Why Make 150k When 450k Is Out There?

[Spleen]

I am a 2nd year med student from a DO school and will come out with a substantial amount of debt. My debt haunts me and will affect my specialty choice.

I don't see why people keep striving to increase reimbursement (it is payment NOT reimbursement) with CMS rates. They are on the verge of bankruptcy and destroying our country financially. The government's influence on healthcare is also the nidus for physician dissatisfaction. Its end will be applauded. Medical waste will cease and primary care will be the specialty of choice.

In the mean time, within the field of primary care is the ability to shun medicare and/or insurance. Be your own change.

There is a shortage of primary care physicians. Health care can't continue without primary care. Where there is demand there is opportunity.

The solution is here http://www.simpd.org/

---

Members don't see this ad.

 

[AwesomO]

Redirecting the topic a bit - I wonder what our profession thinks about this article in the WSJ today:

http://online.wsj.com/article/SB120710036831882059.html?mod=hpp_us_inside_today

I never had issue with established nurses deciding they wanted a wider scope of practice and obtaining a NP degree or I guess in this case DNP. What I am concerned about are kids using this as a back door into medicine. The last thing we need are for all the rejected med school applicants or people who decide they don't want to go through the med school gauntlet taking up seats in nursing school with no intention what so ever of practicing nursing and just jumping from RN to DNP. Can you imagine the effect it would have on nursing numbers if thousands of premeds had a back door into medicine.

A simple solution is to have a required amount of time spent as a RN before one can go to DNP school. Ensuring people going this route are really committed to nursing.

As a side note the people who seemed to be most put off by DNPs are PAs.

 

[AwesomO]

I do worry that in the future, especially if radical changes are made to our health care system, that there is going to be a lot of pressure to use NPs and "doctor nurses" and PAs to do the primary care. In the future I can see more caps on lawsuits and pressure to find more affordable health care. I would imagine that this would provide a large incentive to have midlevels take on more of the burden of primary care. I just don't see any way around it, unless we can convince the government not to cut costs. But when has that ever worked in the past?

Mid levels are not really what should be worrying people. If anything it's that medicare is going to implode in the next 10 to 15 years. I'm sure the govts initial solution will be drastic cuts in reimburstment. However that initial wave will most likely hit all the high paying specialties first.

 

[Coastie]

Don't forget the "trickle-down" effect on specialties. Many specialists are already hiring mid-levels to offload some of their non-procedural workload, and we can expect that trend to continue as more routine care ends up in specialists' offices by default. Already-overburdened hospital emergency departments will get even busier, too. None of this will result in less expensive care...quite the opposite, actually. That's what people like Ms. Mundinger are counting on. Family physicians have other ideas, but it will take political backing and support to bring them to fruition.

Two specialty groups leaders quoted in that article: AAFP and ASA.

Family Practice and Anesthesiology are on the forefront. We should all really work together on this bit. Many other specialties don't get it, but we're getting it from both sides...

 

[Museless]

I'm probably going to regret taking the topic and poster seriously, but here goes...

I'm an FM resident. I'd be lying if I didn't say I worry sometimes about my loans. It's scary to see all those zeroes (I owe almost 300K, thanks private med school) and since I'm not paying off the interest right now, it just keeps going up. I'd rather not be in debt, but I already am. Maybe THAT was my 300k mistake.

Now that I'm in debt, I have two choices: do what I want to do, which is a little bit of everything (I got bored on specialty rotations because neurologists do neurology all day every day - ob does ob all day every day - peds does peds all day every day) or make a second mistake, and pick a career based on financial remuneration.

The debt problem will be corrected in time. $170k of my debt is fixed at 2.7%. The career problem would be with me until I retire. So I made the long-term decision, not the short-term one, based on what I want my life to be about instead of what I want right now.

I've never seen a U-Haul following a hearse, know what I'm sayin'? Money and "stuff" just don't impress me that much.

 

[andwhat]

I think that there has GOT to be some endpoint to what is going on. I mean why should the guy watching the surgery get paid more than the indivdual DOING the surgery and actually SAVING the patient's life?
I think that this is going to get fixed, and the increasing numbers of CRNAs certainly will help the situation out.

 

[Disciple]

Redirecting the topic a bit - I wonder what our profession thinks about this article in the WSJ today:

http://online.wsj.com/article/SB120710036831882059.html?mod=hpp_us_inside_today

Did I read this right?

The National Board of Medical Examiners (NBME) is helping to write the board exam for DNPs?

 

[Disciple]

Calculated risk for the AACN I suppose.

It would quite useful data for physicians should the first few rounds of test takers not fair well.

 

[andwhat]

this will fail miserably. I think that the Health Care Primary Care shortage issue will further deteriorate if this prevails.

This is truly a mockery of the M.D. profession. I feel sorry for the greatest victims of all out of this, the patient.
This is what it comes down to, the patient doesn't deserve this horribly inadequate health care.

The patient will be obtaining significantly lower than deserved health care, does somebody out there actually consider this a 'fix' of some sorts?

SHOW ME ONE SINGLE COUNTRY WHERE THIS HAPPENS.
You will not find one. It is unbelievably ridiculous, and further accentuates the sad status of the significant Primary Care shortage.
It is ridiculous.

A nurse is not a doctor. Goodness it is amazing and truly.

In essence, what is a Nurse Practitioner or Physician Assistant? Sounds like people are trying aggressively to exploit this loophole -- and let them assume physician responsibilities, earning significantly less pay --
HENCE less money to hand out to Physicians. Physicians are who they should actually be working harder to satisfy, instead of making absolutely insane "nurse doctors" FREAKIN RIDICULOUS

Thats what its all about right folks? Money.

 

[iatrosB]

I think that there has GOT to be some endpoint to what is going on. I mean why should the guy watching the surgery get paid more than the indivdual DOING the surgery and actually SAVING the patient's life?
I think that this is going to get fixed, and the increasing numbers of CRNAs certainly will help the situation out.

Easy now...without modern anesthesia, good surgical outcomes would not occur. The biggest revolution in surgery has actually been safer anesthesia!

And don't root for CRNA's...they are too close to our NP's and we need to stand united for patient care.

I'm usually in your corner because you're FM...but don't call out gas, they ARE very important.

 

[iatrosB]

this will fail miserably. I think that the Health Care Primary Care shortage issue will further deteriorate if this prevails.
This is truly a mockery of the M.D. profession. I feel sorry for the greatest victims of all out of this, the patient. This is what it comes down to, the patient.
The patient will be obtaining significantly lower than deserved health care, does somebody out there actually consider this a 'fix' of some sorts?
It is ridiculous.

We need studies to show this.

 

[herpmed]

Sophie: I greatly respect you, this forum and this discussion, but these comments were not accurate and are insulting to thousands of physician-scientists and biomedical researchers. In fact, virtually all of us pay our own way via research grants and clinical care. Most researchers must support 80-100% of their salary via direct grant or clinical dollars. An extremely small amount of medical school support may be used for start up funds or bridging funds, but this is tiny and is done to enhance the institution and as a "loss leader". In fact, via indirect grant support, biomedical research supports the institution financially, not the other way around. I bring in far more than 100% of my salary via grants and clinical dollars. A basic or transitional science researcher who loses their grant support is out of work or going to be doing other thinks quickly.

Finally, you should be aware that currently, only about 10% of investigator-initiated grants (R01s) are being funded. Although it is undoubtedly true that some grants are not going towards clinically useful (now or in the near future) research, the extreme competitiveness of the federal grant process does not support years of random research. The medications and care you provide now and in the future were developed based on the basic science and animal models you find distasteful. Regardless, that research funded itself (via grants), your tuition most certainly did not go up because it was being done at your medical school.

End of hijack, but I didn't want the thousands of readers of this thread to believe that their debt burden was caused by biomedical research or that if they went to a school with less research, they would pay less tuition because of it.

These comments do not require a proviso. This is all 100% correct. It is very unfortunate that successful grant proposal submission is rapidly becoming the purview of those only in politically (meant within the circles of the review committees) popular avenues of investigation. Many of those funded and renewed already hold a couple of active grants. Unfortunately, new approaches to old problems and previously little-explored avenues of investigation are unlikely to be funded at all.
The quote was a bit off the topic in the string, however, important comments nontheless.

 

[andwhat]

Easy now...without modern anesthesia, good surgical outcomes would not occur. The biggest revolution in surgery has actually been safer anesthesia!

And don't root for CRNA's...they are too close to our NP's and we need to stand united for patient care.

I'm usually in your corner because you're FM...but don't call out gas, they ARE very important.

no I agree with you, but it is crazy, otherwise pay surgeons more?? I do not know... but hey... its the way that it is, and thats that.
I think that Anesthesia is amazing, esp the ICU docs, that don't work in the OR. They all know their stuff, but ICU Anesthesiologists appear to be wicked smart?? some of the smartest docs that I have ever met. Unfortunately they do tend to talk too much at times, not a bad thing because I would prefer a doctor to be passionate about their field.
This field is not as popular as others in Anesthesia, ICU that is.
Similar to this Nurse Anesthetist issue, they are now adding this insanely unbelievable Dr. Nurse to try and further cut health care costs??? and further delay significant issues in primary care.
Man its desperation nowadays let me tell you. That is the most pathetic thing that I have ever read,
Dr. Nurse.

 

[AwesomO]

Similar to this Nurse Anesthetist issue, they are now adding this insanely unbelievable Dr. Nurse to try and further cut health care costs??? and further delay significant issues in primary care.
Man its desperation nowadays let me tell you. That is the most pathetic thing that I have ever read,
Dr. Nurse.

I'm pretty supportive of mid levels. I have no issue with them practicing within their scope which I view as assistants to physicians who can provide a lot of the leg work and at times work on their own patient panel with careful physician oversight (not unlike an residents in residency).

One thing I'm not a big fan of is calling them "Dr." in the medical setting. We all know that it's just a play on words for political reasons. ie I'm a board certified Dr!, Hi my names Dr. Posing as one.

Another is this strong push for too wide and independent scope of practice. I'm all about the team model but that involves working as a team and not having people trying to usurp the quarterback because they want to be in the spotlight. You don't see Plexico Burress trying to take over Eli Manning's position. Or if you did, what you would see is some poor quarterbacking, probably NFL Europe quality. I don't think thats what patients want.

 

[Leukocyte]

It is not all about the money. It is more about having "fun" and enjoying what you do. That is why there are still people entering demanding feilds like General Surgery and Neurosurgery.

If you enter medicine to be rich, then good luck. How many people on Forbes "World's Wealthiest" are physicians?

I am a FM resident who has has his heart in surgery. Athough it does not make lot of financial sence, I am planning on doing a second residency in surgery after finishing my FM residency. I just gotta do that I enjoy doing. If I have to wake-up at 4am for a patient, I do not want to manage his DKA, or intubate him, I WANT TO TAKE HIM TO THE OR, AND OPERATE ON HIM.

 

[persia]

This is an interesting thread. I am not sure why Jet decided to throw this molotov cocktail into the generally peaceful FM forum, but here it is.

I like FM, and I also like gas. If I could do everything, then I would. If I could do two things, then I would. But I can't. FM has its drawbacks, like pts who drone on and on when you ask them, 'any allergies?' But gas too, has drawbacks and as much as I loved my surgery rotations (I loved them!!), I did think that some of the anesthesiologists I saw were sort of - something.

It depressed me to watch them sleeping during surgery. Or doing sudoki puzzles (sp?), or reading People. Some were really superb clinicians, really excellent. But many I saw were sort of dull around the edges. A few community gasser's seemed really depressed. Is it boring doing 30 cateract pts a day? I would do anesthesia, except I wonder if I would also feel depressed and miss the stimulation of seeing patients and having to diagnose different stuff. Clinic isn't perfect, but it keeps your mind sharp with new pts, new diagnoses and pt interaction.

But it's a crazy system where an anesthesiologist gets 450K working half as hard as a FM doc, who is working like a dog. Damn crazy system. I don't know the answer. Maybe the FM docs should be getting the 450 and the anesthesiologists the 150K. Jet, what was the point of throwing this bomb in here?

 

[jetproppilot]

Jet, what was the point of throwing this bomb in here?

Read post # 57.

You also noted this was an "...interesting thread."

 

[sophiejane]

Most researchers must support 80-100% of their salary via direct grant or clinical dollars. An extremely small amount of medical school support may be used for start up funds or bridging funds, but this is tiny and is done to enhance the institution and as a "loss leader". In fact, via indirect grant support, biomedical research supports the institution financially, not the other way around. I bring in far more than 100% of my salary via grants and clinical dollars. A basic or transitional science researcher who loses their grant support is out of work or going to be doing other thinks quickly.

Point taken, my apologies. I was uninformed.

 

[NewmansOwn]

I think it's natural to feel threatened by mid-levels -- any profession is, at least nominally, threatened by those who are willing to do work cheaper.

But I tend to agree with AwesomO (my favorite episode of South Park, by the way) on this one. Physicians are physicians for a reason -- we know tons more than PAs or any variation of nurse. Trying to block out midlevels from expanding their scope of practice is short-sighted and nothing more than a "quick fix." What we should be doing is positioning ourselves at the top of this tumbling heap -- because that's exactly where our knowledge, experience and training says we belong.

Plenty of studies have shown that a primary care practice with midlevels (so long as it is run efficiently) generates considerably more revenue than one without. PAs and NPs in clinic generate MUCH more (tens of thousands) than it costs to retain them. That money, then, goes back into the practice -- and yes, some of it, into physicians' pockets.

And any anesthesiologist (jet included) will tell you: if CRNAs weren't around, there wouldn't be NEARLY enough professionals to administer all the anesthesia that is needed country-wide. Similarly, the goal of anesthesiology is to position itself in a place of efficient oversight for CRNAs, while the future of their specialty's scope moves further and further towards critical care.

Ol' Mary has been up to these tricks for a while. Anyone worth their stones knows a nurse isn't a doctor. For her to say her graduates will have "the medical knowledge of a physician and the added skills of a nurse" is one of the most illogical statements I have ever read. Every one of us is now dumber for having listening to her. I award her no points, and may God have mercy on her soul.

 

[D5W]

Thanks for starting this thread Jet. As a 4th year med student about to start a residency in primary care (IM, not FM though) AND being 200k+ this issue has weighed on my mind heavily for the past few years and I was tempted to go into Anesthesia specifically. I grew up poor and money is important to me. I am passionate about IM and judging by the rate physician reimbursment is being cut, I figure I may as well go into something I really like b/c the only logical prediction for the future is that all doctor's will be making less in the years to come.

 

[michaelrack]

Thanks for starting this thread Jet. As a 4th year med student about to start a residency in primary care (IM, not FM though) AND being 200k+ this issue has weighed on my mind heavily for the past few years and I was tempted to go into Anesthesia specifically. I grew up poor and money is important to me. I am passionate about IM and judging by the rate physician reimbursment is being cut, I figure I may as well go into something I really like b/c the only logical prediction for the future is that all doctor's will be making less in the years to come.

I encourage idealistic medical students who are interested in primary care to follow their passions and do an IM or FM residency. When you become burned out with primary care (which may happen before you finish residency) you can always do a fellowship. Sleep medicine is open to both FM/IM, and is only one year. No need to do an anesthesia residency, unless that's what interests you.

 

[TX515]

These threads make me sick:

For the person who was complaining about a FM doc ONLY having 55k a year to pay the bills, take care of family, etc: NEWS FLASH, the average person only makes around 35-40k a year, if that.

I grew up in a household where my parents made less than 20,000$, combined. That day sucks when you're a senior in high school and your mom tells you they can't afford to send you to college.

 

[sophiejane]

I grew up in a household where my parents made less than 20,000$, combined. That day sucks when you're a senior in high school and your mom tells you they can't afford to send you to college.

My parents didn't contribute to my college tuition. I worked, I got scholarships and grants and they helped when they could. I worked throughout and graduated summa cum laude, 6 months early. It can be done.

Not having parental financial support is not an excuse not to go to or do well in college.

 

[racerx]

Just having some fun here, so don't get all bent. However, as they say, if the shoe fits. . .

Top Ten Reasons Why some choose $150K versus $450K:
10.Easier/less time to find tax shelters in which to hide a larger percentage of my money, more time treating patients.

9. After #10 is accomplished, I pay less in taxes.

8.Government programs for loan payback assistance.

7. I'm not THAT much of a morning person.

6. Seems to be a trend toward positive correlation between $450K and higher rates of substance abuse versus $150K. Just sayin'.

5. Will keep the kids from asking for an in-ground pool.

4. Fewer calls from alumni fund-raisers.

3. I measure "it" with a ruler, not the size of the bank account.

2. A 15% medicare/medicaid cut is a smaller chunk at $150K, than $450K. . . and we all know they're a'comin.

1. Smaller chunks for the Ex to get. (And I KNOW some of you can relate to that)

Thank you, thank you. . .I'll be here through next Wednesday! And, try the veal!!!

 

[Miami_med]

I'm too lazy to do a search. Anyone know what the AVERAGE loan debt for 4 years of medical school is these days?

I know we hear from the folks in the $200-300K range, but I'd venture to guess that's nowhere near the average. I owe about $140. My loan payments are going to be ~$1400/month on a 10 year plan.

My husband also works, and we are going to live in a rural area by choice (we can't WAIT!). Paying back my loans is not going to be an issue.

I know you guys would like to say it's one way for everyone, but there are as many different ways to skin this cat as there are people who choose FM.

Having said that, from what I have seen of my colleagues, we don't drive junker cars and live in cracker boxes and eat Ramen. We have nice lives, our kids go to college, we have a great work/life balance, a satisfying job and money in the bank.

See, the thing is, I don't think there is this grand sense of entitlement among many who choose primary care. Yes, we work hard. But everyone works hard. I came to medicine late and had a blast in my 20s, so I can't really sympathize with those of you who are mourning the loss of that decade. I don't care to spend a lot of money on a Hummer or a Lexus with surround sound, I'm happy with a hybrid and NPR.

I think the reason you don't understand us is because I think a lot of us felt "called" to FM and don't think we'd be happy in anything else. I do believe there are way more of us who are here for the job than in any other specialty.

Who is really "called" to anesthesia? I mean, if it payed $180K and FM payed $300K, which would you have chosen?

Debt averages are just that, averages. I can say that the three factors that most influence this are "drumroll please" parents who pay, a previous work life or a significant other providing support, private vs. public school. I can say though, that A) If you took the average debt of a student who's parents were NOT well off, it is probably higher. B) This is the type of student more likely to enter primary care. C) This is the type of student who may not have had the same type of experience with handling larger amounts of money (and the associated consequences).

I'm not arguing about what we should want or care about. Pretty much everything I'm interested in doing is dumb from a financial perspective, but we should be accurate about our interpretation of the statistics.

I think that money in ALL specialties is about flexibility. What we should really be at war with is congress and the Stark Laws, because they are really what keeps the less saturated markets from offering fair compensation outside of direct reimbursement.

 

[Shinken]

Why Make 450k When 750k Is Out There?

 

[sophiejane]

Why Make 450k When 750k Is Out There?

That is beautiful.

 

[Ypo.]

UHHHHHHHH.....

LEE'S THE DUDE THAT STARTED SDN....AND HE POSTED ON THIS THREAD.....

I GUESS THIS IS AN IMPORTANT (albeit uncomfortable) ISSUE, HUH?

^
Anyone care to guess the personality disorder?


Advice: why don't you just go be happy with your high-paying specialty?

 

[TX515]

My parents didn't contribute to my college tuition. I worked, I got scholarships and grants and they helped when they could. I worked throughout and graduated summa cum laude, 6 months early. It can be done.

Not having parental financial support is not an excuse not to go to or do well in college.

Oh I also worked through college and did well enough to be accepted into medical school.

I'm just saying, $150,000 is not a bad living. In the East Texas area I've seen starting salaries in the 190's. But I think I'd hate doing primary care. It's not really a money thing. I just like anesthesiology more than all the other fields.

 

[andwhat]

^
Anyone care to guess the personality disorder?


Advice: why don't you just go be happy with your high-paying specialty?

Let us please not forget that an Anesthesiologist cannot be gainfully employed at all and whatsoever without a Surgeon or a Specialist.

Also there is the waking up at ridiculously early times for the rest of your life issue.

Malpractice, the list goes on and on.

 

[thedman888]

not just primary care, the overall shortage pf physicians are bringing mid-levels into all specialties. from ER PA's/NP's to CRNAs etc.... i wonder if the new DrNP residency will start specialty fellowships like general surgery, general rad (cxr specialists), gas, general GI (scoping specialists), etc.... u get the point

 

[iatrosB]

Well, if nothing else, this thread has breathed some life into the FM forum

ata boy jet

 

[Museless]

By the way Turbo, one thing that everyone seems to miss, is that sometimes primary care chooses the medical student, and not the other way around (grades, USMLE scores, etc. etc.)

Ah, yes, the other side of the arrogance coin.

I'd put my record up against any successful rads or gas applicant's.

I'd come out looking mighty fine, since I was AOA, and board scores can't get much higher.

And yes, I measure it with a ruler. Nah, two rulers, end-to-end.

(Actually, I'm a woman. The rest is God's honest truth.)

 

[racerx]

And yes, I measure it with a ruler. Nah, two rulers, end-to-end.

(Actually, I'm a woman. The rest is God's honest truth.)

I measure it with a metric ruler (cm) and pretend it's in inches. Makes me feel better about myself.

 

[NewmansOwn]

I haven't heard that one in a while! Well played.

Thank you sir. That scene immediately came to mind after reading the article...

 

[fakin' the funk]

this blog is truly sad to me. i chose family medicine because i love patient care, because i want to help people in a way that is meaningful and to become a part of a community and love my work so that i am not just dreading getting up to go to work to make money to get to retirement as soon as possible.

i am $250k in debt would NEVER let my debt control my choice for what i do for the rest of my life. regardless of residency choice, we will all have a roof over our heads and cars and food on the table. i see the opportunity to have been able to go to medical school and to be a doctor as an amazing privilege, NOT a reason to think i "deserve" a certain paycheck.

the pride and egotism in medicine is astonishing.

for those of you who "work to live" i feel sad for you that you chose a profession that you don't actually love.

as for the practical part of paying off loans, i plan on working in the underserved community and becoming involved in loan repayment programs. i'm not worried about it.

Are you the FM clerkship director who makes students WRITE A POEM ABOUT A PATIENT YOU SAW during that rotation?

 

[iatrosB]

Are you the FM clerkship director who makes students WRITE A POEM ABOUT A PATIENT YOU SAW during that rotation?

Poem??

I had to write an 8 page paper!

 

[Coastie]

Poem??

I had to write an 8 page paper!

I had to make a paper collage using tissues containing blood from accu checks of the most common transmissible diseases, and now my girlfriend won't kiss me

 

[ViolinCello]

Don't forget the "trickle-down" effect on specialties. Many specialists are already hiring mid-levels to offload some of their non-procedural workload, and we can expect that trend to continue as more routine care ends up in specialists' offices by default. Already-overburdened hospital emergency departments will get even busier, too. None of this will result in less expensive care...quite the opposite, actually. That's what people like Ms. Mundinger are counting on. Family physicians have other ideas, but it will take political backing and support to bring them to fruition.

What is interesting are Ms. Mudinger's conflicts of interest: http://hcrenewal.blogspot.com/2008/04/what-influences-advocacy-for-doctor.html#links

 

[ViolinCello]

I never had issue with established nurses deciding they wanted a wider scope of practice and obtaining a NP degree or I guess in this case DNP. What I am concerned about are kids using this as a back door into medicine. The last thing we need are for all the rejected med school applicants or people who decide they don't want to go through the med school gauntlet taking up seats in nursing school with no intention what so ever of practicing nursing and just jumping from RN to DNP. Can you imagine the effect it would have on nursing numbers if thousands of premeds had a back door into medicine.

A simple solution is to have a required amount of time spent as a RN before one can go to DNP school. Ensuring people going this route are really committed to nursing.

As a side note the people who seemed to be most put off by DNPs are PAs.

Af first I read this thread and thought great, another NP bashing thread....but you raise some valid points.

In the past, you could get your ARNP only after having been a nurse for several years. Most programs didn't admit you right out of undergrad. That changed, and now, someone with a BA/BS can be an ARNP in 2 years. I know some people think this is better b/c they do not have to go back and "undo" what they learned as an RN, but many others think this lack of experience is concerning.

Some people think you need to get the DNP today b/c we have devalued the ARNP with this 2 year track. Part of demand for the 2 year degree is because of the 80 hour rule that went into effect for residency programs a couple of years ago. I know in my part of the country, my friends were flocking to get their NPs so they could get better paying jobs without having to work the bad conditions they often faced on the floors. Now we are seeing salaries level out a bit more.

I see female premeds heading down the DNP road if med school does not pan out, but I think most male premeds will still go the route of PAs. I'm not sterotyping, just looking at the facts.

I am not in any way disrespecting my profession, but I have thought for a long time that we are heading in the wrong direction.

 

[Doowai]

I measure it with a metric ruler (cm) and pretend it's in inches. Makes me feel better about myself.

I use the little key on travel maps - where one inch equals 150 miles.

 

[sophiejane]

I am not in any way disrespecting my profession, but I have thought for a long time that we are heading in the wrong direction.

I have nothing to say about your post except that I love that picture of Jacqueline DuPre (and is that Barenboim next to her?). She was my absolute idol growing up...



Carry on!

 

[la petite mort]

I've never really liked the idea as a home for an investment unless you know for sure the property will go sky high in value. Too much work via upkeep and such imo.

Quite.

 

[la petite mort]

I'm paying for med school from an inheritance I received, not loans (before you hate me, know that where I live, it costs only $23000, four years and internship included. Hell, there are used cars that cost more than that).

So I guess that excuses my unpractical idealism. I've never even considered going into anything but peds or family medicine. My dream is to practice in a rural community and teach people about life-long paliative care. I guess to give back the gift and blessing of being able to study what I love, unhampered by financial constraints.

 

[Dr McSteamy]

I have savings. so i will have my debt paid off 99% before i start residency.
money is not an issue from the getgo.

I don't know much. but here's my understanding/misunderstanding..

why make 150k? I don't think this figure is even set in stone. As an FP, I would hope to do more than just the bread and butter office visits. I would want to do procedures, cosmetics, and other noninvasive & cash-only procedures.
I would hope that would net me more than just 150k.
250k maybe?
I don't want to get too greedy. But I hope the figure will increase with the right marketing.
There are FP's out there making 400-500k, and they're not working like a dog. they must be doing something right.

 

[secretwave101]

But I think I'd hate doing primary care. It's not really a money thing. I just like anesthesiology more than all the other fields.

This is the right way to choose a specialty, which is why the OP's post seems inappropriate and confrontational to me.

 

[fakin' the funk]

This is the right way to choose a specialty, which is why the OP's post seems inappropriate and confrontational to me.

Inappropriate and confrontational is business-as-usual for the OP

 

[leviathan]

This is the right way to choose a specialty, which is why the OP's post seems inappropriate and confrontational to me.

Which begs the same question as to why the OP is in medicine at all. I'm sure a lot of people who ask that question about FM vs. specialties also asked the same question about pursuing a lesser-paying career vs. medicine. And of course their med school interviews were full of absolute BS statements about how they wanted to "help people".

 

[secretwave101]

Aw well, I gotta give a few props to the FM crew for showing the world that - generally serene and placid forum notwithstanding - we do in fact have a pulse. Apparently it can get above 80 once in awhile too.

Plus, if the OP gets too annoying...Sophie will put some Teachin' on him.

 

[andwhat]

Which begs the same question as to why the OP is in medicine at all. I'm sure a lot of people who ask that question about FM vs. specialties also asked the same question about pursuing a lesser-paying career vs. medicine. And of course their med school interviews were full of absolute BS statements about how they wanted to "help people".

it is sickening, and sad at the very same time, this guy Jetpropilot went to his own board and wanted attention there, stating that FM had actually bashed him. Did they not read the title of this thread? Why choose a lower paying career in Medicine than another one?
I think that its truly a disappointment, the maturity level of such characters, as well as integrity as a physician.
Thank God that he is not in Primary Care. That is the greatest relief to civilization actually.
I just thank goodness, that there is not a Surgeon each and every living day, who is directly responsible for whether or not I am even making a living.
The specialists, who can probably do their own Anesthesia on their own patients.
Going to the hospital at 5 am every day, getting scutted out hardcore by Surgeons and Specialists.