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Joey
7 months

Let's do some quick comparisons of medical systems. Let's look at the US, the UK, Germany, and the Netherlands.

In the US, primary care docs earn an average of $161k a year while specialists earn an average of $230k a year. In the UK, that's $118k and $150k respectively. In the Netherlands that's $117k and $253k respectively.

In Germany that's $77k for specialists and no info for GPs.

How about patient visits a week for primary care doctors? 19 per day in the US 41 per day in the UK 243 per week in Germany (over 48 a day if working 5 days a week over 34 a day if working 7 days a week)

24.6 per day in the Netherlands is my best estimate.

How about time spent with each patient for a routine visit? US 18 minutes UK 10 minutes Germany 6 minutes

Netherlands 10 minutes (time of average consultation)

Population density per sq km US 33 UK 265 Germany 225

Nethlerlands 411

Yes some of these numbers are a few years older. I invite anyone who can find more up-to-date numbers to share them here. This was the best I could in one sitting. However, I doubt there has been a drastic change. So if you want overworked physicians who are underpaid, socialized medicine can you help you get there. One way to have socialized medicine and get around this is to pay your doctors very well but be a small, densely populated country with high taxes.

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23 comments
nachdenken!
No specialized doctor in Germany is working below 150k$
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JoeyAuthor
Yeah, my source could be wrong but I saw these figures repeated. In my mind, this makes sense. If you set a low rate for the cost of treatment and it's not negotiable, the doctor will have to see a ton of patients or take a hit monitarily. Set the price low enough and both will happen.
nachdenken!
Hanover Fiste, give me a break and take my word. I have tons of friends who are specialised doctors. Salaries range from 60.000 (beginners) to 200.000+ (gurus). We are talking about specialiaed docs and not what you call primary care doctors. Or ask google
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JoeyAuthor
nachdenken!, Or you can ask Google. This is about average salaries. The best doctors make a lot more. This NPR article says PCP in Germany earn about $123k a year American but doesn't indicate where the number is from. That's a third of what they earned in the 1980's. https://www.npr.org/templates/story/story.php?storyId=91931036
Hanover Fiste
nachdenken!, I'm not calling you wrong, but it's the job of the person making a claim to show evidence. Joey shared his sources. I'm not out for an argument....but I don't believe someone who has "tons of friends" who are doctor specialists.
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JoeyAuthor
nachdenken!, The article I used at the top was sourced. Source: U.S. Health Care Spending: Comparison with Other Organization for Economic Co-operation and Development (OECD) Countries, the Congressional Research Service (CRS), September 17, 2007. Notes: Amounts are adjusted using U.S. dollar purchasing-power parities. Amounts from previous years are trended up to 2004 dollars using the annualized Bureau of Labor Statistics Employment Cost Index for wages and salaries of health services workers in private industry. It is not known whether wage growth in health professions in other countries was similar to that in the United States. One country has both salaried and self-employed general practitioners. In the United States, salaried general practitioners earn an average of $134,600, compared to $154,200 if self-employed. Recent data are available only for 21 of the 30 OECD countries.
nachdenken!
Hanover Fiste, ok, fine with me
Viqueen
I'm not sure the number of visits per week is necessarily a good comparison. Maybe rather the number of doctors or promary care physicians per 100 000 inhabitants? Because the systems are so different. If I email my family doctor and ask her to renew my daughter's Epipen prescription, it will probably count as a visit, although I never actually went anywhere. It will also count as a very short visit of about 2 minutes maximum.
Viqueen
Also, if I need to see a specialist quickly, in Estonia this will be achieved by a referral by another doctor. Unless it's done during a regular visit, writing the referral it would probably be another "visit".
Hanover Fiste
Viqueen, it comes down to how much time the doc spends with the patient. Was there sufficient data gathered to make a valid diagnosis? Are you a human being, or a burger to be assembled and microwaved?
JoeyAuthor
Viqueen, that's an assumption of how visits are calculated. The same features are available in the US system. I think visits per day or per week is an excellent point of comparison because it has nothing to do with the relative health of the population and should be calculated the same way. That is, how many patients are seen a day. Most tellingly, the source I used for time spent with patients is the National Center for Biotechnology Information, US National Library of Medicine. This is a government source that should be comparing apples to apples and in fact compared patient times with physicians. In the US, doctors spend more time with their patients. I respect your opinion but if you are going to refute the idea here, you need to back it up with more than a supposition.
Viqueen
I wasn't actually refuting anything yet, more like thinking out loud. The data needs analysis in order to understand the collection methods and such. But as I have mentioned before, the claims of more face time are not supported by my personal experience at all. Total time spent in a doctor's office, yes. That's looooong. But not face time with the actual doctor. Because in the US it's always been like a conveyor method: the nurses do most everything. Then you wait. And wait. And there are 4-5 patients similarly waiting in different rooms. And then the doctor comes and is in and out in about five minutes. Makes sense from an efficiency point of view. But then again, I'm a relatively healthy individual and have seen maybe 5-6 doctors altogether in the US.
JoeyAuthor
Viqueen, my experience in the US has been different. I get at least 15 minutes with my PCP at check ups. At specialists it varies. When I hurt my hand the doc examined me and told me it was fine in under five minutes (it was, I was being overly cautious). On the other hand, my wife's OB sits and chats with us until the nurse comes in to remind her to go to her next patient.
JADED JOEY (πŸ™Š5)
1. The German health care system is not the holy grail and it still needs improvement. However, everybody has insurance and it works quite well. 2. I'm not really into job opportunities and salary of medical personnel, but I do know that a lot of German doctors (and other hospital staff) move to GB or Switzerland to work. What does population density has to do with anything?
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JoeyAuthor
The Netherlands has a great system in a lot of ways (honestly, all the countries do). However, when comparing the effectiveness of different systems I think you need to consider the infrastructure. The Dutch system has a huge advantage in that, if I recall correctly, that the majority of citizens live within three minutes of a doctor and almost all live within ten minutes of a doctor. Providing free, convenient health care must have lower costs in that situation, at least in my mind. I was trying to look into how many German doctors left Germany. The free education and lower relative pay seem like a convenient situation to leave the country, but I hadn't looked much.
JADED JOEY (πŸ™Š5)
Joey, health care isn't free in any of those country. Health insurance is mandatory. That's something else than free. I think I get your point about population density. The free education in Germany is especially convenient for Switzerland where they don't have to invest much into education since they just buy educated professionals from other countries. Can't really blame them since all countries try to attract educated foreigners. The free education is a fact to consider when you compare income in the US and Europe as well. Doctors in the US start their career with about 120K of debt. Also look at the working hours per week and holidays and such.
JoeyAuthor
JADED JOEY (πŸ™Š5), you're right about health care not being free. In Germany and the Netherlands it's mandatory. The UK, I believe, has a single payer system, which is what I meant by free (even though it's taxpayer funded).
JoeyAuthor
JADED JOEY (πŸ™Š5), the debt is important factor as well. It can cut both ways, in a sense. A qualified doctor with significant debt will have a more difficult time moving to Germany if the pay is less. However, I doubt this is a huge factor in that type of decision.
Viqueen
Finally looked up a few stats on Estonia. Population density: about 30 people per square km, i.e. less than the US. Not sure about doctor salaries, but the system for primary care physicians is the following. They get a base amount of around 1000 euros from the state health insurance fund every month. And in 2017 numbers, the following: for every under 3 years old patient in their registry 7,16 euros; 3-7-y.o. 5,33 euros; 7-50-y.o. 3,72 euros; 50-70-y.o. 4,55 euros, over 70-y.o. 5,46 euros. Most PCPs have about 2000 patients in their registry, but this can vary. The amounts need to cover rent, supplies, nurses, etc. There is an additional fund for things like blood tests, X-rays, MRIs. Those get compensated by the state health insurance fund separately.
JoeyAuthor
Thanks for adding that.
Infidel Castro
"Underpaid." Right.
Hanover Fiste
So....you're saying German doctors are 3 times faster than American doctors? 🀣 And all that for half the pay!
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