How to make a lot of money?

[MNCASC]

Hi, I am just curious how one can make a lot of money after IM residency. I most likely will do hospital medicine or primary care. Not too concerned about fellowship but if I were to do one it'd be a less competitive field (ID, endo or nephro). My main goal is to stay in Southern california. Until recently I didn't care too much about making a lot of money. But now that I live in Southern California and desire to live somewhere nice close to the ocean I am considering how one can make a lot of money in medicine. Would that mean even leaving medicine and doing some business job like consulting, research? Or maybe private practice?

Now before you lecture me, understand that this is just a recent idea that I want to look more into. Most of my career I have not cared at all about how much money I will make. And I generally enjoy medicine. And I know if I wanted to be super rich then medicine is not the right field. Most likely I will do hospitalist or primary care and be fine with around 200K (or whatever the starting salaries are). I am just curious.

So for those of you who make a lot or know ppl that make a lot even if it's not directly pt care, let me know.

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[bobow98]

Hey my friend.
Life is short.
Have you heard of YOLO?

Reddit - Dive into anything

www.reddit.com

 

[DrMetal]

So for those of you who make a lot or know ppl that make a lot even if it's not directly pt care, let me know.

Here's how I intend to do it:

 

[Osteoth]

Hospital medicine: RVU based job where they’ll give you a ton (25+) patients or round at multiple hospitals with lower censuses at one FTE each.

PCP: own your own clinic, do your own labs, ekg, joints, skin stuff etc. employ other docs and mid levels until your clinic is full, then open another clinic and continue building your empire. This is a better way to produce passive income down the road if you can stomach outpatient.

 

[chessknt]

Step 1-Don't live in southern California

 

[end stage fibro]

Step 1-Don't live in southern California

OP in case you think this is tongue
in cheek- it’s not. living in so cal is orthogonal to your question and literally will set you back many years in terms of financial independence, if not decades. fellow so cal native and certified beach bum telling you this

 

[MNCASC]

OP in case you think this is tongue
in cheek- it’s not. living in so cal is orthogonal to your question and literally will set you back many years in terms of financial independence, if not decades. fellow so cal native and certified beach bum telling you this

I understand it puts me at a disadvantage. But I have to live here. Can't leave.

 

[chessknt]

I understand it puts me at a disadvantage. But I have to live here. Can't leave.

Well then you are accepting subpar pay and astronomical taxes and living expenses. You arent going to be happy if wealth is a goal of yours by living there (at least as an IM doctor).

 

[Chemist0157]

Hi, I am just curious how one can make a lot of money after IM residency. I most likely will do hospital medicine or primary care. Not too concerned about fellowship but if I were to do one it'd be a less competitive field (ID, endo or nephro). My main goal is to stay in Southern california. Until recently I didn't care too much about making a lot of money. But now that I live in Southern California and desire to live somewhere nice close to the ocean I am considering how one can make a lot of money in medicine. Would that mean even leaving medicine and doing some business job like consulting, research? Or maybe private practice?

Now before you lecture me, understand that this is just a recent idea that I want to look more into. Most of my career I have not cared at all about how much money I will make. And I generally enjoy medicine. And I know if I wanted to be super rich then medicine is not the right field. Most likely I will do hospitalist or primary care and be fine with around 200K (or whatever the starting salaries are). I am just curious.

So for those of you who make a lot or know ppl that make a lot even if it's not directly pt care, let me know.

I don't think you can make a lot of money if you settle at 200K and live in southern California. There is theoretically some consulting job out there that could be paid well, but you probably need connections. I don't think research is going to be a moneymaker. Outpatient IM/private practice can be good if you are up to the task of starting your own practice. Most people are not. It would depend on demand in your area as well.

I think the average hospitalists works their expected shifts and then some. How much they keep depends on local cost of living, loans, and such. You can build wealth with investments, but there is not much else beyond "work more."

I wouldn't do nephrology in California. My understanding is the market is saturated, and I would be skittish after the legislation that was being considered on their last round of elections/voting with regards to outpatient dialysis units. I am not sure about ID or endocrinology.

 

[HemeOncHopeful19]

I understand it puts me at a disadvantage. But I have to live here. Can't leave.

Why? Are you wearing an ankle monitor?

 

[Redpancreas]

Take big risks outside of medicine with your money with a decent fraction of your salary and keep the rest for financial security. Seriously, invest in yourself. Whether it's social media, trading commodities, etc. find something you're good at and capitalize on it. This generation's no longer treating medicine as a 24/7 job so use that to your advantage.

 

[rokshana]

You will have a job as endocrine, but not a lot of money... if money is the goal... do gi, cards, or hem onc

 

[Osteoth]

You will have a job as endocrine, but not a lot of money... if money is the goal... do gi, cards, or hem onc

True. Just working clinically in non competitive specialties you can probably tap out around $500k. You can double that in GI of cards. Heme if you can become a partner in an infusion center but it’s hard to find those these days.

 

[sloh]

PCP: own your own clinic, do your own labs, ekg, joints, skin stuff etc. employ other docs and mid levels until your clinic is full, then open another clinic and continue building your empire. This is a better way to produce passive income down the road if you can stomach outpatient.

Pretty difficult market to break into with behemoths like Kaiser all around here

 

[MNCASC]

what about direct primary care? Not to derail my original post. But that sounds kind of cool. I'm sure you can't make as much money though

 

[gutonc]

what about direct primary care? Not to derail my original post. But that sounds kind of cool. I'm sure you can't make as much money though

Paging @VA Hopeful Dr for DPC insight.

Honestly, in a saturated market like SoCal, DPC might not be a bad way to go. Especially if your ethical boundaries are...flexible.

 

[VA Hopeful Dr]

what about direct primary care? Not to derail my original post. But that sounds kind of cool. I'm sure you can't make as much money though

It certainly can make pretty good money. Breaking 300k isn't all that rare if you really hustle and control your overhead well. But it does take a fair degree of business savvy and long range thinking, both of which most doctors lack.

 

[robellis]

It certainly can make pretty good money. Breaking 300k isn't all that rare if you really hustle and control your overhead well. But it does take a fair degree of business savvy and long range thinking, both of which most doctors lack.

300k is tipping money bro, not even close to the GI/cards ballers

 

[MNCASC]

Paging @VA Hopeful Dr for DPC insight.

Honestly, in a saturated market like SoCal, DPC might not be a bad way to go. Especially if your ethical boundaries are...flexible.

what do you mean by flexible ethical boundaries?

 

[chessknt]

what do you mean by flexible ethical boundaries?

You aren't going to start off as a PCP doing DPC, ask these questions down the road when you are close to being finished.

 

[gutonc]

what do you mean by flexible ethical boundaries?

Think like a naturopath.

 

[Osteoth]

Pretty difficult market to break into with behemoths like Kaiser all around here

A lot of desert in SoCal to be mined for gold

 

[DrMetal]

what do you mean by flexible ethical boundaries?

(I'm gonna throw in as many BB references here as I can).

Why do you need to stay in SoCal? Something personal, family related, hot girl/boyfriend?

 

[disorder]

What's your definition of a lot money?
Honestly, you will not be "rich" with 500k salary in socal.

 

[chessknt]

A lot of desert in SoCal to be mined for gold

I dont know dude desert towns are usually super poor.... The ones that are affluent (eg palm springs) aren't exactly hurting for docs.

 

[VA Hopeful Dr]

300k is tipping money bro, not even close to the GI/cards ballers

Obviously, but that wasn't what I was asked about. It's also not neurosurgery money either.

However 300k is pretty good primary care money given the much shorter time in training.

 

[DrMetal]

I live in SoCal. Was born and raised here, now I'm bound here by the military (we have a lot of Navy and USMC down here).

The weather is great, food and drink is great, year-round golf, real estate is $$$ (but I was fortunate enough to get in early).

The physician market is totally SATURATED, not only by physicians but also by mid-levels. Running joke is you could throw a rock on the beach and hit a hospitalist, cardiologist, GI, etc etc. I tried to get a part-time gig (moonlighting, weekends, crosscover, etc), wasn't able to do so in my immediate vicinity. Was told they were well covered (as per the plethora of mid-levels most places have been hiring). I'm glad I'm in the military and not looking for something full time down here.

The comment by @Osteoth regarding the desert is actually on point. If you go about 60 miles inland from the coast, SoCal is full of wide open spaces. There's a lot of new communities popping up (Riverside, San Bernardino County, etc . . .look to the Loma Linda healthcare system) that need physicians. Much of the population is poor, indigenous, uninsured, but also sick as hell with a lot of pathology (if you're into that kinda stuff). Pay is slightly better too than coastal towns. I know many who live coastal and do the 60 miles commute (yeah that's rough, but such is the CA life).

 

[MNCASC]

(I'm gonna throw in as many BB references here as I can).

Why do you need to stay in SoCal? Something personal, family related, hot girl/boyfriend?

Hot GF who needs to stay here. And I love living here

 

[sloh]

I live in SoCal. Was born and raised here, now I'm bound here by the military (we have a lot of Navy and USMC down here).

The weather is great, food and drink is great, year-round golf, real estate is $$$ (but I was fortunate enough to get in early).

The physician market is totally SATURATED, not only by physicians but also by mid-levels. Running joke is you could throw a rock on the beach and hit a hospitalist, cardiologist, GI, etc etc. I tried to get a part-time gig (moonlighting, weekends, crosscover, etc), wasn't able to do so in my immediate vicinity. Was told they were well covered (as per the plethora of mid-levels most places have been hiring). I'm glad I'm in the military and not looking for something full time down here.

The comment by @Osteoth regarding the desert is actually on point. If you go about 60 miles inland from the coast, SoCal is full of wide open spaces. There's a lot of new communities popping up (Riverside, San Bernardino County, etc . . .look to the Loma Linda healthcare system) that need physicians. Much of the population is poor, indigenous, uninsured, but also sick as hell with a lot of pathology (if you're into that kinda stuff). Pay is slightly better too than coastal towns. I know many who live coastal and do the 60 miles commute (yeah that's rough, but such is the CA life).

True! I live in LA and grew up in the SGV. Very saturated here and it ain’t cheap if you want to live in the nicer neighborhoods. I’d say you should be clearing at least 350k/yr.

 

[D P356]

Hot GF who needs to stay here. And I love living here

just no, bro.

married? No. You’re a free agent.

she doesn’t have the good looks market cornered. I’d guess you’ve been together less than 6 months. If things go south you may have some resentment towards her. You want to be there more for her than you actually want to live in the area yourself (which you listed 2nd).

 

[DrMetal]

just no, bro.

married? No. You’re a free agent.

she doesn’t have the good looks market cornered. I’d guess you’ve been together less than 6 months. If things go south you may have some resentment towards her. You want to be there more for her than you actually want to live in the area yourself (which you listed 2nd).

Well, hold up there. It depends on how hot. Are we talking at least an LA 8 or 9? Is she cray cray? Hot and NOT cray cray, now that would be a keeper.

@MNCASC Do you guys have family ties here? It's hard when you do, when you've grown up in a metro area and now want to work/live there. What sucks is that you used to be able to get a descent job in SoCal (maybe not exactly the pay, or job title you wanted, but you could find something descent). Now it seems like a lot of places are just completely shutting the doors.

I generally tell people who have no hard ties here to GTFOH.

 

[bobow98]

just no, bro.

married? No. You’re a free agent.

she doesn’t have the good looks market cornered. I’d guess you’ve been together less than 6 months. If things go south you may have some resentment towards her. You want to be there more for her than you actually want to live in the area yourself (which you listed 2nd).

How do you know <6 months? I'm curious.

Can't deny the POP* I guess...


*(ref: Balshe, A., Critchlow, T., et al. Belly - POP. Roc Nation Records. 2017; 8.9: 22-32s)

 

[D P356]

How do you know <6 months? I'm curious.

Can't deny the POP* I guess...


*(ref: Balshe, A., Critchlow, T., et al. Belly - POP. Roc Nation Records. 2017; 8.9: 22-32s)

interesting question,

If @MNCASC gives us the actual time, l can tell you.

 

[Deecee2DO]

True. Just working clinically in non competitive specialties you can probably tap out around $500k. You can double that in GI of cards. Heme if you can become a partner in an infusion center but it’s hard to find those these days.

You can make 500K in non competitive IM subs? which ones lol only other solidly paying subs aside from Cards GI and HO is PCC and Allergy (def not 500K+ but 350K to 450K in certain areas and depending on the practice model). The rest arent exactly the best investments from a monetary standpoint

 

[MNCASC]

interesting question,

If @MNCASC gives us the actual time, l can tell you.

Dating for almost a year now

 

[MNCASC]

You can make 500K in non competitive IM subs? which ones lol only other solidly paying subs aside from Cards GI and HO is PCC and Allergy (def not 500K+ but 350K to 450K in certain areas and depending on the practice model). The rest arent exactly the best investments from a monetary standpoint

I'd also like to hear which specialties? Endo, nephro or ID?

 

[Osteoth]

You can make 500K in non competitive IM subs? which ones lol only other solidly paying subs aside from Cards GI and HO is PCC and Allergy (def not 500K+ but 350K to 450K in certain areas and depending on the practice model). The rest arent exactly the best investments from a monetary standpoint

If you’re a practice owner in primary care or employ other docs or mid levels you can hit that.

As a hospitalist you’d need to work hard in an undesireable area or employ docs or mid levels as above but you can hit that. Especially if you’re comfortable seeing a high volume (30+)

 

[MNCASC]

Gonna revive this thread. What about careers outside of medicine to make a lot of $$$? Medical devices? Sales? Research? Pharm?

 

[gutonc]

Gonna revive this thread. What about careers outside of medicine to make a lot of $$$? Medical devices? Sales? Research? Pharm?

In SoCal?
1. Porn
2. Cocaine
3. TV/Film production
4. Botox, etc. (Although this is pseudo-medical, so maybe not up your alley)
5. Porn
6. MLM
7. Influencing/Porn
8. Weed (non-medical)
9. Prostitution/Porn
10. Shake Shack

 

[HemeOncHopeful19]

In SoCal?
1. Porn
2. Cocaine
3. TV/Film production
4. Botox, etc. (Although this is pseudo-medical, so maybe not up your alley)
5. Porn
6. MLM
7. Influencing/Porn
8. Weed (non-medical)
9. Prostitution/Porn
10. Shake Shack

Are we talking mainstream porn here or some sort of OnlyFans setup? Also what about being the medical consultant for medical-themed porn?

 

[aafisahar]

Gonna revive this thread. What about careers outside of medicine to make a lot of $$$? Medical devices? Sales? Research? Pharm?

Meth

 

[gutonc]

Are we talking mainstream porn here or some sort of OnlyFans setup? Also what about being the medical consultant for medical-themed porn?

All of the above?

To slightly more seriously answer the question, your side hustle shouldn't also be in medicine. You should be working on setting up passive income streams that aren't co-dependent on each other or your primary job in medicine.

 

[DrMetal]

well here ya go: (while some of us just talk about here on SDN, others are actually living the dream!)

Endocrinologist Charged After Bomb-Making Supplies Found

Florida physician was also charged with narcotics trafficking and possession of controlled substances. He has been placed on leave from his Naples office.

www.medscape.com

 

[lorilynkirchner]

In general, you can earn a lot of money in different cases and different ways.

 

[aafisahar]

In general, you can earn a lot of money in different cases and different ways.

to win sport games, score more points than the other team

 

[gutonc]

Since I suspect this thread is about to become a spam magnet, just going to close.