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apollo99214

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According to the Medscape Physician Compensation Report 2016, family physicians make $207,000 on average. I have some questions related to this:
Does anybody know roughly how many patients per day or per week a family doctor would see to earn around $207,000?

Approximately what percent of established patient visits are 99213 vs 99214?

What percent of time do family doctors bill a 99213 or 99214 on top of a 99396/other complete physical?

I've heard from a few physicians and read online that ~ 60% of what a doctor bills goes to overhead. Is it then safe to assume that the remaining 40% is take-home salary?
 

mark v

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There is so much that goes in to answering this question that it is difficult to make generalizations.

1. Is this talking about all family docs? Does it take in to account those doing urgent care? Is any particular part of the country over/under sampled in the survey?

2. I try to shoot for around 70% 99214 charges. With my patient population, it's pretty realistic.

3. I used to double dip a wellness and a problem visit but this ended up screwing over patients when insurance did not want to cover so I stopped doing it. It's not worth losing business over $100.
 

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According to the Medscape Physician Compensation Report 2016, family physicians make $207,000 on average. I have some questions related to this:
Does anybody know roughly how many patients per day or per week a family doctor would see to earn around $207,000?

Approximately what percent of established patient visits are 99213 vs 99214?

What percent of time do family doctors bill a 99213 or 99214 on top of a 99396/other complete physical?

I've heard from a few physicians and read online that ~ 60% of what a doctor bills goes to overhead. Is it then safe to assume that the remaining 40% is take-home salary?
Its easy math. Last I checked, the average wRVU for family med was around $40. Let's assuming 4.5 days/week seeing patients and 12 patients/half day. That's 108 patient encounters/week. At least 50% of your visits should be level 4 (I agree that 70% is a good place to shoot for as well) so each visit gets you roughly 1.33-ish wRVU using that formula. That earns you 5745/week. Multiply that by let's say 45 weeks and you're looking at 260k/year.

You can play around with those numbers to get your 207k.
 

apollo99214

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thank you both for your responses. The reason I was asking is because I had played around with numbers myself and I was consistently getting numbers more around 250-270 rather than 207 so I wasn't sure if I was missing something. Your responses reiterated what I was thinking, so thanks again.
 

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thank you both for your responses. The reason I was asking is because I had played around with numbers myself and I was consistently getting numbers more around 250-270 rather than 207 so I wasn't sure if I was missing something. Your responses reiterated what I was thinking, so thanks again.
You aren't taking into consideration quality measures that give you bonuses every quarter as well as RVU's. My wRVU is $52.60.
 

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You aren't taking into consideration quality measures that give you bonuses every quarter as well as RVU's. My wRVU is $52.60.

So is that $52.60 your take home or do you have to pay overhead with that?
 

cabinbuilder

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So is that $52.60 your take home or do you have to pay overhead with that?
That's the wRVU multiplier that my job gives me. I have to make a minimum of 312 RVU's a month. Anything over that 312 number gets multiplied by $52.60 and that is my quarterly RVU bonus. This is different from the quality measures that are tracked: pneumovax, flu shots, HgA1C, etc. I have to hit 80% of all my charts to get the $8000 bonus each quarter. So that's an easy extra 32,000/yr before taxes.

I don't have overhead. I am a salaried physician who works urgent care. My job requires me to work 10 days a month.

I have 2 locum jobs that I have too. I pick up 2 weekends a month about 100 miles from where I live and I do a week in Wyoming once a month for a change cuz I get sick of seeing sinus infections everyday.
 

NRAI2001

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That's the wRVU multiplier that my job gives me. I have to make a minimum of 312 RVU's a month. Anything over that 312 number gets multiplied by $52.60 and that is my quarterly RVU bonus. This is different from the quality measures that are tracked: pneumovax, flu shots, HgA1C, etc. I have to hit 80% of all my charts to get the $8000 bonus each quarter. So that's an easy extra 32,000/yr before taxes.

I don't have overhead. I am a salaried physician who works urgent care.

So you have a base salary where your quota is basically 312 RVU a month and then whatever you make above that you get 52.60 per RVU?

What is your base if you don't mind sharing? Or maybe an average base for a set up like yours?

Sorry I'm new to all this?..
 

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So you have a base salary where your quota is basically 312 RVU a month and then whatever you make above that you get 52.60 per RVU?

What is your base if you don't mind sharing? Or maybe an average base for a set up like yours?

Sorry I'm new to all this?..

I'm still in my first year so I have salary guarantee the first year of 243K regardless of how many RVU's I make. My base salary is 207K and whatever RVU bonus I would get up to the extra 43K is "subtracted" from the extra 43K so in the first year I have to exceed 243K in order to get an RVU check. I do get the quality incentive checks every quarter. Once my year is up in March so that will change me over to the lower base +RVU model. Working 10 days a month I average about 450 RVU's a month.

so...........
450-312= 138 RVU excess x 52.60 = 7258/month extra minus taxes of course.
 

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I'm still in my first year so I have salary guarantee the first year of 243K regardless of how many RVU's I make. My base salary is 207K and whatever RVU bonus I would get up to the extra 43K is "subtracted" from the extra 43K so in the first year I have to exceed 243K in order to get an RVU check. I do get the quality incentive checks every quarter. Once my year is up in March so that will change me over to the lower base +RVU model. Working 10 days a month I average about 450 RVU's a month.

so...........
450-312= 138 RVU excess x 52.60 = 7258/month extra minus taxes of course.

You work 10 days a month and average 450 RVUs, please correct me but could you work 30 days a month then average like 1300 RVUs then get 1300-312 bonus which would be 52 x 1000 or about 50,000 dollars in bonus a month???
 

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cabinbuilder

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You work 10 days a month and average 450 RVUs, please correct me but could you work 30 days a month then average like 1300 RVUs then get 1300-312 bonus which would be 52 x 1000 or about 50,000 dollars in bonus a month???
I suppose that is technically possible. I work 12 hour shifts. There has to be enough open shifts available to work every day and there isn't. The only time I can pick up extra shifts on my perm job would be when someone takes vacation/sick time. But then you have 10 other doctors vying for those same shifts. That's why I pick up shifts elsewhere.
 

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I suppose that is technically possible. I work 12 hour shifts. There has to be enough open shifts available to work every day and there isn't. The only time I can pick up extra shifts on my perm job would be when someone takes vacation/sick time. But then you have 10 other doctors vying for those same shifts. That's why I pick up shifts elsewhere.
And 30, 12-hour shifts sounds like about the worst lifestyle ever. You'd be hard pressed to find anyone who could do that more than 1-2 months tops.

Seriously, those 12 hour days are long - especially this time of year.
 

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And 30, 12-hour shifts sounds like about the worst lifestyle ever. You'd be hard pressed to find anyone who could do that more than 1-2 months tops.

Seriously, those 12 hour days are long - especially this time of year.

True dat. When I did locums there were months that I worked 26 of 30 days. I made a lot of money but paid a LOT of taxes too. Many times putting in the extra days doesn't give you much extra $$ in the long term.
 

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You work 10 days a month and average 450 RVUs, please correct me but could you work 30 days a month then average like 1300 RVUs then get 1300-312 bonus which would be 52 x 1000 or about 50,000 dollars in bonus a month???
When I worked a 26 day month my RVU average was about 700. It all depends on what comes through the door.
 

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When I worked a 26 day month my RVU average was about 700. It all depends on what comes through the door.
That and how you code it.

When I was doing urgent care, I coded URIs as URIs and didn't give prescriptions - so level 3. 50 of those only bought my 50 wRVUs. My partner coded all of those as sinus infections/bronchitis, gave antibiotics (because he's a turd) and coded them level 4, so the same number of patients would get 75 wRVU. At the national average from 2 years ago ($40/wRVU) he would have earned an extra $1,000 per shift that way. If we cut that down to 25 of those type patients (reasonable average) across the 12 shifts we each did... that's an extra $6000/month.

Bastard.
 
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VA Hopeful Dr

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True dat. When I did locums there were months that I worked 26 of 30 days. I made a lot of money but paid a LOT of taxes too. Many times putting in the extra days doesn't give you much extra $$ in the long term.
Someone needs a better accountant :)
 
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That and how you code it.

When I was doing urgent care, I coded URIs as URIs and didn't give prescriptions - so level 3. 50 of those only bought my 50 wRVUs. My partner coded all of those as sinus infections/bronchitis, gave antibiotics (because he's a turd) and coded them level 4, so the same number of patients would get 75 wRVU. At the national average from 2 years ago ($40/wRVU) he would have earned an extra $1,000 per shift that way. If we cut that down to 25 of those type patients (reasonable average) across the 12 shifts we each did... that's an extra $6000/month.

Bastard.

dont hate the playa, hate the game. - someone from the wire said that, maybe Omar.
 
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Mad Jack

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That and how you code it.

When I was doing urgent care, I coded URIs as URIs and didn't give prescriptions - so level 3. 50 of those only bought my 50 wRVUs. My partner coded all of those as sinus infections/bronchitis, gave antibiotics (because he's a turd) and coded them level 4, so the same number of patients would get 75 wRVU. At the national average from 2 years ago ($40/wRVU) he would have earned an extra $1,000 per shift that way. If we cut that down to 25 of those type patients (reasonable average) across the 12 shifts we each did... that's an extra $6000/month.

Bastard.
They're actually looking to crack down on that sort of coding from what I've heard. Had a couple people from legal and billing and coding come in to talk with us about coding the other day, said that insurance expects a certain amount of stuff to be within each category, and they're developing algorithms to determine providers who are outliers (coding every case of the sniffles as a 4, for instance) so that they can sue for their money back. And insurers talk, so once one sues, they tell their friends to look into you, next thing you know you've got 4 lawsuits for six figures on your hands like some of the nightmare cases they reviewed for us. He may be winning in the short run, but in the age of big data, he might be in for a beating down the road.
 
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VA Hopeful Dr

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They're actually looking to crack down on that sort of coding from what I've heard. Had a couple people from legal and billing and coding come in to talk with us about coding the other day, said that insurance expects a certain amount of stuff to be within each category, and they're developing algorithms to determine providers who are outliers (coding every case of the sniffles as a 4, for instance) so that they can sue for their money back. And insurers talk, so once one sues, they tell their friends to look into you, next thing you know you've got 4 lawsuits for six figures on your hands like some of the nightmare cases they reviewed for us. He may be winning in the short run, but in the age of big data, he might be in for a beating down the road.
The biggest thing is to make sure the final diagnosis meets the level you're coding. I could do a full history and head-to-toe physical, but if the patient just has a few mosquito bites then coding that a level 4 is asking for trouble.

But if you hit all your bullet points and end up with something that requires prescription medication treatment then a level 4 is fine. I'll take an audit any day with how I used to code.
 
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When I worked a 26 day month my RVU average was about 700. It all depends on what comes through the door.

Understood but based on your setup if you were able to find a job that allowed you to work 30 days a month or around there you would be clearing 40k+ per month easily!
 

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Understood but based on your setup if you were able to find a job that allowed you to work 30 days a month or around there you would be clearing 40k+ per month easily!
In theory, yes but there are also "rules" of the job and most would not let you do that many days in a row.
 

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In theory, yes but there are also "rules" of the job and most would not let you do that many days in a row.
Yeah that is just asking for burn out of the doc (which is bad for them) and increased patient complaints, and likely more medical errors.

Jesus H. what's with all the medical students coming in here with these God-awful stupid plans to make big bucks lately?
 
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Understood but based on your setup if you were able to find a job that allowed you to work 30 days a month or around there you would be clearing 40k+ per month easily!

in the long run this is not healthy, in the short run this amount of work as a medical professional can lead to depression.
 

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Yeah that is just asking for burn out of the doc (which is bad for them) and increased patient complaints, and likely more medical errors.

Jesus H. what's with all the medical students coming in here with these God-awful stupid plans to make big bucks lately?

Just seeing what's possible. Besides, some of us would prefer to make more than what fm docs average...
 

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Yeah that is just asking for burn out of the doc (which is bad for them) and increased patient complaints, and likely more medical errors.

Jesus H. what's with all the medical students coming in here with these God-awful stupid plans to make big bucks lately?

I hear ya. I worked 6 days a week for almost 2 years straight doing locums but got killed in the end with taxes so it really wasn't worth it in the end. They will "get it" once residency hits and they start getting tired. I'm with you, I thought this was an attending forum only??

And since when was 260+K chump change? I mean with my base salary and picking up 4-5 extra days a month that has come out to around 60K extra for me this year and I didn't have to work that hard to do it.
 

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Yeah that is just asking for burn out of the doc (which is bad for them) and increased patient complaints, and likely more medical errors.

Jesus H. what's with all the medical students coming in here with these God-awful stupid plans to make big bucks lately?


Lack of perspective -- recall that for most of them, their life/work experience consists of moving out of mommy and daddy's house into a dorm where other neurotic 18-22 pre-meds held court on "life advice" and "getting into med school advice" and other such nonsense; interspaced with that were jobs that likely included the phrase,"Would you like fries with that" -- and the payscales that went with it. So now, figuring that with a terminal degree and prescribing authority, they're entitled to more, voila' -- we have people who think they're entitled who are just beginning life who want what some of us have spent years earning when they step out of residency --- life is not a microwave as you well know --- when they get told,"No" and the reality and weight of sole responsibility for patient care hits them in the face, it'll change.

For me, it's getting to the point where I don't want to respond to any of it -- I tend to break that rule for more egregious examples --- and if they want to earn more than FM docs earn, fine, go be another type of physician --- I've seen plenty of IM specialists, surgeons, etc. who sacrificed their lives on the altar of medicine to be sad, lonely people at the end of their careers -- sure, they were surrounded by cool toys, but had no family.

Recall that some people can't get it through their heads that some of us are not motivated by money -- sure, it beats not having money any day of the week but it's not the be all/end all to me. It's a medium that allows me to do more of what I want to do and that's all it is....
 
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JustPlainBill

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Just seeing what's possible. Besides, some of us would prefer to make more than what fm docs average...

If you really want to see what's possible --- go open your own pizza joint -- in 2 years with good marketing, you can make more than what the average FM doc makes after 11 years of training.
Or spend the time you spend in medical school at the driving range seriously smacking golf balls and put the same amount of effort in to being good at golf -- you'll be able to go pro after 4 years of that and have a shot at making significantly more money.
Or figure out how to broker lumber harvested in Washington State and bring it to the areas of the southwest that are currently experiencing a construction boom -- you'll make more than an FM doc ---
Or work for 3 years, living like a dumpster diver, invest the money in a Chick-Fil-A franchise and within 2 years, you'll be making more than an FM doc.
Or go in the Army for 4 years with a contract guarantee as an Airborne Ranger, earn rank and learn the skillsets and go to work as an overseas executive protection specialist -- you'll have fun and earn more than an FM doc
Or become a firefighter/paramedic and earn an nursing license on the side -- you'll work less and earn more than an FM doc --- open your own CPR/BLS/ACLS teaching center and you can make extra.
Or become a cop for 4 years, go into SWAT and then start an LLC teaching "active shooter response" to corporations and run "security assessments" of their facilities ---
Or plan a small business and open an urgent care center hiring docs/PAs/NPs -- you'll definitely make more than an FM doc.
do I need to continue this?

Be an FM doc because you want to be one. If you're going into it for the money, you're in the wrong field.
 
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Mjolner

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If you really want to see what's possible --- go open your own pizza joint -- in 2 years with good marketing, you can make more than what the average FM doc makes after 11 years of training.
Or spend the time you spend in medical school at the driving range seriously smacking golf balls and put the same amount of effort in to being good at golf -- you'll be able to go pro after 4 years of that and have a shot at making significantly more money.
Or figure out how to broker lumber harvested in Washington State and bring it to the areas of the southwest that are currently experiencing a construction boom -- you'll make more than an FM doc ---
Or work for 3 years, living like a dumpster diver, invest the money in a Chick-Fil-A franchise and within 2 years, you'll be making more than an FM doc.
Or go in the Army for 4 years with a contract guarantee as an Airborne Ranger, earn rank and learn the skillsets and go to work as an overseas executive protection specialist -- you'll have fun and earn more than an FM doc
Or become a firefighter/paramedic and earn an nursing license on the side -- you'll work less and earn more than an FM doc --- open your own CPR/BLS/ACLS teaching center and you can make extra.
Or become a cop for 4 years, go into SWAT and then start an LLC teaching "active shooter response" to corporations and run "security assessments" of their facilities ---
Or plan a small business and open an urgent care center hiring docs/PAs/NPs -- you'll definitely make more than an FM doc.
do I need to continue this?

Be an FM doc because you want to be one. If you're going into it for the money, you're in the wrong field.

Did you actually say that becoming a professional athlete was a viable career option as becoming a cop?

Cause I feel like I just read that.


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Did you actually say that becoming a professional athlete was a viable career option as becoming a cop?

Cause I feel like I just read that.


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Having been a motivated individual as a high school student with an almost obsessive drive to excel in everything I did, I was number 2 man on the golf team at the high school I did my junior year at (military brat) having not played any serious golf for at least a year --- didn't take long when I was up before school to smack 500 balls downrange and back at it after school for a round of golf and more range time --- went from a first game high score of 116 to a before playoffs score of 80. If I can do it in one year, I would assume any sufficiently motivated individual, with the same drive as it takes to get through medical school, can earn a pro ticket in 4 years -- I think it was Fuzzy Zoeller who did it at age 36. Now, I did NOT say Tiger Woods level, but pro level nonetheless.

What you read? subject to your own interpretation.
 

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Having been a motivated individual as a high school student with an almost obsessive drive to excel in everything I did, I was number 2 man on the golf team at the high school I did my junior year at (military brat) having not played any serious golf for at least a year --- didn't take long when I was up before school to smack 500 balls downrange and back at it after school for a round of golf and more range time --- went from a first game high score of 116 to a before playoffs score of 80. If I can do it in one year, I would assume any sufficiently motivated individual, with the same drive as it takes to get through medical school, can earn a pro ticket in 4 years -- I think it was Fuzzy Zoeller who did it at age 36. Now, I did NOT say Tiger Woods level, but pro level nonetheless.

What you read? subject to your own interpretation.

And Mike Tyson took to boxing pretty well. But I bet 99.99999% of this forum would not.

I really enjoy your posts and wisdom, but you you're stretching here.

Many people don't have the physical ability to perform at professional sports regardless of drive. Division I college teams are full of guys who want it and are driven, bust just don't have the ability for the next step. Not to mention farm teams.


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I could be wrong but I think a lot of these posts are from people that want/wanted to match into a "sexy" specialty but will get / got "stuck" with FM. They miss the point of why some of us go into this field and they fail to see the value of family life / work balance.
 

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And Mike Tyson took to boxing pretty well. But I bet 99.99999% of this forum would not.

I really enjoy your posts and wisdom, but you you're stretching here.

Many people don't have the physical ability to perform at professional sports regardless of drive. Division I college teams are full of guys who want it and are driven, bust just don't have the ability for the next step. Not to mention farm teams.


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And we're all entitled to our opinion -- post I responded to made mention of seeing what was possible --- my contention has always been, you're only limited by your imagination --- there's a group that regularly proves this every day of the week at Coronado, California --- people in that group regularly break previously insurmountable physical barriers -- like doing 1500 lunges in 8 hours or moving at your physical/mental peak for a week straight with no sleep or whatever --- limitation is only in your mind. That's all I was saying.

If I had stayed with "what's possible" -- I'd be stocking groceries at WalMart, eating my PB&J at 0100, sending my children to the local community college and driving a 15 year old beater with no A/C and dying internally as I looked at my wife cause I'd be thinking ,"This lovely woman who gave me the best years of her life, her love, and her body who had so many opportunities doesn't deserve this all because my job went to India."..... So I changed the rules as to "what was possible", altered the game and did what it took to get what I wanted ---- and because of the blood, sweat and tears coupled with the grace of God, I'm seeing 12 to 25 patients per day, my children go to Baylor, I'm driving a pretty nice jeep, my wife is happy and works because she wants to and we get to go on nice family outings/vacations a couple of times a year....

But I grow weary of this "conversation" --- especially since med students obviously know all about medicine and life.....

enjoy the time you have on this spinning blue ball we call Earth -- you only have so many evolutions around the sun --
 
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Wow, this thread became super painful. You would think with the number of 30 something non-traditionals who go into Family Med, we would get spared some of this, but I suppose not.

I honestly think that my life, now, today, as a resident, with a stay at home wife and child, is easier, less stressful than the life lead by many of my patients. Certainly we look forward to an attending salary, but I will never lose perspective of what my patients have to do, to make ends meat. I acknowledge that due to my degree, I will be a in a solid position to leverage a solid, comfortable salary, but I don't think I am any more deserving, or better, than the farmers and other folks I see each day and who work their butts off to have something extra for their kids for Christmas.

Sigh. In any event if you want to talk numbers, the graduates form my place are pulling in the >180's depending upon location, number of patient's seen (some, horror, horror, work a little less because they want to be home w/ family). If you have pissed off the very helpful attendings, of probably the chillest section of SDN, then you have messed up.
 
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Mjolner

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my contention has always been, you're only limited by your imagination --- there's a group that regularly proves this every day of the week at Coronado, California --- people in that group regularly break previously insurmountable physical barriers -- like doing 1500 lunges in 8 hours or moving at your physical/mental peak for a week straight with no sleep or whatever --- limitation is only in your mind. That's all I was saying.

I agree. But your examples are so "lottery winner-esque"

4/5 of baby seals washout during BUD/S training. These are all people more driven than even your more driven medical students and they still ring the bell.

I'm just tired of everyone thinking because they could do medical school they could do anything. We're not special snowflakes. We're just smart, hard working snowflakes who picked a field that happens to provide success for virtually everyone who graduates with a medical degree. To assume that we would also be successful in other fields is unrealistic.

Ask the guys killing themselves doing the landscaping outside my school. Sometimes, hard work isn't enough to be in that top 5% of economic success.



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surrender903

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for the love of god:

you CAN make good money in FM

if you want to work more than 50 hours a week, noone will stop you as an attending, but you are going to be accountable for all your actions as a physician.

burnout is real.

we are all here to help.


does anyone want any sort of festivus/hanukah/christmas/kwanaza pie/cookies/sweets?
 
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W19

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for the love of god:

you CAN make good money in FM

if you want to work more than 50 hours a week, noone will stop you as an attending, but you are going to be accountable for all your actions as a physician.

burnout is real.

we are all here to help.


does anyone want any sort of festivus/hanukah/christmas/kwanaza pie/cookies/sweets?
It is even possible to make ~300k/year working ~50 hrs/wk?
 

JustPlainBill

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It is even possible to make ~300k/year working ~50 hrs/wk?

So, let's start with a few definitions --

$300k/year -- do you mean "bring home" aka what gets deposited into your checking account on a biweekly basis (300k/26 = $11,538.46) or do you mean $300k/year less taxes (medicare, income tax, etc) less benefits (health, LTD/STD, vision,dental) less retirement contributions (up to you)?

If you mean $300k/year before taxes/deductions -- sure. If you mean $300k/year after taxes/deductions -- you'd have to really work at it -- as that means approximately $405,000 before taxes assuming a 35% tax bracket not including deductions for benefits and retirement contributions.

Recall that there are couples who manage to put away $1million for retirement before they are 55 who are firefighters and elementary teachers that make probably less than $60k/year before taxes -- and they do this while managing to live in a nice but not elaborate home sufficient to raise a family and still enjoy life -- the kids go to college but likely need some student loans ---

the reason I bring this up is too often med students have an altered sense of reality when it comes to finances and salaries --- I worked my tail off and my wife held a full time job making $24k/year and total household income was around $42k/year before taxes, IIRC when I was transitioning into medical school --- she and the children drove the newer minivan, I had the beater Toyota standard shift pick up with no a/c that was 10 years old, our big night out was to take the children to CiCi's all you can eat pizza where we could feed everyone for less than $20 AND had enough left over to let the children to spend $0.25 a pop on a few of those gumball machine trinket dispensers. We used to have "movie night" combined with "Chipotle night" where we'd go to Family Video and let the children each pick a movie to rent and then let them help us cook while we made the fixings for make your own "Chipotle" burritos. The children wore hand me downs that were cycled through our church and we were greatful. We saved for Christmas all year (or tried to) and made sure the children had a "big" Christmas ($250/child). It was hard but we did it. I went without medical insurance for 2 years since we couldn't afford it -- doctored myself with hot toddy's and mucinex.

Yeah, I get that you've got student loans to pay back -- my monthly bill is going to be between $1800/month (25 year plan) to $3500/month (10 year plan) --- If you're in medicine for the money, you chose unwisely.
 
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cabinbuilder

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So, let's start with a few definitions --

$300k/year -- do you mean "bring home" aka what gets deposited into your checking account on a biweekly basis (300k/26 = $11,538.46) or do you mean $300k/year less taxes (medicare, income tax, etc) less benefits (health, LTD/STD, vision,dental) less retirement contributions (up to you)?

If you mean $300k/year before taxes/deductions -- sure. If you mean $300k/year after taxes/deductions -- you'd have to really work at it -- as that means approximately $405,000 before taxes assuming a 35% tax bracket not including deductions for benefits and retirement contributions.

Recall that there are couples who manage to put away $1million for retirement before they are 55 who are firefighters and elementary teachers that make probably less than $60k/year before taxes -- and they do this while managing to live in a nice but not elaborate home sufficient to raise a family and still enjoy life -- the kids go to college but likely need some student loans ---

the reason I bring this up is too often med students have an altered sense of reality when it comes to finances and salaries --- I worked my tail off and my wife held a full time job making $24k/year and total household income was around $42k/year before taxes, IIRC when I was transitioning into medical school --- she and the children drove the newer minivan, I had the beater Toyota standard shift pick up with no a/c that was 10 years old, our big night out was to take the children to CiCi's all you can eat pizza where we could feed everyone for less than $20 AND had enough left over to let the children to spend $0.25 a pop on a few of those gumball machine trinket dispensers. We used to have "movie night" combined with "Chipotle night" where we'd go to Family Video and let the children each pick a movie to rent and then let them help us cook while we made the fixings for make your own "Chipotle" burritos. The children wore hand me downs that were cycled through our church and we were greatful. We saved for Christmas all year (or tried to) and made sure the children had a "big" Christmas ($250/child). It was hard but we did it. I went without medical insurance for 2 years since we couldn't afford it -- doctored myself with hot toddy's and mucinex.

Yeah, I get that you've got student loans to pay back -- my monthly bill is going to be between $1800/month (25 year plan) to $3500/month (10 year plan) --- If you're in medicine for the money, you chose unwisely.


True that: Yes I am over the 300K mark gross salary. However, I just looked at my Taxes that have been taken out $86,000+ and add what they took out for health insurance, disability, 401K etc and that's another 25K . So $100,000 I never saw. Now take out my student loan payment, time share mortgage, home mortgage, sons college, divorce alimony, car payment and I barely break even. I do extra locums on the side just to have some extra for big expenses that come up. It sounds like a lot but in the end I pretty much am paycheck to paycheck at this point. I'm hoping to turn that around in 3-4 years.
 

JamaicanHerb

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True that: Yes I am over the 300K mark gross salary. However, I just looked at my Taxes that have been taken out $86,000+ and add what they took out for health insurance, disability, 401K etc and that's another 25K . So $100,000 I never saw. Now take out my student loan payment, time share mortgage, home mortgage, sons college, divorce alimony, car payment and I barely break even. I do extra locums on the side just to have some extra for big expenses that come up. It sounds like a lot but in the end I pretty much am paycheck to paycheck at this point. I'm hoping to turn that around in 3-4 years.

i do take pleasure in the gender equality.
 
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