Best place to practice interventional pain

IPSIS: Formerly the Spine Intervention Society
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I'm still in residency but very concerned about the future of our great nation. It seems that my most productive years will be spent working hard (something I want to do) and paying high taxes to fund medicare/social security/pensions (several things I DON'T want to do) and on top of it being paid very little to do so... :mad:

To top it all off the dollar is dying and the country is propped up on debt and I don't have a good feeling about the economic future.

Does anyone have any leads as to what countries meet all my criteria:
1) need pain doctors
2) value healthcare
3) won't tax me to death
4) will pay a decent amount
5) will provide me with a feeling of satisfaction that what I do is valued and will eventually pay off my student loans and allow me to have a nice retirement.

I know some of you out there have thought about this in detail...
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Someone posted the average salaries of doctors in other countries and it wasn't pretty. Americans are by far the best paid doctors anywhere. If you practice overseas, in addition to their own socialist trends, you'd have to deal with protectionist working/immigration policies. Of the international options, probably the best paid would be something like an assignment in Saudi Arabia or UAE. As alarming the healthcare debate and trends are in this country, it's still better than anything else out there as far as I can tell.

Keep in mind also, that even if you live in Thailand, you are still required to pay US income taxes for the privilege of being an American citizen. Not sure how the IRS would find out but if they do, it's tax fraud.
 
hyperalgesia said:
Someone posted the average salaries of doctors in other countries and it wasn't pretty. Americans are by far the best paid doctors anywhere. If you practice overseas, in addition to their own socialist trends, you'd have to deal with protectionist working/immigration policies. Of the international options, probably the best paid would be something like an assignment in Saudi Arabia or UAE. As alarming the healthcare debate and trends are in this country, it's still better than anything else out there as far as I can tell.

Keep in mind also, that even if you live in Thailand, you are still required to pay US income taxes for the privilege of being an American citizen. Not sure how the IRS would find out but if they do, it's tax fraud.
Click to expand...

See foreign earned income exclusion: $92k for 2011.
http://www.irs.gov/businesses/small/international/article/0,,id=97130,00.html
 
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I'm with Hyperalgesia. Although, the trend towards socialism (which we need to fight as much as possible) is somewhat depressing and discouraging, America is still the best place to live and practice medicine. Taxes are still comparatively low and income still fairly high, compared to other countries. Most other countries are either socialist (and tax their doctors to death) or dirt poor (and don't have the money to pay their doctors). That being said, we don't have to allow our country (and our profession) to be destroyed any more than they already have been. We just need to stand up for ourselves. Historically, doctors have obediently walked like sheep to the slaughter. It doesn't have to be this way. We don't need to leave the country, we need to fight for our rights. We deserve every penny we earn. We also need to demand tort reform, a real "no-fault" system where we are not powerless chum for the blood thirsty medical malpractice lawyers.
 
SpineBound said:
Does anyone have any leads as to what countries meet all my criteria:
1) need pain doctors
2) value healthcare
3) won't tax me to death
4) will pay a decent amount
5) will provide me with a feeling of satisfaction that what I do is valued and will eventually pay off my student loans and allow me to have a nice retirement.

I know some of you out there have thought about this in detail...
Click to expand...

Atlantis?

Xanadu?

Take solice in knowing your patients who pay for your services will value you and your time.
 
Saudi Arabia or UAE pay very well. Saudi Arabia or UAE actively recruit from the Harvard hospitals. Of course if something goes wrong, you will wish for the kindness of our courts for malpractice. I have heard of physicians that had their hands cut off. Of course if you are a woman, or want to bring one with you, those countries are probably out as well.
 
ok thanks. I feel slightly better now, less like dropping out :bang:

UAE: out because I like my hands and my woman

Xanadu: out because you have to pay to go there, although it would be nice... http://www.xanaduresort-belize.com/

Fight for USA: great idea, but immensely difficult although worth it if successful.
 
move to Monaco, figure out how to become a Monaco Citizen, pay no taxes and have a cash-based practice.

move to Bahamas, figure out how to become a Citizen, pay no income tax and have a cash based practice.

i'd personally choose Monaco...
 
I'd say stay in the US. If you're looking for best places in the US, I'd say the best states to practice in are TX, IN, OK, and NE. In the midwest you are gonna find the best compensation, lowest medmal premiums and lowest cost of living. Then again you're gonna have the worst weather and scenery.....
 
mid|ine said:
Saudi Arabia or UAE pay very well. Saudi Arabia or UAE actively recruit from the Harvard hospitals. Of course if something goes wrong, you will wish for the kindness of our courts for malpractice. I have heard of physicians that had their hands cut off. Of course if you are a woman, or want to bring one with you, those countries are probably out as well.
Click to expand...


why bring one with you when you can find five "barely" legal wives over there? and we wonder why this religion is so popular.
 
SSdoc33 said:
why bring one with you when you can find five "barely" legal wives over there? and we wonder why this religion is so popular.
Click to expand...

One wife is bad enough, who would want 5? :eek:
 
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SSdoc33 said:
well played.
Click to expand...

SEVENTY-TWO VIRGINS
by STEVE MARTIN
The New Yorker
Issue of 2007-01-29
Posted 2007-01-22

Virgin No. 1: Yuck.

Virgin No. 2: Ick.

Virgin No. 3: Ew.

Virgin No. 4: Ow.

Virgin No. 5: Do you like cats? I have fourteen!

Virgin No. 6: I’m Becky. I’ll be legal in two years.

Virgin No. 7: Here, I’ll just pull down your zipper. Oh, sorry!

Virgin No. 8: Can we cuddle first?

Virgin No. 9: It was a garlic-and-onion pizza. Why?

Virgin No. 10: . . . so I see Heath, and he goes, “Like, what are you doing here?,” and I go, “I’m hangin’ out,” so he goes, “Like, what?” . . .

Virgin No. 11: First you’re going to have to show me an up-to-date health certificate.

Virgin No. 12: Hurry! My parents are due home!

Virgin No. 13: Do you want the regular or the special?

Virgin No. 14: I’m eighty-four. So what?

Virgin No. 15: Yes! Yes! Yes! Yes! Yes! Yes! Yes! Yes! Yes! Yes! Yes! Yes! Yes! Yes! Yes! Yes!

Virgin No. 16: Even I know that’s tiny.

Virgin No. 17: “Do it”? Meaning what?

Virgin No. 18: I’m saving myself for Jesus.

Virgin No. 19: Somewhere on my body I have hidden a buffalo nickel.

Virgin No. 20: Don’t touch my hair!

Virgin No. 21: I hope you’re not going to sleep with me and then go sleep with seventy-one others.

Virgin No. 22: Do you mind if we listen to Mannheim Steamroller?

Virgin No. 23: Are you O.K. with the dog on the bed?

Virgin No. 24: Would you mind saying, “Could I see you in my office, Miss Witherspoon?”?

Virgin No. 25: Ride me! Ride me, Lucky Buck!

Virgin No. 26: You like your vanilla hot?

Virgin No. 27: Does Ookums like Snookums?

Virgin No. 28: It’s so romantic here, dead.

Virgin No. 29: Well, I’m a virgin, but my hand isn’t.

Virgin No. 30: You are in?

Virgin No. 31: Hi, cowboy. I just rode down from Brokeback Mountain.

Virgin No. 32: I’m a virgin because I’m so ugly.

Virgin No. 33: You like-ee?

Virgin No. 34: I’ll betcha you can’t get an erection. Go on, impress me. C’mon, show me. Show me, big shot.

Virgin No. 35: By the way, here in Heaven “virgin” has a slightly different meaning. It means “chatty.”

Virgin No. 36: Sure, I like you, but as a friend.

Virgin No. 37: No kissing. I save that for my boyfriend.

Virgin No. 38: I’m Zania, from the planet Xeron. My vagina is on my foot.

Virgin No. 39: It’s a lesion, and, no, I don’t know what kind.

Virgin No. 40: I’m Jewish. Why do you ask?

Virgin No. 41: Hi, I’m Becky. Oh, whoops—you again.

Virgin No. 42: I just love camping! Camping is so great! Can we go camping sometime?

Virgin No. 43: In the spirit of full disclosure, I’m a single mom.

Virgin No. 44: You like my breasts? They were my graduation gift.

Virgin No. 45: When you’re done, you should really check out how cool this ceiling is.

Virgin No. 46: I’m almost there. Just another couple of hours.

Virgin No. 47: Get your own beer, you nitwit.

Virgin No. 48: No, you’ve got it wrong. We’re in the Paradise Casino.

Virgin No. 49: I really enjoyed that. Thank you very much. Gee, it’s late.

Virgin No. 50: You make me feel like a real woman. And after this is over I’m going to find one.

Virgin No. 51: What do you mean, “move a little”?

Virgin No. 52: Not now, I’m on my BlackBerry.

Virgin No. 53: I love it when you put on your pants and leave.

Virgin No. 54: We’ve been together twenty-four hours now, and, you know, sometimes it’s O.K. to say something mildly humorous.

Virgin No. 55: That was terrible. I should have listened to the other virgins.

Virgin No. 56: I think I found it. Is that it? Oh. Is this it? Oh, this must be it. No?

Virgin No. 57: It must be hot in here, because I know it’s not me.

Virgin No. 58: Those are my testicles.

Virgin No. 59: Did you know that “virgin” is an anagram of Irving?

Virgin No. 60: First “Spamalot,” then sex.

Virgin No. 61: Great! I was hoping for circumcised.

Virgin No. 62: Was that it?

Virgin No. 63: Dang. George Clooney was being reckless on a motorcycle, but instead I got you.

Virgin No. 64: Tonight, I become a woman. But until then you can call me Bob.

Virgin No. 65: They’re called “adult diapers.” Why?

Virgin No. 66: We could do it here for free, or on a stage in Düsseldorf for money.

Virgin No. 67: I’m just Virgin No. 67 to you, right?

Virgin No. 68: Pee-yoo. Are you wearing Aramis?

Virgin No. 69: Condom, please.

Virgin No. 70: My name is Mother Teresa.

Virgin No. 71: I’m not very good at this, but let’s start with the Reverse Lotus Blossom.

Virgin No. 72: It was paradise, until you showed up.
 
Just for the sake of being adversarial, what in the world are you guys talking about? Starting salary out of fellowship for me is just about at the top 1% of incomes in the US (according to income tax data) and probably top 99.9% in the world. What other investment vehicle gives such great returns?
 
Tenesma said:
move to Monaco, figure out how to become a Monaco Citizen, pay no taxes and have a cash-based practice.

move to Bahamas, figure out how to become a Citizen, pay no income tax and have a cash based practice.

i'd personally choose Monaco...
Click to expand...

Unfortunately, in order to be a resident your net worth has to be several million with about a million in cash to just leave in their bank.
 
Pain Applicant1 said:
Just for the sake of being adversarial, what in the world are you guys talking about? Starting salary out of fellowship for me is just about at the top 1% of incomes in the US (according to income tax data) and probably top 99.9% in the world. What other investment vehicle gives such great returns?
Click to expand...

Ok I'll take the bait. Do you have any idea what level of income one must generate to be in the top 1% of incomes in the US? It would surprise you and if you're making that out of fellowship then watch out b/c you're either going to be working 80 hr weeks or doing some shady grady billing....
 
You only need $250k/y gross to make the top 1.5%

You are certainly doing well in this income range, but not wealthy or rich. You still have to work to get by and save for retirement. You buy nicer things, live in a nicer home and send your kids to a nicer school. But your not part of the jet set, you don't have a yacht, and you can't just quite your job and do whatever you feel like.

Of course 10% of americans are on some form of welfare. If they would get an education and be responsible for themselves the average household income would go way up. Zeros bring down averages very quick.
 
I think the problem for the "working well-to-do" is that we are being lumped in with the mega-rich. I don't know where that line is. 1m, 10m, 100m, 1b... annual income??? Net-worth of >10m, 50m, 100m, 1b...?
 
10% on welfare??? not in my state... 23% are on food-stamps!!!
remember that the bottom 50% of taxpayers, pay no tax or receive tax credits... that 1% is subsidizing the rest of the country.
 
Tenesma said:
10% on welfare??? not in my state... 23% are on food-stamps!!!
remember that the bottom 50% of taxpayers, pay no tax or receive tax credits... that 1% is subsidizing the rest of the country.
Click to expand...


if there were a larger middle-class, the 1% wouldnt have to subsidize as much, and it would be a much better overall situation. you would still have those living off the welfare state, however. but, the exponential expansion of CEO/worker salary is a bit alarming, wouldnt you say?
 
Working class = people who have to work to survive.
Rich = people who don't

I find it so disconcerting when we are lumped in with the same group of people who have no working requirements. How can I be "megarich" when my net worth is below zero?! I feel like it's this competition where every "working class" person is trying to claw there way up and out. And all the income tax debates are just tools we use to try to one-up our working class brethren. No one is actually trying to take money from the "rich". I would much rather see a value added tax like the FairTax or something that doesn't just completely hammer people for earning money.
 
the expansion of CEO/Worker salary is completely market driven... there are not enough trained executives out there, hence the increasing salaries.

look at wall street banker salaries - we complain about them all the time, but the reality is that there are NOT enough smart kids going into banking industry ....

it is always about supply and demand ---

larger middle class? we have one of the largest middle classes (percentage wise).... the truth is that our middle class doesn't pay much of the bill... and even if they did pay more of the bill, and even if all the billionaires handed over their money to the govt, it still wouldn't fix our mess.... we need to spend less.
 
Tenesma said:
the expansion of CEO/Worker salary is completely market driven... there are not enough trained executives out there, hence the increasing salaries.

look at wall street banker salaries - we complain about them all the time, but the reality is that there are NOT enough smart kids going into banking industry ....

it is always about supply and demand ---

larger middle class? we have one of the largest middle classes (percentage wise).... the truth is that our middle class doesn't pay much of the bill... and even if they did pay more of the bill, and even if all the billionaires handed over their money to the govt, it still wouldn't fix our mess.... we need to spend less.
Click to expand...

you are going to have to justify that comment about too few smart kids were going into banking. i would think science / technology would be the place for them. you know, an industry that provides ideas, innovation, jobs, growth. our financial services sector is WAY overblown. an out of control casino that has the deck stacked in their favor. their bonuses come straight out of the middle class pockets. if thats what america has to offer, then we are really in for a sh$t sandwich.

and, btw, our % of middle class is lower than it has been in decades.
 
The middle class in America is shrinking. Eventually the professionals (doctors, lawyers, etc) will be the middle class. The ultra rich are a lucky bunch for sure, but also have to work very hard on the right projects (Trump, Gates, Spielberg, Madeoff, Buffett, etc) We work hard to do things that don't keep paying us to do them once. That is the real bottleneck between the middle class and the rich. That and taxes.



BTW I jokingly put Made-off in my list
 
in my mind, based on networth, doctors/lawyers are in the middle class (upper middle class).
 
mid|ine said:
Saudi Arabia or UAE pay very well. Saudi Arabia or UAE actively recruit from the Harvard hospitals. Of course if something goes wrong, you will wish for the kindness of our courts for malpractice. I have heard of physicians that had their hands cut off. Of course if you are a woman, or want to bring one with you, those countries are probably out as well.
Click to expand...

Midline,
I also remember at Harvard seeing a few physicians being recruited to work at Saudi hospitals. I know at least one Harvard orthopedist who was paid 3 million per to work in Saudi Arabia for two years. 6 million in 2 years.

Do you have actual personal knowledge of a physician in Saudi’s Arabia having their hands cut off? And if so, were they all locals or this happened to a western trained physician?
 
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bedrock said:
Midline,
I also remember at Harvard seeing a few physicians being recruited to work at Saudi hospitals. I know at least one Harvard orthopedist who was paid 3 million per to work in Saudi Arabia for two years. 6 million in 2 years.

Do you have actual personal knowledge of a physician in Saudi’s Arabia having their hands cut off? And if so, were they all locals or this happened to a western trained physician?
Click to expand...
grew up in saudi, hand cutting off was rare as it is, but foreigners who commited crimes were deported. unless something like murder, however a neighbor of mine (american guy) ran his car oversomeone accidently and instead of being put in jail, he was deported. Things are probably better now as im talking about 80-early 2000s

My friends dad was a physician general surgeon from usa/canada and he was making $400K+ tax free.
western(and western trained) physicians are treated better; more on a pedestal. In the end its all about nationality.
 
Harvard orthopedist could probably make $2M in Amarillo if he had any work ethic.
 
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buddababa said:
grew up in saudi, hand cutting off was rare as it is, but foreigners who commited crimes were deported. unless something like murder, however a neighbor of mine (american guy) ran his car oversomeone accidently and instead of being put in jail, he was deported. Things are probably better now as im talking about 80-early 2000s

My friends dad was a physician general surgeon from usa/canada and he was making $400K+ tax free.
western(and western trained) physicians are treated better; more on a pedestal. In the end its all about nationality.
Click to expand...
If you're American, after the first 120k, you still gotta pay the IRS, no matter where you are.
 
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