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how much will we make?

Discussion in 'Pre-Medical - MD' started by CoronaBOY, Nov 14, 2002.

  1. CoronaBOY

    CoronaBOY Senior Member
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    i do realize that this topic might have been on already, but could not find it...or you can say too lazy to go back to pg.20 of this forum...really sorry...

    i could not resist asking this question after i figure out how much i will owe after 4yrs of med school and how to pay for it...

    so...usually, it will be around 200k...

    does anyone knows actual digit during residency and after that? like average salary...especially during residency?

    da#$, i'm gonna be in so much debt including my undergrad...
     
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  3. Kovox

    Kovox Going Places
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    Anyone, please correct me if I am wrong, but if I remember correctly from my yale proggie, residency pays you 30-40k or less.

    Um, and after you do start working, depending on your area and field of study, primary physicians make about 120k ish and surgery people make more.
     
  4. lola

    lola Bovine Member
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    i was also thinking 30-40k
     
  5. SolidGold

    SolidGold Florida winters are the best!
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    Remember that you can defer all those loans until after you complete your residency, so you'll be making a decent salary when you have to start paying it all back.
     
  6. Warning: this is a soapbox post...if you don't like my soapbox then don't read the post :) Otherwise...feel free to learn some stuff :)

    Ok, I can kind of give some perspective here because my parents (both accountants) have doctors almost exclusively as their clients (that's their niche). A few caveats before people get hard-up about these numbers:
    The amount you make working for a hospital directly is almost always lower than private practice.
    Academic positions almost always pay less than working for a group/your own practice.
    Pay varies around the country and is generally lower in the south (lower cost of living).
    50% of your income goes to taxes (fed/state/local/sales, in the brackets we're talking): learn it, live it, love it.
    Most of these people are a little older, so don't ask for this as your starting salary (shave off a few hundred thousand in some cases)
    Residency: lowest in nation: 34k, highest in nation: 40k (can you say price fixing?!?!) (excluding the military which is about 50k)

    There's some data available on the Internet, I believe, but I'm too lazy to mine for it now. So, I'll just give some anecdotal cases:

    Primary care in NYC, works for hospital: 95k
    Primary care in Chicago, private practice: 130k
    Neurologist, IL, private practice: 950k
    Orthopaedic surgeon, Indiana, private practice: 900k (I've seen one, and only one, in IN that pulls in 8m/yr)
    Urologist, IL, works for a group, IL: 850k
    Anesthesiologist, works for a group, IL: 450k
    Pediatrician, private, IL: 150k
    Orthopaedic surgeon, IL, private prac.: 450k
    Cardiologist, works for hosp.: 280k
    ER doc , works for hosp.: 250k
    Radiologist, private (group member): 425k
    Nephrologist, works for hosp: 300k
    Neurosurgeon, worked for Air Force: 130k (Why did he leave, you ask? His income quintipled the first year out)

    I believe the mean income in the midwest was 200 and change last time I checked.

    These are real numbers. I have worked at my parent's business since I was 10 and consequently have learned a lot about taxes and financial planning.

    Now, a few important facts:
    -Despite making this much, I've seen some dopes have to take loans to pay their taxes every year. Learn to be fiscally responsible early, your accountant will thank you.
    -Gross incomes (listed above) require the following major corrections before you get money in your pocket: 50% for taxes, up to 120k/yr for malpractice, you'll need disability insurance if you want to keep any kind of lifestyle after you bust up your head or whatever, life insurance (so uncle sam doesn't make your kids liquidate your hizouse to pay the estate tax). So, yeah, some dude might make 600k but that can get cut down to 200k of disposable income in the blink of an eye. Not to mention the costs of running your own practice....

    Are physicians overpaid? Absolutely not. Are schoolteachers underpaid? Absolutely. When people rail on doctors for making "so much money" they forget that MBAs and JDs make just as much, if not more, and don't carry the kind of liability that docs carry. They also forget that we rack up a nice house (literally) of debt before we see our first dollar. Second, they forget that most docs work way more than 40hrs/wk (some people never work less than 80). Third, we spend 11-15+ yrs training for our job. Bottom line: despite the high numbers, it doesn't pay to be a doctor. If you got a JD from a top 25 school and started working at 25, you'd make a lot more than a doc in the long run b/c you could start saving much earlier and could work much later (plus you could be building your nest egg as equity in a partnership, something very few docs do).

    My biggest piece of advice: teach yourself the basics. Good accountants are hard to find (you wouldn't believe how many people we get who had CPAs screwing the stuff up) so you want to be able to check their work. Learn to be fiscally responsible. Plan for the future starting from today.

    Hopefully this helps somebody somewhere.

    Oh, one last thing: 22 cents of each patient's dollar goes to paying you, at least as far as BCBS is concerned. Think about that. Insurance companies have no skill, they take little risk (relative to the physician), but they DO get rich off of what should rightfully be your or your patient's money. I was shocked to learn about that figure. It's sick.
     
  7. momofthree

    momofthree Junior Member
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    Well, we just made it through residency/fellowship and are in the 'real life' phase of our training....ie. my husband has a 'real job'. He chose to do Internal Medicine and then specialize in Infectious Disease. He will not ever earn $200K.....though many of the older colleagues that he has did.

    There is a disparity between the retirement benefits and salaries of the older physicians who have been in practice since before the medicare scandals and cuts, HMOs, etc.

    I think suggesting that most physicians will earn over 200K and perhaps as high as 900K is a bit over hte top...perhaps your parents practice as accountants isn't representative of the salaries in medicine as a whole?

    If you are interested in salaries, visit the Medical Student Resource Guide at:

    http://www.studentdoc.com/july_surv.html

    They'll let you search by specialty and years out in practice.
    The only downside is that you don't see the area of the country that these people are practicing in to be able to compare the salary with cost of living/home prices/state taxes, insurance premiums, etc.

    best of luck:cool:

    Kris
     
  8. Kris,

    The disparity you're talking about doesn't really exist. My parents have plenty of clients just out of residency training. The clientel also is diverse ethnically, 65/35 (M/F split), and very diverse as far as specialties go. In fact, a big part of their business is looking at contracts for physicians who are just ending their residencies and helping doctors negotiate for the salaries that they deserve. I'm not saying that this happened to you, but all too often doctors are really taken advantage of right out of residency programs. This is mainly because they're going from making 50k to making 150+. Salaries for 1st/2nd year attendings are lower than for slightly more senior attendings. There is a "dip" before the real money starts to come in (i.e. when the first contract comes up for review).

    Plus, to say that the older docs are not subject to the same market forces as every other doctor isn't exactly right. The salaries I listed are what these people made last year. They suffer just as much as the people right out of residency when it comes to seeing their paycheck getting beaten on by scandels and HMO reductions in payment. Think about it: insurance companies reimburse on a per procedure basis. This means that if you do a 99214, you get paid the same as somebody else from your department doing the same procedure (provided both are equally recognized by the HMO).

    Now, one big thing that could account for your differing view is whether or not you and your collegues work directly for the hospital, or whether you work through a group. Hospitals are pretty much all scumbags when it comes to paying doctors a fair market salary. Often working for a hospital means 1/2 or even 1/3 of your salary in private practice. Some private groups may not be any better, but most are.

    One final note: private practice = no pension. You're responsible for your own retirement so you're losing some money that would have been kicked in by your employer into your 401k, for example.

    Obviously I'm not suggesting that everybody will make 900k a year...that's ridiculous (you can see that some other orthopod made 450, and some (and I don't know how exactly he does this) pulls in 8 million (gross revenue)). I'm just saying that 200k for any specialist (and even some peds and family practitioners) is a good baseline salary. There's one FP that has gross revenues of 1 million dollars / yr but he definately hustles. Bottomline: if you play your cards right you make what you'd like. Lots of these people who make a lot spend a lot of time doing pro bono work...they're not rich scumbags who've forgotten why they became doctors. Don't go into medicine to make money (a few people did this, and they're TOTALLY miserable), but if you can make money doing something you love then why not?

    Thanks for your post, Kris! Best of luck :)

    Neil

    PS: I did check out that site and their numbers echo what I'm talking about. A few of my listed salaries are outliers, but they should be viewed as encouraging...not unobtainable.
     
  9. CoronaBOY

    CoronaBOY Senior Member
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    thanks alot for the input guys...

    helped alot...

    but quick question though...again...

    so after all that taxes and insurance payment...

    how much do 'average' doctors make?...i mean that as how much do docs actually bring home to pay bills and buy food...

    i might sound like going into medicine for money, hehe...

    but trust me...if that was the case we all know that we are better off pursueing MBA right now istead MD...like medicnas put it...

    how i see it is that even tho we are going into medicine with passion and heart, but we still need decent money to live decent life and little pay back after freakin ~10yrs of school work...

    but again...that's just how i see it...
     
  10. IMO you see it correctly :)

    Ok, well, give me a dollar amount (or specialty) to start with and I can break it down based on what your likely living style will be and give you a budget.
     
  11. CoronaBOY

    CoronaBOY Senior Member
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    thanks and sorry if i'm nagging you... :)

    ok...150k/yr...how much of that will docs have at the end...

    and i forgot to say that i was really surprised about 50% tax thoough...:(
     
  12. johnstoner

    johnstoner Ben Franklin on Hashish
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    I wonder what Ophtho's take on this is...

    it sounds crazy to have such a high income dwindle down to less than 1/3 of your income...then i could guess that a salary of

    150K by a IM guy would be equivalent to about 75K take home...dang I'd rather join the military!
     
  13. doepug

    doepug Senior Member
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    Maybe my experiences are skewed, but I find a number of these figures highly suspect. For example, it is unusual for an anesthesiology resident to start at less than $300K, and radiologists (especially IR) make more than listed at this site.

    As a rule, pediatricians make the least, at ~$110K. Most general internists are in the $150 range, and medical subspecialists are typically low $200s (except for cards, which is higher). Most general surgeons make approx $200, although this is substantially higher for CT/vascular/ortho (>$300-350).

    For the record, interns typically begin around $38K and by the end of their training, most residents and fellows make just shy of $50K.

    Anyone interested in academia should plan on making less than half of what they'd make in private practice.

    Hope this helps,

    doepug
    MS III, Johns Hopkins
     
  14. OK, it's hard to do this exactly but let me see if I can help:

    BTW: 50% is for those making 250+ kinda :) and includes all the sales tax you pay. It's an illustration for how much "tax" one pays...but it is useful to find your spending power.

    The highest marginal rate is 36% (Bushie brought this down, it was 39%), state is 0% (Texas) to 12% (NY), SS tax is 6.3?%, medicare is something small too, then you have to figure in 401k contribution, health insurance, disability (if self employed) and life ins. Now, it's important to understand that if you're self employed you pay twice you SS/medicare taxes b/c the employer picks the other half up if you're just employed.

    Figure an effective rate of 23% on 150k, then take 3% state, then about 7% for ss/medcare. If you live in NYC...well, that sucks b/c you pay a big city tax. Other cities make you pay a city tax, but NYC is bad. Let's say that leaves you with like 100k. Then you have your 401k (11k max depending on what your employed matces at) or IRA contribution. Let's say you max your IRA (3k this year), and do 5k in your 401k. You're close to 90k. Don't forget health insurance (500/mo for you and your family). You're down to what, 84k? Ok, then you have the correct amount of life insurance, I'd say 1 million, 20 yr term (for now). That's like 4?k/yr in premiums. 80k. Loan repayments? 2k/mo at least if you want to pay off 150k anytime this lifetime. Well, thankfully you'll be over and done with your loan in 10-12 years :( Wait, you want to live in hizouse, right? :) Let's say you live in a nice apartment for the first decade of your attending career: 2.5k/mo. Down to 26k.

    I would say that's a good figure for disc. spending. I've left a bunch of things up in the air 1) do you own a house? At this income level probably one that's 300-350k. You probably want two 40k cars (that's 1k/mo/car for a 60 month loan at 6.5% or something like that). Don't forget about real estate taxes, house/fire insurance and maint. expenses. On that house you could pay 5k-8k a year for that stuff. 2) How much in loans do you have? 200k...well, then the monthly payment will be closer to 3.5k 3) Is it a 2 income household? Don't forget that I'm not taking kids into account.

    Bottomline: 150k for somebody with a spouse and two kids isn't very much money. I'm not saying you'll be poor, but you certainly won't have a mega cushy lifestyle. Also, you'll have a heck of a time trying to save up for your kids future Ivy league :) education.


    Caveat: Some of my numbers might be off b/c I'm just doing this in my head and I don't remember all of the exact percentages. Sorry if you plan your life around this and it comes out to be off by a little ;) I just hope that this serves some kind of educational purpose.

    Lemme know if I can help with anything else.
     
  15. Jet915

    Jet915 Shi*ter's Rule
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    Hey Medicnas,
    Seems like you know alot about taxes and physician incomes. I was thinking of joining the military out of med. school. How much financially do you think I will be hurting compared to someone who doesnt join the military? Benefits I can think of is that med. school is paid for so no loans (not even mentioning the interest that will be added), no malpractice insurance and part of our salary is tax free (I think, you can tell me if I'm wrong on that). I was planning on serving in the military for atleast 4 years just because I want to give back to my country and I understand that pay as a military physician will be less but I am pretty sure that I will be fine with that. I was just wondering that if you account for all the points I have mentioned, how much am I losing out as a military physician? Thanks.

    Jetson
     
  16. DarkChild

    DarkChild Senior Member
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  17. Jet,

    I can do my best as I have tried to learn as much as possible about the HPSP. Basically, the difference boils down to a couple of key issues:
    1) Specialty (this is where you could get annoyed by the potentially huge pay difference once you're an attending).
    2) How bad do you want to choose your specialty?
    3) How willing are you to move/be stationed anywhere?
    4) How much do you want to deal with the military lifestyle/military medical practice?

    Since you just asked about finances, I'm assuming that you want to join for other reasons (i.e. to serve your country). If you're thinking of joining just for the money then you will probably be frustrated with the whole process...but that's just my opinion based on talking to ex-Army docs and reading message boards about the subject.

    From a purely financial viewpoint you would be better off doing the HPSP thing if you were interested in:
    -Family practice / general practice
    -Internal medicine
    -Pediatrics
    -Neurology (possibly)
    -Derm (possibly)

    Basically, most of the non-surgical specialties. In these cases you're looking at making 100k inside the armed forces with zero malpractice costs. Plus, even though you don't intend on spending 20 years in, you could retire at 46 and draw 50% final base pay (so figure based on a colonel's salary you'd be getting like mid 30s a year for sitting on your duff). You don't have to contribute at all towards retirement if you're a "lifer." This is nice compared to say working for a hospital where you need to contribute 50% to your 401k. Also, inside the military you don't have to pay health insurance and you get some (meager) term life (200k) for like $15 a month. You'd need to up your insurance coverage to 1 million overall (at least), but that shouldn't make a huge dent if you go for term coverage. So, that 100k that the armed forces is paying you goes a long way because it's pretty close to being in your pocket. Also, inside the military I'm pretty sure that you can CHOOSE state residency :) This is great...because you can be a Texas resident for tax purposes (and pay 0% income tax). I mean, if I had to just pull a number out of my butt, I'd say that a 100k military income is like 150k outwith the military. Oh, not to mention that you have 0 in loans to payback :) Not a bad deal :) The military also has other benefits like cheap shopping (tax free?) at the PX/BX. And, if you're willing, you can see the world with your spouse for cheap by using the free MAC (Mobile Air Command) flights and staying on military bases.

    But, like I said, the pay disparity becomes almost ridiculous for orthopods, cardiovascular surgeons, neurosurgeons and the like. Even anesthesiologists will be hard pressed to justify staying in for life. However, if you're having a good time inside the military, 46 isn't too late to start or join a private practice when you've retired from the armed forces.

    Personally, if I were considering peds or family practice I would be a lifer in the branch of my choice if the decision was purely a fiscal one. Oh, also if I was interested in OB I would definately think of the military b/c of 0 in malpractice :)

    To answer your final question: you're certainly not getting fleeced by going the HPSP route. Fiscally it's an amazing deal. It's hard to say if you're coming out ahead (and by how much) because there are a lot of variables like specialty and geographic location. Just make sure you're down with what they're asking you to give up (you become US Gov't Property :) ) and make your decision based on that if at all possible.

    Hopefully this helps somewhat!
     
  18. mvervaine

    mvervaine Senior Member
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    enough to rent out that gym locker to sleep in.
     
  19. Random Access

    Random Access 1K Member
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    Since you had the question mark, it was 6.25 last time I checked.


    Jeez...not giving people much hope here. I don't put much stock in opinions like this, as I know families who lived not the cushy lifestyle, but a good lifestyle, on much less (and have sent their kids to Ivy League schools ;)).
     
  20. Kovox

    Kovox Going Places
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    medicnas...one word to describe you ... "wow" :D

    And I thought I was a math whiz ahaha. Oh well. So the salary figures that are often shown on the links provided above, are those after or before taxes, insurance and stuff?
     
  21. momofthree

    momofthree Junior Member
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    Neil


    Ummmm...OK..well, keep on believing that. I'm here to tell you that the experience that your parents have with their particular clients is not the trend that I see with our friends and colleagues. We have a fairly large group of friends spread out across the country and I'm here to tell you that reimbursements are decreasing, malpractice insurance rates are increasing and retirement benefits are decreasing.

    My husband is in a large group practice and the oldtimers are currently voting on reducing the retirement pay for the 'to be new partners' by 40%. This will affect my husband as well as all physicians hired in the last 15 years. A similar thing is playing out at a friend of our's group practice in PA. Are these anecdotal stories...yes, just as anecdotal as yours. And just as real.

    When you look at the average salary values, you need to be looking at the average, not the high. We were, for example, offered a job in CA that would have paid nearly $100k more/year. The problem was that in that area , we would have paid 3 times what we're paying now for less home....ie real estate is through the roof.

    That's great. Obviously your parents attract an affluent clientel...some people coming out of residency training have three children and nearly 200 thousand dollars in debt. The only wealthier people that I know coming out of training are single.

    Also, don't forget that unless you are in a program to eradicate your debt or are having your parents help you foot the med school bill....paying off that debt costs thousands a month...for a very, very long time.
    Well, this is only partially true. Yes, they are subject to the same market forces, but no, it isn't affecting them quite the same way. Why? Many of them already have full bank accounts/investments/retirement AND they hire junior physicians, PA's and NPs for less money to make up for it....

    Well, I don't want to rain on your parade here...but most peds and fp's won't ever come close to earning 200k....not gonna happen. Bringing up one fp who reportedly earns 1 mill... (if he does, he's doing something illegal) is again, just an anectdotal story. One individual. I'm sure there is an fp out there who can walk on water too.

    I don't think so...I think that there are a lot of people here that are in for the surprise of their lifetimes if that is why they are getting into medicine...

    But...I'm not going to rain on your parade any longer. I hope you earn as much you are hoping.

    Best Wishes,

    Kris
     
  22. momofthree

    momofthree Junior Member
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    So do I....many of them didn't have the incredible debt hovering over them and didn't make the same investment in time in their education and careers.

    After we pay off our loans, credit card debt, cars, mortgage, groceries, gas and electric each month, we're flat broke! I buy my kids clothes at a second hand shop....and we're 1 1/2 years out of fellowship. We are not sitting alone in this boat. Many of our contemporaries are suffering the same way. At some point in our lives, when our med school and credit card debts are less then things will definately be looking up. As it is, my husband and I haven't taken a vacation together in 9 years!


    Food for thought....

    Kris
     
  23. CoronaBOY

    CoronaBOY Senior Member
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    wow...you guys saying that we will be making about same amount of money as average postdoc researchers (in any area), after we bust our butt off for 12+ years...

    and working more than 40hrs week?

    then why does everyone that i know always complaining about doc's high salary?

    i guess they don't know what's going on just like i didn't

    thanks for the input, ya'll
     
  24. DrBlueDevil

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    Check out this mess...

    We're all gonna work ~100 hrs/week in residency (derms/urologists aside, or so they tell me)...

    So I'm guessing we'll work 50 weeks/year (it's probably closer to 53 weeks/year, but I'll go with 50 for this hypothetical).

    Now say $35k is the average salary paid to residents.

    That comes out to $7/hour.

    That's 13 cents LESS per hour than I made one summer cleaning up operating rooms after operations! :)

    Maybe I should switch into a PA program...
     
  25. CoronaBOY

    CoronaBOY Senior Member
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    haha...tell me about it...:)

    right now i'm making $14/hr as a computer geek...

    and sometimes $500 per project which takes about 5hrs...

    that's $100/hr... hmm...maybe i should get part-time job during residency if the workload doesn't kill me... :)
     
  26. DarkChild

    DarkChild Senior Member
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    excellent post momofthree...
    I'm emailing it to myself now too
    :)

     
  27.  
  28. Kris,

    See my budget post...do you agree with some of those numbers? I understand how hard it is, you don't have to tell me twice. Credit card debt is a killer....it's a shame that sometimes there is no other way to put food on the table than to hit up the CC. Hopefully, your post can convince somebody that my assertion about 150k not stretching that far is not completely nonsensical.

    Neil
     
  29. Random Access

    Random Access 1K Member
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    B*tch, b*tch, moan, moan, I'm sure your life is really tough being a doctor and making 6 figures... *sigh* I guess everyone has to say how their situation must be worse than other people's... This is like that couple I was reading about in Time that made $280K between them, but still couldn't afford to retire. Yeah, lots of sympathy for them too...
     
  30. momofthree

    momofthree Junior Member
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    Well, money is a tough topic around here.....the problem with earning more...is that more goes to the taxman. We actually pay 41% of salary to Uncle Sam.

    The practice that my husband is in doesn't offer partnership for two years...at which point it begins paying in 30k/year retirement. We really need the retirement because we are in our mid-thirties and after all of these years of residency and all of the debt, we have exactly...NOTHING set aside...Now the practice is talking about reducing this amount by 40%.

    In addition, the annual bonuses will also die for the newbies. BTW...at a time when they are talking about reducing retirement, the old docs got their 25K annual bonuses....how's that for bs?


    We've been looking at jobs (he's also ID) around the country. There are some with better pay...but then he'd have to take call q3 and drive to 3 or 4 hospitals each day....it's a quality of life trade-off.

    I'm sure that there are docs out there that are doing well for themselves....we happen to have three small children, more debt than God, and ask ourselves daily why in the hell we bothered to do this......it wasn't worth it from our perspective (at least right now). My husband missed all of the major milestones in our children's lives for years (8, to be exact), our marriage suffered...and at the end of the day we have nothing to show for it but stress, and debt. He has stopped really enjoying patient care because clients are viewed now more as potential litigants and they demand to have antibiotics prescribed when not indicated, aren't compliant when they are treated...blah, blah, blah....I think...he's just burned out from years of working so hard only to accumulate more debt ;)

    Maybe in 10 years when we are out of the red and life has settled down, we'll be doing the happy dance as we drive around in our BMWs :rolleyes: for now...we're just plain exhausted....and broke!


    Kris
     
  31. momofthree

    momofthree Junior Member
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    Maybe your parents feel like taking on new clients? :D
     
  32. Ryo-Ohki

    7+ Year Member

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    By nature older members of a species take care of their young members.

    The medical industry is a strange creature where the older seem to feed upon its younger members
     
  33.  
  34. I'm not sure they really even feed on the younger ones...they just steal their souls. :) It is a sad commentary, though. Well...hopefully none of us will grow up and pass the buck onto the next generation!
     
  35. mountainlander

    mountainlander Junior Member
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    Its an interesting discussion. Thank you both for the info. I find that salaries are often proportional to what you have invested. Nothing invested (HS Diploma) less than minimum wage. $40K invested, undergrad degree, barely $50K/ year. $150K invested, MD $200K. I would love to see an analysis that would correlate debt to income ratio for all three groups--I think a lot of people would be surprised at how similar a boat we all are in.....
     
  36. DragonM

    DragonM Member
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    I am confused with all the tax and medical expenses.

    So, do doctors still make as much and if so how much? This is in regards to primary physicians. Do they still make 150k a year after all that tax and expenses paid? I have to wait 10 years before I live the fairy tale life of a mercedes or bmw cushy multimillion dollar housing?

    Not everyone comes out in debt. If you go to a state school, you would have a better headstart than people who go to expensive ivy like stanford schools.

    I'll be honest here, money does matter to a lot of people entering the profession. Is it still lucrative and worth it to become a doctor? No analysis please, just a simple answer will do.
     
  37. Whenever salaries are given they are gross salaries (your gross paycheck before taxes and all of your personal expenses). In some ways a "salary" is really misleading. Many docs get themselves into trouble thinking that if they make 200k they can SPEND 200k!!! This is NOT the case. I can't tell you how much of that 150 you'll see in your pocket (median income for a primary care doc (family practice) is 143k/yr according to this month's issue of Dermatology) but if you see my budget post earlier in this thread you can get some idea...it ain't much.

    Your expenses are the biggest variable. If you commute to work via train, for example, you could save a lot of money and have more disposable income for things like vacations and beer. But when you start to add up things like $500 a month for food (for a family of 5), lease payments or financing on cars (800/mo for 2 cars), insurance for said cars (2k/yr), gas (1k/yr?), house insurance, house payments, house and car maintainance (1k/yr), health insurance (6k/yr) and disability (if you're self employed) you'll be left with something resembling...well....not much. And this "not much" has to pay for clothes, vacations, your kids books/schooling, retirement for you and your spouse, college funds for your kids, charity donations (if you've got any left) and other incidentals.

    Medicine is still a good living. It is not, however, as good a living as it ought to be IMO because of various reasons (insurance/litigation/educational debt/shafting from older docs being the biggest factors). What you do get with an MD are:
    1) The highest level of respect from the public (MDs and judges are the highest, something like an 80% approval rating)
    2) Demand. Rightly or wrongly, the AMA and the medical schools control the amount of doctors entering the profession. Unlike the bottomfeeders, oops...I mean lawyers (I'm allowed...my two best friends are law students :) ) ...there isn't a surplus of docs running around. If you have an MD you will always have work.
    3) Probably the most rewarding profession left around :) As much as insurance companies and ungrateful patients might try to take it away, it's hard to escape the fact that doctors tangibly and meaningfully help others everyday at work.
    4) A decent wage. There's a lot of "grey" to the word decent...so we'll just leave it at that :)

    Hopefully this gives you some perspective. Now, the harsh bottomline:

    If you intend on becoming a primary care doc you will probably never live in a million dollar house (doesn't matter, though, because 300k buys a heck of a house in Texas, and pretty awesome house most other places), you probably won't drive anything more expensive than a 530i (other cars are better values, but if you're into the BMW thing...) and you will still have to plan a long ways ahead of time to send your kids to a private college. You'll also be in serious debt for a very long time if you go to anything more expensive than a state school (unless the military is paying for it). After that debt is paid you'll have a fairly comfortable living, but it's not what you might have built up in your mind.
     

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