5 ms·

> As I understand it, salaries are only one of the many ways that doctors make money. Many "providers" are doctor-owned. No, nowadays, private practices are a

> As I understand it, salaries are only one of the many ways that doctors make money. Many "providers" are doctor-owned. No, nowadays, private practices are a dying breed. Most physicians are, in fact, salaried. And that salary isn't actually all earnings, because a large chunk of their business and professional expenses (insurance, continuing education, various licenses, etc.) all have to be paid out-of-pocket. These expenses are not generally tax-deductible, because of the AMT thresholds, so doctors' actual disposable income is dramatically less than you would think just by looking at the raw salary number. It's very different from other fields (like software engineering) in this regard.

analog31 8y ago
But the earnings aren't all salaries either. As I understand it, doctors earn salaries from employers, but as I understand it, they are also leading investors in provider systems and in the malpractice insurance system. They're not getting poor. The only thing I'm suggesting is that reducing the cost of care will make them poorer, but that could be offset by attracting people to be doctors who don't come from the most affluent backgrounds.
- chimeracoder 8y ago
  > But the earnings aren't all salaries either. As I understand it, doctors earn salaries from employers, but as I understand it, they are also leading investors in provider systems and in the malpractice insurance system. Your understanding is very, very gravely mistaken. Most doctors do not have any of the kids of investment stakes you describe.
- aesclepius 8y ago
  > but as I understand it, they are also leading investors in provider systems and in the malpractice insurance system. You're completely wrong. There's actually the Stark law (https://en.wikipedia.org/wiki/Stark_Law https://en.wikipedia.org/wiki/Stark_Law) set up to prevent doctors from owning industry-related materia or self-referring to any entity with financial relationship. Not only that, but out of my network (100+ other physicians) very few are the 'leading investors' in provider systems, and zero have any skin in the malpractice insurance system. The MBAs run the numbers game, the MDs just work long hours.
  - analog31 8y ago
    When did that law go into effect? The provider network that my employer's insurance plan used for a while advertised on a billboard that it was "doctor owned." What I don't know is how the specific financial or legal relationship worked.

analog31 8y ago

But the earnings aren't all salaries either. As I understand it, doctors earn salaries from employers, but as I understand it, they are also leading investors in provider systems and in the malpractice insurance system. They're not getting poor. The only thing I'm suggesting is that reducing the cost of care will make them poorer, but that could be offset by attracting people to be doctors who don't come from the most affluent backgrounds.

chimeracoder 8y ago
> But the earnings aren't all salaries either. As I understand it, doctors earn salaries from employers, but as I understand it, they are also leading investors in provider systems and in the malpractice insurance system. Your understanding is very, very gravely mistaken. Most doctors do not have any of the kids of investment stakes you describe.
aesclepius 8y ago
> but as I understand it, they are also leading investors in provider systems and in the malpractice insurance system. You're completely wrong. There's actually the Stark law (https://en.wikipedia.org/wiki/Stark_Law https://en.wikipedia.org/wiki/Stark_Law) set up to prevent doctors from owning industry-related materia or self-referring to any entity with financial relationship. Not only that, but out of my network (100+ other physicians) very few are the 'leading investors' in provider systems, and zero have any skin in the malpractice insurance system. The MBAs run the numbers game, the MDs just work long hours.
- analog31 8y ago
  When did that law go into effect? The provider network that my employer's insurance plan used for a while advertised on a billboard that it was "doctor owned." What I don't know is how the specific financial or legal relationship worked.