Why are doctors paid so much?

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Regular Member

Date Joined Apr 2010
Total Posts : 26
   Posted 4/17/2010 11:28 AM (GMT -6)   
As far as I can tell, they are technicians who follow established protocols based on their training and their biases.

Post Edited (reputo) : 4/18/2010 8:35:15 AM (GMT-6)

Regular Member

Date Joined Feb 2010
Total Posts : 385
   Posted 4/17/2010 12:54 PM (GMT -6)   
Personally, I'd rather my doctor be paid more, and my banker paid less.  Especially the doctor that cuts on me.

Veteran Member

Date Joined Jan 2010
Total Posts : 1011
   Posted 4/17/2010 1:54 PM (GMT -6)   
Postop has a good point. Wish more of our best and brightest kids would go to medical school and not to business school. Tells you where the real money is. We need more doctors and scientists.
Dx with PC Dec 2008 at 56, PSA 3.4, Biopsy: T1c, Geason 7 (3+4)

Robotic Surgery March 2009 Hartford Hospital, Dr Wagner
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive
nerves spared, no negitive side effects of surgery

One night in hospital, back to work in 3 weeks

psa Junl 09 <.01
psa Oct 09 <.01
psa Jan 10 .07 re-test one week later .05
psa Mar 10 .28 re-test two weeks later .31

Veteran Member

Date Joined May 2009
Total Posts : 2692
   Posted 4/17/2010 2:03 PM (GMT -6)   
As a businessman, I think we all have this belief that doctors make a lot of money.

Most of the time we look at the income side of the ledger, and not the expense side. Yes they do bill a lot for a relatively small amount of time. But when you deduct for malpractice insurance, cost of running an office, billing expense, education expense, bad debt expense, and factor in average life span is at least 10 years less than average, I'm not sure that it is true, particularly in todays insurance world.
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 4/17/2010 2:47 PM (GMT -6)   
Reputo) looks to me like you are fast tracked on the whole picture and got an early education. How much profit do you think is made on the Zoladex shot each time you get one (reputo). Did you ever read about the bribery lawsuits about zoladex and lupron being pushed by doctors(google it) as a cash cow bonanza for both of them. Cost around $800 million to handle the suits, which we are subsidizing that bad behavior in higher costs...what a country. Question everything at this point. There are some righteous docs whom actually care about patients before lining their pockets...trouble is finding them, but is possible. It took me a long while to find such and been 4 yrs.+(with needed onco-doc) no agendas, no real profits made off me(no drug profits or anything) and excellent information and actual care. I can see he has not cashed in on me and he even believes the drug companies are ripping off everybody and says so openly (duh).
Hey I see you were given Zoladex with those low stats and then got surgery, can you elaborate on this, not often done that way. Some might use casodex prior, they say it makes surgery much harder as gland becomes like a sticky mess while shrinking, per se.  Makes me wonder why your doc didn't have you do casodex or nothing prior to surgery..of course alot of ways are used to treat prostate cancer.
Dx-2002 (Mar)   bad stats, high risk patient big time, total urinary blockage too....amazingly still here and actually in decent shape at this juncture...even surprizes my posterior, seen others with much lesser stats gone in 3-5 yrs., of course I did things alot different than the norm and suggested routes of some of those 8 expert docs opinions that I got early on. cool
(to the naysayers...yeah I am not cured..my day will come..hold your applause)

Youth is wasted on the Young-(W.C. Fields)

Post Edited (zufus) : 4/17/2010 2:01:29 PM (GMT-6)

Regular Member

Date Joined Mar 2010
Total Posts : 58
   Posted 4/17/2010 3:37 PM (GMT -6)   
I guess this is one of those age old arguments that you apply to many occupations. As a high school teacher and now youth worker my income is among the lowest among professional careers here in Australia. I have two university degrees which I am still paying off yet if I was a tiler I would probably earn double...

Forum Moderator

Date Joined Sep 2008
Total Posts : 4274
   Posted 4/17/2010 4:37 PM (GMT -6)   
I guess I'll assume the original poster is joking so I'll try to hold down the sarcasm.  Let's see, your doc pays $150K+ for an undergrad degree then another $200K+ for a medical degree that then allows him to pursue various residencies depending on his/her specialty.  Then he/she makes often makes life and death decisions, has a big influence on patients' QOL then has to deal with an out of control insurance and government bureacracy.  Meanwhile the tile guy has a HS education (maybe), has the awesome responsibility of deciding on how much grout to put down and sometimes takes his pay in cash making one wonder about whether or not the IRS gets their fair share.
Oh yeah, I guess it's logical to compare a physician with a tile guy....
Age 62, Gleason 3 + 4 = 7, T1C, PSA 4.2, 2 of 16 cores cancerous, 27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 4/10/10.  6 month PSA 1.4 and now 1 year PSA at 1.0.  My docs are "delighted"!

Veteran Member

Date Joined Feb 2008
Total Posts : 1858
   Posted 4/17/2010 5:15 PM (GMT -6)   
Mmmmm........lets do the maths. We all say get a doc with plenty of experience. Let's say 1000 robotic ops. carried out over 3 years. Most of these docs receive at least $15000 for the operation.......... this is compensation for the labour involved only and does not include scans, theatre assistants etc nor hospital stay costs. Grand total over 3 years..... 15 million dollars. Add to this consultation fees for a myriad of other services provided quite apart from actually operating. There's not many professions with that sort of compensation for one man's labour. A great deal of skill may be involved but being a surgeon is surely a nice little earner.

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 4/17/2010 5:29 PM (GMT -6)   

i too, am hoping your post was written in the spirit of a joke, not a serious statement.

and you are light years apart in comparing a skilled doctor to a tile layer, come on, no one will buy that.

if you want to pick on salaries, then think how dumb it is how much money professional sports players get paid, and entertainers and movie stars. Is some First Baseman play pro base ball really worth 5 million a day.

the risk and stress and life and death decisions that most doctors have make, i would hardly begrudge what they make after paying a fortune for their educations, their practices, and worse yet, their insurance policies.

there most be another reason why you are angry with doctor's salaries.

david in sc
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14 out - 27 days, Cath #15 - 3/29

Veteran Member

Date Joined May 2009
Total Posts : 2692
   Posted 4/17/2010 5:37 PM (GMT -6)   

You really don't think the doctor nets 15,000 per surgery ?
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01

Veteran Member

Date Joined Jun 2008
Total Posts : 1804
   Posted 4/17/2010 5:49 PM (GMT -6)   
Why are doctors paid so much? Lets see---four years of college, four years of medical school, internship, residency, practice.

My ob/gyn pays over $80,000 each year for malpractice insurance in New York State. After he pays his staff (administrative, nursing, midwife, sonogram technician), I don't imagine he gets to take home as much as one might think. If he practiced in Westchester County (rather than Putnam County), his malpractice insurance would be over $100,000 each year!

While I admire what a good tile guy can do with my bathroom floor, I wouldn't exactly equate his (or her) skills with that of a good doctor or surgeon.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (solitary focus of extraprostatic extension). Perineural tumor infiltration present. Apex margin, bladder neck and SVs negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009 - 0.1, September 0.3, October back to 0.0, December 0.0, March 2010 0.0. Next PSA in 6 months. Thank you God!

Veteran Member

Date Joined Sep 2009
Total Posts : 3172
   Posted 4/17/2010 5:58 PM (GMT -6)   
We want smart people to be doctors. (And president.  And scientists.  And engineers.)

Post Edited (Casey59) : 4/17/2010 5:02:43 PM (GMT-6)

Veteran Member

Date Joined Jul 2006
Total Posts : 686
   Posted 4/17/2010 8:08 PM (GMT -6)   


It is easy to pick on certain profession's earning capacity.  I think most of us agree that pro baseball and basketball players, CEO's and movie stars get paid way too much.  Far more than they are worth.

Doctors are for the most part, not overpaid.  There are a few plastic surgeons and "surgery mill" wheeler dealers who probably make more than they are worth.  My urologist is the best in our area, but will not do more than 6 or 8 DaVinci surgerys per week (yes I said per week)  He is not like the five a day surgery mill wheeler dealers who I think compromise quality with their volume.  Even at 250 surgeries a year my surgeon probably makes enough to do well, but earns it and shares it fairly.  I think his bill is around $8000 per procedure, which must run a full medical office.



PSA up to 4.7 July 2006 , nodule noted during DRE
Biopsy 10/16/06 ,stageT2A
Very Aggressive Gleason 4+4=8  right side
DaVinci Surgery  January 2007
Post op confirms gleason 4+4=8 with no extension or invasion
no long term continence problems
Post surgery PSA continues to be "undetectable"
One side nerves spared
Bi-Mix for ED 
born in 1941

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 4/17/2010 8:14 PM (GMT -6)   
A doctor typically makes more in the clinic than the OR. Only the elite surgeons make the top dollar. In my surgery, my fee to the doctor was itemized at 3k. Not bad for a days work. But the hospital was expensive, the anesthesiologist, the medical assistants, the post care nursing, and of course those 80 dollar Tylenol's...

Sephie makes a great point and I will an elaboration on it:

What bugs me is that in the medical business, lawyers make for than doctors. Of course that also goes with the education business, the auto insurance business, etc. Even in the music industry lawyers make more than almost all musicians.

I would bet that if we could simplify the legal processes, we could cut healthcare cost in half...

Advanced Prostate Cancer at age 44 (I am 47 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

LARP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

Veteran Member

Date Joined May 2008
Total Posts : 1010
   Posted 4/17/2010 9:51 PM (GMT -6)   
I looked up the U.S. average for a Urologist. The number was $180,000. A job's compensation generally has a number of factors that dictate pay scale. A few are education required, skill, number of people who can do the job, number of people willing to do the job, and so on. It takes quite a bit to become a doctor and several years before one begins to see a return on the cost of the medical training. Even in the best of circumstances I would bet you do not meet many doctors in there 20's. I am not sure I would  compare the skill of a tile layer to that of a surgeon. I can lay tile but I do not think many would want me operating on them. turn
I am an engineer just in case someone thinks I am a medical professional. Personally, I am grateful for the treatment I recieved and do not begrudge the doctor his fee. (Which he cut by the way due to my lack of insurance) The treatment costs are  based on the investment in equipment, personnel, facilities and liability insurance. Hospital costs are steep due to the high cost of the aforementioned items and the relatively few patients to spread the cost over. I live in a metro area of about 300,000 and there are two hospitals vying for the patients. Keep in mind that not all of the 300,000 are sick or under a doctors care. An interesting study was done (no I do not have the citation) that showed that medical costs actually went up when more than one facility offerred the same treatment. Say DaVinci or radiation. Reason is both facilities have to make back thier investment and they are sharing a finite pool of patients. In my case I spoke with four radiation facilites before deciding and they all had the same machine. Only one would give me an estimate of cost. The others just said "trust me". Like they did not know what the cost would be and Ouija board was down for the moment.
Well I will cease my ranting.
Best to all,
Diagnosed 04/10/08 Age 58 at the time
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
PSA 02/08 21.5 at diagnosis
PSA 07/08 .82 after 8 wks of hormones
PSA 10/08 .642 one month after completion of IMRT, 6 months hormone
PSA 03/09 .38 six months post radiation and nine months into hormones
PSA 06/09 .36 or .30 depending on who did the test
PSA 09/09 .33 one year after IMRT and 16 months into hormone
PSA 03/10 .32 18 months after IMRT Still on hormones

Regular Member

Date Joined Dec 2009
Total Posts : 214
   Posted 4/17/2010 10:20 PM (GMT -6)   

Just did a bit of google searching -- one site indicated the median salary for urologists in the US is $303 000.  The salary at the 75th percentile is $374 000.

Didn't I read on HW that 20% of the urologists do 80% of the surgeries?  Haven't been able to find what urologists above the 75th percentile make.

Not that I begrudge one penny urologists or any surgeons make.  A relative of mine with a BA in nursing now makes $200 000 Canadian (Canadian $ is now about par with US $.) as a hospital administrator.  If they terminate her contract, they have to pay her hundreds of thousands of dollars.

Had one hospital administrator terminated here for awarding contracts improperly.  Left with 300 or 400K severance

  Doesn't make any sense to me!!


Age:  63 
Biopsy: May 09 showed 2 of 12 cores positive for prostate cancer -- 1 at 5% and 1 at 25%.  Cancer indicated as non aggressive.  Gleason Score: 3+3.
RRP on Oct 23/09 in London, Ontario.  Excellent surgeon. 
7 Weeks Post Op -  The fears I had about bad things about the operation and recovery did not materialise except of course ED!!.  Otherwise, everything went very smoothly.  Incontinence not a problem.  Wear a pad when out just in case. Pain was never a problem.
Pathology:  Unremarkable 
First followup PSA and Visit: Feb 11/10 - 0.0.
Next PSA May
Next doctor's visit in 6 months      

Veteran Member

Date Joined Feb 2008
Total Posts : 1858
   Posted 4/18/2010 4:05 AM (GMT -6)   
goodlife said...

You really don't think the doctor nets 15,000 per surgery ?

I am going on my surgery costs. Surgeon $12000-00, Assistant surgeon $500-00, anesthetist $1500-00. Total cost $14000-00. Add to this first day in hospital (including theatre fees, intensive care in recovery room) $5000-00, 2nd day hospital stay $2000-00. Total operation cost $21,000-00. As the hospital owns the robot lets assume the doctor pays a charge of $3000-$4000 for its use out of the fee he receives from me, that leaves him perhaps $8000-$9000 for his labour. Given doctors and hospital charges in the US are far higher than they are here (with US members quoting $30,000-$45,000) I would have thought that $15000-00 was not an unreasonable figure over there. Correct me if I am wrong.

James C.
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Date Joined Aug 2007
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   Posted 4/18/2010 8:01 AM (GMT -6)   
Not correcting you, but here's some additional figures. In the US, most surgeons are part of a group of several, who mainatin an office, trained staff, and all the expenses associated with that- insurance, training, money saved for future expansions, equipment upgrades, etc.etc, etc. The costs of the group is removed from the fee earned by the doctor, usually the money is put into the practices general earnings and the practices full expenses are paid out of it. The surgeons in the group are paid a certain amount, sometimes with a commission for the number they do, so a more active surgeon will earn more, but the individual doctor will not get a check from an individual surgery. Medicine is business and almost all medical offices that have more than one doctor operate this way. Dollars earned don't equal dollars paid to the surgeons. The costs of practicing medicine in the US is enormous. In my case,, my surgeon charged $15,000, got $8,000 from the insurance and that was paid to the practice and shared by all six specialist Urologists cost of practicing medicine in their group. You could say they work for themselves for a salary, with sometimes a commission for volume. But the point is, a surgeon doesn't cash the check from the patient or the insurance and put that into his checking account. He still has to earn a living to pay for the starter ( or med school ) wife, then the trophy wife, then the medical school debts, along with the life style that is expected of a successful doctor, etc. smilewinkgrin
James C. Age 63
Gonna Make Myself A Better Man www.youtube.com/watch?v=a6cX61oNsRQ&feature=channel
4/07: PSA 7.6, Recheck after 4 weeks Cipro-6.7
7/07 Biopsy: 3 of 16 PCa, 5% invloved, left lobe, GS3+3=6
9/07: Nerve Sparing open RRP, 110gms, Path Report- Stg. pT2c, 10 gms., margins clear
32 Months: PSA's .04 each test since surgery, ED continues: Bimix- .3ml PRN, Trimix- .15ml PRN

Veteran Member

Date Joined Jan 2009
Total Posts : 2243
   Posted 4/18/2010 8:27 AM (GMT -6)   
Looking at all the ads on TV right now, I would say Lawyers makwe more money than they should. Dont let your children grow up to be Lawyers, then they become politicians. A Psychiatrist goes to school as long or longer than any MD. Pays those colloege tuitions and you will be in debt quite awhile. Besides I have more respect for most Dr.s than I do a lawyer. Sorry if I offend anyone.
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed, 61 yo 2010
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
2 pads per day, 1 depends but getting better,
 started ED tx 7/17, slow go
Post op dx of neuropathy
T2C left lateral and left posterior margins involved
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5
Starting IMRT on 1/18/10, Completed 39 tx at 72 gys on 3/12/10
Great family and friends

Regular Member

Date Joined May 2009
Total Posts : 476
   Posted 4/18/2010 8:37 AM (GMT -6)   
There are two types of doctors. Those who work for a business (hospitals, medical groups, etc) and those who run businesses themselves (either a small practice or a group).

The first type get paid a salary. And this salary, while very nice, is not unreasonable considering most docs don't start earning until they are in their thirties. I am an engineer with eight years of higher education and I make a similar salary to my doctor friends who don't run their practices. But I was working earning decent compensation (and paying off my student loans) several years more than my friends.

The second type of docs are businessmen. And you should compare their compensation to other businesses. A frien of mine is a partner in a nineteen doctor practice. They employ over forty people, rent several offices, pay mulpractice and general insurance, etc, etc. He makes a lot more than the docs who are employees, but he also has a higher risk, a lot more work and is responsible not only for the patients but his employees.

I also have a friend who runs a refrigirator repair business. Also about forty employees, different business completely, but similar compensation in the end.

I used to run a software company for several years. I was making more money, but had no life and a constant worry about my two doezen employees. I had a few opportunities to do it again, but prefer to be a salaried worker - much less headache.

The bright and talented people in any industry make a lot more than average. If those people also have an enterpreneurial streak, they will figure out ways to make even more money. What we want (or at least what I want) is the bright and talented doctor treating us. If there is not enough money in it, they will put their energy elsewhere and we will remain with mediocre docs. (There are a lot of those as it is).

Just my two cents....
Father died from poorly differentiated PCa @ 78 - normal PSA and DRE
5 biopsies over 4 years negative while PSA going from 3.8 to 28
Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8
Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere + Avastin)
PSA prior to treatment 1/8/2008 is 33.90, bounced on 1/31/2008 to 38.20, and down at the end of the treatment (4/24/2008) to 20.60
RRP at Duke (Dr. Moul) on 6/16/2008, Gleason downgraded 4+3=7, T3a N0MX, focal extraprostatic extension, two small positive margins
PSA undetectable for 8 months, then 2/6/2009 0.10, 4/26/2009 0.17, 5/22/2009 0.20, 6/11/2009 0.27
ADT (ongoing, duration TBD): Lupron started 6/22/2009
Salvage IMRT to prostate bed and pelvis - 72gy over 40 treatments finished 10/21/2009
PSA 6/25/2009 0.1, T=516, 7/23/2009 <0.05, T<10, 10/21/2009 <0.05, T<10

English Alf
Veteran Member

Date Joined Oct 2009
Total Posts : 2218
   Posted 4/18/2010 8:44 AM (GMT -6)   
The implication of the question is that doctors get rich doing what they do and that is not necessarily the case for as James C pointed out there is a big difference between the gross and net sums involved.

I think this thread could perhaps also be "Why are doctors in the US paid so much?" as well, for in the UK and Holland things are different which is obviously why the health care systems here are a little more acceptable to all. As an outsider I am indeed under the impression that docs in the US get paid more than their counterparts elsewhere

That said I want a guy holding the scalpel that knows what to do when the situation isn't straightforward too.
As with a plane I'd rather the pilot was paid more than the attendant, if the plane has a problem I want a good pilot, if the attendant runs out of nuts I couldn't care less. The ground engineers and air traffic controllers need to be paid more than the baggage handlers for similar reasons.

And Medical care costs a lot. The docs fee or salary is just one component.

(Biased opinion of course from me as there are lots of doctors and nurses in my family - but when my dad started he was earning about one third what my grandfather was earning as a bank manager - and he only started age 25 whereas my grandfather had started age 17. Bank head office paid for the building my GF worked in and his support staff too; my dad's charges though were what paid for the building he worked in and his staff. GF's travelling expenses paid by bank dad paid for his own.) Also biased opinion from me as I tiled my own kitchen and bathroom.

As for show bizz /sports salaries:
Guy from my school became a doc and played rugby for England unpaid in the 1970s.
The late Graham Chapman from Monty Python was a doctor, but I'd rather have paid him to make me laugh than to treat me. "Laughter is the best Medicine"

Age at Dx 48 No Family history of Prostate Cancer
Married 25 years, and I cannot thank my wife enough for her support.
April 2009: PSA 8.6 DRE: negative. Tumour in 2 out of 12 cores. Gleason 3+3.
RALP (nerve-sparing) at AVL-NKI Hospital Amsterdam on 29th July 2009. Stay 1 night.
Partial erections on while catheter still in. Catheter out on 6th Aug 2009.
Dry at night after catheter came out
Post-op Gleason 3+4. Tumour mainly in left near neck of bladder.
Left Seminal Vesicle invaded, (=T3b!)
no perineraul invasion, no vascular invasion. clear margins,
Erection 100% on 15th Aug 2009, but lots of leaking
Stopped wearing pads on 21st Sept 2009
Pre-op style intercourse on 24th Oct 2009 !! No use of tablets, jabs, VED etc.
Nov 17th 2009 PSA = 0.1
Mar 17th 2010 PSA = 0.4!!! referred to radiation therapist

Steve n Dallas
Veteran Member

Date Joined Mar 2008
Total Posts : 4849
   Posted 4/18/2010 9:55 AM (GMT -6)   
This thread reminds me of the aged old QUESTION-> "Why does <insert product name here> cost so darn much?"
ANSWER-> "Ever tried to build one from scratch yourself?"
Everything is cheaper in Mexico. You can go get butchard and have a nice family vacation at the same time.
Last but not least-> If you look around enough - you can find docs fresh out of med school looking for people to pratice on. Who wants a really skilled surgeon when you can save a few bucks.
/end of rantcry
Age 55   - 5'11"   215lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
11/20/09 - 18 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.

Regular Member

Date Joined Jun 2008
Total Posts : 407
   Posted 4/18/2010 1:11 PM (GMT -6)   
reputo, are you participating here to provide social or other commentary, or as someone who has or had prostate cancer? So as to make a comparison, will you please provide us with the salary or approximate income your physician(s) make/earn yearly, and also tell us what you do or did for a living and what you earn or earned as a wage or salary? Thanks.

Age:  60 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample (Gleason's 3+3=6)

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci; Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL; Dr. Robert Nadler, Urologist/Surgeon

Post-Op Gleason's:  3+3, Tertiary 4; Margins:  Free ; Bladder & Urethral:  Free

Seminal vesicles:  Not involved; Lymphatic/Vascular Invasion:  Not involved

Tumor:  T2c; Location:  Bilateral; Volume:  20%; Catheter:  Removed 12-days after surgery

Incontinent:  Yes (1 light (woman's style) pad per day)

ED: Combination of Cialis and MUSE (alprostadil) once weekly: started 9-27-08

Returned to work 9-29-08 (18-19 days post-op)

PSA test result, post-op, 10/08: 0.0; 12/08: 0.0; 4/09: 0.0; 9/09: 0.0; 3/10: 0.0


John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4269
   Posted 4/18/2010 3:53 PM (GMT -6)   
A key rule I have learned in my life is that when you get into trouble get the best lawyer or the best doctor that money can buy. These are two areas that you don't want the 2nd best and most certaintly you don't want the average.

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.


Veteran Member

Date Joined May 2009
Total Posts : 2692
   Posted 4/18/2010 4:46 PM (GMT -6)   
Well said John !
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01

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