As I've thought about some of psychiatry's recent pharmaceutical research scandals, the broader role of money in medicine has naturally come to mind. After all, there is no way to be totally free of conflicts of interest. Any physician in private practice, or any physician who gets credit of any kind for sustaining a volume of clinical work (such as in academia, where physicians often are salaried but must accrue billings to justify that salary from year to year) has an interest in providing services that may conflict with doing what is medically and ethically justified.
The old joke goes that if you walk into a barbershop and ask if you need a haircut, chances are the answer is going to be yes. But we hold physicians to a higher standard than barbers; even when a surgeon or a psychotherapist could use the business, if a procedure is not indicated in a certain case they are obviously expected to honestly say so, despite their own pecuniary interest. Needless to say it doesn't always play out that way.
According to a list I randomly looked up, the average psychiatrist income in this country is $134,000 (I don't know how specifically reliable that particular survey is, but all the figures are on par with other surveys I have seen various places in the past). In terms of all specialties psychiatry is at the low end, but it is comparable with the other office-based, non-procedural specialties. As this list notes, many physicians put in well more than 40 hours per week, including night and weekend hours.
Perhaps it is puritanical of me, but even apart from the general corruption of psychiatry's already fragile knowledge base that I've already written about, I have also been bothered by the sheer tackiness of psychiatrists augmenting their income in a big way essentially by auctioning off their degree-related expertise to the highest bidder (that is, by giving highly lucrative "educational" talks or obtaining drug company research funding that is more about funding than about research).
Obviously physicians should be and will be paid well in the overall scheme of things. It is a demanding and stressful profession requiring prolonged (7-12 years depending on specialty, usually 8 or 9 for psychiatry) education and training beyond an undergraduate degree. And nowadays medical students often graduate with over $100,000 in student loan debt.
A medical degree is earned through a great deal of hard work, but it is also a privilege granted by society for the general health and welfare, not for the enrichment of individuals. Physicians obviously live comfortably, but the great majority of them are not CEO's-with-three-homes-and-a-yacht kind of rich (maybe a nice home, a superfluity of books, a menagerie of high-maintenance pets, and a canoe).
Some people seem to think it's obscene for a baseball player or a rock star to make many millions of dollars, but in a capitalist society one can hardly object. If one is providing entertainment or any other discretionary product, then one deserves whatever income one can pry out of the market. But short of high-end psychoanalysis and cosmetic procedures, health care is not a discretionary product, unless life itself is discretionary.
Some of the high-profile academic psychiatrists who have generated the recent opprobrium (detailed in the link in my post two days ago) earned seven figures over several years from drug companies, above and beyond their already hefty clinical and academic reimbursements. In a field that, due to the potentially devastating effects of mental illness, frequently serves the most socioeconomically dispossessed members of society, that strikes me as being unseemly. For individuals making six figures to have fancy meals bought for them by drug companies soliciting their services seems to me to be in equally poor taste.
Any opinions out there--do psychiatrists and other physicians make too much money, too little, or just right?