200k salary

[drboris]

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How hard is to make 200k a year as an internist? How many hours a week, how many patients a day, all the details? Besides the fact that some people find rounding very tedious and monotonous, why is so bad if the doctor is still getting paid for an office visit each time he/she visits the patient?

I am mulling over IM and EM, and like certain aspects of both, but since I am going to have ~200k loan afterm med school, I want to choose a specialty that will reward me financially for my time. Since money is not my main motivation, I want to research these and other fields in more detail. Please contribute any insights and/or personal experiences...especially if you are also in my shoes (either in terms of specialty of loans)!

Thanks!

Since there are less med students going into primary care each year, maybe reimbursement will increase in the future?

 

[ckent]

200 K salary is currently doable if you own your own practice and have several physicians or PA's, NP working under you. If you are talking about working a solo practice, the only way that I could see it being done is if you worked as a hospitalist and saw many more patients then you were capable of by consulting everyone (which many hospitalist in private practice currently do) and if you were willing to work hours that mos tpeople would not be willing to (eg nights, weekends, holidays, etc, these hours usually generate more business). In terms of comparing EM to IM, I'd encourage you to read the EM vs IM thread in the EM forum and really think about what you want to do. The fact is that IM salaries are currently decreasing, and I believe that IM physicians are less able to depend on market forces driving demand because there are very few internists who can afford not to take medicare or managed care patients, and both of those forces are driving compensation downward (even with a 1.5% increase this year instead of the scheduled 4.5% decrease, 1.5 is still less then inflation so it still represents a decrease). I would do an EM rotation and make sure that's what you really want to do before signing up for it, I think that very different personalities like IM vs EM. I also tend to believe that EM physicians are less susceptible to reimbursement issues because they really are driven by the market, even if a hosptial is losing money in their EM department, they need EM physicians on staff all the time so they will compete with other ER's salary wise. I coudl be mistaken though, I'm no medical economist.

http://forums.studentdoctor.net/showthread.php?s=&threadid=99829

 

[DrQuinn]

Agreed with CKent. IM and EM are very different specialties. Do an EM rotation and see what you think of it. Keep your mind open.

Even if the average IM salary (guessing) is $150k a year, that is a LOT of money. I owe 190k, consolidated and locked in at 2.6 (which will drop to 1.45% in 4 years), and will be paying 700 a month for 30 years... at 1.45% that is less than what i can make putting it in a money market... so there is no need to hurry and pay it.

Let's say with 150k a year, 1/3 is taken out in taxes. 100k left. 700 a month x 12 = 8400 a year. You still have 92k to blow on wine women and song.

Q, DO

 

[Southern Hick]

hey quinn,

who is your lender? is it sallie mae?


thanks!

 

[DrQuinn]

Originally posted by Southern Hick
hey quinn,

who is your lender? is it sallie mae?


thanks!

yeah i went through sallie mae. easy as pie.

Q, DO

 

[bartholomew]

My impression was that if one earns an income of 150k, you'll be paying much closer to 50% in taxes...Nonetheless, still a salary near if not within the top 10% in America.

 

[Idiopathic]

I believe with taxes, SS and medicare, you pay right at 49%. Could be wrong though. With deductions, it aint quite that bad, as you should legitimately pay only 30-35% or so (especially when you factor in standard deductions and student loan interest, etc.)

 

[bustbones26]

Are you going to choose IM over ER if you can make over 200K or not? Vice versa? Does anybody choose a field they actually like to do anymore?

 

[ckent]

Originally posted by bustbones26
Are you going to choose IM over ER if you can make over 200K or not? Vice versa? Does anybody choose a field they actually like to do anymore?

You should always choose a field that you like to do. Salaries in medicine are in pretty rapid flux, it wouldn't surprise me at all to see a lot of specialties see their salaries bottom out in the next 10-20 yrs or so. That being said, I suspect that EM's salaries are less susceptible to the bottoming out then other specialties because of how the EM marketplace works (eg you always need an ER doc on call if you own an ER, irrespective of how much money that doc is actually generating). Your earning potential as an attending is very difficult to predict in most specialties of medicine right now, it's much safer just to pick a field that you enjoy so you won't be miserable when you picked a field for the cash only to find out that it's not there after you finish residency. That being said, lifestyle and future salary shouldn't be completely disregarded, but I just don't think that you should base your whole decision on it.

 

[drboris]

I am not going to pick my specialty simply based on $$$. However, lifestyle is a major factor for me. I want to have a well rounded life (family, leisure, and $$), and not be at the hospital or on call all the time. With all the years of hard work that we have to put in, I want to see results as soon as possible and not wait until I am in my mid 30s to feel the fruits of success, both in my schedule and financially.

Thanks for everyone's input!

 

[rajvosa]

Originally posted by Idiopathic
I believe with taxes, SS and medicare, you pay right at 49%. Could be wrong though. With deductions, it aint quite that bad, as you should legitimately pay only 30-35% or so (especially when you factor in standard deductions and student loan interest, etc.)

Unfortunately, you cannot deduct student loan interest unless you make less than 80K combined with your spouse. Also, you can deduct the interest ONLY FOR THE FIRST 60 months.
That's it!

Correct me if I am wrong.

 

[Linie]

I also tend to believe that EM physicians are less susceptible to reimbursement issues because they really are driven by the market, even if a hosptial is losing money in their EM department, they need EM physicians on staff all the time so they will compete with other ER's salary wise. I coudl be mistaken though, I'm no medical economist.

I've heard of hospitals shutting down their ERs because of all the money lost on providing care for people who walk in the door with no insurance. The hospital keeps bed filled by post-op patients and admissions from internists. Now, don't ask me what hospital or anything, I couldn't tell you. AND I'm sure that's a vanishingly small minority of hospitals.

 

[Tom345]

the answer to ur que is- you can easily make 200k if you put in 9 hrs a day. most places, u can start at 150k- except big cities. but you have to focus on life style. ER is shift system...good if you can take the stress. if not, IM is best. lots of scut work and pt pleasing, but low stress. think lifestyle man. life is too short. enjoy it while you can!!!!!!!!!!!!!!!