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I Am a Lecherous Shyster.

January 19, 2014

For some reason Elisabeth Rosenthal is angry.  Maybe she’s got a headache.  Maybe her ex is a doctor.  Maybe her cat died.  Why else this one-sided evisceration of doctors in the New York Times this morning?  All doctors are out to get your money.  I’m out to get your money.  My whole motivation for killing myself in school and impoverishing myself with loans is to get your money.  Yep.  You found me out.

I realize that fair and balanced reporting is all in the eyes of the beholder.  CBS did a story recently about how all doctors are essentially whiners.  Ben Brown wrote a mathematical masterpiece that indirectly refutes Rosenthal’s position that doctors make this big mess of money.  But if you hate doctors you will believe Rosenthal and if you are a doctor you’ll believe Ben.  I can’t change the doctor-hater’s minds.

Look.  I make a good living.  Sorry.  I show up at work, anesthetize the people I’m assigned to anesthetize, go home, and do it again the next day.  For this privilege I worked hard.  Someone pays me good money for it.  Sorry.  You can be an anesthesiologist if you like.  I had no special advantages.  But if you think I make too much, OK.  My good friend Kevin Tabb, the CEO of my hospital, makes a whole lot more than me.  Is he a lecherous shyster too?  My brother-in-law makes bank, and I mean bank, on Wall Street.  The owners of Elisabeth Rosenthal’s newspaper?  Bank.

I have no idea where my salary comes from.  I didn’t get to negotiate.  It’s certainly not what Rosenthal thinks it is.  I wouldn’t have the first idea how to “maximize profits.”   If I ran the world we’d all be broke and my kids’ pre-school teachers would be making a million dollars.  However, I cannot deny that some doctors have profits in mind when they care for you.  That sucks and I wish it weren’t true.  But what’s the difference between my lecherous colleagues, Kevin Tabb, my brother-in-law, and the major shareholders of the New York Times Company?  Nothing.  We are all capitalists.  Wall street is capitalism.  The NYT is on the New York Stock Exchange and that’s capitalism. The American medical system is also capitalism.  Free-market healthcare.  It is.  So why vilify workers in a system designed to make people money for maximizing profits?  Isn’t that the whole point?  If my brother-in-law didn’t spend every waking moment trying to make money he’d get fired.  But I’m a selfish rich person?  You all agreed, I guess, that you want a capitalistic healthcare market.  “Universal healthcare is socialism”, remember?  Then you can’t blame doctors for being capitalists.  Sorry.



From → Healthcare

  1. Kary VanAllen permalink

    I’m an Anesthesiologist also and I feel that I am compensated fairly for the risk and stress that I assume by putting sicker and sicker patients to sleep. If I make a mistake a patient may die. If Elizabeth Rosenthal makes a mistake her editor corrects it.

  2. Vic Nicholls permalink

    I read all the links you provided.

    I come up with several questions for the calculations given on pay:

    1) IT works nights, evenings, weekends, holidays and take call. Now that there are hospitalists, there are those who don’t take call. I know of some surgeons that negotiated a $1K bonus for on call and they got their work hours rearranged for office visits. I don’t get that in IT.

    2) Actually interns & residents hours have decreased by the law.

    3) As for cost, 30% of medical school students come from medical families. Are we to gather that no one helps out in the family? Interns and residents don’t share room and board, etc. like those in college do?

    4) Loan repayment programs such as those offered by the military are not a solution for the majority. Yes, but how many are willing to wait for a year to get in them? I’ve never heard that the services have a lot of spots available.

    5) What about those who marry another doctor? If it takes 20 years to pay off debt, you have someone in their middle to late 40’s now earning about a $200K paycheck. Add another one to that and that’s at least (by the figures presented) 20 years at that salary. So your highest earning years, no loans to pay off at a $200K or in the case of doc/doc marriages: $400K a year at least.

    6) If this were true about the money, how come no doctor lives in my middle income neighborhood? In addition, what about salary going up during those 20 years? That’s not calculated in there.

    7) I also don’t see that doctors and nurses I know get 5-6 weeks of vacation. We only get 2.

    I don’t think the intention here is to blanket all docs. I think what we see here is the fact that there are those who use the system to get better pay or get it inflated, and that medical care is way more expensive than it needs to be. There is a lot of waste in the system. We pay more but don’t get value for it.

    Your CEO, yes now he is a leach. Just by virtue of being any sort of health care related CEO. LOL.

    • Vic. Thanks for reading! You are absolutely right that everyone is frustrated that health care is so expensive, and people are looking for someone to blame. I was really reacting to the extreme negative tone of the NYT piece. I would refer to to Dr. Brown with your points about his work, which are valid questions. As to Kevin Tabb, he’s a leach in the nicest possible way… 🙂

      • Vic Nicholls permalink

        Well here is my take: I can’t see radiology or dermatology or opthamology getting the $$$ they do. Direct patient care should get the bulk of it. Surgery and ob/gyn after that. Peds, if you don’t include them in primary care. Gas passing, you can easily lose your behind off that, so I don’t have a problem with that either. I came out of it during the last surgery, and went back under without a problem. I have to feel for the gas passer … plus you have to take the ego from the other side of the blood brain barrier. Surgeons: strong back, weak mind, Burj Dubai sized egos.

        First, if you can get the missed/delayed dx problems fixed, you can get rid of some admin and risk management. Mr. Tabb might be, but I can think of a lot who aren’t.

        The other is to take a gander at the insurance companies. Some of the stuff they do bears reviewing. It would help if the state medical boards did their part and patients were allowed to take the responsibility for some things. There is a time to sue and a time to act like adults. Enough said on that issue.


  3. Alex permalink

    Ms. Leng, I do hope that you read this for I read an article that you wrote about how you first started your career as a nurse and are now an anesthesiologist. It was a coincidence if not, a miracle that I found that article. The thing is, I am currently a nursing major and only have 1 more year before I graduate with my BSN but I am starting to rethink my career path and wanting to enter medical school to become an anesthesiologist. I was hoping maybe you could tell me about your experience and how you were able to do both. I feel as if you are truly an inspiration to me and I would be glad to talk to someone who was in the same shoes as I am now. Please feel free to contact me whenever you can. Thank you.

    • Alex-
      Oh my I don’t envy you your decision! So many people have asked me about this. I’ll give you a two-part answer. First, my own decision. I decided to go to med school because I was frustrated with nursing (I was NOT an NP). The thing about regular RN floor nursing is that you have a lot of responsibility and no power. People told me I should do ICU nursing or NP or nurse anesthetist but I was stubborn. At the time I thought I wanted to be the one making the decisions, being involved in the discussion around the bed on morning rounds, have that authority that you’re talking about. Having been a nurse I thought I knew what I was getting into. I had no idea.

      Part 2. I generally try to steer people away from medicine unless they are absolutely 100% couldnt-imagine-doing-anything-else, wanted-to-be-since-I-was-five kind of sure. This is not because the education and training take so long and are so hard. It’s because the hardness never ends. You sign up for medicine you sign up for a lifetime of call, nights, weekends, holidays, long hours. It never really gets any easier. You sign up for medicine you sign up for that lifestyle. Now, being an NP or CRNA can be hard but usually you are not buying into a lifestyle, but into a job. NPs can enjoy independence, diagnosis, treatment, definitely caring, and everything you talked about. Some NPs and CRNAs take call many work long hours, but your options for work/life balance are greater. A lot of what you would do as an NP and how respected you would be depends on where you chose to practice, and who with. A physician or physician group that values and honors their NPs is a great and rewarding place to work.

      Find out as much as you can about both. Shadow doctors and nurses, ask people what it’s like, be a CNA in different settings. You never know what it will be like for sure, but arm yourself with knowledge.

      Hope this helps. Good luck!
      Show message history

  4. Hi Shirie…

    Just wanted to thank you for the comment you left on my article on KevinMD. As a rule, I don’t comment on other blogs. Because I really enjoyed your post, though, I just wanted to let you know we appear to be of the same mindset. A couple of my most recent articles are directly related to what you are saying in this post (frighteningly similar, actually, which is why I decided to leave this note). Take a look at these:

    (since you are an anesthesiologist)

    (since you seem to agree that doctors get a bad rap)

    The second article already appeared on Kevin’s site, and the first one will be up in about two weeks. I guess we’re both greedy, huh…lol… I worked in Finance and IT for about 12 years before going to medical school, so I can confirm that, in most cases, physicians are not “rich.” But don’t say that out loud–you’ll take a beating for it. Anyway, thanks again for the comment on my post and feel free to let me know if you ever want to write a guest post on my site. Take care, and best of luck to you.


    • Luis –
      Thanks for reading! Lord, that post on anesthesia and primary care is hilarious! I scared my kids I was laughing so loud. I’ll keep you in mind and will definitely read more of your work.

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