Amount of hours to make 100k

[Neuroguy887]

So my plan is to avoid burning out and I don't care for putting on the golden handcuffs of a mortgage, luxury car, etc. I'll have no student debt. So, I figure if I can make 100k/year (before taxes) I'll be living my dream life. How many shifts per month will accomplish this is it pretty easy to find such a gig?

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[Dr.Evil1]

Depends on your location etc but this is easily attainable as the normal full time emergency physician salary would be aprox 200k to 500k.

You will have to work more than this to get through residency etc. You shouldn't go into emergency medicine if you are just doing it so that you can work 1-2 shifts per week. Given your name is "Neuroguy" I would think about more than just the number of hours you need to work to make 100k when contemplating a career in EM.

 

[Aspiringphysician]

This is an interesting post. I have sometimes thought about going into EM instead of FM, but I really love outpatient setting in FM. However, I think EM docs make about 250k a year, or maybe 200k a year? I'm assuming they work 4 12 hour shifts a week, so 48 hours a week on average? Let's assume an average salary of 220k for an EM doc. 48 hrs/week. That's about $95 per hour.

Also, let's assume that 25% of your salary goes to taxes. So 100/0.75=133.33. How many hours would you need to work to make $133,333.33? (Sorry, I hate rounding). You would need to make 11,111.11 per month. Divide that by 4 wks. $2,777.78 per week. Divide that by $95 (that's how much you make per hr) = 29.23 hours a week. 30 hours a week is probably more on the safe side.


Now, this is considering that you will find a hospital who lets you work just 30 hours a week. Also, you have to realize that in EM, all doctors have to go through night shifts. So keep that in mind! This is honestly the one thing that turned me away from EM, I know that I really will not be able to handle night shifts, and disruptions in a normal sleep schedule. I know med school and residency might be something like this, but I know I won't be able to go through it all my life.

 

[SoCuteMD]

So my plan is to avoid burning out and I don't care for putting on the golden handcuffs of a mortgage, luxury car, etc. I'll have no student debt. So, I figure if I can make 100k/year (before taxes) I'll be living my dream life. How many shifts per month will accomplish this is it pretty easy to find such a gig?

Bear in mind that you will probably have to cover your own health insurance, and that you probably will not get any other benefits (retirement, disability, CME, etc). Also keep in mind that you may not be the most attractive candidate for a job. Don't get me wrong - you'll find a place to work but it may not be desirable (location, subspecialty services, malignant consultants/leadership) as many "good" places are only interested in hiring full timers (but will consider letting full timers drop down to part time). In addition, your training and learning are not done the moment you graduate from residency - there's a lot of learning and development that go on during your first few years as an attending, and by working a limited schedule you run the risk of never fully coming into your own as an attending.

I estimate around here you'd need about 13 hours/week for 48 weeks/yr to earn 100k - but I used numbers on the low side ($150/hr) since my impression is that there is little part time/per diem work available around here, so much of what you can find is urgent care and that is the average of the local per hour amount and the local urgent care hourly rate.

 

[SoCuteMD]

This is an interesting post. I have sometimes thought about going into EM instead of FM, but I really love outpatient setting in FM. However, I think EM docs make about 250k a year, or maybe 200k a year? I'm assuming they work 4 12 hour shifts a week, so 48 hours a week on average? Let's assume an average salary of 220k for an EM doc. 48 hrs/week. That's about $95 per hour.

Also, let's assume that 25% of your salary goes to taxes. So 100/0.75=133.33. How many hours would you need to work to make $133,333.33? (Sorry, I hate rounding). You would need to make 11,111.11 per month. Divide that by 4 wks. $2,777.78 per week. Divide that by $95 (that's how much you make per hr) = 29.23 hours a week. 30 hours a week is probably more on the safe side.


Now, this is considering that you will find a hospital who lets you work just 30 hours a week. Also, you have to realize that in EM, all doctors have to go through night shifts. So keep that in mind! This is honestly the one thing that turned me away from EM, I know that I really will not be able to handle night shifts, and disruptions in a normal sleep schedule. I know med school and residency might be something like this, but I know I won't be able to go through it all my life.

Your numbers are way way off in terms of EM hours/week, and tax rates and hourly rate for EM.

 

[Aspiringphysician]

Your numbers are way way off in terms of EM hours/week, and tax rates and hourly rate for EM.

What would your estimate be for OP's question?

 

[Aspiringphysician]

Would OP really only need 13 hours per week? Like one or two 12 hour shifts would put him in the 6 figure category? That sounds way too good to be true

 

[RustedFox]

I paid about 33% to the federal government in taxes last year. It stings.

 

[Aspiringphysician]

Now I definitely want to live in washington.

 

[SoCuteMD]

Would OP really only need 13 hours per week? Like one or two 12 hour shifts would put him in the 6 figure category? That sounds way too good to be true

If you could find a job that was willing to take you on per diem and had enough availability and paid $150/hr (the rate is not a stretch) then you could make 93000/yr. However, if you read my entire post earlier in the thread you'd see that this is not necessarily an arrangement it would be easy to find. Even if you could find it, it's likely you'd be working a bunch of days one week and then way less for a few weeks - possibly filling in while people were away. You'd have last choice of shifts (if any choice at all). You would have absolutely no benefits, either. As you become a grown up, benefits are worth almost as much as the job itself. My benefits are worth approximately 20% of my total compensation package. My health insurance alone costs my employer 5500/yr. Then there are the increased costs associated with being an attending. My chair is very adamant that board certification is not covered by our CME funds, so I pay that out of pocket. I pay for supplemental disability - I didn't buy the cheap policy and it's not tax deductible since I'm not self-employed.

 

[southerndoc]

You can easily fond jobs paying $300/hr. Work full time for 2 months and you have your $100k. Most places wont allow this because it would leave them without coverage for the remaining 10 months.

 

[TooMuchResearch]

Also, if you're picking EM because of the pay, perhaps you should pay a visit to the current EM burn out thread.

 

[Birdstrike]

So my plan is to avoid burning out and I don't care for putting on the golden handcuffs of a mortgage, luxury car, etc. I'll have no student debt. So, I figure if I can make 100k/year (before taxes) I'll be living my dream life. How many shifts per month will accomplish this is it pretty easy to find such a gig?

This is the Chupacabra or Big Foot of Emergency Medicine. It exists in theory but just doesn't seem to materialize. Others above have pointed to why, but mainly it comes down to overhead. Every doctor in every specialty has a fixed amount of overhead expenses just to break even for yourself or your employer. It may be less for EM, but still exists. These are fixed costs that aren't less because you work less, they are fixed. Even if you work zero hours, you (or somebody has got to pay them): malpractice insurance, health insurance, DEA license, society memberships, retirement fund, administrative fees, etc.

In other words, it costs money to put you out on the floor. So the amount you are generating per hour is negative dollars per your day 1. Then at some point you see enough patients to reach $0 per hour, then as you keep producing, the hourly climbs steeply. Then it climbs even higher and more than linearly as you get above the clouds (the clouds being your fixed overhead you're done paying).

Just think about it. Is there really any reason a Dermatologist can't work 2 days per week?

Why not for a Neurosurgeon? They generate a hell of a lot more money than an EP. Why can't they just find a hospital that signs up 3 neurosurgeons to "job share" hours?

It comes down to money.

It's cheaper to have one guy who want to work hard (1/3 the malpractice policies to pay for, 1/3 the licenses, fees, recruiting, and so on and so on).

So in theory, your flying unicorn job may be real, but you just ain't going to find it. Why?

Because a work horse is just a whole lot more practical, less high-maintenance, and a hell of a lot cheaper.

Trust me dude, if this flying unicorn existed for all of us, don't you think we'd all be riding it?

Oh you're right, this exists, but once you show up it's, "Oops. Sorry, we're a little short staffed. Would you mind working a little extra? Just for a little while?"

For every, 6 shift per month unicorn, I'll show you 10 work horses working 3 shifts per month more than they want to.

My suggestion: find something you like enough to work 40 hr per week at.

 

[Chip N Sawbones]

You can easily fond jobs paying $300/hr. Work full time for 2 months and you have your $100k. Most places wont allow this because it would leave them without coverage for the remaining 10 months.

Would locums be an option for this if you were willing to work in rural locations and/or move around a lot?

 

[Neuroguy887]

This is the Chupacabra or Big Foot of Emergency Medicine. It exists in theory but just doesn't seem to materialize. Others above have pointed to why, but mainly it comes down to overhead. Every doctor in every specialty has a fixed amount of overhead expenses just to break even for yourself or your employer. It may be less for EM, but still exists. These are fixed costs that aren't less because you work less, they are fixed. Even if you work zero hours, you (or somebody has got to pay them): malpractice insurance, health insurance, DEA license, society memberships, retirement fund, administrative fees, etc.

In other words, it costs money to put you out on the floor. So the amount you are generating per hour is negative dollars per your day 1. Then at some point you see enough patients to reach $0 per hour, then as you keep producing, the hourly climbs steeply. Then it climbs even higher and more than linearly as you get above the clouds (the clouds being your fixed overhead you're done paying).

Just think about it. Is there really any reason a Dermatologist can't work 2 days per week?

Why not for a Neurosurgeon? They generate a hell of a lot more money than an EP. Why can't they just find a hospital that signs up 3 neurosurgeons to "job share" hours?

It comes down to money.

It's cheaper to have one guy who want to work hard (1/3 the malpractice policies to pay for, 1/3 the licenses, fees, recruiting, and so on and so on).

So in theory, your flying unicorn job may be real, but you just ain't going to find it. Why?

Because a work horse is just a whole lot more practical, less high-maintenance, and a hell of a lot cheaper.

Trust me dude, if this flying unicorn existed for all of us, don't you think we'd all be riding it?

Oh you're right, this exists, but once you show up it's, "Oops. Sorry, we're a little short staffed. Would you mind working a little extra? Just for a little while?"

For every, 6 shift per month unicorn, I'll show you 10 work horses working 3 shifts per month more than they want to.

My suggestion: find something you like enough to work 40 hr per week at.

Well I know it exists because I've met several physicians who do exactly this via a locum company that sends them to rural areas. One guy literally lives in Israel 6 weeks then comes and works a week in the states. The only thing I wasn't sure is if the pay is much lower and whether it's available in larger cities.

Also I don't see how wanting to make 100k per year is going into EM for the money... It's more about going into EM for the possibility of shift work which few other specialties offer. It's harder to be dermatologist, cardiologist, or neurosurgeon who works 2 days a week because you have to be available to build a referral base.

 

[gutonc]

Would locums be an option for this if you were willing to work in rural locations and/or move around a lot?

Sure. But now instead of 1 medical license, you have to maintain 5 or 10 to keep your options open. And you're definitely on your own for insurance (life, health, disability, hopefully not malpractice...but maybe).

Of course, the OP started this thread asking about finding a "job" that would let you do this. And the answer is essentially no. Then he changed his tune to "can you string together a series of locums gigs to make this happen because I know a guy who does it?" and the answer to that is "probably, if you don't go crazy doing it." But that's not a "job" as we typically think of it...it's freelancing.

 

[Neuroguy887]

Sure. But now instead of 1 medical license, you have to maintain 5 or 10 to keep your options open. And you're definitely on your own for insurance (life, health, disability, hopefully not malpractice...but maybe).

Of course, the OP started this thread asking about finding a "job" that would let you do this. And the answer is essentially no. Then he changed his tune to "can you string together a series of locums gigs to make this happen because I know a guy who does it?" and the answer to that is "probably, if you don't go crazy doing it." But that's not a "job" as we typically think of it...it's freelancing.

So no hospitals hire part-time ER docs? What about all the female docs who want to cut back hours after having kids do they only do locum?
I am fine with paying for my own benefits.

 

[Neuroguy887]

according to this thread it's pretty normal to get part time (2-3 days/week) jobs as a hospitalist: http://forums.studentdoctor.net/threads/what-is-the-best-specialty-for-part-time-work.905176/

I would assume it would be similar in EM but maybe not.

 

[SoCuteMD]

So no hospitals hire part-time ER docs? What about all the female docs who want to cut back hours after having kids do they only do locum?
I am fine with paying for my own benefits.

There's a HUGE difference between an established person cutting back their hours and a new person asking to come in part time (especially if said new person is a fresh residency graduate or has never really practiced full time - please reference my first post in this thread). The established person may still be denied their request, but you can not equate cutting back with a new part time hire. Add to that the fact that a new part time hire is much much less likely to participate in the "citizenship" component of the department. At the community site I work at, each full timer is required to pick up one task/committee/cause that they contribute to - a part time person is probably not going to do that. An established physician is just that - she or he has proven themselves capable of the work, able to work within that particular system and (hopefully) an asset to the department. Those characteristics may make it worth it for a department to keep someone like that on even if they drop to part time.

Most of the women I know in EM work full time but I can think of a few who work part time.
- 1 who is 20+ years into her career and is part time now but was originally full time
- 1 who came to the health system as a "package deal" with her husband (both are awesome), but had to take a different site than she wanted because they don't hire part time at original site
- 1 who works nights

 

[The White Coat Investor]

So my plan is to avoid burning out and I don't care for putting on the golden handcuffs of a mortgage, luxury car, etc. I'll have no student debt. So, I figure if I can make 100k/year (before taxes) I'll be living my dream life. How many shifts per month will accomplish this is it pretty easy to find such a gig?

I love seeing this stuff from medical students. I can't wait to hear what you think in 10 years. I've got an argument going in a comments section on my blog where doctors are arguing that living on a six figure salary isn't all rosy.

Here's a link if you're interested: http://whitecoatinvestor.com/whats-your-problem/

At any rate, at $250 an hour, you'd need to work 400 hours per year to make $100K. That's about 4 eight hour shifts or 3 twelve hour shifts per month. If you can only get $150 an hour, it's 55 hours a month, or 7 eight hour shifts or 5 twelve hour shifts. It's just math, it's not THAT hard.

 

[Neuroguy887]

I love seeing this stuff from medical students. I can't wait to hear what you think in 10 years. I've got an argument going in a comments section on my blog where doctors are arguing that living on a six figure salary isn't all rosy.

Here's a link if you're interested: http://whitecoatinvestor.com/whats-your-problem/

At any rate, at $250 an hour, you'd need to work 400 hours per year to make $100K. That's about 4 eight hour shifts or 3 twelve hour shifts per month. If you can only get $150 an hour, it's 55 hours a month, or 7 eight hour shifts or 5 twelve hour shifts. It's just math, it's not THAT hard.

I didn't know if part-timers make $250/hr or 150 or what so that's why I was asking.

Also, anyone who is 'struggling' while making 6 figures is completely delusional and is trying to live well above their means. Do you realize that most people in this country live happy lives and can pay for kids off 60k/year?

 

[SoCuteMD]

I didn't know if part-timers make $250/hr or 150 or what so that's why I was asking.

Also, anyone who is 'struggling' while making 6 figures is completely delusional and is trying to live well above their means. Do you realize that most people in this country live happy lives and can pay for kids off 60k/year?

It's awesome when medical students come in and ridicule what established, well-informed posters have to say. It's even funnier when they come in asking about personal finance and then are rude to the author of a well-received personal finance book for doctors. But sure, tell us more about personal finance.

Must be nice to come out of medical school debt free and then talk about how the rest of us, who had to take out loans for medical school, are delusional when it comes to our personal finances.

@The White Coat Investor actually started a great thread on attending personal finances a few years ago: http://forums.studentdoctor.net/threads/an-emergency-docs-budget.817037/

 

[RustedFox]

I didn't know if part-timers make $250/hr or 150 or what so that's why I was asking.

Also, anyone who is 'struggling' while making 6 figures is completely delusional and is trying to live well above their means. Do you realize that most people in this country live happy lives and can pay for kids off 60k/year?

Do you realize that those same people don't give up 11 wage-earning years accruing 300K+ in debt? Oh, and most of those that do put in the time and money get accused of being "greedy doctors" once their reimbursements get cut by people who spent half the time in school and make often 2-3x more money?

Dude, STFU and listen. Seriously.

 

[deleted128562]

This med student is probably like a couple of kids I went to school with.... drove around in BMWs paid for by daddy, had school fully paid by daddy, and loved to tell the rest of us how we were greedy to want a big salary. Easy to preach when you aren't the one 300k in debt or trying to provide for a family.

 

[RustedFox]

This med student is probably like a couple of kids I went to school with.... drove around in BMWs paid for by daddy, had school fully paid by daddy, and loved to tell the rest of us how we were greedy to want a big salary. Easy to preach when you aren't the one 300k in debt or trying to provide for a family.

Ah, I see you and I went to the same school. You know; the one jam-packed with kids who have never worked a day in their lives, and were there because "well, that's what I'm supposed to do".

 

[Psai]

I didn't know if part-timers make $250/hr or 150 or what so that's why I was asking.

Also, anyone who is 'struggling' while making 6 figures is completely delusional and is trying to live well above their means. Do you realize that most people in this country live happy lives and can pay for kids off 60k/year?

Are you really a medical student? This post is rather preachy for someone with no student debt and is trying to live a lazy life

 

[Birdstrike]

It's awesome when medical students come in and ridicule what established, well-informed posters have to say. It's even funnier when they come in asking about personal finance and then are rude to the author of a well-received personal finance book for doctors. But sure, tell us more about personal finance.

Must be nice to come out of medical school debt free and then talk about how the rest of us, who had to take out loans for medical school, are delusional when it comes to our personal finances.

@The White Coat Investor actually started a great thread on attending personal finances a few years ago: http://forums.studentdoctor.net/threads/an-emergency-docs-budget.817037/

It's sort of like the med student threads that ask if you can go into EM and not ever have to work nights. Or the threads asking if you can somehow go into EM and not work holidays. You'll get 55 posts of people saying, "Well...but...if..." when every single one of them know the answer is a categorical, "No."

I remember one time in medical school, an old school surgeon was giving a lecture. A med student raised his hand and said, "I don't like getting up early in the morning. Is it possible to be a surgeon and schedule your OR cases to start at 10am instead of 7:00?"

The surgeon looked at him mystified and said, "If I had a frickin' dollar for every time a med student asked me that, I wouldn't have to set my alarm and get up and go to work at all. If you don't like getting up early in the morning, for Chr-st's sake, don't become a surgeon!"

You can try to keep fitting the square peg in the round hole all you want, or you can save yourself a lot of frustration by just listening what people are trying to tell you.

Point blank: If you don't want to worse your a$$ off, don't go into Emergency Medicine. Otherwise, you'll be badly disappointed.

 

[RustedFox]

Hahahahahahahaaaaaaa.....

I can remember a MS-3 RustedFox looking at his roommate during the early days of his surgery core rotation and saying - "This is bull****. Anything that can be done at 5 in the morning, can also be done at 7 in the morning with the appropriate number of neurons participating."

 

[SoCuteMD]

Ah, I see you and I went to the same school. You know; the one jam-packed with kids who have never worked a day in their lives, and were there because "well, that's what I'm supposed to do".

I took 2 years off in between college and med school. I worked full time at one of those research assistant jobs that pays jack and if you're lucky results in a publication or two. During the interview process i remember talking to some other women and we all said we were "taking the year off." I followed up with, "So what are you doing this year?" thinking that they'd be working similar jobs. No, no, they were actually taking the year OFF, living in apartments paid for by mommy and daddy.

 

[southerndoc]

Most places won't hire part-timers unless they pay their own medical malpractice insurance. Who wants to pay $40k/yr in malpractice if their employee/IC is only going to work 20 hours/week? Then they have to pay another $40k/yr to hire another part-timer. Hire one full-timer and you save $40k/yr not counting the numbers of hours saved with CME, other benefits, etc.

 

[alpinism]

You attendings can't hide the truth about EM forever...

I know this one EM doc who only works 2- 8hr shifts per week. One is always on a Tuesday from 8am till 4pm (with an hour break for lunch) so he can coach his daughter's soccer team after school. He's never missed a game yet. The other shift is for the SF 49ers were he works as a sideline doc for every game (plus free season tickets for family and friends). While at work he sees 1 patient per hour and only 1 at a time. Only true emergency patients too. All very grateful. In fact, they usually bring him lunch including fresh chocolate chip cookies for dessert (he's always complaining about getting too much food at work). He also has NPs that take care of all the rectals, abscesses, diabetic ulcers, and psych pts. They do all the paperwork too. While they're working he's in the physician lounge sipping gourmet coffee from his Keurig and catching up on the latest PEOPLE magazine.

Sigh, I can't wait...

 

[Cerberus]

I think 100k is definitely possible and part time is also entirely possible. I know several part time EM docs (mostly mothers who want more time with their kids). It is not at all hard to find a place offering locums in my neck of the woods (NYC). That said, almost no one does it? Why? Because 100k really isn't that much money and they more money you make, the more you realize it isn't enough given the tax rate and costs associated with being a doctor.

 

[diphenyl]

@RustedFox I feel you brother. I vividly recall medical school, seeing my classmates who had not one dollar of debt because mommy and daddy paid for everything including their BMW/ porshe. I really resented them in a way because they were typically the screw up, failing tests, always complaining about the work load. Most had never worked a day in their life. Meanwhile I had always had a job since age 15 to contribute and worked full time throughout undergrad. This thread kinda brought up a real sore subject. A lot of applicants that I have heard from, both on here and in person, are getting into EM for all the wrong reasons. They are attracted to the decent compensation and a perceived "better lifestyle". They have no passion for the field. They follow the money and a perceived easy route. These are the people who get into residency and are utterly disappointed when it turns out that this perceived "lifestyle" specialty is not easy at all. They are shocked by all the nights/ weekends/ holidays we work, consultants who belittle us, patients who are completely unappreciative if not openly hostile, and the tremendous amount of medico legal liability we take on. If these people had a better taste of the field while in medical school, and not some rose colored picture they get during a 4 week rotation, I would bet the amount of annual applicants would drop by at least 1/3.

 

[Venko]

My sarcasm detector was malfunctioning...so I withdrew my post

Sorry all

 

[WannabeEM]

Hmm...so for eight hours per week he sees 8 pts, likely in San Francisco given that his other, "shift," is there. If he did that over the course of the year he sees about 400 pts for the hospital. How much does your friend get paid for this? San Fran is a competitive city for EM with generally lower returns for the hospitals and if they have a contract with an nfl team that means they pay the team a considerable amount of money...(my understanding is to be a team doc for a professional team means you pay the team for the privilege and make money in the follow up appointments, advertising etc).

Lets just indulge your idea that this person exists and this job exists and it returns 200k (just playing along here)...it's definitely the exception and not the rule.

My wife and I were watching, "he's just not that into you" on television and its like that...everyone knows someone who gets paid tons of money for doing seemingly nothing....the fact is most people are misrepresenting their situation and those few who have something like this are definitely the exception and not the rule.

For most EPs, work is going to be challenging, the hours are going to be challenging, your patients may be indifferent to you at best and you'll be cpensated well.

I'm chuckling inside about your thought that we are hiding something from you because you know one attending who apparently has the worlds best job and you think that hospital or others are going to give you the same thing...good luck kid

Psst - pretty sure alpinism's post was entirely sarcasm.

 

[deleted128562]

Venko, I think your sarcasm detector is malfunctioning. Please have it repaired ASAP.

Hmm...so for eight hours per week he sees 8 pts, likely in San Francisco given that his other, "shift," is there. If he did that over the course of the year he sees about 400 pts for the hospital. How much does your friend get paid for this? San Fran is a competitive city for EM with generally lower returns for the hospitals and if they have a contract with an nfl team that means they pay the team a considerable amount of money...(my understanding is to be a team doc for a professional team means you pay the team for the privilege and make money in the follow up appointments, advertising etc).

Lets just indulge your idea that this person exists and this job exists and it returns 200k (just playing along here)...it's definitely the exception and not the rule.

My wife and I were watching, "he's just not that into you" on television and its like that...everyone knows someone who gets paid tons of money for doing seemingly nothing....the fact is most people are misrepresenting their situation and those few who have something like this are definitely the exception and not the rule.

For most EPs, work is going to be challenging, the hours are going to be challenging, your patients may be indifferent to you at best and you'll be cpensated well.

I'm chuckling inside about your thought that we are hiding something from you because you know one attending who apparently has the worlds best job and you think that hospital or others are going to give you the same thing...good luck kid

 

[Birdstrike]

Venko, I think your sarcasm detector is malfunctioning. Please have it repaired ASAP.

The sarcasm detector: It's the first thing to short out after a grueling stretch of way-too-busy, circadian-assaulting shifts.

Lol

 

[Arcan57]

Going part-time after residency is a really bad idea for a number of reasons which have been detailed extensively in other posts. In addition, part-timers (especially fresh grad part-timers) have little investment in the shops they work at and create substantial headaches for admin. Since it's typically admin that does the hiring, this makes FGPTs a difficult sell to any place that has a choice. We currently have a PT doc that hasn't worked a shift with us yet and we're debating whether it's even worth the time to try and orient them to the ED considering we'll be fully staffed come the summer. I don't personally know of any shops that combine: high pay, willingness to hire FGPTs, and non-malignant work environment.

 

[Birdstrike]

... 100k really isn't that much money and they more money you make, the more you realize it isn't enough given the tax rate and costs associated with being a doctor.

Absolutely true. I would rephrase it more like this: "100K isn't 100k."

After taxes, fees, homeowners insurance, disability policies, student loans, fees, fees, fees, bills, bills, bills, FICA tax, Obamacare tax increases, ad infinitum....

You're lucky to take home 1/3, which you can live on but sure isn't going to leave much left over for the toys/travel/hobbies said part timer would be working part time to enjoy.

 

[Birdstrike]

Going part-time after residency is a really bad idea for a number of reasons which have been detailed extensively in other posts. In addition, part-timers (especially fresh grad part-timers) have little investment in the shops they work at and create substantial headaches for admin. Since it's typically admin that does the hiring, this makes FGPTs a difficult sell to any place that has a choice. We currently have a PT doc that hasn't worked a shift with us yet and we're debating whether it's even worth the time to try and orient them to the ED considering we'll be fully staffed come the summer. I don't personally know of any shops that combine: high pay, willingness to hire FGPTs, and non-malignant work environment.

Agree. The only way to do it would be a do the traveling, fire-fighter gigs, flying to the most painfully understaffed and desperate locations constantly (living in hotels like a rock star without a band, without the rock and without the star).

"Doc Star"

Otherwise there is part-time for doctors, it's called "semi-retirement" at the end of a career, not at the start of it.

Also, here's something I haven't seen brought up. How are you going to get any good at anything doing it only 2 days a week? I can't tell you how much learning there is to do after residency. (It's different for the semi-retirement doc who has 100,000 patient encounters under their belt). To come out of the gate sputtering on 1/2 cylinders shoots yourself in the foot. Plus it just looks horrible applying for a job:

"Residency trained doctor, just graduated, young, eager, energetic. Seeking part time work."

Huh? (With the possible exception of family reasons/ just had baby).

Hey, if you can make it work out great, more power to you. I'm just giving my two cents on how much harder this can be to put into action than is sold to people.

 

[Old_Mil]

So my plan is to avoid burning out and I don't care for putting on the golden handcuffs of a mortgage, luxury car, etc. I'll have no student debt. So, I figure if I can make 100k/year (before taxes) I'll be living my dream life. How many shifts per month will accomplish this is it pretty easy to find such a gig?

It will be easier as an independent contractor than as an employee or with a democratic group. This having been said, as an independent contractor you will be paying for health, disability, retirement, etc out of pocket and will have to work more hours every month to fund these things. The hourly rate difference between advertised employed + benefits and IC jobs is not enough to buy these things retail.

What you should look at is "how much should I make"? The unfortunate reality is that the more you work, the higher your taxes and by the end of the month most full time EPs are essentially working two shifts and getting paid for one of them.

The magic number is 225k. Once you cross the 226.5k threshhold your tax bracket goes up 6%. Once you cross the 250k threshhold you're rich and get a bonus 1% medicare tax. Once you cross the 300k threshhold you start losing tax deductions. So if you're looking to maximize the efficiency of each hour you spend at work you want to work just enough to keep your salary at 225k a year or less. Beyond this it's a case of seriously diminishing returns. The number of shifts this works out depends on your rate, at my shop you want to be at 6-7 shifts a month, no more. These numbers are lower for single people or married folks filing separately.

 

[Apollyon]

I strongly suspect that neuroguy is checking this thread, but I predict that he is long gone, and won't respond any more. However, on the other side of the same coin, he might come back, and continue with the same spiel, and tell us we don't understand. The very distant bronze medal is the guy to come back and say either "hey, it was just a thought, and doesn't look like a good one", or "just kidding!"

Maybe we can guilt him into standing up for himself a little bit.

Or maybe not.

 

[The White Coat Investor]

Most places won't hire part-timers unless they pay their own medical malpractice insurance. Who wants to pay $40k/yr in malpractice if their employee/IC is only going to work 20 hours/week? Then they have to pay another $40k/yr to hire another part-timer. Hire one full-timer and you save $40k/yr not counting the numbers of hours saved with CME, other benefits, etc.

Your malpractice is $40K? Time to change states pal.

 

[The White Coat Investor]

It will be easier as an independent contractor than as an employee or with a democratic group. This having been said, as an independent contractor you will be paying for health, disability, retirement, etc out of pocket and will have to work more hours every month to fund these things. The hourly rate difference between advertised employed + benefits and IC jobs is not enough to buy these things retail.

What you should look at is "how much should I make"? The unfortunate reality is that the more you work, the higher your taxes and by the end of the month most full time EPs are essentially working two shifts and getting paid for one of them.

The magic number is 225k. Once you cross the 226.5k threshhold your tax bracket goes up 6%. Once you cross the 250k threshhold you're rich and get a bonus 1% medicare tax. Once you cross the 300k threshhold you start losing tax deductions. So if you're looking to maximize the efficiency of each hour you spend at work you want to work just enough to keep your salary at 225k a year or less. Beyond this it's a case of seriously diminishing returns. The number of shifts this works out depends on your rate, at my shop you want to be at 6-7 shifts a month, no more. These numbers are lower for single people or married folks filing separately.

I can't quite tell, but you don't seem to get how tax brackets work. Income is always good. As you move up to the next bracket, only the amount in that bracket is subject to a higher tax.

What you're saying is that for some reason it is worth it to you to work for $250*.75= $187.5 per hour after tax in the 25% bracket but not $180 per hour in the 28% bracket. While that might be true, I kind of doubt it.

 

[The White Coat Investor]

I didn't know if part-timers make $250/hr or 150 or what so that's why I was asking.

Also, anyone who is 'struggling' while making 6 figures is completely delusional and is trying to live well above their means. Do you realize that most people in this country live happy lives and can pay for kids off 60k/year?

I actually agree with you and don't see your comment as rude at all. But it is important to understand both perspectives in this discussion. $100K sure doesn't feel like much to someone who is 35 and has a net worth of -$300K, all at 7%+.

 

[The White Coat Investor]

I think it is completely reasonable to go part time, either as locums, as a prn employee, or as a partner in a democratic group. However, it will be very difficult, and probably not a good idea, to do that right out of residency.

 

[BoardingDoc]

I can't quite tell, but you don't seem to get how tax brackets work. Income is always good. As you move up to the next bracket, only the amount in that bracket is subject to a higher tax.

What you're saying is that for some reason it is worth it to you to work for $250*.75= $187.5 per hour after tax in the 25% bracket but not $180 per hour in the 28% bracket. While that might be true, I kind of doubt it.

Exactly. Just to clarify for anyone who isn't quite getting this, when you "jump a tax bracket" it doesn't mean that your entire income is subject to that tax rate.

Example: Lets say that the base tax rate is 5%, but that the tax bracket for people making more than 100k is 10%. If I make 80,000 then my takehome is 80k * 0.95. Simple, right?

Now, if I make 120k, my takehome is NOT 120k * 0.9. My takehome is (100k * 0.95) + (20k * 0.90).

This is one of the most commonly misunderstood concepts in finance, but a very very important one to grasp.

TL;DR: More income is GOOD. Even if it bumps you into a higher tax bracket.

 

[Old_Mil]

I fully understand how tax brackets work. More income is good, but as I stated in my original post, the more you work, the more you experience diminishing returns. Where the "sweet spot" is for any particular person is up to them; working two shifts to get paid one is not worth it for me.

 

[OCDEMS]

Med student. Previous career before going back. The OP's opinion regarding salary is super prevalent in my medical school, at least in my observation of 23-27 year olds with no life experience. They're not all bad people, nor are all of them super privileged (although there is that crowd). They just have no idea of what the purchasing power of $100k is, let alone $250-300k. You know how many times I've heard, "I didn't go into this for the money. I could EASILY live off $100-150k a year." I actually heard one student, gulp, who went so far as to lambast physicians for needing that much money. BUT...

Ask one of them how much money they'd need to retire, how much a typical car payment is, a mortgage, money for their kid's college (this one always gets me, especially considering the number of students whose own parents are forking over cash), disability insurance, life insurance, etc and they'll stare at you like you're someone from a different planet.

I personally think that one of the best things a medical school could do would be to integrate practical personal finance classes early in the curriculum. Students should be shown what a monthly mortgage is on a $200k, $400k, and so forth home. They should be shown what $500k buys in a city like NYC, SF, or DC. It just blows my mind. The concept goes the other way too. Not every medical student thinks money grows on trees. Just the opposite for some, especially those who've legitimately grown up on the bottom end of middle class. I just sort of stare in disbelief. I feel like there is such a lack of basic financial literacy that it's incredible. I really ponder if some of my classmates are going to upgrade to attending one day and turn into a hand grenade of bad financial decisions.

 

[southerndoc]

Your malpractice is $40K? Time to change states pal.

No, I think that's the national average.

I live in a state with very good tort laws (gross negligence requirement, although this is in the process of being challenged).