Is anyone else worried about scary debt levels and declining reimbursements?

[HughMyron]

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Lol, that's hilarious for a variety of reasons (e.g., not just white people live in rural areas).

Heh, I guess I might be colored by perceptions of my home state, where the only people in rural areas are white. I can't tell which state it is because of identification hazard, but it's one of the WICHE.

 

[Doudline]

And that's AFTER living with my parents for several extra years, eating cheap (I mean one meal a day--and something cheap like subway--sort of cheap) and taking public transit rather than having my own car.

You could get three good meals a day for the price of a single Subway submarine, if you knew how to manage your money.
Just sayin'.

 

[Law2Doc]

Yes, but the specialties that are on the low end of the average are usually PCPs and have far more opportunities for loan forgiveness programs.

Also, those averages include academic physicians which are paid less and bring down the average.

Not saying you are wrong for being conservative and planning for the worst, but there are a lot of factors that influence earning potential that are well within a persons control. Expecting to be within a SD of the average is perfectly reasonable so long as you dont choose a specialty known to pay less. If you are interested in peds, you should be going to a cheap school to begin with and taking advantage of loan forgiveness programs.

My point is you won't know what you like until you are in your third year of med school and tried on a few things for size. By then it's too late to decide you should be in a "cheap school". Expecting to be within one standard deviation of an average that includes some very lucrative specialties which pull up the average is not a reasonable starting assumption. "Academic" jobs in ortho and plastics are still pulling up the average for many fields, so you can't really take the view that academics as a group pulls down the average -- these just group tighter around the average but the distribution is similar. Again, you have to be more conservative in your calculations because frankly there is a decent chance you are going to like a less lucrative field best and from that point a 50% chance you will be below average. Use something like $130k in your calculations. A one SD spread from $200k puts about half the people into the world of bad planning.

 

[deleted393595]

Lol, that's hilarious for a variety of reasons (e.g., not just white people live in rural areas).

Sadly enough, what he was describing is true for some parts Central Texas. Don't know though if they'd perceive minorities differently if they were physicians.

 

[MedPR]

Yeah, I mean, I have some reservations about working in rural places because I'm not white and I would rather not have to deal with intolerant rednecks for part of my life, but it's option I would prefer to the military.

Yea because all rural areas are populated by "intolerant rednecks". Racism and bigotry goes both ways Bro.

Sent from my SGH-T999 using SDN Mobile

 

[HughMyron]

Yea because all rural areas are populated by "intolerant rednecks". Racism and bigotry goes both ways Bro.

Sent from my SGH-T999 using SDN Mobile

I was tempted to post an equally snarky response, but I won't rise to your bait. I hope that, as a student admitted this cycle, you are intelligent enough to recognize hyperbole when you see it.

 

[MedPR]

I was tempted to post an equally snarky response, but I won't rise to your bait. I hope that, as a student admitted this cycle, you are intelligent enough to recognize hyperbole when you see it.

I'm equally capable of recognizing when someone realizes they made a dumb comment then tries to cover it up with "haha I was jk. relax".

 

[HughMyron]

I'm equally capable of recognizing when someone realizes they made a dumb comment then tries to cover it up with "haha I was jk. relax".

I wasn't kidding though lol.


I don't think everyone in rural America is a card-carrying KKK member.

But I also expect that if I, as a minority physician, go to rural America, I will be treated with distrust and intolerance.

 

[deleted393595]

But I also expect that if I, as a minority physician, go to rural America, I will be treated with distrust and intolerance.

No...

 

[FSU2013]

But I also expect that if I, as a minority physician, go to rural America, I will be treated with distrust and intolerance.

if you're looking for it, you'll find it. But if you go to a community as a physician with the intent to help the community, you'll find that small town folks (or rednecks as you'd like to call them/most of my family) are the backbone of the country. I can't imagine a town without an MD being anything but welcoming to a doc who wants to come and be part of the community because he or she is black/Indian/Asian/whatever.

 

[notbobtrustme]

if you're looking for it, you'll find it. But if you go to a community as a physician with the intent to help the community, you'll find that small town folks (or rednecks as you'd like to call them/most of my family) are the backbone of the country. I can't imagine a town without an MD being anything but welcoming to a doc who wants to come and be part of the community because he or she is black/Indian/Asian/whatever.

Actually, the backbone of the country is made up of major city centers, which account for between 70-90% of the country's GDP.

Rural locales have been in decline for the last 100 years and will continue to decline as opportunistic continue to dry up.

 

[Silent Cool]

While the " average physician" may make 200k, that averages all the specialties together. There are a Lot of physicians who are below that average. Eg the average for pediatrics in the recent Medscape survey was below $150k. Since you don't really know what field you are going to like going in, and since you don't know if you will be paid the average (half of you won't) your blanket statement is faulty. You need to take a more conservative approach and assume a salary below average for a below average specialty. So assume $130k and you will be safer. You may end up average, or even above average in a lucrative field, and all this will be moot, but that's not the assumption you want to bank on.

Law2Doc is correct--unfortunately. Who the F*** goes to medical school to make 130K? Likewise, why the F*** should students be graduating now (or in the near future) with debt loads at $500K+? That is absurd. It's also why I am thinking of quitting. CRNAs and many advanced practices nurses--hell, PA's, too--make in the ballpark mentioned above.

As I have mentioned in other threads, the inflated tuition--just like the mortgage bubble--is directly because of government intervention. Get the government out of education, housing, and healthcare. The amount of debt that people have is heading all of us to a giant clusterf***.

Needless to say, DO NOT go into pediatrics. I can't imagine anyone in his or her right mind choosing primary care with the amount of debt that people have coming out now. It's absurd and wrong.


https://www.youtube.com/watch?v=1b8nN5nPAyE

Choose your school and your profession wisely.

 

[kyamh]

Another point....even if you only make $130k a year, consider the first few years after residency. You suddenly go from making $40k to $130k....an increase of $90k If you suck it up for a few years and put $60k of that surplus directly into loans, you will pay then off really quickly. The best part is that you are used to living cheaply so spending $70k a year instead of $40k will feel nice.

 

[yehhhboiii]

Another point....even if you only make $130k a year, consider the first few years after residency. You suddenly go from making $40k to $130k....an increase of $90k If you suck it up for a few years and put $60k of that surplus directly into loans, you will pay then off really quickly. The best part is that you are used to living cheaply so spending $70k a year instead of $40k will feel nice.

yeah no, you have no idea what you're talking about

 

[kyamh]

yeah no, you have no idea what you're talking about

Uh, I do - my guardian completed medical training when I was in high school. I went from living on her $40k resident salary to just slightly more to help pay off loans. She payed off all her student loans in just under 4 years.

 

[occams_razor]

you will most likely not have close to 400k in medical school debt. and even if you have 400k in debt, a 200k salary is still VERY substantial. there are people with 150k in debt making less than 50 k a year.

yep I have a few friends who graduated from law school and are in the boat right now (making in the 50s with 150-200k in debt just from law school).

OP, if you can get into a state med school you will be in good shape financially, considering you have no debt from undergrad. consider yourself lucky, I know people at private med schools who are paying 100% with loans and they do have considerable undergrad debt or debt from masters or post-bacc programs

 

[StephanieZ]

yeah no, you have no idea what you're talking about

Why does kyamh have no idea what he/she is talking about? Please explain. It sounds like a perfectly reasonable option.

 

[peltier]

Carrying a huge debt burden after medical school will hang you. Period. After all the MCATs, Board scores, residency, etc., you become a physician and practice, and then you realize it is a job that earns a respectable amount BUT not an astronomical amount. You have overhead, malpractice, taxes, your own health insurance, etc. Plus a mortgage, retirement etc......getting the picture yet? That 250k salary gets swallowed up really fast....add a 1500.00 per month student loan payment ON TOP of all of this and you can see why some physicians actually end up living paycheck to paycheck....

 

[StephanieZ]

Carrying a huge debt burden after medical school will hang you. Period. After all the MCATs, Board scores, residency, etc., you become a physician and practice, and then you realize it is a job that earns a respectable amount BUT not an astronomical amount. You have overhead, malpractice, taxes, your own health insurance, etc. Plus a mortgage, retirement etc......getting the picture yet? That 250k salary gets swallowed up really fast....add a 1500.00 per month student loan payment ON TOP of all of this and you can see why some physicians actually end up living paycheck to paycheck....

No, I really don't see that. No overhead unless you have your own business, subtract malpractice and taxes from your take home pay and it is still alot more than most people live on. Doctors aren't the only ones with mortages and retirements to pay for. If you are making six figures and living paycheck to paycheck, you need to adjust your lifestyle, not cry broke.

 

[yehhhboiii]

Uh, I do - my guardian completed medical training when I was in high school. I went from living on her $40k resident salary to just slightly more to help pay off loans. She payed off all her student loans in just under 4 years.

no you don't. you know someone who has relevant experience. you yourself have none
it's similar to when premeds give advice about medical school and say they have experience because they have friends in medical school. it's hearsay and second hand information which is not useful

having a salary jump from 40k to 130k means that you can now spend 60k on loans and 70k on yourself? that's not how it works

 

[wholeheartedly]

Why does kyamh have no idea what he/she is talking about? Please explain. It sounds like a perfectly reasonable option.

You have to factor in taxes as well.

 

[circulus vitios]

Carrying a huge debt burden after medical school will hang you. Period. After all the MCATs, Board scores, residency, etc., you become a physician and practice, and then you realize it is a job that earns a respectable amount BUT not an astronomical amount. You have overhead, malpractice, taxes, your own health insurance, etc. Plus a mortgage, retirement etc......getting the picture yet? That 250k salary gets swallowed up really fast....add a 1500.00 per month student loan payment ON TOP of all of this and you can see why some physicians actually end up living paycheck to paycheck....

If you scale your living expenses with your income, you live pay check to pay check? You've made an unintuitive and amazing discovery, peltier.

 

[peltier]

If you read my original post, you will find that I didn't say I lived paycheck to paycheck, but I know physicians who do...and they are not in the specialties and they live in urban areas on the coasts. What I am telling you is that 250k, AFTER all the taxes, saving for retirement, cost of home, life, disability, malpractice and health insurance plus social security and medicare taxes, a mortgage...etc. leaves most physicians with a lot less than you think. So if you want to pile up debt in medical school and then become a pediatrician or family doc, your salary might get to 180k. ADD a student loan payment of 1,300-1,800/month on TOP of all of what I just mentioned and add in the cost of raising a family, and guess what, you are now a middle class citizen....I make about 400k/year, take one vacation/year drive a 7 year old used car and don't live paycheck to paycheck...but I was also fortunate to pick a specialty that pays well.

My advice to all the medical students I have on my rotations is that they graduate with as little debt as possible. Current medical students are paying three times what I paid to go to school just 16 years ago.

 

[peltier]

You kids better get educated really quickly. In private practice, I own my own business. I am a partner with 80 other physicians and we own an office with a staff of 40. My overhead is roughly 15% of gross earnings, which amounts to 60k. My taxes are in the neighborhood of 90k. You still think by eating Top Ramen I will make a dent in this? I have already lost 150k and can't even begin to make a dent in changing this. Medical schools do a horrible job in educating young doctors about becoming a partner in a business or running his or her own practice, but since private guys like me are becoming dinosaurs anyway, it doesn't matter. Most physicians are becoming employees, so a lot of you won't have to worry about the same things I currently do. Which is one of the reasons I am concerned when a medical student graduates with 300-500k in debt. It will cripple you....

 

[occams_razor]

You kids better get educated really quickly. In private practice, I own my own business. I am a partner with 80 other physicians and we own an office with a staff of 40. My overhead is roughly 15% of gross earnings, which amounts to 60k. My taxes are in the neighborhood of 90k. You still think by eating Top Ramen I will make a dent in this? I have already lost 150k and can't even begin to make a dent in changing this. Medical schools do a horrible job in educating young doctors about becoming a partner in a business or running his or her own practice, but since private guys like me are becoming dinosaurs anyway, it doesn't matter. Most physicians are becoming employees, so a lot of you won't have to worry about the same things I currently do. Which is one of the reasons I am concerned when a medical student graduates with 300-500k in debt. It will cripple you....

300k is just about what it costs for 4 years at a private med school though. many people can only afford to go to med school using loans. even Ben Bernanke's son has 400k in med school debt.

"The median four-year cost to attend medical school -- which includes outlays like living expenses and books -- for the class of 2013 is $278,455 at private schools and $207,868 at public ones"

source: http://www.bloomberg.com/news/2013-...000-means-even-bernanke-son-carries-debt.html

 

[peltier]

300k is just about what it costs for 4 years at a private med school though. many people can only afford to go to med school using loans. even Ben Bernanke’s son has 400k in med school debt.

"The median four-year cost to attend medical school -- which includes outlays like living expenses and books -- for the class of 2013 is $278,455 at private schools and $207,868 at public ones"

source: http://www.bloomberg.com/news/2013-...000-means-even-bernanke-son-carries-debt.html

The sad truth is it is becoming cost prohibitive to attend....

 

[jombojuice22]

having a salary jump from 40k to 130k means that you can now spend 60k on loans and 70k on yourself? that's not how it works

You have to factor in taxes as well.

I still don't understand...

Our 40k salary resident is going to end up with ~30k take home pay. If I haven't done the calculations wrong, our 130k attending should be ending up with ~85k after Uncle Sam has had his way with him. Put 30k of that towards cost of living, 55k for loans... Assuming 300k loans at 8% interest, we have it paid off in about 7 years. I suppose after 4 years of being a poor med student and 3-4 years of being an overworked / underpaid resident, it would kinda make you wish you went to PA school if you had to spend another 7 years afterwards living on ramen noodles.

However, 30k/year in post tax dollars is a pretty darn comfortable living for a single person with no dependents. At least by most people's standards it is. But I suppose a lot of this goes out the window if you're trying to support a non-working spouse, 2 kids, a house and 2 cars. In that case, hope you went into a well-paying specialty...

If we give our hypothetical doctor 300k of debt and a 170k pre-tax salary (~100k post tax?), he gets the loans paid off in ~5 years assuming 30k post-tax dollars go to cost of living and 70k go to paying off debt.

Am I missing something? It's tough to get the loans paid off and getting tougher, but it still seems very possible to get it done quickly as long as you avoid the golden handcuffs for a few years post-residency.

 

[TheWeeIceMan]

I still don't understand...

Our 40k salary resident is going to end up with ~30k take home pay. If I haven't done the calculations wrong, our 130k attending should be ending up with ~85k after Uncle Sam has had his way with him. Put 30k of that towards cost of living, 55k for loans... Assuming 300k loans at 8% interest, we have it paid off in about 7 years. I suppose after 4 years of being a poor med student and 3-4 years of being an overworked / underpaid resident, it would kinda make you wish you went to PA school if you had to spend another 7 years afterwards living on ramen noodles.

However, 30k/year in post tax dollars is a pretty darn comfortable living for a single person with no dependents. At least by most people's standards it is. But I suppose a lot of this goes out the window if you're trying to support a non-working spouse, 2 kids, a house and 2 cars. In that case, hope you went into a well-paying specialty...

If we give our hypothetical doctor 300k of debt and a 170k pre-tax salary (~100k post tax?), he gets the loans paid off in ~5 years assuming 30k post-tax dollars go to cost of living and 70k go to paying off debt.

Am I missing something? It's tough to get the loans paid off and getting tougher, but it still seems very possible to get it done quickly as long as you avoid the golden handcuffs for a few years post-residency.

I mean sure, it's possible to make that happen. However, post-residency, you are probably looking at being 30 years old at absolute minimum. If you go the route you laid out, you pretty much have to delay a house, kids, vacation, retirement planning, new vehicle, etc. until you are in your mid-30s at the very earliest. From what I've heard, this is considerably harder than it sounds.

Also, when you are an attending, there are certain expenses that make living on 30k post tax more difficult than for the average person.

 

[StephanieZ]

having a salary jump from 40k to 130k means that you can now spend 60k on loans and 70k on yourself? that's not how it works

You keep saying that's not how it works, but you don't care to explain why, even though I've asked. If someone wants to do that and they have the discipline to keep living on a resident's salary, how is that "not how it works"?

You have to factor in taxes as well.

Even factoring in taxes, most doctors will stay make more than most americans. Also, this is besides the point. Kyamh's suggestion was to keep living on a residents salary after residency and use the surplus to pay off loans. Unless your salary after factoring in taxes leaves you with around 40k and no surplus, kyamh's point still stands.

What I am telling you is that 250k, AFTER all the taxes, saving for retirement, cost of home, life, disability, malpractice and health insurance plus social security and medicare taxes, a mortgage...etc. leaves most physicians with a lot less than you think. So if you want to pile up debt in medical school and then become a pediatrician or family doc, your salary might get to 180k. ADD a student loan payment of 1,300-1,800/month on TOP of all of what I just mentioned and add in the cost of raising a family, and guess what, you are now a middle class citizen

And what I said was even after factoring in taxes and malpractice, most physicians make more than most americans. Savings for retirement, mortage, disability, health insurance, cost of raising a family, etc. does not factor in because most middle class americans have those expenses as well and manage to do alright no less than what a doctor makes. If you live a middle class, 40k lifestyle on a doctor's salary, you will end up with surplus, even after taxes and malpractice (which are the only expenses out of the ones you've listed that are exclusive to physicians).

I mean sure, it's possible to make that happen. However, post-residency, you are probably looking at being 30 years old at absolute minimum. If you go the route you laid out, you pretty much have to delay a house, kids, vacation, retirement planning, new vehicle, etc. until you are in your mid-30s at the very earliest. From what I've heard, this is considerably harder than it sounds.

But the point is that it's possible. If one is disciplined and good at delayed gratification, it's possible. It doesn't "not work that way" just because that's not how you chose to do it. I imagine it is very hard to delay the gratification of a large salary but to say that anyone who suggests it simply doesn't know what they are talking about (not saying that you said this) is really narrow-minded. I don't think one needs a degree in finance to realize that if your take home pay is A and you manage to live on B, and A - B = C, than C is surplus and could potentially be put towards loans.

Also, when you are an attending, there are certain expenses that make living on 30k post tax more difficult than for the average person.

Such as? And whatever those expenses are, subtract that from your pay when you count take-home pay. Again, unless your take home pay ends up being 40k after all expenses, if you live on 40k, you will have surplus.

 

[Frazier]

I still don't understand...

Our 40k salary resident is going to end up with ~30k take home pay. If I haven't done the calculations wrong, our 130k attending should be ending up with ~85k after Uncle Sam has had his way with him. Put 30k of that towards cost of living, 55k for loans... Assuming 300k loans at 8% interest, we have it paid off in about 7 years. I suppose after 4 years of being a poor med student and 3-4 years of being an overworked / underpaid resident, it would kinda make you wish you went to PA school if you had to spend another 7 years afterwards living on ramen noodles.

However, 30k/year in post tax dollars is a pretty darn comfortable living for a single person with no dependents. At least by most people's standards it is. But I suppose a lot of this goes out the window if you're trying to support a non-working spouse, 2 kids, a house and 2 cars. In that case, hope you went into a well-paying specialty...

If we give our hypothetical doctor 300k of debt and a 170k pre-tax salary (~100k post tax?), he gets the loans paid off in ~5 years assuming 30k post-tax dollars go to cost of living and 70k go to paying off debt.

Am I missing something? It's tough to get the loans paid off and getting tougher, but it still seems very possible to get it done quickly as long as you avoid the golden handcuffs for a few years post-residency.

You kind of touched on it, but not nearly emphasized it enough.

Living on 30k for 7 years... post-residency... sounds like an awful idea that only pre-meds would consider.

Also, the crusader that will come in and say "30k ain't bad! I could live well on 30k. My single mother raised me and my 8 sisters on only 15k, a mechanical pencil (without lead), and some belly button lint!!!1!1!"

Save it.

No one wants to go through pre-med, med school, internship, and residency...just to go another 7 years after that living on 30k per year.

 

[StephanieZ]

No one wants to go through pre-med, med school, internship, and residency...just ti go another 7 years living on 30k per year.

Awesome, that's their prerogative. But it's not about what is and is not possible as much as it is about what people do and do not want to do.

 

[Beargryllz]

Do the people posting here not know what the median household income is in America? Do we not realize that most working adults are also paying taxes, a mortgage, electric bills, etc.?

 

[Frazier]

Awesome, that's their prerogative. But it's not about what is and is not possible as much as it is about what people do and do not want to do.

What is the point of your debate then?

If you want to talk about "well, what are the possibilities?"

...Get a bunch of roommates and live off of 10k per year post-residency; you can pay off that debt even faster!

 

[Frazier]

Do the people posting here not know what the median household income is in America? Do we not realize that most working adults are also paying taxes, a mortgage, electric bills, etc.?

How far along in the process are you?

 

[StephanieZ]

What is the point of your debate then?

My debate was more directed at yehhhboiii's comment that the suggestion made by kyamh was simply "not how it works", yet failure to offer valid reasons for why. There is a tendency to dismiss premed opinions and views without actually disproving them simply because "You're premed, you don't know what you are talking about." That's very dismissive and doesn't actually further debate. My main point is that an increase in income does not necessarily have to come with a significant upgrade in lifestyle. My mom taught me fiscal responsibility my whole life and somehow I don't think it's a silly idea I'm going to grow out of once I have an MD after my name.

 

[notbobtrustme]

The median income for all of the USA is 49k/year gross. If you can't make 150k gross work, then you're the one with the problem, not the system.

 

[circulus vitios]

Bottom line is that you're dumb if: you go to an expensive school, match into FM, then get a job at a hospital/group that doesn't offer student loan repayment.

If you match into a specialty that pays $250k/year or more, you should have no trouble paying off ridiculous amounts of student loans. $250k/year is about $155k/year take home. Figure $55k/year post-tax living expenses -- mortgage payment for an apartment or small house, used car payment, retirement contributions, etc. -- and put the remaining $100k/year toward student loans. If you think living on $55k/year post-tax is torturous, which is equivalent to like $75k/year pre-tax income, then keep it mind that it's only for a few years while you pay down your student loans.

 

[peltier]

Ok. Let's say you make 250k. You have to pay for these items ALL of them if you are intelligent:

Malpractice insurance. not an option
Life insurance.
Car insurance. not an option.
Health insurance. not an option.
Disability insurance...optional but you are a ***** if you don't get one.

Taxes both state and federal
Medicare taxes.
Now, retirement, saving for your kids college, a mortgage and then homeowners insurance, etc.

Yes. You can live well IF and only IF you don't want a family. If you don't want kids and the spouse and the house, you will be fine, BUT, few docs I know are single, and most end up with the kids, spouse and house....just saying....so after all that spending, you are not left with as much discretionary money as you think.

I pay 14,500/year health. 20,000 malpractice. 3,500/year life, 6,000/year disability.
90,000 in taxes between state and feds....now let's do the math...plus I squirrel away 40k/year retirement....I have just spent 134,000 and I haven't included my mortgage OR OVERHEAD cuz I am in private practice.....

when you get done, it will ASTOUND you how much money flies out in OVERHEAD, TAXES and INSURANCE.....

 

[peltier]

I forgot to add the 40 k for retirement.....BINGO. What does it add up to? 174k....WOW....

 

[jombojuice22]

You keep saying that's not how it works, but you don't care to explain why, even though I've asked. If someone wants to do that and they have the discipline to keep living on a resident's salary, how is that "not how it works"?

I think the reason your post kind of outraged some people is that the guy you quoted ignored taxes, which take out a huge chunk of money. When you go from 40k to 130k salary, what really happens is that you go from ~30k to ~85k take-home pay. A big increase to be sure, and yes you'll be living more comfortably than the average American, but it's only about half as big of an increase as the $90k kyamh thought it was.

Do the people posting here not know what the median household income is in America? Do we not realize that most working adults are also paying taxes, a mortgage, electric bills, etc.?

In 2010, ~20% of American households earned >100k. Of course, most of those households had two earners. Only ~6% of individuals had 6 figure income, so even a physician in a low-paying specialty is pretty firmly at the top of the pyramid when it is viewed as a whole. However, I think people on here tend to compare themselves to other professionals at the top of the pyramid. There are many other areas a person can go into and become successful at that don't require an additional 4 years of school beyond undergrad, 3-7 years of residency, and 5-10 MORE years paying off 300k+ loans before you start to seriously save for retirement.

Hypothetical average physician matriculates at age 25, finishes school at 29, residency until 33, graduates with 250k debt which he pays off in 7 years.... Now he's 40 and finally ready to start making money!

On the other hand, take a hypothetical businessman / banker / computer programmer / engineer / etc. Graduate undergrad, get a job. Start off at much lower salary, but also able to begin investing much earlier (it's kind of a big deal to start investing money nearly 20 years before the physician will be able to do so) and don't have crushing amounts of debt. Work your way up saving aggressively...By the time the doctor finally pays off his loans, somebody in another professional field already has retirement on his radar. If you do the math, physicians end up not being much better off than PA's or RN's until they've been working for a long time.


I dunno. I don't think it's fair to say "physicians are greedy, look at how much better off they are than the average person!" The average person didn't go to college, didn't dedicate a huge chunk of their life (along with their social life) to learn a specialized and critically important skill and didn't take on the risk of having 200-300k+ in loans. While physicians are working 12 hour days and studying in their time off so they can make life or death decisions, the average person is watching Jersey Shore and drinking PBR.

 

[circulus vitios]

Ok. Let's say you make 250k. You have to pay for these items ALL of them if you are intelligent:

Unless you're the owner of a solo practice, why in the **** are you paying for your own malpractice/health/disability/life insurance AND overhead? It should be a shared cost if you're part of a private practice physician group, and if you're a hospital employee then you should never, ever have to think about it. Get a new job.

Also, you're missing the point. It's a temporary financial arrangement to quickly pay down student loans. If you go to one of those ridiculous $80k/year COA schools and do a 5 year residency -- in which case you should be making more than $250k/year, but whatever -- you will have about $450k in student loans after it's all said and done. If you make $250k/year and live on $55k/year post-tax, you would be able to put $100k/year toward your loans and pay them off in about 5 years. Or, if you're smart, you'll only do it for a couple years and then go back to a traditional 10 or whatever year repayment, so compounding interest won't hurt you as badly.

 

[circulus vitios]

I dunno. I don't think it's fair to say "physicians are greedy, look at how much better off they are than the average person!" The average person didn't go to college, didn't dedicate a huge chunk of their life (along with their social life) to learn a specialized and critically important skill and didn't take on the risk of having 200-300k+ in loans. While physicians are working 12 hour days and studying in their time off so they can make life or death decisions, the average person is watching Jersey Shore and drinking PBR.

It's a $200-300k+ investment to make $200k-300k+ a year for the rest of your life.

 

[StephanieZ]

Ok. Let's say you make 250k. You have to pay for these items ALL of them if you are intelligent:

Malpractice insurance. not an option
Life insurance.
Car insurance. not an option.
Health insurance. not an option.
Disability insurance...optional but you are a ***** if you don't get one.

Taxes both state and federal
Medicare taxes.
Now, retirement, saving for your kids college, a mortgage and then homeowners insurance, etc.

Once again, the things I've bolded are things that average middle class families have to pay as well, so to consider them an additional strain on your take-home pay is incorrect. Most people who say "live on 40k" are already accounting for those expenses because they are expenses that EVERYONE has.

Yes. You can live well IF and only IF you don't want a family.

I already have a family and we still do okay on <50k a year. Again, many middle income people have families and they do okay. You can still live well as a doctor even if you have a family, but it's all about what you consider "living well".

I have just spent 134,000 and I haven't included my mortgage OR OVERHEAD cuz I am in private practice.....

when you get done, it will ASTOUND you how much money flies out in OVERHEAD, TAXES and INSURANCE.....

If you are in private practice, this is a moot point because you are, by definition, a business owner and have different considerations than a doctor who isn't self-employed. I still don't see how money "flies out" in taxes and insurance, though. Aren't taxes taken out of your check? Don't you pay a set amount for insurance each year? So Net - Taxes - Insurace = Gross. Gross should still be greater than the average working american and if it's not than medical school is a bad investment.

 

[jombojuice22]

It's a $200-300k+ investment to make $200k-300k+ a year for the rest of your life.

I suppose the numbers I used above were not quite realistic. I assumed 170k salary, but the averages after practicing for a few years are significantly higher than that. Also, I said taking on loans like that is a risk because what happens if you suffer a serious injury that prevents you from practicing? What if you screw something up with your boards, match, or whatever and aren't able to get a residency/job? You aren't going to be able to just get a job doing whatever and pay off those loans. The interest will crush you unless you have a high-paying job. I think there is definite risk involved in taking on that much debt.

Also, I think it's not quite as simple as you make it out to be. In addition to the 300k you're paying for education, there is also the opportunity cost of the 4 extra years spent in school, ~4 years in residency, and, say, 5 years spent paying back loans. That's 13 years during which you've essentially been spinning your wheels financially while others are saving and investing.

Physicians come out ahead in the long run, but don't underestimate the power of compounding interest over time... I just think that when you look at the numbers, it becomes apparent that going into medicine because you want to use $100's for toilet paper is not a good plan, unless maybe you're smart enough to match one of the uber high paying specialties.

 

[notbobtrustme]

Ok. Let's say you make 250k. You have to pay for these items ALL of them if you are intelligent:

Malpractice insurance. not an option
Life insurance.
Car insurance. not an option.
Health insurance. not an option.
Disability insurance...optional but you are a ***** if you don't get one.

Taxes both state and federal
Medicare taxes.
Now, retirement, saving for your kids college, a mortgage and then homeowners insurance, etc.

Yes. You can live well IF and only IF you don't want a family. If you don't want kids and the spouse and the house, you will be fine, BUT, few docs I know are single, and most end up with the kids, spouse and house....just saying....so after all that spending, you are not left with as much discretionary money as you think.

I pay 14,500/year health. 20,000 malpractice. 3,500/year life, 6,000/year disability.
90,000 in taxes between state and feds....now let's do the math...plus I squirrel away 40k/year retirement....I have just spent 134,000 and I haven't included my mortgage OR OVERHEAD cuz I am in private practice.....

when you get done, it will ASTOUND you how much money flies out in OVERHEAD, TAXES and INSURANCE.....

There's a reason why the stereotype that doctors are terribly at finance persists.

 

[yehhhboiii]

My debate was more directed at yehhhboiii's comment that the suggestion made by kyamh was simply "not how it works", yet failure to offer valid reasons for why. There is a tendency to dismiss premed opinions and views without actually disproving them simply because "You're premed, you don't know what you are talking about." That's very dismissive and doesn't actually further debate. My main point is that an increase in income does not necessarily have to come with a significant upgrade in lifestyle. My mom taught me fiscal responsibility my whole life and somehow I don't think it's a silly idea I'm going to grow out of once I have an MD after my name.

that's because it's obvious from reading your posts that you've never worked a real job or had any real responsibilities. you have no idea what managing personal finances is like. you barely have a grasp of the concept behind it. there's no point in debating someone who hasn't had any relevant experience at all. that's the reason why no one cares about a premed's opinions. for you, the salary is just theoretical numbers that you calculate on a piece of paper. for an attending, it's how they pay back their loans, their mortgage, car payments, insurance, bills, etc.

comparing physicians with the median american is stupid. no one goes to college, med school and residency to make the same as the median american (who happens to be doing quite poorly).

 

[peltier]

I can't seem to impress upon some of you how much ignorance is present amongst both premeds and medical students. The more you make, the more tax you pay, period. I laid out, first hand, some FIXED expenses, and yet, there is still an argument about how I might not be fiscally responsible. That is simply NOT the case. What I am telling you is that your will be astounded at how much of your check actually goes to overhead, taxes, insurance, etc. I live an extremely reasonable lifestyle, am managing to save for retirement, etc. But I am also aware I own a small business, and how many of you are owners of a small business...a private practice? None of you are. You don't have employees, pay their benefits, etc. My kind of practice is disappearing rapidly anyway so it might be a moot point to argue about any of this....

 

[pre med 2014]

Some of the 'ignorant' posts are actually quite accurate assuming a single bachelor. If you don't have a house, wife, kids, etc... Paying back loans is much much easier.

 

[StephanieZ]

that's because it's obvious from reading your posts that you've never worked a real job or had any real responsibilities. you have no idea what managing personal finances is like. you barely have a grasp of the concept behind it. there's no point in debating someone who hasn't had any relevant experience at all. that's the reason why no one cares about a premed's opinions. for you, the salary is just theoretical numbers that you calculate on a piece of paper. for an attending, it's how they pay back their loans, their mortgage, car payments, insurance, bills, etc.

comparing physicians with the median american is stupid. no one goes to college, med school and residency to make the same as the median american (who happens to be doing quite poorly).

We are going to have to agree to disagree here. I respect your opinion, but it's quite obvious that posting on this thread is a waste of time as nobody is going to change their mind.

 

[yehhhboiii]

We are going to have to agree to disagree here. I respect your opinion, but it's quite obvious that posting on this thread is a waste of time as nobody is going to change their mind.

lol you don't even know about the impact of taxes on paychecks
feel free to post all the snarky gifs you want but please get some real life experience before you decide to chime in