Are you concerned about salaries decreasing?

[sanityonleave]

Alright, I'm well aware that I'm opening quite a can of worms here. That said, I'm enjoying my last summer vacation for the next 50 years and waxing poetic about life, liberty, and the pursuit of happiness. I searched for a similar thread and couldn't find one within the last two years.

So here's my question to you guys: are you worried about the possibility of physician salaries decreasing? Do you have a "plan B" if phys salaries decrease below what you would consider "acceptable" for the hours/commitment required?

I realize that talking about income seems to be anathema around here, but I think it's a bit silly not to discuss it at all. I'm not asking for predictions about the future of physician salaries or medicine (that seems to always degenerate into a flame war), just what effects salary changes will have on you personally.

I'll go first and answer my own question: I'm not concerned about decreasing salaries per se. I realize that I'll never make the kind of money that my father makes as a physician (GI, private practice, ~600k/yr -- though he works ~80 hour weeks on average), and while that's a strange feeling, I don't have a significant issue with it. I don't forsee salaries dropping to the point that I would be dissatisfied with my quality of life, and thus I'm not concerned about what fluctuations might happen. I have the advantage of having relatively little educational debt (likely ~45k by the end of school) thanks to relatively low public school tuition, scholarships, and parental assistance.

That said, while I don't have a "plan B", if salaries were to drop significantly to the point where I was unable to earn ~100k/yr or greater and was still required to work ~60 hours/week, I would probably consider shifting out of clinical medicine. I don't think I could leave medicine entirely (I like it too much), but if things really got that bad I could see myself moving into medical technology/administration/device research/something else that either a) required less hours or b) paid better. Those options don't appeal to me nearly as much as clinical medicine, but if I have a family and my spouse doesn't have an income I would make the switch for the sake of providing what I consider an "acceptable" level of support for my family.

Thoughts? Flames?

tl;dr: Are you worried about salaries decreasing and, if so, do you have a "plan B" if salaries drop below what you consider an acceptable lifestyle?

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[drturkleton]

Short answer is I'm not worried - I just don't think it will happen. If pay were too low and hours were too high, here's what I'd consider:

If my spouse were cool with it,
- moving to a location where pay is higher and/or hours are lower
- transitioning my practice to cash-only/no insurance/no medicare if feasible (this may introduce serious financial uncertainty)
- practicing in another country where US MDs are in demand and barriers to entry are low;

otherwise,
- leveraging my medical background in a business capacity within medicine/science like you mention
- leveraging my medical background in finance/consulting

 

[jdh71]

I'm going into a specialty with may actually see an increase in wages as hospitals try to recruit intensivists as employees, with that said. Wages for the high wage earners have really no where to go but down, especially gas and rads. Though, to think anyone will be starving would not be the case not even close. I think it will always be a good and stable job regardless. If we ever find ourselves making less than $100k on average, it will be because the country and economy suck so bad that you wouldn't dare try to do something else. The physician may not have lived in the palace, but he regularly ate at the king's table . . .

 

[shaggy alfresco]

- practicing in another country where US MDs are in demand and barriers to entry are low;

Which country is that?


Hehe, and the answer is yes, obviously I like to make money. But as a non-trad who is leaving a successful career having made decent money (as much as many physicians do), I know the sense of unfulfilledness that you can have when you have all the money you could reasonably want but hate the fact that 75% of your waking hours are in a job you hate - it crushes your spirit like no other. People who go straight into medicine without doing the corporate grind may not realize how bad a job that you truly dislike can be.

I made the change when I realized I'd pretty much rather be homeless than continue what I was doing. So money is of course important, and obviously like most people, I'd love to make a lot of money in addition to doing what I love, but bitter life experience has taught me how much of a secondary concern money is. I want to wake up in the morning and look forward to how I spend my day instead of longing for that 6pm or 7pm to come so I can get out. Not all days will be roses and sunshine in any job, but I don't want to simply tolerate my existence (or worse). So far, even with all the hiccups, everything I've seen in the specialty that I want to be tells me that I'd practice even if reimbursements were extremely low. And that's a good feeling.

But everyone's mileage may vary.

 

[drturkleton]

Which country is that?

Who knows, I'm just thinking of a few anecdotes I've heard. But Shaggy, it sounds like we're in a similar situation. I didn't even leave my career because I disliked it - I just knew I liked science and medicine more. I do agree with you and wish working out in the real world (i.e. not a lab) were required before entrance to medical school. The most important thing I learned is that there is ALWAYS someone who makes more money. If you're an investment banker, you're jealous of the private equity guys. The private equity guys are jealous of the hedge fund traders. Even some investment bankers think doctors are the ones making bank. Everyone always thinks someone else makes more money, and it's better to stop worrying about it sooner than later.

 

[OveractiveBrain]

tl;dr: Are you worried about salaries decreasing and, if so, do you have a "plan B" if salaries drop below what you consider an acceptable lifestyle?

Still playing powerball! I almost won on saturday. I was only 5 numbers off!

 

[NOsquid]

As long as IBR and PSLF stay on the table, or school is made cheaper, I don't care. Might take some of the dbags out of med school.

 

[DoctwoB]

I care. I'm going into specialties assuming that they'll make less then they will currently, but I still don't want to make less money. Only a medstudent/pre-med would say they don't care if their salary is slashed.

 

[shaggy alfresco]

I care. I'm going into specialties assuming that they'll make less then they will currently, but I still don't want to make less money. Only a medstudent/pre-med would say they don't care if their salary is slashed.

I think most people want to make money, but it's different to caring enough to have a 'plan B' as the OP says.

 

[surftheiop]

I think its inevitable that MD salaries will fall in comparison to some other professions. That being said, I'm not too concerned because I'm going into it planning to make a little less than people are making now so shouldn't be a huge shock down the road if salaries are smaller.

Also, seeing as academic salaries are already lower, I doubt they would fall the same percentage as other salaries, so the difference between academic and non-academic salaries won't be as large as currently. So I would be probably even more inclined to do academics than I am now.

Also to help me keep things in perspective, my mom makes like 110K at her job now, but she has been working for the same organization for 26 years, 20 years of which making <55k with a master's degree. (My dad makes like 30k so my mom is the family money maker).
So in comparison, I'll have two extra years school, 160k debt (go to your state school!). Then I'll make 50k for 4-5 years instead of 20, and then if I'm making 110k as attending I'll be way better off than my parents by my mid 30's.

 

[Alvarez13]

Which country is that?


Hehe, and the answer is yes, obviously I like to make money. But as a non-trad who is leaving a successful career having made decent money (as much as many physicians do), I know the sense of unfulfilledness that you can have when you have all the money you could reasonably want but hate the fact that 75% of your waking hours are in a job you hate - it crushes your spirit like no other. People who go straight into medicine without doing the corporate grind may not realize how bad a job that you truly dislike can be.

I made the change when I realized I'd pretty much rather be homeless than continue what I was doing. So money is of course important, and obviously like most people, I'd love to make a lot of money in addition to doing what I love, but bitter life experience has taught me how much of a secondary concern money is. I want to wake up in the morning and look forward to how I spend my day instead of longing for that 6pm or 7pm to come so I can get out. Not all days will be roses and sunshine in any job, but I don't want to simply tolerate my existence (or worse). So far, even with all the hiccups, everything I've seen in the specialty that I want to be tells me that I'd practice even if reimbursements were extremely low. And that's a good feeling.

But everyone's mileage may vary.

I'm from cubicle land too and feel the exact same way. Am missing the health insurance and pay right now, but at least I'm excited about what's ahead for once.

 

[IwannabeDrP]

Hehe, and the answer is yes, obviously I like to make money. But as a non-trad who is leaving a successful career having made decent money (as much as many physicians do), I know the sense of unfulfilledness that you can have when you have all the money you could reasonably want but hate the fact that 75% of your waking hours are in a job you hate - it crushes your spirit like no other. People who go straight into medicine without doing the corporate grind may not realize how bad a job that you truly dislike can be.

It makes you appreciate it all the more. The personal satisfaction found in medicine far outweighs the industries' financial uncertainty.


OP, check out this article (quick read). It's not salary related but I found it apropro given our decision to pursue medicine. I personally would not choose to leave clinical medicine even if salaries fell below 100k.

http://www.nytimes.com/2011/05/31/opinion/31brooks.html?_r=4

A few excerpts:

...Most successful young people don’t look inside and then plan a life. They look outside and find a problem, which summons their life....

....But, of course, when you read a biography of someone you admire, it’s rarely the things that made them happy that compel your admiration. It’s the things they did to court unhappiness — the things they did that were arduous and miserable, which sometimes cost them friends and aroused hatred. It’s excellence, not happiness, that we admire most...

 

[DrVanNostran]

Alright, I'm well aware that I'm opening quite a can of worms here. That said, I'm enjoying my last summer vacation for the next 50 years and waxing poetic about life, liberty, and the pursuit of happiness. I searched for a similar thread and couldn't find one within the last two years.

So here's my question to you guys: are you worried about the possibility of physician salaries decreasing? Do you have a "plan B" if phys salaries decrease below what you would consider "acceptable" for the hours/commitment required?

I realize that talking about income seems to be anathema around here, but I think it's a bit silly not to discuss it at all. I'm not asking for predictions about the future of physician salaries or medicine (that seems to always degenerate into a flame war), just what effects salary changes will have on you personally.

I'll go first and answer my own question: I'm not concerned about decreasing salaries per se. I realize that I'll never make the kind of money that my father makes as a physician (GI, private practice, ~600k/yr -- though he works ~80 hour weeks on average), and while that's a strange feeling, I don't have a significant issue with it. I don't forsee salaries dropping to the point that I would be dissatisfied with my quality of life, and thus I'm not concerned about what fluctuations might happen. I have the advantage of having relatively little educational debt (likely ~45k by the end of school) thanks to relatively low public school tuition, scholarships, and parental assistance.

That said, while I don't have a "plan B", if salaries were to drop significantly to the point where I was unable to earn ~100k/yr or greater and was still required to work ~60 hours/week, I would probably consider shifting out of clinical medicine. I don't think I could leave medicine entirely (I like it too much), but if things really got that bad I could see myself moving into medical technology/administration/device research/something else that either a) required less hours or b) paid better. Those options don't appeal to me nearly as much as clinical medicine, but if I have a family and my spouse doesn't have an income I would make the switch for the sake of providing what I consider an "acceptable" level of support for my family.

Thoughts? Flames?

tl;dr: Are you worried about salaries decreasing and, if so, do you have a "plan B" if salaries drop below what you consider an acceptable lifestyle?

I am somewhat concerned about decreasing salaries, and it has made me consider other specialities. But at the end of the day, I think I will be applying to IM with hopes of Heme-onc (which still has a respectable and high overall salary).

My question is to you. Your father is in PP in a very high paying speciality. What has been his opinion? I am sure he has given you some great insight, unless, you are like me and are scared to ask

 

[Dr Love]

tl;dr: Are you worried about salaries decreasing and, if so, do you have a "plan B" if salaries drop below what you consider an acceptable lifestyle?

I didn't go into medicine for the money. That said, I want my chedda.

 

[badasshairday]

hot damn. OP's dad is a baller, shotcaller.

 

[High Roller]

What scares the hell outta me is the debt I took on.

If I reach a point where I'm unhappy doing medicine or my life goals change...I can't realistically do anything else that is capable of paying the man off.

Its asinine how much schools are asking you sell your soul for an education.

 

[High Roller]

I am somewhat concerned about decreasing salaries, and it has made me consider other specialities. But at the end of the day, I think I will be applying to IM with hopes of Heme-onc (which still has a respectable and high overall salary).

My question is to you. Your father is in PP in a very high paying speciality. What has been his opinion? I am sure he has given you some great insight, unless, you are like me and are scared to ask

You still thinking bout EM?

 

[DrVanNostran]

You still thinking bout EM?

I'm taking an EM elective early. I am keeping an open mind to it. However, I think the general lifestyle, patient population, and content of Heme-Onc are more appealing to me.