Jet Delivers Some Monetary Truth To Med Students You Aint Gonna Find Elsewhere

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jetproppilot

jetproppilot

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DISCLAIMER: If you're a philanthropic, self sacrificing doctor (or MD2B) no need for you to read this.

But if you are a monetarily struggling med student/resident with a desire to take care of people but-at-the-same-time be able to live the lifestyle you deserve, given your extreme, self-sacrificing time/money/emotional/relationship investment,

PLEASE READ ON.

Another disclaimer:

I DIDNT MAKE THE RULES. I'M JUST PASSING ON REALITY.....REALITY THAT YOUR MED SCHOOL/RESIDENT ACADEMIC COLLEAGUES WON'T DIVULGE.

Whats the reality?

Specialization in medicine pays more.

ALOT more.

This isnt a FEEL GOOD thread.

Its a thread, if you're a med student, that I hope you'll at least keep in the back of your mind when you select a specialty.

Truth is IT PISSES ME OFF that I'm writing this.

Cuz I recognize the value of primary care medicine.

I recognize the priceless value of going to one primary care dude, a dude who's pager when he's on call never stops going off.....a dude who's known you for 5, 10, 15, TWENTY years....GEEZUM PETES I've got a buddy who's a pediatrician and when the dudes on call, I'm tellin' ya, its like at least six pages an hour.

But said pediatrician buddy doesnt get reimbursed fairly for his sacrifice. Nor does most INTERNAL MED/FAMILY MED/PEDIATRICIAN/GERIATRICIAN colleagues.....or any other branch of primary care I unknowingly excluded....

I'M TELLIN' YA, THAT IS NOT RIGHT.

And I wish it were different.

But it isn't.

So back to reality.....

I know what its like to be a med student....(unknowingly) naive, idealistic, liking every rotation, gravitating to what I "LIKE"....

I'm respectfully asking you to take a step back from what you LIKE as a med student.

And examine your affinity to whatever specialty objectively and pragmatically, realizing youre gonna probably spend 30 years doing what you've selected, and collecting money for your work. Money you've earned, and money you DESERVE.....(uhhhh....yeah, I know about the concept of ENTITLEMENT....and how, at least if you've ever sought self-help-therapy, how BAD entitlement is....but in this elongated, sacrificing-your-twenties profession, I BEG TO DIFFER. YA GOTTA BE ENTITLED TO A CERTAIN LEVEL OF REIMBURSEMENT AFTER SACRIFICING YOUR TWENTIES, DONTCHA THINK? DID THE PSYCHOLOGISTS THAT TELL US ENTITLEMENT IS BAD SPEND THEIR TWENTIES REPORTING TO SOMEONE ELSE? DID THEY TAKE NIGHT CALL? WERE THEY FORCED TO WORK AFTER BEING UP ALL NIGHT?

Here's where you've gotta taka leappa faith, and listen to someone who's been practicing private-practice medicine for more than a decade:

You are engulfed in THE EXPERIENCE now.

WHAT ABOUT FIVE YEARS FROM NOW? TEN YEARS?

Will you be happy then?

Of course noone has a crystal ball.... but this is a pragmatic, kinda money-oriented thread....

....and what I can guarantee is.....that after your med student/resident life is over your priorities will change or at least be redirected...

you'll probably get married....have kids....

that s hit costs money!

RETURN TO CURRENT DAY...

Gas is 4 buks a gallon.😱

College students are standing in food camp lines....

Mid-income families are having a hard time making ends meet...

SO...UHHHH......JET......WHATS THE POINT OF ALL YOUR BULL HERE?

My point, med student friends, is I want you to THINK FIVE TO TEN YEARS AHEAD. AND SOME OF THE VERY COOL AREAS DON'T PAY YOU MUCH. AND SOMEDAY, MANY YEARS FROM NOW FROM YOUR CURRENT LIFE, YOUR INCOME IS GONNA MATTER.

No matter how much you try and explain it away right now.

This isnt a plug for anesthesia.

Its a plug for you to consider a medicine subspecialty.

While you still can......interventional rads, interventional cardiology, derm, orthopedics, GI, rad/onc, path, spine......

I didnt make the rules.

Choose wisely.
 
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So what is the best way to make some real moolah in anesthesia?
 
toughlife said:
So what is the best way to make some real moolah in anesthesia?
Click to expand...

Be willing to move to a small town....which aint so bad....hell I did it for eight years....

BUT YOU DON'T EVEN HAFFTA DO THAT, TRUTH BEING SAID...

use your contacts....

Look, I'm not some special individual.

And I've shared the wealth.

Which leads me to believe that if CA-3 residents use their CONTACTS....whatever that means to you....dudes that finished before you and are now in successful private practice...or dudes that are friends of dudes that finished before you that are now in private practice....or even s hit you hear here on SDN anesthesia (the competing group from my original gig posted on here not long ago, begging for a quality partner....

I'm not gonna do the work for you.

Its up to you.

I can tell you, though, that the haffa mil plus (W-2 haffa mil...no smokescreens) partnerships are out there for the taking.

If you're the right dude....and have the assertiveness to find them.
 
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Anyone think this is a situation that will resolve itself eventually?

Can primary care docs really continue to make so little over the next 40-50 years?
 
jetproppilot said:
Be willing to move to a small town....which aint so bad....hell I did it for eight years....

BUT YOU DON'T EVEN HAFFTA DO THAT, TRUTH BEING SAID...(uhhhh......right, UT?)

use your contacts....

Look, I'm not some special individual.

And I've shared the wealth.

Which leads me to believe that if CA-3 residents use their CONTACTS....whatever that means to you....dudes that finished before you and are now in successful private practice...or dudes that are friends of dudes that finished before you that are now in private practice....or even s hit you hear here on SDN anesthesia (the competing group from my original gig posted on here not long ago, begging for a quality partner....haffa mil plus....

I'm not gonna do the work for you.

Its up to you.

I can tell you, though, that the haffa mil plus (W-2 haffa mil...no smokescreens) partnerships are out there for the taking.

If you're the right dude....and have the assertiveness to find them.

All my Homies here...Mil, Noy, UT....would be lying to you if they didnt report to you that there are some big money practices out there. Looking for partners. They KNOW. And I KNOW.

NOW THATS SOME NON BULLS HIT REPORTING ON SDN ANESTHESIA!!!!:laugh:
Click to expand...

Nice. I have heard of some graduates from my program hitting the half a mill mark so I will explore that a bit further.
 
Question though: what's going to happen to subspecialist salaries when the all-American third-payor system goes kaput? Cuz it will. It has to. This house of cards is not going to last forever.
I'm a PA. Been doing this for 8 years. Mostly FP and urgent care, some EM. Right now my clever supervising doc has figured out that he doesn't get paid to see patients, but to do procedures. So he does them--lots of them. He's the major owner of a 6-doctor practice that's doubled in size in the past 3 years. He and the other docs do colons, EGDs, vasectomies, etc.; anything in FP but no OB. Our clinic has on-site MRI, CT, US, full lab/xray. I'm not sure how this all plays out in light of Stark law...and it bugs me when I get a memo from the US tech: "Please order more US". Ugh. I'll order an US if I need an US. I don't do them to pad anyone's pocket. But anyway, if it weren't so profitable to offer all these services in-house we wouldn't have them, right?
I'm on this site and have been for the past 3 years because I'm not content being a PA. I want to go to medical school like the majority of people on this site. But do I want to make all these sacrifices to be a struggling family doctor? I dunno; it's a tough call, and not really one I have to make yet. I really love primary care, but there's a real appeal to being expert at something. There's also a bigger appeal to being able to work smarter, not harder.
ugh....
 
toughlife said:
Nice. I have heard of some graduates from my program hitting the half a mill mark so I will explore that a bit further.
Click to expand...

Dude what are you talking about? You and I are supposed to open up our own group. Short term memory:laugh:
 
starting at half mill+ seems far fetched

although have heard someone mention 700G/yr in north dakota with 5 year contract...3.5 million then invest/retire
 
v
 
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Jet, there are a lot of super idealistic naysayers out there … but some of us med students are listening, and we hear what you’re saying.
 
videolectures said:
starting at half mill+ seems far fetched

although have heard someone mention 700G/yr in north dakota with 5 year contract...3.5 million then invest/retire
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500+ is not that uncommon but you have to be willing to relocated to BFE. A CA-3 recently stated that he is getting 600K offers but they are in a small town in ARIZONA.

My two questions are :
how can you make the most $ during residency?
what's up with amb surg centers? how common is it for anesthesia to own an ASC? how does one go about building/landing one and managing it successfully?
 
GuP said:
500+ is not that uncommon but you have to be willing to relocated to BFE. A CA-3 recently stated that he is getting 600K offers but they are in a small town in ARIZONA.

My questions is how can you make the most $ during residency?
Click to expand...

Investing in a retirement account, moonlighting if you can hack it, and saving your sanity so you can make real money when you leave.
 
radslooking said:
Investing in a retirement account, moonlighting if you can hack it, and saving your sanity so you can make real money when you leave.
Click to expand...

A retirement account investment is mandatory here.

How do you land moonlighting gigs? Where do you look for them - obviously residents ahead will know but are there any other venues? And how early can you start i.e. PGY 1, CA-1,etc?
 
GuP said:
My two questions are :
how can you make the most $ during residency?
what's up with amb surg centers? how common is it for anesthesia to own an ASC? how does one go about building/landing one and managing it successfully?
Click to expand...

1) Wouldn't worry about that. Absent the rare opportunity to moonlight a LOT the amount of money you can save in residency will be trivial compared to your attending potential

2) ASC ownership varies highly by locality, but the market is pretty saturated. Like most things in medicine that reimburse far more than they should, payers are getting wise. I doubt ASC's will be a cash cow for our generation, particularly for anesthesiologists. (ASC's have an incentive to offer ownership to new surgeons b/c they bring business - not for for anesthesia.)
 
jetproppilot said:
But said pediatrician buddy doesnt get reimbursed fairly for his sacrifice. Nor does most INTERNAL MED/FAMILY MED/PEDIATRICIAN/GERIATRICIAN colleagues.....or any other branch of primary care I unknowingly excluded...
Click to expand...

When you say this, are you including EM in the primary care fields?
 
GuP said:
A retirement account investment is mandatory here.

How do you land moonlighting gigs? Where do you look for them - obviously residents ahead will know but are there any other venues? And how early can you start i.e. PGY 1, CA-1,etc?
Click to expand...

in general you cannot start moonlighting until your CA one year. however, my program has us starting anesthesiology in our pgy one years. after your OR anes orientation you can start moonlighting -- at my program getting paid for staying late...so i will be able to moonlight albeit somewhat passively toward the end of my pgy one year.... if programs are set up like this you can moonlight earlier, otherwise its ca one year.
 
videolectures... 700k x 5 years does NOT leave you with 3.5mill to invest/retire...

you gotta figure that your average living expenses (if you don't live too large) are about 100k/year - and then you take into account that after taxes you are left with about 400k... so that means 300k x 5 which is 1.5 mill to invest/retire - which ain't much....
 
Tenesma said:
you gotta figure that your average living expenses (if you don't live too large) are about 100k/year - and then you take into account that after taxes you are left with about 400k... so that means 300k x 5 which is 1.5 mill to invest/retire - which ain't much....
Click to expand...

1.5MM in muni bonds at 5% will give you 75K/yr tax free. If you can live on 100K/yr, then you can are close to retiring. Two more years and you should have it easy.
 
What's the financial future of anesthesiology look like?
 
mudshadow said:
Jetpro, you're saying we can make the big $$$ in path?
Yeah right.
Click to expand...

:laugh::laugh:

Its OK.

You can reply with an arrogant-yet-naive, unknowing reply.

There are many, many private practice path groups out there making a very pretty penny.

Wanna my former partners, Jeff R.'s (Trin remembers him) sister is a pathologist in Arkansas, making what we make, with most days resembling a dermatologist's schedule.

I went to med school with a dude who went into path since his dad had a very successful practice in Miami.....he might be retired by now...

The path group at my former and current hospital are doing quite well...

They do take call, though.....for frozens mostly....but doesnt happen much.

Lemme give you some advice:

Its OK to reply arrogantly sometimes.

But its important to know what you're talking about first and foremost before said reply, otherwise you're just making yourself look stupid.:slap:
 
toughlife said:
So what is the best way to make some real moolah in anesthesia?
Click to expand...


Sell out your field, "supervise" 20 CRNAs all at the same time doing all their cases in remote locations while you do your own cases and make even more money.

Why settle for 350k when you can "supervise" CRNAs and make double that amount??

MO MONEY MO MONEY MO MONEY!!!! $$$$$$$$
 
tacoman2493 said:
Sell out your field, "supervise" 20 CRNAs all at the same time doing all their cases in remote locations while you do your own cases and make even more money.

Why settle for 350k when you can "supervise" CRNAs and make double that amount??

MO MONEY MO MONEY MO MONEY!!!! $$$$$$$$
Click to expand...

can't and won't happen.
i know you might be a mythical cave dweller,
but do you even have a clue?
 
SleepIsGood said:
Dude what are you talking about? You and I are supposed to open up our own group. Short term memory:laugh:
Click to expand...

I haven't forgotten. I am just trying to learn how to the game is played dawg!
 
jetproppilot said:
disclaimer: If You're A Philanthropic, Self Sacrificing Doctor (or Md2b) No Need For You To Read This.

but If You Are A Monetarily Struggling Med Student/resident With A Desire To Take Care Of People But-at-the-same-time Be Able To Live The Lifestyle You Deserve, Given Your Extreme, Self-sacrificing Time/money/emotional/relationship Investment,

please Read On.

Another Disclaimer:

i Didnt Make The Rules. I'm Just Passing On Reality.....reality That Your Med School/resident Academic Colleagues Won't Divulge.

Whats The Reality?

specialization In Medicine Pays More.

alot More.

This Isnt A feel Good Thread.

Its A Thread, If You're A Med Student, That I Hope You'll At Least Keep In The Back Of Your Mind When You Select A Specialty.

Truth Is it Pisses Me Off That I'm Writing This.

Cuz I recognize The Value Of primary Care Medicine.

I Recognize The priceless Value Of Going To one Primary Care Dude, A Dude Who's Pager When He's On Call Never Stops Going Off.....a Dude Who's Known You For 5, 10, 15, Twenty Years....geezum Petes I've Got A Buddy Who's A Pediatrician And When The Dudes On Call, i'm Tellin' Ya, Its Like at Least Six Pages An Hour.

but Said Pediatrician Buddy Doesnt Get Reimbursed Fairly For His Sacrifice. Nor Does Most Internal Med/family Med/pediatrician/geriatrician Colleagues.....or Any Other Branch Of Primary Care I Unknowingly Excluded....

i'm Tellin' Ya, That Is Not Right.

And I Wish It Were Different.

But It isn't.

So back To Reality.....

I Know What Its Like To Be A Med Student....(unknowingly) naive, Idealistic, Liking Every Rotation, Gravitating To What I "like"....

I'm Respectfully Asking You To Take A Step Back From What You like As A Med Student.

And Examine Your Affinity To Whatever Specialty objectively And Pragmatically, Realizing Youre Gonna Probably Spend 30 Years Doing What You've Selected, And Collecting money For Your Work. Money You've Earned, And Money You deserve.....(uhhhh....yeah, I Know About The Concept Of Entitlement....and How, At Least If You've Ever Sought Self-help-therapy, How Bad Entitlement Is....but In This Elongated, Sacrificing-your-twenties Profession, I Beg To Differ. Ya Gotta Be Entitled To A Certain Level Of Reimbursement After Sacrificing Your Twenties, Dontcha Think? Did The Psychologists That Tell Us Entitlement Is Bad Spend Their Twenties Reporting To Someone Else? Did They Take Night Call? Were They Forced To Work After Being Up All Night?

Here's Where You've Gotta Taka Leappa Faith, And Listen To Someone Who's Been Practicing Private-practice Medicine For More Than A Decade:

you Are Engulfed In The Experience Now.

what About Five Years From Now? Ten Years?

Will You Be Happy Then?

Of Course Noone Has A crystal Ball.... But This Is A pragmatic, Kinda Money-oriented Thread....

....and What I Can Guarantee Is.....that After Your Med Student/resident Life Is Over your Priorities Will Change Or At Least Be Redirected...

You'll Probably Get Married....have Kids....

that S Hit Costs Money!

return To Current Day...

Gas Is 4 Buks A Gallon.😱

College Students Are Standing In food Camp Lines....

Mid-income Families Are Having A Hard Time Making Ends Meet...

so...uhhhh......jet......whats The Point Of All Your Bull Here?

My Point, Med Student Friends, Is I Want You To think Five To Ten Years Ahead. And Some Of The Very Cool Specialties Don't Pay You Much. And Someday, Many Years From Now From Your Current Life, Your Income Is Gonna Matter.

No Matter How Much You Try And Explain It Away Right Now.

This Isnt A Plug For Anesthesia.

Its A Plug For You To Consider A Medicine subspecialty.

While You Still Can......interventional Rads, Interventional Cardiology, Derm, Orthopedics, Gi, Rad/onc, Path, Spine......

I Didnt Make The Rules.

Choose Wisely.
Click to expand...


Y
S
A
F
A
 
Jet, does ophtho still fall into one of the fields with $$?
 
Tenesma said:
videolectures... 700k x 5 years does NOT leave you with 3.5mill to invest/retire...

you gotta figure that your average living expenses (if you don't live too large) are about 100k/year - and then you take into account that after taxes you are left with about 400k... so that means 300k x 5 which is 1.5 mill to invest/retire - which ain't much....
Click to expand...
Expenses of 100k/year if you don't live too large! Tenesma, that's not exactly average living expenses for most people in the US when median incomes in every state in the US are much lower than that. One of the benefits of living in a small town in BFE (besides being paid more) is that you can live on much less and get a lot more for your money. 100k is a ****load of money to most people who aren't anesthesiologists. Good lord, I'm really looking forward to the day when I can post all over SDN about how I'm not living too large on $100k per year!
 
Pharm Life said:
Tenesma, that's not exactly average living expenses for most people in the US
Click to expand...

[rant]
Average income is irrelevant. What's relevant is the lifestyle that a talented, hardworking individual can achieve after investing a dozen years in a career. Comparing physicians to people who work salary jobs that require 0-4 years of training post high school - that is entirely useless. Your comparison should be MBA's, top flight law grads, entrepreneurs ...

On that scale, 100K/yr (which, even in absolute terms will buy you an upper middle class lifestyle) is far, far from living large
[/rant]
 
Pharm Life said:
Expenses of 100k/year if you don't live too large! Tenesma, that's not exactly average living expenses for most people in the US when median incomes in every state in the US are much lower than that. One of the benefits of living in a small town in BFE (besides being paid more) is that you can live on much less and get a lot more for your money. 100k is a ****load of money to most people who aren't anesthesiologists. Good lord, I'm really looking forward to the day when I can post all over SDN about how I'm not living too large on $100k per year!
Click to expand...

What does BFE stand for?
 
rsgillmd said:
What does BFE stand for?
Click to expand...

butt fu-- Egypt - This place is far out in the middle of nowhere and apparently hardly anyone lives there, would want to live there, or would want to visit. You probably would not even come across this place on a cross country trip to anywhere meaningful.
 
Pilot Doc said:
[rant]
Average income is irrelevant. What's relevant is the lifestyle that a talented, hardworking individual can achieve after investing a dozen years in a career. Comparing physicians to people who work salary jobs that require 0-4 years of training post high school - that is entirely useless. Your comparison should be MBA's, top flight law grads, entrepreneurs ...

On that scale, 100K/yr (which, even in absolute terms will buy you an upper middle class lifestyle) is far, far from living large
[/rant]
Click to expand...
No, you missed my point (or maybe we're just defining a modest lifestyle differently). The point I wanted to make is that in a small town, you can have a decent standard of living on far less than what you'd need in a more desirable location. This is one reason why people move to small towns like Jet was saying he did. They pay you extra money to go there, and the cost of living is lower than it would be otherwise. So you wouldn't need to live on that much money to get an upper middle class lifestyle. A modest lifestyle by my definition means that you live like the people around you and don't stand out as the wealthiest guy in town even though you probably are. For a doctor making $750k, this will be living at a level far below their net income in just about every community in the country. Even more, if you're in some small town in an undesirable location where the average upper middle class family is living on $50k and you're living on $100k, that's not going to be modest by the standards of that community!

HunterGatherer said:
butt fu-- Egypt - This place is far out in the middle of nowhere and apparently hardly anyone lives there, would want to live there, or would want to visit. You probably would not even come across this place on a cross country trip to anywhere meaningful.
Click to expand...
Exactly.
 
v
 
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Pharm Life said:
(or maybe we're just defining a modest lifestyle differently). ... A modest lifestyle by my definition means that you live like the people around you and don't stand out as the wealthiest guy in town even though you probably are.
Click to expand...

"Living like the people around you" and "don't stand out as the wealthiest guy in town" are far, far apart.

I agree if by modest you mean at the median, then yes 100K is a lot.

If modest means living so that dozens of families in your town clearly spend more than you - which is my definition - then I think 100K is plenty modest.

And as for physicians being the wealthiest guy in the community - that's almost never the case. Docs make a good living but the people who make real money (e.g. buildings named after you money) are the ones who own businesses - be it farms or fast food or beer distributorships. I grew up in a small town with a lot of successful docs - but none of them had "real money" when it came down to it.
 
You can make money in primary care too if you are willing to go to a small town and/or rural area. Easily make 400-500K
 
ZAZA67401 said:
You can make money in primary care too if you are willing to go to a small town and/or rural area. Easily make 400-500K
Click to expand...

If that was the case, most of the med students would of thought about that before going off about loans and entering the residency training in a subspecialty. Some primary care doctors would of move to those areas if they are complaining about their salary now.
 
jetproppilot said:
You're calling me a doosh?😆

One could be bad judgement.

Two means you've got issues.



Jet, just ignore this mudshadow person. Don't add fuel to the fire. His/her post and username indicates he wants to sling mud and deteriorate this thread into the type that happens when milmd and plank start bashing each other.

I don't know you, but from your posts I gather you'd be the type of person I would like to work with and turn to for honest advice. I'm sure practically everyone else on this forum feels the same way. So once again, ignore this person.
Click to expand...
 
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Hmph

If anybody knows of anyone offering this pay in BFE lemme know who/where. I could care less where I live if the $$ right.
 
If the US does move towards a universal health care type model, how will the pay for anesthesia change??
 
Tenesma said:
videolectures... 700k x 5 years does NOT leave you with 3.5mill to invest/retire...

you gotta figure that your average living expenses (if you don't live too large) are about 100k/year - and then you take into account that after taxes you are left with about 400k... so that means 300k x 5 which is 1.5 mill to invest/retire - which ain't much....
Click to expand...

When did 100K/yr to live become average? My husband and I live very comfortabely on 40K, and in a city. We don't have children, but I can't imagine they would run up at least another $60k, if not more a year. What am I missing?
 
rgerwin said:
What am I missing?
Click to expand...

Are you living in an apartment by chance?

When I lived in an apartment before I was married and had kids, I could have been quite comfortable on $40K no problem. Now I am a resident w/ 4 kids. I can assure you that $40K doesn't get you very far especially if you have a mortgage, property taxes, daycare expenses, car payments, 529 plans, home repairs, formula, diapers, life insurance, student loans, church and are expected to save 10-20% of your income for retirement. Family life gets expensive quickly.

6 months to go... Whew!
 
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mudshadow said:
Whatadoosh.
Why are you spending all of your waking hours on some stupid website instilling premeds with your dysgenic brand of dystopian rhetoric? And why are so many of these innocent minds hanging on to your every word? I am sure they are all well aware that your primary diversion is watching guys in funny hats flip poker cards on the flicker box. Extreme poker fan? If you admitted to pleasuring yourself to Sesame Street instead, it may garner you more respect.
Click to expand...

I've been lurking on these boards for a number of years and recently joined. I just want to say that the posts by Jet have probably been the most helpful of anyone on these boards. The guy is trying to help people out. This thread, in particular, should be read by every medical student. He is pointing out facts that they should know before they decide on a specialty. That is all..

Thanks again Jet.
 
HunterGatherer said:
butt fu-- Egypt - This place is far out in the middle of nowhere and apparently hardly anyone lives there, would want to live there, or would want to visit. You probably would not even come across this place on a cross country trip to anywhere meaningful.
Click to expand...

I never understood why ppl said "BFE"...then driving home one time I saw a sign pointing to Egypt, TX. It does exist, haha!
 
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