Very Rich Are Leaving the Merely Rich Behind - NYT

[Bozita]

http://www.nytimes.com/2006/11/27/business/27richer.html?hp&ex=1164690000&en=8ce83432e4bd8730&ei=5094&partner=homepage

November 27, 2006

Gilded Paychecks

Very Rich Are Leaving the Merely Rich Behind
By LOUIS UCHITELLE

A decade into the practice of medicine, still striving to become “a well regarded physician-scientist,” Robert H. Glassman concluded that he was not making enough money. So he answered an ad in the New England Journal of Medicine from a business consulting firm hiring doctors.

And today, after moving on to Wall Street as an adviser on medical investments, he is a multimillionaire.

Such routes to great wealth were just opening up to physicians when Dr. Glassman was in school, graduating from Harvard College in 1983 and Harvard Medical School four years later. Hoping to achieve breakthroughs in curing cancer, his specialty, he plunged into research, even dreaming of a Nobel Prize, until Wall Street reordered his life.

Just how far he had come from a doctor’s traditional upper-middle-class expectations struck home at the 20th reunion of his college class. By then he was working for Merrill Lynch and soon would become a managing director of health care investment banking.

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[Trillo]

1. Guess he can leave the "healing" to others.

Too bad all that education was wasted on a greedy mind.

Guess Wall Street needs field expertise for preemption.

[qwlauren35]

8. What percentage...

of medical students are in it to heal and not for the money?

I think over half of them are in it for either the power or the money. The power to heal has some serious aphrodisiac qualities, akin to playing God. And LAWDAMERCY, the money.

If you think doctors go into the business to heal, then please explain the growing number of plastic surgeons, or the huge number of dentists who are doing cosmetic surgery.

Or, take a look at the HUGE number of doctors in HMOs who are foreign born. And why, because the lower HMO salary is acceptable to them.

Makes me wonder what it costs to get a medical degree abroad and then retake the boards in America. Would our American doctors be in so much debt?

A doctor is one of those professions that can't be "outsourced"... but it can obviously be imported!

Just one more reason why I think the US is going to morph into something unrecognizable within another 100 years, or less.

I remember about 20 years ago reading science fiction about the rich getting richer and the poor getting poorer, where the poor were human incubators and living organ donors, selling every imaginable service to the rich in order to survive.

And what truly amazes me is that I don't see Europe heading in this direction. Just us. What have they figured out that we have not?

[leveymg]

2. From wanting to cure cancer to Wall Street. What a waste.

Poor Glassman. He just couldn't live on $300K a year.

[lapfog_1]

3. He's gone from curing cancer

to making sure that people are NOT cured, and that they pay for patented medicines for the rest of their lives.

[papau]

4. But HMO's say Doctor's pay's too high, so there may be more MDs leaving for

for higher paying work on Wall Street

Since we value being the paid middle management of corporations that are the professional middle men for our investment choices at a much higher level than we value of the services of Doctors to our life, why would we not expect Doctors to quit being part of the health care system?

As long as we care to protect the excessive salaries of - the existence of - the hired management of the corporate world that are the middlemen in our health care system, we are letting the GOP "let the markets decide our health care" concept rule our lives.

One of my kids is downing in $200,000 in medical school school debt and is in her 3rd year post MD, working as a resident at $43,000 a year while paying $18,000 for urban apartment rent, and she does not see the "doctor’s traditional upper-middle-class expectations" as part of her life.

But the Dems want to reduce the interest rate on future school loans - wow ....

Not that the idea is not nice - but there are other more major problems to deal with.

[HughBeaumont]

5. Read Louis' book "The Disposable American"

Really hits home about how damned evil most CEOs and uber-wealthy are and how little they care about ruining thousands upon thousands of lives with layoffs. Uchitelle maps out how demoralizing and counter-productive layoffs actually are, and severely cuts into the myths of their benefits.

[SheilaT]

6. Those of you condemning this one

doctor are missing the point, which is that the Very Rich are getting a lot richer a lot faster than the Merely Rich. Part of that is a direct result of six years of tax cuts for the Wealthy and Extremely Wealthy.

Another aspect -- one which applies to this doctor no doubt -- is the fact that medical school is obscenely expensive these days and there are few or no scholarships, unlike at the undergraduate level. And even though doctors begin collecting a paycheck when they begin a residency, according to one website I just checked, it's in the neighborhood of $35,000 per year, which while not a trivial amount, isn't a great hourly wage when you realize they typically work 80 plus hours per week. And residency lasts 3-4 years, longer in some specialties. So doctors leave med school many thousands of dollars in debt and since they won't be in practice for several more years. Usually noble goals of healing are long since ground out of them.

What may be the more surprising thing is that more doctors don't go off into areas where they can make lots of money without missing sleep. Personally I can't find much fault with the specific doctor mentioned here, but I can find a lot of fault with a system that unintentionally encourages this kind of thing.

[AnneD]

7. When I first graduated...

from Nursing School, I had a choice. My child was 16 months old. I had missed many of those early milestones. I tried to work at the hospitals because they paid more. They had switched to 12 hour days. How humane is that? I threw up my hands in disgust and switched to Public School Nursing. My income dropped by over 10K and I struggled, but I had time to be a Mom to my daughter. I have been doing this for some time and unlike many of my colleagues, will be eligible for a defined benefit retirement at the ripe old age of 57. After that, I will have a little bit of time left in me that I will work strictly for the money in an overseas contract if I can get one. I then want to do something non medical (and therefore make more money)in retirement.
I can't say as I blame these Docs. The system is set up this way and it is too bad. We have been squawking about this for some time but it falls on deaf ears. If you think it is bad now, just wait a few years when we are all trying to use this dwindling resource.

[MadHound]

9. Yes, but,

The Merely rich get the same tax breaks as the Very Rich. They're all included in the same tax bracket, and get the same breaks.

As far as doctors go, lets do some comparison. When a doctor gets out of residency, they are saddled with a debt load averaging around $105,000. However average starting pay is $150,000. Let's compare that to a high school teacher, who when they get out of a masters program(required by law) will be saddled with a debt load of $47,000, but will, at most, be getting paid an average of $35,000. And yes, while a teacher can get a job with a bachelors degree, their starting pay is averaging out to $27,000, while a med student entering residency is paid an average of, as you said, $35,000. In addition, pay raises for the doctore are much more frequent,and are much larger than teachers. A teacher, at the prime of their earning power will be lucky to crack the $70,000 mark on average, whereas a doctor will easily break the $250,000 mark, or better depending what branch they go into.

Oh, and don't forget, a lot of teachers, especially ones just starting out, pull eighty hour weeks also. They just don't do it at a professional facility like residents do, they have the joy of taking their work home with them.