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Our (uphill) road to success

December 2010

Hospitalists aren’t doing too badly by any calculation. This is especially true when one considers the current state of our economy. While the stock market (at least as I write this) is holding its own, our unemployment rate is stuck in the double digits and many economists are speaking of the double dip recession. But despite the travails of most Americans, we continue to see our salary increase, at least according to the most recent MGMA data.

That being said, I understand the frustration that many veteran docs have with the current reimbursement maze. Many complain that getting paid has become such an unwieldy process that it has taken all the joy out of practicing medicine. As such, the common theme when discussing our children’s future is that we would never advise them to become a doctor.

Frankly, I just don’t get that. One thing you won’t see any time in the near future is an unemployed physician who wants to work. We should all be thankful for that.

Now that I have put our compensation in perspective, allow me to proceed with my usual Rube Goldberg approach. The question at hand is just how high will hospitalists’ salaries go? Well, if we are to assume that after more than 10 years we have enough data to create linear projections, let’s make those projections!

To do this I borrowed MGMA’s graph of hospitalist salaries from 1996 to 2010. I then performed a linear analysis using a “best fit” trend line via Excel.

Actually, I am not entirely sure what I did. But a lack of understanding of mathematical models or economic realities never stopped Wall Street from making trillion dollar bets, so why should it stop me? And note that I have not taken important factors into consideration such as inflation, health care reform or the income-deflating predictions of the Mayan calendar.

First, based on my best mathematical calculations, our salaries will continue to increase forever. Yes, it is time to rejoice and buy that beach home on credit.

Second, here are the key milestones to watch for. By the year 2020, you will be making $276,054. This is outstanding assuming you aren’t already making this much or more. According to the most recent census bureau information, you will be earning more that 98.5% of all Americans. And with a growing plurality of hospitalists working every other week, thereby averaging only 40 hours a week, well, this is none too shabby.

By the year 2030, you’re raking in $326,764. Think invasive cardiologist dough if they, or any specialist, still make that much in 2030. If the average hospitalist is 38 today, you are now 58 years young. You might still have some pep in your step, but don’t be surprised if much of your newly earned mint is going to college tuitions and the treatment of some newly acquired medical ailments. Unfortunately, based on current employment trends for non-physicians, assuming your children took your advice to avoid a career as a doctor, they may still be living at home. Simply put, if all of your offspring are still on your payroll, you may not feel so rich.

By the year 2040, your salary will round out at $377,344. You will be 68, and suddenly your greatest fear will no longer be over suffering the indignity of being incorrectly identified as a medical resident but being confused for a patient. “No I really am the doctor! I don’t need a bed pan, and get your hands off me!” This of course assumes you aren’t a delirious patient who still thinks he or she is the doctor. Sadly, I have seen this before, which perhaps proves we remain the worst patients well beyond our days of doctoring. Regardless of your circumstance, with this kind of money at your disposal, you will likely be painfully reminded of the saying: “Youth is wasted on the young.”

By the year 2050, you will be nearly 80 but making an incredible $428,915. I suspect most of us will be retired or dead or nearly dead but not retired due to any of the financially constraining reasons already mentioned.

And hopefully, none of us will still be trying to hold out for the million-dollar-a-year payday. No good news here. Based on my current projections, hospitalists don’t hit that milestone until the year 2164.

But to heck with that reality. Let’s recalculate the numbers with an exponential salary analysis (again, borrowing a Wall Street trick: If you don’t like what numbers say, make a new model!) According to this mathematical model, we make our first million bucks a year by 2070. Admittedly, my two models have a margin of error of just under a century. Perhaps this should give a hospitalist pause before making financial decisions based on any of my calculations.

Either way, I am unlikely to be around when hospitalists are million dollar men or woman, pending the discovery of the fountain of youth or advances in cryogenic preservation. But I won’t be the least disappointed if I were able to know that my great (great) grandchild pioneered our field into seven-digit compensation. Likely, he or she could do far worse.