re: Most overpaid professions

Is the venture yours or your dad's?

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icegator337

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Most overpaid professions
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I bet you are not any of the following:


I'm a real estate agent...did it to be overpaid

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So you could afford this spiffy hairdo obviously!


Enjoy your riches.

Gross margins are only about 20-25% of revenue in a well run insurance agency, 10-15% at older agencies. Revenue is defined as commission income, not gross premium.

Most of your insurance dollar goes to the company to pay out claims in the current year and run the insurer, about 0.80 - 0.85 of every dollar, about 0.05 for catastrophic loss and the agent (an independent contractor) gets the paltry 0.10 left over to run his office, pay employees and try grind out a profit.

Contrary to popular belief, insurance companies are not very profitable versus other businesses and insurance stocks generally lag the market historically.

Agents do okay, but not unless they're very well run and I know plenty who grind it out with 10-12% margins as small business owners because they don't use technology effectively.

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People also don't realize that what a surgeon gets paid for a surgical procedure also includes a 90 global period, which means 3 months of treating the patient post op without reimbursement.

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If I remember correctly, the Medicare reimbursement for a CT surgeon for bypass surgery, including a 5-day hospital stay (and the 4-8 hour procedure, depending on which surgeon is performing it. Average time of 6 hours is probably fairly accurate) is $1800. As you say, this also includes seeing that patient back and keeping them healthy for 90 days after surgery. A "crazy" surgeon who doesn't care about lifestyle can crank out two a day for probably 4 days a week. Most could stand to do one a day and maybe a minor procedure in the afternoon with some clinic. These patients are such a headache to take care of in the hospital, too. They're not your normal healthy people who go to the hospital. They're people who just had their chest cracked open and, almost always, spent some time on bypass.

So for a guy who does four a week, he'll always have at least 2 patients in the hospital and be on call 24/7 for them (again- they're sick. And they get sick and die FAST. You don't just answer questions on the phone, you frequently drive in to be at the bedside), he would be reimbursed $374,000/year. This is cheating because it doesn't include 1-2 half days/week in clinic or any other procedures, but I can tell you for damn sure, that amount of money for that lifestyle is terrible.


Oddly enough, for giggles, when a dermatologist (or general surgeon, FP, or internist) removes a basal cell carcinoma (cancerous mole that almost never spreads more than skin deep) from a person's face, it takes 15 minutes and the reimbursement is usually somewhere around $800. Now, of course, medicine isn't just about money. And there's plenty to be said for enjoying what you do, enjoying acuity (life and death in your hands. REALLY seeing results in what you do), but this means that, if there was someone who was good enough to open a mole clinic, they could outearn the CT surgeon's CABG reimbursement and ICU/inpatient stays in 45 minutes a day. And the mole patients go home and usually just get a phone call for the results. It's a wildly screwy system. And this, of course, is geared to outsiders and not medical professionals. No one does only one procedure over and over and there are other sources of income than the two listed above for these two groups, but these are two of the "bread and butter" cases. And it's kind of ridiculous yet interesting.


And lastly, I think the number I read up there for surgeons ($203,000ish) is on the low side, but this is going to take into consideration lots of very different kinds of practices (retired guys that operate once a week vs guys in rural USA that cover multiple hospitals, never take a day off, and make close to or more than $1m/year and many different groups in between). I do know that I wouldn't take a job as a general surgeon for that kind of money without some major perks or very low volume of work.

Yeah I'd say the np's who are a doctor of nurse practitioner could go through med school

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Yeah I'd say the np's who are a doctor of nurse practitioner could go through med school

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At the very least, these folks could make it. Probably a pretty decent number of RNs, too. It takes a lot less intelligence than willingness to learn and, especially, willingness and ability to change thought process. Much of the "intelligence gap" between doctors, mid-levels, and nurses is from the ways they are trained rather than their inherent "intelligence."
That said, there's a hell of a lot of people who are engineers, small business owners, teachers, etc that are plenty smart enough to be doctors.



No, not every RN or NP or teacher ever to live could have made it as a doctor. But I think the number is a lot higher than most people do.

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Most of the medical professionals are overpaid. This includes especially the medical administrators.

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Dumbfrick.

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don't see how anyone can ever say doctor is overpaid ..

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Some are. Some aren't. The way reimbursement is in medicine is fricking retarded. They pay stupidly high amounts for bullshite things, while paying shite for much more important and technically difficult procedures etc. For example, a stent in the leg pays a shite ton more than one in the heart. BCBS allows $460 to cauterize a mouth ulcer with a silver nitrate stick. Cost of supplies-about $.05. Time-5 seconds. But you can spend a fricking hour with an extremely complicated patient, make a diagnosis that would make House jealous and get $170 tops. Not bad, but frick it. Just find an ulcer, cauterize it and punt them to a specialist or someone else. The system is frickED! No incentive to use your brain and solve an issue. Easier and more profitable to order a bunch of test and lab to make a diagnosis that a thorough exam and history would've made. But insurance and the gov't/m'care set the rules.

Accountants.