Is medicine still worth it? 2015

[WingedOx]

Its called taxes
ANd opportunity cost
And student loans

Are u new?

And if you can't account for all three and still live a "luxurious comfortable life" then you've got some serious financial literacy/responsibility issues.

---

Members don't see this ad.

 

[Mad Jack]

And if you can't account for all three and still live a "luxurious comfortable life" then you've got some serious financial literacy/responsibility issues.

Depends on your specialty, how much debt you have, and what area you live in. Around here, the average outpatient FM or IM doctor is pulling around $180k in salary, per the annual Medscape poll.

• Annual Gross Pay$180,000.00
• Federal Withholding$35,547.25
• Social Security$7,347.00
• Medicare$2,349.00
• Connecticut$8,970.00
• Expenses$18,000.00

Net Pay$107,786.75

Expenses includes maxing out a 403b or similar, as well as a small amount to cover my share of health insurance costs from my employer. Now, let's look at my loans, which will be just shy of 400k post-residency:

Loan Calculator

Loan Balance: $400,000.00
Adjusted Loan Balance: $404,040.40
Loan Interest Rate: 6.80%
Loan Fees: 1.00%
Loan Term: 30 years
Minimum Payment: $50.00
Degree Program: Doctor (M.D.)
Monthly Loan Payment: $2,634.04

Multiply that out by 12, and you get a net income of $76,178.27, before any other expenses (CME costs, a $565/year license fee, MOC costs, etc). MOC is estimated to cost $16,725 every 10 years for general internists if it ever gets implemented, which averages to another $1,672.50 per year. So that brings us down to $73,940.77, and that's assuming you aren't paying your own malpractice and you're a member of no other professional organizations. While that's no small amount of money, it's certainly not an extravagant sum that will allow one to live a "luxurious" lifestyle, in any sense of the word.

 

[NeuResurgens]

"Worth it" is a 100% subjective term. Is it easy? No. Does it make as much money as it used to? No. Is there more administrative BS? Yes. Is it still worth it for people who love science, enjoy helping others, like doing research, want a challenging career? Yes. You have to decide what your own values are and how medicine aligns with those.

 

[Perrotfish]

Depends on your specialty, how much debt you have, and what area you live in. Around here, the average outpatient FM or IM doctor is pulling around $180k in salary, per the annual Medscape poll.

• Annual Gross Pay$180,000.00
• Federal Withholding$35,547.25
• Social Security$7,347.00
• Medicare$2,349.00
• Connecticut$8,970.00
• Expenses$18,000.00

Net Pay$107,786.75

Expenses includes maxing out a 403b or similar, as well as a small amount to cover my share of health insurance costs from my employer. Now, let's look at my loans, which will be just shy of 400k post-residency:

Loan Calculator

Loan Balance: $400,000.00
Adjusted Loan Balance: $404,040.40
Loan Interest Rate: 6.80%
Loan Fees: 1.00%
Loan Term: 30 years
Minimum Payment: $50.00
Degree Program: Doctor (M.D.)
Monthly Loan Payment: $2,634.04

Multiply that out by 12, and you get a net income of $76,178.27, before any other expenses (CME costs, a $565/year license fee, MOC costs, etc). MOC is estimated to cost $16,725 every 10 years for general internists if it ever gets implemented, which averages to another $1,672.50 per year. So that brings us down to $73,940.77, and that's assuming you aren't paying your own malpractice and you're a member of no other professional organizations. While that's no small amount of money, it's certainly not an extravagant sum that will allow one to live a "luxurious" lifestyle, in any sense of the word.

You do not get to count the 18K that you put into retirement savings as somehow not being income. Taxes are an arguable point (if you want to focus on post-tax income you need to compare it to other post-tax incomes) but savings are not.

 

[Mad Jack]

You do not get to count the 18K that you put into retirement savings as somehow not being income. Taxes are an arguable point (if you want to focus on post-tax income you need to compare it to other post-tax incomes) but savings are not.

I'm just pointing out that the actual amount of money one has to spend after taking care of necessary things is much, much less than what one would expect. Plus, given that most physicians aren't exactly going to be surviving on social security alone in retirement, those savings are more a requirement than an option. Unless you want to retire in poverty I guess. Only 16.5k of that was savings, the rest was health insurance and other misc. Deductible costs (and that's being generous- I was paying roughly 90/paycheck in deductibles- parking, health insurance, dental, and vision- at my last job).

 

[Doudline]

And considering that the median debt after medical school is slightly north of 200k, 400k is probably 90th+ percentile.

 

[Perrotfish]

I'm just pointing out that the actual amount of money one has to spend after taking care of necessary things is much, much less than what one would expect. Plus, given that most physicians aren't exactly going to be surviving on social security alone in retirement, those savings are more a requirement than an option.

Housing, transportation, and food are also not really optional. Except that the amount and quality of those things are option. When you make 180K you can reasonably argue that you should be able to deduct higher taxes and loan payments as a kind of business expense, and that after tax after debt income is a better measurement of what you really make. Whatever you have leftover after that, though, is your earnings. If you choose to put more into savings, or housing, or health insurance, or school for your children you may not feel that that is optional, but it clearly is because most of this country is not getting those things because no one can afford them. Its discretionary spending.

And considering that the median debt after medical school is slightly north of 200k, 400k is probably 90th+ percentile.

The average LOAN for medical school is 200k. It starts compounding the day you take it out. Most people end up paying back a principle that is 1.5 times what they took out on their first day out of residency.

 

[Mad Jack]

Housing, transportation, and food are also not really optional. Except that the amount and quality of those things are option. When you make 180K you can reasonably argue that you should be able to deduct higher taxes and loan payments as a kind of business expense, and that after tax after debt income is a better measurement of what you really make. Whatever you have leftover after that, though, is your earnings. If you choose to put more into savings, or housing, or health insurance, or school for your children you may not feel that that is optional, but it clearly is because most of this country is not getting those things because no one can afford them. Its discretionary spending.

At the end of the day though, people need to save for retirement. As physicians, we're getting a very, very late start, and time matters more than anything when you're compounding gains in the market. Saving isn't optional, particularly in a world in which we very likely won't have social security when we retire- that's a big part of the reason that 401k contributions are deductible from gross income (that and a few of the tax implications that come with withdrawal gains, etc). Even putting the maximum money in, you've lost a minimum of eleven working years during which you could have contributed tax-free, which permanently hurts your portfolio and is impossible to fully recover from.

Ultimately, however, my point was that one could lose a lot of their income to necessary things, and that you end up with a much smaller amount than many premeds and medical students realize. There's no extravagant spending involved in my calculations- just basic necessities to practice and one day retire. The money left over is enough to live a good life, but not enough to quickly pay down one's debt or live like you're rich.

 

[Doudline]

The average LOAN for medical school is 200k. It starts compounding the day you take it out. Most people end up paying back a principle that is 1.5 times what they took out on their first day out of residency.

Considering a starting loan of $200k, and a loan interest rate of 6.80%, the compounded loan amount after residency would be (rounded up):

3 years residency: $244k
5 years residency: $278k
7 years residency: $317k

Let us say the average resident spends 5 years in residency (generous - the figure is more likely to be in the 4.XX range considering the weighting of residents), you're looking at a 0.78 increase, not a 1.5 increase.

 

[WingedOx]

I also consider location and cost of living to be controllable factors here when it all comes down. You can live really well on 170k per year but it's not going to be in Manhattan. And if you're living in Manhattan that's your own damn fault.

 

[WingedOx]

Even putting the maximum money in, you've lost a minimum of eleven working years during which you could have contributed tax-free, which permanently hurts your portfolio and is impossible to fully recover from.

I was required to contribute 8% during residency. I REALLY could have used that money before I was able to moonlight, but nowadays I'm glad I did.

Also I'm not sure it's all that fair to count undergrad as "lost years" since the alternative is... well... not going to make you much money in the long run.

 

[Mad Jack]

I was required to contribute 8% during residency. I REALLY could have used that money before I was able to moonlight, but nowadays I'm glad I did.

Also I'm not sure it's all that fair to count undergrad as "lost years" since the alternative is... well... not going to make you much money in the long run.

The payoff for most non-physicians isn't as substantial as you'd think. Those with vocational and technical skills can outearn college graduates in many majors, all while spending substantially less time and money on their education.

http://www.economist.com/news/unite...-return-higher-education-would-be-much-better

They aren't lost years for some of us. But for many, they are, particularly as debt levels have climbed and entry level opportunities for college graduates have dwindled.

 

[WingedOx]

The payoff for most non-physicians isn't as substantial as you'd think. Those with vocational and technical skills can outearn college graduates in many majors, all while spending substantially less time and money on their education.

http://www.economist.com/news/unite...-return-higher-education-would-be-much-better

They aren't lost years for some of us. But for many, they are, particularly as debt levels have climbed and entry level opportunities for college graduates have dwindled.

Sure, but at that point we're comparing apples and oranges. There aren't many of us who are making the skilled trades vs medicine comparison, obviously.

...bringing us back to the question: Is medicine worth it... opposed to what else?

 

[7331poas]

Some people would never be happy doing commonly cited alternatives like comp sci or engineering. For many it is easy to be fascinated by the body and medical thought processes, and not so easy to be fascinated by math and code!

My point is that the very fact that you are talking about doing what you like makes you better off than most Americans. Its unbelievable how well off a person becomes as a physician as far as their social class in society and the opportunities they give their children.

You talk about being happy doing what you do. Most people work a job they hate so they can give their family a better life.

I guess this comes off as a dick but whenever people say if you want money dont do it, I shake my head vigorous internally. YOU GET A JOB. That is huge in this life. It even pays 6 figures once you hit a certain age. Most premeds dont get that idea.

Other fields outside of CS, its not like that. Many of my friends leaving school cannot even find a job leaving school, much less one that pays these salaries that magically make it worth it over medical school.

 

[efle]

I think it's a unique case when talking about people that are capable of being physicians though. Far higher chance that they had options and wouldn't be struggling to find and keep a job they hate

 

[NeuResurgens]

I think it's a unique case when talking about people that are capable of being physicians though. Far higher chance that they had options and wouldn't be struggling to find and keep a job they hate

I've posted this before, but I've been told people who are smart enough to become doctors are usually smart enough to produce pretty lucratively in other fields too, perhaps to a greater degree than what they would as physicians. Depends on who it is though (obviously some really smart people don't have the people skills to make it in business, etc.)

 

[Freezer]

When this topic was in discussion before I went to medical school, it had all the same talking points such as debt, salary, hours, paperwork, and on and on and on. But the one thing that no one seems to mention and may have changed my mind back then was the fact that the people you work with are typically awful human beings and I am not talking about patients (patients are actually pretty chill on average). However, If you think the trolls on SDN get filtered in the admissions process, you'd be mistaken and I often wonder if aggressive arrogance gives you an advantage to getting accepted. Medicine is filled with "Type A" BS and you will find yourself working with 3 types of people on a day to day basis: The people you know would push you under a bus if given the chance, the people that might push you under a bus if given the chance, and the people you didnt know had their own bus and just got the engine warmed up. Doctors, nurses, midlevels, med students are all the same. There is a reason why more medical schools are focusing curriculum on interprofessionalism and further are even trying to find ways to teach their students how to be empathetic. It's because in a profession filled with people who publicly want to help people, a lot of them are just interprofessional sociopaths.

 

[Neutropix]

I've posted this before, but I've been told people who are smart enough to become doctors are usually smart enough to produce pretty lucratively in other fields too, perhaps to a greater degree than what they would as physicians. Depends on who it is though (obviously some really smart people don't have the people skills to make it in business, etc.)

Have you not been following any of the prior discourse between physicians and medical students?

In summary, with anectdotes and data, they explained how it is a myth people with other degrees--professional or otherwise--make more than physicians (or could). People who make more are typically outliers and the others will likely spend most of their lives in attempt to start a business or climb the corporate ladder w/o success.

Frankly, you shouldn't be giving advice to anyone on this subject because you're not a doctor/med student, and you have no concept of what the actual workforce looks like based on your prior posts.

 

[WingedOx]

When this topic was in discussion before I went to medical school, it had all the same talking points such as debt, salary, hours, paperwork, and on and on and on. But the one thing that no one seems to mention and may have changed my mind back then was the fact that the people you work with are typically awful human beings and I am not talking about patients (patients are actually pretty chill on average). However, If you think the trolls on SDN get filtered in the admissions process, you'd be mistaken and I often wonder if aggressive arrogance gives you an advantage to getting accepted. Medicine is filled with "Type A" BS and you will find yourself working with 3 types of people on a day to day basis: The people you know would push you under a bus if given the chance, the people that might push you under a bus if given the chance, and the people you didnt know had their own bus and just got the engine warmed up. Doctors, nurses, midlevels, med students are all the same. There is a reason why more medical schools are focusing curriculum on interprofessionalism and further are even trying to find ways to teach their students how to be empathetic. It's because in a profession filled with people who publicly want to help people, a lot of them are just interprofessional sociopaths.

Geisinger that bad, huh?

All kidding aside, this ain't wrong. Though once you escape the bullsh-t that is medical school you choose where you work and which dinguses you want to surround yourself with.

 

[allantois]

Geisinger that bad, huh?

All kidding aside, this ain't wrong. Though once you escape the bullsh-t that is medical school you choose where you work and which dinguses you want to surround yourself with.

What happens when 90% of physicians become employed and there's no way to escape dinguses?

 

[Perrotfish]

Considering a starting loan of $200k, and a loan interest rate of 6.80%, the compounded loan amount after residency would be (rounded up):

3 years residency: $244k
5 years residency: $278k
7 years residency: $317k

Let us say the average resident spends 5 years in residency (generous - the figure is more likely to be in the 4.XX range considering the weighting of residents), you're looking at a 0.78 increase, not a 1.5 increase.

It doesn't start compounding when you hit residency. It starts compounding the day you take it out. And you take 1/4th of the loan out at the start of each of the 4 years of medical school.

So for a three year residency, 200K total loan you have 50 K at 6.8 interest for 7 years, 50K for 6 years, 50 K for 5 years, and 50 K for 4 years.
Or: 80K + 74K +70 K + 65K, or 289K at the end of a 3 year residency.

Not quite 300K, but close enough

 

[Doudline]

It doesn't start compounding when you hit residency. It starts compounding the day you take it out. And you take 1/4th of the loan out at the start of each of the 4 years of medical school.

So for a three year residency, 200K total loan you have 50 K at 6.8 interest for 7 years, 50K for 6 years, 50 K for 5 years, and 50 K for 4 years.
Or: 80K + 74K +70 K + 65K, or 289K at the end of a 3 year residency.

Not quite 300K, but close enough

The $200k is the compounded figure after 4 years of medical school, therefore it's not 50k/year but 42.3k. Your calculations with 42.3k amount to what I enumerated in my previous post.

 

[NeuResurgens]

Have you not been following any of the prior discourse between physicians and medical students?

In summary, with anectdotes and data, they explained how it is a myth people with other degrees--professional or otherwise--make more than physicians (or could). People who make more are typically outliers and the others will likely spend most of their lives in attempt to start a business or climb the corporate ladder w/o success.

Frankly, you shouldn't be giving advice to anyone on this subject because you're not a doctor/med student, and you have no concept of what the actual workforce looks like based on your prior posts.

Geez, a little salty aren't we? I never said it's a fact, just that I've heard it before. And I'm certainly not encouraging anyone to abandon medicine based on it. If it's simply not true, then cool.

I'm not a medical student yet. But "no concept" of the workforce seems like a hasty judgement as well; not sure why you're so quick with personal attacks based on this. Which posts are you referencing, exactly?

 

[NeuResurgens]

When this topic was in discussion before I went to medical school, it had all the same talking points such as debt, salary, hours, paperwork, and on and on and on. But the one thing that no one seems to mention and may have changed my mind back then was the fact that the people you work with are typically awful human beings and I am not talking about patients (patients are actually pretty chill on average). However, If you think the trolls on SDN get filtered in the admissions process, you'd be mistaken and I often wonder if aggressive arrogance gives you an advantage to getting accepted. Medicine is filled with "Type A" BS and you will find yourself working with 3 types of people on a day to day basis: The people you know would push you under a bus if given the chance, the people that might push you under a bus if given the chance, and the people you didnt know had their own bus and just got the engine warmed up. Doctors, nurses, midlevels, med students are all the same. There is a reason why more medical schools are focusing curriculum on interprofessionalism and further are even trying to find ways to teach their students how to be empathetic. It's because in a profession filled with people who publicly want to help people, a lot of them are just interprofessional sociopaths.

This may be just because it's the Internet, but I've seen a lot of doctor bashing by the nursing cyber warriors lately. Oddly enough I've been seeing some paramedics doing it too. Medicine does seem like kind of a civil-war-type field at times.

 

[efle]

Something I haven't seen mentioned: it may have some serious desensitization effects. From the way I've seen the Med staff behave so unaffected in the ER and with very sick children, makes me wonder if that's something they can turn off when they leave to stay emotionally open and empathetic with their friends and family

 

[NeuResurgens]

Something I haven't seen mentioned: it may have some serious desensitization effects. From the way I've seen the Med staff behave so unaffected in the ER and with very sick children, makes me wonder if that's something they can turn off when they leave to stay emotionally open and empathetic with their friends and family

Correct me if I'm wrong, but I'm pretty sure that's something you learn fairly early in the process.. Even in my limited role in my hospital I've seen how desensitized the staff gets and it happens increasingly often to me the more patients I see. I feel like some providers learn to separate emotion at work from emotion in personal life, but I think depending on the person's personality they may be a bit more callous than the average person because of their experiences.

 

[Pusheen]

Canada is socialized; their physicians are doing just fine. Everyone who's in it for the money, is free to get out.

Can we seriously stop with this attitude? I think everyone here can admit that we are at least partially in it for the money, and THAT'S OK.
I'm sorry I don't want to give 10+ years of my life working and studying like a slave and then not be appropriately compensated for my efforts. We can be paid like the socialized countries when our education is free or cheap and the route to being a physician is shorter and simpler, just like it is in said countries.

 

[efle]

Can we seriously stop with this attitude? I think everyone here can admit that we are at least partially in it for the money, and THAT'S OK.
I'm sorry I don't want to give 10+ years of my life working and studying like a slave and then not be appropriately compensated for my efforts. We can be paid like the socialized countries when our education is free or cheap and the route to being a physician is shorter and simpler, just like it is in said countries.

Don't forget about hours worked , too. I wouldn't mind dropping 300k to 200k if I also got to work 40 hours a week instead of 55+

 

[Pusheen]

That was a bit harsh, I agree. However, I don't think physicians who are threatening to abandon the profession will really proceed with those plans. The truth is that the government can exercise ultimate control over reimbursements and the public is not going to feel sorry for a doc whose income dropped from 300k to 200k.

I'm kinda confused as to how this ties in to our two previous posts, but sure

 

[Pusheen]

Don't forget about hours worked , too. I wouldn't mind dropping 300k to 200k if I also got to work 40 hours a week instead of 55+

yea, I don't even care as much once we're hitting multiple hundred thousand dollars, I feel like anything above 200k doesn't really make a big difference in lifestyle or comfort, esp if it's only one earner in a double-income household . Going below 100-120k though for any doc is ridiculous though, at least with the current setup.

 

[Turkishking]

If you're passionate about medicine, you will do what ever it takes to accomplish that goal..

 

[NeuResurgens]

That was a bit harsh, I agree. However, I don't think physicians who are threatening to abandon the profession will really proceed with those plans. The truth is that the government can exercise ultimate control over reimbursements and the public is not going to feel sorry for a doc whose income dropped from 300k to 200k.

Yep, I think a lot of people are upset and worried with prospects of drops in compensation because of rhetoric like "physicians paid like teachers" and such. It remains to be seen what will happen to physician compensation with some of the more recent reforms.

I think the valid points here were mentioned by Pusheen - a drop in compensation is fair if medical school becomes free or cheap and the stress from being a doctor is lessened (protection from suits, shortening of working hours, etc.).

It's such a hot button issue here in the states because it concerns people's livelihoods.. If you talk about changing compensation things can get heated.

 

[allantois]

yea, I don't even care as much once we're hitting multiple hundred thousand dollars, I feel like anything above 200k doesn't really make a big difference in lifestyle or comfort, esp if it's only one earner in a double-income household . Going below 100-120k though for any doc is ridiculous though, at least with the current setup.

Our healthcare system is deeply broken. A huge part of the problem is the fee for service system which enables greedy physicians in certain specialties to make 500k+ by doing unnecessary procedures and creating a huge strain on the system. For those people, I say that they can leave medicine as they long forgot why they entered the profession. I don't think anyone has a problem with a hard-working family doc putting in 55 hours to make 200k.

 

[Pusheen]

Our healthcare system is deeply broken. A huge part of the problem is the fee for service system which enables greedy physicians in certain specialties to make 500k+ by doing unnecessary procedures and creating a huge strain on the system. For those people, I say that they can leave medicine as they long forgot why they entered the profession. I don't think anyone has a problem with a hard-working doc putting in 55 hours to make 300k.

I personally don't think that that is causing the biggest part of the healthcare expense issues....I would probably put at least some blame on those who abuse the healthcare system, e.g. treating the hospital like a motel, coming into the ED as one would to a PCP, frivolous lawsuits, ect. Plus our healthcare system just seems very wasteful and inefficient with resources in general. It's just the American way, I suppose, go big or go home.

 

[NeuResurgens]

I personally don't think that that is causing the biggest part of the healthcare expense issues....I would probably put at least some blame on those who abuse the healthcare system, e.g. treating the hospital like a motel, coming into the ED as one would to a PCP, frivolous lawsuits, ect. Plus our healthcare system just seems very wasteful and inefficient with resources in general. It's just the American way, I suppose, go big or go home.

I've read some things about the "do everything possible" route that a lot of people employ at end of life, I.e. Aggressively treating stage IV cancers, keeping people on ventilators for twenty years because they "know of someone" who survived the one in a million chances, you know what I mean. Supposedly this also drives up costs a lot. Its not an easy thing to fix because people are freaked out about "death panels" which would tell people treatment isn't advised.

 

[Pusheen]

I've read some things about the "do everything possible" route that a lot of people employ at end of life, I.e. Aggressively treating stage IV cancers, keeping people on ventilators for twenty years because they "know of someone" who survived the one in a million chances, you know what I mean. Supposedly this also drives up costs a lot. Its not an easy thing to fix because people are freaked out about "death panels" which would tell people treatment isn't advised.

yeah, I know in other countries, treatment would simply be refused and most people would be ok with that because they don't really know any better, and for all intents and purposes, whether in a coma or stage 4 cancer, their loved one is dead.
Here in the US though, there is such a strong emphasis on individualism, and valuing the life and well being of an individual above all else. We will use extraordinary resources to try to help out that one person, and screw the community. It's not necessarily a bad thing, it's just the way we do stuff here and it has its pros and cons.
I know I'd hate to be seriously ill in a poorer, socialized country.

 

[NeuResurgens]

yeah, I know in other countries, treatment would simply be refused and most people would be ok with that because they don't really know any better, and for all intents and purposes, whether in a coma or stage 4 cancer, their loved one is dead.
Here in the US though, there is such a strong emphasis on individualism, and valuing the life and well being of an individual above all else. We will use extraordinary resources to try to help out that one person, and screw the community. It's not necessarily a bad thing, it's just the way we do stuff here and it has its pros and cons.
I know I'd hate to be seriously ill in a poorer, socialized country.

You nailed it. So much of it is our American culture - we love beating the odds-, never give up- and comeback-type stories. Many of us will try to save our loved ones no matter the cost, sometimes refusing to give up on their treatment for a long time. Different philosophies breed different systems.

 

[Neutropix]

Geez, a little salty aren't we? I never said it's a fact, just that I've heard it before. And I'm certainly not encouraging anyone to abandon medicine based on it. If it's simply not true, then cool.

I'm not a medical student yet. But "no concept" of the workforce seems like a hasty judgement as well; not sure why you're so quick with personal attacks based on this. Which posts are you referencing, exactly?

The prior post I was referring to is this
"I've posted this before, but I've been told people who are smart enough to become doctors are usually smart enough to produce pretty lucratively in other fields too, perhaps to a greater degree than what they would as physicians. Depends on who it is though (obviously some really smart people don't have the people skills to make it in business, etc.)"

This is the post I am referring to that lead me to believe your understanding of work outside of medicine is infinitesimal. Just take a second to briefly read that statement and tell me if that came from an educated point of view.

Now, the way you worded that echoed the sentiment that, "Almost anyone can make equal to or money than physicians given the same amount of intelligence and drive."

This is a weird fallacy that has somehow permeated pre-allo, which is my guess some kind of defense mechanism for deciding against the pursuit of medicine. For sure read the first page and a half from this forum before replying to this btw.

Anyhow, I am not trying to be salty. Rather, I was just pointing out that given that one post your understanding of work outside of medicine is small. It's constructive criticism don't get defensive. Obviously it's preallo so we take what everyone says with a grain of salt; it's the principle that matters.

You're premed not prelaw/business, etc, so that's ok. Sometimes we have to get checked when we step outside of our reach of qualification. If I went to the Med allo forums and started giving residency advice people would question me as well.

 

[Crayola227]

The sort of lifestyle and **** you deal with makes medicine a very very poor choice if you're approaching it as a job to make money.

If it is not your passion none of the money made will make up for said bull****.

If you're interested, read as much of my post history as you can.

Try to find my post about how you pretty much have to be willing to die for the profession.

 

[WingedOx]

Don't forget about hours worked , too. I wouldn't mind dropping 300k to 200k if I also got to work 40 hours a week instead of 55+

I mean, I work 40 a week right now, but as I said, I'm not making a surgeon salary.

 

[WingedOx]

What happens when 90% of physicians become employed and there's no way to escape dinguses?

Strangely enough there are studies that have shown the opposite is true. 90% of the dickishness is done by 5% of the physicians. (replace "dickishness" with "unprofessional behavior" and you get the point)

 

[NeuResurgens]

The prior post I was referring to is this
"I've posted this before, but I've been told people who are smart enough to become doctors are usually smart enough to produce pretty lucratively in other fields too, perhaps to a greater degree than what they would as physicians. Depends on who it is though (obviously some really smart people don't have the people skills to make it in business, etc.)"

This is the post I am referring to that lead me to believe your understanding of work outside of medicine is infinitesimal. Just take a second to briefly read that statement and tell me if that came from an educated point of view.

Now, the way you worded that echoed the sentiment that, "Almost anyone can make equal to or money than physicians given the same amount of intelligence and drive."

This is a weird fallacy that has somehow permeated pre-allo, which is my guess some kind of defense mechanism for deciding against the pursuit of medicine. For sure read the first page and a half from this forum before replying to this btw.

Anyhow, I am not trying to be salty. Rather, I was just pointing out that given that one post your understanding of work outside of medicine is small. It's constructive criticism don't get defensive. Obviously it's preallo so we take what everyone says with a grain of salt; it's the principle that matters.

You're premed not prelaw/business, etc, so that's ok. Sometimes we have to get checked when we step outside of our reach of qualification. If I went to the Med allo forums and started giving residency advice people would question me as well.

I see what you're saying, thanks for the explanation. It's definitely something I've heard multiple times in pre-allo, so when the topic was brought up I was just echoing what I had heard. But your claims against this assertion do make sense when you think about how business works - the ceiling is very high but the floor is also very low, and most don't end up reaching the high ceiling. Indeed, one of the perks of medicine is that if you do it right it's much more secure than other fields.

Also makes sense that people use it in a way to self justify when deciding against medicine. If your heart isn't ultimately set on it, it's fairly easy to think up reasons not to do it. This idea might have been born and been perpetuated by people in this position.

Sorry if it sounded too defensive. I was just trying to clarify that I didn't necessarily endorse the idea, but rather was just responding to Efle's question. But I understand your desire to correct a myth that might deter people from medicine.

 

[Seth Joo]

Canada is socialized; their physicians are doing just fine. Everyone who's in it for the money, is free to get out.

And you forget that medical education in Canada is nearly free compared to the US, Canadian students are not dragging around 300k in debt when they leave medical school, many US medical students are carrying around that kind of debt, that is why once you take out taxes and student loan payments, a doctor's salary is not that amazing. Most countries that have universal health care also have subsidized and or almost free higher education, no student loan nonsense like we have to deal with here in America.

Some people have rich parents who can pay for their schooling, most do not.

A friend of mine from high school is a police detective at the Boston Police Department, I think he earns nearly 150k a year, has no student debt, roughly that is the salary of a typical primary care physician.

 

[allantois]

And you forget that medical education in Canada is nearly free compared to the US, Canadian students are not dragging around 300k in debt when they leave medical school, many US medical students are carrying around that kind of debt, that is why once you take out taxes and student loan payments, a doctor's salary is not that amazing. Most countries that have universal health care also have subsidized and or almost free higher education, no student loan nonsense like we have to deal with here in America.

Some people have rich parents who can pay for their schooling, most do not.

A friend of mine from high school is a police detective at the Boston Police Department, I think he earns nearly 150k a year, has no student debt, roughly that is the salary of a typical primary care physician.

Well, I'm not saying we don't need free education

 

[Seth Joo]

Well, I'm not saying we don't need free education

It won't happen in America because the student loan system has allowed colleges to raise tuition year after at a rate faster than inflation.

The cost of attending a DO school, namely my own, tripled in 15 years, salaries for doctors did not increase during that time.

 

[moisne]

You ask this question on a pre-med forum... lol

 

[Perrotfish]

Our healthcare system is deeply broken. A huge part of the problem is the fee for service system which enables greedy physicians in certain specialties to make 500k+ by doing unnecessary procedures and creating a huge strain on the system. For those people, I say that they can leave medicine as they long forgot why they entered the profession. I don't think anyone has a problem with a hard-working family doc putting in 55 hours to make 200k.

Unnecessary is a very complicated word in medicine. Nothing we do is unconsensual, so who exactly gets to decide what is unnecessary? Is it unnecessary to do a hip replacement on an 85 year old with comorbidities? The medical expert, looking at a 100K procedure for someone with a significant chance of dying post op and an expected lifespan of less than 5 years would probably say yes. The 85 year old, faced with the prospect of living his remaining years with pain and limited mobility, might think its completely necessary. Of course, even the 85 year old might think differently if he was spending his own life savings rather than some amalgam of anonymous Americans' treasure, but then again he probably wouldn't mind if he was rich enough to afford 100K and is this really a decision you think his income should affect?

Greedy is also a slippery slope word. Most people try to maximize their income, and most physicians work hard. That doesn't mean that physician salaries are, objectively, reasonable, but when people are providing a fee for a service are you sure you can draw a clear line in the sane where reasonable compensation stops? Do you think that anyone would go into 'greedy' specialties like Orthopedics or interventional cardiology if they were compensated for their years of hellish training with the same pay that a Pediatrician makes for 3 years of residency? Are you sure that 200K for an FP IS reasonable? The average household, with their 50K household income and 35K individual income, might disagree.

The truth is that, when we have a problem, we want a villain to be responsible for it. We've been trained by a thousand Marvel movies to believe that behind every real crisis is an evil force. We think all we need to do is find them (and drop them into an Arc reactor) and we can make everything better. Real problems aren't like that. Medicine is expensive because everyone who is sick wants expensive, cutting edge stuff. Are there greedy d-bags in medicine? Of course, they're everywhere, but they're not really the problem. The problem is that the American people want to buy something really, really expensive in our national healthcare system and they're depressed that it costs a lot of money. If we wanted medicine to cost less money, we would need to buy less medicine. Which means rationing. Which is hard. And while its easy, as the healthcare professional, to say 'that ICU stay isn't worth it' or 'that operation is unnecessary' we all know that our utilitarianism would go right out the window if it was our own health or our own families.

 

[allantois]

Is it unnecessary to do a hip replacement on an 85 year old with comorbidities?

Do you think that anyone would go into 'greedy' specialties like Orthopedics or interventional cardiology if they were compensated for their years of hellish training with the same pay that a Pediatrician makes for 3 years of residency?

At the rate our population is aging, our government will go beyond bankrupt if it provides all 85 year olds with hip replacements. I do not know who should decide the questions of necessity, but it seems to me that there is a conflict of interest when that person is the surgeon receiving tens of thousands $ for performing the procedure.

I am sure that people would still go into Orthopedics and other fields even if those fields did not have the potential of bringing in a $500k+ income. We know this by looking around the world, and realizing that in countries like UK physician's income does not vary widely among different specialties. That would also encourage medical students to choose the specialty they actually like, rather than the one with highest income potential. And if that deters certain students from entering medical school, then that's fine as there is no shortage of med school applicants. And who said that a pediatrician could not have turned out to be a great surgeon?

I am definitely not anti-physician or wanting to take healthcare away from people. I would love to see everyone covered under universal care. I also don't think that physicians' income should somehow be limited by a magic number. Ideally, a fee for service system would work just fine, but there are individual practitioners abusing the system and increasing costs; and it's not always done for the sake of the patient, either. I also don't like that we are going in the direction of having physicians employed by hospitals and healthcare groups as those people are most definitely not concerned with bringing the costs down or doing what's best for patients.

 

[Bleachboy987]

I'm just curious, why do people say medicine doesn't make good money? From what I know, you'd have to be a successful businessman, IB, or partner at a prominent law firm to make significantly more than a doctor does. The very lowest paid medical specialties still make more than 150k which is much much higher than most Americans will ever make. Now I realize that in areas like LA and NYC, 150-300k is nothing, but in normal suburban cities that sort of money is way more than enough for a luxurious and comfortable life. Obviously no Manhattan penthouses or new Ferraris, but a 150-300k salary is still upper middle class. So please explain to me why this salary isn't enough?

150k-300k is upper middle class????? That's a huge amount of money and well enough to live anywhere in NYC. I live in flushing Queens and people make 60-70k and have happy normal lives. I'm still in shock that 300k is considered within the middle class for people.