For The People Going Into Medicine for the Money.

[907914]

Although the media portrays it as solely a physician salary issue, the cost of healthcare is mainly focused in administrative costs. If physician reimbursement is cut and nothing is done to minimize administration then we won’t accomplish anything

If we continue here we will likely derail this into a socialized medicine thread. Here is a place we can take the convo:

Survey of intergenerational opinions on socialized medicine/single payer/'medicare for all'

After being on here for a while, talking with fellow applicants at interviews, and speaking with med students, residents, and attendings I have discovered that there is a wide margin of opinions on the matter of socialized medicine/single payer/'medicare for all.' However, I have noticed a trend...

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[beattheprocess]

My personal financial situation doesn’t matter.

It really does though. You wouldn’t be saying that if you were rich.

 

[Jappa]

If we continue here we will likely derail this into a socialized medicine thread. Here is a place we can take the convo:

Survey of intergenerational opinions on socialized medicine/single payer/'medicare for all'

After being on here for a while, talking with fellow applicants at interviews, and speaking with med students, residents, and attendings I have discovered that there is a wide margin of opinions on the matter of socialized medicine/single payer/'medicare for all.' However, I have noticed a trend...

forums.studentdoctor.net

Did some searching after I asked that question and found a whole thread on it as well: just got done reading through it, very interesting points brought up.

Medicare for all and physician salaries

I'm not even sure what determines reimbursement rates right now, but will a single payer healthcare system drive down physician wages? With all the current hype about medicare for all it seems like it will be implemented sometime in the near future, which has me wondering how our compensation...

forums.studentdoctor.net

 

[beattheprocess]

I grew up in a six figure income, had the opportunity to be in that financial position as an adult, quit that financial position to come back to school. So yes, I would still be saying this if I were rich.

But that’s not your situation right now. It’d be pretty stupid to support policy that benefits a position that you no longer hold.

 

[Tiran145]

My engineering classmates are starting out with 100K+ right out of undergrad so assuming med school + residency + fellowship is ~10 years that’s the time they can be making a million bucks with no debt or stressful schooling.

Where Cali with crazy cost of living? Unless your in petroleum more like 70-80

 

[beattheprocess]

Person decides to give up wealth to help others

Is that the only reason?

I also don’t consider giving up “6 figures” for the chance to make 200k a year at the minimum a sacrifice. It’s an investment if anything.

 

[DoctHouse]

Why shouldn't money be of concern? It's a job. People are literally going to school for 8 years and paying tons of debt, so they best be receiving a good return on their investment. Almost nobody would become a doctor if they made $50k lets be real. If money is a main motivator, I say who cares? That doesn't necessarily mean they don't have a desire to help people and save lives. That whole "they'll be miserable" thing is cliche now.
*edited: typo*

 

[beattheprocess]

Alright, normally I am not a voice of reason...but what are you doing

Right now? Watching season 3 of 13 reasons why (it's really really really bad).

But I do think it’s interesting when most say they support something because so many people will benefit from it, but it surprisingly also happens to benefit them as well.

 

[longhaul3]

I read so many places on SDN that medicine is not the way to go if you're just out to make money but I know so many people who want to go into it for just that (not that I have any confidence any of them will make it but)

So, for those of you who can look back on a career, what would you tell those people they should go into instead? What are these "so many other careers with much better financial outlook" ? I've googled into finance jobs and very few get above a FM salary so, what is it then?

Money is a major motivating factor and makes medicine a really attractive profession. If doctors made 60-70k, a lot fewer people would be interested, and there's no shame in admitting that. However, medicine isn't a great profession to go into solely for the money. It requires a lot more sacrifice, time, and hard work than most other high-end professions, and most people who can get into med school could conceivably make it in one of those professions as well.

P.S. you have the right idea with your profile picture...do a few TLIFs a few days a week and your boat will be paid off before you can say "Stryker"

 

[mcat_taker]

Don't residents usually get around 40k a year though? I always hear the "starving resident" trope but honestly I know a lot of people in the working world who are happy to get 40k a year. I know it isn't proportional to debt, and the hours are insane, but in terms of living standards based on money I don't really get how it's that bad. Especially because you know your income will go up so the burden of debt is hopefully temporary.

Considering you are one of the most educated people in the country making 40k a year for the insane hours its bad. Not sure who in the working world is happy to make 40k a year. Factor in the fact that this is 8 years after college and med school that you are making that.

 

[calipremed5768]

Which doctors can afford supercars (Lambos, ferraris, Aston martins etc). Asking for a friend who needs to make an ex gf who broke his heart jealous.

 

[Cornfed101]

Which doctors can afford supercars (Lambos, ferraris, Aston martins etc). Asking for a friend who needs to make an ex gf who broke his heart jealous.

It is unwise to own cars that add up to more than half of your annual income. So you can do the math. $300k car, you should be making $600k. Keep in mind that your doctor salary is not your only source of income if you are investing as you should be

 

[calipremed5768]

Ok I’ll tell my friend to keep working on blackjack and options trading to invest the money he makes as a doctor

 

[mcat_taker]

Not to beat a dead horse here, as many have expressed similar sentiments. You would need to strike it incredibly lucky to pass 200k as an engineer, of any kind. If you want to pass 200k, you need to put in 60 hour work weeks busting your hump trying to work your way up the management ladder and then at that point you need to keep performing at that level or else you're going to be replaced by the guy coming up right behind you doing the same thing you were doing and then you need to start all over again at a different company. Tech/Engineering are not these easy come, will never go careers. You need to work very hard through undergrad and then start out as an average engineer/tech employee making ~70kish and only then can you begin the climb. It could very well take you just as long as med school (7 years, which is the low end of what is considered a Senior Engineer/Tech employee) or longer to reach even comparable compensation as FM. Even 90 percentile ChemEs, for example, only make 170k, which is still less than any MD would. All with the expectation that you need to put in the 50-60 hour work weeks and that you're replaceable as there are always new grads gunning for your spot. It's doable, but most won't, even if they were premeds, because there just aren't the job opportunities in engineering/tech that there were even 7 years ago. There are twice as many engineering graduates as there are jobs sadly.

TL;DR
Yes, immediate gratification of these careers can be attractive, but you won't ever come close to the level of income and job security as an MD because everyone who has been in college the last 5-8 years has seen these industries blow up in salary and have subsequently studied these fields and are now facing significant competition and job market saturation that is only going to get worse.

There are other jobs besides engineering that will pay. Finance and consulting. Many of the big shops pay 100k starting to new college grads at 22. Hell my youngest brother interned at an investment bank this summer while in college and made 15k in less than a full summer. After a few years of experience big consulting firms will be paying you 200k a year. These are jobs that require much less weekend work time-- medicine is 24/7 and as an attending you will be covering the hospital on many weekends and holidays unless you do strictly outpatient clinic-- no matter your seniority. My other brother works in finance and makes almost as much as my mom (but he's in his 20s and hasn't peaked his income and my mom is 32 years post residency and has). Medicine does not pay nearly as well as it used to plus your QOL is horrible while in school and residency compared to your working peers.

 

[calipremed5768]

People don’t get that it’s incredibly rare to get promoted in finance and consulting jobs. At bulge bracket banks only ~10% of analysts move onto associate. Also I guarantee that entry level finance employees work more than residents.

 

[Calizboosted76]

- Delayed gratification. You've spent the last decade plus at or below poverty level working and studying absolutely insane hours while your friends are at the bar or on vacation.

Oh good. I thought this was just me

 

[Calizboosted76]

Fwiw the only ones I know that own those types are geriatrician and a family doc. My dad's a derm and I drive a ford lol

Also plenty of people can afford it but that doesn't mean they find it wise to drop that much on a car

THIS. I work with a vast majority of different physicians and I always wondered to myself why some of them are not driving these types of vehicles. The fact of the matter is that not everyone is a car person. One doctor I know has multiple fancy cars and another I know drives a minivan because he says that he would rather spend his money on traveling.

 

[calipremed5768]

people who have those cars don’t really drive them around though. That’s why used supercars usually only have like 5k miles

 

[Calizboosted76]

people who have those cars don’t really drive them around though. That’s why used supercars usually only have like 5k miles

Well I am telling you out of the 100 docs that I work with (neurosurgery, IM, EM, Gensurg, ortho) 15 out of the 100 have "Super cars" the other 85 drive regular vehicles. I believe this is area dependent though. I am in Florida so I assume that Docs out in Hollywood would more likely have these types of vehicles.

 

[lull]

the other 85 drive regular vehicles

i.e., tesla

 

[Calizboosted76]

i.e., tesla

I guess I should have specified that lol. Yes a majority of them have Tesla, Porsche, Raptors. By regular vehicle I in no way meant cheap haha. But there are a few that drive ole beaters because they just got out of residency and want to buy a house and pay off their loans. I even know a Doc that traded in his Mercedes for a miata..... We still haven't stopped giving his **** for it.

 

[beattheprocess]

Raptors

You mean Jaguar?

 

[Calizboosted76]

You mean Jaguar?

No? lol
Ford Raptor.

 

[beattheprocess]

No? lol
Ford Raptor.

I just have a hard time picturing doctors driving massive pick up trucks.

 

[Calizboosted76]

I just have a hard time picturing doctors driving massive pick up trucks.

Let me restate, I live in central Florida. HICKVILLE. Lol

 

[Calizboosted76]

And when I say Raptors yes, you are picturing the correct version. Multiple big lifted trucks on swamper tires. Lol.

 

[mcat_taker]

People don’t get that it’s incredibly rare to get promoted in finance and consulting jobs. At bulge bracket banks only ~10% of analysts move onto associate. Also I guarantee that entry level finance employees work more than residents.

Yes newly hired junior investment bankers do work a lot of hours, no question. Although I do think the culture is changing a bit because unlike residency where you have no choice but to put up with it until you graduate (that and you have a ton to learn before you are let loose with no supervision with people's lives), in investment banking you can always quit and find a different job if it gets to be too miserable. They can work you hard but you have somewhat more leverage-- also you are getting paid a lot for those hours which makes it somewhat more bearable-- but yes means to an end like residency.

Anyone from any no name school who is smart and works hard can get a great GPA and MCAT and get into med school somewhere. It's a good job for most people who like it and want to do it (despite the opportunity cost). On the other side- the best jobs in finance require a lot of social capital to get. At the top investment banks (one of which my brother interned at- all the kids there were all ivy league or maybe a select few T15 schools). The bulge bracket or top banks get thousands of apps and they filter out based on your academic pedigree. Without an elite academic pedigree you simply will not get that coveted I-banking or private equity job to get your foot in the door without an extraordinary amount of extra work to stand out or a very good connection. Many people go to business school for this reason-- Person X didn't go to a great undergrad but then went ivy league for business school and retooled his network, gained extra social capital, and has a new elite academic pedigree to apply for those jobs. Meanwhile person Y went to harvard, yale, princeton for undergrad and gets that job off the bat with no lost opportunity cost of business school.

Same goes for consulting gigs at bain, McKinsey, bcg

 

[CidHighwind]

Even with debt and opportunity cost, medicine has the best ROI out of any degree. Finance doesn’t pay what everyone here thinks unless you’re the “top guys”, and if you’re a partner in a successful surgicenter or derm practice you’ll make great money as well. I think the major difference is that in medicine, you’re really not making “doctor money” until you’re in your early-mid 30s, so it’s harder to “enjoy” your money.

 

[CidHighwind]

Also as a side note, I always find it disturbing how people say how little you earn as a resident. While it’s true that you’re working a ton and the dollar per hour ratio isn’t great, you’re still making an “average” income. When normal people keep hearing how residents make “nothing”, but are making more than them even then, it makes them dislike doctors even more.

 

[Detective SnowBucket]

Also as a side note, I always find it disturbing how people say how little you earn as a resident. While it’s true that you’re working a ton and the dollar per hour ratio isn’t great, you’re still making an “average” income. When normal people keep hearing how residents make “nothing”, but are making more than them even then, it makes them dislike doctors even more.

How many of those 'normal people' making this average wage have $250k in debt

 

[mcat_taker]

Also as a side note, I always find it disturbing how people say how little you earn as a resident. While it’s true that you’re working a ton and the dollar per hour ratio isn’t great, you’re still making an “average” income. When normal people keep hearing how residents make “nothing”, but are making more than them even then, it makes them dislike doctors even more.

Dude because comparisons are not done in a vacuum. A resident is not someone working for UPS or Mcdonalds with a HS degree who works a normal 40 hour workweek. A resident has 8 years of graduate education and is making 4 dollars an hour in their late 20s to early 30s if you divide by the amount of hours worked. It doesn't matter what you think an average income is for middle america. Apples to oranges.

 

[CidHighwind]

Dude because comparisons are not done in a vacuum. A resident is not someone working for UPS or Mcdonalds with a HS degree who works a normal 40 hour workweek. A resident has 8 years of graduate education and is making 4 dollars an hour in their late 20s to early 30s if you divide by the amount of hours worked. It doesn't matter what you think an average income is for middle america. Apples to oranges.

There’s a lot of PhD students that have just as much training and take jobs making 50-60k. Also it’s honestly a nice thing that they even pay us in residency, they could make us pay tuition for residency like they do for dentists. Also as crappy as residency is, they still give you 3-4 weeks of vacation every year. That’s a lot more than those UPS and McDonald workers get.

How many of those 'normal people' making this average wage have $250k in debt

Anyone that went to a private college comes out with that much debt, and most take jobs starting at 50-65k a year.

 

[aldol16]

Opinion | That Beloved Hospital? It’s Driving Up Health Care Costs (Published 2019)

It’s easy to criticize pharmaceutical and insurance companies. But we spend much more on hospitals.

nyti.ms

Something to ponder.

 

[aldol16]

There’s a lot of PhD students that have just as much training and take jobs making 50-60k. Also it’s honestly a nice thing that they even pay us in residency, they could make us pay tuition for residency like they do for dentists. Also as crappy as residency is, they still give you 3-4 weeks of vacation every year. That’s a lot more than those UPS and McDonald workers get.

Yes, but wages and salaries don't exist in a vacuum. Wages have to be viewed in light of revenue generated. (Totally hypothetical scenario with made up numbers) If a fast food worker generates $18 of revenue/hr for a company and the company pays that worker $15/hr (the remaining $3 to cover operating costs and small profit margin), then that's pretty reasonable. But if a worker generates $100/hr for the company and the company pays that worker $7.50 an hour, then that's not reasonable. Although one does have to factor in increased operating costs for hospitals versus a fast food joint.

 

[CidHighwind]

Yes, but wages and salaries don't exist in a vacuum. Wages have to be viewed in light of revenue generated. (Totally hypothetical scenario with made up numbers) If a fast food worker generates $18 of revenue/hr for a company and the company pays that worker $15/hr (the remaining $3 to cover operating costs and small profit margin), then that's pretty reasonable. But if a worker generates $100/hr for the company and the company pays that worker $7.50 an hour, then that's not reasonable. Although one does have to factor in increased operating costs for hospitals versus a fast food joint.

That’s capitalism my friend. Many physicians “generate” a revenue of 7 figures, but their salary is only a fraction of that.

 

[aldol16]

That’s capitalism my friend. Many physicians “generate” a revenue of 7 figures, but their salary is only a fraction of that.

Sure, but the marginal value of money drops off steeply. For a resident living in a big city (where many academic centers are), an added $50k would almost double their salary whereas an added $50k for a physician making $300k would likely cause less of an impact. I think there's wiggle room for resident pay. The issue I think is with how those spots are funded and Medicare regulations (that I know nothing about). You see many academic centers building new hospitals, new facilities, etc. It's because if they dump their profits back into the hospital, that doesn't go on the balance books as profit. So then they can report marginal profits so it looks better. I wonder how much of an impact it could make if only a fraction of that money is repurposed to resident pay.

 

[mcat_taker]

That’s capitalism my friend. Many physicians “generate” a revenue of 7 figures, but their salary is only a fraction of that.

Except residents don't generate any revenue. They don't have independent practice rights so they don't independently bring in any revenue for a hospital.

 

[mcat_taker]

There’s a lot of PhD students that have just as much training and take jobs making 50-60k. Also it’s honestly a nice thing that they even pay us in residency, they could make us pay tuition for residency like they do for dentists. Also as crappy as residency is, they still give you 3-4 weeks of vacation every year. That’s a lot more than those UPS and McDonald workers get.



Anyone that went to a private college comes out with that much debt, and most take jobs starting at 50-65k a year.

Yea and guess what, most medical students come out of college with debt too so add on more debt for med school. And then they don't start making 50-60k a year because they go to medical school after college where they are students full time instead of starting to pay off that debt.

 

[Detective SnowBucket]

There’s a lot of PhD students that have just as much training and take jobs making 50-60k. Also it’s honestly a nice thing that they even pay us in residency, they could make us pay tuition for residency like they do for dentists. Also as crappy as residency is, they still give you 3-4 weeks of vacation every year. That’s a lot more than those UPS and McDonald workers get.



Anyone that went to a private college comes out with that much debt, and most take jobs starting at 50-65k a year.

Which they start seriously paying off 7 yrs before Fm and 11 yrs before ortho, thats some serious interest to be build up.

 

[CidHighwind]

Sure, but the marginal value of money drops off steeply. For a resident living in a big city (where many academic centers are), an added $50k would almost double their salary whereas an added $50k for a physician making $300k would likely cause less of an impact. I think there's wiggle room for resident pay. The issue I think is with how those spots are funded and Medicare regulations (that I know nothing about). You see many academic centers building new hospitals, new facilities, etc. It's because if they dump their profits back into the hospital, that doesn't go on the balance books as profit. So then they can report marginal profits so it looks better. I wonder how much of an impact it could make if only a fraction of that money is repurposed to resident pay.

Well you do know that Medicare gives about $150k a year for each spot. The other $100k goes to the university/hospital.

Except residents don't generate any revenue. They don't have independent practice rights so they don't independently bring in any revenue for a hospital.

Residents aren’t med students. They’re supervised doctors. Their notes can be billed for (which is how attendings can just write “agree with above”) and help with the workflow in the hospital. Why do you think some residencies extend their residencies through research years where they still cover call, or what EM does and just make an extra year?

Yea and guess what, most medical students come out of college with debt too so add on more debt for med school. And then they don't start making 50-60k a year because they go to medical school after college where they are students full time instead of starting to pay off that debt.

I mean, many people are going to grad school nowadays, and that isn’t cheap. I do agree that school in general is way too expensive, but no one feels sorry for doctors. Especially since the doctors will be able to get a job paying 250-300k, and many contracts have loan forgiveness. The worst thing would be taking on the debt and not finishing med school...

Which they start seriously paying off 7 yrs before Fm and 11 yrs before ortho, thats some serious interest to be build up.

The PhD student usuall got a masters beforehand, and usually has to do several postdocs before they get the job. Many PhDs start making “money” in their 30s just like physicians. Physicians sacrifice the most initial time and put in the most work initially, but have the biggest payoff.

 

[Detective SnowBucket]

The PhD student usuall got a masters beforehand, and usually has to do several postdocs before they get the job. Many PhDs start making “money” in their 30s just like physicians. Physicians sacrifice the most initial time and put in the most work initially, but have the biggest payoff.

And that's a bad investment. It doesn't matter if a profession is a bad investment - people just don't go into it - unless your health relies on that profession.

 

[longhaul3]

Also I guarantee that entry level finance employees work more than residents.

This is probably true for some specialties but is definitely not true for surgical residents except when they are on elective, research, or off-service rotations.

 

[calipremed5768]

Isn’t there an 80hr/week law. At some I banks certain groups work 100hr weeks depending on deal flow

 

[CidHighwind]

And that's a bad investment. It doesn't matter if a profession is a bad investment - people just don't go into it - unless your health relies on that profession.

What’s a better investment? And don’t use the top end of one profession and compare it to the lower end of ours. You someone in tech can make 6 figures working for Google or Boeing for good money, but that’s like them saying someone can go into medicine, become a dermatologist or plastic surgeon and make celebrity money.

 

[longhaul3]

Isn’t there an 80hr/week law. At some I banks certain groups work 100hr weeks depending on deal flow

Yep, there are rules, but the work needs to be done...

 

[calipremed5768]

I mean what hospital would risk malpractice lawsuit if a resident who worked over the legal limit kills somebody

 

[Cornfed101]

I mean what hospital would risk malpractice lawsuit if a resident who worked over the legal limit kills somebody

That’s why they were implemented in the first place

 

[Detective SnowBucket]

Tell me what’s a better investment? And don’t use the top end of one profession and compare it to the lower end of ours. You someone in tech can make 6 figures working for Google or Boeing for good money, but that’s like them saying someone can go into medicine, become a dermatologist or plastic surgeon and make celebrity money.

That's not what I'm here to do, hence me starting this thread. Also believe the second verb comes at the end: Tell me what a better investment is. Also, is that a question? Imperatives don't get a question mark.

 

[CidHighwind]

That's not what I'm here to do, hence me starting this thread. Also believe the second verb comes at the end: Tell me what a better investment is. Also, is that a question? Imperatives don't get a question mark.

There’s really nothing to discuss. People just say that because it means less people to compete with to get into medical school. The reality is that there’s no “easy” path to a great career (sans nepotism) and you’ll have to put work in to any lucrative path. Medicine is the most lucrative, but it’s also the most work.

 

[mcat_taker]

There’s really nothing to discuss. People just say that because it means less people to compete with to get into medical school. The reality is that there’s no “easy” path to a great career (sans nepotism) and you’ll have to put work in to any lucrative path. Medicine is the most lucrative, but it’s also the most work.

Ok I don't know if you are just trolling but you need to stop with the medicine is the most lucrative nonsense. That is laughable. I don't know if you are actually a med student or still a premed but the reality is that a majority of doctors graduating med school go into IM, FM, or peds. Please tell a pediatrician they are rich and have the most lucrative career-- especially when they graduate after 11 years and have a starting salary of 150-160k out of residency to show for it with 300-400k of debt due to interest from college and med school. 200k in salary doesn't go as far as you think when you start having kids and debt to pay off. Same goes for a hospitalist working half the weekends a year 12 hours on the weeks they are on for 250k. Or tell that to the ID doc, endocrinologist, or nephrologist who went into additional training for less pay than a primary care doctor makes. People go into those fields because of interest or better lifestyle than hospital medicine not because they are going to get rich.

There is downward pressure on salaries in tons of fields right now because of mid levels. EM is kind of the last hold out but EM salaries won't be this inflated forever.

Yes-- there are subspecialties that make a lot of money-- cardiology/ GI after IM and obviously things like ortho, urology, derm, ENT where you will make double or triple what a hospitalist or pediatrician makes-- but don't forget how competitive those fields are. There is no guarantee that someone gets a cards or GI fellowship because they take the top of IM grads. And obviously surgical subs like ortho and urology have less mid level pressure but also extremely difficult to match into for residency and those fields have additional years of training involved. Most docs graduating med school are not doing orthopedic spine making 700k plus.