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Doctors Starting Salaries – Do We Really Feel Sorry For People Who Make This Much?

20 comments

In the “Physician Placement Starting Salary Survey: 2007 Report Based on 2006 Data,” conducted in collaboration with the National Association of Physician Recruiters, found that physician-owned practices offered comparable salaries to hospital/IDS salaries for family practice without obstetrics ($130,000 versus $135,000), general internal medicine ($150,000 vs. $145,000) and noninvasive diagnostic radiology ($350,000 vs. $345,000). The pay-scales are high. Doctors can easily make over $1 million per year. I am not complaining about their salaries. I am complaining about their whining about lawsuit abuse. It does not exist and yet these rich doctors are using it to trick the public on tort reform.

Do we feel so sorry for doctors who make this much, to say its okay to injure your patients and pay nothing for their suffering? That is what the AMA and the U.S. Chamber of Commerce say that doctors want. There are almost no lawsuits against doctors. In Hawaii there were less than 30 last year. The doctors are making a lot of money. Why does everyone feel sorry for them?

Or maybe you don’t feel sorry for them. I am looking for a sense of what patients feel about doctors’ salaries and doctors injuring patients. What do you think?

20 Comments

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    In England, they make half. However, come hell or high water, they go home at 5 PM. You have an ice pick sticking from your head. Waiting time for emergency surgery? Six days.

    I would appreciate a survey of law school grads, offered $175K knowing no real world law. And partners making $1million plus a year to damage our economy, and to destroy $millions in economic value every year left alive.

  2. Dr. Anonymous says:
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    The bias of this author has motivated him to morbidly exaggerate the facts. I am a new physician, freshly out of medical school. I can promise that of the 50 or so established physicians I know personally, not a single one is earning anywhere near $1 million/year. I do find the yearly salaries stated to be approximately correct. Is 130K-150K unreasonable for a primary care physician? I believe it’s absurdly low. These Dr.’s have completed 11 years education and training beyond high school, at a minimum, and have accumulated $150,000-$300,000 of educational debt. After taxes and student loan expenses (which are almost completely taxable), the earnings drop to about $50,000/year. What do trial attorneys earn? How about sports players? What is the average salary for a VP with a B.A. in business at any major corporation in this country? What the author fails to explain, due to bias or ignorance, is the absolutely horrendous waste in our health care system. This is money spent directly due to fear on the part of my colleagues of being sued. This parasitic activity of Plaintiff’s Attorneys causes thousands of expensive, unnecessary tests and man hours to be wasted daily. Why do my colleagues order unnecessary tests to rule out disease or injury that has a less than 1% chance of being present? The answer is the same universally, uttered in emergency rooms and hospitals daily around the country, “it’s my license, I’m not taking any chances”. A tremendous amount of money is wasted in the hospitals due to these fears. If the opportunity for lawyers to earn millions in judgments was reduced, how many attorneys would take up the cause of medical malpractice? I have yet to meet a single Physician who hasn’t devoted his entire professional life to learning safe care for his patients. It’s what drives us. Furthermore, in Florida, when Physicians rallied for limitation on attorney’s fees in malpractice cases, suddenly the trial attorney lobby groups felt a 3 strikes rule was necessary, curious timing. This has become a battle of livelihood. I would suggest that the average American ask themselves an honest question, “What is the difference in a person whose goal is to be Dr. vs. an aspiring lawyer?” After reflection, decide who’s being honest.

  3. James Cool says:
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    Dr. Anonymous:

    Wayne is obviously biased. But your post reveals you’re hardly impartial. To Wayne’s credit, at least his post isn’t anonymous.

    Let’s be real for a second. Doctors make mistakes. Sometimes they intentionally hurt people (it does happen) or they order tests or prescribe drugs solely for the kick backs and incentives. Medicine, like law, is a business.

    That being said, whether a doctor means to or not, professional negligence sometimes results in people being seriously injured. Are you honestly saying those people ought not be justly compensated for their injuries?

    Surely many lawyers make fine livings handling medical malpractice cases. But the notion that the majority of these claims are frivolous is not only patently biased, it ignores reality. Bringing a medical malpractice case under current tort laws requires a six figure investment on the part of an attorney. This is because medical malpractice insurers put up incredible fights to deny pay outs to justly injured victims. Thus one must spend a lot of money on experts, depositions, consultations, etc.

    The true villain in this debate is the insurance industry. For years, big insurance has mismanaged its investments and under-reserved. That is why, despite declining med mal law suits and the institution of damage caps, medical malpractice insurance premiums keep on rising. Big insurance pits doctors against lawyers and lawyers against doctors and tells the people it’s the fault of other plaintiffs who’ve been injured while they rake in the profits. We’re so busy fighting each other, we don’t notice big insurance making money at both ends.

    It is perhaps the greatest shell game of all time. Big insurance keeps the players eyes off he ball long enough to take everyone’s money. In the end, doctors are afraid of law suits and are raped by high premiums, trial lawyers are denigrated and forced to bet the farm on even the simplest cases and patients are left injured, holding the bag and unable to get fair compensation because tort reform laws make their claims worthless if they value below $300,000.

    Let’s be real: Doctors want to help people. Believe it or not, so do trial attorneys. Both are highly educated and both perform valuable services in society. Both are justly compensated. There is nothing wrong with either group making money and in that respect, Wayne’s post may be somewhat out of place. But bear in mind that civil justice is about just that–justice. Uninjured people do not collect 7 figure verdicts. Uninjured people do not get their claims taken by trial lawyers. The insurance companies have lobbied for laws that prohibit all but the most grievously injured plaintiff’s from ever reaching the courthouse steps.

    If we’re serious about helping people…all of us, doctor and lawyers need to join forces and help beat back the tide of anti-consumer legislation driven by big insurance companies. They’re screwing doctors, lawyers, and patients. Big insurance knows that as long as we’re busy fighting each other, we won’t fight them.

  4. James Cool says:
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    Supremacy Claus:

    The percentage of law grads making $175k is remarkably small. Especially now. We’re talking 5% and lower. The average (median) start salary for most law graduates is approx. $55,000 public sector and 75-80k private sector depending on the economics of your city. Additionally, the glut of lawyers (blame the ABA) has driven median incomes down all over for attorneys. The number of millionaire partners is very, very small. Much smaller than the number of millionaire doctors, I’d venture.

    The reason doctor’s salaries remain high is because the AMA has artificially created a doctor shortage by refusing to accredit new medical schools. It is the exact opposite of the mistake the ABA made by accrediting too many law schools creating a glut of lawyers.

    Because the AMA has artificially created a bull market for doctors, the price of medicine remains very high whereas the cost of legal services is at a record low. You’ll note that one of the few industries widely considered to have avoided the recession is the medical field.

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    I respect what doctors do and I am also proud of what lawyers do. We are service providers and the service is justice. Health without justice is not a satisfactory world to live in. I also don’t agree with the focus of Dr. A’s response on the cost of health care. How about the many patients who are dying easch year or being seriously injured by medical negligence. That isn’t my statistic and conclusion, its from Harvard School of public health. It amounts to a fully loaded 747 crashing each week. So whaqt is it? Is that sad fact because doctors are performing unnecessary tests? the statements by doctors like young Dr. A is what is wrong with medicine. He is wrong on the facts, is repeating the the myths that the insurance industry and U.S. Chamber spread. All I ask for is that the good doctor spend time trying to improve the delivery of health care and look at why patients are being injured. The anesthesiologists did just that and reduced the incidence of malpractice markedly. When illogical arguments like the “too many tests” defense are put aside maybe the medical profession will regain its stature. Until then blaming lawyers for bad doctors is just going to further erode the profession.

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    Mr. Cool: Anytime you want the resume and full information of the author of the Supremacy, let me know. It will be the meaningless information of a stranger.

    Lawyer Hypocrisy Test:

    Will you or will you not support the removal of the privity obstacle to a legal malpractice case by an adverse third party? If you will not, shut up you lying hypocrite.

    The overwhelming majority of medmal cases are weak cases, and fail at every stage of litigation. The filing of a weak case is legal malpractice. I believe in torts. Show us that you do too, to improve the careless performance of your profession, and to make the victims of lawyer carelessness whole with money damages.

    The standard answer, the lawyer owes no duty of care to the other side is absolutely not true. There are dozens if not hundreds of duties to the adverse third party in the Rules of Evidence, of Conduct, of Civil Procedure, and of Criminal Procedure, as well as in hundreds of appellate decisions dating back a 1000 years.

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    Every medical error is the fault of the lawyer. The health provider has a duty to survive. Instead of investigating and preventing errors, the cover up seeks to help the entity survive. All reports will be subject to discovery.

    When the lawyer is willing to open all work products to discovery, and to immunize all good faith investigation of medical error, that is when a big drop will result.

    Harvard is an extreme left wing nutso place. Nothing coming out of it has the slightest credibility. The real death rate from medical error is around 3000 people a year. That is a pretty low rate given the billions of procedures carried out each year. You are safer in the hospital than at home, in terms of the risk of death.

  8. James Cool says:
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    Claus:

    By the removal of what you call the “privity obstacle” are you suggesting that we permit third parties (i.e. defendant doctors or perhaps neutral uninvolved parties) to sue lawyers for malpractice? If so, I’m not sure that’s a privity problem as much as it is a standing problem. You need to be injured in some fashion in order to be sued.

    If you mean defendant doctors ought to be able to sue those who bring “frivolous” suits against them, then such a remedy already exists. Here in Arizona is is called “wrongful institution of civil proceedings.” Admittedly, WICP deals primarily with lawsuits brought for an improper purpose (i.e. harassment or extortion). However, lawyers and plaintiffs are also subject to sanctions for filing “frivolous” lawsuits under Rule 11 of the Fed. R. Civ. Pro.. These sanctions could include fines or contempt. Additionally, if these law suits fail to state cognizable claims or name the right defendants they are subject to dismissal under Rule 12 of the FRCP and the prevailing party is often awarded attorneys fees in these scenarios.

    If, as you say, the majority of these suits are without merit, then how come they’re not all being dismissed with attorneys fees for the defendants? How come more attorneys are not facing Rule 11 sanctions?

    Regarding your argument that one is safer than a hospital than at home, I agree. When I taught high school English, I remember telling students that this was a fallacy known as “straw man.” In essence, a straw man is where you conflate your opponents argument with an absurd facsimile which can be easily torn down..i.e., like a straw man. I’m not sure I see your point there.

    In short, I think the system already provides adequate remedies for folks who are the victims of these “frivolous” law suits to be made whole via sanctions and the award of fees.

    All that said, you make an interesting point about opening internal reports to discovery. I believe you meant to argue that we ought to seal these investigations so they cannot be used against the hospital/doctors. This will encourage and promote safety, you contend. I do not disagree that might promote safety. But my concern is this: How do we ensure, in that scenario, that someone who has been seriously hurt or killed by medical negligence (and it does happen from time to time) will be fairly compensated for their losses, or to adopt your phraseology, made whole?

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    Mr. Cool: I clicked on your profile by mistake. I did not know you were a student. I apologize for any harsh tone. I have no desire to pick on a student. I do suggest you find another specialty than medmal. It is dead, without a future.

    1) “”wrongful institution of civil proceedings.” Admittedly, WICP deals primarily with lawsuits brought for an improper purpose (i.e. harassment or extortion)” You are correct. The plaintiff must prove malice. Short of a taped or written confession by the lawyer, that recourse is hollow. It is infinitesimally rare. Rule 11 is also hollow, because of its 21 days Take Backsies for the lawyer. It was effective from 1983 to 1993. That is why Congress gutted it at the request of its lawyer lobbyists. No one else has had that privity obstacle as you know since 1905. And no one else has a Take Backsies for their carelessness. The judges in medmal get campaign donations from plaintiff and from defense bars. Their self-interest is to hold a trial, despite the risks to the defense lawyer’s legal interests. So the judge has the same bias and personal self-interest as both bars.

    2) The victims of medical error should get Medicaid after an attestation by the defendant. That can be done quickly. It is also a more honest remedy. Every penny of medmal comes from the public in the form of higher prices, or decreased access (see the closure of maternity wards, trauma centers, and even emergency rooms).

    3) The immunity of the hospital should be in exchange for a thorough investigation of the error and systematic changes to prevent it recurrence, plus its publication to the Web so all similar entities may implement the solutions without suffering the error.

    4) The idea that money is compensation for a serious injury can only be seriously proposed by a healthy young person. It is a lawyer scam, a pretext to plunder health care.

  10. James Cool says:
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    Claus:

    I don’t feel picked on. I promise if I start to feel over-matched I will let you know.

    1.) I agree that R.11 could have more teeth. But as with many tort “reform” measures, changes to Rule 11 were reactionary and partisan. That said, if a suit is truly frivolous, I see no reason not to sanction an attorney or Plaintiff. Just remember, sometimes one has to file suit in order to get the discovery necessary to learn what really happened. Thus we find ourselves with a quandary–openness might reduce suits but doctors fear it will generate more. I agree this is a difficult position for everyone.

    2.) Medicaid also comes from the public. Also, you ignore how the insurance industry works. Technically, the money does come from the public in some fashion, but if Big Insurance is doing their job right, it comes out of reserves. Does it not trouble you in the slightest that insurance premiums keep rising and pay outs keep dropping desipite the fact that law suits and verdict means are dropping? Who’s the real bad guy here? I think it’s insurance companies.

    Also, Medicaid will pay a person’s medical bills and it will attempt to remedy their medical condition. But what of their pain and suffering? What of the things they lost? Such as the ability to live a normal life? What about family of those who have lost a loved one to medical malpractice–how will medicaid compensate them?

    3.) Your investigation and safety reform idea is a noble one. I have no argument against it, except for the quandary identified earlier. If your position is “end med mal suits and we’ll do this” then you know very little about negotiation. Polar positions rarely result in fruitful negotiations. If you want to propose compromise reforms that still offers some means of recompense for victims while providing greater protection to doctors, a tit for tat compromise, then let’s hear it.

    4.) Okay, you contend money does not compensate injury. I don’t disagree per se. Tell me: what does? Can we bring the wrongfully dead back? Can we make pain disappear when medicine cannot heal it? We ought to fix what can be fixed, help what can be helped, and make up for what cannot be fixed or helped. So, if not by money, how do we do that?

    If your answer is: “life sucks, people get hurt and die” then I find that woefully unacceptable.”

    I would find arguments against money damages more persuasive if they weren’t based in quaint, Marxist aversions to the power of money.

    So…what’s your solution?

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    I support sanctions against attorneys who file frivolous lawsuits. Attorneys who hide evidence or play games in the discovery process should be sanctioned and in the adversarial process in court it is not uncommon to have one side seen sanctions against the other side for such abuse. In a case I was involved in here in Hawaii, the trial judge ordered a fine of over $1 million when a party hid evidence. Attorney negligence also must be treated equally with any other kind of negligence. If I make a mistake and my client suffers harm and if the mistake was because I was negligent _ my work fell below the standard of care for an attorney _ I should pay my client for what he or she or it lost because of me. And you know it does happen. I was a good student in school but I din’t make 100 on every exam. I made mistakes then and I still do. And when I do make a mistake I have a higher duty to tell my client than the average person because I am a licensed attorney and I know the law and I know my duty. Doctors and lawyers share a higher ground when it comes to our mistakes and although we don’t have to be perfect we do have to be humble and honest. Professional degrees sometimes bring with them a certain amount of arrogance. Like Dr. Anonymous I have 10 years of college and I worked hard, suffered a lot (if you can call taking tests in college real suffering …. probably not) and so I ask does that give me some excuse for anything? Truck drivers and waitresses suffer and work hard. I see a lot more frivolous defenses in my cases than frivolous cases. The attorneys on the other side get paid by the hour by huge insurance comnpanbies. The longer the case takes and ther more complicated it gets the better for them. I don’t get paid unless my client collects money and I have to pay for everything. I reject many cases that have merit because I can not afford to gamble the costs to find out if we can win. In medical malpractice cases the minimum it costs to get a case to trial ins $25,000 for experts and it can go over $100,000 or #200,000 easily. The doctors do not settle their cases and so it is a full out and expensive war. I made a mistake in a case once and my client suffered because of it. I called the client in and explained my mistake and how it hurt him. I gave him the information on my insurance and told him to bring a claim with them. I admitted my mistake and explained to him that I buy insurance to protect my clienst as well as myself. The client remains a friend to this day and I feel good about doing the right thing. I am interested in whether any doctors out there have ever done the same as I did? In 30 years of practice I have never seen a doctor admit to any mistake. Anyone out there want to comment?

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    Mr. Parsons: Is the filing of weak claim a type of legal malpractice? Are you willing to compensate the adverse third party, as well as your client for damages from your carelessness? You have absolute scienter of the lawsuit lotto of weak cases, since the failure rate has been over 70% for decades, and at every stage of litigation.

    Compare to this. Criminal prosecution, with it 70% success rate (guilty verdict). Young, inexperienced prosecutors, making $80K, instead of $800K. They carry 200 cases instead of 20 a year. They have a long list of elements to each crime. They must prove intent for each element. The burden of proof for each element, and for intent of each element? Beyond a reasonable doubt (about 80% certainty), instead of preponderance of evidence (about 51% certainty, without showing intent). Why can’t you meet that professional standard of due care?

    As to duties, there are more duties statutorily enumerated to the adverse third party than to the client. When negligence is shown to have injured the adverse third party, in many cases if not most, it will be per se.

    So, do you support ending the privity obstacle to a legal malpractice claim by the adverse third party? That is a neutral proposal, since plaintiffs may sue defense lawyers for filing a weak defense. How on earth can you justify this unjust immunity if you do not support ending it?

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    Dear Supremacy: You need to do a little more homework lest your opinions suffer from poor research. You obviously haven’t been involved or close to much real courtroom work. Can you explain to me where your data comes from that most plaintiff’s cases involve per se negligence? That is a very interesting statement. Also, what do you think the burden of proof is in a negligence tort case. Please add some references to support your opinions. I am getting the impression that you just like to make accusations and not back them up with anything.

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    That (making unsupported accusations)is typical og Big Insurance, Big Pharma, and the Wall Street crowd. The U.S. Chamber of Commerce would love a person like you. Or maybe you work for them. Do you work in one of those industries and why do you support their positions?

    How did you get that handle. Its catchy but allows you to hide yourself from criticism like you hand out to everyone else. Whoops. My mistake. You like all doctors even ones who injure people through incompetence, and you like big insurance companies like AIG that rip off their customers and have helped caused the economic crash. Did I miss anyone?

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    Mr. Cool:

    1) Right now malice must be shown before an action can be declared frivolous, and there must be zero justification in the facts or law. In 100% of cases, you have the bad result, ending the lack of justification in fact in 100% of cases. So the word frivolous is hollow, and pretextual, to give only the appearance of viritue. How about just negligence, and the doctrines of strict liability for the weak case?

    2) Insurance companies have an inherent conflict of interest. Their lawyers will never ever really hurt the plaintiff bar. If the plaintiff bar is deterred, they lose their business. So medmal, even if owned by physicians are adversaries to clinical care as much as plaintiff lawyers.

    The injured may get disability to take care of personal and family expenses.

    3) I am patient, I am the parent of a victim of a medical injury that really rocked my family for a decade. I want errors to end more than money. Let’s have a race between the error investigation and the lawsuit. All data revealed in the investigation and to the world on the web is immunized from discovery. Any covered up data is subject to discovery. The revealed data is not to embarrass but to allow similar entities to profit from the error and its correction.

    One of the reasons I do not want to pick on law students is that they are criminal cult indoctrination victims who need help, not condemnation. You have been indoctrinated into Scholasiticist doctrines and methodologies from the 13th Century. There is no chain of causation. There are factors that cluster in space and time to result in a catastrophe. On average, there may be 12. If only one is prevented, the entire catastrophe is prevented.

    4) “Too bad if you had an accident,” is the view in Europe. I believe in torts as an alternative to revenge. However, I would limit payments to those cases where 1) the doctor wants to settle; 2) the deviation is within the knowledge of the jury; 3) where only the plaintiff has the support of an expert. If opposing experts testify in good faith, you have a scientific controversy. The latter cannot be settled by court rhetoric, but only by additional scientific data. When opposing expert testify, the case should be dismissed as outside subject matter jurisdiction, and a violation of the procedural due process rights of the civil defendant to a fair hearing.

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    Mr. Parsons: I work in none of those industries. I am a fictional character. I seem most of them as adversaries bigger than the plaintiff bar.

    Here is a list of duties to adverse third parties, with references. Only the self-dealt, unlawful, unjust privity obstacle prevents accountability of the lawyer.

    http://supremacyclaus.blogspot.com/2007/05/ending-lawyer-immunity-from-legal.html

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    I will look at the website later today. Thanks for providing the reference. As you will note I am not averse to having attorneys sued for misconduct. And “yes” a frivolous claim can result in a suit against the attorney. It might not be a “negligence” claim though since the attorney would be doing an “intentional” act in many situations. The tough area is where there is evidence on both sides. Let’s say you sue someone for stealing your words and violating copyright. The other side says it is original work. You have a trial. The case is close. If you lose are you going to offer to pay damages to the defendant and pay their attorneys fees and court costs?

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    Mr. Parsons: You are describing loser pays. I support the American Rule, where each side pays its legal costs. I believe in torts, as you do.

    We are not discussing loser pays, which I oppose, for the same access to justice reasons you might.

    I am proposing suing the other lawyer when the other lawyer has deviated from lawyer professional standards of due care owed to the adverse party. These standards are enumerated in statutes. I am willing to protect the careless lawyer from retaliatory or other frivolous lawsuits by requiring a certificate of merit be filed with the claim.

    The objection from ALI Torts section reporter? Litigation explosion.

    I privately exploded in laughter at that argument. I thought the irony hilarious.

    Torts will improve the performance of all lawyers, I replied.

  19. James Cool says:
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    I think I speak for everyone when I say: “Huh?”

    I can’t follow your argument anymore, Claus. Too many sentence fragments.

    Sorry =/

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    Mr. Cool: Parse it word for word. Do it six times. It will slowly get clearer. Or, become the victim of a frivolous lawsuit, it will get clear in a second.