Are you sure you want to be a doctor?

[deleted128318]

I'm not including it for the sake of drama, I'm including it because, when figuring out how much of one's income is devoted to taxes, that number is going to be higher than just the income taxes going to one's state or national government. And, when figuring the proportion of income devoted to taxes, this amount cannot be ignored. Thus, while you're paying anywhere from 20-51 (or whatever)% of your income to income taxes, these other taxes that one does pay (all the others I included) drive that percentage upwards. And that is, for the average person, enough of a bump to push them to pay 50% (roughly) of their income to the government. I point this out to counter your argument that most people don't pay anywhere near 50% in taxes. I don't see why this is such a heated debate, or where "anti-unionism" came from...

I referred to "heads in the sand" because most people don't include these little items in personal budgets, and thus never see how much they're truly paying to the government. Then you get arguments like "how much do you really need," and "it's only a small tax raise..."

Not heated. Annoyed. And I know see that I am annoyed because you jumped into the conversation in the middle and thought you knew what we were debating. We were talking about how much of the salary (albeit substantial) a physician actually get to take home and blow. We were not debating how much of a financial obligation we ultimately entertain with respect to our free-speaking country. So when we are talking about how you are only going to make 120k, but actually take home 60k, it was tangential of you to say that [you actually aren't even taking home 60k because you will then pay sales tax on the things that you buy, so you are really only spending 57k]. You missed the forest for the trees.

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[Mr. Freeze]

Not heated. Annoyed. And I know see that I am annoyed because you jumped into the conversation in the middle and thought you knew what we were debating. We were talking about how much of the salary (albeit substantial) a physician actually get to take home and blow on helicopters/ferraris/coke/******/whatever We were not debating how much of a financial obligation we ultimately entertain with respect to our free-speaking country. So when we are talking about how you are only going to make 120k, but actually take home 60k, it was tangential of you to say that [you actually aren't even taking home 60k because you will then pay sales tax on the things that you buy, so you are really only spending 57k]. You missed the forest for the trees.

If I get a Ferrari, and STILL have to buy ******,,,

I tried to read the whole thing, there's is just too much idealism for me...

 

[deleted128318]

If I get a Ferrari, and STILL have to buy ******,,,

I tried to read the whole thing, there's is just too much idealism for me...

At least you got the whole ferrari/****** gist.

 

[Karnage]

And *****ic responses I got. Take this quote for example, courtesy of an illusionist:

"I'm still at a loss as to how spoiled some of you are. Some of you act like $200-300k a year is living in poverty"

Yes, an illusionist. Despite the fact I know more than one doctor who is living VERY comfortably in Fairfield county, CT. And I mean comfortably. Despite the fact that the majority of things around here are ridiculously overpriced, including houses.

Let's listen to the crybaby with a hard-on for making millions. It's sad that you think all Americans are entitled to make well into the six figures. The average salary in this country is $48k. 120k is almost 3x that amount. So, I'm sorry if people don't feel bad for you when they're getting by just fine on their 50k salaries. Physicians are, on average, the highest paid profession. There are ibankers and others who make more, but they're also spending 70+ hours a week slaving at a desk trying to woo clients. The majority of people in the business field and other fields make significantly less than doctors. But hey, you're welcome to keep crying. I mean, you're on an internet forum bawling about how hard it is to live on $120k. hahaha, let me stifle that laugh while I think about the other 90% of the population who makes well under $100k.

And sure it's a growing problem with decreasing salaries and increasing hours, but hey, no one's telling you to do this. There's something called free will, and instead of crying like a baby on an internet forum, go back to school and change careers. I'm sure you'll enjoy making $60k as an accountant or something. Eventually this issue will become a problem and there should be some change when there aren't enough doctors to go around.

Great little comparison.

http://www.businessweek.com/smallbiz/resources/benefits/pay.htm

Hmm, executives, who usually don't assume those positions until they usually have 10+ years of experience are still making roughly the same amount as most doctors. Shocking!!!! Welcome to look at the list of the every day folk who don't make anywhere near the amount of money most physicians do.

Either way, I'm not going to bother reading your reply. It sounds like you're trying to convince yourself to not be a doctor and I couldn't care less.

 

[Hoo\/er]

Its a lot of money. Especially if there are 2 incomes. Yeah, when you get used to any amount of money it seems like less. But please, please please, when you are a doctor making over 100K, remember what the average employee in America makes. Remember that doctors in America make MORE money than doctors in any other country.

There is also evidence that they do worse than some other countries as well: http://news.yahoo.com/s/nm/20070515_nm/healthcare_usa_dc;_ylt=AkpaSDv9tMZxNHPVQKAgYxkDW7oF

And as for being "marginalized," go work in business for awhile, or engineering. Unless you are an executive, you will have a boss. You will, in short be a member of a team. Doctors now have to work like the rest of America. And, on average they still make more.

It is hard to feel sorry for people complaining about being in the upper middle class, in one of the richest countries on earth.

Give me a break, $120k isn't much money if you consider how much that physician has to work in order to earn it. Do you know why the average income in the U.S. is $45k or so? It's because the average work week is 40 hours. Show me a doctor who only works 40 hours a week for $120k per year. I'm sure there are some, but they are few and far between.

 

[Brigade4Radiant]

Give me a break, $120k isn't much money if you consider how much that physician has to work in order to earn it. Do you know why the average income in the U.S. is $45k or so? It's because the average work week is 40 hours. Show me a doctor who only works 40 hours a week for $120k per year. I'm sure there are some, but they are few and far between.

Hour for Hour doctors make way more than the average American.

I know that being a doctor isn't all sunshine and lollipops hell its all lot of crap and hard work. I know many of you guys are bitter for having your expectations of what medicine is truly like dashed into fine powder and you feel like since you hate the practice of medicine so much that every idealstic premed will hate it. But you really can't say that someone will hate it or have your ideals of medicine when they haven't experienced it yet.


Another thing, doctors make good money that much is certain. Please don't use the 4 years thing as an excuse to not be satisfied what about dentists, pharmacists and vets? Vets make about 60k a year after about a 100k debt. The opportunity cost for becoming a doctor is still very high even for other careers. The lowest doctor still breaks 6 figs you can't say that about many other careers. 120k is a lot of money compared to most of Americans if you can live somewhat comfortably in one of the most expensive parts in the world supporting four people and having gardening budgets I say your doing just fine especially for a career that you tried so hard to attain.

 

[8744]

And yet, when those of you who swear that you'd be happy making 120,000 bucks a year get down to it, you're going to run, not walk, away from primary care where you can make even less than that without too much effort.

You can be happy with 120K now because at this point in your lives it may as well be 1.2 million for all the good it's doing you.

As for your wife demanding a mansion, seriously, my long-suffering and incredibly understanding wife has not subjected herself to poverty, three moves in the last six years, and the gnawing uncertainty of the whole adventure to live in a double-wide trailer out behind the jiffy mart. Scoff if you want but an honest woman wants a nice house, a safe neighborhood for her kids, and the ability to not have to worry about money too much.

It's ridiculously easy to take the high road against materialism when your're dating some pretentious poetry major who works at Starbucks but marry a woman who expects some upward mobility, have a few kids, get a few adult responsibilities and you will sing a different tune.

Jeez. Grow a friggin' backbone already. If you don't value your skills how do you expect others to react? I guess that's sort of the point. Most of you have no idea what's involved and therefore feel this residual guilt that you'll make more than the nice fellows assembling my Chalupas. Trust me, you're going to work a lot harder than those guys and their lives are going to be easier than yours.

 

[Eric Lindros]

Give me a break, $120k isn't much money if you consider how much that physician has to work in order to earn it. Do you know why the average income in the U.S. is $45k or so? It's because the average work week is 40 hours. Show me a doctor who only works 40 hours a week for $120k per year. I'm sure there are some, but they are few and far between.

Dude, you are really blowing this out of proportion. An average, say, pediatrician or family doctor out of residency works about 50 hours a week (look it up if you want but that is definitely a fair estimate). That's 10 more hours a week than 40.......for almost triple what an average salary is.

You are acting like all doctors work 100 hours a week. That's just not true.

 

[UVABranch]

Oh ouch. I think I'm going to have to spend a little time crying myself to sleep because of that one.

First of all...Podunk, MD is a joke, because people call the middle of nowhere "Podunk" and I live in the middle of nowhere and go to school in the middle of nowhere.

That's what I thought but I didn't want to be presumptious....I've never heard of the term "podunk" nor the place if it actually exists so I thought I would qualify.

Second of all, don't you dare insinuate that I'm racist. You don't even know me, and yet you feel inclined to tell me my own views on race? Without being 'racist' here...

I didn't, so pump your breaks (as some might say, i.e. slow down). I did not imply anything if for no other reason than I don't know you (nor anyone else on SDN for that matter). More than anything I wanted you to appreciate how your statment might be precieved. Thus I pointed out contridictions to your statement and a possible reason for the statement. That can be a problem with the written word; readers must try to infer the writer's tone.

I'm just pointing out that a majority of underprivledged students who live in cities tend to be minorities, a majority of which are black. Is the fair/right/whatever? No, but that's how it is.

*confused* Are you asking if it's fair that the a majority of underprivledged students who live in cities tend to be minorities?

There is a limited amount of money available for poorer students and when that runs out, that's it. In the area that I live in, people who live in the city tend to be significantly less able to afford the basic things that they need, simply because the cost of living is higher. Therefore, they are considered to need more need-based aid, and are more likely to get it, since it's independant of everything but finances.

I've never worked in a FinAid office so I can't speak to this. My guess is that it's calculated more like a debt to income ratio. Even if it costs more to live in a city a) sallaries usually reflect this (think: an CPA in NYC versus Charleston, SC), b) I don't know of too many inner cities in MD but in Bmore you can rent a house and some apartments for like $400/month. I don't know the going rates in more rural areas of MD, but I figure that could be done for about the same and likely in a safer area (again this is an assumption). With that said I can't speak specifically about what you have seen/expereienced, but I can say (obviously) that there are likely examples to the contrary.

Also, in-state tuition is more expensive in Maryland than in Virginia. That's great that you can get $4,000 tuition.

I didn't pay instate tuition, but I know many who did.

College Park is $6,566 for tuition only, St. Mary's is $9,498, Towson is $5,180, Salisbury is $4,814, etc etc. The catch is that the price goes down as the quality of education goes down. Most of those schools are too far away for anyone who I went to school with to commute to.

I don't agree with you in that the quality of education is directly correlated with how much you pay. UVA was the top public school in the country when I was there and it doesn't get much lower than 4k. College park is pretty good too, so I assume by your calculation St Mary's is better than UMD?

And finally, don't be so presumptuous as to tell me about my life.

I didn't. Qualifiers like “might” and “maybe” and “likely” are not definitive statements. Otherwise I might have started the post with “Let me tell you about yourself.”

I'm glad that you could work your way through college, but these people who I know are supporting their families. They need to be a main contributor to their family's income or their family can't eat and pay the bills. I'm not the least bit bitter. I love the school that I attend, and I'm thankful every day for the merit-based aid that I recieved. I'm thankful that my parents have offered to pay for my tuition, and I'm glad that I made that choice to attend an in-state public college because I'm getting a phenomenol education at a great price. You keep rambling on about your 'reality'...well, don't question mine.

I don’t know if I was really rambling, I thought I made a few succinct statements about what’s going on in my life, that’s all…and no need to quote it, that really is my reality. For real. Don’t have a family to support so I can only imagine the challenges that one might face trying to juggle UG w/ a fam, let alone those who tackle med school. Although again, it can be done:
http://www.oprah.com/tows/slide/200705/20070509/slide_20070509_350_105.jhtml
same story just another article http://www.nhregister.com/site/news.cfm?newsid=18333001&BRD=1281&PAG=461&dept_id=590581&rfi=6

Either way, no need for us to bicker. Maybe I misunderstood you, and you I. If you do wish to discuss it further feel free to PM me. Going back and forth here may not be the best venue for this convo….you know?

Yeah instate at UVa is around 5K/semester now. Not exactly all that expensive. Most of the people I know paid their way through college. So the argument people keep spouting that people couldn't go to college b/c of money is ridiculous.

I totally agree!

Uvabranch I hope you at least got to make 1 foxfield.

Nope. Not then anyway, but there’s still time

 

[badasshairday]

Does anyone know the real figures for a physicians income?

 

[G.O.A.T.]

Does anyone know the real figures for a physicians income?

yes.

 

[nekrogg]

Ok, so the main tool of a union, the WALK-OUT, is something that you'd be willing to do to your patients?

nurses do it.. so should we (kidding)!

in all honesty being a doctor these days is about how you run your business (assuming you are private practice). if you suck, you will top off at 120k. if you are a shrewd business man and provide your patients with incentive (package deals, cheaper medicines) to come to your office as opposed to others, you got yourself a great source of income. i know pediatricians that are earning over a million a year because of the way they run their office. in the end, if you want to make a dollar, it can be done. you just have to go beyond what they offer you in your medical training.

 

[Law2Doc]

in all honesty being a doctor these days is about how you run your business (assuming you are private practice). if you suck, you will top off at 120k. if you are a shrewd business man and provide your patients with incentive (package deals, cheaper medicines) to come to your office as opposed to others, you got yourself a great source of income. i know pediatricians that are earning over a million a year because of the way they run their office. in the end, if you want to make a dollar, it can be done. you just have to go beyond what they offer you in your medical training.

Business sense is part of it, but to a bigger extent it depends on your area of specialization, and your ability to generate throughput. Most people in medicine work for reimbursements from insurance companies. As such, they have no ability to offer package deals, cheaper medicines, or otherwise lure people in with incentives etc. without breaching their agreements with the insurance companies, medicare etc. There are such things as conceirge services, where patients pay cash out of pocket and the physician may accept no insured patients, but this only works if a tiny minority of physicians are doing it -- if everybody does, it rapidly eliminates the fairly small market of self-payors and doctors start going bankrupt (it has happened in certain locales). Most of the million dollar a year practices you see exist because they were set up prior to the current hurdles and impediments to doing this -- you won't see too many new ones springing up. These days if you want more money through your physician income you need to (1) specialize and (2) work longer hours. Which is why you are seeing family doctors and internists earning $120k and less. Not because they are not shrewd, but because their field has been made less lucrative by insurance company reimbursement reductions. Expect this trend to continue, not reverse.

 

[sirus_virus]

Business sense is part of it, but to a bigger extent it depends on your area of specialization, and your ability to generate throughput. Most people in medicine work for reimbursements from insurance companies. As such, they have no ability to offer package deals, cheaper medicines, or otherwise lure people in with incentives etc. without breaching their agreements with the insurance companies, medicare etc. There are such things as conceirge services, where patients pay cash out of pocket and the physician may accept no insured patients, but this only works if a tiny minority of physicians are doing it -- if everybody does, it rapidly eliminates the fairly small market of self-payors and doctors start going bankrupt (it has happened in certain locales). Most of the million dollar a year practices you see exist because they were set up prior to the current hurdles and impediments to doing this -- you won't see too many new ones springing up. These days if you want more money through your physician income you need to (1) specialize and (2) work longer hours. Which is why you are seeing family doctors and internists earning $120k and less. Not because they are not shrewd, but because their field has been made less lucrative by insurance company reimbursement reductions. Expect this trend to continue, not reverse.

Very true. I cannot imagine insurance companies waking up one day and deciding to increase reimbursements significantly. I am sure the '+' sign on their calculators has never been touched.

 

[YupGypsy]

Yes, an illusionist. Despite the fact I know more than one doctor who is living VERY comfortably in Fairfield county, CT. And I mean comfortably. Despite the fact that the majority of things around here are ridiculously overpriced, including houses.

Let's listen to the crybaby with a hard-on for making millions. It's sad that you think all Americans are entitled to make well into the six figures. The average salary in this country is $48k. 120k is almost 3x that amount. So, I'm sorry if people don't feel bad for you when they're getting by just fine on their 50k salaries. Physicians are, on average, the highest paid profession. There are ibankers and others who make more, but they're also spending 70+ hours a week slaving at a desk trying to woo clients. The majority of people in the business field and other fields make significantly less than doctors. But hey, you're welcome to keep crying. I mean, you're on an internet forum bawling about how hard it is to live on $120k. hahaha, let me stifle that laugh while I think about the other 90% of the population who makes well under $100k.

And sure it's a growing problem with decreasing salaries and increasing hours, but hey, no one's telling you to do this. There's something called free will, and instead of crying like a baby on an internet forum, go back to school and change careers. I'm sure you'll enjoy making $60k as an accountant or something. Eventually this issue will become a problem and there should be some change when there aren't enough doctors to go around.

Great little comparison.

http://www.businessweek.com/smallbiz/resources/benefits/pay.htm

Hmm, executives, who usually don't assume those positions until they usually have 10+ years of experience are still making roughly the same amount as most doctors. Shocking!!!! Welcome to look at the list of the every day folk who don't make anywhere near the amount of money most physicians do.

Either way, I'm not going to bother reading your reply. It sounds like you're trying to convince yourself to not be a doctor and I couldn't care less.

some of you just don't get it.

When you hear the same gloomy sentiment from doc after doc, survey after survey, article after article, the trend is unsettling. They're not just "whining," the epidemic is VERY real.

Who cares what the average joe makes, he didn't go through 12+ years of schooling and does NOT have the specialized knowledge.

So when you spent most of your prime years in school, racked up a mountain of debts, subjected yourself to all sorts of mental and physical torture, and when it's all said and done, you work brutal hours, have patients sue you left and right (when things go wrong, they will sue you, when things go right, some WILL still sue you), take all sorts of bureaucratic and administrative bullcrap, just to get twelve cents for every dollar you bill for, you have a right to be pissed.

 

[Brigade4Radiant]

And yet, when those of you who swear that you'd be happy making 120,000 bucks a year get down to it, you're going to run, not walk, away from primary care where you can make even less than that without too much effort.

You can be happy with 120K now because at this point in your lives it may as well be 1.2 million for all the good it's doing you.

As for your wife demanding a mansion, seriously, my long-suffering and incredibly understanding wife has not subjected herself to poverty, three moves in the last six years, and the gnawing uncertainty of the whole adventure to live in a double-wide trailer out behind the jiffy mart. Scoff if you want but an honest woman wants a nice house, a safe neighborhood for her kids, and the ability to not have to worry about money too much.

It's ridiculously easy to take the high road against materialism when your're dating some pretentious poetry major who works at Starbucks but marry a woman who expects some upward mobility, have a few kids, get a few adult responsibilities and you will sing a different tune.

Jeez. Grow a friggin' backbone already. If you don't value your skills how do you expect others to react? I guess that's sort of the point. Most of you have no idea what's involved and therefore feel this residual guilt that you'll make more than the nice fellows assembling my Chalupas. Trust me, you're going to work a lot harder than those guys and their lives are going to be easier than yours.

I seriously doubt that the guys at Taco Bell have an easier life than doctors. I mean you are doing what you wanted to do with your life, your in a career that many spend want to attain but few recieve. No one forced you to leave your cushy engineering job and put your family through 7-8 years of poverty that was a choice that you and your spouse made. Because in the end you believe that it was worth it. Face it, nearly all jobs suck.

What do you have to say about the people who want to be Veterinarians who make about 60k after four years of schooling which the avg debt load is around 100k. Why is it that it is more competitive than most grad school programs. How is making three times what the avg American makes not good money. People with 45k are still able to live comfortably in 90% of America and support their families.

 

[Eric Lindros]

It's ridiculously easy to take the high road against materialism when your're dating some pretentious poetry major who works at Starbucks but marry a woman who expects some upward mobility, have a few kids, get a few adult responsibilities and you will sing a different tune.

My wife is going to work (and she wants to). Problem solved

 

[deleted128562]

Let's listen to the crybaby with a hard-on for making millions. It's sad that you think all Americans are entitled to make well into the six figures. The average salary in this country is $48k. 120k is almost 3x that amount. So, I'm sorry if people don't feel bad for you when they're getting by just fine on their 50k salaries. QUOTE]

You know, I was getting really tired of stupid rhetoric like this until I went and viewed comments that a couple of people had made over on a certain blog..... and they opened my eyes to how good this kind of sentiment might actually be.

So, for all you altruistic premeds out there who think 120K is MORE than enough (for any speicialty), please please please PM me once you get done with residency and I will personally offer you a job, guarenteed. I plan to open up several clinics once I'm a physician, and I would love to employ you. You will only be required to work 80 hours per week, but I'll even allow you to work more if you realize what a privilege it is to help so many people - to touch so many lives. And I will pay you exactly ONE-HUNDRED-TWENTY-THOUSAND DOLLARS PER YEAR!!!!!! Almost three times what the aveage American makes!! All specialties will be welcome to apply at Mr. Hat Clinics, but I would especially encourage those of you who end up in derms, rads, and optho to consider applying.

Further, Mr. Hat Clinics will encourage all physicians to practice "community medicine" (outside of clinic hours of course) with each patient and their families so that you can positively affect every area of their lives.

So, altruistic premeds - if this sounds just what you're looking for - please PM me when you finish residency. A Mr. Hat Clinic job is waiting with your name on it!!

 

[Oddsnends]

Any insurance company executive worried he/she isn't going to be able to post record profits next year should visit the pre-allo forum. The white coat isn't the only similarity between doctors and sheep.

 

[YupGypsy]

I seriously doubt that the guys at Taco Bell have an easier life than doctors. I mean you are doing what you wanted to do with your life, your in a career that many spend want to attain but few recieve. No one forced you to leave your cushy engineering job and put your family through 7-8 years of poverty that was a choice that you and your spouse made. Because in the end you believe that it was worth it. Face it, nearly all jobs suck.

What do you have to say about the people who want to be Veterinarians who make about 60k after four years of schooling which the avg debt load is around 100k. Why is it that it is more competitive than most grad school programs. How is making three times what the avg American makes not good money. People with 45k are still able to live comfortably in 90% of America and support their families.

the guys at Taco bell do have an easier life than doctors. Let's say they mess up an order, the customer would complain, and the order would be replaced, no biggie. Physicians, on the other hand, may face catastrophic consequences for messing up. A decade worth of schooling, license, assets, etc. down the drain for a single mistake.

When their shift ends, they go home and can forget about whatever happened at work. There's no such thing as a "taco" emergency. In medicine, you're never out of the loop. You're haunted day and night.

No one is forced into medicine. But they don't have to take all sorts of **** up the a$$ for choosing medicine, regardless of whether they are aware of it or not.

 

[Brigade4Radiant]

Let's listen to the crybaby with a hard-on for making millions. It's sad that you think all Americans are entitled to make well into the six figures. The average salary in this country is $48k. 120k is almost 3x that amount. So, I'm sorry if people don't feel bad for you when they're getting by just fine on their 50k salaries. QUOTE]

You know, I was getting really tired of stupid rhetoric like this until I went and viewed comments that a couple of people had made over on a certain blog..... and they opened my eyes to how good this kind of sentiment might actually be.

So, for all you altruistic premeds out there who think 120K is MORE than enough (for any speicialty), please please please PM me once you get done with residency and I will personally offer you a job, guarenteed. I plan to open up several clinics once I'm a physician, and I would love to employ you. You will only be required to work 80 hours per week, but I'll even allow you to work more if you realize what a privilege it is to help so many people - to touch so many lives. And I will pay you exactly ONE-HUNDRED-TWENTY-THOUSAND DOLLARS PER YEAR!!!!!! Almost three times what the aveage American makes!! All specialties will be welcome to apply at Mr. Hat Clinics, but I would especially encourage those of you who end up in derms, rads, and optho to consider applying.

Further, Mr. Hat Clinics will encourage all physicians to practice "community medicine" (outside of clinic hours of course) with each patient and their families so that you can positively affect every area of their lives.

So, altruistic premeds - if this sounds just what you're looking for - please PM me when you finish residency. A Mr. Hat Clinic job is waiting with your name on it!!

No one said anything like that in this topic. Most of the physicians who work after residency don't work 80 hours, sure some work as much and some surgeons work in the 100 hour week range but the majority of those physicians make 250k+. The reason why this topic is so damn long is because of the argument that is 120k a good amount of money. Hell, some peds make 350k in a few years

I also think that you should run some animal clinics which employ new Vets that work 50h for about 25k-40k(HINT: to be competative start them out at 40k). You won't get the 80 hour docs but will have people who had 8 years of schooling and are in debt up to 100k. That way you will have both animals and humans covered!!!

It isn't rich but it is a good amount of money

the guys at Taco bell do have an easier life than doctors. Let's say they mess up an order, the customer would complain, and the order would be replaced, no biggie. Physicians, on the other hand, may face catastrophic consequences for messing up. A decade worth of schooling, license, assets, etc. down the drain for a single mistake.

When their shift ends, they go home and can forget about whatever happened at work. There's no such thing as a "taco" emergency. In medicine, you're never out of the loop. You're haunted day and night.

No one is forced into medicine. But they don't have to take all sorts of **** up the a$$ for choosing medicine, regardless of whether they are aware of it or not.

If a customer complains hard enough the employee gets fired and he might have to move out of town to find another job to work at Taco Bell. Heck if he messes up bad enough he might be banned from ever working at a Taco Bell anywhere in America (Tony you crazy SOB).Then there comes the stress of being burned and having your coworkers and mangers yell at you for their mistakes. No such thing as a taco emergency?!!?! LOL!!!! You never had to make 100 soft tacos for a Church program that had already been payed for and had to be made fresh and at a certain time while your coworkers decide to walk out and you are left with your manager and waiting customers yelling at you. Also you have to deal with the threat of getting burned from the iron and having to go to the hospital to pay a $400 on your $6 hour job. You will also have to get a second job because they hate people working near or above 40 hours so expect to work 35 hours a week. PM me though I give you an awesome reference me and the district manager are best buds.

 

[deleted128562]

I also think that you should run some animal clinics which employ new Vets that work 50h for about 25k-40k(HINT: to be competative start them out at 40k). You won't get the 80 hour docs but will have people who had 8 years of schooling and are in debt up to 100k. That way you will have both animals and humans covered!!!

Hey, that's not a bad idea! To make it even more exciting, perhaps the vets could be further employed when certain folks who have no business reproducing (abusive crackheads, etc) come into the clinic.

"Mr. Smith, this is Dr. Davis, one of the vets here at our clinic. He'll be neutering you today. Also, we're running a speical, and if you'd like we can spay your wife for just half price. Offer valid today only."

 

[SunshineNYC]

It's really all about the choices you make and one's priorities. Pre-meds tend to be perfectionists and type-A personalities, wanting to control everything, especially their own destiny, so make a decision instead of complaining. Sure, the medical field has never been worse off in terms of lawsuits, regulations, insurance companies and so forth, however, hopefully many people go into medicine because it is what they desire to do, not just because of the money. I think that getting up and going to a job you love is priceless. Similarly, one can measure wealth in job security, doing what they enjoy, as well as financial freedom or even enjoying financial excesses. Whatever is most important to you in life, pursue it. Someone close to me dreamed of being rich and after being a dentist and realizing that he'd never be as wealthy as he'd hoped, he switched into the computer industry and achieved his goal. Other people have different goals, like to raise good kids (and so they sacrifice long hours and wealth in order to spend more time with their children, maybe they get a job teaching). Whatever... so, I suppose, if your primary goal in life is to be wealthy and live a rich lifestyle, then maybe think about a field other than medicine (go work 16-hour days at Goldman-Sachs), however, if you're main goal in life is to use your abilities to help sick people become well, then medicine is right for you.

Take some time to examine why you want to practice medicine, and if the main reason is because of the profession it used to be and the salary that used to come with it, then maybe reconsider. Personally, I was on a path that would lead to wealth in business, but sitting at a desk made me feel dead inside. I gave up a well-paying business job to work in an ER for a little above minimum wage. I had never been happier. And granted when I have a family, I won't want a minimum-wage salary, but I think I could "make due" on $120,000... and of course get to do what I really love. Sounds like a good deal to me. Though, I must admit, if I could be paid more to do what I loved, I wouldn't complain about that either. So, if you don't like how it is now, try to change it, and if you don't want to put in that effort, instead of complaining, get out of medicine and do something that fulfills your personal goals.

 

[Dimness]

If a customer complains hard enough the employee gets fired and he might have to move out of town to find another job to work at Taco Bell. Heck if he messes up bad enough he might be banned from ever working at a Taco Bell anywhere in America (Tony you crazy SOB).Then there comes the stress of being burned and having your coworkers and mangers yell at you for their mistakes. No such thing as a taco emergency?!!?! LOL!!!! You never had to make 100 soft tacos for a Church program that had already been payed for and had to be made fresh and at a certain time while your coworkers decide to walk out and you are left with your manager and waiting customers yelling at you. Also you have to deal with the threat of getting burned from the iron and having to go to the hospital to pay a $400 on your $6 hour job. You will also have to get a second job because they hate people working near or above 40 hours so expect to work 35 hours a week. PM me though I give you an awesome reference me and the district manager are best buds.

Yeah about that. I'm pretty sure that same person didn't spend a decade of their life learning how to make a taco either.

 

[Brigade4Radiant]

Yeah about that. I'm pretty sure that same person didn't spend a decade of their life learning how to make a taco either.

Yeah I'm also pretty sure that the person making the taco doesn't make 120k a year after 10 years. I'm pretty sure they live in poverty for 10 years with no light at the end of the tunnel. They also get no benifits or insurance of any kind.

 

[Dimness]

Yeah I'm also pretty sure that the person making the taco doesn't make 120k a year after 10 years. I'm pretty sure they live in poverty for 10 years with no light at the end of the tunnel. They also get no benifits or insurance of any kind.

This can go back and forth for eternity. But there's a weekend to enjoy out there. I'll be back later for this. This talk of tacos is making me hungry.

 

[xylem29]

Ha - yea, I've read enough postings, articles, and blogs - and even my mentor who seemed very happy with his job, finally said something that revealed his own resentment, "I wouldn't go to the US for med school, being over $320K in debt is not worth it, and being a doctor won't help you pay it back because doctors don't make that much money, dentists do, but doctors don't" LOL - anyway, yea, we're all premeds who haven't been there done that yet, so I totally take your word for it, because you can never really know what something is like until you are actually there. He's happy because he doesn't just practice medicine, he owns his own case management company and engages in a lot of business projects within healthcare....

I think that most people really go into it with some superficial ideas though, about what it will be like when you are a doctor and the kind of life you will get to live. I think that once people get there and they realize that the money, prestige, respect, and status were all illusions, they get bitter. I think a fellow SDNer said it best when they felt that the reason so many physicians are so bitter and stressed out about their profession is because they all went into medicine in the first place because they wanted "get something" out of it for themselves, rather than wanting "to do something".

I'm pretty sure that the whole idea of altruism fades fast for most, because whenever I read about medicine - it's always about marketshare, turf wars, etc...like patients are just another customer that need your service. While I think there are definitely some who go into it for altruistic reasons, I'm perfectly fine with people who go into it for the prestige and money, etc - we all know that you do not get money and prestige without being damn good at what you do - and we need these people who are damn good at being the best in medicine.

Anyway, I'm not sure anymore if a traditonal track medical career is the right path for me - but I'm still going for an MD b/c it's still a door opener to other careers. I don't think it's right because I have a family doctor and I sometimes think of some of the patients - how does he deal with these idiots everday? Been to the ER a few times, jesus - the crackhead scum that come in and start ****-disturbing....I would never be able to take it. Some of these people don't want to be helped, and in addition to not wanting help they'll make trouble for you....

Even I've been an arrogant patient once - I went to see my family doc complaining of some GI problems and he told it was just due to stress and there was nothing wrong, but I kept insisting I had "this or that" and he should take some stool samples...guess what, the guy refers me to a GI to get scoped..getting scoped is not fun..I learned my lesson. Point is, he knew I had no problems, knew I didn't need to get scoped, but he got me one to teach me a lesson...pretty fcked up if you are supposed to an altruistic savior of humankind if you ask me. I still like him though, b/c he's a realistic type of doc who doesn't do everything by the book, such as giving me free samples of drugs (i mean just creams and over the counter stuff) if he has them instead of making me pay for them or prescribing drugs if I ask (just antibiotics which are only done 2-3 times a year, obviously if it was anything major like for chronic conditions he wouldn't do it) under "bobby" (who is close to me) instead of "me" b/c bob is covered by an insurance plan..doesn't charge me for sick notes or TB tests etc. Just know that a lot of people (like me and everyone I know) will sometimes ask you to bend the rules a bit - and if you don't, then that's the doc's loss in patients, which is a loss in earnings, which is not good for your business. Which I'm learning more and more what medicine is, it's just another business and patients are just consumers of our service....I'm not a doctor yet nor am I even in med school...I already have this cynical view! I guess once I get there it can only go the other direction though! Ha. Maybe people should go into medicine with cynical expectations so it won't be so bad once they get there....

Point is, I think the helping people reason is weak reason for most people, and that's why so many physicians are bitter. They are already physicians, they are already helping people and getting paid pretty nicely - but this is still not good enough, because they are not living the lives they thought they would be living before they got into medicine. Very telling of our true motivations huh?

There are so many other careers that will allow you to help people in more significant and intimate ways if this is all you want to do. Of course, if you want to help people with respect to their health, this is a pretty good job choice. Being an RN is a pretty damn good choice too. All praises to the ones who go into medicine with a fierce passion for helping people though, the ones who go into rural locations, the ones who will spend a lot of their time in free clinics with the indigent, the ones who go abroad to the third world - I'm not knocking you guys. You guys kick butt.

 

[Nasrudin]

[YOUTUBE]http://www.youtube.com/watch?v=1_E21CvWU5o[/YOUTUBE]

 

[IWant2BeADoctor]

I'm absolutely positive. I'm going to specialize in something high paying. Hopefully I'll get into Radiology. 400k-500k isn't bad. I don't plan to stay in Medicine forever anways. Once I earn enough money I do something else.

 

[Cirrus83]

Your bills and utilities are extremely low for manhattan suburbs, and if one spouse is working in the ciy you either need a second car or a monthly commuter pass on the LIRR, so that's another decent expense. And gasoline. And you are assuming nothing every breaks, the kids are never growing out of clothes, no orthodontia, no private schools, no vacations, no eating out, no lawncare/home maintenance, etc.
So as I suggested, comfortable (bordering on modest) but not rich. Which is fine, but don't plan on having money to burn.

Actually his car insurance is overestimated, and I say this as a NYC suburb driver with a pretty lousy accident record (mostly not my fault but driving in NYC means you end up in quite a few) and a car that's not small (or that old).

His housing payment may be somewhat underestimated, however the prices for housing do appear to be coming down from their insane bubble prices so hopefully it'll be affordable by the time we buy houses.

Also, not everyone lives in Long Island, and a monthly MetroCard is only $76 so you might not need a 2nd car (my family has 2 cars but that's only because one is mine which we got after I went to college).

BTW, the schools in Long Island happen to be quite excellent so I don't even think private schools are neccessary, and while the schools in NYC are somewhat less excellent there are still some great schools and there's lots of options for more intelligent kids ranging from more advanced classes to magnet schools. These options do vary by school (the advanced classes I mean, some schools have classes where every kid is basically 2 years ahead along with classes where every kid is basically 1 year ahead, whereas some schools only have the 1 year ahead classes, etc.). And I remember a lot of the kids in my high school went to Mark Twain when they were younger (that would be IS 239 "for the gifted and talented" in Brooklyn) where all the kids were smart. I feel kinda jipped since we didn't have anything quite that advanced in Queens
And of course in NYC there's plenty of great high schools, Townsend Harris, Midwood, Hunter (also junior high school), Stuyvesant, Bronx Science, Brooklyn Technical, and all those new mini schools they're implementing.

Point is, the public school system in NYC actually has plenty of options to help intelligent kids succeed. It's not nearly as nice if your kid isn't smart enough to get into a school with plenty of resources and funding though, since most regular public high schools are basically ancient and have lousy teachers who don't know what they're talking about. Seriously, I once had a heck of an argument with a teacher who simply refused to believe that Jaguar was owned by Ford...and he told me I'd be doomed in high school if I didn't learn to take notes, except the only reason I didn't take notes in his class was because it was ridiculously easy-I was only placed in the class to make it possible for me to take a more advanced science class since the vice principal had decided that I ought to be in the 2 years ahead classes, except since I had long been stuck in the 1 year ahead classes I hadn't already taken the required math class that would let me be 2 years ahead (stupid state rules...I knew all that math anyway). Point is, they ended up putting me in the more advanced science class but kept me with my existing math class, and the only way they could get my schedule to work was to have me be in the regular history class. Point is, the guy never wrote any notes even vaguely worth taking on the board, which was the only reason why I never took notes in his class. Anyways, the NYC public school system is indeed awful when it comes to regular non-advanced classes, but thankfully they provide decent options for the brighter kids (although I will say that no public elementary school, no matter how advanced, compares to the crazy stuff I've seen at hardcore private elementary schools...but I don't think it's really right to have 9 year olds writing 2 papers a night either).

Uh...I guess I'm a little touchy about the whole public school private school thing Us public school kids aren't really all that numerous when you go to a private college, and the private school kids don't always realize that there's actually good public schools lol.

 

[Cirrus83]

He's happy because he doesn't just practice medicine, he owns his own case management company and engages in a lot of business projects within healthcare....

I think that most people really go into it with some superficial ideas though, about what it will be like when you are a doctor and the kind of life you will get to live. I think that once people get there and they realize that the money, prestige, respect, and status were all illusions, they get bitter

Heh, you mentioned something that kind of explains something that I think a lot of pre-meds don't get. How much money you make as a doctor is actually largely just a question of how good a businessman you are. Even if you don't start your own practice, if you choose to join a private practice group there's a lot of different factors you have to consider, and your business abilities (how long till you make partner, how much you make before then, etc.) can make a big difference in how much you make. And if you have your own practice it's kind of up to you to get the higher paying referrals (if you're a specialist) or higher paying primary care patients.

Of course, at a certain point you might have to draw the line where you can't just be a businessman (for example, charging a retainer is very profitable but most primary care doctors seem to be against it since it kind of goes against the spirit of things). I mean heck, if you're really a great businessman you could be a regular Internal Medicine doctor who just does primary care but still rake in a TON of money just because you charge a $10,000 retainer. Of course you'd have to actually convince people to pay you a $10,000 retainer, but a shrewd businessman wouldn't have trouble figuring out how to target the wealthy old people a retainer doc would be attractive to.

Point is, making a lot of money as a doctor is often about owning and running something that might be related, or simply being really good at growing your private practice. But I get the feeling that there are premeds who think that just because you go to school for these extra # of years you'll get X amount of income when you get out.

 

[Law2Doc]

Of course, at a certain point you might have to draw the line where you can't just be a businessman (for example, charging a retainer is very profitable but most primary care doctors seem to be against it since it kind of goes against the spirit of things). I mean heck, if you're really a great businessman you could be a regular Internal Medicine doctor who just does primary care but still rake in a TON of money just because you charge a $10,000 retainer. Of course you'd have to actually convince people to pay you a $10,000 retainer, but a shrewd businessman wouldn't have trouble figuring out how to target the wealthy old people a retainer doc would be attractive to.

Most docs don't do this because they are better businessmen and realize that the high volume business you get through insurance and medicare is frequently more lucrative than you can get doing various cash conceirge retainer practice things. A few people have done quite well with conceirge businesses, but as I have said before it only works if only a few people in a locale are doing it because the number of people willing to go outside of their insurance is quite small and as a physician you cannot both take insurance and cash patients under the terms of most insurance programs. There have been instances where practices have gone bankrupt in some locations where too many people tried to run cash businesses and the market simply wasn't there. Also bear in mind that if it's actually a "retainer", you don't get to spend the retainer money until you earn it, and have to hold it in a segregated account until you do, so a retainer is not probably what you are really talking about. You probably mean a fixed annual fee for services. And this only works if you don't end up with patients who show up with every little ache and pain, which is going to be the case more and more as the population gets older and out of the workforce (so "wealthy old people" probably is exactly the target you want least; young healthy people are where you can make bank). So shrewd business is pretty meaningless in the days of insurance company dominated medicine. People give it lipservice, but to a large extent, other than in a few niches (particularly cosmetic surgery not covered by insurance), those days have come and gone.

 

[midn]

And yet...

Uh oh.

Somebody called down the Panda.

Now this gets serious.

 

[Cirrus83]

Most docs don't do this because they are better businessmen and realize that the high volume business you get through insurance and medicare is frequently more lucrative than you can get doing various cash conceirge retainer practice things. A few people have done quite well with conceirge businesses, but as I have said before it only works if only a few people in a locale are doing it because the number of people willing to go outside of their insurance is quite small and as a physician you cannot both take insurance and cash patients under the terms of most insurance programs. There have been instances where practices have gone bankrupt in some locations where too many people tried to run cash businesses and the market simply wasn't there. Also bear in mind that if it's actually a "retainer", you don't get to spend the retainer money until you earn it, and have to hold it in a segregated account until you do, so a retainer is not probably what you are really talking about. You probably mean a fixed annual fee for services. And this only works if you don't end up with patients who show up with every little ache and pain, which is going to be the case more and more as the population gets older and out of the workforce (so "wealthy old people" probably is exactly the target you want least; young healthy people are where you can make bank). So shrewd business is pretty meaningless in the days of insurance company dominated medicine. People give it lipservice, but to a large extent, other than in a few niches (particularly cosmetic surgery not covered by insurance), those days have come and gone.

Well I think people just call it a retainer but depending on the contract it's sometimes a fee for service (some contracts make it so that the retainer fee pays for all the primary care exams and whatnot, but some places just charge the fee for being their doctor and then still bill insurance).
BTW I'm pretty sure no matter how much volume you run it's pretty hard to compete financially against a practice like MD^2 where the retainer runs $13500 a patient and each doctor sees 50 patients...

Also, usually it's only the really expensive fee docs that'll bundle all the primary care, so you don't have to worry too much about the older population eating into your profits since the fees are so exorbitant, and even the cheaper retainer practices often run sliding scales where older people pay higher fees since they come more often.

But yes there's a lot of complications as far as insurance rules and also state laws go (some docs have gotten in trouble since you can argue that the retainer is basically insurance and you can't just up and sell people insurance, so it's probably legally less troublesome if you DON'T include your services in your fee and make the fee simply a fee to be their PCP).

I think it's doable to charge a small fee though...people who pay for their own health insurance might very well be willing to pay 20% more to avoid the waits (and seriously, $1000 a year isn't even that much in the grand scheme of things, gym memberships cost that much in NYC, lol) and you can still take a good # of patients without having them all show up at once (partnering up with another doc or two would help deal with the variance though, plus vacations wouldn't be a problem). Of course people will think you're the devil lol.

I found it pretty hilarious when I was reading an article that MD2 (the "original" retainer/concierge practice) refuses to do any sort of billing, so anything they don't cover the patients are supposed to file with their insurance companies themselves. I guess their patients are wealthy enough that they don't have trouble paying anyways, but the idea of making your patients do all your billing work seemed pretty hilarious. Man, if regular docs did that it'd be really funny =p

 

[Law2Doc]

but some places just charge the fee for being their doctor and then still bill insurance

I'm pretty sure this is illegal. Same with the last paragraph of your post. If a doctor requires the patient to pay cash, he cannot also accept insurance, so it becomes the patient's problem. The conceirge docs don't bill the insurance companies because they can't. Which is why most docs don't do conceirge because the volume of business of insured patients is better.

 

[Nasrudin]

And yet, when those of you who swear that you'd be happy making 120,000 bucks a year get down to it, you're going to run, not walk, away from primary care where you can make even less than that without too much effort.

You can be happy with 120K now because at this point in your lives it may as well be 1.2 million for all the good it's doing you.

As for your wife demanding a mansion, seriously, my long-suffering and incredibly understanding wife has not subjected herself to poverty, three moves in the last six years, and the gnawing uncertainty of the whole adventure to live in a double-wide trailer out behind the jiffy mart. Scoff if you want but an honest woman wants a nice house, a safe neighborhood for her kids, and the ability to not have to worry about money too much.

It's ridiculously easy to take the high road against materialism when your're dating some pretentious poetry major who works at Starbucks but marry a woman who expects some upward mobility, have a few kids, get a few adult responsibilities and you will sing a different tune.

Jeez. Grow a friggin' backbone already. If you don't value your skills how do you expect others to react? I guess that's sort of the point. Most of you have no idea what's involved and therefore feel this residual guilt that you'll make more than the nice fellows assembling my Chalupas. Trust me, you're going to work a lot harder than those guys and their lives are going to be easier than yours.

Wait. I've think I've seen this one before. It goes like this.....Wiseguy premed or otherwise takes the position that medicine is horrible. Cut to the advance of a legion of idealistic premeds. And culminating in the waking of the grouchy old dragon on the mountain whose bombastic angry tomes spare no one, not the ex-girlfriend at starbucks, not the chalupa man, and certainly not the young premed whose combination of naivete' and idolatry you obviously crave. See you at the next show.

 

[Institute]

All I have to say is 'risk' and 'malpractice'. These are the biggest factors contributing to the gripes of physicians not earning enough. Solo practictioners could easily consume 120k if they practice solo just on malpractice.

And of course, all it really takes is one successful lawsuit against you to vitiate your practice.

To add, you also have medications that you have to buy (which are excruciatingly expensive) for treatments, a staff to pay, and of course the insurance companies who are typically giving their payouts far beyond their payout dates.

You also better believe that services I provide are 'elite' services and not something the common laymen can do, therefore one should be ready to pay a lot for my services especially since the risk is so high.

 

[Law2Doc]

And of course, all it really takes is one successful lawsuit against you to vitiate your practice.

Not usually -- that's the whole point of insurance. Many doctors will get sued multiple times in their careers; it doesn't end their practice. Mistakes and bad consequences happen -- It's part of the business of medicine.

 

[Institute]

Not usually -- that's the whole point of insurance. Many doctors will get sued multiple times in their careers; it doesn't end their practice. Mistakes and bad consequences happen -- It's part of the business of medicine.

for solo practice? I could understand that with group practice. Then again, I suppose it depends on the degree of the lawsuit.

 

[kito]

Any insurance company executive worried he/she isn't going to be able to post record profits next year should visit the pre-allo forum. The white coat isn't the only similarity between doctors and sheep.

Amen to that.

 

[kito]

http://www.newyorker.com/archive/2005/04/04/050404fa_fact

 

[Dimness]

Not usually -- that's the whole point of insurance. Many doctors will get sued multiple times in their careers; it doesn't end their practice. Mistakes and bad consequences happen -- It's part of the business of medicine.

I don't know. A lot of practices have ended because insurance premiums skyrocket after a lawsuit. That's what sucks about the whole deal. You can win a case in court, but your premiums still go up.

 

[YupGypsy]

If a customer complains hard enough the employee gets fired and he might have to move out of town to find another job to work at Taco Bell. Heck if he messes up bad enough he might be banned from ever working at a Taco Bell anywhere in America (Tony you crazy SOB).Then there comes the stress of being burned and having your coworkers and mangers yell at you for their mistakes. No such thing as a taco emergency?!!?! LOL!!!! You never had to make 100 soft tacos for a Church program that had already been payed for and had to be made fresh and at a certain time while your coworkers decide to walk out and you are left with your manager and waiting customers yelling at you. Also you have to deal with the threat of getting burned from the iron and having to go to the hospital to pay a $400 on your $6 hour job. You will also have to get a second job because they hate people working near or above 40 hours so expect to work 35 hours a week. PM me though I give you an awesome reference me and the district manager are best buds.

The imbecility in your argument speaks quite well for itself.

Thank you for saving me a counter-argument.

 

[Brigade4Radiant]

The imbecility in your argument speaks quite well for itself.

Thank you for saving me a counter-argument.

Wow, you completly missed the point. And if you don't have an argument to my post then why bother quoting it? Please leave this topic and never come back.

 

[Brown429]

why are you guys comparing someone that makes 19-24k a year with perhaps a GED/High school diploma to a physician???

120k is not much at all because you go through "hell" in med school and residency sacrificing so much of your time and youth for a career, while John Smith who graduated with an MBA in 5 years is making 120K (from a top-tier school) STARTING.

I hope I make at least 250K+ after 3 years and not work over 50 hours...but thats me and what I want. For so much time and sacrifice I expect to make that. Yes...medicine will make me happy...but working less than 50hrs a week and making 250k+ will make me even happier. Even @ 250k a year is not enough to be "rich" after taxes and...the kids private school, the dream home, cars, wife, ect ect...but you could always live an average life and just be well off...but you only live once....