While compensation is not my primary intrerest in plastics and reconstruction, it is the one area that I cannot pin down a straight obvious answer and that there seems to be a lot of misinformation? Any other questions I'm answering myself by reading. I am posting this question here on the Student Doctor Network because I am hoping to get some quick informed answers from people here.
There seems to be a major disconnect between the perception (and rumors) about plastic surgery compensation and realities of reported data. I understand that plastics and reconstruction has a greater variability in terms of geographic location as well as practice settings and decision of balance between reconstructive medical cases and elective cosmetics. However, I am constantly getting told that plastics is super competitive because of the earning potential being sky high and incidentally defending my interest in the field as not being ALL ABOUT THE EARNING which is annoying. Truth is, I get why dermatology is competitive if you work 40ish hours a week for 300k-ish yearly salary if your priorities are compensation and lifestyle. But if you're doing the work that it takes not only to match into plastics and reconstruction, then the rough residency (at least very rough by any IM standard), and willing to work 60+ hours a week as an attending, then I see survey after survey showing plastics as only earning on average a little higher than GS, less than vascular, much less than ortho and CT and NS... I don't understand why I'm having to defend that I'm not interested primarily in money just because I'm interested in plastics. Is it just that even medical people have been affected by Nip/Tuck's overblown stereotype of the 1 million plus earning? Is it that the 250-300k figure is far under reported because in addition to salary there are usually huge kickbacks that aren't reported (i.e. only reconstructive is figured in with those figures but plastics as a field tends to have figures more in the range of 500k-1m for private practice?)
Bottom line is that if I look at physician salaries in a table (I'll URL some), and going only based on that and hours worked etc, and I was only interested in money, I would NEVER pick plastics and reconstruction. Am I only getting part of the picture? What in the world is... going on? I would like to submit these as very accessible common (conflicting) points of view, and would really appreciate anyone who can clear up the dynamic of perception and reality regarding plastics median/mean compensation:
1) Easy google search: http://www.profilesdatabase.com/resources/2011-2012-physician-salary-survey 270-380ish starting vs national mean but Rads is way higher, Ortho beats it out by a little or by a lot depending on the subspeciality, derm right up there, but honestly this actually is more lenient to plastics than most salary sites Ive seen. http://www.medscape.com/features/slideshow/compensation/2012/public slide 2 plastics beat out by a bunch including gastroenterology and even oncology here. This is pretty up to date but widely different numbers (I know absolute values are a crapshoot of how they adjust for multiple factors but Im trying to just compare WITHIN surveys for comparable methodology). http://www.studentdoc.com/plastic-surgery-salary.html seems pretty inflated compared to most surveys; here though low is 237k mean 412k and high 820k indicating more people in the low categories than a few very high earners probably on the top of the elective pool Im guessing? Doesnt it seem like MOST (overwhelmingly) plastic surgeons are not earning near what the very few at the top are; but we all have to deal with defending our interest in the non-elective side (if we have such an interest that is)? http://www.mommd.com/component/option,com_core/Itemid,66/dir,0/lang,en/spec_id,56/task,physiciansalarydetail/ again geography can make this vary but look at some of the other specialities.
2) I shadowed a plastic surgeon who was chief at a local hospitals plastics department (pretty big department). He was adamant that most people were being overly politically correct about motivations of premedical and medical students in selection of career path; he personally directly said dermatology and plastics are the most competitive IM and Surgery specialities by a healthy margain BECAUSE of the compensation. Again, this is a guy who is very successful on the inside heading up a department. I didnt have the temerity to ask about the figures Id heard and figure out why other fields werent as coveted in proportion to how much more they earned (given comparable hours/week and night call). Otolaryngology/ENT has the stereotype of being Every Night Tennis and Optho is also a less strenuous call (unless youre 100% cosmetic, again most plastics people arent from what Im seeing and reading); but they make about the same amount .?
3) The Ultimate Guide to Choosing a Medical Specialty really kicks the point home for me: they cite in my version (dont know if its most updated its not with me) plastics as being about 280k average compensation. CT 400+, Neurosurgery same, ortho beats it no matter the specialization, lots of other specialities beat that figure. Yet, there is a sentence directly in the lifestyle considerations portion that says that regardess of subspecialization, plastics and reconstructive surgery tends to be one of the highest compensated medical specialities ALONG WITH CT AND NS. A) It looks like it is WAY BELOW CT and NS according to the book, B) other specialities that surpass the plastic surgery figure arent even mentioned (they say CT and NS leaving out Ortho etc etc).
I could go on but you all get the gist. I feel like I talk to people on the street, or medical people at any level of training/work setting, and they almost all have this perception about plastic surgery compensation compared to other specialties that is NOT supported at all by the numbers, and frankly even regarding those specialties which earn 5 figures less but are pretty close (i.e. within 100k of the mean), many of those you dont have to work as hard to match in and many of those you dont have to work as hard the rest of your life through training and also as an attending. So what gives? Under-reported salaries, elective procedures arent reported in the compensation numbers and only us students dont realize it and factor that in, perhaps plastic surgeons under-report what they make to avoid jealousy? Or honestly going into plastic surgery for the money is a fools errand because reality is, eveyone is wrong and the propoganda myth is just so strong that this is a well-kept secret (if so . Why?) What is going on with the (VERY STRONG and UNIVERSAL it seems) gap of perception vs reported figures? Anyone else get where Im coming from?
There seems to be a major disconnect between the perception (and rumors) about plastic surgery compensation and realities of reported data. I understand that plastics and reconstruction has a greater variability in terms of geographic location as well as practice settings and decision of balance between reconstructive medical cases and elective cosmetics. However, I am constantly getting told that plastics is super competitive because of the earning potential being sky high and incidentally defending my interest in the field as not being ALL ABOUT THE EARNING which is annoying. Truth is, I get why dermatology is competitive if you work 40ish hours a week for 300k-ish yearly salary if your priorities are compensation and lifestyle. But if you're doing the work that it takes not only to match into plastics and reconstruction, then the rough residency (at least very rough by any IM standard), and willing to work 60+ hours a week as an attending, then I see survey after survey showing plastics as only earning on average a little higher than GS, less than vascular, much less than ortho and CT and NS... I don't understand why I'm having to defend that I'm not interested primarily in money just because I'm interested in plastics. Is it just that even medical people have been affected by Nip/Tuck's overblown stereotype of the 1 million plus earning? Is it that the 250-300k figure is far under reported because in addition to salary there are usually huge kickbacks that aren't reported (i.e. only reconstructive is figured in with those figures but plastics as a field tends to have figures more in the range of 500k-1m for private practice?)
Bottom line is that if I look at physician salaries in a table (I'll URL some), and going only based on that and hours worked etc, and I was only interested in money, I would NEVER pick plastics and reconstruction. Am I only getting part of the picture? What in the world is... going on? I would like to submit these as very accessible common (conflicting) points of view, and would really appreciate anyone who can clear up the dynamic of perception and reality regarding plastics median/mean compensation:
1) Easy google search: http://www.profilesdatabase.com/resources/2011-2012-physician-salary-survey 270-380ish starting vs national mean but Rads is way higher, Ortho beats it out by a little or by a lot depending on the subspeciality, derm right up there, but honestly this actually is more lenient to plastics than most salary sites Ive seen. http://www.medscape.com/features/slideshow/compensation/2012/public slide 2 plastics beat out by a bunch including gastroenterology and even oncology here. This is pretty up to date but widely different numbers (I know absolute values are a crapshoot of how they adjust for multiple factors but Im trying to just compare WITHIN surveys for comparable methodology). http://www.studentdoc.com/plastic-surgery-salary.html seems pretty inflated compared to most surveys; here though low is 237k mean 412k and high 820k indicating more people in the low categories than a few very high earners probably on the top of the elective pool Im guessing? Doesnt it seem like MOST (overwhelmingly) plastic surgeons are not earning near what the very few at the top are; but we all have to deal with defending our interest in the non-elective side (if we have such an interest that is)? http://www.mommd.com/component/option,com_core/Itemid,66/dir,0/lang,en/spec_id,56/task,physiciansalarydetail/ again geography can make this vary but look at some of the other specialities.
2) I shadowed a plastic surgeon who was chief at a local hospitals plastics department (pretty big department). He was adamant that most people were being overly politically correct about motivations of premedical and medical students in selection of career path; he personally directly said dermatology and plastics are the most competitive IM and Surgery specialities by a healthy margain BECAUSE of the compensation. Again, this is a guy who is very successful on the inside heading up a department. I didnt have the temerity to ask about the figures Id heard and figure out why other fields werent as coveted in proportion to how much more they earned (given comparable hours/week and night call). Otolaryngology/ENT has the stereotype of being Every Night Tennis and Optho is also a less strenuous call (unless youre 100% cosmetic, again most plastics people arent from what Im seeing and reading); but they make about the same amount .?
3) The Ultimate Guide to Choosing a Medical Specialty really kicks the point home for me: they cite in my version (dont know if its most updated its not with me) plastics as being about 280k average compensation. CT 400+, Neurosurgery same, ortho beats it no matter the specialization, lots of other specialities beat that figure. Yet, there is a sentence directly in the lifestyle considerations portion that says that regardess of subspecialization, plastics and reconstructive surgery tends to be one of the highest compensated medical specialities ALONG WITH CT AND NS. A) It looks like it is WAY BELOW CT and NS according to the book, B) other specialities that surpass the plastic surgery figure arent even mentioned (they say CT and NS leaving out Ortho etc etc).
I could go on but you all get the gist. I feel like I talk to people on the street, or medical people at any level of training/work setting, and they almost all have this perception about plastic surgery compensation compared to other specialties that is NOT supported at all by the numbers, and frankly even regarding those specialties which earn 5 figures less but are pretty close (i.e. within 100k of the mean), many of those you dont have to work as hard to match in and many of those you dont have to work as hard the rest of your life through training and also as an attending. So what gives? Under-reported salaries, elective procedures arent reported in the compensation numbers and only us students dont realize it and factor that in, perhaps plastic surgeons under-report what they make to avoid jealousy? Or honestly going into plastic surgery for the money is a fools errand because reality is, eveyone is wrong and the propoganda myth is just so strong that this is a well-kept secret (if so . Why?) What is going on with the (VERY STRONG and UNIVERSAL it seems) gap of perception vs reported figures? Anyone else get where Im coming from?