← Becker’s Healthcare Podcast
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- [00:00]
A
This is Scott Becker with the Becker's Healthcare podcast. I am thrilled today to be joined by Tyler Polk. Tyler is known as the Salary doctor and he does a tremendous job following compensation for physicians and residents and more throughout healthcare. I've gotten to know him, follow his work. Brilliant, brilliant person, and excited to visit him with today. And he's got a fascinating origin story as to how we started to really follow this area. Tyler, can you take a moment and introduce yourself yourself and tell us a little bit about what you do?
- [00:35]
B
Absolutely, Scott, and thank you for having me on the podcast. And by the way, I just saw this podcast was ranked number one on Apple for business news. So congrats to you and your team on that achievement. That's really great.
- [00:46]
A
Thank you very much. We are always working and we have a great team and we're thrilled to have guests like you. So thank you very, very much. Tyler, tell us about yourself, the origin story, which I love, and about what you're seeing in physician compensation.
- [01:00]
B
Yeah, so as you mentioned, my name is Tyler Polk and I am the founder of Salary Doctor. Really kind of my origin story started about three years ago. I'm fortunate enough to be married to my beautiful wife, who I've been connected to since undergrad, medical school, and now residency. And really, you know, this whole thing started when I, you know, when my wife was going through residency at the time and applying to different programs. And so back then I started a website called Review My Residency and really the goal of that was to bring transparency to residency programs. So it became kind of a grassroots initiative to allow medical students a platform to share and discuss residency programs and talk about applications and the whole process. I mean, I think it's something you really don't appreciate as part of the general public until you really go through it or if you know someone who's gone through it. But then, you know, that kind of transition, as you know, time went on, a lot of the discussion points on that platform became around physician compensation. Right? Every medical student resident wants to know, at the end of this long 10 to 12 year journey, you know, how much money can I expect to make? Right? And for good reason, because medical students are graduating with the highest ever debt burden that we've seen. And I'll talk about that a little bit later. But that brought me to this new idea for my current website and platform called Salary Doctor. And it's really just kind of a platform where we collect and we publish for free anonymous physician compensation data across all different specialties, regions and practice types. So Whether you're employed by a hospital, you're a 1099 private practice, or in an academic setting.
- [02:50]
A
And talk to us a little bit, what are you learning so far about compensation? Obviously, residents are underpaid. They've gone through four medical years of medical school, then four years or three years of residency, and it's not until their early 30s that they're actually out earning a living, making a true living, a long, arduous path. But what are some of the things that you're learning in watching this compensation and how it all works?
- [03:14]
B
Yeah, I think one of the biggest findings that we're seeing is there is a greater and greater disparity between the primary care fields in the more specialized subfields within medicine. Right. And I think that's why we're seeing, you know, more kind of mid levels or NPS and pas going to the primary care field. Because when you grad, you can imagine as a medical student. Right. All things being equal, if you're graduating with two to three hundred thousand dollars of student loans. Right. And if primary care is paying on average about 242,000 250,000 compared to a more specialized field that might start off at $400,000 a year, the incentives just aren't really aligned to go into primary care as often. And I think where we're seeing a lot of interaction and a lot of engagement from physicians in the primary care field.
- [04:07]
A
Got it. But at the end of the day, we need more specialists, we need more primary care doctors. Is there any solve for any of this? Because simply shifting comp from specialists, which we're so short of, to primary care physicians, which we're so short of, doesn't seem to be to solve any problems. Is there any way to deal with any of this? Or at the end of the day, I mean, not so much how do we solve this? But who's reading what you're doing and how important is this information for hospitals and elsewhere trying to figure out how to compensate people?
- [04:42]
B
Yeah, absolutely. And I think there's a lot of different factors at play here. One of the things and that I engage with on, on X or on Twitter is kind of just the Medicare reimbursement rates. Right. And that's almost a whole different rabbit hole you could go down. But. And you're absolutely right, like we still do need more specialists. Right. And I think any one of us who have ever tried to book a dermatology appointment or, you know, any kind of specialized appointment, you can appreciate how long of a waiting period you may Have. Right. And so we definitely need to encourage more physicians to continue going into those fields. But as far as solving for it, I think, you know, that's one piece of the puzzle that salary doctor is trying to solve for is just awareness. Right. Because, you know, when you Google today, you know, how much does a family medicine doctor make? You're going to get wildly different results. And so part of it may just be simply misinformation. Right. You know, when you're on this journey becoming a doctor, you know, a lot of people are interested in the compensation, but it may not be the first thing on your mind. But I think as you see, you know, the transition through residency, it definitely becomes more of a consideration. And I think. So the piece of the puzzle that I'm trying to solve for is just having better quality information. And I would say the other thing, you know, just because you're going into a primary care field doesn't mean you have to make, you know, on the lower end of that, the wage spectrum. Right. And I think the other thing that I'm trying to highlight, and we are gathering more kind of lifestyle questions and contextual information behind these compensations, is by providing, you know, the young physicians ideas of how you can make more compensation. Right. I mean, you could go into family medicine and own four urgent care clinics. Right. I mean, there is a pathway to, you know, increasing your earnings within primary care.
- [06:35]
A
Oh, and you've also got, and it's a horrendous thing for health equity, but it's, it's a great thing. Primary care physicians, you have more and more people going concierge where they get paid in up front, free each year to make sure they're very accessible and that the primary care physician's not overwhelmed. And again, I don't fault the primary care physicians for this one bit, God bless them, but it does speak to the fact that, that we really need more primary care physicians. So there are ways to make more money as a primary care physician, but it's very hard to make more money as a primary care physician and also serve a cross section of patients in a traditional way. That's very, very hard. But what a challenging situation. Tyler, what else are you sort of watching that, that's top of mind for you that you're watching?
- [07:20]
B
Yeah. So if I could just kind of go back to the cost of education. I've been doing a lot of research in this space and actually the AAMC just published a report in March of last year. You know, I'm really been keeping my eye on the growing debt burden per medical student that's graduating. And today, about 50% of medical students are going to enter practice with a median debt burden of about $205,000. But what's even more surprising is that one in four are actually going into practice with more than 300 grand of a debt burden. Right. And so, you know, kind of the reason why this is so interesting and fascinating to me and something I'm keeping an eye on is I think it really influences choices. You know, it influences the specialty you go into, the location, the lifestyle. And it underscores why physician compensation must be transparent, fair and aligned with the amount of debt that new doctors are taking on.
- [08:17]
A
No. Yeah, 100%. If you're taking on 300,000 to go to, to go to medical school and all the way through, and then you end up in a specialty that pays you 200,000 or less, which after taxes is 120, 130,000. And you're going to take on a mortgage and you're going to try and have a lifestyle and you're also trying to, perhaps depending on what you want to do, to at some point go half time or three quarters time, that debt becomes very hard to manage. If you're not willing to just crank out lots of dollars in a high earning specialty, it becomes a very huge disincentive to people going into specialties that are not very high paid.
- [08:58]
B
Yeah, absolutely, absolutely. And I think a lot of these, you know, and it's not even this specific issue is not even just, you know, specific to primary care, but you know, if you speak to any family physician or just physician in general, they're having to see more and more patients every single year without seeing an actual increase in their, you know, productivity. Bonus. Right. And so if you're seeing more patients this year than you did last year, but you're still making the same amount of compensation, you know, I consider that a pay decrease and it's really unfortunate. And I think it's one of the major factors leading to physician burnout.
- [09:34]
A
100%. It's depressing and difficult. And then you've got lots of people when we go on, you know, I see your stuff on Twitter on X and you get people that denigrate physician pay when they do that. And we're so short physicians, both surgeons and primary care proceduralists as well as primary care. How do you react to that when people are so, so attacking the pay that physicians are making?
- [10:02]
B
Yeah, so I've always said this since I even started to review my Residency. Yeah, my, my kind of favorite thing to say is that, you know, saying your doctor is underpaid is a very unpopular opinion. Right. But I think when you step back and you consider 12 plus plus years of education and by the way, the, the 2 to 300 grand of medical school loans does not include the four years of undergrad student loans that they may and likely have as well. But as far as, you know, the focus on physician compensation, I think it's just a factor of a few different things, one of them being, you know, paying our physicians fairly. And I think I post about this a lot on X. But if you look at the Medicare reimbursement rate, it hasn't really kept pace with inflation in terms of real dollars. And so when, you know, when you have a large payer like Medicare, they kind of set the benchmark of what it comes to, for reimbursing physicians. And so when that isn't moving upward, you know, their, their revenue model isn't really increasing. And so it's harder to make more money next year than you made this year if Medicare is not paying more.
- [11:17]
A
Especially as Medicare becomes a bigger portion and Medicaid becomes bigger portions of everybody's payer sort of mix. As those get bigger and bigger, as the commercial payers get tougher, it becomes a much more challenging situation. Talk for moment. Tyler, you've done this incredible job of starting to build out this platform around Salary doctor. You follow it so interestingly, you're really intelligent, intelligent person yourself. So it's fun to watch what you say and what you post. Where can people find more about Celery doctor And then what are you most focused on and excited about this year?
- [11:53]
B
Yeah, so at Salary Doctor, I am laser focused on physicians. So we have a ton of engagement from medical students, residents and attendings. And I believe really that by focusing solely on that physician experience, we can go deeper. So that means more accurate data, better insights, better context for the things that medical students and residents are interested in, things like RVUs, call schedules and subspecialties. And I think that kind of depth is harder to achieve when you're trying to serve, you know, more, you know, every type of provider all at once. And one of the things that I'm most excited about, that we've recently added to the platform is that we're adding Lifestyle Insights. And we, these have become very, very popular and they add a ton of context to, to the compensation data. So now when doctors submit their compensation to Salary Doctor, they can now describe their schedule, their hours, their call burden and what they love or don't love about their job. And that's super insightful information for somebody that's looking at, you know, after spending 12 years of training, you know, they're looking at a 40 to 50 year career. You know, you really want to go into something that you love, you know, not just, you know, beyond the compensation. You know, you really want to love your job. So you have a very long career ahead of you.
- [13:16]
A
No, it's a great, great point. And so many physicians end up burnt out early either because they haven't made the ability to create something beyond just a core job or they haven't really loved it. They have to love it. And getting a sense of if more people are in an area and happy and thriving, probably a better area to be in. Tyler, what a pleasure to visit with you. Where can people learn more about celery? Dr. I just am a huge fan of what you're doing. I appreciate you joining us today. People learn more about, about celery.
- [13:48]
B
Dr. Yeah, so feel free to, you know, go to celerydoctor doctor.com I'm also very active on, on X and Twitter as I know you are. And that's one of the things I would, I would encourage, you know, other people in this healthcare space is to just dive in and get involved in the community. There's so many different platforms, whether it's X or Instagram or, you know, Internet podcasts, YouTube interviews. There's really a lot of great discussions specifically on, you know, Med X or Med Twitter. You know, I've seen a lot of great posts and a lot of doctors getting involved in this space in different ways. And it's really great to connect with other, you know, leaders in healthcare and what they're focused on and what they're doing. But all I would ask, you know, feel free to check out the platform on salary. Dr. We're growing every single day. We have over 10,000 active members in the community and we just want to provide more openness and transparency for physicians.
- [14:47]
A
Tyler, what a fantastic pleasure to visit with you. I'm so glad I follow you on Twitter and email to see what you're doing, what you're thinking you're talking about. Again, Tyler Polk, salary doctor, thank you for joining us on the Beckers Healthcare podcast.