How to make a lot of money?

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IMPCPJJANTMAN

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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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MNCASC said:
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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Here's how I intend to do it:

breaking bad idgaf GIF
 
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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 said:
Step 1-Don't live in southern California
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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
 
end stage fibro said:
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
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I understand it puts me at a disadvantage. But I have to live here. Can't leave.
 
MNCASC said:
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.
Click to expand...
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.
 
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 said:
You will have a job as endocrine, but not a lot of money... if money is the goal... do gi, cards, or hem onc
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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.
 
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Osteoth said:
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.
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Pretty difficult market to break into with behemoths like Kaiser all around here
 
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
 
MNCASC said:
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
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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.
 
MNCASC said:
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
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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.
 
VA Hopeful Dr said:
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.
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300k is tipping money bro, not even close to the GI/cards ballers
 
robellis said:
300k is tipping money bro, not even close to the GI/cards ballers
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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.
 
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).
 
DrMetal said:
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).
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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.
 
MNCASC said:
Hot GF who needs to stay here. And I love living here
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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).
 
D P356 said:
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).
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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.
 
D P356 said:
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).
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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)
 
Osteoth said:
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.
Click to expand...
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
 
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Deecee2DO said:
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
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I'd also like to hear which specialties? Endo, nephro or ID?
 
Deecee2DO said:
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
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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+)
 
Gonna revive this thread. What about careers outside of medicine to make a lot of $$$? Medical devices? Sales? Research? Pharm?
 
MNCASC said:
Gonna revive this thread. What about careers outside of medicine to make a lot of $$$? Medical devices? Sales? Research? Pharm?
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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
 
gutonc said:
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
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Are we talking mainstream porn here or some sort of OnlyFans setup? Also what about being the medical consultant for medical-themed porn?
 
HemeOncHopeful19 said:
Are we talking mainstream porn here or some sort of OnlyFans setup? Also what about being the medical consultant for medical-themed porn?
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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.
 
well here ya go: (while some of us just talk about here on SDN, others are actually living the dream!)

www.medscape.com

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 www.medscape.com
 
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