Salary Discrepancy

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Hi Everyone,
I am an undergraduate student who has begun taking pre-med courses but have still not decided whether to pursue medicine professionally. Although finances are not the only important matter to me, they are quite important (especially considering the major investment that medical school is and the extensive years of training when salary is minimal) and I have been talking to a number of health care professionals about this. Overall I have been getting a bit discouraged. One person told me that his wife and many of his friends are Doctors and that they are not really finding the profession to be lucrative. Another person told me (he is a Doctor) that primary care physicians earn around 110K dollars. I don't see how this fits in with the BLS salary report as well as other reports that have the median income of primary care physicians as around 170K dollars, and many specialties earning around 2-300K dollars. Are these salary reports that I read online inaccurate? Is it possible that the Doctors that I spoke with (who all live in Queens, New York) are reporting the income of people in their neighborhood and maybe Doctors in New York City earn less than Doctors in other cities? I would appreciate some responses from people who have [I]first hand experience[I] with this (like practicing physicians or those who have already begun their job search; I am not looking for salary estimates from the internet because I have seen them already and am not sure I can rely on them).
Thanks!

There's great variability between specialties, practice type (academic vs private practice), and location.

Medicine is not an easy "get rich quick" road, but you should always be comfortable.

Yes, you are correct. Salaries tend to be lower for more desirable cities such as New York.

Originally Posted by armybound

There's great variability between specialties, practice type (academic vs private practice), and location.

Medicine is not an easy "get rich quick" road, but you should always be comfortable.

This.

And yes, physicians in NYC do tend to make less money than physicians almost anywhere else in the country.

While that 110K seems to be really low to me (and it is low), it is true that the more desirable the location, the less you will likely be paid. Going by here in Chicago, you should look at the areas around NYC, rather than the city, for more lucrative positions.

Originally Posted by SoulinNeed

While that 110K seems to be really low to me (and it is low), it is true that the more desirable the location, the less you will likely be paid. Going by here in Chicago, you should look at the areas around NYC, rather than the city, for more lucrative positions.

Woe is me, how shall I live on $110k?!

Originally Posted by SoulinNeed

While that 110K seems to be really low to me (and it is low), it is true that the more desirable the location, the less you will likely be paid. Going by here in Chicago, you should look at the areas around NYC, rather than the city, for more lucrative positions.

Don't forget to factor in cost of living, too. NYC is a much more expensive place to live than Bumbfck, Idaho.

Originally Posted by Charles Darwin

Don't forget to factor in cost of living, too. NYC is a much more expensive place to live than Bumbfck, Idaho.

This.

Originally Posted by NickNaylor

Woe is me, how shall I live on $110k?!

I meant low in terms of the average.

Originally Posted by NickNaylor

Woe is me, how shall I live on $110k?!

These are some super srs 1st world problems here, NIck.

Honestly, if you are worried about money, you should be a PA or a Nurse. They are very well compensated. They don't have to take the responsibility if something goes wrong, and they get to have a normal life with family and kids. I didn't know this originally, but not all physicians are happy. Some probably hate what they do because they didn't end up in a specialty/residency/fellowship/location/coworkers that they originally dream when they were a medical student.

The only problem is that there is a healthcare glut. We are at the peak of heathcare spending. Things can only go downhill when they are at a peak.

Originally Posted by loljkttyl

Yes, you are correct. Salaries tend to be lower for more desirable cities such as New York.

Pretty sure that this is completely wrong. NYC physicians get compensated really well, and this is because of the high cost of living and the high taxes. This inflated salary pretty much levels off after you factor everything in and is comparable to other cities. But, if you could not have a family and live in a frugal state of mind, I have seen doctors make a really good living out here.

Originally Posted by macho07

Pretty sure that this is completely wrong. NYC physicians get compensated really well, and this is because of the high cost of living and the high taxes. This inflated salary pretty much levels off after you factor everything in and is comparable to other cities. But, if you could not have a family and live in a frugal state of mind, I have seen doctors make a really good living out here.

No actually. You are wrong. The opportunity to rake in the real big bucks is certainly found in major cities. However, the AVERAGE salaries are lower in many major cities than in other areas. The northeast especially has lower average salaries than any other region of the country.

Originally Posted by macho07

Pretty sure that this is completely wrong. NYC physicians get compensated really well, and this is because of the high cost of living and the high taxes. This inflated salary pretty much levels off after you factor everything in and is comparable to other cities. But, if you could not have a family and live in a frugal state of mind, I have seen doctors make a really good living out here.

The markets in the big cities are so saturated with physicians (usually because of their desirability/multiple academic medical centers) that salaries fall. This is why, for example, a general surgeon in a rural area might make twice the salary of a surgeon in major urban area. And, really, the effect is more than that due to the cheaper cost of living.

But, of course, everyone wants to live on the coasts, so enjoy your lower salaries.

Originally Posted by YES123

Another person told me (he is a Doctor) that primary care physicians earn around 110K dollars. I don't see how this fits in with the BLS salary report as well as other reports that have the median income of primary care physicians as around 170K dollars, and many specialties earning around 2-300K dollars. Are these salary reports that I read online inaccurate?

The online salary reports are all over the place, and are frequently inaccurate. I wouldn't worry too much.

As for the 110K number...it depends. For someone coming right out of residency, looking to join a practice that is just outpatient internal medicine (no peds, no gyn, no procedures), that might be accurate. You should certainly expect to make more when you're an experienced physician.

Plus, as others have said, salaries in the NE (NYC, Philly) are s***. You can make a heck of a lot more, even in parts of California and Hawaii.

Originally Posted by NickNaylor

Woe is me, how shall I live on $110k?!

110k is honestly not that much when you factor in huge loan repayments, cost of living in major cities and wanting to establish roots and ties. Just paying taxes and loans will eat a significant chunk of that.

Originally Posted by notbobtrustme

110k is honestly not that much when you factor in huge loan repayments, cost of living in major cities and wanting to establish roots and ties. Just paying taxes and loans will eat a significant chunk of that.

How will I survive?! I need to establish roots and ties! It's critical!

Has the $110,000 we're talking about already been taxed? Had Medicare/SS taken out? Has the 401k (do physicians even use these for retirement planning?) been removed? Have health benefits been removed?

Maybe I just missed it in the thread.

In b4 "but but but 110k isn't really that much etc etc." - wait...

Originally Posted by notbobtrustme

110k is honestly not that much when you factor in huge loan repayments, cost of living in major cities and wanting to establish roots and ties. Just paying taxes and loans will eat a significant chunk of that.

Nevermind.

Originally Posted by Bacchus

Has the $110,000 we're talking about already been taxed? Had Medicare/SS taken out? Has the 401k (do physicians even use these for retirement planning?) been removed? Have health benefits been removed?

Maybe I just missed it in the thread.

It really doesn't matter - the fact that people think it's nearly impossible to live on $110k is laughable. Yes, even in big cities where real estate is astronomically expensive. By no means do I think that physician salaries should be reduced, but some perspective is important here lest physicians continue to be thought of as greedy and out of touch with reality.

The provider, being paid $110,000, should have looked for a job elsewhere. A gross income of $110,000 is pitiful for a provider of our caliber.

Originally Posted by Bacchus

The provider, being paid $110,000, should have looked for a job elsewhere. A gross income of $110,000 is pitiful for a provider of our caliber.

The point was that people saying it's damned near impossible to live on an income of $110k (pre-tax or post-tax - it doesn't matter) need to come back to the "real world." Whether or not $110k is worthwhile compensation is a whole other discussion (though I agree with you).

Originally Posted by YES123

Hi Everyone,
I am an undergraduate student who has begun taking pre-med courses but have still not decided whether to pursue medicine professionally. Although finances are not the only important matter to me, they are quite important (especially considering the major investment that medical school is and the extensive years of training when salary is minimal) and I have been talking to a number of health care professionals about this. Overall I have been getting a bit discouraged. One person told me that his wife and many of his friends are Doctors and that they are not really finding the profession to be lucrative. Another person told me (he is a Doctor) that primary care physicians earn around 110K dollars. I don't see how this fits in with the BLS salary report as well as other reports that have the median income of primary care physicians as around 170K dollars, and many specialties earning around 2-300K dollars. Are these salary reports that I read online inaccurate? Is it possible that the Doctors that I spoke with (who all live in Queens, New York) are reporting the income of people in their neighborhood and maybe Doctors in New York City earn less than Doctors in other cities? I would appreciate some responses from people who have [I]first hand experience[I] with this (like practicing physicians or those who have already begun their job search; I am not looking for salary estimates from the internet because I have seen them already and am not sure I can rely on them).
Thanks!

First, if you are this focused on the bottom line, medicine is probably not for you. You will have 4 years of school, 3-5 years of residency, and maybe a year or two of fellowship ahead of you before you see the kind of money you are seeing in some of those surveys, assuming they don't change the rules on you before you are done (many think big changes are coming). So you really have to factor in time value of money -- 100k received ten years from now is worth a LOT less than 100k today. So apply a hefty discount rate to most of the salaries you see in medicine. A job that pays you $60k in year one is a lot more lucrative than the longer medical tracks. Second, the numbers you see are averages. Half of the people earn less than that. If you see an average for pediatrics in a region of 120k, that usually means there are folks out there earning 90s, and folks earning 150k. Third, a lot of salary info you see online is from headhunters. They only make money if job searchers call, so their figures are often quite atypically high. There are plenty of stories of folks calling them for a 200k job and being told that that job is no longer open, but that they have almost one just as good ( but in a less desirable location for 30% less money). So you pretty much need to discount anything you see from a career search source. Finally, this is a tough road. You will log more hours and more overnights than most other paths. Your income will be delayed longer than most other paths. Your tuition debt will be higher than most other paths. So unless you really love the job, it probably not a great choice. Just saying.

Hi to all!
First of all, I thank all who took the time to apply to my query. It is heartening to know that so many people would take so much time to help me out.
Just a few comments that are relevant:
1) The median salaries that I am looking at are those reported by the federal government and by Medical organizations (not recruiters). The lower salaries that I am hearing from a couple of health professionals (and these may be out-liars, although they claim that these low salaries are the norm) is just based on a few conversations and is not based on a very large sample size (hence I ask this question here, with the hope for the perspective of more NYC Doctors).
2) Many of the responses that I have gotten are wonderful, but I am still looking for a few more. It would be especially valuable to me if there is either a physician practicing in NYC who could comment about this, or a resident that has already begun looking at jobs in NYC. While all responses are valuable I am looking for people with first hand experience of the job market there.
Thanks again!

Originally Posted by NickNaylor

The point was that people saying it's damned near impossible to live on an income of $110k (pre-tax or post-tax - it doesn't matter) need to come back to the "real world." Whether or not $110k is worthwhile compensation is a whole other discussion (though I agree with you).

110k is really nothing for a physician.

Take away 1700+ each month for federal taxes if you are married (more if you are unmarried). Take away 2800 a month for student loan repayments. Before you can spend a dime, you are already out half your paycheck. And we haven't considered anything else yet, such as state taxes, medical insurance, malpractice, car, home, etc etc. 110k goes away real quick when you have that level of debt burden and taxes to deal with.

Where is the 110k number coming from?

According to 2010 MGMA, the median income of FB w/o OB is $184k and the 25% percentile is $151k.

Originally Posted by notbobtrustme

110k is really nothing for a physician.

Take away 1700+ each month for federal taxes if you are married (more if you are unmarried). Take away 2800 a month for student loan repayments. Before you can spend a dime, you are already out half your paycheck. And we haven't considered anything else yet, such as state taxes, medical insurance, malpractice, car, home, etc etc. 110k goes away real quick when you have that level of debt burden and taxes to deal with.

Please, you don't need to tell me about budgeting and where money goes. According to your calculations, that leaves you with $56k of net income. That's more than the median GROSS income in the US. Again, my point isn't whether or not this is adequate for a physician - it isn't. However, if you can't live off of $56k of net income, then you're not living within your means - plain and simple.

Originally Posted by Barcu

No actually. You are wrong. The opportunity to rake in the real big bucks is certainly found in major cities. However, the AVERAGE salaries are lower in many major cities than in other areas. The northeast especially has lower average salaries than any other region of the country.

I'm not claiming to know much of anything, but I have talked personally to emergency physicians in New York, Miami, and Naples (last two are in Florida). The difference in pay, from those that I have spoken with, between naples and miami is about 30K, with miami being the higher one. Then the difference between NYC and Miami is about 70K with NYC being higher. Perhaps I'm wrong overall but in these instances NYC definitely pays higher. Maybe the whole underpaying big cities because its what most people want to do could pertain to other cities, but I don't think that applies to NYC and Miami per se. It does make logical sense, but that doesn't mean it always applies to every situation. don't get sentimental on an online forum.

Originally Posted by macho07

I'm not claiming to know much of anything, but I have talked personally to emergency physicians in New York, Miami, and Naples (last two are in Florida). The difference in pay, from those that I have spoken with, between naples and miami is about 30K, with miami being the higher one. Then the difference between NYC and Miami is about 70K with NYC being higher. Perhaps I'm wrong overall but in these instances NYC definitely pays higher. Maybe the whole underpaying big cities because its what most people want to do could pertain to other cities, but I don't think that applies to NYC and Miami per se. It does make logical sense, but that doesn't mean it always applies to every situation. don't get sentimental on an online forum.

The problem is that there are many different ways to organize a practice. Anecdotes really aren't useful on this topic for that very reason.

Originally Posted by NickNaylor

The problem is that there are many different ways to organize a practice. Anecdotes really aren't useful on this topic for that very reason.

So if anecdotes aren't useful and online salary comparisons are skewed, how can anyone get a true sense of what the truth is? I would argue that anecdotes are probably the best source of information. Hearing it from the horses mouth versus hearing it from what someone thinks is happening is better to me, but that doesn't mean much.

Originally Posted by notbobtrustme

110k is really nothing for a physician.

Take away 1700+ each month for federal taxes if you are married (more if you are unmarried). Take away 2800 a month for student loan repayments. Before you can spend a dime, you are already out half your paycheck. And we haven't considered anything else yet, such as state taxes, medical insurance, malpractice, car, home, etc etc. 110k goes away real quick when you have that level of debt burden and taxes to deal with.

FYI, a person making $110,000/yr will take home about $2,750/bi weekly. This is after ALL taxes (in a state with a high income tax) and a 15% retirement deduction and health ins + heath club dues and charity donation. (how do I know? It's what my mom makes)
Also, anyone making new student loans will have annual payments capped at 10% of a person's discretionary income.

This Medscape report breaks physician compensation down by specialties and region: http://www.medscape.com/sites/public...cian-comp/2011

Originally Posted by loljkttyl

This Medscape report breaks physician compensation down by specialties and by region: http://www.medscape.com/sites/public...cian-comp/2011

Looking at anesthesia it probably doesn't differentiate between PP and academics. Though not all academic jobs pay poorly.

Originally Posted by macho07

So if anecdotes aren't useful and online salary comparisons are skewed, how can anyone get a true sense of what the truth is? I would argue that anecdotes are probably the best source of information. Hearing it from the horses mouth versus hearing it from what someone thinks is happening is better to me, but that doesn't mean much.

I would put more faith in the salary surveys than anecdotes. Though the surveys are flawed, they will likely paint a more realistic picture of things than a single physician's discussion of their compensation.

Originally Posted by NickNaylor

I would put more faith in the salary surveys than anecdotes. Though the surveys are flawed, they will likely paint a more realistic picture of things than a single physician's discussion of their compensation.

I respectfully disagree. If I was looking for the average of the region than I would use the salary surveys but if I wanted to know about a specific city compensates their physicians, I would ask someone who works there. I talked to ten docs altogether, not one but I get your point. Either way I agree with you about being able to live off of a six figure salary. I guess it's rather irrelevant if one makes 275000 versus 250000. No one should starve.

You are going to be a Dr! You should not only have to sacrifice your 20s and early 30s to accomplish this, but then when you are told you are only making 110k, you shouldn't complain, because you are the idealistic pre-med and you should work for free because you are helping others. Lifetime of servitude and you better not ask for money!!!! Also 110k is A LOT OF $$$$$$...LIKE OMG....$2k/bi-weekly...>WHOAAAAA!!!! Forget retirement, college for kids, vacations, entertainment, because you are a Dr and should slave away helping others because you are an idealistic pre-med and $110k is SOO MUCH $$$$!!!!! :meanie :

Silly pre-med forums.

Originally Posted by NickNaylor

Woe is me, how shall I live on $110k?!

Damn straight woe is me. I did not sacrifice my 20s/30s to earn the same $$ I could have straight out of college with an accounting degree and worked for a private firm. You can make 6-70k at one of the big 4 accouting firms, go private, easily make $100k at the age of 24. Get out of your idealistic world and back to reality. By sacrificing a good chunk of my life in school and training, I would like to be compensated very well. Also, if you like $110k, you can take that and send me the rest of the money you earn (will help me fund my 2 vacations a year I will be taking).

If you are in it for the money, then medicine is not the right path for you. Medical school and residency can be grueling, as can actual practice. Physicians are compensated well, that's true, but it's not that great when you consider all the work that must be put into the education. If you are like me and went straight from high school to college to medical school, then when it's all over you'll wonder where your twenties went.

In general, if you live in a desirable location (NYC, LA, Chicago, Miami, etc.) then expect to make less than if you live in a less desirable place (Detroit). There is just more competition for jobs (and patients) there.

Originally Posted by notbobtrustme

110k is really nothing for a physician.

Take away 1700+ each month for federal taxes if you are married (more if you are unmarried). Take away 2800 a month for student loan repayments. Before you can spend a dime, you are already out half your paycheck. And we haven't considered anything else yet, such asstate taxes, medical insurance, malpractice, car, home, etc etc. ...

All those things in bold are going to reduce your federal taxes. Loan amount you must pay is about 10% of sallary; i.e. less than $1000. This sallary may be at place where you get your loan written off if you pay for 10 years. If you work for a sallay malpratice is paid by employer. After FICA etc your take home mabe about $6000-$7000. If you are married, of course, your spouse may have some contribution to home finance.

Originally Posted by NickNaylor

Please, you don't need to tell me about budgeting and where money goes. According to your calculations, that leaves you with $56k of net income. That's more than the median GROSS income in the US. Again, my point isn't whether or not this is adequate for a physician - it isn't. However, if you can't live off of $56k of net income, then you're not living within your means - plain and simple.

x1000

Originally Posted by ChiDO

Damn straight woe is me. I did not sacrifice my 20s/30s to earn the same $$ I could have straight out of college with an accounting degree and worked for a private firm. You can make 6-70k at one of the big 4 accouting firms, go private, easily make $100k at the age of 24....

Grass is greener on the other side. May be $100k for accounting is top 1%tile while $110k for physicians is bottom 1%. May be that guy just scored 180 on Step1. Who knows? The devil is in details.

Lies, Damn Lies, Statistics, and then there are anecdotes.

Originally Posted by IMSingular

Grass is greener on the other side. May be $100k for accounting is top 1%tile while $110k for physicians is bottom 1%. May be that guy just scored 180 on Step1. Who knows? The devil is in details.

Lies, Damn Lies, Statistics, and then there are anecdotes.

Your step score does not delineate your pay. It may self-select a specialty, but your pay isn't affected otherwise.

Originally Posted by Bacchus

Your step score does not delineate your pay. It may self-select a specialty, but your pay isn't affected otherwise.

May be low Step1 score leads to a residency in a place not as well regarded, and that may have an impact on where you get a job and sallary at that place. Though there is no dierct effect it may affect indirectly. Without details whether it is justified is not clear. Just 10% of sallary loan payment for 10 years and you could be off the hook if you do work at some places. Some times you work at low sallary because your tutions may have been waived to work at under served areas. Then 110K is almost 130K.

Originally Posted by NickNaylor

Please, you don't need to tell me about budgeting and where money goes. According to your calculations, that leaves you with $56k of net income. That's more than the median GROSS income in the US. Again, my point isn't whether or not this is adequate for a physician - it isn't. However, if you can't live off of $56k of net income, then you're not living within your means - plain and simple.

Have you ever lived on 56k/year? It's really not that much. I currently make ~60k/year and **** is tough. I live in a very modest 2 bedroom home (paid around 220,000 for it back in 2008) with my wife and kid. 56k is simply not enough nowadays. I spend like 400 bucks a month just on traveling to and from work with high gas prices or train expenses. My expenses increased 250 bucks a month on the 1st of this year without me adding a single dime to the budget. Health insurance went up ~75/month, the Metra service went up 40 bucks/month, homeowners' association fee went up 25 bucks/month, water/sewage went up 10 bucks/month. I didn't change a single thing from Dec to Jan and yet just the cost of living ****ed me over for 7% of my paycheck.

If you think earning 56k/year is a lot of money, just wait until you get to the real world.

Well, I've lived for 9 years in a third world country and 6 years on welfare with my parents, and plenty of my friends are still in families that make <$40k/year before taxes. Yes, it's not that much. But, you have a house! And your wife/SO can still work!

A lot of people don't have a house.

Originally Posted by notbobtrustme

Have you ever lived on 56k/year? It's really not that much. I currently make ~60k/year and **** is tough. I live in a very modest 2 bedroom home (paid around 220,000 for it back in 2008) with my wife and kid. 56k is simply not enough nowadays. I spend like 400 bucks a month just on traveling to and from work with high gas prices or train expenses. My expenses increased 250 bucks a month on the 1st of this year without me adding a single dime to the budget. Health insurance went up ~75/month, the Metra service went up 40 bucks/month, homeowners' association fee went up 25 bucks/month, water/sewage went up 10 bucks/month. I didn't change a single thing from Dec to Jan and yet just the cost of living ****ed me over for 7% of my paycheck.

If you think earning 56k/year is a lot of money, just wait until you get to the real world.

I manage to live a pretty fantastic lifestyle on about $20k/year for living expenses. So yes, I understand what the "real world" is like. But then again I don't have a wife, kids, or a $220k home. If you think those things are necessary and yet you continue to bemoan your income, perhaps reevaluating what is and isn't affordable/necessary is in order.

To be fair, kids and wives aren't just "things" to a lot of people.

Originally Posted by notbobtrustme

Have you ever lived on 56k/year? It's really not that much. I currently make ~60k/year and **** is tough....

If you think earning 56k/year is a lot of money, just wait until you get to the real world.

Lol, these kinds of discussions always degenerate into salary and lifestyle pissing contests. I've lived on (i.e. spent) $300K a year when single in my 20s, and I've lived on $72 a year while married in my 30s. That is not a typo; we really did live on $6 a month on average for an entire calendar year once. While our lifestyle was certainly primitive, it was rich in other ways.

This lifestyle you've chosen, especially a house so far from employment, is an expensive lifestyle. But that doesn't change the fact that $56K a year is a hell of a lot of income by any measurement.

Originally Posted by NickNaylor

I manage to live a pretty fantastic lifestyle on about $20k/year for living expenses. So yes, I understand what the "real world" is like. But then again I don't have a wife, kids, or a $220k home. If you think those things are necessary and yet you continue to bemoan your income, perhaps reevaluating what is and isn't affordable/necessary is in order.

Dude, that's when you have jack **** for responsibilities. Anyone can live comfortably on that. You don't understand what having real responsibility is. Family health insurance, buying baby clothes, fixing the water heater so you can have a shower. These are responsibilities. Not shoveling 3 dollar shots on thirsty Thursdays.

You can't relate to my situation because it's utterly alien to you, just like I can't relate to a starving african's situation because it's utterly alien to me. But with my life experience, I can definitely tell you living on 56k/year is not as easy as you make it out to be.

OK. What should be minimum wages then? Is it whatever market decides? How rich a doctor should be compared to this minimum wage guy? Why that shouldn't be decided by the market as well? Why give easy loans to MD students rather than let the market decide?