Pediatrician - Good Doctors Bad Businessman

Host: Medical School of the University of New Jersey. Guest: Usually, it's a four year undergraduate program and a four year medical program. Sometimes you can get a combined six year program, but it's usually an year extension college. Host: Okay, and how much would that cost? Guest: Well, a low-end would be about $25,000 for a typical college state school and college private schools, it varies slightly, $55,000. So if you took that figure times 8, low-end would be $200,000 and there are typically many paying double that. So it's not inexpensive to go to a college today and become a doctor, it's hugely expensive. Host: Can you just speak about residency? Guest: The residency, Pediatrics takes approximately a three-year program which means you are getting paid, not enough to pay back any loans, enough to at least at that point for the apartment and to become a resident. Host: And could you describe to us the certification process? Guest: Well, after you finish your residency program, you can practice. You will go on and take an exam and the exam is pretty extensive, but that’s of the best part. You find that all the new pediatricians have to get recertified and that’s a process in routine 5-10 years depending on if it's a personal practice a lot of times. It's only been previously certified for life, these guys don’t have a genuine to get recertified. That’s what they are trying to do to make everybody not be a life long certified doctor, but a continuous education with recertification. A lot of the doctors who are already in the practice resent that, because you are keeping up with medical education with proof to get your license renewed, you institution reviews what you are doing and your medical staff of the institution, your Director of Pediatrics reviews what you are doing on a regular basis, because you want to keep everybody doing -- we consider the best quality of care for every child that’s taken care by our institution. Host: What are the causes of dues? Guest: Dues are extremely spent. On the medical side it can run you a thousand dollars. If it's on the pediatric $750. You take all these different courses to keep your medical education up. Many of these courses can run in the thousands of dollars. So it's not an expensive process to get the education. Thank God, the institution I am at happens to have 2 to 3 lectures in the winter a week for just certification lectures you get one hour at a time for CME credits, so you can get your number which happen to be 50 every two years and it's not a process that’s simple, but you have to keep up, because our good doctor is always as good as our knowledge. Host: And after all this money spent, how much do you make? Guest: An average pediatrician makes slightly more than a principal, but if you take in the fact you are not getting free healthcare, which is a big issue today obviously, retirement funds, you are paying back loans and if you have $200,000 with a loan to payback, you could be paying it back you could be paying it back with interest 10,000 to 15,000 a year, so you could easily bill over $100,000 which is not a lot of money for some putting in 12 years of education. Host: How much would it cost for solo practice in this time? Guest: To open up the solo practice. Well, first of all you just can't find a place to rent which is not going to be cheap. You have to get a lot of equipments in your office, different types of tables, you have to buy vaccines. As an average pediatrician and I would assume has an inventory of $50,000 to $100,000 with the vaccines, because you have to have it, if you can't give it. I know you don’t believe this, but we vaccinate a thousand kids fully that costs to a pediatrician if we buy all these vaccines can be over a million dollars, wholesale. So here we are not making. We are making the least of all specialty, but at the same time we have an outlay of vaccines and it's huge, making very difficult for anybody who gets out of medical school unless he comes from a rich family to be able to afford to open a medical practice. Host: And how much is in malpractice? Guest: Malpractice for pediatrician if you are lucky can get it around to -- I can talk only about New York. If you are part of a co-ops thing like a hospital, it could as low as 16. There are some guys paying below $20,000. So it's not a small expense and there is -- you have to stay to trying to race it to 15% to 20%. Now that will knock pediatricians out of practice, but obstetricians there are rumors that their malpractice is going to hit $225,000 and if they make $3000 a delivery, at 75 deliveries they are paying their malpractice, probably another 50 that let them pay their overhead. That’s a 125 deliveries and a lot of them are doing more than a hundred deliveries a year. How do afford to stay in business? So there are some issues that have to be dealt with down the road. Host: How many hours does a typical pediatrician work? Guest: Well, I can only talk about myself. I am on call 24 hours a day, seven days a week. Most people don’t call you at 9 o’clock at night with not important questions. So usually the calls get off hours are usually important. Many doctors don’t even take off hours. If you call them at 8 o’clock in the morning, I don’t think that’s a good idea. Or go to the ER first and then the ER doctor calls -- I don’t think that’s a good idea, because I think a pediatrician is an extension too in the family. So if they are going to call you, they have something major. Most pediatricians are working 40 to 80 hours in an office depending on what kind of practice they have. So it's a lot of long hours, you also -- there are places in the hospitals. We have to go to hospitals and we see babies or if the kid admitted. So the hours are extremely long. But if we ask more pediatricians forgetting the money aspect, they didn’t really go in for the money. They really went into, because they had a love for taking care of children. It's probably the only part of medicine we can see a kid grow up almost like an extension to your family and many of them come back and they see you several years after they are married and they bring you their kids to you. So it's sort of like a nice place to be in, not a nice place to make money. Host: So is that the main reason why you would want to become a pediatrician? Guest: Well, you don’t want to see bad things. You do see it, but you are like an extension to a lot of families. You are like a father or an uncle to lot of children. So it's like one of the nicest parts of medicine. You can make a big difference in a person’s life. So it's sort of like a very special area, but because you care, and most of pediatrician I know, I can't speak for all pediatricians, will find a way if a kid comes up and they don’t have the money or they can't afford or the insurance is not quite in there, most aren’t going to trim you away. I mean there are right guys all the time. So they are really good caring doctors, but they are not very good businessmen. That’s the nature of good pediatricians. In fact, in my institution we've have several kids with cancer where a hematologist did it for free and we knew he was going do it for free. He didn’t say no. The previous hematologist it was never a question what insurance you had, it's a question of what we can do, because they also were bad businessmen. Now we don’t know if that’s true for all people who treat cancer, but my experience with two particular individuals has been that and I am proud to say I know these people. So they are very good doctors, but bad businessmen. So maybe that’s what the description of the pediatrician. A good doctor, bad businessman. Does that make sense? Host: Yes.