Money Talk: Should Doctors talk to Students about Salary?

 

CNN published an interesting Report last year regarding Physician pay. The article revealed the scrutiny that Physicians are under in regards to their salary. Sources say – quite possibly no other occupation in the country receives such attention regarding the income its members receive. And that’s not a new trend – more than 70% of respondents of a survey published in the 1985 American Journal of Public Health believed doctors were overpaid.

 

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Consider that physicians must complete at least four years of college, four years of medical school, and between three to eight years of residency training prior to becoming a real, practicing doctor, Many physicians don’t start earning “doctor-level” salaries until they are well into their 30s.

A recent study by MedScape revealed that 51% of doctors believe they’re not fairly compensated. Of primary care physicians, this percentage increases to 55%. To gain a little deeper perspective of the above statistics, our 4th Year Medical Student writer Liz McKinnon reveals a personal take on money talk from a physician first hand. Do you think physicians opinions about salary will influence the decision to enter the field of Medicine for future aspiring doctors?

 

Should Doctors Talk to Students About Salary?

 

“It’s fair,” he said. “The compensation isn’t the highest it could be, but I do well.”

It was downtime during the outpatient portion of one of my rotations, and a fellow student had just asked an attending about his salary, a question that, up until that point, was something I thought was off-limits. Doctors were more than happy to talk to you about treating pancreatitis, the outcomes of drug trials, and why someone in the midst of blasting electronic candy on their cell phone is never experiencing 10/10 pain. But…isn’t it considered kinda rude to talk about money?

I’m no etiquette school graduate, but I do know this: In most social arenas, asking someone how much money they make is a little bit like walking into a crowded room and promptly passing gas. No matter what, it’s just something you don’t do.

“After insurance, making payments for my apartment, bills, and sending off another chunk to student loans, I don’t have very much left over to take home to my family. But it could be worse, I guess.”

My fellow students nodded along as the doctor continued telling us about how if he could do it all over again, he would strongly reconsider medicine as a career because he didn’t think the pay merited his responsibilities towards his patients nor the teaching capabilities he had for his residents. I just sat there dumbfounded, most likely frowning myself into a mask of horror, and thinking in my head, “It’s none of my business how much this doctor makes.”

But then the real question emerged as I headed for the cafeteria with my group after the morning was done.

Is it my business?

“Of course it is,” one of the students replied to me. “Whether we like it or not, being a doctor is a job. If you were training someone who was entering your field of study, wouldn’t you want to educate them on exactly what they are getting into?”

That was hardly the answer I expected out of a 3rd year medical student, who just a few short years ago was writing essays about how he wanted to be a doctor because he wanted to help people. And I tended to believe that once you get into medicine, you make a contract with yourself that the compensation doesn’t and will never matter because the basis of knowledge is for the greater good of humanity. This is because ultimately medicine is a unique “field of study” in which the goods and services that are being exchanged include such necessary commodities as a functional beating heart.

“It’s not like you’re a pre-med trying to find a reason to keep studying for your organic chemistry final,” said my colleague. “This is the rest of your life. And if you think it doesn’t matter how much you’re going to take home and live on, you’re being naïve.”

Honestly, I never thought of it when put that way. My colleague was essentially saying that if you are blind to the fact that compensation isn’t something to consider when deciding what you want to do in life, you’re not fully taking in the weight of your decisions. And if this isn’t something you can bring yourself to ask, then you are not adequately preparing for the monumental challenges that lie ahead in the real working world.

So, was I being naïve? At what point is it okay to ask doctors about their lifestyle, satisfaction, and compensation? Is it ever okay to cross that line?

To investigate the answer to this big question further, I decided to go straight to the source. While working late one night, I proposed the question to my attendings and resident team. And to my surprise, there were a variety of answers.

One older female attending told me that it really depended on the student’s immediate goals and where they fell in the timeline of their training. She said that she would much rather have the conversation about salary if the student was preparing a residency application in her specialty and wanted to know more about what he or she could expect. She added that if a first year student asked her the same question, she would question their dedication to medicine altogether.

Another younger doctor said it was all about tact. If a student abruptly brought up money, he would be hesitant to answer and frankly insulted that someone would be so abrupt (see also: passing gas in a crowded room). But if a student began a conversation wanting to know more and more about the doctor’s job, he would be a bit more free in talking about the breadth of his profession. “And honestly,” he said, “compensation would just naturally come up in the conversation.”

Lastly, a resident answered my question with a resounding no. “That’s never appropriate to ask in a learning environment,” she said. “Anyone can look up those statistics on the internet if they really and truly were curious.”

Other doctors and students told me that knowing the student asking the question was another big factor. If a doctor has come to know a student through and through over a few weeks or months, he might be willing to disclose sensitive details about his lifestyle. Otherwise, he would consider this to be blatant rudeness on the student’s part and dismiss the question as an act of unprofessional behavior.

A range of answers means a range of beliefs out there amongst the medical community. From the ones who are willing to talk about it to the ones who would side-step the issue until they are clear to the opposing wall, asking questions about compensation is an enormous risk. And I’m not just talking about dodging judgment after asking that big question. Even if we get our answers how will the information affect our decisions to pursue certain fields of medicine? Will we be as satisfied with our decision as the day we put on our white coats and pledged our dedication to ourselves and our future patients?

As we students move up into the world, from 2nd to 3rd year or 3rd year to budding residents, we must always remember that the wide wings of professionalism extend to the things we want to ask but should have the good sense to ask only when the time and place is appropriate. Have a sixth sense about this kind of thing, and know who you are dealing with in a rotation. Before you explore the side of medicine as a business, recount the reasons why you chose medicine in the very beginning.

Remember that while you will one day be truly working as a doctor, your principles have not changed in the sense that you do not see your daily activities as transactions, but rather patient encounters with real human beings. And above all, give yourself a chance to be immersed in the various fields of medicine and be open to all career possibilities within it. All the money in the world won’t matter if you don’t enjoy what you do.

 

 

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DanielleKrolMD
Dr. Danielle Krol, a native of the Philadelphia area, spent the majority of her early life growing up in New Jersey. With over 15 years’ experience in Dance and Theatrical Arts, Dr. Krol was pursuing a career as an actress until her mother was diagnosed with metastatic breast cancer. For the 3 years that followed, Dr. Krol placed her life on hold and took the responsibility of Caretaker for her terminally ill mother. Her passion for medicine came about during her mother’s illness, and her determination to become a doctor came about after her passing in 2002.