as attendings, what's a good percent of salary to safe?

[pinipig523]

What about some of you higher income earners (400k, 500k, 600k and more), are you all still trying to put away 20%? Or is it more because you have more excess income to save? Or is it less because you feel a set amount is all you need to put away (50k or 100k) to reach your goals? What is the max you have heard of people putting away pretax, including all the tricks in your bag (db plan, hsa, 401k, profit sharing, etc)? Thanks for sharing.

Yes, 20% is key. I don't know about super high earners like 1M though, but I would still say 20% is a good number.

Pretax.

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[Zanegray]

Try to also think about getting out of debt, too. I have student loans, but they're at a paltry 1.6% (read awesome)

As mentioned in another post... Those of us who went through medschool recently got screwed on the interest thing. Our loans beginning 2006 are set at 6.5% despite interest rates being at all time lows. I'll pay it off as fast as I can. And b***h about it...

 

[JacobMcCandles]

What about some of you higher income earners (400k, 500k, 600k and more), are you all still trying to put away 20%? Or is it more because you have more excess income to save? Or is it less because you feel a set amount is all you need to put away (50k or 100k) to reach your goals? What is the max you have heard of people putting away pretax, including all the tricks in your bag (db plan, hsa, 401k, profit sharing, etc)? Thanks for sharing.

I think it would depend on how lavish they wanted to be in retirement. If they wanted to continue to live that kind of lifestyle, I'm sure they're socking a lot back. Just like everyone else, if they spend every penny they make, they're going to be in trouble come retirement.

If a high earner is someone that is fine living a standard of life well below their salary then I would think they should still be putting away a huge chunk into retirement accounts and maybe a little bit in more liquid accounts in case they decide they want to take an extra vacation or something. I'd still try to put away as much as possible early on as time is something you need to take advantage of in regards to investing.

 

[winkleweizen]

As mentioned in another post... Those of us who went through medschool recently got screwed on the interest thing. Our loans beginning 2006 are set at 6.5% despite interest rates being at all time lows. I'll pay it off as fast as I can. And b***h about it...

and its even worse now...no more subsidized loans.

 

[EctopicFetus]

Other than "catch up" contributions in 2012 the max is 17k 401k, 33k PSP, 50k DB. Throw in another 6k in HSA and thats all the pretax you can do.

I think as mentioned above it depends on what you expect now and what you want later...

I think if you are making 400 or more 100k in pretax retirement is the wise way to go. This differs for everyone but thats my opinion.

 

[DreamingTheLive]

A lot of experience in this thread, wanted some thoughts on this piece:

http://journals.lww.com/em-news/Fulltext/2011/02000/Is_This_the_Future_of_Emergency_Medicine_.1.aspx

As a likely EM applicant next fall, I find articles about this to be a bit worrisome. The PD of our EM program is extremely "positive" about the future for EM physicians, and I want to be swayed into believing his vision, I really do, but I can't shake some nagging reservations. He insists that there is and will continue to be a massive shortage of EM physicians, and that the public outright demands PHYSICIAN care for medical emergencies. I agree, in my opinion, the public does....to an extent. But they also don't exactly like paying for these services....and perhaps in the near future hospitals won't either. Frankly, I'm a bit worried that hospitals will markedly phase out MD's in the EM (as much as possible) and replace them with cheaper PA's and NP's (no offense of course), marketing this as a terrific boon to the public in the package of "reformed and affordable healthcare". Clearly, I don't believe that mid-levels truly can replace EM-trained physicians....but I do think that hospitals/gov't could trick the public into believing this is so. Please tell me I'm wrong.

 

[JacobMcCandles]

A lot of experience in this thread, wanted some thoughts on this piece:

http://journals.lww.com/em-news/Fulltext/2011/02000/Is_This_the_Future_of_Emergency_Medicine_.1.aspx

As a likely EM applicant next fall, I find articles about this to be a bit worrisome. The PD of our EM program is extremely "positive" about the future for EM physicians, and I want to be swayed into believing his vision, I really do, but I can't shake some nagging reservations. He insists that there is and will continue to be a massive shortage of EM physicians, and that the public outright demands PHYSICIAN care for medical emergencies. I agree, in my opinion, the public does....to an extent. But they also don't exactly like paying for these services....and perhaps in the near future hospitals won't either. Frankly, I'm a bit worried that hospitals will markedly phase out MD's in the EM (as much as possible) and replace them with cheaper PA's and NP's (no offense of course), marketing this as a terrific boon to the public in the package of "reformed and affordable healthcare". Clearly, I don't believe that mid-levels truly can replace EM-trained physicians....but I do think that hospitals/gov't could trick the public into believing this is so. Please tell me I'm wrong.

There's doom and gloom pieces out there about every specialty. The simple answer is there will be some midlevel providers covering some rural EDs because there just aren't enough board certified EM docs out there to staff every ED. There will also be some midlevel providers running fast track areas in some hospitals as well.

As far as midlevels working without supervision in an ED? I just don't see that happening any time soon. There's a lot of changes trying to be made that could potentially hurt EM but I think overall, EM is a great spot to be in. We just have to continue to look out for our profession and for each other.

 

[EctopicFetus]

Fear is natural as the future is unknown. PAs def wont be taking over and NPs will struggle. Docs who are at risk need to show value by beaing on hospital boards, and while we hate it patient satisfaction and providing great care.

 

[la gringa]

i'll tell ya'll the thing NOT to do: be single and have a career threatening injury, be denied DI previously for an unrelated injury, then only work full time for 1 year out of the first 2.5 out of residency, and rack up huge amounts of debt CC, family loan, and student loans well over $300k. and not own a thing.... leased car, apartment...

i need a financial advisor to set up my next 5 yrs... sucks watching your friends live the life you were supposed to have, but knowing you gotta keep the purse strings tight.

so if all else fails, all of ya'll know you did better than this girl...

 

[AmoryBlaine]

Just a quick note on this for some of the younger people:

Until you are maxing out contributions to your retirement account and not spending more than you earn every month, you do not even need to think about a financial adviser. An adviser will not help you control your personal spending, they will try to sell you DI (which you need) and whole life (which you probably do not need).

 

[Birdstrike]

.

 

[DreamingTheLive]

Birdstrike.

Awesome.

 

[la gringa]

Amory - I guess what i really need is a swift kick in the ass and/or someone to help me set a reasonable budget and debt paydown plan. Read the above - if I elaborated, you probably wouldn't believe the whole story.

 

[AmoryBlaine]

On midlevels:


Of all the things I could say about the future of EM, one thing I have zero, I mean zero concern about, is the worry that midlevels will "take over" this specific specialty. It's just takes too damn much skill, knowledge, experience and training to do what a boarded EM doc does, and do it fast, do it safely, and leave the majority of your patients satisfied enough to keep administrators happy. It's one of the, if not the most, under appreciated and most difficult specialties out there; the one that gets the least respect, but about which everyone says, "Oh, I could never do it."

There are some specialties, that have to worry because they are comparatively way over payed for drastically easier work. These specialties should be worried. If a nurse can do what you do, THEY WILL.

It don't doubt that the government will try to push midlevels, but in EM the liability is so high, it will backfire. There are just too many "not sick" people that turn out to have life and limb threatening issues and if you think it's easy to triage these out in 60 seconds easily then you either you haven't been doing this long enough or you're just going to be dangerous.

I don't think it will ever happen in EM, to the extent that board certified EM docs jobs are threatened. If you know of a high acuity ED that had no doc shortage and was FULLY STAFFED with boarded EM docs, who then got thrown out for cheaper midlevels, post it here, I'd be interested to read about it. Generally, mid levels in EM, are brought in to fill a void where a crisis shortage occurs, or to work in close supervision with docs cherry picking the people who aren't even sick, ie, who didn't need doctors to begin with.

I respect midlevels. They definitely have an important role, but that role is not to be doctor.

Extremely well said. The classic area of midlevel creep is anesthesia. Nothing against my gas colleagues but routine GETA for a routine bowel resection is not rocket science. The whole point of GETA is that for the vast majority of cases any problem has already been anticipated. There are lots of tricky things in anesthesia (cardiac, liver, OB, trauma) etc and for these you notice the attending is more hands on.

EM is a different game. The best midlevel I have ever met was at the level of a decent early 2nd year resident.

 

[Croooz]

Amory - I guess what i really need is a swift kick in the ass and/or someone to help me set a reasonable budget and debt paydown plan. Read the above - if I elaborated, you probably wouldn't believe the whole story.

Go to Dave Ramsey's Total Money Makeover and you can find associates in your area. For a couple hundred dollars they will help. Granted all you are really paying for is accountability but a few hundred to save you thousands and get you back on track ain't bad.