January 27th, 2016

Here’s an Idea: Justify Your Specialty’s (Low) Relative Salary Using Moral Superiority

In an otherwise excellent piece on recruitment to the ID field from the pages of Infectious Diseases Newscomes this:

But while inadequate compensation [for ID doctors] may hamper recruitment, it also could prove beneficial to some degree … Reduced salaries filter out the less-passionate applicants in favor of those who are more dedicated to their patients and to research within the field … “People obviously don’t go into infectious disease as a get-rich-quick scheme … Let’s say the infectious disease reimbursement was double what it is now. There undoubtedly would be more people electing to go into infectious disease, but are they the kind of people we want? I won’t answer that question, but it is certainly something to think about.”

Good grief.

Now look — I understand that money shouldn’t be the primary motivation for a career choice. And furthermore, I’m in total agreement that when some lofty celebrity, athlete, or executive chooses a suspect path based on what appear to be solely financial incentives, it’s reasonable to question the wisdom of their decision.

But are we really ready to justify low ID reimbursement as a way of drawing the most committed doctors to the field?

If so, then let’s cut the salaries even further! Let’s see if I’ve got the math right, using the example above only going in the opposite direction:

Low salaries for ID doctors → More dedication to the field.
Cut salaries 50% → Double how dedicated ID doctors are to what they do.
Result:  A 2X stronger pool of ID docs.

This is nonsense, of course.

In the current reality of heavy medical school debts, other subspecialty options, subsidized hospitalist salaries, and the need for extra years of fellowship training, it stands to reason that lower paid specialties such as ID are going to suffer.

No sense justifying this pay gap by some unsubstantiated claim of moral superiority.

Instead, we should be aggressively lobbying that what ID docs do — which is improve patient outcomes, manage complex cases, support other clinicians, deal with public health emergencies, establish protocols and policies, and reduce unnecessary costs — brings value to the healthcare system, and be dutifully acknowledged. Read here for more.

Thank you.

The following video has nothing to do with the above rant, but sure is amazing.

[youtube http://www.youtube.com/watch?v=vdTrr_VRKgU&w=560&h=315]

3 Responses to “Here’s an Idea: Justify Your Specialty’s (Low) Relative Salary Using Moral Superiority”

  1. Sanjat Kanjilal says:

    I shudder to think of the astronomical dedication of the ID doc who works for $10 / year.

    Worth mentioning that in addition to helping manage fast-moving pandemics (read: Zika), ID docs also play an important role in helping manage slower-moving (but arguably more serious) public health crises such as multi-drug resistance by guiding stewardship practices (protocols / practices as you mention above).

  2. John Cascone says:

    presumably one of the lowest paid water-skiers

  3. Cathy says:

    The formula you lay out has worked wonders in public education.

HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Contributing Editor

NEJM Journal Watch
Infectious Diseases

Biography | Disclosures | Summaries

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