Thank you all for the great comments and for the links to other sites. Thank you for the contact information as well. Some of the comments are better than the article.
Just some Housekeeping before we move on with the World Tour.
I want to thank "DocGonzo" for his/her help with the graph in the last article. With your assistance I was able to fix it.
I also want to thank all of you who are living abroad for the info and the contacts. And I have been corrected about France. "Fruitcake", an American living in France, informed me that last year they added gatekeeper physicians. However the going to a doctor without a referral apparently only costs a Euro ($1.34 today).
There was a great deal of good discussion about Canada on the Daily KOS. The link for my Diatribune readers is http://www.dailykos.com/...
As far as Canadian physicians, I have worked with several graduates of McGill University. One of the physicians in our town moved here from Quebec. He is an extremely good doctor and a brilliant surgeon. There are good and bad doctors everywhere. As far as I can tell the Canadian physicians are just as good as US physicians.
I know I came off harsh about doctor wages. Clearly this is a sore point. I am not at all upset with what I make. It is just that wages for physicians have not moved in 10 years and I get tired of everyone thinking I make millions. I have a cabinet maker friend that makes almost 1/3 more than I do.
I was curious after watching the movie "Sicko" and reading the comments about doctor pay. So I started to look around on the web. What I found did not surprise me. While doctor wages have been stagnant in the US they have continued to rise elsewhere. The disparity now between the US and other nations is growing much smaller. It was difficult to find info but I did find some interesting things. This is a 2002 article from Canada.
Family doctors and general practitioners in 1999-2000, working a typical 54.7-hour week, on average billed OHIP $168,300 a year, according to Ontario Medical Association figures. Their average net earnings after overhead expenses is $99,300, the OMA reports.
That means their pay is less than skilled tradespeople willing to work 50 to 60 hours a week, plus some weekends, installing and repairing machinery at vehicle assembly plants in Windsor, Oshawa, Oakville and St. Thomas.
Other tradespeople can earn more than $75,000 a year, as much or more than a doctor working a 40-hour week.
Geof Botting, head of Ottawa's Regional Centre for Excellence in Skilled Occupations, says efficient drywall workers, carpet installers and automatic transmission rebuilders can earn more than $80,000 annually. The centre is a partnership among area school boards and community colleges to promote skilled trades as a career option.
Mr. Botting said good auto-body repair workers earn $70,000 to $80,000 a year.
Skilled autoworkers willing to work 56 to 60 hours a week, plus some weekends, at General Motors, Ford or DaimlerChrysler can earn up to $130,000 a year after completing a free apprenticeship program, according to John Bettes, a Canadian Auto Workers spokesman.
[Remember this is the Canadian dollar.]
.....
Being a doctor, on the other hand, is not nearly as lucrative as most people think, Dr. Maher said.
"I know a lot of people working in the government with a bachelor's degree who do little most of the time and make $60,000 a year plus benefits. I make $75,000 a year with no benefits. There is no pension, no sick days, nothing."
Most doctors work extra hours if they can to earn extra income, he said. He said a family doctor working an average 37.5 hours a week will gross about $132,000 a year and spend at least a third of his income on overhead.
......
"The government is paying GPs $105 to $110 an hour. If you take off the overhead of $35 an hour you are left with $75, which is what I am making. Who is going to spend nine years in university, run up a $100,000 debt and accept all the stress and responsibility to make what an electrician is making?"
It will take a salary of $150,000 a year without benefits for a 37.5-hour week or $130,000 salary with benefits to attract more Ontario doctors into family medicine, Dr. Maher said.
Ottawa's Doctor Shortage - Queueing for Health Care
© Copyright 2002 The Ottawa Citizen
This was written in 2002 which was the latest I could find. Apparently quite a bit was written then because it was a breaking point for the doctors who fought for and won a raise after this article. For comparison, GP's in the US make around $100,000 in 2007. Family practice doctors make about $130,000. The Canadian doctor in the article was making $55,000. I make $175,000 after a knock down drag out fight with my boss 2 months ago. (After she had hired a new Male physician for $175.) Until that time I made $160,000. But again I not only had 9 years of University/Medical school education, but 4 years in residency (hell) and 15 years of real world experience. I was unable to find a comparable Canadian salary number for Ob/Gyns.
Last month, on the brink of a withdrawal of services by specialists angered by the Liberals' flip-flop on an arbitrated award, the province and the B.C. Medical Association reached a settlement that would see $392 million more pumped into doctors' wages.
Of that, $185 million will be used to top up the fee schedule the Medical Services Commission uses to pay "fee-for-service" doctors. The rest will be split between boosting on-call rates and developing strategic initiatives to stabilize the funding system.
That $185 million represents about a compounded (spread over nearly two years) 11.6-per-cent increase over the $1.63 billion spent last year on fee-for-services.
But doctors say that only begins to close the gap between what they believe they are worth and what they are actually paid.
....
As a "full-service family physician," Burak still delivers babies, does house calls and makes hospital visits. He has privileges at three area hospitals.
Burak, who is the honourary secretary-treasurer of the BCMA, last year billed the Medical Services Commission just over $250,000.
But out of that, more than $104,000 went to office expenses, including his share of a secretarial/office pool of eight full- and part-time employees, all of whom get better pay increases than he does. It also went for the office lease and medical supplies.
A large portion of the remainder went to income tax and to pay for Burak's own benefits, such as health and dental insurance. What's left, he said, reinforces his overwhelming belief that doctors are no better paid than other professionals.
http://shazam.econ.ubc.ca/...
Then there is Britain:
250,000 Pounds a Year translates to US$ 507,248/- a year, which perhaps only what the specialist surgeons and Interventional cardiologists in America can hope to make - and yet it's the kind of money that some of the Family medicine MDs - ( called General Practitioners in UK) are making.
Official data showed that 50% of the the England GPs were making more than 100,000 Pounds a year ( US$ 202,899/- in July 2007 Exchange rates) and 10% of them made more than 150,000 Pounds a year ( US$ 304,349/- in July 2007 Exchange rates)
All this due to the 2004 contract where the GPs were to be rewarded more for being on the forefront of care and improve preventive care services. I personally think rewarding primary care is good - but then, when these docs starting enjoying the pay and cutting back on work by closing down evening patients and taking whole weekends off, and still making crazy money - then you begin to feel - "OK..they MUST be getting overpaid then!"
Before the 2004 Contract - the average pays were 70,000 Pounds a year (US$ $142,029 in July 2007 Exchange rates), which were just a wee bit less than the national average of family medicine docs in USA
And how do incomes of General Practitioners in the Rest of the United Kingdom Fare in 2006-2007? Here are the average earnings figures:
England = 103,500 pounds a year
N. Ireland = 91,500 pounds a year
Wales = 92,000 Pounds a year
Scotland = 83,000 Pounds a year
http://mdsalaries.blogspot.com/...
That's it! I am moving to England. Cheerio!
What is interesting about all this is that England actually spends less per capita than Canada.
In the end I do not think it is physician salary that makes the difference. In the US cost could be lowered by cutting out the insurance industry with its 31% overhead. The 11 billion dollars of profit that the top 6 companies took this year could go a long way. Just cutting out the insurance industry would allow us to give health care to everyone for the same amount, or less, than we pay now.
I hope that answers some of your questions. I should continue the tour on Sunday.