Doctors and Money problems

One of the things I have noticed while working in family medicine is that many patients and the public in general have this idea that all physicians are rich / wealthy. Certainly many physicians make decent money. However the days where being a physician automatically meant being wealthy are over. I think that the specialties hit the hardest with decrease in reimbursement and pay are the primary care fields, particularly family medicine and pediatrics. 

As I have gotten to know and understand the 2 doctors I am working with right now in family medicine it has become very clear that they are struggling to make ends meet with their clinic / business. It is a common story that can be seen throughout the united states. A new physician just finishing their 7 years of training (not counting college) and they have an average of $150,000 + in student loans. As they interview and look for jobs they feel that the offers are too low so they decide to open their own practice. The usually lack the business skills and abilities to run a business and they struggle to get things going. Often they are required to borrow more money to get the capital to start their practice.

It will take them 2 - 4 years to get their practice up and running if they are fortunate enough to not go out of business. Finally when they have enough patients to make a living they realize that reimbursement has continued to drop and when all is said and done they never make the kind of money they thought that they were going to make. I tell people when asked about medicine as a business to not go into medicine if they are doing it for the money, because simply put the money is not there anymore especially if you are considering primary care.

Most of the rich doctors you hear about, make their money by running a good business and not from the practice of medicine alone or they are highly trained specialists. A doctor with superb business acumen can still carve out a niche business and do well but the days of "rich" doctors from what I am seeing are but a fading memory. The reasons for this decline in reimbursement are vast and could fill up an entire book on the subject. I still think that medicine is a great career but I knew going into it that I could make a lot more money doing business than I could practicing medicine and I still decided to leave business for the time being and pursue medicine. I am sure when I am done I will reunite with business and combine medicine with it.