Coming to terms with Being Middle Class

[aneftp]

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Im stuck in the midwest but 20 min from a top 20 city in population due to family and having kids in near future so big help to have family nearby. Jan has been the first really cold/crud this season and it will be wrapped up by mid march.

Do i like the idea of florida, tx, arizona for year round warmness... for sure. Cali would be on my list too but it took me 6 hrs to drive what should have been 3 hrs of a drive from lax on a fri at noon. Id like to pick a city and just air bnb a month in a warm place during these times maybe start that in 5 years.

IMHO if you aren't obligated to be in a VHCOL due to family, you can FIRE and work PT by 50 yo. Im not interested in reaching FIRE at 60+. My desire to reach FIRE early is to make up for the lost time in my 20s and 30s. I'm playing 4d chess now not later.

Kids (and obviously divorce) may slow down those plans

My 49 yo urologist friend is fire except now he’s got 3 kids in college and 1 just got into med school and the other 2 are deciding. So he’s looking at trying to pay another 400k for med school just for one kid. It’s endless

He makes a crap load 2 plus million in low cost area in upper Midwest but he also misses his Florida downtown home.

So a lot of people who think they can be retired in their 40s have not factored in kids school.

 

[dozitgetchahi]

Im stuck in the midwest but 20 min from a top 20 city in population due to family and having kids in near future so big help to have family nearby. Jan has been the first really cold/crud this season and it will be wrapped up by mid march.

Do i like the idea of florida, tx, arizona for year round warmness... for sure. Cali would be on my list too but it took me 6 hrs to drive what should have been 3 hrs of a drive from lax on a fri at noon. Id like to pick a city and just air bnb a month in a warm place during these times maybe start that in 5 years.

IMHO if you aren't obligated to be in a VHCOL due to family, you can FIRE and work PT by 50 yo. Im not interested in reaching FIRE at 60+. My desire to reach FIRE early is to make up for the lost time in my 20s and 30s. I'm playing 4d chess now not later.

Exactly - the “geographical arbitrage” of income with a goal towards something like FIRE is a benefit too.

I don’t want to stop working altogether. But at some point, I’d like to know 1) I have enough in the bank to be set if something crazy happens (injury, etc etc) and I had to stop working and/or 2) I can keep working, but it’s on my terms. Maybe 2-3 days a week with a curated patient panel that are people I really want to be seeing.

 

[dozitgetchahi]

Kids (and obviously divorce) may slow down those plans

My 49 yo urologist friend is fire except now he’s got 3 kids in college and 1 just got into med school and the other 2 are deciding. So he’s looking at trying to pay another 400k for med school just for one kid. It’s endless

He makes a crap load 2 plus million in low cost area in upper Midwest but he also misses his Florida downtown home.

So a lot of people who think they can be retired in their 40s have not factored in kids school.

My kids already know that I won’t be paying for college or grad school etc. I paid my own way and I’m still knocking out the debt. I’m not delaying my own retirement etc to give a free ride there. My kids are expected to progress through their education and arrive at a career on the other end that will make them a functional, self sufficient member of society. My brother is in his 30s and still lives in my parents house, consuming their resources while he pays no rent. My kids know that under no circumstances will they be doing the same thing.

Divorce? I’ve already been through that once, and yeah, it’s a pain in the ass.

 

[finalpsychyear]

Kids (and obviously divorce) may slow down those plans

My 49 yo urologist friend is fire except now he’s got 3 kids in college and 1 just got into med school and the other 2 are deciding. So he’s looking at trying to pay another 400k for med school just for one kid. It’s endless

He makes a crap load 2 plus million in low cost area in upper Midwest but he also misses his Florida downtown home.

So a lot of people who think they can be retired in their 40s have not factored in kids school.

How long has he been making 2m? Is he close to 10m liquid investments?

 

[pgg]

As for “culture” - not discrediting it, but I’m not sure culture alone is worth the immense price you pay to live in a VHCOL area.

I'd rather give myself a paper cut and rub lemon juice in it than live in one of those desirable big cities.

But as devil's advocate goes, I do recognize that city culture goes beyond restaurant choice and theater venues. If you're a minority of some sort, some of those rural areas can be a little less welcoming. I totally get why some people choose to remain in those expensive cities to be closer to their communities.

 

[deleted1130227]

I'd rather give myself a paper cut and rub lemon juice in it than live in one of those desirable big cities.

But as devil's advocate goes, I do recognize that city culture goes beyond restaurant choice and theater venues. If you're a minority of some sort, some of those rural areas can be a little less welcoming. I totally get why some people choose to remain in those expensive cities to be closer to their communities.

Don't forget politics. Not many lefties (even non-minorities) would consider Lubbock, Texas. Not many Righties of whatever color would consider Portland, Oregon.

 

[anonperson]

Im stuck in the midwest but 20 min from a top 20 city in population due to family and having kids in near future so big help to have family nearby. Jan has been the first really cold/crud this season and it will be wrapped up by mid march.

Do i like the idea of florida, tx, arizona for year round warmness... for sure. Cali would be on my list too but it took me 6 hrs to drive what should have been 3 hrs of a drive from lax on a fri at noon. Id like to pick a city and just air bnb a month in a warm place during these times maybe start that in 5 years.

IMHO if you aren't obligated to be in a VHCOL due to family, you can FIRE and work PT by 50 yo. Im not interested in reaching FIRE at 60+. My desire to reach FIRE early is to make up for the lost time in my 20s and 30s. I'm playing 4d chess now not later.

Kids will completely change retirement equation.

Even if using public schools like I do.
Tutoring, music lessons, sports etc.

If your child ends up special needs, then be prepared to work a long time.

My kids are fine but I already know I will be working probably until I die so I can help them with school and housing etc.

I don't mind, just comes with the territory.

 

[SRYSPAC]

At the end of the day, you pay your money and you take your chances.

Or, rather, to quote Warren Buffet - “price is what you pay, value is what you get”. Culture and city amenities certainly have value. I just am not convinced that the value is worth the huge price often charged. (It does or does not have enough value depending on the person. To you and I, the extent of that value might not be apparent; to someone else, it does) Also, note that I’m not really complaining about having to drive to get to a big city. (I never said you complained; I just don't buy the argument that being 4 hours away from a major city is the same as being able to drive 30 min into NYC, for example. [btw I hate NYC so it's just an example] The whole point of my comments were to say that it doesn't bother you but it does bother someone. Whether they are right or wrong is not for you and I to decide, but I do agree that those on that side could certainly take some perspective and go outside their bubble a little bit, or a lot.) For me, I don’t feel like I’m giving very much up at all. The rest of the situation suits me quite nicely. I think a lot of docs would realize that they don’t need the big expense, big tax, big city “la vida loca” lifestyle if they gave it a try. (I agree with you and my family and I realized long ago we don't need those either, much like you) The people who live in VHCOL areas, however, are often complaining bitterly about how expensive it all is and how they feel “middle class” despite objectively making near 1% income. It all starts to sound a bit ridiculous. (It does start to sound a bit ridiculous, but that viewpoint in itself starts to sound very judgmental, and I admit to having that view myself.)

If people make that VHCOL choice for the sake of “culture” and saying they live in a hip/trendy area or whatever, then they should make that choice and deal with the compromises that come along with it. But they shouldn’t act like there aren’t alternatives. If people can’t stomach true “flyover country”, then they can consider any of the other several dozen metro areas in the country that are more affordable. There are more than 3 US metro areas to live in.

Some quick comments above. I have caught myself being very judgmental about what choices people make in terms of lifestyle, big purchases, homes, and geographic location. At the end of the day, it's all personal, and I try not to get worked up about it or defend my choice to live outside one of those areas, or keep costs low, as much as its annoying to hear things like: "You bought a place in THAT section of town?" 🙄

 

[dozitgetchahi]

Some quick comments above. I have caught myself being very judgmental about what choices people make in terms of lifestyle, big purchases, homes, and geographic location. At the end of the day, it's all personal, and I try not to get worked up about it or defend my choice to live outside one of those areas, or keep costs low, as much as its annoying to hear things like: "You bought a place in THAT section of town?" 🙄

As always, if someone wants to make certain choices for certain reasons, go for it. It’s a free country.

But those folks shouldn’t expect a sympathetic ear when they start complaining about those choices to other people who intentionally made different choices to avoid the issues they're complaining about. 🤷‍♂️

 

[SRYSPAC]

As always, if someone wants to make certain choices for certain reasons, go for it. It’s a free country.

But those folks shouldn’t expect a sympathetic ear when they start complaining about those choices to other people who intentionally made different choices to avoid the issues they're complaining about. 🤷‍♂️

Absolutely; I just choose not to be an ear (sympathetic or not) at all 😆

 

[IM_to_ortho_hopeful]

Dude you all over the place. Pick a damn field man annoying as hell

IM_to_ortho_to_rads_hopeful.

Fixed it for you.

If ortho doesn’t work out I need a backup plan. Definitely do not want to be an internist. Imagine coming home everyday and your kids seeing you hating your life and your career, grinding to an early grave just for a paycheck. Your kids need to see you bleeding passion for what you do to raise them well and be a great role model

 

[sevo00]

If ortho doesn’t work out I need a backup plan. Definitely do not want to be an internist. Imagine coming home everyday and your kids seeing you hating your life and your career, grinding to an early grave just for a paycheck. Your kids need to see you bleeding passion for what you do to raise them well and be a great role model

You’re Wrong. You don’t need a burning passion for your job. I don’t have a burning passion for anesthesia. It’s just the most bearable specialty for me in All of medicine

 

[IM_to_ortho_hopeful]

You’re Wrong. You don’t need a burning passion for your job. I don’t have a burning passion for anesthesia. It’s just the most bearable specialty for me in All of medicine

I hope one day I can find a career that reaches at least bareable. Unfortunately I didn’t choose internal medicine. Had to soap. Doing whatever I can for my family so my kids don’t have to see me hating my life everyday

 

[aneftp]

You’re Wrong. You don’t need a burning passion for your job. I don’t have a burning passion for anesthesia. It’s just the most bearable specialty for me in All of medicine

Correct. Some people love anesthesia like my brother

I don’t hate it. But I don’t love it.

Like many of us don’t mind doing ob 7-5pm daily. We all hate ob after hours. Unless there is some benefit to doing ob like less days worked

Anesthesia is a means to an end these days for me.

I just knew it would be em, radiology or anesthesia for me.

 

[NicholasPavona]

If ortho doesn’t work out I need a backup plan. Definitely do not want to be an internist. Imagine coming home everyday and your kids seeing you hating your life and your career, grinding to an early grave just for a paycheck. Your kids need to see you bleeding passion for what you do to raise them well and be a great role model

Patently false. Millions of Americans drag their asses to jobs they despise.

 

[Meyer-Overton]

Your kids need to see you bleeding passion for what you do to raise them well and be a great role model

While this is ideal I guess, its not necessary. I think its important to have a job you don't hate, but you don't have to love it. Go in, do a good job, make your money, and find things to enjoy outside of work.

 

[aneftp]

I think there is a misconception of middle class

What the OP and lots of Henry’s (high earner not rich yet ) mean is we are not top 1% net wealth

Top 1% net wealth is approximately 15 million these days. It was 13.6 million last year.

https://finance.yahoo.com/news/rich-enough-top-1-heres-213018631.html

This is the fire number for most docs who like to spend 300-400k a year to comfortably retire for 30 years. Post tax money.

Now if you cut your spending to 150-200k. Than your fire number obviously can be cut in half to 7-8 million for 30 years (for
Those who want to retire by age 50) or sooner

 

[PainInTheAnes]

I think there is a misconception of middle class

What the OP and lots of Henry’s (high earner not rich yet ) mean is we are not top 1% net wealth

Top 1% net wealth is approximately 15 million these days. It was 13.6 million last year.

https://finance.yahoo.com/news/rich-enough-top-1-heres-213018631.html

This is the fire number for most docs who like to spend 300-400k a year to comfortably retire for 30 years. Post tax money.

Now if you cut your spending to 150-200k. Than your fire number obviously can be cut in half to 7-8 million for 30 years (for
Those who want to retire by age 50) or sooner

I don't think I know anyone with that level of wealth who spends that amount of money post tax. Maybe one CEO/VP couple. At least in America, I don't think most of the non-finance rich people do the dumber stuff like they do in oligarchy societies like Dubai or Russia.

At some level of wealth you're looking more generational and less spending. Only athletes and gambling addicts can blow 15 million dollars and go broke before they die. I've heard of almost zero successful people who spend more than they earn if they've saved that much.



Even this guy. 1.25m on taxes, 300k mortgage, 150k on family, 150k car, 400k savings, 76k on other pleasures.

No one with any sense really spends over 500k if they have 10+ million, unless they're really wasting it on people they don't know.

 

[emergentmd]

My kids already know that I won’t be paying for college or grad school etc. I paid my own way and I’m still knocking out the debt. I’m not delaying my own retirement etc to give a free ride there. My kids are expected to progress through their education and arrive at a career on the other end that will make them a functional, self sufficient member of society. My brother is in his 30s and still lives in my parents house, consuming their resources while he pays no rent. My kids know that under no circumstances will they be doing the same thing.

Divorce? I’ve already been through that once, and yeah, it’s a pain in the ass.

I have always thought this same way. Me, paid everything for myself while dirt poor.

As I get older, I do not wish this on my kids.

Plus, if I don't spend my $$ on the ones I created and Love, who am I going to spend it on when I am living?

When I die, the kids will get it and likely won't need it. So they will have a car full of money to give to their kids who I may not even know or their spouse spending it all?

Someone is going to spend the hard earned money I made, so it might as well be me and my kids.

 

[<(^_^)>]

I think there is a misconception of middle class

What the OP and lots of Henry’s (high earner not rich yet ) mean is we are not top 1% net wealth

Top 1% net wealth is approximately 15 million these days. It was 13.6 million last year.

https://finance.yahoo.com/news/rich-enough-top-1-heres-213018631.html

This is the fire number for most docs who like to spend 300-400k a year to comfortably retire for 30 years. Post tax money.

Now if you cut your spending to 150-200k. Than your fire number obviously can be cut in half to 7-8 million for 30 years (for
Those who want to retire by age 50) or sooner

Worth noting the top 1% is mostly old people, likely in part because they have had more time for their money to grow and contrary to their initial beliefs they aren’t spending it much from 75-85 going on insane adventures. Hanging out with the grand kids doesn’t cost 2k a night etc.

Also worth noting the top 2% (aka richer than 98% of people) is just 2.5M.

How rich you feel is virtually entirely a byproduct of who you associate with. If you keep climbing the socioeconomic ladder hanging out with ever-richer people as you yourself make more money you’ll never feel rich. And of course one wonders if feeling rich is even something that is important to begin with.

 

[pgg]

How rich you feel is virtually entirely a byproduct of who you associate with. If you keep climbing the socioeconomic ladder hanging out with ever-richer people as you yourself make more money you’ll never feel rich. And of course one wonders if feeling rich is even something that is important to begin with.

Another reason not to live in big "desirable" cities and VHCOL areas.

There are a lot fewer people out here cosplaying at being rich. The only things my neighbors have that I envy are tractors.

 

[nimbus]

Another reason not to live in big "desirable" cities and VHCOL areas.

There are a lot fewer people out here cosplaying at being rich. The only things my neighbors have that I envy are tractors.

Cosplaying farmer ain’t cheap either 😉

 

[MTGas2B]

Cosplaying farmer ain’t cheap either 😉

But at least your write a lot of it off...

 

[aneftp]

“
The Angels, Ohtani's first team in the U.S., initially paid Mizuhara $85,000 before increasing his salary to $250,000 in 2022, according to the prosecutors' filing. When he moved to the Dodgers with Ohtani in 2024, his salary grew to $500,000. Ohtani also paid Mizuhara a separate salary and gave him a Porsche Cayenne, the filing states.

In his letter, Mizuhara wrote that Ohtani paid him roughly $2,500 a month from October to January and $125 to $130 a month from February to September. Mizuhara said he struggled to make ends meet because he had to live near Ohtani in California, pay for his wife's travel between the U.S. and Japan, and rent accommodations while traveling with Ohtani to Japan in the offseason.”

Dude couldn’t live off what most of us make. Everyone trying to keeping Up with the Joneses

Audio reveals ex-interpreter impersonating Ohtani

Federal prosecutors released an audio recording in which they say Ippei Mizuhara impersonates Shohei Ohtani in an attempt to wire money from Ohtani's bank account.

www.espn.com

 

[eyeeye_captain]

“
The Angels, Ohtani's first team in the U.S., initially paid Mizuhara $85,000 before increasing his salary to $250,000 in 2022, according to the prosecutors' filing. When he moved to the Dodgers with Ohtani in 2024, his salary grew to $500,000. Ohtani also paid Mizuhara a separate salary and gave him a Porsche Cayenne, the filing states.

In his letter, Mizuhara wrote that Ohtani paid him roughly $2,500 a month from October to January and $125 to $130 a month from February to September. Mizuhara said he struggled to make ends meet because he had to live near Ohtani in California, pay for his wife's travel between the U.S. and Japan, and rent accommodations while traveling with Ohtani to Japan in the offseason.”

Dude couldn’t live off what most of us make. Everyone trying to keeping Up with the Joneses

To be fair, it reads like Ohtani didn’t put this guy up in the guest house and he had to find housing in a swanky part of LA and some swanky part of Japan. He also didn’t make the $250k until after 4 years of carrying the beeper 24/7 for maybe $100k.

If you think about it, his career earnings path is a lot like becoming a doctor in LA. 4 years of residency at $85k (UCLA PGY money is around $90k), then a couple years at $250k in a first/crappy job, and then hit $500k at year 3 in practice. It’s impossible to rack up enough student loan debt to compete with his gambling habit, but there are definitely folks out there over $500k. I can see someone struggling pretty easily.

 

[aneftp]

To be fair, it reads like Ohtani didn’t put this guy up in the guest house and he had to find housing in a swanky part of LA and some swanky part of Japan. He also didn’t make the $250k until after 4 years of carrying the beeper 24/7 for maybe $100k.

If you think about it, his career earnings path is a lot like becoming a doctor in LA. 4 years of residency at $85k (UCLA PGY money is around $90k), then a couple years at $250k in a first/crappy job, and then hit $500k at year 3 in practice. It’s impossible to rack up enough student loan debt to compete with his gambling habit, but there are definitely folks out there over $500k. I can see someone struggling pretty easily.

No one says you gotta rent $5000 a month downtown LA condo or wherever he lives.
Yes California income taxes don’t help

I live super cheap (at times). Some people cant
Help themselves. I spend $10-20 for dinner and the wife and kids blow $200. I don’t order alcohol or even soda. They do. They adds $50.

People can adjust living standards. He just chose not to. The billionaire guy (he’s got mutiple
Homes) but his main house 15 homes from me has his own private jet he took the girls and their friends for 5th grade graduation to the Bahamas. Im not gonna to compete with that. Nor do I want to.

His Swedish wife is cheating on him. But he was cheating on her first. He’s not old. Younger than me. 46 yo billionaire. Don’t get suckered into that life if you can’t afford it.

It’s tempting though

 

[amyl]

As someone who left a HCOL desirable metro (dallas) for a LCOL smaller town (Florence, Sc) I’m so happy we took this leap of faith. My old practice (while very lucrative) was super toxic - backstabbing partners, high call burden, high hours burden, high acuity, lots of holiday and weekend call (not to mention the extended care team that’s creates a bad culture environment with crnas). No amount of $ is worth it - I didn’t know how bad it was until I was somewhere else. I’m not stressed, I’m sleeping better, more vacation time and early days… good and nice crnas, supportive partners, easy cases.

Guys - I beg you - get out of the rat race. Remember the purpose of money is to make your life better… stop killing yourselves for it. The ONLY purpose of money is to make your life better…. The pursuit of $ is not supposed to suck your soul out.
I’m glad we gave this a chance - I don’t miss the big city at all. No traffic, nice people. Much better quality of life. I’m mad at myself for all the efforts I made at my old practice - I regret that most of all. And I regret not leaving sooner

 

[PainInTheAnes]

As someone who left a HCOL desirable metro (dallas) for a LCOL smaller town (Florence, Sc) I’m so happy we took this leap of faith. My old practice (while very lucrative) was super toxic - backstabbing partners, high call burden, high hours burden, high acuity, lots of holiday and weekend call (not to mention the extended care team that’s creates a bad culture environment with crnas). No amount of $ is worth it - I didn’t know how bad it was until I was somewhere else. I’m not stressed, I’m sleeping better, more vacation time and early days… good and nice crnas, supportive partners, easy cases.

Guys - I beg you - get out of the rat race. Remember the purpose of money is to make your life better… stop killing yourselves for it. The ONLY purpose of money is to make your life better…. The pursuit of $ is not supposed to suck your soul out.
I’m glad we gave this a chance - I don’t miss the big city at all. No traffic, nice people. Much better quality of life. I’m mad at myself for all the efforts I made at my old practice - I regret that most of all. And I regret not leaving sooner

LCOL is so much slower pace, and modern logistics means you have better restaurants and travel options than ever before even in small places. It’s a great life

 

[crash2500]

As someone who left a HCOL desirable metro (dallas) for a LCOL smaller town (Florence, Sc) I’m so happy we took this leap of faith. My old practice (while very lucrative) was super toxic - backstabbing partners, high call burden, high hours burden, high acuity, lots of holiday and weekend call (not to mention the extended care team that’s creates a bad culture environment with crnas). No amount of $ is worth it - I didn’t know how bad it was until I was somewhere else. I’m not stressed, I’m sleeping better, more vacation time and early days… good and nice crnas, supportive partners, easy cases.

Guys - I beg you - get out of the rat race. Remember the purpose of money is to make your life better… stop killing yourselves for it. The ONLY purpose of money is to make your life better…. The pursuit of $ is not supposed to suck your soul out.
I’m glad we gave this a chance - I don’t miss the big city at all. No traffic, nice people. Much better quality of life. I’m mad at myself for all the efforts I made at my old practice - I regret that most of all. And I regret not leaving sooner

Back stabbing partners?!!?

 

[NicholasPavona]

Back stabbing partners?!!?

A little redundant, I agree.

 

[nimbus]

My old practice (while very lucrative) was super toxic - backstabbing partners, high call burden, high hours burden, high acuity, lots of holiday and weekend call (not to mention the extended care team that’s creates a bad culture environment with crnas). No amount of $ is worth it

Unfortunately the most lucrative practices tend to attract those types of people. We are getting people returning from some “premier” practices because they like the culture here better. Money is important but there is more to work than money.

 

[amyl]

LCOL is so much slower pace, and modern logistics means you have better restaurants and travel options than ever before even in small places. It’s a great life

I agree - there’s an airport in town American services but I have to connect through charlotte to get anywhere great. But I can leave my house half an hour before my flight leaves… we have two good restaurants in town - both would hold their own in dallas. Lots of great places are 2-3 hour car ride away - Charleston Charlotte Hilton head Savannah etc. the nice beach is an hour. There’s not a fancy movie theater - which I do miss… but the extra vacation and time with my family is worth it. I guess it’s not for everyone but we like it lots so far… I’ll love it once it warms up a touch.

 

[amyl]

Unfortunately the most lucrative practices tend to attract those types of people. We are getting people returning from some “premier” practices because they like the culture here better. Money is important but there is more to work than money.

Culture is everything. I’m glad your group gets that. Money is only worth what you have to give up to get it - health, wellbeing, relationships, sleep, sanity… or just being a non grouchy person. A bad place and situation will bring out the b— in everyone.

This is a still a very lucrative job… I make way more per hour here for easier work than I did in dallas. The only reason I made the $ I did there is I was forced to work more than I wanted - their concept of an FTE is ridiculous.

 

[kidthor]

Unfortunately the most lucrative practices tend to attract those types of people. We are getting people returning from some “premier” practices because they like the culture here better. Money is important but there is more to work than money.

Absolutely. My group is by far not highly paid but it’s good enough and my coworkers are all fantastic and we have a great work-life balance.

The high money groups are skimming money from somewhere… now that it’s harder to skim off the underlings many of them are skimming more and more off of their own partners till they implode.

 

[Drwine]

Absolutely. My group is by far not highly paid but it’s good enough and my coworkers are all fantastic and we have a great work-life balance.

The high money groups are skimming money from somewhere… now that it’s harder to skim off the underlings many of them are skimming more and more off of their own partners till they implode.

The real money today is in subsidies from facilities that want to crank out procedures. Reimbursements are falling and the market rate is too high to make significant money off of anesthesiologists.

 

[kidthor]

The real money today is in subsidies from facilities that want to crank out procedures. Reimbursements are falling and the market rate is too high to make significant money off of anesthesiologists.

Yes, noting that in a group some may be more “equal” than others and find a way to divert that subsidy to themselves. (Btw I’d call it a stipend or operations fee)

 

[VA Hopeful Dr]

I agree - there’s an airport in town American services but I have to connect through charlotte to get anywhere great. But I can leave my house half an hour before my flight leaves… we have two good restaurants in town - both would hold their own in dallas. Lots of great places are 2-3 hour car ride away - Charleston Charlotte Hilton head Savannah etc. the nice beach is an hour. There’s not a fancy movie theater - which I do miss… but the extra vacation and time with my family is worth it. I guess it’s not for everyone but we like it lots so far… I’ll love it once it warms up a touch.

I have a friend that moved to the upstate where I am from Florence, and he had nothing but good things to say about the anesthesiology group down there.

 

[Splenda88]

At the end of the day, you pay your money and you take your chances.

Or, rather, to quote Warren Buffet - “price is what you pay, value is what you get”. Culture and city amenities certainly have value. I just am not convinced that the value is worth the huge price often charged. Also, note that I’m not really complaining about having to drive to get to a big city. For me, I don’t feel like I’m giving very much up at all. The rest of the situation suits me quite nicely. I think a lot of docs would realize that they don’t need the big expense, big tax, big city “la vida loca” lifestyle if they gave it a try. The people who live in VHCOL areas, however, are often complaining bitterly about how expensive it all is and how they feel “middle class” despite objectively making near 1% income. It all starts to sound a bit ridiculous.

If people make that VHCOL choice for the sake of “culture” and saying they live in a hip/trendy area or whatever, then they should make that choice and deal with the compromises that come along with it. But they shouldn’t act like there aren’t alternatives. If people can’t stomach true “flyover country”, then they can consider any of the other several dozen metro areas in the country that are more affordable. There are more than 3 US metro areas to live in.

I am with you, but some people have major ties to these VHCOL areas

However, I don't know how enjoyable that is to be living paycheck-to-paycheck in 1000 sqft home with your spouse and 2-3 kids, and have to think twice about enjoying dinner at a Michelin restaurant when you make > 300k/yr.

I practice the middle of the road approach. I live in a LCOL area and fly out wherever/whenever I want to enjoy these amenities lavishly while saving/investing a good amount of money every year. I guess it helps when your mortgage is akin to a luxury car payment these days.

 

[Splenda88]

I don't think I know anyone with that level of wealth who spends that amount of money post tax. Maybe one CEO/VP couple. At least in America, I don't think most of the non-finance rich people do the dumber stuff like they do in oligarchy societies like Dubai or Russia.

At some level of wealth you're looking more generational and less spending. Only athletes and gambling addicts can blow 15 million dollars and go broke before they die. I've heard of almost zero successful people who spend more than they earn if they've saved that much.



Even this guy. 1.25m on taxes, 300k mortgage, 150k on family, 150k car, 400k savings, 76k on other pleasures.

No one with any sense really spends over 500k if they have 10+ million, unless they're really wasting it on people they don't know.

 

[dozitgetchahi]

I am with you, but some people have major ties to these VHCOL areas

However, I don't know how enjoyable that is to be living paycheck-to-paycheck in 1000 sqft home with your spouse and 2-3 kids, and have to think twice about enjoying dinner at a Michelin restaurant when you make > 300k/yr.

I practice the middle of the road approach. I live in a LCOL area and fly out wherever/whenever I want to enjoy these amenities lavishly while saving/investing a good amount of money every year. I guess it helps when your mortgage is akin to a luxury car payment these days.

That’s my strategy too. Make big money in an LCOL area, and then have the money to actually enjoy doing city stuff when I go to the city (or whatever other locale I want to visit). And save/invest.

 

[deleted1130227]

The real money today is in subsidies from facilities that want to crank out procedures. Reimbursements are falling and the market rate is too high to make significant money off of anesthesiologists.

True, but if you are the one or two that have the relationship with administration, you can still wield the case assignments and schedule as a shield and a sword.

 

[sloh]

I am with you, but some people have major ties to these VHCOL areas

However, I don't know how enjoyable that is to be living paycheck-to-paycheck in 1000 sqft home with your spouse and 2-3 kids, and have to think twice about enjoying dinner at a Michelin restaurant when you make > 300k/yr.

I practice the middle of the road approach. I live in a LCOL area and fly out wherever/whenever I want to enjoy these amenities lavishly while saving/investing a good amount of money every year. I guess it helps when your mortgage is akin to a luxury car payment these days.

Living paycheck to paycheck in HCOL is like window shopping but not being able to buy anything you like. It’s self-torture.

 

[aneftp]

I want/need access to major airports with long distance non stop flights.

I just can’t live in a smaller town (250-500k) as a home base. Look at the airplane crash/accident. That airline was coming from Wichita Kansas. A town of 300-400k (where the Koch brothers are based). I I have friends from Wichita. They make big medicine money. But anytime they fly somewhere they gotta connect to one of the airlines hubs Dallas (mega hub) Chicago (mega hub) etc before flying to their final destination.

If you fly more than 10 times a year. Living in a smaller low cost city is a pain for airline travel

 

[dozitgetchahi]

I want/need access to major airports with long distance non stop flights.

I just can’t live in a smaller town (250-500k) as a home base. Look at the airplane crash/accident. That airline was coming from Wichita Kansas. A town of 300-400k (where the Koch brothers are based). I I have friends from Wichita. They make big medicine money. But anytime they fly somewhere they gotta connect to one of the airlines hubs Dallas (mega hub) Chicago (mega hub) etc before flying to their final destination.

If you fly more than 10 times a year. Living in a smaller low cost city is a pain for airline travel

Minor issue. Not worth making way less money in an HCOL area as a doctor.

 

[aneftp]

Minor issue. Not worth making way less money in an HCOL area as a doctor.

It’s a big issue to some people. Unless you own your own plane for travel.

But than again. I only consider certain areas of California high cost. Hawaii , manhattan , some parts of Chicago. Those are the only true high cost living areas in my opinion.

 

[VA Hopeful Dr]

I want/need access to major airports with long distance non stop flights.

I just can’t live in a smaller town (250-500k) as a home base. Look at the airplane crash/accident. That airline was coming from Wichita Kansas. A town of 300-400k (where the Koch brothers are based). I I have friends from Wichita. They make big medicine money. But anytime they fly somewhere they gotta connect to one of the airlines hubs Dallas (mega hub) Chicago (mega hub) etc before flying to their final destination.

If you fly more than 10 times a year. Living in a smaller low cost city is a pain for airline travel

Eh, a solid regional airport can make this not terrible. Sure it would be nice not to have to make connections, but there's also something to be said for knowing I can get to the airport 1 hour before my flight leaves without any fear of missing said flight.

 

[aneftp]

Eh, a solid regional airport can make this not terrible. Sure it would be nice not to have to make connections, but there's also something to be said for knowing I can get to the airport 1 hour before my flight leaves without any fear of missing said flight.

It’s the connecting flight. I’ve been stuck in Cincinnati overnight. I got stuck in Atlanta missing a flight from Vail overnight.

If you fly a lot. It becomes a pain.

But I will agree a smaller airport makes it easier to just drive 10-15 min to airport park and get through security in less than 30 min from front door to gate. Which is something you can’t do in a large airport.

 

[finalpsychyear]

It’s the connecting flight. I’ve been stuck in Cincinnati overnight. I got stuck in Atlanta missing a flight from Vail overnight.

If you fly a lot. It becomes a pain.

But I will agree a smaller airport makes it easier to just drive 10-15 min to airport park and get through security in less than 30 min from front door to gate. Which is something you can’t do in a large airport.

I have clear and it took me under 5 min to get thru at newark, phoenix, lax

 

[pgg]

Eh, a solid regional airport can make this not terrible. Sure it would be nice not to have to make connections, but there's also something to be said for knowing I can get to the airport 1 hour before my flight leaves without any fear of missing said flight.

I don't fly a ton - just a few times per year on average. I do pay more if a direct flight is an option because connections add risk and hassle.

But I'm a little perplexed at why people cite easy access to a major international airport as a reason to put up with living in a HCOL area. Seriously how close do you need to be?

10 minutes?

Is an hour (or even two) such a hardship to drive a few or a dozen times per year to get to and from an airport? Of course not. Some people commute that much to work every day. If you're going to spend five or eleven hours on a plane, what's so awful about two hours in your car?

The country is full of low and medium COL places within two hours of a major international airport. I'm less than 90 minutes from two of them in one of the highest cost of living cities in the US (Washington DC) yet I live in a low to mid COL place. My home and property would easily cost 10x as much if it was inside the beltway.

My travel plans hopes and dreams aren't the least bit impeded by being a whole hour away from Dulles.

 

[DirtDocMD]

I don't fly a ton - just a few times per year on average. I do pay more if a direct flight is an option because connections add risk and hassle.

But I'm a little perplexed at why people cite easy access to a major international airport as a reason to put up with living in a HCOL area. Seriously how close do you need to be?

10 minutes?

Is an hour (or even two) such a hardship to drive a few or a dozen times per year to get to and from an airport? Of course not. Some people commute that much to work every day. If you're going to spend five or eleven hours on a plane, what's so awful about two hours in your car?

The country is full of low and medium COL places within two hours of a major international airport. I'm less than 90 minutes from two of them in one of the highest cost of living cities in the US (Washington DC) yet I live in a low to mid COL place. My home and property would easily cost 10x as much if it was inside the beltway.

Yep. When I lived in Dallas, I had to allow an hour to fight my way through traffic to get to the airport. I also had to allow at least an hour to get through the bureaucracy/crowded lines at DFW.

Living in a much smaller city, now. Takes 15 mins to get to airport, 15 minutes to get through lines. Yeah, connecting flight is through DFW, but it’s only about a 45-60 min flight. It’s not “quicker”, but not really any slower, either, unless there’s a huge layover.

For anyone that flies 4-5x a year or less, I wouldn’t even consider it when choosing places to live.