that they represent revenue, not profit. Like so many doctors, knowing there's a difference between revenue and profit is around the upper limit of my financial acumen. Most of what I know comes from Shark Tank, but I do know that. According to Medscape, right now the average pediatrician makes $173,000, the average neurologist makes $217,000, general surgeon $279,000, radiologist $349,000, and, at the highest end, the average orthopedic surgeon makes $405,000.
So doctors are earning very solid salaries, once they are done with their training. Of course, medical school is expensive. The average graduate carries a debt of $169,000. Less talked about is the salaries doctors make during their first years after finishing medical school, before they begin independent practice, known as residency and fellowship. Today Medscape published its annual results of a national survey of how much doctors are making during that time.
Doctors are spending more and more time in residency and fellowship programs—sometimes up to a decade—but their salaries during those years (accounting for inflation) haven't increased in 40 years. Factoring in time spent in school and residency, one study from economists at Yale recently found that the average female primary care physician would have made more money over the course of her career had she been a physician assistant.
Most people know that going into medicine to get rich is a mistake in multiple dimensions. Unless you're into writing ethically dubious diet books or making ethically dubious TV shows. But in the face of a potentially staggering physician shortage—the Association of American Medical Colleges warns of a deficit of 130,600 doctors by 2025—people who want to go into medicine (particularly primary care) have to envisage financial viability in their grand mission. At $51,000 before taxes, a doctor working 80 hours per week for 48 weeks per year earns $13.28 hourly. Not everyone is working 80-hour weeks regularly—the recently imposed maximum allowed—but in specialties like surgery, many residents and fellows are. A lot of those hours are on weekends and overnights, under extreme stress at extreme stakes.
Doctors aren't struggling to feed their families, and of course they don't care about money. But the overall lifestyle isn't as Rick Ross as a glance at Medicare payments or mid-career salary might imply.