Dok, I wrote that no doc should make more than 400-500 K (and BTW, did neither reveal or discuss my own income), and most should be in the 200-300 range. If you call this income "shitty", you reveal all about your priorities and values ... there is nothing to add. Except that very many procedures are superfluous and do not improve incomes, at least not with the liberal indication policies of many money motivated colleagues, as you probably know. But I agree that patient satisfaction is a problem - a lot of patients want "something done", even though it may be nonsensical.