GMO to wait out Obamacare

[atrialfib]

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Title says it. This is kind of a throw away account, btw. What is everyone's thoughts on taking a GMO tour before residency to sound out what the Obamacare situation will be in 3-4 years?

 

[HighPriest]

If it sucks, then what?

 

[atrialfib]

well nothing i guess. i have a handful of specialties that I'm still interested in. i'm still trying to decide. i'd just like to see how reimbursements, etc pan out in the long term. frankly, i'd like to stay in the military. but i do know people who have been bounced out for various reasons. i'm a fairly conservative person, and i'd like to know what my prospects look like if i end up in the civilian world down the line.

 

[HighPriest]

While I am not ecstatic about the ACA, I don't think it will change the general scope of reimbursement. Family Docs aren't going to suddenly start making more than neurosurgeons. If you're thinking a primary care specialty, you may as well do a residency. You'll, in many cases, make more in the military anyway. If you're trying to decide if orthopedic surgeons are going to be paupers in 4 years, I won't stress about it. If you just need more time to decide on a specialty, then so be it. If it's a matter of whether or not urology is going surpass ortho (or whatever comparison you'd like), and we're making a career decision based upon a few G a year, then I think the military may be a rough place for you anyway.
Personally, I wouldn't do a GMO tour just to watch how things pan out. But I also have less than zero desire to stay in the military for any longer a period than I am required.

 

[jabreal00]

It seems like such a hair-brained thought that I don't even know where to start. I have a feeling that "Obamacare" should be the least of the OP worries

 

[Beargryllz]

I see only downsides and absolutely no upside to this decision

But, it does mean less competition, so go for it!

 

[DeadCactus]

Did you hold off on college to wait out Y2K and medical school to wait out 2012?

 

[Perrotfish]

well nothing i guess. i have a handful of specialties that I'm still interested in. i'm still trying to decide. i'd just like to see how reimbursements, etc pan out in the long term. frankly, i'd like to stay in the military. but i do know people who have been bounced out for various reasons. i'm a fairly conservative person, and i'd like to know what my prospects look like if i end up in the civilian world down the line.

1) Read through old SDN threads, or old articles on healthcare. There has been enormous anxiety about the future of medicine since the 1980s. Do you really think that its going to reach a point everyone agrees is stable in 4 years? If ortho collapses but urology keeps a high reimbursement, will you really take that to mean that urology will keep a high reimbursement 4 years after that? As far as I can tell the only time people feel certain about the future of their profession is after its completely collapsed (see airline pilots, or lawyers), and even then there's a good chance they're wrong.

2) If you're really uncertain about your profession's financial future and its causing you a great deal of stress, an alternative to waiting for clairvoyance is to improve your personal financial position. The less you live on, and the more you save, the better your position. The future of medicine doesn't matter, at least from a financial prospective, if you get the money out in the present. Every 250K you save is 10K/year of unearned income you can live off of for the rest of you life. With HPSP if you are very frugal (living with roommates and driving very old cars in a lower cost area), match in a low cost area, and do a residency followed by payback you could theoretically stash the first 500K of income before you even finish your payback period. Not saying that that's necessarily the right choice, as it means lving on 25K as a resident and 40-50 K as an attending (you'll have very little left over for kids/vacations/boats), but its certainly a viable choice and its a lot easier to live on a lower income when you're young than when you're old.

FWIW I think your anxiety is more legitimate than some of the above posters seem to believe. We have watched professions collapse in the past (again: laywers and airline pilots). However I don't see waiting it out as GMO as a good solution. Actually residency training might be a way to ensure that if the profession collapses you can still ride out the storm safely ensconsed in the government. Notably, the people who joined the military as lawyers and pilots are still in, and still eligible for officer pay and the military's insane pension plan, despite the collapse of their professions in the outside world.

 

[HighPriest]

1) Read through old SDN threads, or old articles on healthcare. There has been enormous anxiety about the future of medicine since the 1980s. Do you really think that its going to reach a point everyone agrees is stable in 4 years? If ortho collapses but urology keeps a high reimbursement, will you really take that to mean that urology will keep a high reimbursement 4 years after that? As far as I can tell the only time people feel certain about the future of their profession is after its completely collapsed (see airline pilots, or lawyers), and even then there's a good chance they're wrong.

2) If you're really uncertain about your profession's financial future and its causing you a great deal of stress, an alternative to waiting for clairvoyance is to improve your personal financial position. The less you live on, and the more you save, the better your position. The future of medicine doesn't matter, at least from a financial prospective, if you get the money out in the present. Every 250K you save is 10K/year of unearned income you can live off of for the rest of you life. With HPSP if you are very frugal (living with roommates and driving very old cars in a lower cost area), match in a low cost area, and do a residency followed by payback you could theoretically stash the first 500K of income before you even finish your payback period. Not saying that that's necessarily the right choice, as it means lving on 25K as a resident and 40-50 K as an attending (you'll have very little left over for kids/vacations/boats), but its certainly a viable choice and its a lot easier to live on a lower income when you're young than when you're old.

FWIW I think your anxiety is more legitimate than some of the above posters seem to believe. We have watched professions collapse in the past (again: laywers and airline pilots). However I don't see waiting it out as GMO as a good solution. Actually residency training might be a way to ensure that if the profession collapses you can still ride out the storm safely ensconsed in the government. Notably, the people who joined the military as lawyers and pilots are still in, and still eligible for officer pay and the military's insane pension plan, despite the collapse of their professions in the outside world.

Agree with all of this. E'rybody worried about reimbursement, but sitting on the sidelines isn't going to change what is to come, I suppose is my point. Like most of us, you're probably fairly invested in medicine now, and so at least for some time you're committed. Might as well be trained and committed.

 

[Gastrapathy]

What is plan b?


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