An emergency doc's budget

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
So I'd like to get this straight. I've got two friends who are both EM doctors. One of them works part time and gets around 150-200k a year. Another EM doctor receives around 500-700k a year. The second doctor works 4-5 days a week, 12 hour shifts. Are these two salaries really possible amongst EM doctors?

I can show you some pretty sweet jobs that pay 200-250/hr.... You can make 500-700K per year at one of those jobs if you work you tail off.

Here is the almighty question and I think its hard for anyone to grasp until 'you get there'. For must of us who entered this profession from middle class families at best, maybe some people occasionally have doctors for parents or parents even much better off... anyhow, 150-300K is a BOATLOAD of money. I am not arguing that 600K is ALOT more... but if you are making 600K as a doctor, you are not enjoying life/family and are literally working your tail off... Most of us would rather work a tad bit less, make a tad less, but still well into an upper class income... and watch our kids grow, visit family, travel a bit, etc....

There is a misconception sometimes that doctors are 'rich'. We are, but we are not. We are the working rich. We all can more than easily provide a nice newer home for a our family, clean clothes, reliable cars, and nice family vacations... we cannot rent out french chateaus for a month, have private jets, charter private yachts, etc. You can't do that on 300K income, you can't do that on 600K income.....You are going to need to see another zero on your income to obatin that type of status...

Members don't see this ad.
 
We are the working rich.

Better to be the working rich than the working poor or the working middle class...

From my point of view, 150k is a lot of money. I am a non-traditional premed, attempting to go to med school after being a high school science teacher for 17 years. Applications to both AAMC and AACOMAS are officially submitted!!!! :xf:

People have told me that "as a resident, you will not make a lot of money." Relative to the workload, I would have to agree. But even at $50k a year, that is more per year than I made for the first 10 years of teaching!!!! In that time, I raised a family, bought a house, made two car payments, and still had some money to put aside to go on vacations. I figure that my break-even point where I can still have the exact same standard of living, except not need my wife to work, put enough away for retirement, and pay off student loans is about $125k. Putting an extra $25k on top is just gravy. Any more than that and I would be rolling in the excess!

Remember also, that about $80k/year is the median family income in the US. No matter what, physicians make more than the average. You can enjoy a modest life with a lot less than what most doctors make.

just my $0.02.

dsoz
 
Better to be the working rich than the working poor or the working middle class...

From my point of view, 150k is a lot of money. I am a non-traditional premed, attempting to go to med school after being a high school science teacher for 17 years. Applications to both AAMC and AACOMAS are officially submitted!!!! :xf:

People have told me that "as a resident, you will not make a lot of money." Relative to the workload, I would have to agree. But even at $50k a year, that is more per year than I made for the first 10 years of teaching!!!! In that time, I raised a family, bought a house, made two car payments, and still had some money to put aside to go on vacations. I figure that my break-even point where I can still have the exact same standard of living, except not need my wife to work, put enough away for retirement, and pay off student loans is about $125k. Putting an extra $25k on top is just gravy. Any more than that and I would be rolling in the excess!


dsoz

have you considered taxes? with higher incomes, come higher tax brackets. i use to look at physician salaries as a pre-med much in the same way as you: wih "awe". now that i'm an attending, after taxes, student loan payments, housing payment, car payment and x number of bill payments, an average E.M. physician salary isn't as much I assumed.

it's not an easy job either. it's high paced and highly adrenergic. you may literaly save lives, but there will be times where you get upset at yourself because you could've managed a case better or some consulted was a complete prick with you. anyway, sorry for the tangent!
 
Members don't see this ad :)
Remember also, that about $80k/year is the median family income in the US. No matter what, physicians make more than the average. You can enjoy a modest life with a lot less than what most doctors make.

How many people with that modest life take out about $200-400K in educational loans on average, then let those loans accrue interest for seven years minimum with capitalization?

If you are a non-trad the repayment schedule for you is even more brutal, and the necessity to save for retirement more urgent. Hope you don't have to move out of your house to another city, state, or coast, because the real estate market sucks and you will not get top dollar for your house.

We make more, but we also borrowed more, and we now owe more, and have a shorter time to save for retirement because of the long period of training. By the way, you make too much to fund an IRA. Sorry.

People who aren't further into the process fail to recognize this, and think $125K is plenty. It is, but it is not.
 
People have told me that "as a resident, you will not make a lot of money." Relative to the workload, I would have to agree. But even at $50k a year, that is more per year than I made for the first 10 years of teaching!!!!
dsoz

I am coming off a shift which made me feel very burnt out, and I am only a third year resident. How many of your students threatened to sue you? How many hours a day did you work? How many weekends and overnights and holidays did you miss with your family? How much time did you have off? Did you have time to go to the bathroom during your workday? Did you get to eat a meal?

Maybe these things (in particular work hours) will improve when I am an attending. But this is a HARD JOB. And its a hard road getting there. I get your point is that we are not so poor, and you are correct. I think that docs react to this kind of comment though because there is so little respect for what we do these days, its actually generally a thankless job, it feels like an insult when people say we make too much money after all this hard work and the daily grind.
 
not to mention lost income while you are training 50k x 7-8 years = 400k plus student loans which puts you in the hole more than a half million.
 
not to mention lost income while you are training 50k x 7-8 years = 400k plus student loans which puts you in the hole more than a half million.

FWIW the loss of income is only half that since as a resident you draw a salary.

lastly, to those who claim you cant have a good job AND make good money. I beg to differ. Those jobs ARE indeed out there. They arent advertised by Barb Katz, but rather by word of mouth.

There is a nice job outside of nashville where I have a friend, they work 120-140 hours/ month and make 500k+. Not brutal work either, not seeing 4 patients per hour. The jobs are def out there but you have to do your research.

I just made partner in my group. Work isnt brutal (though it is hard like all ER jobs). Quinn I think took a job he loves as well and pays well.

Dont believe that any job that pays 400k+ is horrible in tons of other ways.
 
OP lives in an expensive house and contributes 24k a year to charity... I think many people would be insulted at the insinuation that it's difficult to budget 200k+ a year in income. My parents make less than that, provided for a family of 5 kids, and we live better than the OP seemingly does. All depends on how you you manage your money, I suppose.
 
OP lives in an expensive house and contributes 24k a year to charity... I think many people would be insulted at the insinuation that it's difficult to budget 200k+ a year in income. My parents make less than that, provided for a family of 5 kids, and we live better than the OP seemingly does. All depends on how you you manage your money, I suppose.

This is the appropriate attitude to have in your stage of life. However, if you get into medical school and are finishing up residency then not having your expenses inflate in a compensatory manner upon graduating requires conscious thought and sometimes difficult decisions. That was the OP's main point, and as someone who's on the OP's end of things, completely valid
 
Last edited:
A few things about your parents. If they're living better with less money and more kids, then somewhere the math doesn't add up. I had family that lived better than we did growing up, even though our family had a higher income. It always made me jealous. They've since defaulted, declared bankruptcy, and now ask me for money and job assistance (as in, can you get us a job at your clinic/hospital). Not saying that your case follows this, but just being logical. Remember, he's also saving a lot more money than most, and is planning for his retirement.

That being said, unlike ActiveDutyMD, I have significantly more student loans, but significantly higher income (two physician family). My budget is different from his. He wasn't trying to say everyone should follow his budget, but just giving examples to the pre-meds and anyone else who thinks we have "the big bucks." All of us are middle class. Where on the spectrum depends on what you do with what you have.
 
A few things about your parents. If they're living better with less money and more kids, then somewhere the math doesn't add up. I had family that lived better than we did growing up, even though our family had a higher income. It always made me jealous. They've since defaulted, declared bankruptcy, and now ask me for money and job assistance (as in, can you get us a job at your clinic/hospital). Not saying that your case follows this, but just being logical. Remember, he's also saving a lot more money than most, and is planning for his retirement.

That being said, unlike ActiveDutyMD, I have significantly more student loans, but significantly higher income (two physician family). My budget is different from his. He wasn't trying to say everyone should follow his budget, but just giving examples to the pre-meds and anyone else who thinks we have "the big bucks." All of us are middle class. Where on the spectrum depends on what you do with what you have.

My parents are very sharp when it comes to investments and overall financial sense. They don't earn 200k/year, but I'm willing to bet we live above what a lot of people who do earn that much do.

I just think it's a bit.. strange to be posting up this kind of thread when you contribute 24k a year in charity alone. Very noble, but that alone is more than a lot of peoples' salaries for the year! If you can afford to do that, clearly you're doing well. That's really all there is to it.
 
My parents are very sharp when it comes to investments and overall financial sense. They don't earn 200k/year, but I'm willing to bet we live above what a lot of people who do earn that much do.

I just think it's a bit.. strange to be posting up this kind of thread when you contribute 24k a year in charity alone. Very noble, but that alone is more than a lot of peoples' salaries for the year! If you can afford to do that, clearly you're doing well. That's really all there is to it.

The point isn't that physicians don't do well. The point is how quickly small luxuries add up. Physicians spend more than a decade living off on $15k-50k a year and develop an attitude that $200k is such a ridiculously large income that financial planning is a non-issue...
 
I just think it's a bit.. strange to be posting up this kind of thread when you contribute 24k a year in charity alone. Very noble, but that alone is more than a lot of peoples' salaries for the year! If you can afford to do that, clearly you're doing well. That's really all there is to it.

I still can't believe how many people don't understand what the "charity" contribution is that is referred to. Mitt Romney makes the same type of charitable contribution if that helps.
 
Members don't see this ad :)
My parents are very sharp when it comes to investments and overall financial sense. They don't earn 200k/year, but I'm willing to bet we live above what a lot of people who do earn that much do.
Also, your definition of "above" is vague. Does it mean you consume more? Are they more frugal? Do you go on more vacations? What does it mean?

We can have as more fun at the San Antonio Zoo for $20 than we can at Sea World for $120, which is the cost of two adult tickets for the day.
 

HIlarious.. on a serious note I dont understand why people would be mad at someone who chooses to donate some of the money he earns.

I dont believe Actuveduty was whining or complaining. Simply he posted his budget.

Then we have people insinuating all sorts of stuff.

200k is good money, no doubt but it isnt buy a jet and fly the world money especially with a family and any type of exit strategy.
 
HIlarious.. on a serious note I dont understand why people would be mad at someone who chooses to donate some of the money he earns.

I dont believe Actuveduty was whining or complaining. Simply he posted his budget.

Then we have people insinuating all sorts of stuff.

200k is good money, no doubt but it isnt buy a jet and fly the world money especially with a family and any type of exit strategy.

This. We make good money as ED docs (especially those of us not contending with 6.8% loans), but it's not enough money to live upper-class unless you came from that background already or you have something lucrative going besides clinical medicine. You also won't make enough to offset a string of failed marriages or a crippling substance/gambling addiction. Barring those or getting suckered into horrifically bad investments and you can probably retire a couple of years after your youngest is out of college.
 
I think that the people who are still in the pipeline don't like to hear that it really is pretty tough on the other side. And it is hard to fathom when you're getting nothing or a little more than nothing how you could gross ~25K a month and still have money issues. I think some students/residents hear that and think "I'll be smarter and better." which is great. Others think "You guys are jackasses and spend your money wrong!" which is less great but understandable. You have to live through it.

I can say though that on the incomes we're talking about $25K/yr for charity or debauchery or garden gnomes isn't the determining factor in financial happiness vs. angst.
 
Last edited:
Active, thank you for posting your personal information and sharing it with the rest of us.

The bottom line is a lot of physician salaries look very good on the surface, especially when you are just a measly student, resident, or any hard working person in society, but you really need to look at the whole picture. There were a ton of sacrifices to make it all the way to becoming a full-fledged physician. Lots of moving from city to city, studying, being evaluated from every which way, and test after test which never seem to end. While others were out having fun, you were working pretty hard. However once you finally reach your goal and start working, you begin to see things in a different way. Consider some of the following which have already been discussed in this and other threads:

1) Physicians income is deferred income. While your friends were out working in their early to mid 20s and starting to save for retirement, you were most likely incurring a 100 to 250K in student loans (unless of course you were fortunate enough to have a family to support you). This deferment of income also means that you reach the highest tax brackets and lose out on certain deductions.

2) Most physicians start working in their early to mid 30s already behind the eight ball saving for retirement. A chunk of your salary will have to go here. 10-20%.

3) My wife and I are both physicians and have been out for 2 years. We both have 200K + in student loans and between taxes (hit that alternative minimum tax) and student loan payments (30 year plan mind you) nearly 60% of our salary was eaten up by these two items alone last year. That is to say, one of us is entirely working for taxes and student loans. This does not include saving for retirement, and actually trying to save some money for a rainy day(you should have a 6 month emergency fund). Just to make things even better, taxes will be increasing in the coming years (next year for instance there is a 0.9% increase in taxes on families making 250K or more for Medicare and federal, state, local, and property taxes will be increasing at some point especially for you rich corporate jet owners making 250K or more).

4) Insurance. Now that you are making the money, you have to protect yourself. Disability insurance is a must, and life insurance should be considered depending on your situation. These things aren't cheap and can eat up a nice chunk of your monthly salary.

5) You have kids? Money needs to be put away for their education. More money to be put away.

6) You want a home? If you intend on putting 20% down, that is additional money that needs to be saved.

That money that looked so good initially, can really go fast: taxes, student loan payments, saving for retirement, insurance, college funds and we haven't even talked about normal living expenses.
 
3) My wife and I are both physicians and have been out for 2 years. We both have 200K + in student loans and between taxes (hit that alternative minimum tax) and student loan payments (30 year plan mind you) nearly 60% of our salary was eaten up by these two items alone last year. That is to say, one of us is entirely working for taxes and student loans. This does not include saving for retirement, and actually trying to save some money for a rainy day(you should have a 6 month emergency fund). Just to make things even better, taxes will be increasing in the coming years (next year for instance there is a 0.9% increase in taxes on families making 250K or more for Medicare and federal, state, local, and property taxes will be increasing at some point especially for you rich corporate jet owners making 250K or more).

I like to be honest.. 60%? NO way.. lets assume you and your spouse each make 200k (avg physician income of about 200k)..

You probably paid 25% in income tax, another 3% to social security due to the cap, 1.5% medicare, I dont know where you live but lets assume a high estimate of 5% to your state. Thats 34.5% of 400k. Lets call that 125k.. That leaves you with 275k. If you both have 200k in loans (400k total at 6% interest if paid over 30 years would be ~$2400/ month) or ~30k per year..

Thats 155k total which is a TON of money but well under 60%.

I agree wit hthe rest of your post.

Also, you forgot the car payment, vacation, clothes etc.
 
As a new attending earning about what the OP does (albeit in a different specialty), I just want to say thanks for sharing that information. It is helpful to reflect where the money is really going since there's just no question that spending goes up no matter how hard you try to prevent it when your income goes up. Taxes, student loan payments, and insurance alone are basically non-negotiable.

I don't think the point of this thread is to rip apart people for how they choose to spend their money exactly provided yacht maintenance and chauffeur salary are not in the budget. You may disagree with how the OP exactly breaks down his money. I will not be donating so much to charity AKA religious organizations, but it's not so unreasonable for a family to do so. I know plenty that do at all income levels. I do not own a home yet choosing to only spend $1100 in rent a month for a crappy 1000 sq ft 2 bd/1ba condo with 2 adults, a one year old, and a 50 lb dog. But that has more to do with our reluctance to take on the responsibility of a home than to spend the money. The OP's budget certainly is within the realm of reasonableness if those are his/her priorities. We spend relatively more on vacations. I was born in Europe and this has always been more of a priority for more family.

There's more than one way to live life reasonably.
 
I like to be honest.. 60%? NO way.. lets assume you and your spouse each make 200k (avg physician income of about 200k)..

You probably paid 25% in income tax, another 3% to social security due to the cap, 1.5% medicare, I dont know where you live but lets assume a high estimate of 5% to your state. Thats 34.5% of 400k. Lets call that 125k.. That leaves you with 275k. If you both have 200k in loans (400k total at 6% interest if paid over 30 years would be ~$2400/ month) or ~30k per year..

Thats 155k total which is a TON of money but well under 60%.

I agree wit hthe rest of your post.

Also, you forgot the car payment, vacation, clothes etc.

You are right. I gave a rough estimate and rounded it the wrong way. It is about 50% rounding down. The point being that one of us is entirely working for taxes (don't forget city taxes which in some cities, including ours, is quite high, alternative minimum tax which we learned about the hard way, and property taxes--which I did not include because we do not own a home as of now) and student loans. This doesn't take into consideration any other expenses. This is just taxes and loans.

We made 340 total last year which again sounds incredible, paid 135 in taxes (are we paying our fair share?), and paid 3500 a month in student loans. 52% to be exact. This does not include putting away for retirement (something we purposely did not do our first year working and hurt us some), saving to one day afford a home, paying for disability and life insurance (considerable, but necessary expense) and kids college fund (because you certainly aren't getting any help from anyone to pay for their education).

Granted, it was our choice to incur such a debt to get an education and become a physician. We were unfortunate that our families could not afford to pay for our schooling or help us out much. Otherwise, we would be in great shape. The student loans are our nice home payment.

Taxes will be increasing in the future as well. Like I said 0.9% increase next year on families making 250K or more for Medicare and it seems inevitable that federal income taxes, some state taxes, and city taxes will be increasing for these salary levels as well.

I guess the point is to show that a very high salary on the surface, while still a decent salary overall, is not as great as you initially would expect, especially when you start looking a little deeper. Let's also not forget, most physicians are working pretty hard for this money. We all sacrificed a lot and again deferred this income. In addition, do not forget there is a lawyer around every corner. They need to feed their families too. They are hurting as well. Again, this was our choice to become a physician. I love what I do and wouldn't change it for anything, but there are plenty of other ways to make significant money. Being a physician, especially if you have to finance the education yourself, is not one of them.
 
HPB,

Believe me.. I have been an attending for 2 years now and moonlit before that. I make good money and trust me when I have to pay my taxes it kills me. through write offs I made 320k last year but with my home, moonlighting income which allowed independent contractor write offs, kids, etc I paid just over 60k in federal taxes, not including, medicare, social security etc.

I have over 3 million in term life insurance (i just got) which costs my ~200/month, disability $415 per month which like you said to me are just not negoatiable.

Between my wife and I we have over 400k in student loan debt not including our home.

We donate to our undergrad institution though a small amount and a bit to some other charities. We also have kids and those incredible costs.

My priorites are family (hence vacation), kids education, retirement, then other crap like nice house, nice car etc.

We have been doing well we have an ok house, old cars 2006 and 2005 model years.

I am not here to tell anyone what to do with their money but if you arent funding your retirement you are screwing yourself. Keep in mind that whatever the amount is you can do depending on your situation if you put in 50k thats 25k from your taxes and 25k from your take home money.

The only way to become financially comfortable as a doc is by finding legal ways to limit your tax burden. The easiest way is to fund retirement.
 
I'm surprised this thread is still active. To all my SDN peeps sorry I've been AWOL. Probably will remain so.

Been out now since 2006. Took academic job in East Coast. Sucked. Difficult to climb up the corporate ladder. Expensive city. Moved to Midwest. Doesn't suck. Cost of living nothing. Bought dream house.

I kinda played it dumb. Bought three cars in 5 years (two Porsches, and a minivan), two houses. Bought my dream house (4+ car garage). Lived large. That's ok. I make a lot of money now. I work on average 14 shifts/mo. ~ 110-120 hours a month. Mixes of 6,7,8s, and 12s. Only about 4 12s a month. Also associate med director (about 38k a year). Save 50k in retirement a year. No credit card debt. No car loans. Still paying off mortgages. Put 1500/month in kids college. Paying off my student loans (slowly, at < 2% interest) and wife's student loans. Never bat an eye when at Target buying stuff.

Life is good. You can work you butt off, 20 shifts a month, make 600k +. But then you'd be missing out on things. I may not make the most at my group, but I do quite well.

Our job isn't easy. I see sick people. Sometimes think about criking someone and then one of my backup airways work. Some drug seekers. Nurses pissed off at a fellow doc. Patient complaints. More drug seekers. People there for no reason.

But I have the best job on earth.

There are fantastic jobs out there. You either need to network or take a ****ty job for a few years and then get better experience and network some more.

FWIW I cold called my current job and got it after the interview. I'm a lucky guy.

Q
 
Bumping to say thanks for posting this. I hear a lot of people say "this isn't enough to live off of" or "this is a luxurious salary" but I rarely see actual numbers, meaning that I don't always get the full picture. I didn't read every single comment in the thread, but I definitely am taking heed of the advice that increasing standard of living modestly is the key to financial success in the years immediately following residency.
 
I would say my wife and I are a special case. Even with a big mortgage, a second mortgage, and quite a few student loan bills, we still come out more than comfortable. I'm always trying to find more things to invest some of that money, because, honestly, while it is nice now to pretty much do whatever we want, it will be nicer to retire 5-10 years earlier. I've maxed out most of my tax savings options (Roth/SEP), and my wife won't be able to put money into her 401k until this August, when she has had 1 year of work. Then we will max that out well.
Paying down student loans doesn't make much sense for me, as they're pretty low. I will probably pay off the vehicles, but there isn't much incentive for me to do that either. Right now, most of my "extra" money goes to buying furniture/painting/adding to the house.
 
Last edited by a moderator:
So all I need to do is marry another doctor. Gotcha.:thumbup:
 
Maybe I ought to update this since I made partner. Lots more room in the budget now. A good chunk is invested, a fair bit more for taxes, a little more for charity and we spend more on stuff and trips. 2nd mortgage still there, but rent covers it. First mortgage now lower after refinancing.
 
Update it and resurrect the thread with a fresh take.

Please?

Do yours. The more people post, the better idea people will get about what we earn.
Mine's changed significantly as well, but the opposite direction.
 
Thank you all for being willing to contribute to this thread. As a nontrad on the starting end staring down quite a bit of debt, it's good to have this perspective.
 
Gross income as an IC - ~$40k/month. Federal taxes around $112k (will go up significantly next year). Average net income per month after all expenses (including but not limiteed to taxes, mortgage, loans, maximally funded SEP) ~$2.7k. Majority of expenses are the mortgage, child care, then medical bills.
 
Last edited:
Do yours. The more people post, the better idea people will get about what we earn.
Mine's changed significantly as well, but the opposite direction.

Do my what... my budget ?

I've only been working for just shy of four months now. The "start-up costs" of moving, new furniture, car repairs.... they'd muddy the waters too much. Once I get "settled", then sure.
 
Gross income as an IC - ~$40k/month. Federal taxes around $112k (will go up significantly next year). Average net income per month after all expenses (including but not limiteed to taxes, mortgage, loans, maximally funded SEP) ~$2.7k. Majority of expenses are the mortgage, child care, then medical bills.

Do you mind me asking why your taxes will significantly rise next year? Is the "fiscal cliff" involved?
 
Do you mind me asking why your taxes will significantly rise next year? Is the "fiscal cliff" involved?

Obama is going to raise taxes on those earning >250k. This will likely affect most EM physicians and has nothing to do with the fiscal cliff...this is what we voted for
 
Obama is going to raise taxes on those earning >250k. This will likely affect most EM physicians and has nothing to do with the fiscal cliff...this is what we voted for

By we you mean americans in general.. Not the majority of those who will be affected.

We will see what the tax deal brings. If they cut spending by $4 for every $1 they raise in new taxes then im fine with letting all the bush tax cuts expire.
 
By we you mean americans in general.. Not the majority of those who will be affected.

We will see what the tax deal brings. If they cut spending by $4 for every $1 they raise in new taxes then im fine with letting all the bush tax cuts expire.

Where would you make the cuts? Not just directing this at you... its just something that I hear sooo many people say, and I'm wondering if there is just something that they all know about the budget that I don't. 60% of the budget is comprised of defense spending, Social Security, and Medicare/Medicaid (mostly Medicare) at about 20-21% each. 13% goes to so-called "entitlement" programming. 6% goes to interest payments on the national debt. The last 20% miscellaneous, but no less important. Like roads/transportation, public schools, NIH/research funding, VA bennies. Stuff like that.

Where would you make the cuts? Just curious.
 
Where would you make the cuts? Not just directing this at you... its just something that I hear sooo many people say, and I'm wondering if there is just something that they all know about the budget that I don't. 60% of the budget is comprised of defense spending, Social Security, and Medicare/Medicaid (mostly Medicare) at about 20-21% each. 13% goes to so-called "entitlement" programming. 6% goes to interest payments on the national debt. The last 20% miscellaneous, but no less important. Like roads/transportation, public schools, NIH/research funding, VA bennies. Stuff like that.

Where would you make the cuts? Just curious.

Defense it's obvious we do not need that much money going to defense. The defense budget should be cut by half and we still be more than alright.
 
Defense it's obvious we do not need that much money going to defense. The defense budget should be cut by half and we still be more than alright.

1) I'm not sure what you mean by 'alright'. Alright as in, we likely won't be facing a 'red dawn' type scenario? Of course, that's absolutely true. Alright as in, we will still be able to keep middle eastern countries from using their military powers to disrupt our economy by, say, closing the straights of hormuz? Alright as in we will be able to dictate who can and can't acquire what weapons systems? Alright as in we can continue to wage small operations on four continents to hunt down criminals and terrorists that our citizens demand to be absolutely and completely safe from? No I'm not sure we can have enormous defense cuts and still do all that. Its not 'obvious' that we can cut the defense budget in half unless you're fine with a nuclear Iran, a terroist controlled Yemin, a Russian controled Georgia, a roiled oil market, and a smoking hole where Israel used to be. The problem with quitting the game of international politics is that everyone else keeps playing.

2) The military is an entity with a lot of long term investments that can be ruined by short term decision making. It costs a lot more to build something than to maintain it, and cutting the budget in half can scrab hundreds of billions of dollars worth of training, research, munitions, vehicles, and even bases to save a few hundred million on maintinance and salaries. Which would be fine, but we all know that we're going to be right back at war as soon as the next bomb blows up in Times square, and then we're going to need to re-buy everything we trashed.

3) The miltary hires a LOT of people. You can cut the defense budget gradually over years, and retire people out. However its generally viewed as a bad idea for the economy to simply give several hundred thousand people pink slips.

4) A big portion of the military's budget is fixed, non-defense costs. Insuring injured veterans, paying pensions, etc. Half the budget is more than three quarters of what's actually spent on current defense.
 
I don't see why everyone is ripping on the op. Sure, my father makes 24k/year with seven kids, and I know how to live like that, but one of the reasons I chose this specialty is to be able to contribute something like 24k/year for charity. I know how hard it is for low income families out there and I went into this field so I can be a column they can lean on.

What I was curious about is how come not many people here suggest opening a business for retirement. I was planning on saving up like 300k so I can go halfsies with one of my brothers on a business. He would do all the work and I would put in all the money. That would be one part of my retirement fund as I plan on going over seas to start a few residencies in some developing 2nd world countries where I will not be making any money.

Is the business model not a good retirement plan because of the volatility and inherent risk associated with running a business?
 
What I was curious about is how come not many people here suggest opening a business for retirement. I was planning on saving up like 300k so I can go halfsies with one of my brothers on a business. He would do all the work and I would put in all the money. That would be one part of my retirement fund as I plan on going over seas to start a few residencies in some developing 2nd world countries where I will not be making any money.

Is the business model not a good retirement plan because of the volatility and inherent risk associated with running a business?

Under no circumstances would I do this. More than half of all new small business fail in under 4 years. See chart below for details based on sector.

businesssurvivalsmall.gif


Lending money to family to start a business is even worse because you have no direct control over the day to day operations (per what you said your plan was.) When the business fails, it changes the relationship you have with your sibling. Even if you take a laissez-faire approach and figure "easy come, easy go," your sibling will see that he or she "wasted" 300,000 USD of YOUR money. Good luck keeping the same relationship after that. My relationship with my sister is way more important than that.

Develop an asset allocation, put your money in low cost index funds, rebalance, and stay the course. ADMD developed a blog after (I believe) making this post. Check it out at http://whitecoatinvestor.com. It has lots of good information for doctors (and future doctors.)
 
Where would you make the cuts? Not just directing this at you... its just something that I hear sooo many people say, and I'm wondering if there is just something that they all know about the budget that I don't. 60% of the budget is comprised of defense spending, Social Security, and Medicare/Medicaid (mostly Medicare) at about 20-21% each. 13% goes to so-called "entitlement" programming. 6% goes to interest payments on the national debt. The last 20% miscellaneous, but no less important. Like roads/transportation, public schools, NIH/research funding, VA bennies. Stuff like that.

Where would you make the cuts? Just curious.

Since there are no easy answers and answering a question like this is bound to open up criticism but Im fine with that. Here is a broad based plan from me. Keep in mind I dont do this for a living. You surely wouldnt ask someone in economics or policy to reduce your fracture or suture up your kid.

Here goes.
1) End the war in afghanistan, cut 7.5% of our military spending, let the military decide where. Cuts by 1% per yr and 0.5% the last yr.
2) Allow the govt to negotiate prescription drug costs (somehow as docs we get screwed but big pharma reaps the rewards, they have one of the highest profit margins as a group of any publicly traded sector).
3) Medicare starts at 67 for anyone under 50 on Jan 1 2013
4) Legalize and tax weed like tobacco
5) Cut the 60 billion found in the dept of education.. cut it to about 1/3 of that. Fix whatever idiot rule allows the interest rate on this money to go to 6.8%. Mine were all cheaper and were not subsidized. I know this would cut some aid, so be it.
6) Repeal obamacare
7) simplify the tax code (I would be fine for an extremely simple tax code for example 10% VAT type tax plus 10% for all income above 150k leaving ONLY the mortgage tax deduction. NOTHING ELSE. I am open to other options).
8) I wouldnt touch social security but I believe I addressed the other 2 big ones.
9) Shrink federal govt employment by 10-15% through attrition, bring pay in line with private jobs.
10) Bring congress back into social security
11) Continue to stop medicare/medicaid fraud (10% of all costs of the program)
12) Cut aid to all countries that dont support us (Pakistan, Egypt etc).

I would then raise taxes 0.5% per yr across the board until we reach the pre bush tax cut numbers (assuming #7 is a no go).

Oh some extra money here..
http://www.coburn.senate.gov/public...&File_id=b69a6ebd-7ebe-41b7-bb03-c25a5e194365
My favorites:

$30 million to help Pakistani Mango farmers: This was part of a four-year, $90 million effort to boost hiring and sales among Pakistani businesses funded through the U.S. Agency for International Development.

$765,828 for pancakes: Federal funding went to the Anacostia Economic Development Corp to build an International House of Pancake franchise (and train its workers) in an "underserved community." The underserved community, however, turned out to the a toney area of Washington D.C. - Columbia Heights, which is termed "one of Washington's more desirable neighborhoods."

$120 million in retirement and disability benefits to federal employees who have died: The Inspector General for the U.S. Office of Personnel management found that "the amount of post-death improper payments is consistently $100 million - $150 million annually, totaling over $601 million in the last five years."

$652,740 to create an Oklahoma "visitor's center": The scenic highway that runs from Talihina, Oklahoma to Mena, Ark., already has three visitor's centers, but this federal grant would create a fourth. The abandoned rock house that the government proposes to turn into a new visitor's center will cost more than 14 times the median value of a home in the area. That would be bad enough, but the Talimena Drive area is in good shape, while the rest of eastern Oklahoma's roads could use some serious attention. The area ranks 8th in the nation for its number of "structurally deficient" bridges.

$113,277 for video games: The International Center for the History of Electronic Games got the money to conduct a detailed conservation survey of video games.

$484,000 for pizza: A private developer was giving federal grant money to build Mellow Mushroom Pizza Bakers, an Arlington, Tx., outlet known for its tongue-in-cheek references to drug and hippie culture.

$100,000 for a celebrity chef show in Indonesia: The Washington State Fruit Commission asked for the grant to help promote their fruit and cooking recipes in "an emerging market." Can you spell "Boondoggle?"

$10 million for Pakistani Sesame Street: We must really love the Pakistanis. We must have a close and trusting relationship with the country that somehow managed to miss the fact that Osama bin Laden was living within spitting distance of a Pakistani military base for years. Because, after funding the Pakistani Mango growers, the government felt it needed to spend some time and money remaking big bird and the other Sesame Street characters into a show called "SimSim Humara" for the Pakistani market.

$550,000 for "Rockin' the Kremlin: A documentary on how rock and roll contributed to the end of the cold war.

$702,558 to bring television to Vietnamese villages: No, it wasn't just for the sitcoms. Researchers at Pennsylvania State University wanted to know how television affects family formation and reproductive health. So where better to study the problem than 14 remote Vietnamese villages, where the government paid to bring the t.v.s and gas generators, because, of course, these villages also don't have electric power?

In quotes is about 163 Million. Enough to throw a great party.


Send that to the CBO for scoring ok? I can help you.. it would bring us way in line.

Glitterbox What would you do? Keep in mind even if you taxed every penny earned over 250k you couldnt balance the budget.
 
I have other specific thoughts as well. Ill wait for your reply.
 
Ectopic that was one of the best posts I have ever read. I agree with every word. Although I might add means testing to social security, however, I haven't really spent time working through all the implications of it yet. You ever make a run for political office you have my vote.
 
I have other specific thoughts as well. Ill wait for your reply.

Ectopic that was one of the best posts I have ever read. I agree with every word. Although I might add means testing to social security, however, I haven't really spent time working through all the implications of it yet. You ever make a run for political office you have my vote.

Dude. Ectopic. Awesome. You covered every base and I couldn't agree more. I personally would up the tax bracket on those making 750K+ (I am negotiable on this number), but otherwise, well done.

Notice how there is no mention of gay rights, abortion, war on holiday, or other talking points. Those issues need to take a back seat for a bit while we focus on pulling our country out of a recession and avoid My Big Fat Greek Wedding.
 

I dunno, tough subject. In theory I think it is unfair and anti-capitalistic. However, I feel that sometimes on the extreme ends of theoretical situations, observed real word consequences are more important than the principles of the theory. I think the number can be very high, such as $1M or even $1.5M per annum but I think there should be SOME limit. I don't want to limit entrepreneurship but I figure at that point someone would rather still strive to make $1.3M per annum and pay 30% taxes then make 400K paying 10% taxes (the numbers are not irrelevant, but as less important than the concept, very negotiable). I think if the annual salary threshold is high enough and the tax increase isn't ludicrous, then it will be a major source of income for the government without deterring those from pursing that kind of wealth.

Part of the reason I support this type of system is because a large majority of people with this kind of wealth inherited it. And while I do not think that we should have 50% estate taxes or be unable to create a fortune for oneself and every generation after, people born into extreme wealth (> $20M net) who have done nothing but won the genetic lottery can contribute a slightly better dish to the potluck.
 
Top