Don't kill me, but............

[Thumper]

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Is it true that the money is no longer in medicine? I swear when I say that I'm not asking for myself, but for a very close friend, who seems completely dishartened because everyone, and I mean everyone, he has talked to has told him to drop the "Med-School Bull****" and go into business. The list includes doctors, nurses, researchers, insurance agents, etc. and they say that the future of Medicine is uncertain due to HMO's and insurance companies and blah blah. Now please, take a deep breath and try to comprehend her position. She has other skills such as knowlege of computers, and would also make a great business woman, so she has options. As for the reason for the butterflies in the stomach, she is afraid that she will spend eight years of her life in med school and specializing, come out as a thirty-something woman, and have to deal with paying back debts and building a life for herself, all while making half what doctors in the past used to make. I know that most of you are probably jumping out of your skin right about now, but I would appreciate some constructive advice so that I may better lead her in the right direction. The bottom line is, she doesn't know if medicine is right for her, and that is what she needs to figure out. So, any advice would be greatly appreciated! Thanks! 🙂

 

[maphilips]

Tell her she needs to figure it out for herself. If she is basing her decisions about medicine on $ then she needs to find a different profession. I know I have considered possible drops in salaries in the future, but I don't give a ****. I know I want to treat people, and those who aren't sure about that can be sure they probably aren't up for it. Good luck.
Mark 😉

 

[THE instiGATOR]

Well, the surgeon I shadow has complained that his horseshoe-shaped house (I'm imagining it's large...it is horseshoe-shaped, after all) projects the sound of his children frollicing in the pool at it's center toward his neighbor's (another physician) home. What a TERRIBLE problem, eh?!?! 😉 😛

I wish I had problems like this!

There is money in medicine. Even if there wasn't, however, I think I still would pursue it. I don't know about you, but deep down I like the challenges that I have had to face up to this point (am I sick in the head?!?). Also, who wants to spend much of their work time in front of a computer!?!

 

[brandonite]

I agree with you about the computer thing... I have done a lot of research, and I spend almost all my time staring at a computer screen, and it drives me crazy.

However, like EllieR, I am a bit worried about these stories I hear about there not being any money in medicine these days. Not because I have to have a swimming pool or anything, but because I am about to go $150 000 in debt, and I want to know that I can pay that off in the future!! If I only make $70 000 a year, it gets really hard to pay something like that off over a lifetime! It's important because if I need to decide now if I can afford to go that much into debt by going to a high cost school.

I'm not going into medicine because of money. But there are a lot of sacrificies that we will have to make (such as that HUGE debtload), and I want to make sure that I can handle that in the future!

 

[Darwin]

Check out <a href="http://www.salary.com." target="_blank">www.salary.com.</a> It gives average salaries and base medians for just about any job in your area. Believe me, there is still a lot of money in medicine. For example, an ob/gyn can expect to make a base median salary of $337,470.00 /year in my area. The problem lies in physicians who, prior to the advent of managed care, made 600K+ and are now only making 300K+. They became adjusted, had planned, and lived according to a lifestyle they can no longer afford and are thus now complaining and stating that there is no longer any money in medicine. They have every right to do this...things are different for us as we will only become adjusted to the lower salary implements. Will they go down any farther? Perhaps a bit, but most that I've spoken to don't see that it will.

 

[none]

Sure, doctors don't make the most money out there, but they have much, much stabler sources of income than the vast majority of careers out there. Basically, if you want money in medicine, there is money to be had.

 

[Drako]

Yes, doctors do not make as much as they use to during the Medicare/Medicaid era. However, their income is still 2-6x the national average. What more could a person want? If your friend's main goal in life is to become wealthy, then the profession she should head to is financial. I know people (in my extended family) who quit their doctor dayjob to go into financial. They are not making seven-figures income. I don't ask them if that makes them happy because I could careless.

Money should not be a concern when you want to study medicine. Medicine is about choosing to sacrifice for the well-being and happiness of others. It is a profession that gives and yet, it is a privilege because your patients put their lives into your hands.

Large income? Why not dentistry? My dentist uncle makes ~500,000/yr after tax. He lives in a 1.5 million dollar home with his lovely wife and daughter. They have two cars (a Jag and a Benz-S500) and a Lexus SUV (the big monster). They have vacation houses in Mexico and Maine. Their daughter has a trust fund that could pay for my living expenses my entire life. She is only eight years old. They take vacation every month! And best of all, they are always smiling because they are happy because they are so rich!

I am in no way saying that you shouldn't be rewarded for your sacrifices while studying to become a doctor. Just don't let the fat green bills be the motivation behind your choosing to jump with both hands and feet into medicine. Ask your friend this question: Will she be happy living FOR others and not for herself? It is idealistic, but if you strive for it and fall short, it won't be too bad.

Good luck to you and your friend in your endeavors.

 

[EpiII]

You must determine why you are interested in pursuing medicine. If the reasons you are interested can't be taken away from you, then you will be happy in medicine.

For me, the challenge, application of science, continual learning, being in one of the best places to help others, worldwide opportunities, etc., are not going away.

As has been reiterated above, physicians are not being paid what they used to be paid, but that is not necessarily a bad thing. Many physicians, especially in CA, and other heavily managed care penetrated states have not had a raise in salary for several years and with inflation, that is effectively a decrease in salary, but that means they are only making 2-5 times what the average person makes. How sad.

I also believe you can pay off the loans with these salaries, it just may mean you can't launch into your dream house with a boat and three cars, etc. right out of med school. That also is sad.

 

[Gotrob]

Everyone keeps talking about how much money is in business. I don't see it, especially now. Money should not be an overriding issue, but if it is, Doctors have little to worry about. The absolute worst medical student in the country (who graduates) will eventually make over 100K a year if he works full time (many make more than this part-time). Is this true for the worst business majors? I think not.

If 100K isn't enough, work harder and you will make more...a lot, lot more.

 

[Hector]

I've also been interested in the income question and here are some thoughts to share. For starters, nobody is going to be able to come up with a consensus about average physician incomes. The Bureau of Job Labor Statistics says the average salary is $169,000. We can assume that the bell curve extends far in each direction and is dependent on training, location, business saavy, and on just how hard a person wants to work.

You all will meet collegues who circulate apocryphal stories of doctors who are scraping by and doctors with four Porsches. The truth is there is a lot of unpredictability. One seasoned internist I knew made $150,000 working under managed care. He was a guy who graduated AOA and trained at the Mayo Clinic (so he was supremely qualified), but he quit his job and started up at a non-HMO group practice making $50,000 so that he could serve his patients better. After four years, his practice now earns him about $80,000.

So not only is there a question about qualifications, but there is also a question of what kind of practice a graduating physician wants. If one chooses an academic job, the salaries are also diminished. The professors at my medical school make approximately $100,000 even after years of experience and training. Some of them find ways to supplement their income by private consulting or side jobs but many don't mind the smaller salary.

If a person were highly motivated and saavy, they could go into private practice, work their tail off, and make a very good living in any field of medicine. But how much money could that same talented, motivated, saavy person make had they gone to Stanford Business School or Law School instead of Stanford School of Medicine?

 

[Darwin]

I feel compelled to digress into the "money in medicine" issue and why it's a black topic...

What is wrong with someone going into medicine for money reasons? Why is it that in no other profession is the individuals' motives questioned? Is a business man interrogated throughout life as to whether or not he is in the business to truly provide a service to the populace or if he's in it to make money?

It is my belief that a fine tuned, precice, intelligent and an overall good person can become a fine healer, even if his/her motivations are founded in reasons of financial security. We have become so afraid and ready to shun those who don't carry a "holier than thou" attitude and still want to pursue medicine. I see and read (as most of us do on this site) thousands of people who all say "I'm doing to help others". It's safe to say that. It's percieved as suicide to say anything else. It's all about playing the game, and 95% of it is not heartfelt. It's amazing to me that in wanting to start a post about money in medicine EllieR has to title it "Don't kill me...but".

Quit being afraid to state that money is a factor...would you spend 12+ years in school to work the rest of your life for $12,000 a year? Why should you, at a young age of 20 or 21, have to truthfully answer questions about yourself that many 90 year olds can't even fathom.

On the GW supplemental there was a question as to whether or not people or science will be more important to you in your practice. I'd bet most put "people"...after all it's the safe answer right? I put a lot of thought into this short essay and ended up putting science...I've got an interview scheduled. Quit "playing the game" by telling and writing what you think others' want to hear so that you "fit in". Stand for what you believe in...don't be afraid to let factors other than a blind dedication to service of humanity be your motivation. Whatever occupation you choose, just be the best you can be, respect others and thier positions, and succeed. At least you'll know you went through the process being true to yourself, and didn't compromise your true motivations just out of fear of being shunned.

In closing, I in no way mean to imply that all of you who have posted are "playing the game", and your posts about service are "unheartfelt". I think we can realize though, that we all feel compelled to state that, whether or not we've really given it any thought. We've been told since the dawn of our decision that money is not going to make us happy in medicine. Those who told us were told that by someone else, and so on. Don't be afraid, and quit jumping on those who aren't (not that anyone did). Just make sure, especially within the art of healing, that whatever you do you are damn good at it. If you save that life, I don't think your patient will think down on you because you chose medicine for reasons other than saving that life...the fact is you did it through a commitment to success, and that's all that matters.

 

[BlackPuma]

ok I feel compelled to dispell some myths

1. pple say you make 100K, yes very true, BUT before taxes, after taxes 32% tax bracket, you make about 70,000.

2. Also, there is no such thing as the Land of Atlas

3. and yes, the Federal Reserve is controlled by the elite....just type Federal Reserve and Conspiracy, and then you realize where ALL OUR hard money goes 🙁

 

[BlackPuma]

also type

Federal Reserve Secrecy 😀

 

[Trek]

Darwin- that's probably the best post I've read on SDN. --Trek

 

[CardiacGuy]

Everyone has brought forth some great points in this argument.

Do people go into medicine to make $$? -yes, otherwise you wouldn't do it.

Is medicine altruistic? No, you want to get something back for your work whether it be financially or job satisfaction.

You don't have to enjoy working with or on people to go into med school. You can always go into research or pathology for example.

Will medicine provide you a comfortable living with the ability to work for a long period of time (if you choose) toward retirement, knowing that you will be set financially until you die? Yes.

Can someone who makes 100-150k per year live comfortably? I should hope so.

Bottom line- Is the sacrifice of med school and residency worth it? Depends on the person.

 

[efs]

I think there is another issue along the same lines that should be considered other than just the money.

Witht he advent of managed care medicine has become a business. It is not the physicians who make all the decisions though.

Wait until you find that you can't treat the patient the way you want to because it isn't covered under their insurance. Or they are not insured, so they have coverage under Medicare/Medicaid. Decisions on medications to prescibe have to take this into account. Capitation contracts with HMOs give the physicians an incentive to see fewer patients, order fewer tests, treat as little as possible. Fee for service payments give the physicians an incentive to order unneeded tests and bill as much as possible. And why not, they are only paying a percentage of the billing anyway. And we need to do it in order to get the care for the patient that needs it. Right?

Money will be a constant consideration. Whether it is paying your student loans, or something else. But medicine is a business.

 

[LilMissDrDoolittle]

I must agree with Trek, I was really impressed by your post Darwin and cannot put it into better words.

 

[Cobragirl]

I have to agree with Darwin & CardiacGuy...if I thought that I'd only be making $30,000 a year once I started practicing (not talking about residency here) there is NO WAY IN HELL, I would go through the torture of medical school. Don't get me wrong, I'm totally enjoying my journey, and I feel very lucky to be where I am, but at the same time, I am NOT doing this purely for altruistic reasons. I want to KNOW that all my hard work will "pay off" in the long run. Hell, I just want to know that the $200,000 I'll owe in student loans will be paid off before I die. Sure, if medical school only cost $10,000 (total!) and only took 2 years to complete, it would be different. But, by God, I am sacrificing a LOT of my life to "help" others...many of whom will never appreciate my hard work...so I think I deserve a "good" life. I don't expect, or need, to make $300,000 a year, but I DO expect to be able to pay off what I've invested and someday have a decent retirement (be able to AFFORD a nursing home room!).

 

[Tweetie_bird]

This is my first day on SDN, so we'll see how I do.

Darwin: you have an awesome post, and I agree with most of what everybody is saying. I'd like to share with you a (true) story I heard about in my medical ethics class. My prof was talking about how salaries are "fixed" according to each profession etc, and he mentioned overhearing a conversation between a doctor and a lawyer on the plane. Ofcourse, neither of them knew each other. My prof overheard the doc telling the lawyer about how he is trying to "get by" on a salary after his new divorce, and how the wife got the house and the kids. When the lawyer questioned the doc how much he got after the divorce, the answer was, "I try to get by with 300K a year." Note: he said "make do." Personally, I do think that docs make too much, regardless of the sacrifice, schooling, and stress involved. (my apologies to those that I have offended)

I suppose my point reiterates what everybody has been saying, except I'd like to stress one thing--PASSION. I would call myself lucky if I made 100K a year being a doctor, even though I know it may take me longer to pay off my loans. To the person who originally posted the question about his friend, does she have PASSION for medicine, so much so that no amount of monetary compensation would make her love the field any more or less? I don't mean to sound like I am "playing the game," but really, if one has to even think of going into another field just because of lack of monetary compensation not being the way it used to, they may not belong there. It is not unethical rethink about going into a field b/c of lack of money, infact it's quite logical. But speaking as a person who moved from a third world country, and had to live on pork and beans for MONTHS b/c that was all we could afford then, I'd say I'd be darned lucky to get paid a lower salary if it meant I could live out my dream of being a physician. I suppose in my eyes the bottom line is--do what you LOVE to do, and the rest will fall into place.

That's just my two cents....cheers!
Tweetie.

 

[Gotrob]

ok I feel compelled to dispell some myths
1. pple say you make 100K, yes very true, BUT before taxes, after taxes 32% tax bracket, you make about 70,000.
••

I don't know what myth this dispells, it is my understanding that most people pay taxes. 70K after taxes sounds much better to me than 25 or 30K after taxes.

Those of you who have the drive and ambition to make a lot of money are going to be able to...and somehow I believe those who are not becoming doctors just to become rich, will find a way to live off of 70K + per year (after taxes).

 

[snowballz]

This whole thread makes me sick..espiecally the jackoff who said medicine is a business. It is, if you treat it that way.

Pre meds shouldn't even be worrying about how much a physician makes because most likely we won't even get into medical school, unless you play the politics game...or unless you were lucky enough to have mommy and daddy who happen to be physicians.

How many of you even know what it is like to make $75,000/ year? My parents got by on less than half that for crying out loud WITH loan payments, expenses, three kids to feed, car payments, credit cards and mortgages. And you are worrying about making $150,000 a year? Bull****. Get over it. Do you really think med school is anymore difficult than getting up at 2 am getting home at 6 pm, doing hard labor for thirty years that has caused crippling arthritis? He makes $9.50/per hour during this entire time. Grim, huh? MEDICAL SCHOOL IS NOT THE MOST DIFFICULT ACCOMPLISHMENT EVER.

If you are going into medicine for the money, I think you're a douchebag. I want you to remember how many med school spots your taking from individuals who would be physicians for free. How many hard working, intelligent individuals who are losing out because you want to run a medical business.

Man..if you guys are my future colleagues, I'm going into research.

Alicia

 

[THE instiGATOR]

😀 I agree with Alicia 😀

I was biting my tongue the entire time, but thanks for saying it Alicia. I wouldn't have said it so harshly, though.

 

[Trek]

Please go into research. I don't want a colleague that looks down on everyone else from atop her high horse. Take care and see you in Science or Nature. --Trek

 

[philly]

alicia- jackass?? you are going to be surprised if you don't think medicine is a business.

 

[Darwin]

Pre meds shouldn't even be worrying about how much a physician makes because most likely we won't even get into medical school, unless you play the politics game...or unless you were lucky enough to have mommy and daddy who happen to be physicians. ••

Alicia,

My point was not to play the politics game. I haven't done so and have been quite successful this application cycle. My father carries a nail bag to work every day and my mother answers phones as a receptionist...they divorced when I was 2. Your statement was trite, uninformed, blanket rhetoric that serves no purpose other than to prove my point exactly. "Congrats" to you for helping me in my argument. And so I read on...

If you are going into medicine for the money, I think you're a douchebag ••

Whoa. Very nicely put. Not only do I have in you a supporter of my plight, but rather creative, unique, self-respecting individual who takes no worry in preceding such words with ones like "jackass". You have shown myself and hundreds of others that you are not only understanding of opinions other than your own, but also compassionate about humanity.

I want you to remember how many med school spots your taking from individuals who would be physicians for free. ••

Oh, and noble too. The fact is, Alicia, that you must first realize how you came across in your post. I will refrain from emulating your rhetoric and rather just let you know that although behind the anonymity of a keypad you might let yourself appear as less intelligent than you really are, please refrain from doing so as I'd rather think of you as a self-respecting individual who doesn't lose her pride in times of confrontation. My best to you in your research endeavors...might I suggest something in the field of arthritic therapies. After all, if you're not going to be able to provide the individual with financial support (I'm assuming it's your father) since you're going to be working for free, perhaps you can provide help in other ways. Take care.

 

[Slingblade the Surgeon]

Snowballz and swampman are the of the same stock as those we run into now who are doctors and say that they hate the profession and wish they had done something else. The reason is that they go into this with mickey mouse expectations of being patch adams or some ****, and they are sorely dissappointed when they realize that everything in our country IS A BUSINESS and those who recognize that excel. A well adjusted individual would recognize that, as the majority of us do, and work that knowledge into our altruistic dreams to figure out the BEST way to serve our communities. Dammit!

 

[CardiacGuy]

Alicia,

I have yet to come across anyone who would be a doctor for free. You are a compassionate arguer, but need to realize that we (as medical professionals) are dealing with reality. Unless someone has a trust fund or has won the Powerball lottery, they will expect some form of compensation after all of their hard work they put in to put those little initials after their name.

Good luck,

 

[Darwin]

Hey Slingblade...Swampman is a good guy and was simply stating that he agreed with the point Alicia was making. The difference between the two is Swampman probably knows how to go about arguing it. Nice point though.

 

[THE instiGATOR]

Originally posted by Darwin:
•Hey Slingblade...Swampman is a good guy and was simply stating that he agreed with the point Alicia was making. The difference between the two is Swampman probably knows how to go about arguing it. Nice point though.•••

Thanks for stickin' up for me Darwin.

It would be silly to ignore the business aspects of medicine...they are there. I would not work for free.

A little background info: My mother works at a Taco Bell and my father is a retired military man with disabilities. As you may infer, my parents don't collectively make near as much as a poorly paid physician.

As Alicia pointed out; people like my mother, and at one time my father, work just as hard as physicians. It is very difficult to hear one claim that 100K+ is not great enough compensation for the time one must invest to acquire an MD.

I will have a bachelor's degree in chemistry. If I did not pursue medicine, I would most likely enroll in a PhD program. After having earned a PhD in chemistry, I could start at ~$70K/yr. If I can pay off my med school loans, any pay greater than this is fine by me. I will have to take care of my family in the future and do look forward to greater financial earnings. I, however, would NEVER claim that physicians aren't paid enough. It is obvious to me that there are more tiresome and less rewarding careers.

Don't jump to conclusions based on a few sentences, Slingblade.

 

[lilycat]

I'm kind of surprised that no one on here has yet brought up the kinds of hours that physicians work and the grueling physical and emotional toll it can take.

I think medicine is a financially stable career -- you will always be employable and be able to earn a good income. However, if you are just looking to get rich, I think that there are many easier and faster ways to do so, IMHO, especially when you take into account a possible 6-figure debt after med school, and the years of lost income during med school, and minimal income during residency and fellowship.

 

[Thumper]

Hey everyone, I just want to thank all of the people who posted their opinions, even the few who felt we were sleazebags for daring to ask such an incredulous question. I will be honest in admitting that one of the main factors behind my advanced education is to ensure myself and family a 'comfortable' lifestyle. Now for some, comfortable means a Benz and a mansion, but for me it means being able to work for a while, put some money aside, and then take some time off to raise my children and be the best parent I can be. Making a seven figure salary is not everything to me, but being able to provide for my family will be (once I begin one!) I love medicine and the healing aspect of it, mainly because I was saved by doctors from a ruptured appendix at the age of seventeen. Were it not for their brains and hard work, I would probably be six feet under right now. What I am trying to say is, while being a doctor is a noble and benevolent job, we can't forget the fact that doctors are people too. Most truly want to help people, but they at least want a little guarantee that after devoting 8-10 years of their lives (after HS), going insanely in debt, and dealing with the grueling hours and HMO's, they will at least have the peace of mind that they won't have to worry about being able to put their kids thru college. The original question is all relative. It depends on what people consider a comfortable living and a good salary. I am sorry if people like Alicia are quick to see the worse in me and others, but I must say that my asking the question does not mean that I am money hungry and cold. What it does mean is that I am concerned about my future, just like everyone else is, and I feel that I have enough supporters on this page to back me up on this. Once again, I thank you all for your posts, especially Darwin who had the most eloquent responses I have ever read! 😀 😀

 

[THE instiGATOR]

EllieR,

There is only one poster who MAY believe you are a sleazebag for asking the question you did (Alicia). I don't know which of us constitute the few.

I thought you were asking for a "friend"?

Oh well, good luck. There are many things you can do aside from earning money to make you happy. Poor parents raise kids as well as do rich parents. If you love your children and let them know you love them, they will be happy. Sorry, I'll stop lecturing you. Just don't get too absorbed with the financial aspect.

I'm pursuing academic medicine so I won't have to think about wages too much. If my plan pans out, I will be salaried and won't have to compromise the quality of the care I provide to earn more.

Take care

 

[Thumper]

Hey Swampman, I'm sorry if you felt I was singling you out, because I wasn't. I was mainly reffering to Alicia, and others who might think like her. I personally have no problem with you. You spoke your mind, but were not rude or pushy about it, and I appreciate that. I hope you don't harbor ill feelings toward me, mainly because I wanted this to be an informative post, and your view gave me a different perspective. What I didn't appreciate was being told that people like me were "douchbags" and "jackoffs"! Thanks again for your post, and I hope to hear more from you! 🙂

 

[Thumper]

BTW, I am asking for a friend. After reading the rude post, however, I felt I had to reply and put a face (personality) to the person who actually wrote it. Sorry about the confusion!