We [ophthalmologists] are the 99%!

Dr. McDonnell

Dear loyal Ophthalmology Times reader and fellow ophthalmologist:

Like you, I chose to attend medical school with the goal of helping patients who were ill and needed curing, comforting, or both. So perhaps the financial rewards of a career in medicine have made you feel slightly embarrassed and concerned that people might be resentful or jealous. Well, here’s good news: research suggests we physicians aren't so financially successful after all.

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The print and television news in the United States was filled, not long ago, with stories about the Occupy Movement. This involved protests, sit-ins, and campers going to places like Wall Street, where the wealthiest 1% of Americans apparently work or generate their wealth. Much written about this 1% group was not very complimentary.

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A look at those within the 1%

Curious as to the identities of those within the 1%, I consulted the website of Professor G. William Domhoff of the Sociology Department of The University of California at Santa Cruz. Dr. Domhoff studies wealth and income distribution in the United States and correlates this with political power.

According to the website, which breaks the top 1% into subsets, “the 99 to 99.5th percentiles largely include physicians, attorneys, upper middle management, and small business people who have done well . . . The net worth for those in the lower half of the top 1% is usually achieved after decades of education, hard work, saving, and investing as a professional or small business person.”

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The website goes on to say that this part of the 1%-which includes a lot of physicians-doesn't exactly qualify as a group of fat cats

“An income of $190,000 post tax or $15,800 per month will certainly be a nice lifestyle but is far from rich . . . Our poor lower half of the top 1% lives well but has some financial worries . . . Those in the 99th to 99.5th percentile lack access to power. For example, most physicians today are having their incomes reduced by HMOs, PPOs, and cost controls from Medicare and insurance companies; the legal profession is suffering from excess capacity, declining demand and global outsourcing; successful small businesses struggle with increasing regulation and taxation. I speak daily with these relative winners in the economic hierarchy and many express frustration.”

The rest of the ranks

Americans who rank in the top 99th to 99.5th, according to this analysis, are not doing so well.

“Most of those in the bottom half of the top 1% lack power . . . and are essentially well-compensated workhorses for the top 0.5%, just like the bottom 99%. In my view, the American dream of striking it rich is merely a well-marketed fantasy that keeps the bottom 99.5% hoping for better and prevents social and political instability. The odds of getting into that top 0.5% are very slim and the door is kept firmly shut by those within it.”

We physicians are really just worker bees, even if we make into the 99% to 99.5% group. For us doctors, the chances of joining the top 0.5% is reportedly miniscule: “membership in this elite group is likely to come from being involved in some aspect of the financial services or banking industry, real estate development . . . or government contracting. Some hard working and clever physicians and attorneys can acquire as much as $15-20 million before retirement, but they are rare.”

Making it to the tippy-top requires physicians to be both hard working and clever? That leaves yours truly out!

But here’s the really sad part: “One might think that physicians, America’s highest-paid professional group, would be largely exempt from the economic currents affecting most other Americans. This isn’t so. Medscape, a key physician website, reports that as of 2013, mean income for male physicians in all specialties was $259,000; for female physicians, it was $199,000. Family practice doctors and internists earned the least, averaging around $175,000. Orthopedic surgeons earned the most, averaging around $450,000; they are the only physician specialty falling within the top 1% by income.” (emphasis added).

It is not an issue for me that, as a physician, I am “just a high-paid workhorse" who is probably not hard working and clever enough to be among the top 0.5% financial rung of Americans. But the revelation that orthopedic surgeons are the only doctors whose average incomes earn them entry into the top 1% is a hard pill to swallow. I say we ophthalmologists occupy the American Academy of Orthopaedic Surgeons!

Reference

http:www2.ucsc.edu/whorulesamerica/power/investment_manager.html