how to make a wad

[mcgmaniac]

I know this will draw alot of fire but I have to do it. I realize medicine isnt the field to get into if you want to get wealthy. I am hoping for some real insight into the economic future of our field. I want to make as much money as possible in working with patients and enjoying medicine. What fields offer the most potential in earnings. I have heard GI, cards, retina, and cosmetic plastics all have big potential. So which ones allow you to really make some bank. Any perspective on how to do this while maintaining a non neurosurgical lifestyle would be nice?

before you throw off and tell me how stupid I am etc. etc. please hold off, I get it, I probably made the wrong choice to get into medicine but now I am pot comitted so to speak and don't want to get out. I think overall I will enjoy most fields with patient interaction in medicine so that part is covered, now I am just trying to figure out the money and lifestyle part"

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[westernmed007]

Wow finally a thread that pretty much sums up alot of what I have been looking for, seriously I think this sums up pretty much how alot of us feel, does anyone have any insight? Any personal experiences or research into medicinal specialty futures? I feel like I have heard 1000x "pick what you like" and obviously I will but I feel like I already like TONS of specialties, I think this thread will give us some great criteria (and whether we like it or not money/lifestyle is a major issue for all of us and our future families) for maybe narrowing my choices down a bit, come on you medicinal-illuminati, shed your light on the rest of us....

 

[chrisisinnocent]

Dermapath is supposed to be the highest $/time worked. But you will never see a patient unless you do it out of a derm residency rather than a path one.
The plastics/cosmetics route is a painful way to make $$$ imo. Demanding patients, long hours, unreasonable expectations etc.
You could always do laser procedures. One of my friends' wife works for a guy who dropped out of general surgery residency and does laser hair removal. Pretty much all the work is done by nurses and all he does is the initial consult, the marketing/schmoozing, and provides the MD after his name on the door.

 

[anonydoc83]

I have heard GI, cards, retina, and cosmetic plastics all have big potential."

All the fields you mentioned are currently among the top, in terms of income; however, i've heard from a cards fellowship director at a major university program that by the time current med students graduate, private practice income potential at partner level will no longer be >$700,000 like it is now. He cited insurance companies' efforts to limit reimbursement (the main cause for reduced income) and cardiac surgeons' vengeance by way of reinstituting CABG as standard of care (though this would have a much lesser impact.)

personally, i feel like if you can stomach radiology (i.e., forgetting about patient care and medical therapy and focusing almost entirely on diagnosis), that's the field to go into if you've got the grit to set-up a business and really pump out the money. Plus, you can always decide to do a fellowship in interventional rads if the field remains viable when you're near the end of your residency.

Anyone else have any thoughts on the future of cards and its subspecialties?

 

[Doublecortin]

I know this will draw alot of fire but I have to do it. I realize medicine isnt the field to get into if you want to get wealthy. I am hoping for some real insight into the economic future of our field. I want to make as much money as possible in working with patients and enjoying medicine. What fields offer the most potential in earnings. I have heard GI, cards, retina, and cosmetic plastics all have big potential. So which ones allow you to really make some bank. Any perspective on how to do this while maintaining a non neurosurgical lifestyle would be nice?

before you throw off and tell me how stupid I am etc. etc. please hold off, I get it, I probably made the wrong choice to get into medicine but now I am pot comitted so to speak and don't want to get out. I think overall I will enjoy most fields with patient interaction in medicine so that part is covered, now I am just trying to figure out the money and lifestyle part"

. I think a lot of people say that you become wealthy by investing your income(e.g. real estate) and starting various business ventures. I think it will be hard to become really wealthy by simply practicing medicine

 

[nogolfinsnow]

If you have access to the careers in medicine website (through AAMC), you can look up the avg compensation for all of the specialties.

 

[-Goose-]

. I think a lot of people say that you become wealthy by investing your income(e.g. real estate) and starting various business ventures. I think it will be hard to become really wealthy by simply practicing medicine

True.

 

[Law2Doc]

. I think a lot of people say that you become wealthy by investing your income(e.g. real estate) and starting various business ventures. I think it will be hard to become really wealthy by simply practicing medicine

That's probably the right answer. Salaries have been flat and are expected to lose some ground before you graduate thanks to the insurance company stranglehold on the profession and the likelihood that the coming administration's (whoever it may be) healthcare package is likely going to adversely impact physician earnings. So if you can see how to make whatever savings you eventually have generate some income, you are on the right track. Don't expect to come out of residency into a wealthy lifestyle -- might happen, but it very well might not. You'll probably be getting a six digit salary but perhaps not the kind of income the prior generation got.

But you probably will earn enough to someday put 5 digits into a non-medicine investment. If you bet right, are smart about it, and get real lucky with the timing, you can be in good shape. The folks who invested at the start of the dotcom boom, for example, made a killing. Similar folks who invested the same amount a decade earlier or later made squat. So it takes some luck.

 

[deleted77919]

You'll probably be getting a six digit salary but perhaps not the kind of income the prior generation got.

This is especially true considering inflation/cost of living increases. Just remember every year physicians get a 0.5% medicare reimbursement rate increase that typically represents a 2.5% loss after inflation. $150,000/yr 20 years ago looks a lot better than $150,000/yr will in 10 years.

 

[Gabujabu]

If you are interested in such things, there are doctors who start companies, invent medical devices, consult, get involved with venture capital, serve on various boards, etc. Of course, it is quite difficult to do any of these things and some involve absolutely no patient care, but a number of people who were successful in each of those activities have spoken at my school at some point. We even had one professor disclose a list of companies he was involved in during a class lecture, and the list was quite long.

 

[mcgmaniac]

excellent..what kind of prof was he?

 

[wanabdoc]

I feel like I have heard 1000x "pick what you like"

Personally, I think this is some of the worst advice people give because ten years from now they don't want you coming back to them and saying "but you told me to become [insert xyz job here] and now I'm misirable. To be honest, I would be happy on a beach somewhere sipping a martini and getting a massage, but that is an uber competitive field to break into. Choose what you would be good at, what you can do everyday and not loathe (because no matter now much you like something, if it becomes your job, you won't like it as much anymore), and what rewards you for your investment adequately.

. I think a lot of people say that you become wealthy by investing your income(e.g. real estate) and starting various business ventures. I think it will be hard to become really wealthy by simply practicing medicine

It is also hard to become wealthy through any other profession (I know, I know, but look at the overall average MBA salary, average accountants salary, average dentists salary, not just cite so and so who struck gold). The rules of life haven't changed in 100s of years, a very few will do exceptional, a few will do well, and most will do average. If you are smart enough to be in medical school than you have the brains or motivation to at least do well.

 

[Cirrus83]

But you probably will earn enough to someday put 5 digits into a non-medicine investment. If you bet right, are smart about it, and get real lucky with the timing, you can be in good shape. The folks who invested at the start of the dotcom boom, for example, made a killing. Similar folks who invested the same amount a decade earlier or later made squat. So it takes some luck.

Yeah, if you really want to bank out, the great thing is that being a doctor means you can save up some money to invest. Well, assuming you don't blow all your spare money on cars anyway, lol.

 

[Bikini Princess]

Radiation oncology is fairly renumerative and also professionally rewarding. Some may be surprised to learn it is an expanding field as well.

 

[Hallm_7]

1. Don't live in the Northeast metros, don't live in California. These areas tend to offer less money for the same job and the cost of living is much higher than places like St Louis, Nashville, or Dallas.

2. Do something that you can completely forget about third party payers. Plastics, derm, and ophthalmology all can be designed to center around elective, cash procedures and patients. Emergency, internal med, and family can all be used to enter into similar practice styles (boutiques, urgent care centers, etc).

3. If you are a surgeon, operate a surgery center.

 

[rohan parwani]

hey why do u say we cant be rich in med field.?
in india were i come for everybody lines up for this field for getting rich

 

[Shredder]

radiology

 

[Coastie]

If you have good biz skills, a primary care practice can make you ALOT of money. This will become more lucrative as fewer docs go into it, and your competition is merely NP's and PA's. Can you say marketing? You'll end up providing better care to more people and making more in the end. Capitalism is a beautiful thing.

If you dont have that good of biz skills, go into something where you won't have to manage/build a physical practice: gas or rads...Of course, several med subspec pay well, in addition, ortho, rad onc, derm, ENT, neurosurg, path sub specs......

 

[civic4982]

consider being a specialist and working in a tertiary care center for a large rural population. big money.

also, as in most things, being a sharp entrepreneur will take you to your goal. many physicians invest into various ventures and do well.

 

[Doowai]

What or how much do you consider "a wad"?

A million, 10 million, any debt, ??????

 

[Doowai]

For some reason a friend of mine's story comes to mine. He was one of my high school classmates. An investor friend bought a small private jet that was all broken down. My high school friend repaired it. In essence one guy put up the capital to buy the wreck and my friend put in sweat equity. Then they sold it for like $4 million dollars, and split the profit. I am not sure how much it is, but my classmate with nothing more than a high school education and knowledge of mechanics and repair got about a million - this was back in 1998, so by now he may have drank the profits away.

 

[def jeff]

Want a lot of money? Read the "millionaire next door." Unfortunately it might not be the message you are looking for.

 

[Twitch]

What or how much do you consider "a wad"?

A million, 10 million, any debt, ??????

IMHO, income should be measured in $/hr.

There are fields that make a "wad" but you also spend a whole bunch of time trying to get it, hence the need to add another dimension.

Furthermore, the $/hr should designate w or w/o benefits (401k, etc).

Now given that, there are about 2000 working hours / yr assuming you work typical business hours 9-5 (or 8-5 if you count an hour off for lunch).

Just to play around with some #'s:

$100/hr as you can see barely just scratches $200k.

$250/hr gets you to half a mill.

Clearly if you're working twice as much (80hrs/wk) and raking in half a mil, your time is worth $125/hr.

On the question of debt. Depends on what type of financial instrument and rate is at play. Additionally if the debt provides a tax relief it's worth more to me.

I could go on...but better get back to studying for my neuro exam for now.

 

[Doowai]

Want a lot of money? Read the "millionaire next door." Unfortunately it might not be the message you are looking for.

IMHO, income should be measured in $/hr.

.

I guess much lik Jeff, I subscribe to the ideas of the millionaire next door. If you make $1000 per hour, but at the end of the year you can only write a check for $10,000 you don't have a wad. If you make $90,000 a year, but at the end of a 5 years you could write a check for $200,000 then you have a wad.

I would rather make more of course, but the real idea is playing a right defense with your money.

Are you a PAW - prodigious accumulator of wealth.

To me the ultimate in not having wad is pro athletes who get $10,000,000 contracts and 20 years later are broke.

Medical doctors are typically UAW - under accumulators of wealth.

To me a wad is having 10 million in assests and equity.

 

[Doowai]

In short:

If you make $500 and spend $500 you are broke

If you make $1000 and spent $1001 - you are in debt, and are a slave to someone until you pay your debt

If you make $100 and spend $50 - you have more of a wad than either of the first two

 

[DadofDr2B]

I know this will draw alot of fire but I have to do it. I realize medicine isnt the field to get into if you want to get wealthy. I am hoping for some real insight into the economic future of our field. I want to make as much money as possible in working with patients and enjoying medicine. What fields offer the most potential in earnings. I have heard GI, cards, retina, and cosmetic plastics all have big potential. So which ones allow you to really make some bank. Any perspective on how to do this while maintaining a non neurosurgical lifestyle would be nice?

before you throw off and tell me how stupid I am etc. etc. please hold off, I get it, I probably made the wrong choice to get into medicine but now I am pot comitted so to speak and don't want to get out. I think overall I will enjoy most fields with patient interaction in medicine so that part is covered, now I am just trying to figure out the money and lifestyle part"

See how a doctor used the insurance companies to bring him patients and then fired the insurance companies. Beautiful.

http://forums.studentdoctor.net/showthread.php?t=516190

 

[sasuke]

Depends on what you call a wad. For some people, $100k/year is enough. For others, they want $500k/year. From what I've seen (and my friends who are attendings now), you can make a lot of money but expect to work a ton of hours too. Basically, what I'm hearing from them now is that the money is good but they don't have time to spend it.

Of the few doctors I know of who made it big, they all did some sort of business venture, whether clinically related or not. One radiologist opened an imaging center with a few friends and he makes about $1 million a year. Another started an internet company related to health care several years ago. It now grosses $20 million a year. It seems like the big money is in industry and business, not in direct clinical practice. Be that as it may, its best to do what you love. Otherwise, in medicine, every day will be hell.

 

[isia]

One key to future happiness (financial and otherwise) as physicans lies in getting involved, speaking out and coming up with our own ideas about how things should be done. Physicans are more powerful than realized. Getting involved in the politics of everything that concerns us is critical, though.
I recently graduated with my MBA and have done some research on where the medical field is going. I understand that the trend of "concierge medicine" can be lucrative and less stressful once you start the business running. And don't let anyone tell you that there is no market demand for it. You can give back as well, by taking on a percentage of patients "pro bono" once you establish a paying patient base. There is an interesting general model described in the article below.
http://www.medscape.com/viewarticle/570378?src=mp&spon=21&uac=100352CZ

I feel that more lifestyle balance needs to be infused in the practice of medicine as well. And it starts with each individual physican becoming more aware of what path and action is right for them. More often than not, the squeeky wheels do get the grease$$.

Still, if you want to make millions$, you need to be creative and strategize into the business of medicine.

 

[DadofDr2B]

One key to future happiness (financial and otherwise) as physicans lies in getting involved, speaking out and coming up with our own ideas about how things should be done. Physicans are more powerful than realized. Getting involved in the politics of everything that concerns us is critical, though.
I recently graduated with my MBA and have done some research on where the medical field is going. I understand that the trend of "concierge medicine" can be lucrative and less stressful once you start the business running. And don't let anyone tell you that there is no market demand for it. You can give back as well, by taking on a percentage of patients "pro bono" once you establish a paying patient base. There is an interesting general model described in the article below.
http://www.medscape.com/viewarticle/570378?src=mp&spon=21&uac=100352CZ

I feel that more lifestyle balance needs to be infused in the practice of medicine as well. And it starts with each individual physican becoming more aware of what path and action is right for them. More often than not, the squeeky wheels do get the grease$$.

Still, if you want to make millions$, you need to be creative and strategize into the business of medicine.

Succession questions come to mind. How do you sell a nonprofit practice? What is its value?

 

[doc20]

the value will depend on the assets and the patient base, with increasing patient base there is also a increase in potential to turn it into for profit .

 

[DadofDr2B]

the value will depend on the assets and the patient base, with increasing patient base there is also a increase in potential to turn it into for profit .

What profit? This is a non profit practice. When you sell the non profit practice for a profit, the IRS will be interested again in taxing the operation from the beginning.

 

[Old_Mil]

Someone said "avoid California, and avoid the NE metros." This is more important than you could possibly imagine. The cost of living where you chose to set up practice is critical to your financial future. The FP who makes $150,000 in a midwestern town of 200,000 residents will own a very nice 2,500 square foot home for $300,000. The same house in a major metropolitan center would cost him 4x as much, and his salary wouldn't be anywhere near $600,000.

Pay a lot of attention to the tax structure of the state where you chose to practice. State taxes and other fees in California and the NE states are wretched. Texas has no state income tax but the property tax rates there more than make up for it.

The best thing you can do to secure your financial future is avoid debt and invest 20% of your income, month in and month out.

 

[doc20]

If you want to make big money, its not through a salaried job at a hospital or even owning a practice but instead its through smart investments and stock markets

 

[HMSBeagle]

If you want to make big money, its not through a salaried job at a hospital or even owning a practice but instead its through smart investments and stock markets

This is by far the smartest comment in this thread. Money in the bank will just sit there. You have to put it to work. Some say to start saving in residency but I don't know if that is realistic, and frankly I think it isn't.

 

[Sinfest]

As others have said, a lot of wealth can be found within investments.

A close friend of mines' father is a cardiologist and makes a pretty darn good living off of that alone(>$300k/year), but he makes a killing every year off of investing within new medical technology(can you say seven-figure salary?).

 

[carlosc1dbz]

I keep hearing things like business ventures in this thread. Can you guys give some examples of some of these "business ventures". I really think that investments are the only way to really get a wad, but you dont need to go into medicine to invest, so dont become a doctor just to get a wad, when you can get a wad other ways that dont take 7+ years.

 

[yohimbine1]

I keep hearing things like business ventures in this thread. Can you guys give some examples of some of these "business ventures". I really think that investments are the only way to really get a wad, but you dont need to go into medicine to invest, so dont become a doctor just to get a wad, when you can get a wad other ways that dont take 7+ years.

Startups. I will give you one example--the First Aid series

Regarding investing--you need money to make money. In fact the same applies to startups. Making money...is no easy feat.