however, it’s also known for having some of the highest healthcare costs in the world.

然而，它也以擁有世界上最高的醫療費用而聞名。

This has led many to wonder, “are American doctors overpaid?”

這使許多人不禁要問："美國醫生的工資是否過高？"

And are those costs being passed onto patients?

而這些成本是否被轉嫁給了病人？

Let’s find out.

讓我們拭目以待。

Dr. Jubbal, MedSchoolInsiders.com.

Jubbal博士，MedSchoolInsiders.com。

As with any question, it’s important to look at both sides of the debate.

與任何問題一樣，重要的是要看辯論的兩方。

We’ll start by exploring the arguments in favor of American doctors being overpaid followed

我們將首先探討支持美國醫生工資過高的論點，然後是

by the arguments against it.

反對它的論點。

If you enjoy content like this, make sure you’re subscribed so you don’t miss out

如果你喜歡這樣的內容，請確保你訂閱了，這樣你就不會錯過。

on any future videos.

在未來的任何視頻上。

Also consider becoming a channel member for additional perks including custom emojis,

還可以考慮成為管道成員，以獲得額外的福利，包括定製表情符號。

discounts on the Med School Insiders website, and priority response to comments.

醫學院內部人士網站上的折扣，以及對評論的優先回應。

Let’s start with the salary for U.S. physicians compared to other countries.

我們先來看看美國醫生的工資與其他國家相比的情況。

According to Medscape’s 2022 Physician Compensation Report, the average physician in the United

根據Medscape的《2022年醫生薪酬報告》，美國的平均醫生

States earns approximately $339,000 per year.

州每年的收入約為339,000美元。

If we break this down further, the average primary care physician earns approximately

如果我們進一步細分，初級保健醫生的平均收入約為

$260,000 and the average specialist earns $368,000.

260,000美元，專家的平均收入為368,000美元。

This puts physicians in the top 2-5% of U.S. earners.

這使醫生處於美國收入最高的2-5%。

It should be noted that physician compensation in the U.S. varies widely both within and

應該指出的是，美國的醫生報酬在國內和國外都有很大的不同。

between specialties.

專科之間。

For instance, doctors working in private practice can often earn significantly more than physicians

例如，在私人診所工作的醫生的收入往往比醫生的收入高得多。

working in community or academic centers.

在社區或學術中心工作。

In addition, more lucrative specialties such as plastic surgery, orthopedic surgery, and

此外，更有利可圖的專業，如整形外科、骨科手術和

cardiology can easily earn upwards of $500,000 per year whereas less lucrative specialties

心臟病學的年收入可以輕鬆達到50萬美元以上，而利潤較低的專業則是

such as family medicine and pediatrics may earn significantly less than that.

諸如家庭醫學和兒科的收入可能遠遠低於這個數字。

Now let’s compare these numbers to doctors in other countries.

現在讓我們把這些數字與其他國家的醫生進行比較。

In Canada, the average physician earns approximately $354,000 CAD per year.

在加拿大，醫生的平均年收入約為354,000加元。

If we convert this to U.S. currency, this is approximately $255,000–which is roughly

如果我們將其轉換為美國貨幣，這大約是25.5萬美元--這大約是

$84,000 less per year than the average U.S. physician.

每年比美國的平均醫生少84,000美元。

In the United Kingdom, the average physician earns £103,000 per year which equates to

在英國，醫生的平均年收入為103,000英鎊，相當於

approximately $115,000 per year.

每年約115,000美元。

And in Germany, the average physician earns roughly 93,000 EURwhich currently equates

而在德國，醫生的平均收入約為93,000歐元，目前相當於1,000歐元。

to about $90,000.

到約90,000美元。

As we can see from these numbers, U.S. physicians are paid substantially more than physicians

從這些數字中我們可以看出，美國醫生的工資大大高於醫生的工資。

in many other wealthy countries.

在許多其他富裕的國家。

Another argument in favor of American doctors being overpaid is that the physician shortage

支持美國醫生工資過高的另一個理由是，醫生短缺

has been artificially inflated.

被人為地誇大了。

There is no shortage of people who want to become doctors.

並不缺乏想成為醫生的人。

Rather, there are systems in place that have limited the number of physicians that can

相反，有一些制度限制了醫生的數量。

be trained each year–the most notable of which is the “residency bottleneck.”

其中最值得注意的是 "住院醫師瓶頸"。

This, in turn, has inflated physician salaries.

這反過來又抬高了醫生的工資。

Each year, thousands of medical students who apply for residency don’t get into a single

每年，數以千計申請住院醫生的醫學生沒有進入任何一家醫院。

program.

方案。

During the most recent 2022 NRMP Match, approximately 6,400 students went unmatched.

在最近的2022年NRMP匹配期間，大約有6400名學生沒有被匹配。

These are individuals who have completed medical school, passed their board exams, and demonstrated

這些人已經完成了醫學院的學習，通過了委員會的考試，並證明了

that they have what it takes to be a doctor–and yet, they are unable to continue their training.

他們有能力成為一名醫生，但他們卻無法繼續接受培訓。

Instead, they must take a gap year to strengthen their application and reapply in hopes of

相反，他們必須休學一年以加強他們的申請，並重新申請，希望能夠

getting in next year.

明年進入。

This lack of residency positions then trickles down and limits our ability to expand medical

這種缺乏住院醫師職位的情況會逐漸減少，並限制我們擴大醫療服務的能力。

school spots as well.

學校的位置也是如此。

The reason that there aren’t enough residency spots is due to the lack of Medicare Graduate

之所以沒有足夠的住院醫師名額，是由於缺乏醫療保障 畢業生

Medical Education, or GME, funding.

醫學教育，或稱GME，資金。

Caps on funding imposed in 1997 have severely limited the number of facilities eligible

1997年規定的資金上限嚴重限制了符合條件的設施的數量。

to receive federal funding making it much harder to open new residency programs.

接受聯邦資助，使得開設新的住院醫師項目變得更加困難。

This is slowly changing with the recent 2021 Consolidated Appropriations Act which will

最近的《2021年綜合撥款法》正在慢慢改變這種情況，該法將

have Medicare provide an additional 1,000 funded slots over 5 years starting in 2023;

從2023年開始的5年內，讓醫療保險提供額外的1,000個資助名額。

however, there will still be thousands of students who go unmatched each year.

然而，每年仍有數以千計的學生沒有得到匹配。

By limiting the number of physicians that can be trained each year, the United States

通過限制每年可培訓的醫生數量，美國

has artificially inflated the demand for physicians giving doctors more leverage in salary negotiations.

人為地誇大了對醫生的需求，使醫生在工資談判中擁有更多的籌碼。

This has subsequently driven up salaries.

這隨後推動了工資上漲。

It’s simple supply and demand: if there are fewer people offering a service, they

這是簡單的供求關係：如果提供某種服務的人少，他們就會

can often charge more for that service.

往往可以為該服務收取更多費用。

For this reason, as the U.S. takes steps toward addressing the physician shortage, we may

為此，在美國採取步驟解決醫生短缺問題的同時，我們可以

very well see physician salaries begin to decrease.

很有可能看到醫生的工資開始下降。

To learn more about the issue of physician shortages in the United States, be sure to

要了解更多關於美國醫生短缺問題的資訊，請務必訪問

check out Why Does America Have So Few Doctors?–link in the description.

查看《為什麼美國的醫生這麼少》--描述中的鏈接。

Lastly, some people argue that many of the responsibilities of a physician can be accomplished

最後，有些人認為，醫生的許多職責都可以完成

by mid-level providers, such as physician assistants and nurse practitioners, at a much

由中級提供者，如醫生助理和執業護士，以更高的價格提供服務。

lower cost.

成本較低。

Traditionally, mid-level providers work in a collaborative fashion with doctors–similar

傳統上，中級醫療服務人員與醫生合作，類似於 "醫生 "的工作方式。

to the relationship between an attending physician and a resident physician.

對主治醫生和住院醫生之間的關係。

That being said, there has been an increased push for independent practice for PAs and

雖然如此，但現在已經有越來越多的人在推動執業醫師的獨立執業。

NPs in recent years, allowing some mid-levels to practice autonomously and without a supervising

近年來，一些中級醫師可以在沒有主管的情況下自主執業。

physician.

醫生。

The average physician in the United States earns approximately $339,000 per year, whereas

在美國，醫生的平均年收入約為339,000美元，而

the average PA earns $122,000 per year and the average NP $118,000 per year.

PA的平均年收入為122,000美元，NP的平均年收入為118,000美元。

This large gap in pay has led many to question if healthcare costs can be decreased by using

這種巨大的薪酬差距使許多人質疑是否可以通過使用以下方法來降低醫療成本

mid-level providers in place of physicians in some clinical settings.

在一些臨床環境中，中級醫療人員代替醫生。

That being said, there are significant differences in the training, experience, and level of

儘管如此，在培訓、經驗和水準方面存在著顯著的差異。

knowledge between physicians and mid-level providers.

醫生和中級醫療人員之間的知識。

As such, there are many concerns regarding independent practice beyond finances.

是以，關於獨立執業，除了財務問題外，還有許多擔憂。

That discussion, however, is beyond the scope of this video.

然而，這一討論已經超出了本視頻的範圍。

For a comprehensive overview of the independent practice debate, be sure to check out our

關於獨立執業辯論的全面概述，請務必查看我們的

NP & PA vs MD & DOcomparison video – link in the description.

NP和PA與MD和DO的比較視頻--描述中的鏈接。

Now let’s get into the arguments against American doctors being overpaid.

現在讓我們來討論一下反對美國醫生工資過高的論點。

To start, becoming a doctor in the United States is incredibly expensive.

首先，在美國成為一名醫生是非常昂貴的。

Before starting medical school, you must first complete a four-year bachelor’s degree.

在開始讀醫學院之前，你必須先完成一個四年制的學士學位。

According to a U.S. News annual survey, the average cost of college tuition per year in

根據U.S.News的年度調查，在美國，每年的大學學費平均費用為1.5萬美元。

2022 was $40,000 for private colleges, $23,000 for out-of-state students at public schools,

2022年，私立大學為40,000美元，公立學校的州外學生為23,000美元。

and $10,000 for in-state residents at public colleges.

而公立大學的州內居民則為10,000美元。

This means that it costs students anywhere from $40,000 to $160,000 to earn their bachelor’s

這意味著，學生要花4萬到16萬美元才能獲得學士學位。

degree.

度。

And these numbers don’t take into account the various other fees associated with applying

而且這些數字還沒有考慮到與申請有關的各種其他費用

to medical school including the costs of taking (and sometimes re-taking) the MCAT, application

包括參加（有時是重新參加）MCAT考試的費用，申請

fees, and attending interviews.

費用，並參加面試。

In contrast, many other countries allow students to matriculate into medical school straight

相比之下，許多其他國家允許學生直接進入醫學院學習。

out of high school with some even offering free college tuition.

高中畢業後，有些人甚至提供免費的大學學費。

Once U.S. students gain admission to medical school, however, the costs escalate even further.

然而，一旦美國學生獲得醫學院的錄取，費用就會進一步升級。

As of 2022, the average cost of medical school tuition in the United States is approximately

截至2022年，美國醫學院的平均學費約為

$55,000 per year with some schools charging more than $70,000 per year.

每年55,000美元，有些學校每年收費超過70,000美元。

In addition, many schools explicitly prohibit students, and for good reason, from working

此外，許多學校明確禁止學生工作，而且理由充分。

during medical school making it practically impossible to earn a livable income during

在醫學院學習期間，幾乎不可能賺取可維持生計的收入。

these four years.

這四年裡。

As a result, the majority of students are forced to rely on loans to pay for school

是以，大多數學生被迫依靠貸款來支付學費

and other living expenses.

和其他生活費用。

It should come as no surprise then that the average medical student graduates with around

是以，毫不奇怪，醫科學生畢業時的平均成績約為

$242,000 of student loan debt with some students owing over $400,000 by the time they graduate.

242,000美元的學生貸款債務，一些學生在畢業時欠下超過400,000美元。

It’s only getting more expensive too as the average cost of medical school rises by

隨著醫學院的平均成本上升，它也變得越來越貴。

approximately $1,500 each year.

每年約1,500美元。

During residency, U.S. doctors will begin earning a salary; however, it is not as much

在實習期間，美國醫生將開始賺取工資；然而，這並不像其他國家那樣多。

as you might expect for someone with over 8 years of post-secondary education.

正如你對一個擁有8年以上中學後教育的人所期望的那樣。

According to Medscape’s 2022 Resident Salary & Debt Report, the average salary for residents

根據Medscape的2022年住院醫師薪資和債務報告，住院醫師的平均工資為

in 2022 was approximately $64,000.

在2022年約為64,000美元。

This may sound like a comfortable salary; however, more than two-thirds of residents

這聽起來像是一份舒適的薪水；然而，超過三分之二的居民

work greater than 50 hours per week, and nearly a quarter work greater than 70 hours per week.

每週工作時間超過50小時，近四分之一的人每週工作時間超過70小時。

This varies widely based on specialty, however, with some specialties averaging closer to

然而，這在不同的專業中差異很大，一些專業的平均水平接近於2000年的水準。

40 hours each week and others more than 80 hours per week.

每週40小時，其他人每週超過80小時。

Although duty hour restrictions exist that limit residents to working no more than 80

雖然存在工作時間的限制，限制居民的工作時間不超過80分鐘

hours per week, many programs violate these restrictions.

每週小時，許多項目違反了這些限制。

If we use a modest estimate of a 60-hour workweek, the average resident physician earns approximately

如果我們使用一個適度的估計，即每週工作60小時，平均住院醫生的收入約為

$21 per hour after nearly a decade of training and accruing between a quarter to half a million

經過近十年的培訓，每小時21美元，積累了25萬到50萬的收入。

dollars of debt.

美元的債務。

Although salaries increase significantly once a resident becomes an attending physician,

儘管一旦住院醫師成為主治醫師，工資就會顯著增加。

they are often well into their 30s by this point and will then have to start the long

在這個時候，他們往往已經進入30多歲，然後將不得不開始漫長的工作。

road of debt repayment.

償債之路。

This brings us to the next point which is the significant opportunity cost associated

這給我們帶來了下一個問題，即與之相關的巨大機會成本。

with becoming a physician in the U.S. Opportunity cost can be defined as the potential loss

機會成本可以被定義為在美國成為醫生的潛在損失。

from a missed opportunity resulting from choosing one alternative over another.

因選擇一種替代方案而錯失機會。

To start, it takes a minimum of 11 years after high school to become a doctor in the United

首先，在美國，高中畢業後至少需要11年才能成為一名醫生。

States.

國家。

That’s 4 years of college, followed by 4 years of medical school and 3 years of residency.

這就是4年的大學，然後是4年的醫學院和3年的住院醫生。

Although there are some pathways that can shorten the length of training slightly, such

雖然有一些途徑可以稍微縮短培訓時間，如

as BS/MD programs, these are not the norm.

作為學士/博士課程，這些並不是常規。

In addition, many specialties have residencies lasting longer than three years–and that’s

此外，許多專業的實習期都超過三年--這就是

not even getting into the various fellowships available.

甚至還沒有涉及到現有的各種研究金。

Physicians spend over a decade of their lives in training before they start their careers.

醫生在開始他們的職業生涯之前，要花超過十年的時間進行培訓。

In comparison, many of their college peers will complete their 4-year degree, start working

相比之下，他們的許多大學同齡人將完成他們的4年學位，開始工作

in their desired field, and begin climbing the career ladder.

在他們所期望的領域，並開始攀登職業階梯。

As such, they will have nearly a decade’s head start in terms of investing and building

是以，他們在投資和建設方面將有近十年的先機。

their wealth.

他們的財富。

This is why I have said many times on this channel that medicine is not a great career

這就是為什麼我在這個頻道上多次說過，醫學不是一個偉大的職業。

if you’re optimizing for money.

如果你是為了錢而優化。

If you do want to optimize for money, however, I have an entire video discussing the highest-paying

如果你確實想為錢而優化，然而，我有一整段視頻討論了報酬最高的

careers over on the Kevin Jubbal, M.D.

在凱文-朱波爾醫學博士的關懷下。

channel – link in the description.

頻道--描述中的鏈接。

The last argument against American doctors being overpaid is that they aren’t actually

反對美國醫生工資過高的最後一個理由是，他們實際上並沒有

the highest earners within medicine.

醫學界的最高收入者。

The real money in medicine is not in the delivery of care, but rather in overseeing the business

醫學的真正財富不在於提供醫療服務，而在於監督業務。

of medicine.

醫學的。

According to a New York Times survey, the average insurance chief executive officer

根據《紐約時報》的一項調查，保險業首席執行官的平均水平是

earns approximately $584,000 per year, the average hospital CEO earns $386,000 per year,

年薪約584,000美元，醫院首席執行官的平均年薪為386,000美元。

and the average hospital administrator earns $237,000 per year.

而醫院管理者的平均年收入為237,000美元。

Although these numbers may not sound much different from physician salaries, they are

雖然這些數字聽起來與醫生的工資沒有什麼不同，但它們是

likely a vast underestimate of administrators’ actual compensation.

這可能是對行政人員實際報酬的巨大低估。

Top executives generally earn the bulk of their income through non-salary compensation

高層管理人員一般通過非工資性報酬獲得大部分收入

such as bonuses and other benefits.

如獎金和其他福利。

For example, the CEO of Aetna earned a salary of about $977,000 in 2012; however, when you

例如，Aetna的首席執行官在2012年的工資約為977,000美元；但是，當你

factor in non-salary compensation such as stocks and options, his total compensation

如果把股票和期權等非工資性報酬計算在內，他的總報酬為

package that year was valued at over $36 million.

那年的一攬子計劃價值超過3600萬美元。

Hospitals and insurers argue that these large salaries are necessary to attract top executives

醫院和保險公司認為，這些高薪對於吸引高層管理人員是必要的。

who have the knowledge and expertise necessary to navigate the complexities of American health

具備必要的知識和專長，能夠駕馭美國複雜的衛生狀況。

care; however, many feel that these salaries are unnecessarily high.

然而，許多人認為這些工資是不必要的高。

According to studies, administrative expenses account for approximately 15-25% of total

根據研究，行政費用約佔總支出的15-25%。

national healthcare expenditures which equates to roughly $600 billion to $1 trillion per

全國醫療衛生支出大約相當於每個月6000億至1萬億美元。

year.

年。

In contrast, doctors’ salaries are estimated to make up only about 8% of healthcare spending.

相比之下，醫生的工資估計只佔醫療支出的8%左右。

As such, many argue that physician salaries are not the primary drivers of the exorbitant

是以，許多人認為，醫生的工資並不是造成高昂工資的主要因素。

healthcare costs we are experiencing in the United States, and lowering administrative

我們在美國所經歷的醫療費用，並降低行政費用。

costs may do a better job of moving the needle.

成本可能會做得更好，使人感動。

As we can see, the question of whether American doctors are overpaid is not so black and white.

我們可以看到，美國醫生的工資是否過高的問題並不那麼黑白分明。

It is a complex question with strong arguments on both sides.

這是一個複雜的問題，雙方都有強有力的論據。

But what do you guys think?

但你們怎麼看？

Do you think American doctors overpaid?

你認為美國醫生的薪酬過高嗎？

Are there any points I missed?

是否有任何我遺漏的要點？

Let me know with a comment below.

請在下面的評論中告訴我。

Thank you all so much for watching.

非常感謝大家的觀看。

If you enjoyed this video, be sure to check out Why America Has So Few Doctorsor NP & PA

如果你喜歡這個視頻，請務必查看《為什麼美國的醫生這麼少》或《NP & PA》。

vs MD & DO | The Scope Creep Controversy.

VS 醫學博士和醫學博士|範圍爬升的爭議。

Much love, and I’ll see you guys there.

非常感謝，我們會在那裡見到你們。