Is it really that bad???

[Brown429]

mann I have not started medical school but everyone here sure makes it seem very gloomy...

pays gonna "suck" according to our expectations
sucks the life out of students for 4 years
then residency stinks and takes away more time depending on specialty
then loans stink to repay after medical school....

then you get out and still have to work a lot...

Idk...im begining to question at this stage if its even worth it (of course I am going to pursue it since I have been accepted and cant imagine doing anything else)....

Is it just that people are more apt to speak out about the negatives of medicine or is this just how it is??????!!!

The only happy physicians I have seen are derms and some ortho...

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[OncoCaP]

mann I have not started medical school but everyone here sure makes it seem very gloomy...

pays gonna "suck" according to our expectations
sucks the life out of students for 4 years
then residency stinks and takes away more time depending on specialty
then loans stink to repay after medical school....

then you get out and still have to work a lot...

Idk...im begining to question at this stage if its even worth it (of course I am going to pursue it since I have been accepted and cant imagine doing anything else)....

Is it just that people are more apt to speak out about the negatives of medicine or is this just how it is??????!!!

The only happy physicians I have seen are derms and some ortho...

Maybe it's only gloomy if you focus on the money side or hate working long hard hours (varies with specialty). The financial side of being a physician has has taken some hits in the past 10 years, but pay is still way above average professional wages (engineers, accountants, etc.). If you get personal satisfaction from doing the actual work of a physician and accept the challenges and the responsibilities that come with it, it's tough to beat ... you'll enjoy it, I'm sure.

People take on all kinds of challenges (mountain climbing, motocross racing, ultimate fighting, living in an AIDS ravaged area to help destitute orphans, etc.) and they enjoy them in part because there is this element of terror and risk (<insert your non-monetary motivation here>). If people are willing to pay $20K per trip or whatever to risk their lives to climb a mountain where they pass skeletons on the way up, why wouldn't med students be willing to take on the challenge of a very stressful job? Some people want to live life in a demanding job like that of a physician rather than stroll on through doing something boring. Some people are on a mission, so to speak. In my opinion, it helps to know what the challenges are so that they don't blind-side you. Let's face it, many things in life suck -- in any profession. That doesn't mean we should hide with the blinds drawn. Yes, there are easier better paying jobs than medicine, but not everyone is looking for easy or better pay. Yes, there are easier jobs, but some people fear boredom more than stress.

 

[Tired Pigeon]

Yes, there are easier better paying jobs than medicine, but not everyone is looking for easy or better pay.

This sums it up nicely.

 

[Critical Mass]

This sums it up nicely.

Agree, but too many of my classmates were under the impression that it was both easy and automatically high paying. I don't think that pre-meds have enough access to the system to honestly make an informed decision before committing to medicine.

 

[spicedmanna]

If people are willing to pay $20K per trip or whatever to risk their lives to climb a mountain where they pass skeletons on the way up, why wouldn't med students be willing to take on the challenge of a very stressful job? Some people want to live life in a demanding job like that of a physician rather than stroll on through doing something boring.

LOL. Very interesting way of putting it, and I resonate with your response.

 

[shivasHeroLike]

so what is a realistic salary of an average physician ?

 

[OncoCaP]

so what is a realistic salary of an average physician ?

I'm starting to think we need a real-time ticker for physician salaries (maybe it can be part of the SDN web site page):
FP 136 up 2.2 .... GAS 400 dn 1 .......GS 220 unch.....................

Here are a couple of surveys (there are many out there)
http://www.allied-physicians.com/salary_surveys/physician-salaries.htm
http://www.cejkasearch.com/compensation/amga_physician_compensation_survey.htm

 

[mountainman123]

No, it is not that bad. I am almost halfway through med school and I love it more and more every day. You can have a comfortable life in medicine and there are many fields that you can go in to where you work 40-50 hours a week and some that are 100+ hours a week. There is something for everyone. The FP I worked with over this last summer only saw patients in the mornings 5 days/week and had a great practice still pulling in 116K/year.

 

[Anka]

I love medical school. Yeah, it has it's rough spots (like Ob/Gyn), but even as a medical student, you get some highs you just don't get watching TV and working in banking raking in the big bucks. Here are a few:
1. The first time a patient tells you their whole life story, because you're doctor enough for them;
2. The first time you suture skin and then see the person back in the office a couple of weeks later to see a well-healed scar;
3. The first time you're doing an H&P, and as you go the differential appears in your mind, and you know what the plan is;
4. The first time you make a pick up that makes a real difference in someone's life;
5. Sitting with a patient who has just been given a life-changing diagnosis, and staying with them while they grieve;
6. The first time a patient refuses to see anyone but "my doctor", and that 'doctor' is you... and they don't care you're a student, because you're the one they want to talk to.
7. Hanging out with the very close friends you'll make over the course of your years at med school
8. Looking up at the end of a long, busy night on call, and realizing you're proud to be part of this team
9. Meeting some of the incredible, giving people who are competent and smart, for whom the patient's interest is the only interest... and working with them day after day.
10. Teaching someone a year younger than you something you know (wow! I actually know something!)
11. Having someone come up to you in the street and say "Hey, Doc! You remember me!" And you remember how a year or so ago, they were intubated in the ICU with an open abdomen and sepsis, and everyone thought they weren't going to make it.
12. During a heart transplant: looking into a patient's chest and seeing it empty, then watching while a new heart is being sewn in. And then it starts beating; and the person is awake and alert the next day.

The list could go on forever. Yeah, we all have our rough spots, but it is wonderous what we get to see and do all day.

Anka

 

[humuhumu]

Maybe it's only gloomy if you focus on the money side or hate working long hard hours (varies with specialty). The financial side of being a physician has has taken some hits in the past 10 years, but pay is still way above average professional wages (engineers, accountants, etc.). If you get personal satisfaction from doing the actual work of a physician and accept the challenges and the responsibilities that come with it, it's tough to beat ... you'll enjoy it, I'm sure.

People take on all kinds of challenges (mountain climbing, motocross racing, ultimate fighting, living in an AIDS ravaged area to help destitute orphans, etc.) and they enjoy them in part because there is this element of terror and risk (<insert your non-monetary motivation here>). If people are willing to pay $20K per trip or whatever to risk their lives to climb a mountain where they pass skeletons on the way up, why wouldn't med students be willing to take on the challenge of a very stressful job? Some people want to live life in a demanding job like that of a physician rather than stroll on through doing something boring. Some people are on a mission, so to speak. In my opinion, it helps to know what the challenges are so that they don't blind-side you. Let's face it, many things in life suck -- in any profession. That doesn't mean we should hide with the blinds drawn. Yes, there are easier better paying jobs than medicine, but not everyone is looking for easy or better pay. Yes, there are easier jobs, but some people fear boredom more than stress.

Wow - I couldn't have said this better myself. Excellent summary of my thoughts on the matter.

 

[humuhumu]

I love medical school. Yeah, it has it's rough spots (like Ob/Gyn), but even as a medical student, you get some highs you just don't get watching TV and working in banking raking in the big bucks. Here are a few:
1. The first time a patient tells you their whole life story, because you're doctor enough for them;
2. The first time you suture skin and then see the person back in the office a couple of weeks later to see a well-healed scar;
3. The first time you're doing an H&P, and as you go the differential appears in your mind, and you know what the plan is;
4. The first time you make a pick up that makes a real difference in someone's life;
5. Sitting with a patient who has just been given a life-changing diagnosis, and staying with them while they grieve;
6. The first time a patient refuses to see anyone but "my doctor", and that 'doctor' is you... and they don't care you're a student, because you're the one they want to talk to.
7. Hanging out with the very close friends you'll make over the course of your years at med school
8. Looking up at the end of a long, busy night on call, and realizing you're proud to be part of this team
9. Meeting some of the incredible, giving people who are competent and smart, for whom the patient's interest is the only interest... and working with them day after day.
10. Teaching someone a year younger than you something you know (wow! I actually know something!)
11. Having someone come up to you in the street and say "Hey, Doc! You remember me!" And you remember how a year or so ago, they were intubated in the ICU with an open abdomen and sepsis, and everyone thought they weren't going to make it.
12. During a heart transplant: looking into a patient's chest and seeing it empty, then watching while a new heart is being sewn in. And then it starts beating; and the person is awake and alert the next day.

The list could go on forever. Yeah, we all have our rough spots, but it is wonderous what we get to see and do all day.

Anka

 

[cfdavid]

Look at medical school and residency as a huge adventure where you'll get to do things and learn things that most people simply will not ever get to participate in. Also, take it day to day, almost. Try to enjoy the process of becoming a doctor.

I'm almost through with 1st year, and although I've heard that 2nd year is a lot more interesting, 1st year is pretty cool as well. You learn SO much, and it's cool as hell. Most of it's attitude, like anything else.

I would not be detered from medicine from a financial perspective. You'll very likely have some great opportunities, and will have some great job stability. However, that's not to say that we don't have our work cut out for us in upcoming battles (whatever they turn out to be) w/r/t reimbursements.
We need to advocate WAY better on behalf of our interests, and it's ridiculous for doctors not to. Especially when pure market forces don't purely dictate our incomes as in other professions. So, we need to ramp it up.

 

[sponge]

No, it is not that bad. I am almost halfway through med school and I love it more and more every day. You can have a comfortable life in medicine and there are many fields that you can go in to where you work 40-50 hours a week and some that are 100+ hours a week. There is something for everyone. The FP I worked with over this last summer only saw patients in the mornings 5 days/week and had a great practice still pulling in 116K/year.

How is this possible? The FP I worked with last semester saw patients for 8 morning or afternoon shifts per week (i.e. 5 days a week with one morning off and one afternoon off), taught a course at the nursing school, and only got 90K/year (not sure if that included the course, probably not, but the teaching wasn't for the whole year). Where does your FP work or what are her/his secrets?

 

[baylormed]

How is this possible? The FP I worked with last semester saw patients for 8 morning or afternoon shifts per week (i.e. 5 days a week with one morning off and one afternoon off), taught a course at the nursing school, and only got 90K/year (not sure if that included the course, probably not, but the teaching wasn't for the whole year). Where does your FP work or what are her/his secrets?

Well, the FP's I know also work 5 days a week from about 8am to 5pm (sometimes 6pm, but never much later). They pull ~130K/year, give or take a few thousands. It doesn't sound too bad to me, because the hours are nice and the job isn't stressfull at all.

 

[Doctor Bagel]

How is this possible? The FP I worked with last semester saw patients for 8 morning or afternoon shifts per week (i.e. 5 days a week with one morning off and one afternoon off), taught a course at the nursing school, and only got 90K/year (not sure if that included the course, probably not, but the teaching wasn't for the whole year). Where does your FP work or what are her/his secrets?

Maybe it's a regional thing? The average salary for FP is significantly higher than $90k/year, so I'm guessing that you don't have to have secrets or anything to earn more than $90k.

 

[indo]

The field of medicine is good. Medical school beats the life out of you then randomly reminds you why you study so hard. The tunnel is dark. The light at the end is bright.

Med students are the type of people who are just waiting for someone to tell them that they can't accomplish something. That is what tests do. They say, "I bet you can't learn all of this." And, med students are narcicistic and self centered enough to say, "watch me" then study for 48 hours straight for histology.

 

[Brown429]

thanks onco, that was an interesting way of putting it. I know there are some good factors about this whole process...just saw a lot of negatives here.

 

[sirus_virus]

mann I have not started medical school but everyone here sure makes it seem very gloomy...

pays gonna "suck" according to our expectations
sucks the life out of students for 4 years
then residency stinks and takes away more time depending on specialty
then loans stink to repay after medical school....
then you get out and still have to work a lot...

Idk...im begining to question at this stage if its even worth it (of course I am going to pursue it since I have been accepted and cant imagine doing anything else)....

Is it just that people are more apt to speak out about the negatives of medicine or is this just how it is??????!!!

The only happy physicians I have seen are derms and some ortho...

You forgot lawsuits.

 

[njaqua]

mann I have not started medical school but everyone here sure makes it seem very gloomy...

pays gonna "suck" according to our expectations
sucks the life out of students for 4 years
then residency stinks and takes away more time depending on specialty
then loans stink to repay after medical school....

then you get out and still have to work a lot...

Idk...im begining to question at this stage if its even worth it (of course I am going to pursue it since I have been accepted and cant imagine doing anything else)....

Is it just that people are more apt to speak out about the negatives of medicine or is this just how it is??????!!!

The only happy physicians I have seen are derms and some ortho...

Misery always seems more common because people like to vent their frustration and share their insecurities. This occurs way more than someone sharing every good day, experience, or feeling they have. So it only seems more common b/c that has greater exposure. That , and some people just like to bitch.

However, I'm glad you made the post b/c I have found myself wondering why the hell some of these people chose medicine. I know first year is stressful but if you're giving up or burning out already it raises questions. So, I conclude with the above paragraph with relative optimism.

 

[ndteej]

I love medical school. Yeah, it has it's rough spots (like Ob/Gyn), but even as a medical student, you get some highs you just don't get watching TV and working in banking raking in the big bucks. Here are a few:
1. The first time a patient tells you their whole life story, because you're doctor enough for them;
2. The first time you suture skin and then see the person back in the office a couple of weeks later to see a well-healed scar;
3. The first time you're doing an H&P, and as you go the differential appears in your mind, and you know what the plan is;
4. The first time you make a pick up that makes a real difference in someone's life;
5. Sitting with a patient who has just been given a life-changing diagnosis, and staying with them while they grieve;
6. The first time a patient refuses to see anyone but "my doctor", and that 'doctor' is you... and they don't care you're a student, because you're the one they want to talk to.
7. Hanging out with the very close friends you'll make over the course of your years at med school
8. Looking up at the end of a long, busy night on call, and realizing you're proud to be part of this team
9. Meeting some of the incredible, giving people who are competent and smart, for whom the patient's interest is the only interest... and working with them day after day.
10. Teaching someone a year younger than you something you know (wow! I actually know something!)
11. Having someone come up to you in the street and say "Hey, Doc! You remember me!" And you remember how a year or so ago, they were intubated in the ICU with an open abdomen and sepsis, and everyone thought they weren't going to make it.
12. During a heart transplant: looking into a patient's chest and seeing it empty, then watching while a new heart is being sewn in. And then it starts beating; and the person is awake and alert the next day.

The list could go on forever. Yeah, we all have our rough spots, but it is wonderous what we get to see and do all day.

Anka

anka-this is probably the best post i've ever read on sdn. thanks for making my day!

 

[psipsina]

I don't think its that bad really. If you treat medschool like its your job you can stay pretty caught up, and even in the darkest of times you know that your worst case scenario if you graduate is a job with a salary that most americans would drool over. One of our proffs said that physicians are in the top one percent in income in the whole country. We have a set of hoops (albeit flaming hoops) that we must jump through but at the end is a really great career with alot of options within it to choose from. Its just easy to loose sight of this when you are being torched by the current hoop.

We're all overachievers (you pretty much have to be to get here) so sometimes its very hard to learn to be ok with not being the best at everything. We're all used to this mentality that if we put in our best effort we can be the best and thats not always the case with medicine which can be a very dissapointing and frustrating experience. Its also difficult when friends in other fields start making money while you're still accumulating debt, even though you know you'd be miserable doing their job it can be a real bummer. Many of us are destined for less time intense specialties that we will be happy in but are frustrated with the years we have to spend neglecting our friends and families while we learn to be doctors. The preclinical years are very isolating because not only are you not socializing you're not even on the wards with patients etc, its just you and your books and some equally tweaked out medstudents.

I also agree that there are some people who come into medschool with unrealistic expectations about income. I personally think 125k/year is a buttload of money and can picture myself living a really nice life on that, but many people imagine themselves making millions and driving ferraris and for most of us this just aint gonna happen. These people usually don't realize this reality until they are too far in debt to pull out. There are also alot of people who come in only wanting to do one specialty (usually a very competitive one) which is a huge mistake because then they are miserable when they end up not pulling the stats to be compeitive. You should enter medschool knowing you could be happy being a family doc or a pediatrician or some suchness, not that you could only be happy if you were a plastic surgeon or a dermatologist.

 

[sweet2th]

I love medical school. Yeah, it has it's rough spots (like Ob/Gyn), but even as a medical student, you get some highs you just don't get watching TV and working in banking raking in the big bucks. Here are a few:
1. The first time a patient tells you their whole life story, because you're doctor enough for them;
2. The first time you suture skin and then see the person back in the office a couple of weeks later to see a well-healed scar;
3. The first time you're doing an H&P, and as you go the differential appears in your mind, and you know what the plan is;
4. The first time you make a pick up that makes a real difference in someone's life;
5. Sitting with a patient who has just been given a life-changing diagnosis, and staying with them while they grieve;
6. The first time a patient refuses to see anyone but "my doctor", and that 'doctor' is you... and they don't care you're a student, because you're the one they want to talk to.
7. Hanging out with the very close friends you'll make over the course of your years at med school
8. Looking up at the end of a long, busy night on call, and realizing you're proud to be part of this team
9. Meeting some of the incredible, giving people who are competent and smart, for whom the patient's interest is the only interest... and working with them day after day.
10. Teaching someone a year younger than you something you know (wow! I actually know something!)
11. Having someone come up to you in the street and say "Hey, Doc! You remember me!" And you remember how a year or so ago, they were intubated in the ICU with an open abdomen and sepsis, and everyone thought they weren't going to make it.
12. During a heart transplant: looking into a patient's chest and seeing it empty, then watching while a new heart is being sewn in. And then it starts beating; and the person is awake and alert the next day.

The list could go on forever. Yeah, we all have our rough spots, but it is wonderous what we get to see and do all day.

Anka

My eyes welled up a bit reading this. Thanks!

 

[Critical Mass]

My eyes welled up a bit reading this. Thanks!

Mine too, only it was because I don't see myself having any of these experiences at my school.

 

[Law2Doc]

Maybe it's a regional thing? The average salary for FP is significantly higher than $90k/year, so I'm guessing that you don't have to have secrets or anything to earn more than $90k.

Well, I'm sure there is some regionality, particularly in terms of costs/overhead, but the funny thing about averages is that by definition a whole lot of people have to earn less than the average. For every FP someone knows who is earning way above the average, there are probably a bunch of folks without such "secrets" toiling away at $90k.

 

[Doctor Bagel]

Well, I'm sure there is some regionality, particularly in terms of costs/overhead, but the funny thing about averages is that by definition a whole lot of people have to earn less than the average. For every FP someone knows who is earning way above the average, there are probably a bunch of folks without such "secrets" toiling away at $90k.

That's true, but from looking at the salary data, it seems like the salary is actually a pretty narrow range. According to salary.com, the median for fp is $151k, the lower 25% is $134 and the upper 75% is $176k. From that data, it seems like a relatively small percentage of fp docs are making $90k. I'm not disputing the poster above, but I do think it's probably that making that little money working full time in any field of medicine is an outlier rather than a norm. Hence, making more doesn't require being in on any inside secrets.

 

[cfdavid]

Well, I'm sure there is some regionality, particularly in terms of costs/overhead, but the funny thing about averages is that by definition a whole lot of people have to earn less than the average. For every FP someone knows who is earning way above the average, there are probably a bunch of folks without such "secrets" toiling away at $90k.

perhaps, but from what i hear, those are the docs without a good office manager keeping on the insurance companies, managing reimbursements.

 

[vtucci]

Psipsina- Okay to play devil's advocate....

125K is not that much money when you take into consideration taxes at the federal and state level. For those of you who have not had a salary like this (I did as a lawyer), you can lose up to 56% off the top in city (if you live in NYC), state and federal taxes, medicare etc. This is also gross salary and does not count malpractice insurance, office overhead etc. You also need to pay off your loans which depending on how much debt you accrued during undergrad and med school could be in excess of 200K. You have rent and health insurance premiums as well.

However, as has been said, you should not be going into medicine for the $$$. There are far easier ways to make money and few opportunities to make the kind of difference that medicine affords.

 

[psipsina]

Psipsina- Okay to play devil's advocate....

125K is not that much money when you take into consideration taxes at the federal and state level. For those of you who have not had a salary like this (I did as a lawyer), you can lose up to 56% off the top in city (if you live in NYC), state and federal taxes, medicare etc. This is also gross salary and does not count malpractice insurance, office overhead etc. You also need to pay off your loans which depending on how much debt you accrued during undergrad and med school could be in excess of 200K. You have rent and health insurance premiums as well.

However, as has been said, you should not be going into medicine for the $$$. There are far easier ways to make money and few opportunities to make the kind of difference that medicine affords.

I'm actually aware of this and still think its alot of money. My husband and I have had a few years that have hovered at about 20K and we were pretty happy despite a little money stress. The years between medschool and undergrad we doubled the income since I was working too and we felt like friggin rockstars. We got to eat out and buy stuff on whims and buy gourmet ingredients to cook with etc, . . . I figure even with my loans (which are smaller than most peoples since I foresaw this possibility and was lucky enough to get into my state school) and a pretty big tax bite we would be able to own a home and go on vacations which is pretty much the only things we are currently missing out on.

I think its really all about perspective. I remember feeling bad for myself at one point in our poorest years because we had a hospital bill we were struggling with, and I realized that there are so many people in this world who don't have things that we take for granted like indoor plumbing and hot baths and showers and a full kitchen cabinet and refridgerator and a big soft bed, . . . its really hard to feel bad for yourself when you think about what a large portion of humanity lives like. Even for most americans the idea one person clearing 75k is amazing. That really is plenty to fulfill all of lifes basic needs and have a little luxury and savings to boot. If you need more than that to be happy then your frame of reference is skewed in some way. Or your trying to fill some other void in your life with money and stuff which never works anyway.

 

[vector2]

...If you need more than that to be happy then your frame of reference is skewed in some way. Or your trying to fill some other void in your life with money and stuff which never works anyway.

It's not that anyone needs more than that to be happy. It just comes down to the fact that being able to afford European automobiles, tailored clothing, and an endless supply of Maryland crab tends to makes one even happier.

 

[EM_Rebuilder]

Well, the FP's I know also work 5 days a week from about 8am to 5pm (sometimes 6pm, but never much later). They pull ~130K/year, give or take a few thousands. It doesn't sound too bad to me, because the hours are nice and the job isn't stressfull at all.

Come to rural West Texas... our FPs are the rich folk in the sticks! Some make 300K+...

 

[Brown429]

once you live in the northeast/west coast isn't it hard to move and adjust to texas? I mean..idk why live in the sticks just to make double the salary if lifestyle is not soo good.

 

[da8s0859q]

The $20,000 mountain climbing comparison is a bit different to me seeing as how I'm one of those people that does enjoy some risky undertakings (skydiving, in my case).

However, this:

I love medical school. Yeah, it has it's rough spots (like Ob/Gyn), but even as a medical student, you get some highs you just don't get watching TV and working in banking raking in the big bucks. Here are a few:
1. The first time a patient tells you their whole life story, because you're doctor enough for them;
2. The first time you suture skin and then see the person back in the office a couple of weeks later to see a well-healed scar;
3. The first time you're doing an H&P, and as you go the differential appears in your mind, and you know what the plan is;
4. The first time you make a pick up that makes a real difference in someone's life;
5. Sitting with a patient who has just been given a life-changing diagnosis, and staying with them while they grieve;
6. The first time a patient refuses to see anyone but "my doctor", and that 'doctor' is you... and they don't care you're a student, because you're the one they want to talk to.
7. Hanging out with the very close friends you'll make over the course of your years at med school
8. Looking up at the end of a long, busy night on call, and realizing you're proud to be part of this team
9. Meeting some of the incredible, giving people who are competent and smart, for whom the patient's interest is the only interest... and working with them day after day.
10. Teaching someone a year younger than you something you know (wow! I actually know something!)
11. Having someone come up to you in the street and say "Hey, Doc! You remember me!" And you remember how a year or so ago, they were intubated in the ICU with an open abdomen and sepsis, and everyone thought they weren't going to make it.
12. During a heart transplant: looking into a patient's chest and seeing it empty, then watching while a new heart is being sewn in. And then it starts beating; and the person is awake and alert the next day.

The list could go on forever. Yeah, we all have our rough spots, but it is wonderous what we get to see and do all day.

Anka

is one of the best posts I've read in a long time.

 

[Jack Daniel]

Yes, there are easier better paying jobs than medicine, but not everyone is looking for easy or better pay. Yes, there are easier jobs, but some people fear boredom more than stress.

This sums it up nicely.

Yep, I'd agree with Tired Pigeon and the above quote. Nicely put.

Of course, this doesn't mean I'm free of the occasional night thinking what the heck am I doing here....

 

[jae9970]

However, as has been said, you should not be going into medicine for the $$$. There are far easier ways to make money and few opportunities to make the kind of difference that medicine affords.

It's just that money shouldn't be the only reason. I don't see that many professions that almost guarantee a six figure in annual incomes..

 

[LJDHC05]

If there's one thing that most med students do well, it is complain. 3 days before a stretch of 4 exams in 5 days, I've got a pretty negative outlook on things, and there's always plenty to b!tch about.

Sure, med school isn't exactly fun, but it beats working for a living. Thinking about the alternative: I'd probably be sitting somewhere at a Phizer lab attending a GC-MS, pushing reaction products, making $55k/yr being a cog in the wheel of pharma...and I'd be looking at that same lab for the next 5-10 years, until my job was outsourced to some 16 year old engineering student in India. Sounds like a blast. How many of you all had a similar back up plan?

I'll take the few years of suffering and some debt for job where I get to make some of the decisions and actually make a difference in someone's life, over sitting in a cubicle obsessing about how I'm gonna get promoted, thank you very much.

 

[Law2Doc]

That's true, but from looking at the salary data, it seems like the salary is actually a pretty narrow range. According to salary.com, the median for fp is $151k, the lower 25% is $134 and the upper 75% is $176k. From that data, it seems like a relatively small percentage of fp docs are making $90k. I'm not disputing the poster above, but I do think it's probably that making that little money working full time in any field of medicine is an outlier rather than a norm. Hence, making more doesn't require being in on any inside secrets.

Depends where you get your data (salary.com is perhaps not the ideal industry salary source for physician salaries; there are quite a few salary things referenced on SDN with suspect data). A table in JAMA a couple years back lists the average FP salary as $132k, and various other articles indicate that FP salaries have been on the decline, not the rise, the last decade or so. (which makes it unlikely for $134 to actually be in the lower 25% -- I would personally put more stock in JAMA). And if you believe EM_Rebuilder's anecdotal post above, you will note that the high end can be higher than $176k, making the low end at least in the $90k range. Bottom line, there are FPs really not making bling.

http://www.medfriends.org/specialty_hours_worked.htm

 

[Law2Doc]

It's just that money shouldn't be the only reason. I don't see that many professions that almost guarantee a six figure in annual incomes..

Guaranteed is a bad word choice, and the older you get, the less you will use it. In my prior career I've worked with plenty of physicians whose practices became bankrupt (not from medmal), and their salaries dropped to zero. Most physicians earn over six digits, but there are really no guarantees in life.

 

[cfdavid]

It's not that anyone needs more than that to be happy. It just comes down to the fact that being able to afford European automobiles, tailored clothing, and an endless supply of Maryland crab tends to makes one even happier.

That's blasphemy here in Detroit!

 

[Doctor Bagel]

Depends where you get your data (salary.com is perhaps not the ideal industry salary source for physician salaries; there are quite a few salary things referenced on SDN with suspect data). A table in JAMA a couple years back lists the average FP salary as $132k, and various other articles indicate that FP salaries have been on the decline, not the rise, the last decade or so. (which makes it unlikely for $134 to actually be in the lower 25% -- I would personally put more stock in JAMA). And if you believe EM_Rebuilder's anecdotal post above, you will note that the high end can be higher than $176k, making the low end at least in the $90k range. Bottom line, there are FPs really not making bling.

http://www.medfriends.org/specialty_hours_worked.htm

Certainly, there are fp's not making "bling," but if they're making $90k, my strong hunch is that it's because of choices they've made about how or where they want to work. If it were really hard to make more than that, which is sort of what was implied above, then the data would reflect that. Right now, I don't think it does. IMO, making $90k is an abnormally low salary for any physician who works fulltime.

Anecdotally (yes, I know that doesn't mean anything), all the fp docs I know make $120k or more.

 

[OncoCaP]

Certainly, there are fp's not making "bling," but if they're making $90k, my strong hunch is that it's because of choices they've made. If it were really hard to make more than that, which is sort of what was implied above, then the data would reflect that. Right now, I don't think it does. Making $90k is an abnormally low salary for any physician who works fulltime.

Maybe it has to do with how much Medicaid & Medicare the physician accepts and how many patients they treat per day? If someone is taking a lot of Medicare patients and not treating very many per day (my guess is that 10-15 minutes is about all you have to spend on a typical FP appointment), they will go bankrupt.

Another issue is billing. How you code makes a huge difference. Tracking your payments is also key. I've worked with physicians who find that an unpaid $10K here another one there, and pretty soon your losing some money. There are some cool EHR programs that also integrate with billing. Whoever knows this FP making $90k can PM me and I can put them in contact with a vendor (careful: GE and other vendors charge like $60K/seat ... don't buy that unless you have a lot of 'bling' to spare ... there are much less expensive & proven options).

If I was doing $90K as a FP and not consciously giving a lot of free care or spending a lot of extra time with patients, I would wonder why I was making so much less than everyone else.

 

[Trismegistus4]

Psipsina- Okay to play devil's advocate....

125K is not that much money when you take into consideration taxes at the federal and state level. For those of you who have not had a salary like this (I did as a lawyer), you can lose up to 56% off the top in city (if you live in NYC), state and federal taxes, medicare etc. This is also gross salary and does not count malpractice insurance, office overhead etc. You also need to pay off your loans which depending on how much debt you accrued during undergrad and med school could be in excess of 200K. You have rent and health insurance premiums as well.

There's no reason to assume Psipsina was talking about some kind of gross revenue--indeed, unless you're a solo practitioner, it doesn't even make sense to do so, because things like office expenses get paid for before the money gets divvied up, and would certainly not be factored into a salary, since the word salary implies that you're being paid a fixed amount as someone else's employee. That's one of the most common mistakes people on SDN make: assuming that these income figures for doctors that get thrown around are pre-business expenses, rather than pre-tax personal incomes. In some areas of the country, malpractice insurance and other business expenses would total more than $125k, and your income would literally be negative if that were your gross revenue.

Still, what you said about taxes is true. People who have never had a "real" job are often shocked when they finally get one and see just how much of their income goes to the gummint before they ever see it.

 

[Tired Pigeon]

Of course, this doesn't mean I'm free of the occasional night thinking what the heck am I doing here....

Jack, we all have those nights. But if we can keep getting up in the morning ready to do it all over again, that's what matters.

 

[OB1🤙]

Agreed- this is a fantastic post. There are very, very few of these moments in med school. But when they happen, the feeling really is incredible. Those moments when you realize, "You know what, all this BS I'm dealing with day in and day out really will be worth it in the end." Those moments that you yourself made a difference in someone's life, status as a lowly useless med student be damned, those moments are priceless. Rare, but completely priceless. They help you sleep happy at night.

That, and the constant sleep-deprived tiredness, of course.

I love medical school. Yeah, it has it's rough spots (like Ob/Gyn), but even as a medical student, you get some highs you just don't get watching TV and working in banking raking in the big bucks. Here are a few:
1. The first time a patient tells you their whole life story, because you're doctor enough for them;
2. The first time you suture skin and then see the person back in the office a couple of weeks later to see a well-healed scar;
3. The first time you're doing an H&P, and as you go the differential appears in your mind, and you know what the plan is;
4. The first time you make a pick up that makes a real difference in someone's life;
5. Sitting with a patient who has just been given a life-changing diagnosis, and staying with them while they grieve;
6. The first time a patient refuses to see anyone but "my doctor", and that 'doctor' is you... and they don't care you're a student, because you're the one they want to talk to.
7. Hanging out with the very close friends you'll make over the course of your years at med school
8. Looking up at the end of a long, busy night on call, and realizing you're proud to be part of this team
9. Meeting some of the incredible, giving people who are competent and smart, for whom the patient's interest is the only interest... and working with them day after day.
10. Teaching someone a year younger than you something you know (wow! I actually know something!)
11. Having someone come up to you in the street and say "Hey, Doc! You remember me!" And you remember how a year or so ago, they were intubated in the ICU with an open abdomen and sepsis, and everyone thought they weren't going to make it.
12. During a heart transplant: looking into a patient's chest and seeing it empty, then watching while a new heart is being sewn in. And then it starts beating; and the person is awake and alert the next day.

The list could go on forever. Yeah, we all have our rough spots, but it is wonderous what we get to see and do all day.

Anka

 

[MattD]

There's no reason to assume Psipsina was talking about some kind of gross revenue--indeed, unless you're a solo practitioner, it doesn't even make sense to do so, because things like office expenses get paid for before the money gets divvied up, and would certainly not be factored into a salary, since the word salary implies that you're being paid a fixed amount as someone else's employee. That's one of the most common mistakes people on SDN make: assuming that these income figures for doctors that get thrown around are pre-business expenses, rather than pre-tax personal incomes. In some areas of the country, malpractice insurance and other business expenses would total more than $125k, and your income would literally be negative if that were your gross revenue.

Still, what you said about taxes is true. People who have never had a "real" job are often shocked when they finally get one and see just how much of their income goes to the gummint before they ever see it.

Yeah really, salary is reported pre-tax, post-expense. If your practice's gross collections for the year is only 125K, you're gonna be in trouble. But if someone says they make 125K a year, that means after expenses, which includes malpractice. As far as the 'omg I have to pay TAXES on that lolrotfomg!!!!!11111!', exactly what profession DOESN'T pay taxes? 125K pre tax is still a heck of a lot more than your neighbors 43K pre tax (American median household income, 2004). Your friend the engineer? He started working around 48K and after a decade might be up to 80K if he moved up the technical ranks. PRE TAX. So even that FP making 90K is beating the 10 year engineering veteran. If you think docs don't make good money, you're crazy. Not crazy like a fox, just plain ass crazy.

This should in no way be taken as an endorsement of the idea that docs shouldn't lobby for themselves to maintain their salaries and get fairly compensated. Of course they should. But it's laughable to hear so many people talking like docs are in the poorhouse.

Some 2005 census stats: Top 20% of households by income: >$88,000. Note though that 77% of these households had 2 incomes, averaging to $45,500 per person.
Households with an income above 100K: 17%
Top 5% of household incomes: $157,000 or greater.

So basically, the lowest paid docs are making in the top 5-10% of HOUSEHOLD income, and we're complaining about the money not being there anymore? I've got a distant relative who was an orthopod in the 70's and 80's. Dude made bank. I want to go into the same field. I won't make as much as he will. But if I make 300K (currently seems to be average to low average for the field), that puts me in the TOP 1.5% HOUSEHOLD INCOME IN THE NATION (cutoff is 250K). Yeah, gimmie a break. I think I'll survive.

 

[Critical Mass]

Certainly, there are fp's not making "bling," but if they're making $90k, my strong hunch is that it's because of choices they've made about how or where they want to work. If it were really hard to make more than that, which is sort of what was implied above, then the data would reflect that. Right now, I don't think it does. IMO, making $90k is an abnormally low salary for any physician who works fulltime.

Anecdotally (yes, I know that doesn't mean anything), all the fp docs I know make $120k or more.

It is tough for me to gauge primary care salaries, especially family medicine. Not only will the number of pediatric cases be variable, but region/demand and lifestyle choice be up to the doc. I used to work with a guy who went the IM route, and after 3 years PGY, he joined a group as a hospitalist that gave him a 20K sign-on and a hard salary of 220K/year. Not to rag on him (it's not like he stole my gf ), but he had to repeat a year of med school and had fairly low boards. I don't remember the last time that I checked salary.com for a hospitalist in our state, but I'm pretty sure that they were reporting a median much lower than that, not to mention that the median is typically the level of someone with at least some experience. 220 as a fresh grad is pretty sweet for the region. The downside is that his agreement starts at 60 hours/week. Indeed my view is that the money is there, but you have to put the time in to get it. Whether or not primary care will continue to be fruitful in the future is anybody's guess.

Back on to fp, the only anecdotal evidence that I have is from my school's family medicine clinic across the street. They are all contracted at about 100K per fiscal year unless they have additional administrative duties. Their teaching responsibilities are included in that, but I don't know how much clinic work they have to take (3 days/week?). I know that in most of the acute cases, their residents do the work and report back to them. I have received scripts from some of the docs whose faces I've never seen. That's probably not their whole salary, though, because all of the ones that I know have other work (rural ER's coverage, sports team docs, etc.)

 

[psipsina]

If you think docs don't make good money, you're crazy. Not crazy like a fox, just plain ass crazy.

Thank god I'm not the only one who still thinks 125k is alot of money for one person to make!

 

[Law2Doc]

So basically, the lowest paid docs are making in the top 5-10% of HOUSEHOLD income, and we're complaining about the money not being there anymore?

These percentages always sound great on paper. But, take it from a career changer, when you are actually making such salary and living pretty modestly you might feel differently.

We aren't talking sports cars, yachts and mansions, we're talking a non-huge apartment in decent part of a city, economy sized hatchback, maybe going out to dinner a couple of times a week. You will be staying in Holiday Inns in Florida for vacation, not the Ritz in Rio. You will be paying all your bills, including loans, but your bank account will be underwhelming. If you have dependants, divorce or health issues, it's probably even going to be more like paycheck to paycheck living.

 

[cfdavid]

These percentages always sound great on paper. But, take it from a career changer, when you are actually making such salary and living pretty modestly you might feel differently.

We aren't talking sports cars, yachts and mansions, we're talking a non-huge apartment in decent part of a city, economy sized hatchback, maybe going out to dinner a couple of times a week. You will be staying in Holiday Inns in Florida for vacation, not the Ritz in Rio. You will be paying all your bills, including loans, but your bank account will be underwhelming. If you have dependants, divorce or health issues, it's probably even going to be more like paycheck to paycheck living.

I agree 100% with Law2 on this one. I'm also a career changer, and have been at the magic "six-figure" level (it varied from year to year, but the swings were'nt that big). Unless you have some sizeable deductions (mortgage interest and home office expenses etc), it's NOT what it may seem. You'd be very suprised. Factor in kids and a wife, and you're looking at a very modest lifestyle.

That being said, I'm extremely confident that PCP's can make very good money if they properly augment their practice towards a larger mix of services that only physicians can provide, and that people are willing to pay for, versus being at the mercy of insurance companies for 100% of your income. It's not that difficult, and I think that if you have that mentality, you could do VERY well. Just start thinkging a bit more entrepreneurial. You can still practice traditional medicine with the "typical" case load of a PCP, but you have a constant, captive audience for other services and procedures that you may consider offering.

I think it could be crazy interesting, and am not totally ruling out IM/FM as a career.

 

[Chulito]

These percentages always sound great on paper. But, take it from a career changer, when you are actually making such salary and living pretty modestly you might feel differently.

We aren't talking sports cars, yachts and mansions, we're talking a non-huge apartment in decent part of a city, economy sized hatchback, maybe going out to dinner a couple of times a week. You will be staying in Holiday Inns in Florida for vacation, not the Ritz in Rio. You will be paying all your bills, including loans, but your bank account will be underwhelming. If you have dependants, divorce or health issues, it's probably even going to be more like paycheck to paycheck living.

I agree 100% with Law2 on this one. I'm also a career changer, and have been at the magic "six-figure" level (it varied from year to year, but the swings were'nt that big). Unless you have some sizeable deductions (mortgage interest and home office expenses etc), it's NOT what it may seem. You'd be very suprised. Factor in kids and a wife, and you're looking at a very modest lifestyle.

I wonder how the other 90-95% manage to survive when they are in the same situation.

 

[Critical Mass]

Thank god I'm not the only one who still thinks 125k is alot of money for one person to make!

I definitely agree with you, but there was a recent poll in pre-allo that asked how much money your parents make; and the mode response was 250K and up. If that is actually true, I can see how people might feel unsuccessful at that salary level.

I think that people definitely feel "punished" while going through medical training and want some recompense. If the majority of med grads really do have white collar roots, it's possible that their peers from college made more lucrative choices with easier training routes. That's about the only explanation I can come up with as to why someone would think 125K was low.