From the St. Louis Post-Dispatch comes an article on income and wealth inequality that I plan to blog more about later. The article contains a passage on doctor salaries:
The splintering of the affluent — a demographic once loosely regarded as one — is profoundly evident in the medical industry. The spectacular lifestyles accorded to some doctors specializing in tummy tucks and facelifts lure gifted surgeons who feel they aren't earning enough reattaching severed limbs.
Procedures that are generally *not* covered by third-party insurance.
Spiraling costs of medical schooling and the temptation of specialists' pay drive doctors away from family practice or pediatrics and straight up the "E-ROAD." That's the fraternal acronym for emergency, radiology, ophthalmology, anesthesiology or dermatology.
Just as we'd expect - just as what's happening with dentistry as I wrote nearly two years ago:
What is happening to cause this switch? Three quotes from the article
In part, it's because dentists have avoided being flattened by the managed-care steamroller, and instead many have turned into upscale marketers. ...
Dentists wrung their hands over their inability to get more insurance coverage -- a failure that now looks heaven-sent. ...
"We shifted from needs-based dentistry to wants-based dentistry," says the youthful-looking Dr. Bryson, who has a dazzling smile. "It has totally transformed our practice and our personal lives. We see a much smaller number of patients, at a slower pace. I can't wait to get in in the morning."
Dentists, who aren't as highly regulated as many medical doctors, are thus able to steer their resources towards the things that consumers want most - cosmetic dental work. And both the patients and dentists are doing nicely, thank you.
When the net surplus from a career begins to exceed that of some alter, we see more people choosing to acquire the human capital necessary to move into that career. This results in a shift to the more lucrative career as time goes on. The costs of becoming a physician are increasing as are the costs associated with being a physician (all that dadgummed paperwork). Add to that the increased demand that comes with third party payment systems. And when incomes don't increase at the same or faster rate as the costs, fewer people will go into those careers. But we are supposed to look down upon doctors who specialize in cosmetic surgery and the like because they aren't choosing some specialty that, supposedly, society at large values more? We shouldn't because they are only acting as we'd expect them to: rationally and in their own self-interest. Instead of looking down upon those who choose these careers, we should instead pay attention to the public mindsets and policies that are driving the costs up and the incomes down.