How do I make as much money as possible?

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CassieBagley said:
This is out of curiosity, not personal motivation, so spare me the advice not to focus on money. So here goes: In which ways can an MD yield the highest income for his educational attainment?

Spinal orthopedics and neurosurgeons have a range of salary that already breaks $1 million per year. However, I am interested in hearing your personal stories or experiences in other ways that MDs of all kinds have made above and beyond normal salaries. For example, have you heard of any MDs going into consulting/advising, pharmaceuticals, medical devices, hospital administration, etc.? Private practive vs hospital? East vs west coast?
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How flexible are you with respect to ethics and morals?
 
CassieBagley said:
This is out of curiosity, not personal motivation, so spare me the advice not to focus on money. So here goes: In which ways can an MD yield the highest income for his educational attainment?

Spinal orthopedics and neurosurgeons have a range of salary that already breaks $1 million per year. However, I am interested in hearing your personal stories or experiences in other ways that MDs of all kinds have made above and beyond normal salaries. For example, have you heard of any MDs going into consulting/advising, pharmaceuticals, medical devices, hospital administration, etc.? Private practive vs hospital? East vs west coast?
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http://en.wikipedia.org/wiki/Patrick_Soon-Shiong
http://en.wikipedia.org/wiki/Julio_Palmaz

Short answer: Own a business that can be scaled substantially. Or invent something. Or save your money and buy assets with a high return. Or buy a business.

Basically, the way you make money in medicine is through business and economic skill (and luck).

Three step answer: 1. Steal underwear 2. ??? 3. Profit
 
CassieBagley said:
Let's assume extremely flexible ethically and morally, but not legally.
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Unfortunately that line is not the clear cut. I all honesty, you can make big bucks in many specialties depending on geography, if you have a niche skill, business sense etc.. Too many factors.

I know a psychiatrist who makes 600K a year, but does a lot of legal consulting. There are neurosurgeons who make 300K because they choose to live in San Francisco and be an academic. It all depends. An internist around here owns nursing homes and nets over million apparently somehow bills for all the patients, however has very questionable practices and apparently provides very poor care.

Do what you enjoy time and time again. Keep your debt low, keep your expenses low, invest wisely - best way to accumulate wealth irrespective of specialty.
 
general practitioner in middle of nowhere, usa

see everything, do everything, bill everything
 
Vicodin is the way to go, they call it "white collar heroin" for a reason =).
 
CassieBagley said:
This is out of curiosity, not personal motivation, so spare me the advice not to focus on money. So here goes: In which ways can an MD yield the highest income for his educational attainment?

Spinal orthopedics and neurosurgeons have a range of salary that already breaks $1 million per year. However, I am interested in hearing your personal stories or experiences in other ways that MDs of all kinds have made above and beyond normal salaries. For example, have you heard of any MDs going into consulting/advising, pharmaceuticals, medical devices, hospital administration, etc.? Private practive vs hospital? East vs west coast?
Click to expand...
Have a 30 patient census in 3 hospitals, hire NPs and PAs to round on them, and if medical students and residents are around, they're free. Then round in all hospitals at whatever time you please, talking to your patients for 1-2 minutes and signing all notes and glancing over prewritten orders.
 
thepoopologist said:
Have a 30 patient census in 3 hospitals, hire NPs and PAs to round on them, and if medical students and residents are around, they're free. Then round in all hospitals at whatever time you please, talking to your patients for 1-2 minutes and signing all notes and glancing over prewritten orders.
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Then lose everything and/or go to prison when your poorly managed patients get sicker or die and sue your ass for malpractice.
 
thepoopologist said:
Have a 30 patient census in 3 hospitals, hire NPs and PAs to round on them, and if medical students and residents are around, they're free. Then round in all hospitals at whatever time you please, talking to your patients for 1-2 minutes and signing all notes and glancing over prewritten orders.
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With a 90 patient census at any time my attending owns four large homes, pays three alimonies, with the home he lives in housing four luxury vehicles.
 
RadicalRadon said:
Then lose everything and/or go to prison when your poorly managed patients get sicker or die and sue your ass for malpractice.
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You think I'm joking, but it's done all the time where I rotate. Patients have no idea what is going on with them, they're just taken on a radiology/laboratory ride and discharged when they're "stable"
 
The richest doctors I know personally bought a ton of land/rental units and built on it and leased it, they also built their own labs and MRI scanning centers. Almost all of them are making most of their money not directly from their physicians income but other ventures.
 
Is it efficient for the attending? As far as maximizing income it's the best, but he only knows what people like me tell him about the patients. Once my attending screamed at me because he discharged a patient with a moderate pericardial effusion. He didn't know Cardiology had been following, or that they had said she was stable for discharge and would be followed outpatient.
 
I've been told the easiest way to make big money is to not focus on the clinical side of medicine and to instead focus on the business side. Focus on things like owning your own equipment (especially imaging, but other things are more practice specific), private practice, concierge medicine, etc.

That said, every attending I've talked to has said this kind of stuff is harder nowadays and either smaller practices can't compete with the big players, or "ethics" are thrown into the mix and prevent some of the above.

Research can be another avenue and getting the right patents and start ups going can make bank and often skirts around the ethical and economies of scale issues. But there is a luck factor in research.

Also... weed cards in California and a few other medical states. A 15 minute consult can net up to $100 in revenue. And there is no reason that consult has to be even 15 minutes long. I could see it done in 5 with the right support staff filling out the right paperwork. All you legally need to do is a history and treatment plan with side effects explained.
 
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cowme said:
Get an MD/MBA, and join big pharma/biotech
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Exactly. Anything in medicine doing procedures or actual medicine will not make major money.

You need to hit the business side and be able to invent a product or sell something. Making patents that big --> multi millions, media like Dr. Oz ---> multi millions, working for pharmeceuticals and pushing products/sales ---> millions.

Doing procedures as a surgeon? If you're lucky you may make a million per year. No where near what the business people in medicine earn.

Check out this guy (billionaire):

http://en.wikipedia.org/wiki/Gary_K._Michelson

He is the inventor of a number of surgical instruments, operative methods and medical implants. Unhappy with the low success rates associated with spinal surgery procedures at the beginning of his career, he spent countless hours developing better implants, instruments and procedures that would enable spinal surgeons to cure a greater proportion of spinal ailments. "Michelson devices" have been implanted globally in hundreds of thousands of patients. He has over 250 U.S. Patents on instruments, methods and devices for advances in spinal and orthopedic surgery and over 950 issued or pending patents worldwide for instruments, operative procedures, and medical devices related to the treatment of spinal disorders. Dr. Michelson is the sole inventor of the most widely used innovations in spinal surgery to date – affecting the lives of millions of patients. His inventions have made spinal surgery safer, faster, more effective and less expensive. In 2005, as the inventor, he sold ownership of many of his spine related patents to Medtronic for a price over $1 billion,[1] catapulting him onto the Forbes 400 where he has since remained.[2] His defense of a patent lawsuit by Medtronic established a major legal precedent in 2003, governing who bears the cost of pre-trial discovery of electronic evidence.[3]
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Medtronic to Pay $1.35 Billion to Inventor
http://www.nytimes.com/2005/04/23/business/23medronic.html?_r=1
 
CassieBagley said:
This is out of curiosity, not personal motivation, so spare me the advice not to focus on money. So here goes: In which ways can an MD yield the highest income for his educational attainment?

Spinal orthopedics and neurosurgeons have a range of salary that already breaks $1 million per year. However, I am interested in hearing your personal stories or experiences in other ways that MDs of all kinds have made above and beyond normal salaries. For example, have you heard of any MDs going into consulting/advising, pharmaceuticals, medical devices, hospital administration, etc.? Private practive vs hospital? East vs west coast?
Click to expand...

Easy, as the poster above me said, get involved in something a very large corporation wants. Aka a new drug or biotech item. You dont even have to own the entire company, just as long as you are involved initially, most likely your share will end up be in the hundreds of millions of dollars when the company is bought.
 
Specialize in GI and scope people 12 hrs/day 7 days/week. You"ll probably hit 7 figures. Make sure to take some SSRI's though to avoid killing yourself.
 
CassieBagley said:
Let's assume extremely flexible ethically and morally, but not legally.
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Find some basic science papers showing that some sort of natural products have some sort of effects on some sort of cell lines (what effect doesn't really matter). Throw together a "nutritional supplement" with a half dozen different flowers and extracts and whatnot in it. Put together an infomercial in which you talk about restoring balance and supporting your immune system or some gibberish like that. Bonus points if you can spin it as some sort of ancient wisdom/traditional healing stuff. Be sure to wear your white coat and mention that you're a board certified doctor. Rake in the bucks from all the gullible suckers out there.
 
6a00d83451b8c369e200e54f6c48b68834-800wi.jpg



Be this guy.
 
Just like anyone in economics will tell you: own the production. In-house lab, in-house x-rays, in-house procedures, etc.
Start your own practice and become partner #1.
Own your own skilled nursing homes, or run a home-health nursing business.
Start your own hospital (partner up with other physicians).
Et cetera.

I'll hate you for furthering the american medical industrial complex if you do any of these, however. We should be focusing on making a single-payer system work in order to pay us respectably.
 
Something that hasn't been mentioned here that should be is asset protection. Sure we'd like to dream about always making more, but in reality you need to protect what you have already made.

Making sure you have the correct legal protections and appropriate insurance can avoid very costly set backs.
 
Partner with a workers compensation law firm who refers clients to you while specializing in pain management.
 
http://www.latimes.com/business/la-fi-omidi-brothers-20120506,0,5461344.story

I think something like this is slightly more realistic than starting up multiple successful pharma companies, or patents that revolutionize a field.

Basic rundown of the story:
-Two brothers, doctors Micheal and Julian Omidi derm/cosmetic surgeon and plastic surgeon working in la/beverly hills area
-start getting into lap band surgery. buy the number 1-800--GET-THIN
-Marketed like crazy. Keep opening new surgical centers/hiring staff to do procedures
-Two very shady individuals. One lost license because he lied on license application about being expelled from UCI for stealing exams. Other got license suspended for 3 years for allowing RN to provide anesthesia for a liposuction
- Made tons of money, own 11 surgical centers?
-5 patients died. now under investigation. allergan maker of lapband wont sell them products anymore.


Although it seems like things might not end too well for these guys I think it's a decent example that you can make it at least into the 7 or 8 figure range with good business sense. These guys saw an opportunity and marketed it like crazy, and their gamble paid off big time. I'm 100% sure if you live in the SoCal area you've heard the commercial dozens of times ( 1800 get thin let your new life begin). Unfortunately it seems like they were also pretty slimy characters.

Somewhat similar to the previous stories about owning nursing homes etc.

edit: its also a good example of why you should avoid being morally bankrupt. Apparently this business was making 20 million dollars a month at one point. If they had acted more ethically they may have made slightly less short term profit, but in the long run probably done much better.
 
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cowme said:
Get an MD/MBA, and join big pharma/biotech
Click to expand...

So funny how med students seem to think MD/MBAs in pharm/biotech make big bucks. Any rad/ent/ortho/plastics etc. will easily make 2-3x what a md/mba would make and will also have far better job security.

Hell, a rad can still make a million/year if all you care about is making maximum money. And I know several ENTs that make between 2 and 3 million.
 
HondoCrouch said:
So funny how med students seem to think MD/MBAs in pharm/biotech make big bucks. Any rad/ent/ortho/plastics etc. will easily make 2-3x what a md/mba would make and will also have far better job security.

Hell, a rad can still make a million/year if all you care about is making maximum money. And I know several ENTs that make between 2 and 3 million.
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Not if you own the company. A successful business owner of a biotech will make much more than any clinician. I know a MD/MBA who recently sold his staffing company for 300 million, that is more than any clinician you can cite.

Granted business is a different animal...much less job security (as you mentioned). But certainly does not have the glass ceiling of medicine. If the question is "how can I possible make the most money"...ownership in a business is always the answer. Other questions like "how can I have a secure job and make a generous paycheck" yield a different answer.
 
Does anyone find this thread really pathetic?
 
id rather make as much money as possible doing something that FEELS LIKE as little work as possible 😉 nobody has ever dogged on someone for making bank while doing something they love (n=1 exceptions do not diminish this point, SDNers..... :meanie:)
 
CassieBagley said:
Haters gonna hate. Not sure if you think it's pathetic b/c talking about money is usually taboo or not, but either way, I'm just really curious in what other docs have done to make hella money. Plus I think there is value in knowing what the possibilities are & alternative routes, even if it is in the context of making $krilla cash money
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:lame:
 
NickNaylor said:
Yeah... what does "$krilla" even mean?
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I'ma take a stab at the derivation of "Skrilla." Eating Shrimp is something that some view as characteristic of those with money. In this context, the word, "Shrimp" evolved to "Skrimps," and then to "skrilla." Instead of saying something like, "I got so much money, all I eat mad shrimp," the word "skrilla" became a phrase that symbolizes having a lot of money. It's like saying, " I'm Cakin !" Eating Cake is viewed as something that affluent people do, but similarly, came to be used as a term for those having a lot of money, or in many cases, as a word that's interchangeable with money. Ebonics is kind of an evolution in American language, isn't it? But I digress.
 
bluv1212 said:
I'ma take a stab at the derivation of "Skrilla." Eating Shrimp is something that some view as characteristic of those with money. In this context, the word, "Shrimp" evolved to "Skrimps," and then to "skrilla." Instead of saying something like, "I got so much money, all I eat mad shrimp," the word "skrilla" became a phrase that symbolizes having a lot of money. It's like saying, " I'm Cakin !" Eating Cake is viewed as something that affluent people do, but similarly, came to be used as a term for those having a lot of money, or in many cases, as a word that's interchangeable with money. Ebonics is kind of an evolution in American language, isn't it? But I digress.
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:what:
 
CassieBagley said:
Haters gonna hate. Not sure if you think it's pathetic b/c talking about money is usually taboo or not, but either way, I'm just really curious in what other docs have done to make hella money. Plus I think there is value in knowing what the possibilities are & alternative routes, even if it is in the context of making $krilla cash money
Click to expand...

You already admitted you would be "flexible with ethics and morals."

What's not pathetic about that?

The crux of your thread basically boils down to "what is the best way for a scumbag to make money?"

Not surprising you'd be like that though, after the whiny neurosurgery thread you started.
 
Evolution of scrilla.

Money --> Paper --> scroll --> scrill --> scrilla, with skrilla as as alternative spelling.
 
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