Setu Mazumdar, MD, CFP

Yes, physician assistants (PAs), nurse practitioners (NPs), and nurse anesthetists (NAs) deserve more pay than doctors. And a number of them are already making more than many physicians.

The other day I met a PA whose salary is $180,000 working in the emergency department. That's more than many family practice doctors, internal medicine doctors, and pediatricians make.

Working alongside him are board-certified emergency medicine physicians who are making about $250,000. Is the extra $70,000 worth it to take on the responsibility of a physician?

When something bad happens to a patient, it's not the PA who’s held responsible. It's always the doctor who suffers the consequences. And the docs have to do the nightshifts. Complicated patient? Punt that to the doctor!

Now don't get me wrong. There are PAs I've worked with who are absolutely outstanding; but there are others who are just plain lazy.

So why do I think these health care practitioners deserve higher pay than physicians? You see, it's all about marketing.

PAs, NPs, and NAs have done a phenomenal job of banding together and carving out a niche for themselves. They have successfully pushed into our domain and have grabbed market share — and ultimately money &mdash; away from us.

They have conveyed their value and have convinced others to believe the value they provide.

They have spoken loudly to the government, the insurance companies, and to patients, and those groups have not only listened, but they've also embraced them.

In the rotten world of Obamacare, with the focus on "quality, affordable" health care, PAs, NPs and nurse anesthetists are going to get an even bigger windfall.

What have doctors done to combat this? Nothing.

In the Super Bowl, two teams fight tooth and nail to the finish — one team doesn’t just give up.

But that's what doctors have done. We haven't even shown up for the game, much less play it. And in the rare occurrence where we do show up, we just sit on the sidelines and watch the other team win.

Doctors have done a lousy job of standing up and conveying our value proposition. We've failed to communicate how many years of sacrifice we've gone through to get where we are.

We've failed to show patients and our government leaders, who think we make too money, about the stress we endure, the long hours we work, the incredible value we provide, the responsibility we take on, and the fact that we're held accountable like no other profession in the country.

We've failed to show them that we deserve 

Don't take this the wrong way. I think doctors 

 get paid way more than other health care practitioners for the value we provide. But we don't 

 to because we've failed to persuade society that we're worth it. And that's the reason why PAs, NPs, and others have become a force that will only get stronger.

Why has this happened and how is this related to your money and finances?

Here’s how I look at it: one reason doctors can’t stand up for themselves is that many simply don’t have their personal financial lives in order.

You might ask “what does that have to do with any of this?” Everything my friend!

Think about it this way. If you’ve got enough assets built up, you have the power to say “No.” Instead many physicians are mired in debt, overspend money they don’t have, mismanage their investments, or hire financial advisors who are not fiduciaries and get burned.

If your personal financial house is a mess, you’ve lost the power to say “No” to the external forces that are controlling how you practice medicine.

How do you start fighting back and getting back in the game? It starts with getting your finances in order first. The first month of the new year has already passed. What are 

 going to do to get your financial life in order and start winning the game?

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PAs, NPs and others have done a phenomenal job of banding together and carving out a niche for themselves. They have successfully pushed into doctors' domain and have grabbed market share - and ultimately money - away from physicians.

Setu Mazumdar, MD, CFP

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