How to make a million dollars a year as a Doctor...

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For a million a year, you'd think he could get a better haircut.

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Wait. As a surgeon, aren't you guaranteed (and I'm really rounding here, so don't call me out) at LEAST like $200-300k/year? I think that could go a lot further than you obviously think. o_0
 
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Its Friday, but 2 more points:

1)When I took Kaplan for USMLE the surgeon was saying its not as easy to make a lot of cash as many would think. He even showed us a check reimbursement from medicaid for 0.01 cents.

2)Also between making 1 million dollars and knowing 75 % of the medical info of William Osler Id take the info.... [instead of a guy with a white jacket on, with a stethoscope around his neck, who routinely writes a "generic soap note" or any note, and is unable to solve problems, even worse thinking he is a legend in his own mind..]
 
how to make a million dollars a year as a doctor? become a dentist; that way, you'll make the million dollars a year way faster. Remember: MS just means "Misinformed Student"
 
Don't flame in the allo forums. Statistically there are a lot more millionaire docs anyway.
 
I just finished a GI fellowship and and will make over 300K this year.
Still I think medicine is a poor field to go into for the energetic and highly motivated. Despite my income, here are some of the negatives
1) losing out on your precious 20's
2) medicare cuts are coming in 2008 and will continue to do so
3) student loan debt of 100K plus interest
4) by the time you make $$ you have missed out on a lot of retirement funding--and now make too much for Roth IRA
5) by the time you finish you can no longer deduct student loan debt because your income to too high
6) You jump to high tax bracket and just multiply your income by 0.6 (60%) for your take home
7) Assuming a Democrat gets elected they will push even more for socialized medicine
8) The most highly prized specialties are SUPER competitive and you have to extra work to get them ie chief year, year of research, etc!!
9) For you alltruistic folks who are not doing it for the money....realize that PRIMARY CARE IS A TRIAGE NURSE AND DUMPING GROUND, YOU WILL WORK HARDER THAN ME AND MAKE 1/4 THE MONEY!!

The plan should be bank $$ while GI is good, then in 10 years when it goes to crap work part time or not at all and get into something else!!

I will discourage and kids from doing medicine!!
 
obviously the OP was a troll... but this is a relevant topic so it deserves some discussion.

I want to go into medicine because it's the only career that will let me be content with myself, if that makes sense. If I devoted the same amount of time into business or investing that I will devote to medicine over the next 8 years, I would probably end up making a lot more money, but I don't really care about business; making money for the sake of making money has never interested me.

OTOH, my undergrad major is in Music, but I don't see myself being satisfied being a college prof. the rest of my life because there are so many other things that I want to understand and be able to do that will only come with a medical education. I realize that I'm only pre-med and this probably all sounds very naive. :oops:

re: socialized medicine. I lived in a country with socialized medicine (Czech Republic) and while it's good in that there is easy access to health care for all citizens, definite abuse takes place. All I can say is that if socialized health care is on the way, the government should subsidize medical education. It is not fair at all to those currently racking up hundreds of thousands of dollars in med-school debt to suddenly take away half their income upon graduation.

re: income. I think the only way to make real money as a physician is living beneath your means long enough to build a fair amount of capital. 250k/year doesn't go as far as it seems after taxes/kids/etc but if you manage to save and invest I think you can do a lot. But that is not a good reason to go into medicine... I think the only thing you should expect financially as a physician is to make enough money to not have to WORRY about money. I don't want a lavish lifestyle; just a regular house with land, maybe a couple 30-year old German cars to take to the track, and the ability to educate my (future) children.

cheers.
 
If healthcare WAS socialized, how much would doctors make? Lets say now they make around $300,000 for an orthopedic spine surgeon. After socializing medicine, would they only make like...$150,000? If so, thats still a good amount of money.

Also, if medicine was socialized, would doctors still pay malpractice insurance?

Ortho spine surgeons could be making $1mil/yr right now... I bet its one of the few medical fields its possible in though (I believe they are the highest paid, right?)
 
His girlfriend cut off her toe.

She thought we could get a million dollars.

It's not fair.
 
I just finished a GI fellowship and and will make over 300K this year.
Still I think medicine is a poor field to go into for the energetic and highly motivated. Despite my income, here are some of the negatives
1) losing out on your precious 20's
2) medicare cuts are coming in 2008 and will continue to do so
3) student loan debt of 100K plus interest
4) by the time you make $$ you have missed out on a lot of retirement funding--and now make too much for Roth IRA
5) by the time you finish you can no longer deduct student loan debt because your income to too high
6) You jump to high tax bracket and just multiply your income by 0.6 (60%) for your take home
7) Assuming a Democrat gets elected they will push even more for socialized medicine
8) The most highly prized specialties are SUPER competitive and you have to extra work to get them ie chief year, year of research, etc!!
9) For you alltruistic folks who are not doing it for the money....realize that PRIMARY CARE IS A TRIAGE NURSE AND DUMPING GROUND, YOU WILL WORK HARDER THAN ME AND MAKE 1/4 THE MONEY!!

The plan should be bank $$ while GI is good, then in 10 years when it goes to crap work part time or not at all and get into something else!!

I will discourage and kids from doing medicine!!

Not sure what country you're in, but tax brackets in the US don't go up as high as 40%. If you're pulling ~$300k, you're in the 33% bracket. On Roth IRA and retirement funding, and student loan deduction during training - this has been discussed numerous times how to do this and who can do it and when. There is a seperate area on SDN that talks about this - look in the finance section.
 
i think other taxes include social security, medicare, state income tax, others? That's how you get to, and exceed, 40%.
 
how to make a million dollars a year as a doctor? become a dentist; that way, you'll make the million dollars a year way faster. Remember: MS just means "Misinformed Student"
Unfortunately, as a dentist, you have to work with teeth. I really don't like teeth.



You can now attempt a comeback with "It's better than looking at <blank>" all day, and I will disagree with you.
 
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Not sure what country you're in, but tax brackets in the US don't go up as high as 40%. If you're pulling ~$300k, you're in the 33% bracket. On Roth IRA and retirement funding, and student loan deduction during training - this has been discussed numerous times how to do this and who can do it and when. There is a seperate area on SDN that talks about this - look in the finance section.
Tack on the state income tax, FICA, and Medicare for good measure.
 
Not sure what country you're in, but tax brackets in the US don't go up as high as 40%. If you're pulling ~$300k, you're in the 33% bracket. On Roth IRA and retirement funding, and student loan deduction during training - this has been discussed numerous times how to do this and who can do it and when. There is a seperate area on SDN that talks about this - look in the finance section.

I believe the highest is actually 38%.
 
The thing is, even though I do have sympathy for the older generation of doctors who saw their incomes (which are not, in most cases, salaries) collapse, it would be hard for me to be disappointed about my own future if "cut in half" meant having gone from $600k to $300k and staying there. What I fear is that more like $100k is going to become the norm--at which point it becomes not really worth it to go through med school and residency.

I never understood this mentality.
You think you should get payed more because you worked your ass
off? There's people in this world that work their ass off 10x more than
you just to give their kids food. You fear you are going to
make $100k?? Cry about it.

I sincerely hope you went to med school because thats what you love
doing, not because theres some huge reward after being miserable
for 10 years. Med school is nothing. I am lucky to be getting a great
education, and I am aware that what I am doing is pie compared
to the day to day existence of a mom walking 5 miles every day to being
her children clean water. $100k is too much for the good we
will be doing in medicine.
 
Can the U.S. have a Universal Healthcare system while increasing doctors' salaries?

I think so. At least I hope so. The U.S. spends at least 40% more than any other industrialized nation on healthcare (1). The cost of Health Care Administration in the U.S. is $1059 USD per capita compared to $307 USD per capita in Canada (2).

Where is all this excess money going? Private insurance companies are doing something with it. They spend way to much on administration costs and they make huge profits. Its an inefficient system that does not benefit patients. The purpose of a corporation is to make a profit for its shareholders, not make sure that the customers are taken care of.

You would think that it would be impossible to continually make huge profits while screwing your customers (unless of course you're a prostitute). But the insurance companies do it all the time with high premiums and poor coverage.

The government, on the other hand, can operate at a loss. Look at our war in Iraq. Look at the deficit.

I think Universal Healthcare would work in the United States if we funneled all that profit and wasted money into actually providing care to everyone and, at the same time, keep physician salaries up -- which is important if we want to produce enough doctors to meet demand.

The roadblocks are, the lobbyists for these big corporations (of which there are about 3.8 lobbyists for each member of congress(3) ) and doctors' fears that salaries will plummet in a Universal Healthcare system.


Sources:
(1) The Case for Universal Medicine

(2) Woolhandler, Steffie M.D., et al. Costs of Health Care Administration in the United States and Canada. The New England Journal of Medicine. August 21, 2003.

(3) Opensecrets.org
 
Can the U.S. have a Universal Healthcare system while increasing doctors' salaries?

I think so. At least I hope so. The U.S. spends at least 40% more than any other industrialized nation on healthcare (1). The cost of Health Care Administration in the U.S. is $1059 USD per capita compared to $307 USD per capita in Canada (2).

Where is all this excess money going? Private insurance companies are doing something with it. They spend way to much on administration costs and they make huge profits. Its an inefficient system that does not benefit patients. The purpose of a corporation is to make a profit for its shareholders, not make sure that the customers are taken care of.

You would think that it would be impossible to continually make huge profits while screwing your customers (unless of course you're a prostitute). But the insurance companies do it all the time with high premiums and poor coverage.

The government, on the other hand, can operate at a loss. Look at our war in Iraq. Look at the deficit.

I think Universal Healthcare would work in the United States if we funneled all that profit and wasted money into actually providing care to everyone and could keep physician salaries up -- which is important if we want to produce enough doctors to meet demand.

The roadblocks are, the lobbyists for these big corporations (of which there are about 3.8 lobbyists for each member of congress(3) ) and doctors' fears that salaries will plummet in a Universal Healthcare system.

Yes. Next time you are in an ambulatory clinic, give some thought to how UTTERLY INSANE our current health-economics predicament is.

1. Patient comes to see doctor.
2. Doctor evaluates/performs service.
3. Doctor has office staff contact random large corporation to ask if what he/she did is ok with them.
4. Non-MD employee of random large company contacts doctor and says "ok/not ok" and sends him/her some money (or not).
5. Patient continues sending money every month to large corporation just in case patient needs to see doctor again.

So the situation is that "3rd-party payors" are just that: an otherwise unrelated corporation whose entire job is to interpose themselves in an otherwise 2-party (doc-patient) relationship. In order to do this, they have to organize a HUGE bureaucracy full of employees, paperwork, and LOADS of unnecessary costs ($100 million CEO salary, not to mention his private jet, office building, board meetings, etc).

And people wonder why healthcare is so expensive? :confused:
 
I heard psychiatrists doing Electric shock therapy can bring in a lot of money. Is this true? thanks:cool:
 
Seriously, everyone is thinking this exact thought if you are in medical school. I don't want to hear those liberal whinings about the poor and all that crap. Everyone is concerned about their future bank account! So, we've worked hard for 4 years of school, and then (for surgery) like 6 to 7 years of residency and we want to make some money. If the system is socialized, the government will be in control of our wages as a whole. We cannot let that happen. What are some ideas to prevent that from happening as well as maximize our bank rolls?


You sound like a plant. There are some very serious problems with communist/socialized health care, but the idea that MDs won't make a million bucks a year isn't one of them. Be serious.
 
Still haven't answered my question...lets say surgeons make like $300,000 now, using the current trends, about how much willl they make in 30 years or so? Can salaries, in 30 or so years, go from like $300,000 to like $150,000?

No they are not! Stop the self-sabatoge!
 
The roadblocks are, the lobbyists for these big corporations (of which there are about 3.8 lobbyists for each member of congress(3) ) and doctors' fears that salaries will plummet in a Universal Healthcare system.

Yes, many doctor's are very afraid of their salaries plummeting, and this is the driving force behind the AMAs hatred of single-payer medicine. As far as quality of medicine goes, we all know it would be better for the patient with single payer. I have my own pet story of hospitalization and insurance problems and I'm sure everyone knows a friend or relative that has had the same issues.
 
Yes, many doctor's are very afraid of their salaries plummeting, and this is the driving force behind the AMAs hatred of single-payer medicine. As far as quality of medicine goes, we all know it would be better for the patient with single payer. I have my own pet story of hospitalization and insurance problems and I'm sure everyone knows a friend or relative that has had the same issues.

Yes, a single payer system is kinda scary. Only because that single payer will have control of all provider salaries.

However, single payer systems could lead to lower prices for medications. In New Zealand (with a universal healthcare system), a government agency called Pharmac is responsible for deciding what medications will be covered. As the governing body for the entire country, pharmaceuticals must negotiate with Pharmac over prices. And if the prices are unacceptable, Pharmac does not list that company's medication as an option for New Zealand's doctors. It's price control that benefits the patients.

The key for a Universal system with a single payer is to have a diverse group that will be in charge of setting compensation for each service. In theory, it sounds good. In practice, who knows.

But it would be in the interest of everyone, in a universal system, for physicians to make a good living. I think people are generally good, but you still have to provide financial benefits to make the long journey into medicine worth it.

At this point I've only briefly read about systems in Canada and New Zealand, but I've heard some good things about Germany's system. There is universal health care, but it isn't a single-payer system.
 
Yes, a single payer system is kinda scary. Only because that single payer will have control of all provider salaries.

However, single payer systems could lead to lower prices for medications. In New Zealand (with a universal healthcare system), a government agency called Pharmac is responsible for deciding what medications will be covered. As the governing body for the entire country, pharmaceuticals must negotiate with Pharmac over prices. And if the prices are unacceptable, Pharmac does not list that company's medication as an option for New Zealand's doctors. It's price control that benefits the patients.

The key for a Universal system with a single payer is to have a diverse group that will be in charge of setting compensation for each service. In theory, it sounds good. In practice, who knows.

But it would be in the interest of everyone, in a universal system, for physicians to make a good living. I think people are generally good, but you still have to provide financial benefits to make the long journey into medicine worth it.

At this point I've only briefly read about systems in Canada and New Zealand, but I've heard some good things about Germany's system. There is universal health care, but it isn't a single-payer system.

I believe in Germany as well as in Australia, they have quasi-governmental, non-profit 3rd-party insurers, and people are mandated to carry a certain level of insurance from one of them. Any experts on this?
 
Yes, many doctor's are very afraid of their salaries plummeting, and this is the driving force behind the AMAs hatred of single-payer medicine. As far as quality of medicine goes, we all know it would be better for the patient with single payer. I have my own pet story of hospitalization and insurance problems and I'm sure everyone knows a friend or relative that has had the same issues.

you think your insurance problems were bad? Try being a Medicaid patient. Your problems are a Medicaid patients wet dream. That's what kills be about single payer advocates. Doesn't anybody notice how much doctors hate Medicare and Medicaid? How they never approve anything but a very short list of drugs and procedures? And how the reimbursement rates are constantly threated to go down? How could we expect anything different from a single payer/socialist/anything where the govn't is writing the check?

Unfortunately access to care does not have anything to do with quality of care. Otherwise Cuba would have a better healthcare system than the U.S.
 
like they say on the Taco Bell commercial we gotta think outside the bun. Having a multitude of insurance companies causes very expensive duplication of general and admin expenses. A properly structured single payer would leave a significantly higher portion of the healthcare dollar to go for direct patient care- and yes to fairly compensate doctors.

The way I see it someone like Michael Bloomberg or Warren Buffet can spearhead healthcare reform. Men like this have no financial or political agenda. If something is not done many of you will be practicing medicine for insulting compensation.
 
Americans expect everything possible to be done for every patient no matter what their prognosis, comorbidities, age or the cost and they usually get this. This would not happen in socialized medicine and it is very hard to take something away that people have come to expect.
 
like they say on the Taco Bell commercial we gotta think outside the bun. Having a multitude of insurance companies causes very expensive duplication of general and admin expenses. A properly structured single payer would leave a significantly higher portion of the healthcare dollar to go for direct patient care- and yes to fairly compensate doctors.

The way I see it someone like Michael Bloomberg or Warren Buffet can spearhead healthcare reform. Men like this have no financial or political agenda. If something is not done many of you will be practicing medicine for insulting compensation.

These two words are too vague. The ideal would obviously be to trend dollars from large insurance companies, pharmaceutical companies and lawyers (including CYA medicine performed due to fear from legal pitfalls) to patients and healthcare providers but there hasn't been a good way to do this. A single payer has too much control; instead of 20 CEOs making $10 million we would have 1 making $200 million.

To add to my above post: Another issue is that so much medical innovation is completed in the U.S. Most of this is highly driven by money. If we have socialized medicine this money decreases and so does the innovation.
 
like they say on the Taco Bell commercial we gotta think outside the bun. Having a multitude of insurance companies causes very expensive duplication of general and admin expenses. A properly structured single payer would leave a significantly higher portion of the healthcare dollar to go for direct patient care- and yes to fairly compensate doctors.

The way I see it someone like Michael Bloomberg or Warren Buffet can spearhead healthcare reform. Men like this have no financial or political agenda. If something is not done many of you will be practicing medicine for insulting compensation.

Yeah, because the last thing I think of when I think of government is administration (or paperwork, or delays, or disorganization, or inefficiency...).

Michael Bloomberg has no political agenda? What planet do you live on?!
 
Neither our government, nor an outside entity is going to rescue physicians from their economic woes. The key is to be independent and have enough money in the bank to float one's living expenses for 6 months so low paying insurance companies and Medicare/Medicaid can be dropped.

It is not easy for physicians to be fiscally responsible. Everybody tells us we're supposed to be rich and the constant delayed gratification makes it even worse. When most of us finish, we have mounds of debt and either have just started a family or are preparing to start one. Then, many doctors leverage themselves to the max with big houses, fancy cars, and other trinkets. Anybody who wants to see how not to handle their finances, check out this recent article from CNN Money.

What really needs to happen is physicians need to live modestly the first 2 or 3 years out of residency and save up some money and pay off debt. It is a very un-American idea, but it does work. During this time, physicians need to save up a legitimate 6 months of living expenses. At this point, if they are in private practice, they can start dropping low paying plans. It is hard to bargain from a position of weakness, which is the position in which most docs place themselves. I know way too many doctors who are 5-10 years out of training and have maxed out credit cards and no money in the bank.

Most dentists I know do exactly that. They work for somebody else for 2 or 3 years and save their money, then they start their own practice. They generally require payment at the time of service and regard insurance as the patient's insurance, not the doctor's insurance.

As far as care for the poor goes, hospitals can pay doctors an hourly or "by the case" rate for taking care of uninsured patients. It is already happening across the country. Let the hospitals collect whatever pittance Medicare throws them.

Fiscal responsibility is the key to solving our problems. Expecting anybody else to solve our problems will result in the same situation as welfare recipients waiting for the government to lift them out of poverty....it ain't gonna happen.
 
Neither our government, nor an outside entity is going to rescue physicians from their economic woes. The key is to be independent and have enough money in the bank to float one's living expenses for 6 months so low paying insurance companies and Medicare/Medicaid can be dropped.

It is not easy for physicians to be fiscally responsible. Everybody tells us we're supposed to be rich and the constant delayed gratification makes it even worse. When most of us finish, we have mounds of debt and either have just started a family or are preparing to start one. Then, many doctors leverage themselves to the max with big houses, fancy cars, and other trinkets. Anybody who wants to see how not to handle their finances, check out this recent article from CNN Money.

What really needs to happen is physicians need to live modestly the first 2 or 3 years out of residency and save up some money and pay off debt. It is a very un-American idea, but it does work. During this time, physicians need to save up a legitimate 6 months of living expenses. At this point, if they are in private practice, they can start dropping low paying plans. It is hard to bargain from a position of weakness, which is the position in which most docs place themselves. I know way too many doctors who are 5-10 years out of training and have maxed out credit cards and no money in the bank.

Most dentists I know do exactly that. They work for somebody else for 2 or 3 years and save their money, then they start their own practice. They generally require payment at the time of service and regard insurance as the patient's insurance, not the doctor's insurance.

As far as care for the poor goes, hospitals can pay doctors an hourly or "by the case" rate for taking care of uninsured patients. It is already happening across the country. Let the hospitals collect whatever pittance Medicare throws them.

Fiscal responsibility is the key to solving our problems. Expecting anybody else to solve our problems will result in the same situation as welfare recipients waiting for the government to lift them out of poverty....it ain't gonna happen.

This is a very insightful idea. How hard is it to arrange a set-up like you're describing? It seems like you're saying bill hospitals an hourly rate for care of indigent patients, and let them do all the legwork to get paid?
 
Neither our government, nor an outside entity is going to rescue physicians from their economic woes. The key is to be independent and have enough money in the bank to float one's living expenses for 6 months so low paying insurance companies and Medicare/Medicaid can be dropped.

It is not easy for physicians to be fiscally responsible. Everybody tells us we're supposed to be rich and the constant delayed gratification makes it even worse. When most of us finish, we have mounds of debt and either have just started a family or are preparing to start one. Then, many doctors leverage themselves to the max with big houses, fancy cars, and other trinkets. Anybody who wants to see how not to handle their finances, check out this recent article from CNN Money.

What really needs to happen is physicians need to live modestly the first 2 or 3 years out of residency and save up some money and pay off debt. It is a very un-American idea, but it does work. During this time, physicians need to save up a legitimate 6 months of living expenses. At this point, if they are in private practice, they can start dropping low paying plans. It is hard to bargain from a position of weakness, which is the position in which most docs place themselves. I know way too many doctors who are 5-10 years out of training and have maxed out credit cards and no money in the bank.

Most dentists I know do exactly that. They work for somebody else for 2 or 3 years and save their money, then they start their own practice. They generally require payment at the time of service and regard insurance as the patient's insurance, not the doctor's insurance.

As far as care for the poor goes, hospitals can pay doctors an hourly or "by the case" rate for taking care of uninsured patients. It is already happening across the country. Let the hospitals collect whatever pittance Medicare throws them.

Fiscal responsibility is the key to solving our problems. Expecting anybody else to solve our problems will result in the same situation as welfare recipients waiting for the government to lift them out of poverty....it ain't gonna happen.

Awesome post! Couldn't agree more. Note, however, that in your second to last paragraph, what you suggest requires physicians to absolve responsibility for direct care for "the poor," and passes this to the hospitals (which, note, I completely agree with). However my experience teaches me that med students have the "bleeding heart syndrome (X)" in which worrying about money (and thus rejecting patients who can't afford payment) somehow makes them greedy. This is a very difficult mentality for the medical profession to overcome; and until it does, physicians will continue to struggle financially.
 
Sufficient funds are earmarked from the government for medicaid and medicare. The insurance companies absorb the lion's share of these funds-leaving table scraps for doctors. Again my colleagues the true culprits here are the health insurance companies. I propose a single government payer-BUT NOT SOCIALIZED MEDICINE- we would not be government employees. A national health clearing facility would have only fiscal and administrative responsibility. The savings would be HUGE (again no duplication of general and administrative expense, no insurance company profits) and more funds would be available for doctors and patient care.
 
Sufficient funds are earmarked from the government for medicaid and medicare. The insurance companies absorb the lion's share of these funds-leaving table scraps for doctors. Again my colleagues the true culprits here are the health insurance companies. I propose a single government payer-BUT NOT SOCIALIZED MEDICINE- we would not be government employees. A national health clearing facility would have only fiscal and administrative responsibility. The savings would be HUGE (again no duplication of general and administrative expense, no insurance company profits) and more funds would be available for doctors and patient care.

It doesn't matter. It's like hiring an independent contractor to do your billing, or having a billing dept in your office. The only real difference is that as your employee, you have to pay the secretaries' soc sec and unemployment taxes. Either way they end up getting the same check from you.

If the government is writing the check, they have you by the short and curly's. It doesn't matter if you own the practice and are responsible for administrative costs, or if you're an employee (in which case you'd still be responsible for the filing and reporting --> admin costs). And the remarkable thing about the government is that no matter what, they pay out less and less and keep more and more.
 
It doesn't matter. It's like hiring an independent contractor to do your billing, or having a billing dept in your office. The only real difference is that as your employee, you have to pay the secretaries' soc sec and unemployment taxes. Either way they end up getting the same check from you.

By this logic there would be no difference in care going to a private hospital that accepts medicare or a VA. I think we can agree that this isn't the case.

Biscuit799 said:
If the government is writing the check, they have you by the short and curly's.

True, although if the government were responsible for paying for every citizen, they'd have a helluva incentive to adequately fund the system. I still wouldn't want to be leveraged by a single entity, but it's not like the Gubmint could dismantle healthcare without the electorate taking notice.
 
which brings me to my new career switch, 400 dollar a head barber, lol, i be making 3 times as much as ER docs for way less training, stress and effort, by the way thats not including tips!!! who tips u as a doc, lol except for the nurses, hehe...


The barbers finally extract their revenge on the surgeons after the surgeons jumped ship 300 years ago!
 
By this logic there would be no difference in care going to a private hospital that accepts medicare or a VA. I think we can agree that this isn't the case.



True, although if the government were responsible for paying for every citizen, they'd have a helluva incentive to adequately fund the system. I still wouldn't want to be leveraged by a single entity, but it's not like the Gubmint could dismantle healthcare without the electorate taking notice.

You mean like social security?

Also, while there certainly is a difference between hospitals that accept medicaid and VA's, the difference is not because of reimbursements. Doctors that work at either hospital don't make significantly more or less than either other doctor. And that's the point, that whether the doctor is an independant practice owner, or a gubmint (haha, i love it, very nice gun shot!) employee, the point is that the government is still calling the shots, and writing the check. And the one who writes the check, calls the shots.
 
Doctors that work at either hospital don't make significantly more or less than either other doctor.

Military physicians sure make less than their civillian counterparts. Yes, they will pay for medical school, but even after that obligation is completed pay is less, that's why nearly all jump ship after their obligation. Visit the military medicine forum to see how many are satisified with being government property.

(and yes, I do realize most VA physicians are not military, but the point is to compare current private income/satisfaction with government paid physicians).
 
And the one who writes the check, calls the shots.

Hey, I'm not disagreeing with you, but you have to admit that there is a significant difference between working in a government-owned, government-run facility versus a private one. The government writes a lot of checks to Boeing, for instance, and I bet they have a much nicer cafeteria than the Pentagon.
 
Military physicians sure make less than their civillian counterparts. Yes, they will pay for medical school, but even after that obligation is completed pay is less, that's why nearly all jump ship after their obligation. Visit the military medicine forum to see how many are satisified with being government property.

(and yes, I do realize most VA physicians are not military, but the point is to compare current private income/satisfaction with government paid physicians).

What you're saying is true. Therefore, I don't think the answer is to make us all miserable by making us all government employees/contractors. The reason military docs get paid less is because the physicians are contractually obligated to the government, and have no choice but to practice as an employee of the gubmint (still hilarious). Military docs are willing to do this out of service to the country. However, the govn't has them by the balls, and as a result, doesn't have to compete for labor by offering higher wages. Thus the constant "jumping ship."

Maybe if the government would pay them better, they wouldn't have to send 12,000 recruiters a year to my med school and save money on cheap lunches and power point presentations.
 
Hey, I'm not disagreeing with you, but you have to admit that there is a significant difference between working in a government-owned, government-run facility versus a private one. The government writes a lot of checks to Boeing, for instance, and I bet they have a much nicer cafeteria than the Pentagon.

Boeing is a huge, publicly traded corporation that can raise private funds, and has the government as a client. There is no government regulation on Boeing. Even current regulations on physicians would hardly allow that kind of business operation, and most docs could never run a corporation like that. As far as differences in practice environment, I have no idea what the facility difference would be like, and I suppose it would depend a lot on the individual physician's desire to keep a well-maintained office given a certain income. I'm sure there will be inherent differences in working for/contracting out too the govn't, but my point is that it doesn't make any difference. Either you take home a paycheck, or you bring in an income. It'll end up working out the same in the end.

Although I guess given your point, you could work independently in a single payer system, keep a crummy, worn down office, and take home the difference. Now that's quite a choice.
 
twitch... and for the others...

federal tax rate is about 35% for most of us sub-specialists - primarily because of the phase-outs (incl. AMT).... even if based on income you would think it is only 28% - very misleading - so 35% it is

then add state tax (and those are also progressive in most states - in my state i will be paying 8% for income

then add medicare at 3%

i am not including social security or short-term disability taxes etc... because they don't really add up that much

so you are looking at 35% + 8% + 3% = 46%.... it doesn't matter how slick you do your accounting - what you take home in income will be taxed at 46% ---
 
how to make a million dollars a year as a doctor? gross $2 million a year before taxes, malpractice, loan payments, etc.
 
Sure you did.


Truer nonsensical words have rarely been written.

Um, yeah. I am 33 years old and finished my Gastroenterology fellowship at the end of June 2007. :laugh:

And yes, the senior partners told me to multiply my income by .6 to determine what my take home will generally be.

And I prefer that my children don't become M.D.'s unless the system is better in 20 years.

And the bottom line is that MD/DO's---we need to get better organized to fight against decreasing reimbursement! Tell the Congressmen that we are cutting their salaries by 10% off the top and see if they complain.
 
Um, yeah. I am 33 years old and finished my Gastroenterology fellowship at the end of June 2007. :laugh:

And yes, the senior partners told me to multiply my income by .6 to determine what my take home will generally be.

And I prefer that my children don't become M.D.'s unless the system is better in 20 years.

And the bottom line is that MD/DO's---we need to get better organized to fight against decreasing reimbursement! Tell the Congressmen that we are cutting their salaries by 10% off the top and see if they complain.

33 is not bad considering it's 4 years undergrad, 4 years med school, 3 residency, 3 fellowship. Did you take a year off somewhere before medical school or after?
 
Took a year off after med school. Wouldn't necessarily recommend that but it worked out in the long run.
 
Sure you did.



Truer nonsensical words have rarely been written.

I don't know anything about Gida, but I've met many physicians who tell me they'd never encourage their kids to go into medicine. when we'd shadow them they'd try to discourage us from going into medicine even though they were top of the line cardiologists who were making big money and in this buisness in the better times of the 80s.

There is just a lot to think about. I don't know what I'd want to do anything else though. I have very personal reasons as to why I want to go into medicine which I've no problem sharing in my personal statement but don't feel like getting into on here.

But if money was all I wanted to do this for or saving the world cliches that are at each extreme, I'd find something else to do.
 
Not sure what country you're in, but tax brackets in the US don't go up as high as 40%. If you're pulling ~$300k, you're in the 33% bracket. On Roth IRA and retirement funding, and student loan deduction during training - this has been discussed numerous times how to do this and who can do it and when. There is a separate area on SDN that talks about this - look in the finance section.
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Let's look at California....35% federal tax, 9.3% state tax, 6.2% social security (x2 if you're self-employed), 1.45% medicare(x2 if you're self-employed) for a grand total of 59.60%.

In all fairness, your marginal tax rate is never that high since you only pay social security on the first $97.5K, which doesn't put anyone into the 35% bracket. Although a single, self-employed California guy whose taxable income is 97K/year has a marginal tax rate of 52.60%.
 
Not sure what country you're in, but tax brackets in the US don't go up as high as 40%. If you're pulling ~$300k, you're in the 33% bracket. On Roth IRA and retirement funding, and student loan deduction during training - this has been discussed numerous times how to do this and who can do it and when. There is a seperate area on SDN that talks about this - look in the finance section.

For my state, and the private practice MD:
Federal = 35%
State = 6.25%
SS Ins = 12.4%
Medicare = 2.9
-------------------
56.55% + property tax, etc, etc, etc.

NOW, on top of that, take out 10-20% of your GROSS pay, as you have to self-fund your own retirement, and you've lost prime compounding years that you spent in med school residency +/- fellowship

= 70% gone and 30% take home.

Oh wait, then there is that student loan payment, too. Out of that 30% take home, subtract another $1000 a month for the next 30 years.
 
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