Anyone want to leave medicine due to health insurance low reimbursements, etc?

Discussion in 'Medical Students - MD' started by IceMan007, May 8, 2008.

  1. IceMan007

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    I'm currently a pre-med and have just started learning more about the medical profession and how physicians get paid. It's very discouraging to see the disconnect between providing proper care to patients and receiving adequate reimbursement for your services, with basically health insurers dictating the practice of medicine. The more I read about the tug-o-war between physicians and health insurers the more discouraged I get about the medical profession and the time and money investment I am facing. At the end of school and residency I'd like to think the sacrifices I have made will be compensated well and were worth my effort, yet it seems the healthcare system continues to get worse for physicians. Are any of you current med students feeling down about all this insurance stuff and declining reimbursements to the point you have contemplated leaving medicine or wish you hadn't chosen this profession?
     
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  3. Taurus

    Taurus Paul Revere of Medicine

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    If you're smart, you'll go dentistry.
     
  4. soonereng

    soonereng Double Trouble
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    Nope. I didn't go into medicine for the money. As a matter of fact, it's really at best a break even proposition since I was an engineer with an established career.

    I wanted to work with my wife who is in the medical field and have our own clinic. That's my goal. If it all becomes socialized and I can't have a private clinic any more, then I would consider ditching it, but I don't really see that happening.
     
  5. IceMan007

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    What field of medicine are you wanting to specialize in?
     
  6. Medicine is the wrong field to enter if you're looking for a high-earning job.

    There are other easier paths towards becoming financially successful.
     
  7. cpants

    cpants Member

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    Like dental school.
     
  8. franklinave

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    Like what?

    Starting a successful company is one way of making money quickly, but what percentage of startups are successful? I really can't think of a more reliably lucrative field than medicine. Can you?
     
  9. eikenhein

    eikenhein my cat is awesome, his name is bandit
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    MBA, DDS, OD, PA, NP, PharmD are all well compensated. If you do a cost-benefit ratio that includes years of study, tuition, compensation, hours worked, etc..., it might even be better than medicine. I'm sure if you could get into med school, you could probably get into those fields as well.
     
  10. franklinave

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    MBA: MBA's are paid much worse, ON AVERAGE, than doctors. Also much more disposable.
    DDS: Is dentistry really easier than medicine? From what I understand it's just as rigorous yet less lucrative, on average.
    OD: What is this?
    PA: Physician assistant? Easier and around 100K/yr less lucrative.
    NP: Is this a naturopath? I haven't seen stats but I'm assuming much less lucrative.
    PharmD: Again, much less pay.
     
  11. franklinave

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    Let's do a quick and rough cost benefit ratio right now:
    Years of study: 4
    Med school debt: ~200k?
    Hours worked: Some easily attainable specialties average around 40 hrs/week and $200k/yr. Some not so easily attainable specialties average around 40 hrs/week and $350k/yr.

    By the end of your third year out of residency you should be able to have repayed your medschool debt. Let's say you work 20 years. Guess which wins (100k times 25 years; rough average over all of the fields you mentioned) vs. (200k+ for ~17 years; 20 years minus the ~3 years you're repaying debt). I think this is obvious.
     
  12. OncoCaP

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    You would be wise to consider all your options. One thing about the medical field is that a large number of doctors, residents, and medical students like to complain (way way above average). They are perfectionistic and if there is a little spot, it gets magnified and analyzed. Some of the experiences aren't that great, but I always like it how I'll read an article about how a physician is just struggling with Medicare and then bringing home $120K/yr with all loans paid. If you keep your expectations reasonable, you'll likely come out OK. Thus, don't let the huge amount of negativity sway you unreasonably. The complaints are way out of proportion with the disease when compared with other professions. Yes, there are problems, but >90% of physicians make over $100K per year even after loan payments. They like things to be good and when they aren't ... they complain about it. In most other professions you just sort of take the good with the bad. In addition, there is still a stunning/surreal amount of money wasted in American medicine, and if you're willing to be creative, you can still get a significant chuck of this even legitimately so. However, this is very competitive arena and I would not assume that you will come out making a huge salary. You won't starve to death and you might get to be part of an amazing profession. Financial rewards are also not the only rewards out there.
     
  13. Strength&Speed

    Strength&Speed Need more speed......

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    It depends from what I've read.

    I saw a relatively believable and well done cost/benefit analysis. Basically it said an MBA generally a better investment over time than MD if you choose low paying specialty. If you don't, your investment is better in the MD. I would assume a DDS would be similar, maybe even better than an MBA, I don't know.

    You can't do consistently better than a high paying medical specialty. I don't care what degree or what line of work you're in...nothing consistently pays that well on average.
     
  14. Strength&Speed

    Strength&Speed Need more speed......

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    franklin...you go to school for 4 years...then at LEAST 3 years afterward. Many will be 5...and then possibly a fellowship. I would say you need to count on 4-5 years. Some surgery guys will be 6-8 yrs. That's 4 years with no income....200,000 in debt, and 3-8 years getting paid 50,000 dollars or less. And loan interest is accumulating that whole time. Meanwhile, your friends are making money that is compounding over time (you know you're 401 k math). And this is money and time at the "prime" of your life, if you believe in such a thing.

    Im not saying don't do it. I recommend it...it was a blast for me. But, be prepared for financial pain for quite a while...until the pendulum shifts for you later on.
     
  15. lord_jeebus

    lord_jeebus 和魂洋才
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    Dentistry :thumbup::thumbup::thumbup:

    I would rather be a dentist than go into most (but not all) fields of medicine.

    There are a few great fields in medicine, and I knew I was interested in one of them when I started. However I think that most fields are not worth going into unless you are passionate about them to the point that you could not do anything else. Many premeds plan to pick their specialty during medical school but I don't think this is wise. (I think it's ok to change your mind if you discover a passion during your clinical years, but going into med school without a concrete Plan A for a life you will enjoy if you don't find that one passion is a bad idea.)

    If you think you are likely to end up an internist or pediatrician, think long and hard about your decision (and great alternatives like dentistry) before you go into it. Financially the decision makes no sense. Once you finish medical school your debt will keep you from doing most things other than practicing medicine.
     
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  17. Taurus

    Taurus Paul Revere of Medicine

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    :thumbup: Exacto mundo.

    It makes absolutely no sense to me why someone would go to medical school to go into primary care anymore. Midlevels like NP's are working very hard to take over that role and they will have some degree of success. Furthermore, the constant studying during medical school, crappy lifestyles for most specialties, litigation threats, recertification, etc. make medicine not worth it for many medical fields.
     
  18. ClockworkDoc

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    What about ER Med? Do docs still stand a chance holding onto that turf?
     
  19. Taurus

    Taurus Paul Revere of Medicine

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    For any field, ask yourself if you feel comfortable with the distance between you and the midlevel. If a midlevel can do what you do except they need your occasional supervision, then the distance is not great enough. That's what you see in primary care, anesthesia, and even ER. I would think twice about those fields.

    Surgeons were smart to never have allowed midlevels to work unsupervised. If you think about it, does it really require 4 years of medical school and 5 years of residency to do a lap chole or appy? No. If we allowed midlevels, they probably could do minor surgeries and do it well with a surgeon as a backup. Why? Because it's mostly procedures and you get better with practice. You don't need a medical degree to get good at procedures, as CRNA's have demonstrated. For EGD's, colonoscopies, and minimally invasive procedures like ERCP's, cardiac cath's, etc, clinicians perform them and may perf stuff, but they can do them because they can use gen surg as a backup.
     
  20. soonereng

    soonereng Double Trouble
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    Quick, someone get the mods! Taurus' account has been hacked, and whoever did it is saying that the midlevels actually have some skills! :eek:




    Just messing with you Taurus... ;)
     
  21. Taurus

    Taurus Paul Revere of Medicine

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    Yeah, you better hope you're not that 1/10 patients. :smuggrin:
     
  22. Terpskins99

    Terpskins99 Fear... The Stig

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    Keep in mind that the vast majority of dentists practice general dentistry. To get into specialties such as orthodontics or oral surgery, you need to graduate in the top 5% of your class. Also, to earn the big bucks as a regular dentist, you need to own your practice (something NO dentist does straight out of dental school... most people join other practices for a couple years and get the crappy/less lucrative cases as the junior dentist).

    IM docs for the most part stay internists by choice. If you wish to specialize, you essentially have the option to do so (barring certain competitive areas depending on what year it is). Many medical specialties are not that difficult to get into: general surgery, neurology, anesthesiology, psychiatry and pathology are just a few where even the average medical student can pursue if they chose to do so.
     
  23. Taurus

    Taurus Paul Revere of Medicine

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    Ok, my gf is a dental student so I get the info straight from the source.

    You don't need to specialize. The amazing thing about dentistry is that you can do endo, ortho, and implants as a GP. You don't need to be a specialist to do those things. That's like saying a FP doc can do surgery, anesthesia, and read film. Furthermore, dental GP need to refer out cases to specialists if they don't feel that they can handle it. My gf is going to take some year-long weekend courses on endo and ortho so that she doesn't have to refer out much. So she can work during the weekdays and learn how to do specialist stuff on the weekends. That's wicked! So you get an idea of how dental GP's can rack up some income quickly. You can get a corporate dentistry job starting at $150k coming out of school. Dentistry is a good gig is the conclusion I've come to.
     
  24. PharmDstudent

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    At $50.5/hour (that's what they make in my area, which is pretty average), I think you're underestimating a PharmD's potential salary.

    Here's a little math:
    Full-time
    ($50.5/hour X 40 hours/week X 52 weeks) = $105,040/year

    Full-time + overtime
    ($50.5/hour X 40 hours/week x 52 weeks) + ($75.75/hour X 20 hours/week x 49 weeks) = $179,275/year (49 weeks used assuming 3 weeks vacation/year)

    For 60 hours of work/week, I would say that a pharmacist does not make "much less pay". ;)
     
  25. indo

    indo Feed me a stray cat

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    I don't understand how some people honestly have trouble deciding which field to go into. Choosing between medicine, dentistry, and law is like deciding between becoming an Astronaut, porn star, or an oil rig worker. The only thing they have in common is the income tax.
     
  26. indo

    indo Feed me a stray cat

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    How much money does a pharmacist earn?
    In: Salary and Pay Rates

    Answer

    Answer

    As PIC in a chain grocery store pharmacy in Tyler, TX, I reap a base salary of $117,000.

    Answer

    Median annual wage and salary earnings of pharmacists in May 2004 were $84,900. The middle 50 percent earned between $75,720 and $94,850 a year. The lowest 10 percent earned less than $61,200, and the highest 10 percent earned more than $109,850 a year. Median annual earnings in the industries employing the largest numbers of pharmacists in May 2004 were:

    Department stores $86,720
    Grocery stores 85,680
    Health and personal care stores 85,380
    General medical and surgical hospitals 84,560
    Other general merchandise stores 84,170

    Refer to:

    http://www.collegegrad.com/careers/Pharmacists.shtml#ear

    Median annual wage and salary earnings of pharmacists in May 2004 were $84,900. The middle 50 percent earned between $75,720 and $94,850 a year. The lowest 10 percent earned less than $61,200, and the highest 10 percent earned more than $109,850 a year. Median annual earnings in the industries employing the largest numbers of pharmacists in May 2004 were:

    Department stores $86,720
    Grocery stores 85,680
    Health and personal care stores 85,380
    General medical and surgical hospitals 84,560
    Other general merchandise stores 84,170

    Refer to:

    http://www.collegegrad.com/careers/Pharmacists.shtml#ear




    How much money does a doctor earn?
    In: Health, Salary and Pay Rates

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    Physicians have among the highest earnings of any occupation. According to the Medical Group Management Association's Physician Compensation and Production Survey, median total compensation for physicians in 2002 varied by specialty, as shown in table 1 (below). Total compensation for physicians reflects the amount reported as direct compensation for tax purposes, plus all voluntary salary reductions. Salary, bonus and/or incentive payments, research stipends, honoraria, and distribution of profits were included in total compensation.

    Anesthesiology: $306,964
    Surgery, general: $255,438
    Obstetrics/gynecology: $233,061
    Psychiatry: $163,144
    Internal medicine: $155,530
    Pediatrics/adolescent medicine: $152,690
    Family practice (without obstetrics): $150,267

    (This is from the Medical Group Management Association, Physician Compensation and Production Report, 2003, as reprinted in the Department of Labor's career outlook handbook.)
     
  27. dilated

    dilated Fought Law; Law Won

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    You forgot to discount for expected decreases in future earnings. Medicare is scheduled to go bankrupt in 10 years. Oh, did I mention that that bankruptcy date is only if you slash physician fees by 5% a year, every year?

    I think people are fine with the current system's level of reimbursement for the most part. It's the fact that there is absolutely no way that there won't be massive cuts in it that is the problem. Primary care can only be pushed so far before they're literally making what PAs do, but specialists are ripe for the cutting.
     
  28. Dreaming

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    Your logic is flawed. Some people enjoy eating hamburgers, pizza, and steaks. They don't have to "choose" only 1 to enjoy. They are all different yet it is possible to enjoy all of them.
     
  29. Taurus

    Taurus Paul Revere of Medicine

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  30. Law2Doc

    Law2Doc 5K+ Member
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    Unlike the other things you list, an MBA is not a preprofessional degree. You don't get an MBA to get into a field. You get an MBA after you have been working in that field. People on here are so focussed on graduate degrees that lead to jobs that they somehow keep lumping this one in, errantly. The typical model is you work for a couple of years in an industry, and then your employer pays for you to get an MBA. And then you come back to a promotion (not a new job). So it's not a good one to lump in with MD, JD, DDS etc.

    At any rate, many folks on other paths earn salaries less likely to regress with declining insurance reimbursements, and earn salaries much sooner than folks on the MD path. The concept of the time value of money should not be ignored -- a six digit salary in 3-5 years is worth more than a slightly larger salary you might earn 7-10 years out. And debt is higher on the medicine path than most other fields, which can't be ignored from the income calculation. So medicine is a field where incomes are declining, it takes a long time to earn a decent salary, you run up high debt. If you cannot see that these factors don't translate into the most lucrative path, then you deserve what you get.
    SMART people don't go into medicine for the money. They live comfortably on the income that path provides, knowing they could likely have earned more, but would enjoy it less. Take it from someone who came from exactly that latter path.
     
  31. indo

    indo Feed me a stray cat

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    That isn't a good analogy because a person doesn't have to choose a single food for the duration of their career.

    The point is that Law and Medicine are different enough that there really shouldn't be much intrapersonal debate on which to choose. If you like law for reasons a, b, and c and Medicine doesn't offer a, b, and c then there isn't much to decide. Sure, law and medicine both require you to study your *** off and they both throw loads of paperwork at you but other than that studying law and studying medicine aren't alike. With that in mind, people asking themselves if they should go into law or into medicine are really just asking, "what will my parents and their relatives be most impressed by?"
     
  32. eikenhein

    eikenhein my cat is awesome, his name is bandit
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    I don't think it is common for a person to have M.D., D.D.S., and L.L.B., behind their name.
     
  33. vtucci

    vtucci Attending in Emergency Medicine
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    Definitely true that most people do not have MD, DDS and LLB behind their names. LLB- eikenhein, you must be from Europe?

    However, there is a growing number of us who have or will have MD and JD (like Law2Doc and myself).

    Also, not all companies will pay for an MBA. Many business executives end up footing the bill for this themselves in an effort to make themselves more competitive.
     
  34. PharmDstudent

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    Salaries keep going up all the time. Stats from 2004 are outdated to say the least. If someone offered me $40.8/hour (which is what they would be paying if the salary was $84,900/year for 52 weeks of working 40hrs/week), I'd laugh in their face. :laugh: That's 19% less than what my pharmacists are making.
     
  35. AlberttheGator

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    I love my situation.... No debt or loans coming out of med school, everything paid for... so when I get out right away I'm making money.. cha ching.
     
  36. eikenhein

    eikenhein my cat is awesome, his name is bandit
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    CANADA
     
  37. Law2Doc

    Law2Doc 5K+ Member
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    The majority of students at the top 25 graduate business schools have their tuition paid for by an employer. The MBA is meant by design to be a "career enhancer", one that builds on existing business skills and experiences, and thus something companies will pay for. Folks who go get an MBA to get their first job are misconstruing the purpose of the degree. But if you are already a business executive, and your firm doesn't want to pony up, then sure, you might try to use an MBA to make yourself more competitive within that same firm or industry. Again not something particularly useful to think about coming right out of college.
     
  38. osli

    osli Senior Member

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    MBA, Finance, and Law paths offer the potential for very high compensation for a very select few who probably won't have the lifestyle to enjoy it, great compensation for a significant slice who also probably won't have the lifestyle to enjoy it, and good compensation for the rest who may or may not be able to enjoy it.

    Dentistry offers great compensation for a minority slice who were either top of the class or work their butts off... the former enjoy their money, the latter do not.

    Medicine offers very high compensation for a select few who probably won't get to enjoy it, great compensation for a significant minority who will likely be able to enjoy it, and good compensation for the rest, some of whom will continue to work their butts off and some who will enjoy it.

    Bottom line? Medicine is only attractive if: (a) you are passionate about it and nothing else matters... that applies to both the very elite doing neurosurgery and transplant surgery, and the bottom doing pediatrics and internal medicine; (b) you are bright enough to aim for that upper significant minority who make great money in specialties that afford them some semblance of a life... Derm, ENT, Rads, Gas, Ophtho, maybe Ortho, etc. For that section, the financial mathematics is in favor of medicine, even after the 4 years of debt and 4+ years of indentured servitude. If primary care isn't your calling, then the financial equation is much more favorable for dentistry, pharmacy, maybe even business or law (not big law).

    And I love the PharmD math above using 52 working weeks with 20 hours overtime week in week out. I'll take the gig with 8-12 weeks vacation and 50-60 hour averages making twice that. For that, I'm happy to go into debt up to my eyeballs. Fortunately, my actual interests line up perfectly with what common sense says I should be interested in, so I'll actually be very happy in what I hope do.
     
  39. PharmDstudent

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    I'm really surprised at how unfamiliar people are with pharmacists salaries. I was a pre-med first, but I do a lot of research online for the heck of it, so I know what other professionals are making (in general).

    Vacation is always paid, that's why I didn't include it. Typical package is 2-3 weeks/year, benefits, and retirement, but the vacation time can be negotiated depending on the demand and geographical location. Bonuses are possible too if the pharmacy is managed properly.
     
  40. indo

    indo Feed me a stray cat

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    Underwater welders make a ton of money...dangerous though.
     
  41. AwesomO

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    I tell a lot of the premeds I meet to consider PA school.

    You still get to work in the medical field, will most likely have an ultra cush job (compared to that of a physician), and have an 80-100K a year salary with benefits (which is the equivalent of upper level management at most companies).
    Best of all you don't have to do residency. If you want to be an Ortho PA then you apply for and get the job. If you get bored of that you can switch to Critical care. If you want something more relaxing after a few years you can switch to primary care.
    All that for 2 years training after undergrad and almost none of the head aches that come with being a physician.
     
  42. USCguy

    USCguy Earnest Internist

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    Sure people can make more money by starting a successful business or doing something in the business world that pays well, but that doesn't mean anybody can go do that. I'll take medicine anyday over my other career options coming out of college with a generic biology degree. I did biology because I enjoyed science. it eventually led me to medicine.

    I interviewed for two jobs post undergrad to work the 9 months before I started med school (didn't tell them i was planning on staying only 9 months). One was as an environmental consultant and the other was working for the state in the environmental department doing regulatory work (inspection reports, violation letters, etc). The first job offered $25,000 to start (working 60 hrs/week) and s*** for benefits. The guy said when the economy turns down every few years, he has to let people go and the higher paid people are first. That means that if I stay there for a few years and work my salary up to $40,000, I'm getting axed when the economy goes down the crapper. Now I'm a "high" paid job applicant applying against younger people that will take less money. I left the interview when he told me that (appreciated his honesty though).

    The second job offered $29,900. It was a state job and raises, etc. were by pay grade. The max I would make there would be $54,900 (assuming normal performance and promotions) and that would take quite a while to attain. This job had more security and better benefits, but you had to sit at a desk in a cubicle most days writing legal documents to send to companies that were violating pollution codes. I was offered this job, but turned it down after my conscience attacked (3 months of training would be wasted).

    All in all, even socialized medicine sounds better than either of these (in my case) realistic options. Of course, there is always grad school, but I hate research. Even after you account for the additional educational requirements, debt, and crap that goes with practicing medicine; A secure job (which you enjoy most days) that pays $130,000/year is better than the other options where you max out at $50-60 working the same hours.

    Don't go into medicine soley for financial reasons, but don't NOT go into medicine solely for financial reasons
    IMO, of course
     
  43. Law2Doc

    Law2Doc 5K+ Member
    Physician Moderator Emeritus

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    Well, most people with credentials adequate to get into med school will not max out at $60k in all other fields. You could have found something more lucrative if money were your primary goal. I agree that these two options would not get you to the same tax bracket as a physician, but that means nothing -- there are thousands of jobs out there that don't pay well. Doesn't mean that's what premeds are choosing between. Comparing med school to a 25k or 29k job is a bizarre comparison. Compare med school to some of the higher net income options a lot of us had (or left) and you will come to a very different conclusion. Which is why it's foolish to go into medicine for the money. Medicine is a long process where you forgo decent earnings for a long period of time, run up higher debt than pretty much any graduate schooling option, and the incomes are being hit with declining reimbursements. It has good security, and thus far a decent salary, but most other professional tracks are shorter, cheaper, and actually on the rise in income in recent years.
     
  44. USCguy

    USCguy Earnest Internist

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    My post was a reflection of my personal experience. Within the realm of careers I was interested in, medicine was far and away the better choice, both financially and non-financially.

    "don't do it solely for the money, don't not do it solely for the money"
     
  45. marvinGardens

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    Any opinions on whether the scheduled reductions in medicare reimbursements are likely to be voted into law by Congress?

    "One-third of the country is insured by Medicare, and over the next nine years, the government program plans to cut payments to physicians by about 40%, while practice costs are projected to increase 20%, according to the American Medical Association. The first of those cuts will take place in July, when the reimbursement rate to doctors will drop by 10.6%. The next cut, of 5%, will occur in January."

    http://www.forbes.com/2008/05/05/physicians-training-prospects-lead-careers-cx_tw_0505doctors.html
     
  46. hardy

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    Have you heard of Time Value of money?

    Not so obvious anymore.
     
  47. indo

    indo Feed me a stray cat

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    I just saw some paperwork on a pharmacist who has 1 year experience: 12,000 /month. Not bad.
     
  48. 186321

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    You say that but try looking at teeth for 10 hours a day. My father and grandfather are both dentists. If I became one I would be set up with a free office in an amazing location and pool full of patients as my grandfather retires. However, I didn't choose dentistry because I know it would bore the living poop out of me and I would never be truly happy.

    By the way, dentists don't make a killing. Don't get me wrong, Papa has a few million in the bank but he has worked his whole life for it. Not to mention I expressed interest in dentistry early in my life and he was very adamant about me pursuing other options (like medicine) as he believed I would be happier with medicine.
     
  49. NonTradMed

    NonTradMed Perpetual Student

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    I have a friend who was a first year dental student who dropped out to go to medical school. His father is also a dentist. We hit upon talks about medical residency and ended up touching on dentistry. I asked him why dental students even bother to specialize if they can just learn on their own.

    His reply is that by law, general dentists cannot advertise as a endo/ortho/etc to the general public. Hence lies the problem with general dentists trying to specialize without doing a residency. The equipment for those specialized jobs can be expensive and given the startup cost of a dental practice, it would be prohibitively expensive to buy equipments for doing ortho and then only have a handful of patients who come in to have ortho jobs done. You don't want to end up with hundreds of thousands of dollars in equipment sitting there for a handful of patients. Not cost efficient at all.

    Dentistry is a small business with limited producers (i.e the dentist) so to maximize profit, you can't afford to start with a gigantic startup cost. Hence, it's not as easy as doing some weekend courses and telling patients you can do nonGP stuff now.

    My friend's girlfriend is also a dental student as is her father (I knew, kinda incestuous :D) and she said her father worked as a general dentist for several years before going back for an ortho residency. She says this is pretty common for dentists who want to specialize. Dentistry is all about speed, not so much about doing as many different types of procedure as possible.

    Good luck to your girlfriend on specializing but I've been told most students will end up doing general dentistry unless they do a residency afterwards.

    And just to add some substance to the money debate. Just remember that it really sucks to work in something you hate, be it medicine or business or law. None of these professions will put you in the poorhouse, but it can significantly affect the quality of your life. You have to ask yourself, is it worth 20 years of misery for a 6000 sq ft house vs. 3000 sq ft house? I say 'no' but others may disagree. ;)
     
  50. PharmDstudent

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    It depends on how far away they want to co-exist with and/or sleep from their spouse. ;)
     
  51. Taurus

    Taurus Paul Revere of Medicine

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    General dentists make an average of $150-200k already. If they want to make more, the entrepreneurial GP's can take yearlong weekend courses in endo, ortho, implants, etc. to improve on their skillset. I think it's crazy that dental specialists would allow GP's to do these procedures without any cert or residency, but that's how it works and it's not going to change. If GP's didn't do some basic endo for example, then dentistry would be just about drilling and it wouldn't be enough to stay in business.

    The beauty of general dentistry is that they are the first point of contact for the patients. They control the patients. The ortho, endo, perio specialists depend on GP's for referrals. Therefore, if the GP does not want to refer out, he doesn't have to. If the GP feels comfortable doing the endo or ortho, they can do it themselves and refer only the most complex cases. They get to cherry-pick the cases. This is the equivalent of a FP doing surgery, psych, anesthesia, rads, etc. themselves and only sending out only the complex cases.

    I wouldn't worry about equipment costs. The investment would be worth it if you can find the demand. For example, how much does a molar endo pay? $800 - cash. Another thing, you have to remember that the morbidity and mortality from dental procedures is small. People usually don't die, have brain damage, or lose limbs from dental procedures. If a dentist screws up, they can usually fix it with fillings, crowns, implants, etc. Hence, why the malpractice premiums for dentists is so low ~$3000. Therefore, you just need to be good enough to do endo or ortho to be able to offer it. Chances are, the patients won't know the difference.

    Not all dentists would do this. If they did, the specialists would go out of business. The thing with being a dental specialist is that if you're an ortho or endo you're stuck with that field. You can't go back to doing general dentistry. So, if more GP's get wiser, then specialists may suffer.

    My gf's aunt has this setup and is raking in money. If I had to do it all over again, I would probably consider this route.
     
  52. Dreaming

    Dreaming Member

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    What I meant was that someone can like Law because of a, b, and c (which are not offerred in med), but can like Medicine because of x, y, and z (which are not offerred in law).
     

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