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How would one make over $500K with the future health reform?

Discussion in 'Pre-Medical - MD' started by maxxpricey, Aug 16, 2011.

  1. maxxpricey

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    So I was talking to my friend today about medicine and the potential health care reform in general, he's interested in both medicine and IB, but advised me not to go into medicine since salaries will significantly be lower and that wouldn't be nice with $200K debt from med school. I told him I'm still considering it anyway, since I can't really see myself doing anything other than medicine, and definitely not IB.

    I remembered a previous conversation with a family medicine doctor with a private practice I shadowed saying that he made $600K including billing costs, overhead taxes etc. by doing some elective dermatology procedures and endoscopy aswell as the occasional OB. Seeing as he's already a senior doctor I can see how this is possible but then I thought with the future health reform, this can't be possible right? Plastic surgeons/dermatologists should be unaffected to also?

    Edit: It seems people are getting confused. I am not asking how I can get over $500K if I pursue medicine. I was just wondering if those high-paying salaries days will be over, out of interest, a discussion rather. Not a question for my own benefit.
     
    #1 maxxpricey, Aug 16, 2011
    Last edited: Aug 17, 2011
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  3. Whatyousay

    Whatyousay A few loose screws
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    Work somewhere that doesn't take Medicare or Medicaid?

    iunno.
     
  4. postbacpremed87

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    There is no sense worrying about something that hasn't fully been decided yet. This is destined for the Supreme Court.

    Anyways..even with any new implementation and lower physician salaries, going to medical school is still a winning proposition financially in the long run...you will make $2-3 million more in a life than your pharmacy buddies and $4-5 million more than people who do engineering.

     
  5. NickNaylor

    NickNaylor Thank You for Smoking
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    Unless some kind of truly extreme regulation comes into play, the best route to make money (if that's your primary concern) is to go into a specialty that is largely cash-based in a private setting. The most obvious fields are derm and plastics.
     
  6. Narmerguy

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    How did you decide that $500k is suddenly unattainable? How many doctors even make $500K today. There's no way for anyone to know this kind of stuff to be honest so there's no real sense in worrying yourself (unless this answer is critical to your decision to becoming a doctor).
     
  7. mishaS

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    If you really need to make tons of money more than anything else, then becoming a plastic surgeon, and only doing elective procedures is for you. Make sure to put your motivations into your personal statement btw, admissions really respects honesty.
     
  8. paul411

    paul411 ANES
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    :laugh::thumbup:
     
  9. raltima07

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    There will always be money in medicine; how much? I have no idea - I iz premed
     
  10. maxxpricey

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    It's not my main motivation, I was just wondering if this would ever be possible again. If it was, I'd get an MBA and go do IB or business.
     
  11. TheMightySmiter

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    Seems like anything over 500k a year is completely unnecessary, but what do I know. :rolleyes:


    I think the lucrative specialties where you own your own practice will still be lucrative--ortho, plastics, derm. You can choose not to accept Medicare patients if you don't want to.
     
  12. gettheleadout

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    So if you can't make $500k in medicine you want to do business instead? Is that what you're saying?
     
  13. maxxpricey

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    What? No. I'm saying that if money was my main priority in life, I would go do business or IB instead. But it's not, so I don't want to do them.
     
  14. gettheleadout

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    Oh, sorry, I read your "if it was" as referring to the money making being possible (and assumed you meant not, because that wouldn't make sense) instead of it being your main motivation.
     
  15. maxxpricey

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    It's alright, I guess that's my fault I didn't make it clear enough.
     
  16. gettheleadout

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    Nah don't worry about it. Anyway, don't worry about this whole issue either. Picking an arbitrary amount like $500k (or any amount, really) and asking anyone if doctor's will be able to make that much in the future isn't much better than asking a magic 8-ball. Even if it's not your prime motivation, reimbursement is something to consider when taking on massive debt, so it's good to give some thought to the issue. If you're already $150k in debt from undergrad and have thousands in credit card debt, it can be handy to know you need to prefer cheaper schools for medical school and apply as such.
     
  17. CeltSoxDoc

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    I would be careful about saying stuff like this. If you really want to be a physician, money should not be a motivating factor so do not concern yourself over it. There is a reason you put all this time into an education as well invest so many resources into your future as a physician. Most likely if you are bright enough to go to medical school, you can likely compete proficiently in top-notch fields of business such as investment banking, consulting, equity-trading etc... The reason you apply this knowledge and invest this time into medicine is because you are not motivated by avarice, but by looking beyond that salary and applying your immense intelligence and talent to such an impacting, humanitarian field as medicine.

    To answer your question though, yes, depending on what type of physician you are, your salary will likely fall by about 20-25% depending on a variety of factors. To be honest though, if you are making 400,000 dollars a year as an interventional cardiologist seeing that fall to even 300,000 is not exactly anything to frown upon. You will be better off than 98% of Americans, and you will be compensated richly for all of the hard work you put in to become a doctor. Again though, money should not be a motivating factor, you must ultimately realize why and who you are doing this for.

    There will still be avenues for you to vastly increase your income as a physician. Depending on the sub-speciality, insurance plans you accept, patient populations and location of your practice, number of privately owned and run clinics (avoiding hospital or group practice revenue-sharing/premiums) you will easily be able to attain income far-exceding 500,000 dollars a year. A lot of physicians with business sense also invest in or own side businesses outside of their practice which generates additional income.

    Financially physicians will never be struggling, and there are plenty of ways to increase revenue if that is the path you choose (as long as you arent sacrificing morals or the quality of care your patients receive). Do not let money motivate you though, that is one of the worst mindsets to maintain as you enter into this wonderful field.
     
  18. NickNaylor

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    While I would agree that $300k is still a pretty significant amount of money, if that drop were to happen suddenly to currently practicing physicians their lives would be significantly impacted.
     
  19. 0919mmk

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    In the year 2000, doctors will make $2.4 million a year. Adjusted for inflation, that will be equivalent to the salary of a good pole dancer today.
     
  20. gettheleadout

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    Who are you to say that? How do you know if a particular interventional cards doc feels he would be as adequately compensated for his work at $300k instead of $400k? Putting a value on someone else's time and labor is making a claim that is extremely hard to support.

    As Nick said, people adjust their lifestyle to their income. Cutting someone's salary by 25% pre-tax is a huge change.
     
  21. CodeBlu

    CodeBlu Dream Weaver
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    I can't imagine how many docs would just stop seeing medicare and medicaid patients and start pursuing other avenues of income, whether that be medical consulting etc.
     
  22. Long Way to Go

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    I hate to break it to you buddy, but Y2K didn't actually happen.
     
  23. 0919mmk

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    There was no year 2000? Crap - then I'm 25 not 26!!

    Obviously not on team Coco. It's ok, you will learn the ways.
     
  24. Narmerguy

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    That's true but also a very different argument. Whether the pay drop is gradual or sudden, most people have more of a problem with having a cut at all. That battle must be resolved before worrying about how the cut should be implemented.

    More importantly, the conjecture of pays falling from $400,000 to $300,000 is not worth debating since there was no basis for the numbers that poster gave. None of us have any clue how large of a paycut various specialties will take. I don't imagine it'll be even across the board.
     
  25. CeltSoxDoc

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    Agreed. People definitely do adjust their lifestyles to their income, but this is retrospective, we can all calm down. These are all fictional numbers used to create an example, it is not the gospel. I am saying that as physicians we will still be better off than a significant portion of fellow americans even if a salary goes down 20% 400,000-> 320,000. Trust me, I know a handful of cardiologists who are going to be feeling this effect in November when it kicks in and they are not worried. They will have to cut back on a vacation and will wait another year to buy that new flat screen TV, but we would sound pathetic to cry and complain about this when most americans dont have this luxury. So please don't worry about how we are not going to be adequately compensated, doctors always will be adequately compensated and that should not change. Health care reform will eliminate some of the unnecessary costs doctors face also, research it before you protest on behalf of it. The best doctors I have worked with are the ones who volunteer their time and labor at no cost just because they know what they are doing is right. I am saying that as a physician if you are motivated to help people first and foremost, there is a good chance that you wont mind buying that smaller lexus instead of the mercedes down the line because your salary dropped by 80,000 dollars. I am happy to have the opportunity to be a physician, and while I am not advocating that doctors should take a discount and be inappropriately compensated for their efforts, I also believe that it is ludicrous to complain about pay cuts to a current slight exorbitant compensation also. Again, this is not universal for every sub-speciality it is just an example.
     
    #24 CeltSoxDoc, Aug 16, 2011
    Last edited: Aug 16, 2011
  26. postbacpremed87

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    You do not know this. It is unsubstantiated and patently false. No one knows how big cuts will be. Some specialties will more than likely see cuts, but to say WILL be 250k instead of 400k is just WRONG.:caution:

    To speak about things with such certainty is arrogant and misguided.
     
  27. sustentacular

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    You can always be one of those doctors who gets paid a lot to testify against other doctors in malpractice suits.
     
  28. tn4596

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    waht you need 500k for... lol? women?
     
  29. vin5cent0

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    I always hate this argument. "If I was interested in money, I would go into [insert potentially lucrative field here] and not medicine".

    That's all fine and dandy, but I think people forget the one crucial thing about medicine - It's a guaranteed six figure salary, no question. How many of you actually think you could actually hack a $250,000 salary in the business world? I doubt many on here. My dad is what I would call a successful businessman and does well for himself, but he earns what is probably an average salary between medical specialties.

    People often lose perspective when dealing with money. If you go into medicine, you will more than likely make more money than you would in any other profession. Sure, with an MBA the amount of money you could make probably far exceeds what you could as a doctor, but those guys are far and few between. If you think you can make more in business, then by all means, take that route. My guess is that you'll probably earn ~80 grand for the rest of your life while you could've comfortably earned 3x that amount as a physician.

    And, while I'm on my soapbox.. I think some people on here don't realize how much a $200,000 salary is. People always seem to think they need $500,000+. If you're earning $200,000/year, you can live a very comfortable life with a fairly large family, far above the average family, if you aren't a ditz with money. So, don't worry about the future of reimbursements. Yeah, they might and probably will go down, but they will never go down so far as to make medicine not worthwhile. The truth is that most of us on here, me included, could probably never earn a salary as high as a physician's in another sort of career (barring other medical careers).
     
  30. gettheleadout

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    I agree with this.
    You can live very comfortably on half of that.
     
  31. Noam Chomsky

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    Money should not be a motivating factor? Please get real..
     
  32. NickNaylor

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    Not the motivating factor. I don't think that anyone is arguing that it shouldn't be a motivating factor.
     
  33. ElCapone

    ElCapone Don't Lawyer Me
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    Although I haven't started undergrad yet and fully understand that I may change my mind later on about going into medicine, I echo this sentiment. Money shouldn't be the main motivator, but at the end of the day, we want to be paid.
     
  34. ponyo

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    Considering how most of my business peers have starting salaries $60k-80k, and I don't think any of them are wildly more competent than I am, I feel like it's pretty unlikely that I would earn $80k for the rest of my life if I switched to business...

    Yes, we have to put things into perspective. But perspective means that we have to evaluate ourselves against other people of comparable abilities and drive, and most of us are just not median-salary-earners, at least not in highly populated fields.

    Personally, I am crossing my fingers and hoping that I will be psychologically compensated despite being left behind in the income race. But if that kind of abstract, ephemeral, somewhat egotistical sense of self-satisfaction wasn't worth an extra couple hundred k's a year, I'd get the hell out.
     
  35. Narmerguy

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    Being successful in business requires skills that can be wildly different from what we need to succeed. Simply because we seem competent, intelligent, and competitive for what we're shooting at doesn't mean we could have the same success in business. It's a totally different game.

    Perhaps for the superstars that are smart, well connected, you can reasonably say they'd excel at business. But so many physicians and premeds struggle at things that the business community thrives on.
     
  36. BionicMan

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    Accept cash payments only, then be the very best. People tired of waiting in lines for foreign doctors they don't want to see will be more than happy to pay. Something like this occurred in Canada and was very successful before their socialist government shut it down.
     
  37. Lunasly

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    Forget it... :p
     
  38. postbacpremed87

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    On that note I am going to bed. I swear the things I read on SDN these days...

     
  39. postbacpremed87

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    You changed it before I got a chance to respond to it appropriately...probably a good call

     
  40. maxxpricey

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    I didn't say I want over $500K, I was just wondering if with the future health reform if those days will be over. Out of interest.
     
  41. maxxpricey

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    Forget what?
     
  42. TheMightySmiter

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    Well, I think most people aspire to get a job where they can live comfortably and support a family. So, yes, money can be a motivating factor and there's nothing wrong with that. If doctors made 30k a year, I probably would not go into medicine, because it wouldn't be worth it even if I loved the job. But if money is your only motivation for going into medicine, you will probably be miserable.
     
  43. vin5cent0

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    Eh.. BS. You don't walk out of school and earn 80k/year with a business degree unless you landed a VERY lucky job or have great skills/connections.

    As I said, the average person who could make 300k/year as a doctor would probably never make half of that as a businessman/woman. Again, medicine may not pay extremely well, but it enables many of us to earn 6 figures, something we probably couldn't do without. And if we could, it wouldn't be until later in life. Believe it or not, most people don't start making 6 figures early in their career. A doctor earns 6 figures the moment he's done training. If you think I'm wrong, go into business. Don't come crying when you're earning a quarter of what a physician is, though.
     
  44. TheMightySmiter

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    I think people tend to assume that working on Wall Street is the norm when you've majored in business. This is totally false. It is REALLY tough to get an entry level job on Wall Street. You nearly always need to either a) have connections, b) have interned for a major finance corporation, or c) preferably both. Most business and finance grads are probably making average 40-50k starting salary, and that's if they're from a good business school.
     
  45. Narmerguy

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    Don't forget how important name brand for your college is. They eat up those Ivy's like hotcakes so there's not many spots left.
     
  46. ponyo

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    Sorry for the confusion, but I counted signing bonuses, so we're looking at more like 60+10, 70+10, 65+15, that kind of thing, which are DEFINITELY not limited to Wall St. (I just figured why not, since it's so up or out.) Regardless, my point wasn't that working on Wall St. or in firms with comparable compensation is the norm. It's not. But I don't think I'm supposed to go immediately to the median starting salary whenever I evaluate the compensation level of a field, but rather consider the level at which people similar to me are placed, and that means the level of most of my friends. I'm not trying to minimise what they do, but I certainly don't think it's drastically harder than what we do.

    Having an SO in the field also kind of takes the glamour away from it :p

    Lastly, sorry if I'm wrong, but don't you go into entry-level jobs after undergrad? I always had this impression that you're supposed to work for 2 years then either pay for your own MBA or get your firm to pay for it in exchange for leaving later.
     
  47. maxxpricey

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    I have good business skills, I established 2 successful businesses by the age of 13. A lot of people told me I was "born for business" or a "Business orientated' person. I think that if I worked hard enough I could do quite well in the business field, but that's not the lifestyle I want. Plus a bunch of other reasons. You really can't "assume"/"guess" what would happen to people if they took the business route when you know nothing about them, esp. their business background.
     
  48. paul411

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    What kind of businesses?
     
  49. NickNaylor

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    Landscaping + lemonade stand.
     
  50. maxxpricey

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    Graphic design (inc. programming) & skateboarding/surfing/skiing equipment.
     
  51. paul411

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    And what happened to them?
     

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