Advice for Med Student Worried About Single Payer

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Overthink

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M1 with projected $350k loans looking for honest advice. How should single payer affect career choice/potential to change careers?

I know no one can accurately predict the future, but is projecting 20-30% declines in compensation (estimate of all medicare billing from here: http://www.drsforamerica.org/blog/w...FjAMegQICBAB&usg=AOvVaw1lEUBIZrddei3LF1kqfI9L) reasonable?
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Overthink said:
M1 with projected $350k loans looking for honest advice. How should single payer affect career choice/potential to change careers?

I know no one can accurately predict the future, but is projecting 20-30% declines in compensation (estimate of all medicare billing from here: http://www.drsforamerica.org/blog/w...FjAMegQICBAB&usg=AOvVaw1lEUBIZrddei3LF1kqfI9L) reasonable?
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If you really want to be a clinician, you should consider minimizing as much educational debt as possible. Or, minimizing your length of training. It might be more feasible to consider PA, NP, or CRNA routes. Unless you have some family financial backing, it is unlikely that you will be able to afford financing the start of a private practice after completing your training. Your remaining options: Work and then partner into an existing practice; forsake "ownership" all together and work in the public sector, work for a hospital health system.

Here some really good internet resources to get you thinking about MD finances NOW:

The White Coat Investor

Rebel.MD - The Voice of Hippocratic Medicine in America

Home - Semi-Retired MD

Home - Physician on FIRE

Physician Side Gigs
 
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Overthink said:
M1 with projected $350k loans looking for honest advice. How should single payer affect career choice/potential to change careers?

I know no one can accurately predict the future, but is projecting 20-30% declines in compensation (estimate of all medicare billing from here: http://www.drsforamerica.org/blog/what-if-doctors-got-paid-only-medicare-rates) reasonable?
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This has been debated for decades and I don't think we are any closer to single payer than we ever were.

If you never really liked working with people and your primary reason for being a doc was money/prestige, I would go into a computing/programming field.

If you like working with people, you like science and you are already a med student, you will want to focus on your studies and finding a specialty where you relate to the docs. I would keep an eye on your loans but not to the point it will distract you.
 
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No idea if they still do this, but when i began my anesthesia residency in 1981 the US Army offered me the following:
1. Second lieutenant pay and I would be "free" to my residency program at UCSD. (more $$ than I was getting)
2. Credit towards retirement for college, medical school and residency training (which means I would have 12 years credit towards retirement before actually serving). You could retire with a pension after 8 years!), as an officer, which is a good thing in terms of $$.
3. I think they also were willing to pay off any outstanding loans as I served.
Only reason I did not do it was my (eventual) ex wife did like the inability to pick my assignments.
Anyway you might give the recruiters a call, they might take you out to lunch :)
 
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Thanks everyone for the input. My concerns have mainly come from following the news and reading health economics articles. I have no family financially backing me and no savings, going into this. The potential problem is medical school tuition is currently at its highest in real terms in history. Paying those fees and then coming out the other end in 8-10 years to a changed medical landscape is frightening. Basically buying at the "top" of the cycle in investment parlance.

Are there side revenue streams I should be educating myself about at this stage?

The suggestion of military service is always a useful route, although I am unaware of any loan forgiveness if you only do a military residency.
 
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Single payer isn’t happening in the USA lol.

Bernie uttered the words socialism and single payer in 2012 and got trump elected lol.

Love America. The ideals this country was built upon is opposite to single payer.
 
willabeast said:
No idea if they still do this, but when i began my anesthesia residency in 1981 the US Army offered me the following:
1. Second lieutenant pay and I would be "free" to my residency program at UCSD. (more $$ than I was getting)
2. Credit towards retirement for college, medical school and residency training (which means I would have 12 years credit towards retirement before actually serving). You could retire with a pension after 8 years!), as an officer, which is a good thing in terms of $$.
3. I think they also were willing to pay off any outstanding loans as I served.
Only reason I did not do it was my (eventual) ex wife did like the inability to pick my assignments.
Anyway you might give the recruiters a call, they might take you out to lunch :)
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This is excellent advice.

The path for OP would be to look at the "Health Professions Scholarship" of the various branches. These guys get school paid for, go through accredited residency/fellowship, serve our country, travel, etc. The pension is impressive and actually increases, year after year after you retire until you die.

Not for everyone but definitely an option to look into.
 
Just focus on being a good dr and getting into a residency that pays well when you’re out.

Be willing to move anywhere and knock out those loans. It is not worth it if you want to be a pediatrician in NYC.
 
Overthink said:
Thanks everyone for the input. My concerns have mainly come from following the news and reading health economics articles. I have no family financially backing me and no savings, going into this. The potential problem is medical school tuition is currently at its highest in real terms in history. Paying those fees and then coming out the other end in 8-10 years to a changed medical landscape is frightening. Basically buying at the "top" of the cycle in investment parlance.

Are there side revenue streams I should be educating myself about at this stage?

The suggestion of military service is always a useful route, although I am unaware of any loan forgiveness if you only do a military residency.
Click to expand...

//
ACTIVE MEDICAL CORPS BENEFITS
By choosing to practice in the active Army, you'll receive a comprehensive benefits package that includes a competitive salary and financial incentives such as medical school loan repayment. In addition, you will practice in an environment free of overhead and malpractice insurance costs, and receive low-cost or no-cost medical, dental and life insurance, generous retirement plan options, housing allowances and 30 days of paid vacation earned annually. You'll also enjoy a reasonable work-life balance that provides plenty of time for family and recreational pursuits.


HEALTH PROFESSIONS SCHOLARSHIP PROGRAM
As a medical student, you may be eligible for a full-tuition scholarship, plus a monthly stipend of more than $2,000. You must be enrolled in or have a letter of acceptance from an accredited medical school. This program is open to U.S. citizens. Qualifying medical students are also eligible to receive a $20,000 sign-on bonus.

Learn more about the Health Professions Scholarship Program.
//Physician Benefits & Salary
 
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drusso said:
Is going to medical school a wise financial decision?
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There was an article in the WSJ recently about a dentist who had one million dollars in loans to repay.
//
DRAPER, Utah—Mike Meru, a 37-year-old orthodontist, made a big investment in his education. As of Thursday, he owed $1,060,945.42 in student loans.

Mr. Meru pays only $1,589.97 a month—not enough to cover the interest, so his debt from seven years at the University of Southern California grows by $130 a day. In two decades, his loan balance will be $2 million.//

Mike Meru Has $1 Million in Student Loans. How Did That Happen?
 
Why the hell would anyone go to usc dental? The cost is so absurd. Education, like everything else, is a commodity. Shop for the best deal.
 
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paindoc007 said:
Why the hell would anyone go to usc dental? The cost is so absurd. Education, like everything else, is a commodity. Shop for the best deal.
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Maybe he likes USC football?
300751277.jpg
 
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Overthink said:
Thanks everyone for the input. My concerns have mainly come from following the news and reading health economics articles. I have no family financially backing me and no savings, going into this. The potential problem is medical school tuition is currently at its highest in real terms in history. Paying those fees and then coming out the other end in 8-10 years to a changed medical landscape is frightening. Basically buying at the "top" of the cycle in investment parlance.

Are there side revenue streams I should be educating myself about at this stage?

The suggestion of military service is always a useful route, although I am unaware of any loan forgiveness if you only do a military residency.
Click to expand...

reimbursements have been declining for decades now, that's the reality you are going to face upon completion of training which should worry you more than the "single payer" fear mongers. study hard, get high scores, and get good training and you'll get a good paying job. if you're at a bottom tier school and perform poorly, well you're stuck
 
Gauss said:
reimbursements have been declining for decades now, that's the reality you are going to face upon completion of training which should worry you more than the "single payer" fear mongers. study hard, get high scores, and get good training and you'll get a good paying job. if you're at a bottom tier school and perform poorly, well you're stuck
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not really. i know plenty of sh$tty docs with crappy training who make a lot. are they performing good/legitimate medicine? nope. but you still can make a lot without being an academic star
 
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SSdoc33 said:
not really. i know plenty of sh$tty docs with crappy training who make a lot. are they performing good/legitimate medicine? nope. but you still can make a lot without being an academic star
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Especially those that I call "medical surfers" who ride whatever is the current money making wave be it phen-phen, testosterone replacement, bio equivalent hormones, etc.
 
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Overthink said:
M1 with projected $350k loans looking for honest advice. How should single payer affect career choice/potential to change careers?

I know no one can accurately predict the future, but is projecting 20-30% declines in compensation (estimate of all medicare billing from here: http://www.drsforamerica.org/blog/w...FjAMegQICBAB&usg=AOvVaw1lEUBIZrddei3LF1kqfI9L) reasonable?
Click to expand...
You will have to live somewhat frugally for a few years after residency, but I don't think any Dr. has to worry about their financial future even with those type of debts. There is no immense healthcare change coming that will change the financial outlook of physicians that drastically. You may even be able to start paying off your loans a bit in residency, depending on where you go and how you live. And then maybe another 5-10 years, and you should be free of your school debt if you live within your means.
 
SSdoc33 said:
not really. i know plenty of sh$tty docs with crappy training who make a lot. are they performing good/legitimate medicine? nope. but you still can make a lot without being an academic star
Click to expand...

I was implying an ethical, good paying job... didn't know that actually had to be clearly stated
much easier to be a chiro or naturopath rather and MD or DO if you purely want to profit
 
One of my added concerns is the likely phase-out of public service loan forgiveness as well as income-based repayment plans. Under the higher ed. reform bill called the PROSPER Act, both programs would be eliminated. It is slated to go into effect late 2019. Federal loans for graduate studies would be capped at $150,000. I'm not sure how fast the medical school education market will respond to this change. I would estimate that for the next few years, tuition would remain unchanged. Considering the current average allopathic loan burden is ~$190,000, it would mean many students, including myself, would have to use private loans, with their adjustable interest rates, hidden fees, and other "surprises" instead of the protections of federal debt.

Reference: http://www.medicaleconomics.com/business/medical-education-debt-implications-prosper-act
 
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Overthink said:
One of my added concerns is the likely phase-out of public service loan forgiveness as well as income-based repayment plans. Under the higher ed. reform bill called the PROSPER Act, both programs would be eliminated. It is slated to go into effect late 2019. Federal loans for graduate studies would be capped at $150,000. I'm not sure how fast the medical school education market will respond to this change. I would estimate that for the next few years, tuition would remain unchanged. Considering the current average allopathic loan burden is ~$190,000, it would mean many students, including myself, would have to use private loans, with their adjustable interest rates, hidden fees, and other "surprises" instead of the protections of federal debt.

Reference: http://www.medicaleconomics.com/business/medical-education-debt-implications-prosper-act
Click to expand...


So if you are concerned about this , don't vote GOP
 
I would get out of medicine now before you get into too much debt. If you go to a VERY cheap state school or get some sort of scholarship, then stay in medicine, as long as you want to be employed once you are an attending physician. There will be a <5% chance you could do private practice in 13 years from now.
 
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