Is becoming a physician a financial high risk maneuver?

Discussion in 'Medical Students - MD' started by sirus_virus, Jun 1, 2008.

  1. sirus_virus

    sirus_virus nonsense poster

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    http://www.aamc.org/newsroom/reporter/jan08/debt.htm

    "In a worst-case scenario, the 2007 report update estimated that in 2033, physicians who opt for the standard 10-year loan repayment plan would see half of their after-tax earnings going to loan repayment"

    I am no genius but all these reports from the AAMC seem to point to one thing and one thing only, poverty awaits this generation of physicians.

    In this report by 2031 physicians might be coughing up 61% of after tax income in just loan repayment.

    https://services.aamc.org/Publications/showfile.cfm?file=version35.pdf&prd_id=121&prv_id=137&pdf_id=35

    So if debt is growing by 8.3% and income is growing by only 0.6%, basic math says physicians are in serious trouble. How are our medical schools responding to this? They hike the tuition even more. This is beginning to look like the back in the day Vegas mobsters who loan you money they know you cant pay.
     
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  3. cfdavid

    cfdavid Banned
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    Well, it's not going to be just this generation of physicians. I think the baby-boom generation will turn out to be the most prosperous, as a whole, generation that this nation may ever see. At least for the next 50 years.

    Doom and gloom? Perhaps. But, our national debt and deficits (and the fact that we can't just raise interest rates to 10% to shore up the spending power of the dollar) are going to be super burdensome to future generations, including ours.

    We'll see where things go. ***Americans can no longer have a negative savings rate (and yeah, it blows that education, including borrowing costs, is becoming so much more expensive) and enjoy the same standard of living. Not without all the other negative trends in our economy as a whole. It's just not looking very good.

    That being said, I'm still very optomistic about OUR profession as a whole. At least we have demand on our side. So, it's not going to be about poverty for physicians. It means that doctors, like ALL Americans are going to have to adjust to an entirely different world (at least for the next few decades).
    This means a downsizing of lifestyle.

    BUT, look at our current standard of living compared to say, other advanced economies. We can still enjoy comparative good standards of living in the U.S., but our expectations definitely need to change (we aren't going to have a choice actually). We'll still have access to food, clean water, tv's, internet, cell phones, cars/trucks, refrigerators and microwaves etc. etc.

    So, we'll need to seek out non-monetary/materialistic ways to achieve fullfillment (not a bad idea anyway). This could be good for our country. Learning to live on a bit less, and learning to seek happiness from some of the more basic aspects of life.

    I realize the above seems a bit idealistic, but again, we're not going to have too many options other than to try and adopt this type of attitude.

    We just can't have the lack of production capacity (i.e. wealth creating industries), national debt, budget deficits, major medicare crises looming, and expect that we're going to enjoy a similar level of prosperity as in the past. This is a fact.

    Here's the challenge. We can work hard to force change in governmental spending, end completely counterproductive wars (and make sure we don't get lured into more wars which = more debt), shore up critical industries, and even target (perhaps a good way to spend gov't money) wealth creating industries, have a government that encourages SAVING (thus investment and R&D) as opposed to refering to it's citizens as "the American CONSUMER"..... etc. etc.
     
  4. Baritonebass

    Baritonebass Junior Member

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    We'll talking to young Doctors (mid-30s) no does a standard 10 year repayment. Spead $250,000 over 30 years comes out to $1,629.81 a month. assuming you bring home at least $120,000 (meaning you make $200,000 minus malpractice, tax,401K, fudge factor) you should have something left.

    If your motivation is money there are better ways to make a buck
     
  5. Law2Doc

    Law2Doc 5K+ Member
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    Agreed. You will still earn an okay living. It just won't be as lucrative as some prior generations. Which is fine if your goal is to have a certain career. Not as fine if your goal is to have a certain income. According to a number of publications, pretty much every other profession has shown growth against inflation at the same time that medicine has been losing ground. In the face of higher debt, loss of ground against inflation, and lower reimbursement amounts it's clear that physician career incomes for the upcoming crop of doctors aren't going to be what they used to be. But that is not the same as "poverty" by any stretch of the imagination. We are talking about a career where you now likely will be comfortable, but hardly rich.
     
  6. McGillGrad

    McGillGrad Building Mind and Body

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    Job security and satisfaction trumps material goods every time.

    Live within your means at any salary level and you'll be enjoying life.

    Not every physician has a background in finance, but it should probably be made a prerequisite in med school.
     
  7. TOMFighter

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    This post is pretty stupid IMHO. Economy is bad, and everyone is going to have to take a hit on that, but Docs will always remain on top. With education and sacrifice comes due rewards. Market always wins here. Don't worry about it.

    "In the long run, schools will have a hard time filling their classes with good students if graduates can't repay their debts without undue hardship."
    —H. Paul Jolly, Ph.D., AAMC senior associate vice president
     
    #6 TOMFighter, Jun 1, 2008
    Last edited: Jun 1, 2008
  8. cfdavid

    cfdavid Banned
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    I honestly think they should cut out some of the "fluff" of typical Year I clinical medicine and add in some basic economics/finance. This wouldn't even need to be technical, but just to give med students an overall appreciation of financial jargon so they'll be better prepared down the road.
     
  9. Law2Doc

    Law2Doc 5K+ Member
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    By the time you are in med school understanding economics/finance is too late. The folks who think of medicine as the same cash cow of yesteryear will already have enrolled, not realizing there are other careers that are more $ oriented and higher yield. By then it's game over, the die is cast. You need to make finance a prereq.
     
  10. TOMFighter

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    Don't listen to this guy. He chimes in on every financial thread with doom and gloom overtones. I think he's trying to secure a medical seat for his children in the future with hopes that people will get discouraged with his bull**** antics.

    Just look at the life doctors live now. Look at the life doctors live in Canada under socialized medicine also. Enough said.
     
  11. cfdavid

    cfdavid Banned
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    Not a bad idea, but I was speaking more to simply helping them out down the road, in their own personal lives versus as a qualifying mechanism for career decisions. Then again, like I said, not a bad idea.....
     
  12. TOMFighter

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    All this coming from the guy who went from doing law to doing medicine.

    Did you just all of a sudden fall in love with the idea of taking care of the sick after 3 years of reading lawbooks and writing papers?

    Or perhaps you found medicine more lucrative.

    You're full of it.

    Never trust a statement coming from a guy with J.D. It's a degree in bull****ting. He's a professional bull****ter.
     
    #11 TOMFighter, Jun 1, 2008
    Last edited: Jun 1, 2008
  13. McGillGrad

    McGillGrad Building Mind and Body

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    All very valid points.:)


     
  14. GreenShirt

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    The general wisdom with financial aid is "Don't take out more in loans than your sum of your starting salary". With the average medical student loan running around $140K, the majority of students aren't going to run into any problems since they'll be starting around ~$200K.

    Unless, of course, you go into primary car, in which case you're screwed....which is also why people don't go into PC in large number anymore.
     
  15. parto123

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    Are you for real? First, even though I disagreed with him on many an occasion, law2doc is usually the most reasonable poster on the finance threads.

    Also, L2d worked at a large law firm, which means he made an enormous financial sacrifice to go to med school and become a doctor.
     
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  17. JacobSilge

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    No, it is certainly not a high risk maneuver. The issue is just that it isn't a high reward maneuver. It will never be impossible to pay the loans back, it's just going to hurt more and more.
     
  18. McGillGrad

    McGillGrad Building Mind and Body

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    I see this as a good thing (if it were true to be a bad financial move), because it will clear out the greedy people and leave those who practice for the sake of medicine for a living wage.
     
  19. TOMFighter

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    And who might this be?

    Just wait till you have to take a sabatical from your wife/family in residency and in practice. Greedy people? yah right. Is there something wrong with being paid a commensurate wage?
     
  20. TOMFighter

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    I call b.s.

    No one leaves a successful practice (law practice) to go to medical school to become a doctor. Either a troll or there's more to it.
     
  21. TOMFighter

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    You heard him. After all your work, you might just be able to buy some groceries? Or maybe you'll have to stand on the side of the street and beg for change. Damn, the admissions committee did a great job in selecting some of you communists in here. However, I doubt your communist ideals will be upheld through the hell of residency and practice - especially when you have to make family and social sacrifices.

    Young and conservative - don't have a heart. Old and liberal - don't have a brain.
     
  22. McGillGrad

    McGillGrad Building Mind and Body

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    Greedy, as in those who think only about the money and prestige.

    Of course we should be compensated for the 8-10 years of education and sacrifice. On the other hand, I have worked in finance and the business world before medical school and I can tell you that no amount of money can make me sell my soul again (just to make rich people richer).



     
  23. Law2Doc

    Law2Doc 5K+ Member
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    Exactly. Career changes frequently are based on criteria other than financial. If you are going to do a job that necessitates working long hours, years of training, you really need to like it. No amount of money makes the Monday morning alarm clock sound better, but liking your job sure helps you get up each day. This is where the folks coming straight through from college tend to be at a disadvantage. What you think is important from that perspective isn't always so.
     
  24. cfdavid

    cfdavid Banned
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    why would you find this so hard to comprehend? unless you're the type that would just "duke it out" in a career you chose as a 21 year old, but turned out to dislike. you'll find a lot of non-trads left decent careers to go into medicine.
     
  25. cfdavid

    cfdavid Banned
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    i'm with you on this law2.
     
  26. jelly476

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    meh i think as long as we arent all running out and putting 50 grand down on a horse or spending 30k on exotic fox fur from the war torn regions of the congo then we'll be ok.
     
  27. jelly476

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    oh trips to space are also out.
     
  28. Baritonebass

    Baritonebass Junior Member

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    we'll working at a successful practic(law or medicine) and owning it is two different things!!! cause being an associate at a law firm I heard sucks and life doesn't get good til you make partner. (3 lawyers in my class)
     
  29. sirus_virus

    sirus_virus nonsense poster

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    Another one vomits sunshine. :laugh::laugh:
     
  30. sirus_virus

    sirus_virus nonsense poster

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    Your motivation will not mater when your loan payments are due and your salary is too low to meet up. It is not like you are going to put motivation inside an envelope and send it to Sallie Mae. Once again, salaries are dropping and debt is rising, do the math.
     
  31. sirus_virus

    sirus_virus nonsense poster

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    I am surprised at your use of the word 'rich' when talking about medicine. That issue has been long forgoten buried and discarded. No one is getting rich as a physician anytime soon. I also disagree with your analysis that physicians will be comfortable. Remember it is not just debt rising, malpractice and every other overhead cost is rising rapidly while pay is dropping. Basic math says poverty is no longer an illusion.
     
    #29 sirus_virus, Jun 2, 2008
    Last edited: Jun 2, 2008
  32. HanginInThere

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    Well said.
     
  33. McGillGrad

    McGillGrad Building Mind and Body

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    Have you ever lived in the real world? I ask because there seems to be a disconnect between reality of a 120,000$ salary and your illusions of comfort.

    If you cannot live comfortably on 120,000$ gross ,then you are a fool. No matter where you live (minus 3-4 big cities where salaries are much higher for the same job b/c of the higher cost of living).
     
  34. mjl1717

    mjl1717 Senior Member

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    First -this is funny..
    Although I think there is an element of truth here.. I wont gang up on L2D..Because many of his posts are on the money..
    ["The evil that men do lives after them the good is often interred in there bones"]
     
  35. AmoryBlaine

    AmoryBlaine the last tycoon

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    Law2Doc is a frequent, intelligent, and conscientious poster on SDN. I appreciate his posts and the experience he brings to the table.

    You can disagree with him all you want but don't be rude. From reading your posts I'm not even sure what your argument is or I would try to respond to it...
     
  36. AmoryBlaine

    AmoryBlaine the last tycoon

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    What a strange post! L2D said that physicans would be "hardly rich" and then you disagreed with him for saying that physicians would be rich. Do we need to define hardly.

    These salary/debt/inflation/reiumbursement threads are numerous as the stars. I only weigh in b/c of the fear they are probably inspiring in certain hearts.

    Listen, no one knows the future. No one knows if medicine will be "socialized" in 5 years to where we are all making $50,000 a year and working side-by-side with DNPs. Maybe all of the dire predictions will come true and the sky will fall.

    I personally doubt it -- accuse me of wish-thinking if you like. These threads tend to compare the maximum of debt (say 250) with the minimum of salary (say 120) and that IS a pretty scary contingency. But there are alot of people out there whose debt is less and who will make more money.

    All I can tell you about are the contracts my friends who are senior residents are signing. 200 for gen IM, 350 for EM, 400+ for anesthesia, 300 for Ortho plus 100k sign-on bonus. The ortho figure is from an area where most people would not want to work but the others are in nice, desired cities. If you can't pay off a 200k debt on 350k a year then you are a fool, plain and simple.

    The point of this thread was the intersection of massive debt and declining salaries. If thing continue as they are we WILL hit a point where medicine is financially impossible. But we are not there now.
     
  37. DrKitty

    DrKitty Senior Member

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    Why does everyone assume LawtoDoc is a "he?"
     
  38. 45408

    45408 aw buddy

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    Eh, I did a text analysis on some of his longer posts :D and they pretty definitively pointed towards being male. Unless law school teaches all their students to write like men.
     
  39. 45408

    45408 aw buddy

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    I don't know why they're allowed to get away with this. Their teaching-related expenses certainly aren't increasing that rapidly.
     
  40. Baritonebass

    Baritonebass Junior Member

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    I set the average salary at $200K(could be wrong) the $120K was the take home (a physcian told me a rough estimate is to multiply by .6) which is after expenses(mal-practice, ect...) and tax. but i guess I wasn't thinking surgery. but my point was essentially the same that in the worst case(200K salary, $250k debt) you won't be on welfare. I know non-science people with $40K debt and 35K salary(there call teachers just in case you didn't know)
     
  41. jbrice1639

    jbrice1639 Cub Fan, Bud Man

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    no one racks up 16k+ posts and becomes a mod on a board by trolling...and LOTS of lawyers leave successful practices because they don't like it. I can think of at least 4 friends, all under 30, all making six figures in law that have quit to go back to school or pursue other interests. it happens.
     
  42. TheRealMD

    TheRealMD "The Mac Guy"

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    I argue the real risk pre-meds face today isn't paying off $250k debt with a declining salary. People before me have done it (while bitching a lot, but still did) and people after me will probably be able to do it (however, an expected increase of bitching will ensue).

    No, the real risk is when people turn down a cheaper school like "Baylor" (or any other school really) which will put them in $100k for a school like Harvard that will put them in $250k+ debt (and you'll see in pre-allo a billion threads with debt vs. prestige right now). When you start betting your future not on a specific salary, but a perceived increase of salary because you went to a "higher" ranked school, that's the real risk. Most people who are accepted usually have a choice of going to a cheaper school versus a well ranked one. And boy, when parents have no clue besides rankings, they'll rattle their kid like no other to go to the higher ranked school.

    Anyway, that's how I see it just finishing this app process (thank god). Am I wrong?
     
  43. flip26

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    Yes, the people before us have paid off their debts fairly easily because they left med school with maybe $100k in debt and they locked in at 2 percent interest rates. I don't think there are that many doctors in practice today who have paid off a $250k debt because these debt levels are much more recent. People finishing their residencies today and starting repayment will have a much lower debt total than what people entering med school this year will have in 7+ years...

    The real problem is that people entering med school today are entering untested waters - sky high tuitions, declining compensation, and unfavorable interest rates and loan terms, all set against the backdrop of a cry for "change" in national health care policy that is not likely to help physicians...in another 10 years when people can look back on the decisions that today's med students made, including the assumptions they made about their ability to repay these enormous loans, only then will we know if it was a good idea or not...

    I agree with your point about people taking on massive increases in debt to attend the higher status school - just about the craziest thing ever.
     
  44. Dedikated2liftn

    Dedikated2liftn Bodybuilder

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    Not all of us have a choice; I was forced to decide between two private universities where cumulative tuition is ~250K. I'll get back to you in ten years when I can accurately tell whether or not my decision to take my acceptance was a blessing or a curse.
     
  45. TOMFighter

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    LOL at these posts. Continue to spread the misinformation. My brother is applying in 3 years, so hopefully this will keep competition down.

    Untested waters is bologna. Look at other countries at the life Doctors live and the compensation. I already posted a thread about this with all that information. It's high everywhere. And 100K of debt is really not that much if you're taking home 120K/yr (after the original 200K/yr salary) Subspecialties gross 400k+/yr.

    Doctors won't live comfortably? are you kidding me?

    Avg salary in the U.S. is like 38K/yr (BEFORE TAXES!!!)

    Again, keep spreading the misinformation. It keeps competition down.
     
  46. TOMFighter

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    After residency, I will have paid off any debt., probably already.

    I have about 70K+ (from inheritance) going into medical school (public med school)....so that'll last at least 2 years with living expenses and books and everything. Tuition is like 23K/yr

    so then I have 50K of debt out of medical school....

    pay 10K/yr in residency from a 40-50K/yr salary (all the way to 50-60K/yr last few years)

    Done. Start fresh with as much as 300-400K/yr (I've seen the jobs posted online for this - COME JOIN OUR GROUP - MONEY IS NO OBJECT - seniors gross as much as 700K/yr or more, some a million)...take home 0.6/yr from that with loads of benefits that equal 0.7/yr of that....

    let's remind the idiots here who all think a lifestyle short of the rapper 50 cent is living means poverty that 38K/yr is the avg salary in the U.S. (BEFORE TAXES....so you're taking home like 25K/yr....
     
  47. wisconsindoctor

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    I agree. I know of a few people that left 6 figure management level jobs to go into medicine. Money is not everything. Success is not everything (well, in sports it is). Doing what one enjoys is what matters. People are not the same at the age of 30 when they were 20 or 21 years old.

    It is VERY common for people to change careers (CAREERS NOT JOBS) at least a couple of times during the adult working life.

    Life is to short to stick with something you dislike.

    To the OP, this isn't anything knew. 20 and 30 year loan repayment plans will be common. The amount of money a doctor will have at the end of each month will determine on the lifestyle, area of living, and the area the doctor works in (derm vs. internal med).
     
  48. wisconsindoctor

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    I wouldn't use that 70K to pay for medical school. But that is me. I would use it for other means. Like a saftey net if needed.
     
  49. wisconsindoctor

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    The average houehold income is around $48,200. Per couple, that means they are making around $12- 13/hr.
     
  50. wisconsindoctor

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    The liberal arts college that I got my B.S. in Biology from now has tution at $20,020 per year. When I started college it was at $15,000/yr.
     
  51. MSKalltheway

    MSKalltheway I got the magic stick

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    [/quote]Unless, of course, you go into primary care, in which case you're screwed....which is also why people don't go into PC in large number anymore.[/quote]

    Anyone have that vomit emoticon I can borrow?

    Unless you've taken a poor paying academic peds position fresh out of residency and youre saddled with >200K in debt, I wouldnt be inclined to worry too much and even then you should be making ends meet. For the average new physician, having an inability to pay your loans back on 120K should require you get your head or living situation examined. Obviously there's always that case where she had three kids before med school and her husband cant work, but for the average new physician...be serious.
     
  52. TOMFighter

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    Oh, you wanna use household income?????

    Well, then add another extra to the SINGLE PERSON INCOME I REPORTED.

    Heck, If I marry another doctor, you can double all that I just reported.
     

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