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This really baffles me...

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    (Original post by anoldbaby)
    correlate pay with productivity is a dangerous slope... just like privatisation
    Firing ineffective doctors also looks like privatisation. But this weeds out dangerous and incompetent doctors who put their patients at risk. Your job should not be safe just because you have a medical degree. Patients must come first.

    I think correlating pay to performance is the only way to help motivate staff without further complicating the hierarchical structure in the profession. If you're better than your peers, you ask for and get a small pay increase to reflect this. This means hospitals can reward good staff and progress them slightly without the feast and famine issue (you get promoted, big pay rise; then you're stuck on that for years until the next big pay rise). Also, it slows the rate at which doctors need to be promoted to keep them happy--you get a small increase in pay for performance biannually, so you feel less hard done by if you are not promoted year on year.
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    (Original post by enxr)
    Firing ineffective doctors also looks like privatisation. But this weeds out dangerous and incompetent doctors who put their patients at risk. Your job should not be safe just because you have a medical degree. Patients must come first.

    I think correlating pay to performance is the only way to help motivate staff without further complicating the hierarchical structure in the profession. If you're better than your peers, you ask for and get a small pay increase to reflect this. This means hospitals can reward good staff and progress them slightly without the feast and famine issue (you get promoted, big pay rise; then you're stuck on that for years until the next big pay rise). Also, it slows the rate at which doctors need to be promoted to keep them happy--you get a small increase in pay for performance biannually, so you feel less hard done by if you are not promoted year on year.
    removing doctors that are danger and clearly incompetent is fine... if there is a perfect pay performance system then that's okay too... but unfortunately there isnt… just think of those difficult cases... no doctors would want to deal with them because they are less likely to have a good outcome... everyone would want to work on the easy and fast cases so they can do more and earn more... and how would you measure risk/complication.. simple model isn't enough to reflect complicated cases so those patients will lose out.. complex model... yes welcome paperwork! and what about work place harmony... do you want the surgeons to blame the medics for not picking up stuff which impact their performance and pay and vice versa....
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    Probably to lure them away from the private sector?
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    (Original post by like a boss)
    Let's look at the facts about medicine:

    - Thousands of people apply to do it, it is the single most competitive course in the country. Many of these people genuinely want to help people, however many applicants are motivated by the money.
    - Only a fractions of applicants will get a place onto the course. The people that get places are not necessarily the ones who are most suited for the job. The ones motivated by money will make less caring doctors and waste government funded training.
    - Doctors are still paid 6-figure salaries once they specialise, even though there is such a large supply of people who would do medicine even if it paid alot less.

    So why are doctors still paid so much? Basic supply and demand states that when supply increases, price decreases. However the government still pays doctors high salaries even though there are many people not getting places into medicine, who would be willing to do the job without the motivation of money. I know that doctors undoubtedly deserve their wages, but if they were paid less we would only get applicants who want to do medicine for the right reasons.

    Frankly I think your perspective is extremely limited. Do you not think Bankers that earn millions or Footballers, Actors etc. Paid insane amounts of money, yet contribute far less that a qualified consultant? I understand your frustration, but medical professionals are worth every penny, they should try and up wages for all of them into more level playing field especially the Allied Health Professions inclusive of Nursing and Midwifery.

    It is expensive, but it is also just a number to help people quantify what it means to be a Doctor. It is hard work and to think after 10-18 years of study to be told, your only worth £50,000? I'm not saying at all that finance is great, in fact I am personally of the belief that a Global Resource Based Economy is really the next evolutionary leap for humanity. However, in the meantime, while were waiting for the world to catch up in consensus, why shouldn't a Doctor be well paid?

    Another way to look at it is this. You are a skill profession, you work long and hard at your professional skills and talent, but you still need a medium of exchange at present to live a normal life. I wouldn't turn down the money because I would feel I earned every penny, as a Footballer on 1M + and ask them if they honestly think they deserve that money compared to a Neurosurgeon who might be nearer 200k if they are lucky. If you truly believe what you say, when you qualify you would have to voluntarily give up some of your wage to prove your point, but after incurring all the debt and stress, most people, myself included would probably be like, you know what I need every penny of that to help keep funding my CPD, pay of my Debts and yes, pay for a holiday or two as I would have worked hard to get there and no doubt be stressed from time to time.

    Finance is a horrible area, but I felt the need to share the importance of not selling oneself short, it is an honour to practice medicine, it should be free like most things in this world, but until humanity reaches that level of development we have no choice but to work at a level everyone is happy with. To date that is a monetary system, it's flawed, it promotes inequality, it puts the wrong objective as priority and it will crash at some point, but until it does do you really think punishing Doctors by taking their wages is fair? Do you also think that after all the Vetting to get into medical school all Doctors are just after the money? Bearing in mind a significant population of medical recruits are mature students?

    Food for thought.
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    To be quite honest, doctors deserve to earn a lot more than they currently do..

    Their salaries in this country really arent spectacular, im sure there are plenty of docs who dont even make 6 figures. In america they earn a lot more
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    (Original post by bertstare)
    To be quite honest, doctors deserve to earn a lot more than they currently do..

    Their salaries in this country really arent spectacular, im sure there are plenty of docs who dont even make 6 figures. In america they earn a lot more
    That's also because on average they graduate with a quarter of a million dollars of unprotected private debt though. At least we don't have that to contend with!
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    (Original post by nexttime)
    That's also because on average they graduate with a quarter of a million dollars of unprotected private debt though. At least we don't have that to contend with!
    University education in America is seriously messed up.

    EDIT: In terms of fees, rather than content.
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    (Original post by Davidragon)
    University education in America is seriously messed up.

    EDIT: In terms of fees, rather than content.
    Very much so, but it's also the most widely and easily recognized. You win some, you lose some.
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    (Original post by nexttime)
    That's also because on average they graduate with a quarter of a million dollars of unprotected private debt though. At least we don't have that to contend with!
    Now fees are 9 thousand a year and considering some degrees are six years long if you plus factor the living expenses for cities like London after the exchange rate it won't be far from that.
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    (Original post by Mathlete 4 the win)
    Now fees are 9 thousand a year and considering some degrees are six years long if you plus factor the living expenses for cities like London after the exchange rate it won't be far from that.
    Its high, but not that high. 4x9K fees (as fees are only for the first 4 years) and maybe 6K per year living expenses at the top end. = roughly $110K of government-protected low interest debt is hardly comparable to twice that in private loans that you could default on should you become ill/want to change career.
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    (Original post by TooSexyForMyStethoscope)
    I've heard the opposite...that soon 60% of all doctors will be Consultants
    Where've you heard that? It's pretty much the opposite of what I've heard...

    60% of all doctors will become GPs. Consultant jobs are going to become less plentiful - as consultants retire trusts aren't going to re-recruit to those posts, instead they'll create specialty doctor posts for which they can pay considerably less.

    (Original post by TooSexyForMyStethoscope)
    ...so rather than every 35 year old with a CCT being a Consultant
    Having a CCT doesn't make you a consultant, it just means you can apply for a consultant job. If there are less consultant posts on offer then more of these CCT-holders will become specialty doctors or go abroad.
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    (Original post by enxr)

    I think correlating pay to performance
    ..and how could you measure a doctor's performance??
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    (Original post by .eXe)
    Anyone who enters medicine for the money is a complete fool. 5 years to finish, 2 years to train, 3-5 more years to specialize....10-12 years later you actually start your career. Even at this point, you aren't making much and your first priority is paying your loans back.

    In all that time you could've just done business and made a ton of cash...especially if you had the grades that med school require...getting into business school would've been a breeze anyways.

    So yes, don't do medicine for the money, you will just realize what a tool you are 15 years later.
    It's not as easy as that. You don't just breeze in start a business and start earning millions.
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    (Original post by theatrical)
    Where've you heard that? It's pretty much the opposite of what I've heard...

    60% of all doctors will become GPs. Consultant jobs are going to become less plentiful - as consultants retire trusts aren't going to re-recruit to those posts, instead they'll create specialty doctor posts for which they can pay considerably less.



    Having a CCT doesn't make you a consultant, it just means you can apply for a consultant job. If there are less consultant posts on offer then more of these CCT-holders will become specialty doctors or go abroad.
    I think it was on Radio 4. I distinctly remember since it was about the rising NHS wage bill and apparently more junior doctors intend to become specialists than ever before...so they were predicting a 60% rise in 'consultant level' jobs (in combo with increased retirement age, pension changes etc) that the NHS would have to pay for. My previous post was poorly worded, I believe this was a purely predictive study as opposed to the immediate problem of too many juniors. As you say the number of Consultant posts will be declining.

    I do realise that a CCT doesn't make you a Consultant, I was just trying to give an example of how the career structure may be changing....different 'grades' of Consultant if you like
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    (Original post by Besakt)
    It's not as easy as that. You don't just breeze in start a business and start earning millions.
    I clearly said "in that time", indicating the 10-12 or so years that it takes to become a fully trained doctor. I know business doesn't mean insta-millionaire.
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    (Original post by .eXe)
    I clearly said "in that time", indicating the 10-12 or so years that it takes to become a fully trained doctor. I know business doesn't mean insta-millionaire.
    Even if you are extremely clever if you start up a business there is not guarantee in 10-12 years time you'll make a lot of money (I'm classing a lot of money as £35-40k plus). In fact, I know many very intelligent people that have gone into business and have been in business for decades and just make enough to get by. There is also the risk that is attached to business you aren't guaranteed a job.
    Contrast this to a doctor, 10-12 years they have high job security, no/little worries about losing the job, probably the same amount of stress and a guaranteed income flow.
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    (Original post by TooSexyForMyStethoscope)
    ...apparently more junior doctors intend to become specialists than ever before...so they were predicting a 60% rise in 'consultant level' jobs
    That makes no sense. Just because more junior doctors might intend on becoming specialists doesn't mean they will or can. Trusts aren't going to increase the number of specialty training posts just because more people want to do it, and they certainly aren't going to create posts that aren't needed.

    There's currently bottlenecks at ST3 level and then at CCT level (though less so). As consultant posts are left vacant, there will be a relative rise in specialty doctor posts - I can't understand where this 60% rise in 'consultant-level jobs' is going to come from...?
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    (Original post by theatrical)
    That makes no sense. Just because more junior doctors might intend on becoming specialists doesn't mean they will or can. Trusts aren't going to increase the number of specialty training posts just because more people want to do it, and they certainly aren't going to create posts that aren't needed.

    There's currently bottlenecks at ST3 level and then at CCT level (though less so). As consultant posts are left vacant, there will be a relative rise in specialty doctor posts - I can't understand where this 60% rise in 'consultant-level jobs' is going to come from...?
    As I said, it was on the radio :rolleyes: I clearly posted in haste without thinking it through. The main point of the feature appeared to be interviewing some bloke from the BMA about the possibility of senior trainees emigrating if there were no consultant posts for them.

    You are perfectly correct, just because people intend to become specialists doesn't mean they will get to be.
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    Doctors don't really contribute anything to the economy, they leech off it, so their pay should be pretty low.

    Let's face it, we've been hiring foreign doctors since the birth of the NHS and no-one has been any the wiser. I'd happily have an East-European or Asian doctor who got his degree from a 2-bit uni in no-where-istan treat me than I would a preening trust-fund doll from the Home Counties anyday!
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    (Original post by happyhands)
    Doctors don't really contribute anything to the economy, they leech off it, so their pay should be pretty low.
    Lol wut.

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