Is your doctor worth more than a plumber?

plumberdoctor-hourly-wage-pamela-wible

I asked a group of docs I’m coaching how much they’re worth per hour. Interesting question given docs have 11+ years of specialized training beyond high school. Surgeons spend most of their 20s and 30s in school. By the time these folks graduate, they’ve got 200K+ med school debt—before kids, spouse or house. Many docs just don’t have time to develop a social life, fall in love, have children—until their 30s or later!

What’s it worth to have all that training? Where does all that delayed gratification and self-sacrifice lead? Some urgent care jobs pay docs $75/hour. Of course, patients want to see doctors for a $20 copay. Is that all we’re worth?

When I asked docs to tell me what they’re worth, many refused to respond. Why? Confusion, overwhelm, low self-worth? Maybe most doctors have been devalued for so long, they just have no idea what they’re worth. 

Those who responded were all over the map. DC Psychiatrists charge $600 per hour. A Colorado family doc is $200/hr. One in Louisiana charges $100. As a reference, a family nurse practitioner in Alaska bills at $466/hr and a med student in California claims he’s worth $600. So what’s the truth? How much are you worth per hour? (This is not an optional question. You really do need to know.)

Reality check: let’s compare doctors to plumbers. Much shorter training and tuition costs. Just a year at a community college post GED/high school. Then (depending on location) 2-5 years of paid apprenticeship before getting licensed. And what do plumbers charge? I just had a guy fix my toilet tank. Took 15 minutes. I paid $125. A gynecologist in Washington state pays her 26 year-old plumber $350/hr for emergencies.

Plumber liability insurance is usually less than $1K annually. Compare that to a family doctor at 10K+ or neurosurgeon 100-200K+ yearly. Just for professional liability insurance. Before a patient even walks in the door.

So is plumber in Washington worth 3.5 times as much as a family doc in Louisiana?

What do you think?

What would you pay for an hour with a doctor?

Addendum: As I’m publishing this (no joke), my landlord calls to tell me my office bathroom is flooding. I rush down to assess the damage. Not bad. Maybe all pricing is relative to need and urgency.

 Click here to find out how dog walkers are earning more than doctors.

Pamela Wible, M.D., is a practicing family doc in Oregon. She pioneered the first ideal clinic designed by patients. Now she helps others open ideal clinics too. Join our upcoming retreat and learn how.

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77 comments on “Is your doctor worth more than a plumber?
  1. Elizabeth Faraone says:

    What is the life of a human being worth. There are a lot of people dying because they can’t afford medical care. My mother, as a nurse trained during World War II, healed many patients and saved patients lives when there was medical neglect. She loved her profession and was happy with her salary of $50,000 a year. The more experience she had and the more knowledge she gained (she spent unpaid hours joyfully in the medical library), the better she became as a healer. She never compared her salary to a lawyer, doctor, banker or plumber. But what she did complain about were policies that created unsafe nursing and she always stood up, with no fear, to the hospital administration and to doctors who were being negligent. My mother lived for her work. Imagine if she had been given the opportunity to become a doctor. I’ve only met a few doctors who I admire. I think the focus needs to be on self improvement and patient advocacy and stopping the abuse in medical school and training a lot more people to become doctors.

    • Pamela Wible MD says:

      Your mom sounds amazing. Medicine is a spiritual calling and I always practice that way. Never turned anyone away for lack of money in 12+ years. We absolutely must eradicate the environment that undervalues our healers. Stop the human rights abuse, bullying, sleep deprivation in training. Have safe working environments. AND our healers must be able to sustain themselves on a salary that allows them to continue doing the beautiful work they do in the world (while paying student loans). Far too many docs go out of business or live hand to mouth because they charge LESS than a plumber. After being abused and undervalued for so long, health professionals devalue themselves. Terrible cycle.

    • Ramona P. says:

      I would be happy making $50,000/year, if I didn’t have close to $300,000 in med school debt (my undergraduate years were all paid through scholarships – so I am “lucky” in that respect). It makes me sad, as someone who went into this career naive and innocent, hoping the money woes would fix themselves – but they do not. Until this gets fixed, I cannot in good conscience truly suggest going into medicine today. I’m torn when I meet wonderful kids who would make wonderful doctors. But on the other hand, I don’t want to see them doomed to my same fate. How can we keep doing this? I wish someone had really sat with me and shown the financial implications. It’s been almost 10 years since graduation and barely any of my lians are paid because I wasn’t making enough during training. Furthermore because of budget issues, no job is secure now. Yet, we have more hospital conglomerates taking over and it’s becoming more difficult to open our own practices.

  2. MIchele A Scott, MD says:

    I am currently receiving $125/hr. That is independent contractor fee. Rates for some of the urgent cares in this area (South Carolina) are $85-$95/hr for a physician, not an NP or PA. That is including benefits. So I think I should ask for a raise. However, I have been told by at least one office at which I work as an independent contractor at $100/hr that they can’t afford to pay me any more than that. Wow. Perhaps they can’t. Perhaps they need better coding and billing!
    Note: I hope to switch over to aesthetics and take home more of the income I generate.

    • Pamela Wible MD says:

      My mom charged $100/hr for psychiatry in the 1970-80s. Your hourly wage is less than hers 40+ years ago.

      • MIchele A Scott, MD says:

        I thought I was doing really well with $125/hr. I started at $55/hr out of FP residency in 1992, working in a small community ER in my South Carolina hometown. I went as high as $105/hr in 2000 working at another, busier ER in another small town in S.C. That rate went down in 2006 to about $70/hr (but with full benefits and a regular 40 hour work week) doing urgent care in a mixed urgent care, pain management, primary care clinic. That pretty sweet job lasted until 5 new urgent care facilities opened in our small city of 30,000 in a year’s time. In 2011, when I started working at one of these new urgent cares, with 20 years of experience mind you, I was offered $85/hr, again with benefits, but now working every other weekend (less pay for a less pleasing work schedule and even worse work conditions, as it turned out). When THAT job ended, I began my journey into the land of the completely unknown, working with chiropractors. I have been consistently paid what I have asked for, but I never ask for more than $125/hr, as that seems to be what the market will bear. I believe it’s time for a change. Since the places I work won’t pay a higher rate, I must find a new line of work. Totally sucks at age 53, but what’s a girl to do? My next adventure is into aesthetics, which is something I hope will generate enough income to pay bills, build retirement, and finish paying for my daughter’s college education, all without killing myself trying to keep up with 12 hour days, 5 days a week.

    • Danielle Murstein, MD says:

      To Dr. Michele S.,
      I think that your independent contractor fee is low and that the company makes a lot more than that collecting the insurance and co-pays for your work. That being said, if you love what you are doing, it may be worth it. I am winding down my private practice, and starting locums tenens, because I like a lot of variety and seeing different systems of care without having to do any of the scheduling or billing. This leaves me free to just do the medical part, which is what I like.

      I have just started doing locums tenens, and recently was offered a job I didn’t care whether I got or not. So when they told me the hourly rate, I said it was too low, and added $25 to it. They didn’t bat an eyelash and said, no problem. Probably could have asked for more. Locums may pay more than the “independent contractor” position you have, and locums will also cover your transportation and malpractice. Just something to consider.

  3. sue says:

    This disparity is to some degree due to the entitlement mentality. Increasingly, people think they are entitled to medical care at no cost to them. Consequently, they devalue the services of a doctor and think it should be “free” – that a third party should pay all expenses. People generally don’t think a third party should pay for a plumber, or for their routine car maintenance. But they think somebody else is responsible for paying for every aspect of their health care.

    That’s why I support the direct primary care model. I also think doctors practicing direct primary care should be encouraged to figure out a way to help provide care for low income people who can’t afford the cost of direct primary care. Get the middleman out of the picture altogether.

  4. Karyn Tapley, MD says:

    Elizabeth, almost all doctors and nurses would agree with you in your opinion. The ideal you put forth is excellent….however….I came out of medical school and residency with $405K in debt. While I completely agree with you about what medicine *should* be about, the wonders of the medical library (which fascinate me & Dr. Wible, and almost every doctor I know) doesn’t pay that debt off, and certainly doesn’t keep bill collectors away or your credit score intact (so you can obtain malpractice insurance). Your mother trained at a time when even doctors (99% white males, btw) only paid a few hundred to a couple thousand for their education if anything at all (some were trained for free in the military during wartime, as you noted). Over the years, the bureaucracy has overtaken our world (not just medicine) and now we docs AND nurses are overwhelmed with expenses and costs that have little to nothing to do with the care we would like to give. In just the last week, I have shelled out over $3000 to “belong” to professional organizations that do NOTHING essentially for me at a personal/professional level because I am “expected” to have these associations. If I do NOT shell out the money, I am dropped from their rosters and suddenly I appear to the public as a less-than-competent doctor. Why? Because it’s “expected.” Where does that $3000 then come from? I’ve not found any money in the medical library, to date. Some of us are fighting the good fight and trying to take medicine back from the bureaucracies and Big Insurance…but it’s going to take the buy-in of patients like yourself to understand that doctors are not the ones driving this mess right now. We’re on your side. 🙂

  5. Thaddeus Buttmunch, MD says:

    Well..plumbing IS a Literal “Shit Job” unless you do clean installations. Those apprenticeships are hard to Get-unless you Know someone in the business (or-maybe-if you’re an Ex Convict with training in the Joint-lol.) They have to get under sinks, and haul heavy water heaters. But-YES-our training takes a LONG time-TOO long, if you ask Me. That Premed crap and much of the first two years of medical school are a waste of time and money and don’t contribute to making us better physicians. My issues with our profession is the Managed Care hassles and recertification. And, I’m a Late Middle Age Bachelor. I didn’t learn Social Skills when I was supposed to.

    • Pamela Wible MD says:

      Yes. I do think we have delayed social, financial, and emotional milestones in medicine. Yet another occupational hazard of the job.

  6. Stacey says:

    Nothing. That’s what. NOTHING.

  7. Maurice says:

    Truthfully, I have been sick since I was 6 years old, I am now 55 and never resolved my condition. Always offered prescriptions that did not help. Over time I was prescribed 5 ssri’s at once along with pain meds,muscle relaxants, benzo, on and on, huge bills and never properly tested with protocol.I have given up. I think a minimum charge for survival should be charged, but not ridiculous amounts that lead to nothing at all. If they find a diagnosis they should be awarded a compensation for the finding. That would give some incentive to actually try.I’m tired of hearing it could be, guessing then prescribe a med for probability instead of testing for an actual diagnosis.Treating symptoms is wrong, and leads to over prescribed meds leading to more side effects, leading to more prescriptions. Poisoning us leading to mental problems, toxicities, and overtaxing organs to a point of permanent damage. Top it off, doctors have no training in toxicities. They act like drugs are safe, yet it is illegal to take a prescription not prescribed by a doctor.
    $60 an hour is fair, compensation regarding diagnosis should be scaled
    Go to work, stop dubbing off,stop acting like you know it all,follow protocol, and actually don’t prescribe anything without actual proof of the condition period.I had a friend with dry gangrene for 5 years, they treated it blindly. I told him to demand a biopsy and look at the damn thing under a microscope. They finally did and treated it properly. 5 years limping around. so ridiculous!

  8. Ann S says:

    When I started out, just out of family medicine residency, I worked for various medical clinics and I was paid around $65/hour. I did several things that made a difference.
    First, I never signed up to work exclusively for one clinic. I worked part time at several places. This gave me the flexibility to say “goodbye” to any place that didn’t treat me well. I regularly assessed my pay and I got rid of the lowest income locations and increased the high income ones, especially if I liked working with them.
    Second, every time I negotiated a contract, I asked for more than what was offered. I would simply say, “Could you go a little higher? You will find that I am worth it.” The only time I did not get an increase in my pay was the time when the recruiter said,”we can’t go that high because you would make more than the head of the department.” OK, that’s a reasonable reason for my pay.
    Third, I would never hesitate to turn down work that didn’t pay well. There were some jobs that came out to $40/hour for a family practice doc after calculating pay amount in relation to hours worked. The VA offered $60/hour for physicians when nurse practitioners were making $65/hour in the community. I told the recruiter the pay was too low and she said, “maybe you could make up by the volume of work we have available”. Ha!
    Finally, I learned my lesson. I opened my own clinic. I control my hours. I do specialty care for niche populations that I love working with. Some days I only make $100/hour but I have many days I make $200/hour and I recently had a really good day where it was close to $500/hour.
    These things are possible in family medicine and probably other specialties but it takes creativity and a willingness to try new ideas. On my way to my current wonderful state, I had plenty of failures and lessons in what I didn’t want. But the important thing was not to get stuck in those places and focus on what will work.

  9. In 2016, $340/hr. Starting Jan 01, 2017, 15% increase = 390 per hr.For that, each patient has 24/7 access to me by phone, text message and email. This service is not available anywhere else & it’s never abused. Job satisfaction is highest I’ve ever had.

  10. PARACKAL OOMMEN THOMAS says:

    There are many reasons for a lower HOURLY RATE for Doctors.
    WHT YOU DO NOT TAKE INTO ACCOUNT IS THAT THE DOCTORS are SEEING FOUR to TEN people per HOUR.
    At $150. per patient FOR ONE HOUR DOCTOR GETS $1,500.00.
    THERE ARE HOSPITALS WHO CHARGE $250.00 per hour for DOCTOR
    WHICH MEANS $2,500.00 PER HOUR FOR A DOCTOR.
    THE REASON IS THAT HOSPITALS MOSTLY ARE IN THE HANDS OF VENTURE
    CAPITALISTS WHO HAS ONLY PROFIT MOTIVE- DOCTORS ARE NOT
    SERVICE ORIENTED ANY MORE.
    CONSIDER ALSO MOST OFTEN THE ACTUAL DIAGNOSIS is done after
    HALF A DOZEN VISITS TO THE DOCTOR so MULTIPLY $2,5500 by 6
    and come up with $15,000.00 per hour.
    YET DOCTOR HAS NO OBLIGATION TO CURE – he may just sent the
    patient to a SPECIALIST in the network.
    A mechanic HAS TO DO THE JOB AND MAKE THE CAR RUN AGAIN.

    • Pamela Wible MD says:

      Yes. MBAs have very divergent ethics than doctors and as a result the profession has been degraded and both docs and patients are miserable in assembly-line medicine. I have heard of a psychiatrist who sees seriously mentally ill like schizophrenics for med checks (refills) 10 and hour (I would never refer anyone to him) but in general the docs I know in private practice are REAL healers. They see patients 1-2 an hour and really care.

      Difference between a car and a human is that you can recommend all sorts of medications, diet changes, and lifestyle improvements and the patient can end up at the McDonald’s drivethru on the way home with a supersized meal. Fix the car muffler or transmission and it’s unlikely the car will undermine your efforts. With humans, you just never know . . .

    • Ramona P. says:

      That’s offensive. We are doing our job. Pathologists are required to give definitive and life-changing diagnoses on each and every case. Yet, we are continuously being required to see more and more cases in the same amount of time with more restrictions on resources. A recruiter just told me avg locum path jobs are paying $90/hour – which I had no comparison for (things we’re not taught in med school). I honestly had no idea if that was good. I’ve become defeated and feel like I’m drowning in student debt because of my own doing and deserve it for not understanding everything better from the beginning, before committing to this career. When we’re finally in the real world, we realize that a love for our profession and our patients doesn’t fulfill our need to pay massive student loans in an increasingly more unstable (and worse paying) healthcare system. Fortunately I came across this article to consider that maybe I should be more careful of what salaries I accept.

      • Pamela Wible MD says:

        You absolutely need to value yourself! As mentioned in another comment here – my mom billed and received over $100 per hour in the 1970-80s as a private practice psychiatrist. You should not be making less than my mom did 40 years ago Ramona! Plus back then she paid $900 tuition per year for med school. 1965 grad. Am I making my point?

    • Ann S says:

      Wow! You sound like you are really angry and you must have had a bad situation with medicine at some time.
      If a doctor sees ten patients an hour, they might get reimbursed $150 per patient but this is highly unlikely. More likely , the insurance company will lower that to $40 to 50 dollars per patient or even lower. If the doctor is in private practice, they have to cover their own office expenses. This means paying utilities, rent and the payroll of any employees along with malpractice and professional fees. This is also covered in hospital practices but then the hospital and all the administrators get a cut too. In many cases, especially private practice, all of these get paid before the doctor gets any income at all.
      I am surprised that you have found that it takes six visits to receive an accurate diagnosis. I think I am able to reach a solution for most folks in one to two visits although there are always people who are more complicated that take more investigation to diagnose. Most of the common illnesses today are not ones that can be cured. Problems like diabetes, low back pain, high blood pressure and others can be improved by medical care and lifestyle changes. Sadly most people do not choose to make the changes in lifestyle that can eliminate or decrease the need for medications in many of these cases.
      The human body is not like a machine. It is much more complicated than that. And, incidentally, I have had many cases where I have had to take my car into the shop two or three times to get a problem fixed. The mechanic worked like most doctors- he fixed the most common cause of problem I was noticing and when that didn’t work, he had to try less common causes until he found what was needed. He is a smart guy but, even with the electronic diagnostic equipment they use, things can be missed.

  11. M. Rizzo Moore, CRNP says:

    Hello Pamela,
    I am weighing in as an NP in PA. My salary at a family practice is $ 50 hourly, and my second job is about $ 56 hourly. I have great benefits, decent vacation time off, and about $3000 for CME. Of course, I spend many extra hours charting, calling and filling out paperwork for insurance companies. I do not get paid for this time. In my opinion, family physicians do not get proper reimbursement. It can be grueling… seeing so many patients. It’s such an important job! It’s time for a healthcare raise! And, please, more vacation time for the healers, they need to recharge and enjoy life!

  12. Sean says:

    $300-600 an hour depending upon services rendered. An equally important question I think is what is the free market willing to pay for these services. The market is so distorted by the mutant outgrowth of the insurance industry, with Medicare at its core, that many patients don’t have any idea what they should be paying and what individual segments of medical care are actually worth.

    • Pamela Wible MD says:

      Well Sean ~ A doc I know charges $95 monthly and a family just established with her who had been paying $2500 monthly to another doc. I think what the market will bear is wildly erratic and dependent on a variety of factors (income level,location, doc confidence level, services rendered and whether they are available anywhere else in the city or state, gratitude, customer service)

  13. Pamela Wible MD says:

    We allowed our profession to be devalued. Now we devalue ourselves and resent when patients devalue us. It’s a cycle. Time to take our beloved profession back from the parasites.

  14. Diane Austin says:

    I think American specialists are overpaid while generalists are underpaid compared to their international peers.

    • Stephen Rodrigues, MD says:

      You are correct as this is a business model adopted after a few physicians decided that they would rig and game the system in their favor, by perpetrating helping someone in physical pain by replacing skeletal parts. It turns out that physical pain is simply treated with physical therapy.

      When the surgeons breached the true and replaced it with false by removing skeleton to treat pain, they were performing magic. It turns out this is exactly like performing magic which is lucrative as long as no one figures out how the magician is deceiving everyone.

      Correctly think physical pain is located in the soft connective and muscle tissues treated with hands-on physical therapy.

      Incorrectly, please do not think, pain in the knee is treated with knee replacement. That idea is too simplistic and is while humanly possible is 100% wrong and unnecessary.

  15. Richard Eldridge says:

    It’s all about supply and demand. High demand, low supply, means high price. This leads me to the conclusion that there are regulations in place to deliberately keep the supply of doctors low. More medical schools can be built. And residency requirements can easily be adjusted to allow more doctors to be trained.

  16. Terra says:

    Theoretically we are worth what someone is willing to pay us.
    But the market has been distorted for so long, it is hard for most patients and most doctors to understand the value.
    Your writing can help people rediscover real prices.

    [We don’t buy insurance to pay for our groceries or gasoline or other regular purchase, because we don’t want the extra 30 to 50% increase in cost. Most of us don’t expect other people to pay for our groceries (which we require for survival) or gasoline or car tires or attorney or plumber.]

  17. Julie Greene says:

    Human worthiness goes beyond the paycheck and beyond what one does for a living, Pamela. I think it’s a pity that plumbers are shamed and doctors are treated like gods these days. The reason so many have to call the plumber is due to the drugs that cause the toilet to back up. All the plumbers know who is on drugs. Who makes more house calls? Who isn’t afraid of poop? C’mon…..

  18. Boy, that is one great question. I was a neurosurgeon for 20 years and had no idea about my worth. After a number of lawsuits I changed into pain medicine and also treated opiate addicts with Suboxone for 11 years. I practiced very safe medicine but a lot of my patients were folks that no one else would see. At that time I saw only 12 people a day and took at least 30 minutes to see a patient so that puts my value at $400 an hour. The OMB was prodded to investigate me and shut me down. They took 2 years to do this investigation and said I could have an hearing. My lawyer quit helping me as I couldn’t pay him and he told me that if they found one thing wrong at the hearing they would fine me $50-100,000 and still revoke my license. So I gave up.
    Now I’m living on SSD of $2,200 a month and will gladly do your yard work for $15 an hour!!! I have tried to get jobs and no one wants to hire a disabled 63 year old. I do talk to people about their medical situations in a general way but have never charged for that.
    So now I’m working happily for $15 an hour.

    • Stephen Rodrigues, MD says:

      Your story and your betrayal can be traced back to the original sin of our predecessors who changed the location of pain from the correct location muscles and connective tissues to the incorrect location skeleton and nerves.

      I to have a type of pain practice and you Suboxone. My goal is to treat and eradicate the intramuscular pain pathology with spray and stretch, active tissue release, dry and wet needling and many of the prolotherapy type of injections.

      If you read Stewart Hackett, Janet Travell, Edward Rachlin and C Chan Gunn, you will begin to witness what is true. Physical pain is treated with physical therapy. Physical pain is located in muscles which will fully benefit from the full forces of physical therapy.

      Muscles which do not receive physical therapy will begin to contract and squeeze the life out of everything in them around them surrounding them crushing bone and making it look really bad on the MRI. The skeleton cannot be killed unless you kill the human being. The skeleton is beholding on the forces applied by muscles. Treat the muscles and the skeleton will rejuvenate itself naturally & perfectly.

      It took me ten years to decide that bone on bone, degenerative joint disease, worn-out joint, disk space narrowing and pinched nerve were all not true.

      It is biologically impossible for the skeleton or the nervous system to be the 1st location of pain.

      Thus it is impossible to remove the pain pathology by removing skeleton or rearranging nerves.

      Every time I mention this to one of my colleagues they look at me like I’m crazy! They are in disbelief because the idea of bone-on-bone plus replacement is etched into their consciousness, it is 100% wrong.

      Think about it replacing living tissue that God gave you with cold dead man-made metal.

      The weight of this betrayal is crushing every American to death. Until the original sin is corrected and physical pain is treated with physical therapy nothing good is going to happen.

  19. Stephen Rodrigues, MD says:

    As a general medicine front-line practitioner, I’ve discovered that there is a glitch in the fundamentals of medicine which has taken every physician from being an honorable profession to one that is almost entirely dishonorable. Most do not know what is happening.

    60 years ago three profound events occurred a person had a knee replaced for knee pain, spinal fusion for back pain and brain surgery for a headache. Although humanly possible to perform these procedures without killing the patient they were all unnecessary. This is because the skeleton is an innocent bystander in most all physical pain complaints.

    Human biology dictates that the muscle system is the 1st natural and most common location for most all physical pain complaints. Entry-level treatment for muscle-derived pain is massage, chiropractic and osteopathic services, spray and stretch, traction and inversion.

    Upper-level physical medicine and rehabilitation options are acupuncture, dry and wet needling, Travell type tender and trigger point needling.

    The idea of amputating, removing, and rearranging the skeleton to treat physical pain opened a Pandora’s box and ushered in hellfire and brimstone for Americans. This means all Americans are suffering under this tragic betrayal of humanity.

    Someone should’ve stopped this scheme 50 years ago, but it became too profitable and subsequently sold to Wall Street and now the federal government through lobbyist.

    An orthopedic surgeon can generate $100,000 for the system by performing a spinal fusion. Those funds go straight to the upper echelons of medicine. The patient is left crippled and handicap because the idea of spinal fusion is completely incorrect.

    As primary care providers, our jobs are to order the MRIs and send them all to the orthopedic, or a neurologic surgeons for definitive treatment.

    To balance out costs and revenue sheets, we on the bottom are being squeezed to death under this present broken system.

    Everyone believes that bone on bone, degenerative joint disease, narrowing of the disc space and that the human skeleton can wear out is beyond my imagination today because it’s a complete fallacy.

    Is not possible for the skeleton to wear-out like a part on a car. It will break, and it will automatically repair itself >100 times if necessary.
    It’s unfathomable to me today that people to get in line to get joints replaced thinking that the man-made product is better than the God-given perfect viable and natural tissues.

    Did you know that Health and Human Services WILL allow a 70-year-old to get bilateral knee replacements and back surgeries which will do nothing for their primary source of muscle-derived pain?

    Did you know Health and Human Services WILL NOT allow a Medicare beneficiary to receive enough physical therapy, no acupuncture, not enough trigger point therapy?

    Epiphany: I never thought I would stumble over this tragic betrayal. I never thought it would be so difficult to convince the most educated Americans that they been miss-educated and are 1st doing harm. General doctors are playing a pivotal role in gruesome behaviors among Americans upon Americans for profits.

    Solution: Correct the fundamental breaches of the laws of human biology.
    Conclusion: If True and correct is not restored back into the fundamental of science and the healthcare systems, nothing good is going to happen.

  20. Regina Bahten, D.O. says:

    A prestigious neurosurgeon calls a plumber to tend to his leaky faucet. The problem requires an easy fix and the entire job takes less than two minutes. Before leaving, the plumber says, “That will be $200.”
    The surgeon replies, “I am a neurosurgeon and even I do not charge $100 a minute!”
    The plumber says, “Neither did I– when I was a neurosurgeon.”

    Would it be funny if I told you that my brother is a plumber? Seriously.

  21. Evan says:

    As a nurse and a medic I firmly reject some of the above comments that create a “us vs them” conversation. Yes, I have caught some mistakes from MDs, who cares? They are human. Yes, CNAs, LPNs, RNs are very capable of many things. However, the vast majority of the time I rely on doctors to make diagnosis and direct care, they happen to be experts at it! My favorite docs are the ones that recognize that health care, at least in the hospital, is a team endeavor and every one has a very important role. The “us vs them” mantra gets us nowhere. In fact, I believe that the quicker we can focus on making health care a more humane and inclusive professional field, the better off and happier professionals and patients will be. Let’s be nicer to each other, it goes a long way.

    • Pamela Wible MD says:

      Agree! <3

    • Stephen Rodrigues, MD says:

      Is very difficult to see the 1st error if you don’t know what to look for. What you witnessing are innocent human behaviors. What you don’t see is the original sinful behavior. Anything placed on top of the original sin betrays the patient.

      I remember back in the 80s in training at DC General Hospital; the nurses were the true healer’s because they guarded their patients like mama grizzlies. They were very wise learning from the school of hard knocks. They were educators and helped make certain that we as interns and residents stay true. Staying true and correct as long as you follow the laws of human biology becomes easier as you understand what you are doing. Sure people make mistakes which are human and normal. But when you crossed the line into playing God nothing you do is correct.

      Based on the laws of human biology any human who gets skeletal parts removed, rearranged, fused together for the treatment of physical pain is incorrect.

      Once you breach and betray the evidence of the law of human biology, you 1st are doing harm. Everything else that you do cannot take away that bad action.

      When our predecessors sinned against the true evidence they basically set all of us up to fail each other. Everyone is looking for the reason why we have utter chaos when the reasons are all physician designed.

  22. R C says:

    I’m just a resident, but I have only 75k in debt (thankful to have received a nice scholarship for Med school), and I make on average $16/hr. I hope to open my own Ideal clinic when I graduate. I think I’ll be worth $300/hr right outside of residency.

    • Pamela Wible MD says:

      Thanks for your honesty! Nice to see a doc value themselves. So many earn far below they are willing to charge and then they get resentful (100+ hour weeks, minimum wage).

  23. Eric Shibley says:

    Stop being untrusting and please pull out that red carpet you have from your front door, learn to say NO. It’s vitamin N which is really needed. Medical students should practice to say NO ten times each morning in front of the mirror before getting out of the house.Doctors need to stop giving out advise without getting paid first, depending on complexity of the cases they should take somewhere between $100 to $600 per month from each patient. The only thing is price fixed in this country is Doctor fee. Nowhere in the world in no profession allowed this to happen to themselves.Recently in Venezuela communist dictator confiscated 4 million toys because someone tried to sell those more than the price that was fixed by government. We are in a worst situation and 500 plus doctors each year committing suicide in this public war against us and no one even talks. Lawyer, electrician, plumber, auto mechanic, construction worker anyone, and everyone’s time and expertise of worth many times more than doctor because we let this happen to us.

  24. We are billing $75 per half hour with patients. They love the time and ability to ask questions and get them answered. We are a direct care PT clinic and kicked the insurance companies to the curb Jan 1, 2015. Best thing we ever did! We have gained 10+ hours a week in our family life and best of all no insurance stuff to deal with.

  25. Dr. Joe says:

    What really got me is when my plummer told me that they were taking their yearly family 6 week vacation. 6 weeks…mercy a 3 day weekend was our only hope. Bummer deal and to make it more of a bummer, he destroyed my grass with his truck so it was easier for him to get on the roof to get to vent pipes. The yard cost me an additional $200 to get fixed. He didn’t bat an eye.

  26. Charlotte Pearce says:

    Since my ability to self- diagnose is woefully lacking, I have concluded that an hour with a physician is priceless. I think it behooves me to pay for the expertise that leads to a cure or pain relief. Using the plumber as an example, a toilet can be replaced fairly easily unlike a major organ. I believe physician and their family should be able to live a comfortable life. Therefore, I would certainly be willing to pay double or triple the amount given to someone in the trades. Ultimately I would like to see all aspects of whole profession: health care, drugs and supplies removed from Wall Street. I saw a major shift in the hospital world once MBAs took over administration.

  27. Dara Lifschutz says:

    You wanted to know what we think we’re worth? These are the actual numbers before taxes. And I do believe it’s less than most plumbers. I haven’t seen any locum company willing to pay over $200/hour.

    Furthermore, since 2008, I have never had a salary raise, only cuts (as much as 30%). I know these numbers are higher than for family practice, but we as a specialty have had to eat lots of humble pie. I know radiology salaries are on the higher end, but they’re not nearly as inflated as many people think.

    After taxes, the $160/hr rad makes probably less than…I don’t know, but I know a massage costs about $100 in many places…the therapist probably doesn’t take home nearly as much.

    Thoughts?

    Xo
    http://www1.salary.com/radiologist-hourly-wages.html

    • Pamela Wible MD says:

      Hourly wages by profession is a fascinating study. Pro-athletes make insane amounts of money while residents in all medical specialties are near minimum wage when factoring in hours worked. I think all medical professionals should be clear on what they are worth and demand to be paid accordingly. Yet most have been devalued for so long by corp med and even society at large that many people feel docs are barely worth the $20 copay. And docs (too often) seem to accept whatever they are offered without negotiation. Calculating one’s hourly wage and comparing to other professionals such as plumbers and attorneys is a big wake-up call for health professionals who have fallen into the trap of devaluing themselves (after learning to be devalued so long by others). It’s amazing that we allow this to continue to degrade our beloved profession. Though not a great solution for rads and hospital-based docs, I do feel that private practice offers better care for patients and the best opportunity for docs to lower their overhead and retain their hard-earned revenue from a patient panel that truly appreciated them.

    • Pamela Wible MD says:

      Radiologists should not be earning less than plumbers. Looks like they do in many parts of the country based on your link Dara.

  28. Pricey plumber says:

    Plumbing companies may charge around $125 per hour for a licensed professional and a service vehicle filled with equipment to be at your house, but plumbers do not make $125 per hour as pay. $30 per hour is closer to the going rate. I just don’t believe the comparison is accurate. Also $1000 annually in liability sounds a bit off. Maybe to ensure one service vehicle for the year but definetly not enough to cover liability.

  29. Pamela Wible MD says:

    “When I was a practicing surgeon, I was making about $115/hour, based on yearly earnings of $350,000 and working 3,000 hours per year. This was after 4 years of college, 4 years of medical school, 5 years of general surgery residency, 2 years of plastic surgery residency, 1 year of microsurgery fellowship, 2 years at the NIH and another year in the research lab. I was about 37 years old when I had my first “real” job not involved with education. I just paid my plumber $203 for 15 minutes of work to fix a faucet leak. Maybe I made a bad career choice.” ~ Ron Barton

  30. Timothy Campbell says:

    You underestimate the time and effort to become a Registered Master Plumber. It’s more like 10 years. I guarantee you that although residents aren’t paid well, they are paid far better than apprentices. Journeymen make a decent wage if they are unionized. Only Master Plunbers are permitted to enter into contracts with customers. RMP’s also have overheard–you have medical offices, we have shops, trucks, tools, etc. We are required by law to pass tests to become licensed. The primary reason for this is to ensure that we properly construct plumbing systems to prevent contamination and ensure proper sanitation. I think I recall a chapter in Dr. Osler’s book about the importance of sanitation to public health. And, by the way, those chemistry, biology and physics labs you used in school? We built them. We also build the piping systems in your hospitals and medical office buildings. Yes, RMP’s are businessmen and women who make money. But we also lose money if a job costs more than we anticipated. We pay our employees either way. I could go on. Don’t confuse RMP’s who have built large businesses with apprentices or entry level journeymen and I won’t mistake you for a med student or a resident.

  31. Jessica says:

    Please don’t quote the facts on this, but I recall seeing some “news special” about 2013 about the happiest countries and why. I believe it was Denmark that won first place. The explanation what their lack of the “disposable” culture that we have in America. For example, most families inherit dishes from their family, whereas in America we register for thousands of dollars worth of new dishes when marrying. That married with 40+ percent income tax rate that funds healthcare among other public needs. The final reason what that everyone made similar salaries from teachers, to physicians to plumbers (yes those three professions were mentioned). If I recall their salaries translated to something like 40k, 47k and 45k respectively. I found the whole idea very interesting.

  32. Inspiring as I think of how much is too much. As I am wondering how to calculate what to charge. Yes, if you are a FM that works by contract you will be pay $70 to $80 per hour depending on your location. Great info, thanks Pamela!

  33. Cassidy Ryan says:

    I guess ill be a voice of a plumber. I know this convo is nearing the end but id like to put in my 2 cents. I have a pretty good p.o.v. from where im at. Im a commercial plumber in Washington State with 14 years exp. I dont do service plumbing unless im doing a sidejob under my own license. My sister is a , naturopathic doctor in Bellevue Washington. My mom was an RN in Longview Washington and just recently retired.
    I just get straight to the wages. At my job I make an hourly rate. I get paid from my employer $30 an hour. When I do a sidejob, i charge $140 just to knock on your door. Then, my hourly rate is $70 an hour and that doesn’t start till I bring my tools in the house. If I work for 10 minutes I still charge before hour so if I came in and get a job maybe you could some toilet seat I would charge you $210 for the ten minutes i was there. My mom and she retired two years ago as an RN she was making $60 an hour. She earned every penny. My sister has there been straight up with me but I’ve done some math on my own and I figure she makes about 300k a year. What has a lot to do with what kind of medicine to practices and where she’s located. Bellevue is a very rich area. If you think hiring skilled labor is expensive, try hiring unskilled labor and see how much that costs you.

    • Cassidy Ryan says:

      I want to just say that I didnt proofread my last comment until now and I think its obvoius what mistakes I made, just wanted to say that talk to text likes to humiliate people I think. No, I dont do meth. I also wanted to add a couple things. I have 14 years experience in the field of Plumbing. I did a four-year in class apprenticeship program in Utah and now live in Washington State. Every plumber charges different for side jobs, house calls or service work. I’m not speaking for all plumbers with my prices I’m just speaking for myself and what I charge. I know some people that will just charge hourly no matter what they won’t charge just to show up and they won’t charge four hour minimums. I might have lost the subject of where the topic is going but it kind of seems like it was about wages and I just wanted to Point mine out

      • Pamela Wible MD says:

        Thanks Cassidy! Really appreciate hearing from an actual plumber. What are the rates for housecalls? (Since I guess all plumbers must do housecalls)

  34. Ed says:

    What are Doctors worth? Most are worth a lot more than they gross at the end of the year. There’s a long wait period for doctors to truly be rewarded for their hard work. They have extremely difficult jobs having to deal with the public on a mass scale & the lives that they help restore & improve people’s quality of life is just priceless. With that said most people aren’t rich & hospitals, insurance companies & governments play a roll in managing costs which effects many doctors earnings. I’d say most doctors are worth $5000-$10000 a week or $250000-$500000 a year net earnings.

    As a master plumber I have incite into what plumbers actually make. There are several factors that go into what plumbing companies charge. Your toilet tank example is stating that plumbing companies charge $500 per hour. This is clearly not the reality though. Plumbing companies don’t have rows of stopped up toilets lined up to unclog. I wish making $125 to unstop your toilet was as simple as a 15 minute process but it probably took at least 15 minutes to collect payment, at least 30-45 minutes getting to your clogged toilet & the same amount of time to travel back to the shop to wait on the next call to come in. That $125 quickly turns into at least an hour & a half. Which is $83.33 per hour for this particular scenario without fuel costs being deducted or any other expenses. So the next time your toilet clogs & that plumbing company sends a plumber out on the same day because it’s an emergency and you can’t wait until tomorrow consider what your are really paying for. Plumbers do not get paid for every hour that they work.

  35. Hahaha WOWSERS I can’t resist!!!
    Although this has probably been addressed in the comments already your title is super captivating and I had to take the click and comment bait!!!.
    As a Canberra Plumber for over 10 years and a plumber for the last 20 years I can’t help but speak from a biased plumbers perspective albeit from across the globe. My purpose is not to undermine the medical industry but to point out some flaws in this line of argument.
    First point of contention I have is with the mentioned “jobs”. Are the referenced urgent care jobs nurses, ambulance drivers and alike? i would suppose if this be the case then the “training requirements would not hold a $200k or a decade long training regime nor an excruciatingly high education bill and be more likely fall in with more mainstream degree costings but I will concede more than those of a plumber. I will state however $75 per hour or $3K for a 40 hr week post degree is pretty darn good compared to a plumber employee who would struggle to hit $1500/week (not a company owner/ employer/self employed plumber)
    The average medical urgency worker is an employee of an institution or public health system and as such has ZERO out of pocket expenses apart from regular travel and general clothes maintenance costs (if that!!!-I’m not sure about regulations on soiled medical clothes) that having been said it is very much inline with what a plumber (not self employed) needs to provide with the exception of personal tools which are generally not supplied because plumbers loose them….(I bet one or two of my readers have found a tradesman tool or two after a visit… lol
    I’m self employed and own a plumbing company and can say I am happy with what I earn, however it takes a long time and many skillsets not taught to get to the confidence level of a businessman (taxes, employment, HR, financing etc. etc.)
    As for the upper tears of medical training (surgeons etc) well yes they should get paid more but also be given an avenue to earn earlier without having to eat bread and butter while they study (I have a few doctor friends- they will know what I mean…
    All in all a plumber will have unseen expenses and for the 30 minutes they were at your house they spent 2-3 times that amount in sundry time to get there, stock up, do taxes, pay people, etc, etc… so It’s not as well paid as first thought.
    That’s all I have time for I have to do my stocktake and taxes and organise my day and ,and, and, and, and LAUGH

    • Pamela Wible MD says:

      I really appreciate the plumber’s perspective here. Figured this would be an interesting read for you. I was definitely comparing the entrepreneurial plumber with the entrepreneurial physician.

  36. Joomun says:

    Money is important in life. But the satisfaction and sheer pleasure of restoring health to a patient is priceless. As a gynaecologist, the mere fact of saving a motherand the child during highrisks and lifethreatening conditions brings an incomensurable selfless feeling of being useful to humankind. I will always remembet the night when I was on call for a hospital some 10km from home. I was called at 3am to attend a pregnant lady with a very serious lifethreatening condition(Abruptio placenta). At 4am while I was removing my gloves,I looked at the clock. It was 4am. Mother and baby were fine.

  37. jazz brown says:

    hello, Pamela,
    I am jazz brown. we always provide the best plumbing service in Las Vegas.

  38. john the says:

    hello
    I read your blog, which is very interesting. so thank you.

  39. Plumber says:

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