Lifestyle and money

[TRAMD]

TRAMD dunno about your avatar there bro. Im about ready to rip on it, but will give you time to change it to something less dorky before I do.

Huh? I am confused as to your reasoning and where you are going with this . . .

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[TRAMD]

I'm not a med student (hopefully next year!!), so forgive me if I'm ignorant on the subject. But, I dont understand why Oncology is so low on the list. From what I understand, they're still compensated pretty well, aren't they? Contrary to a post on here, one of the radiologists I work for said it's "booming" right now (i think he was referring in part to $$$). Plus, what kind of hours/lifestyle do they have? I have always been told that cancer doesn't grow on the weekends... so I thought the lifestyle was pretty good too. Especially because I was under the impression that a lot of internists are hired by hospitals to deal with patients like hem/onc through the 2nd and 3rd shift hours.. maybe not???

I think you are right about this. I am not sure why it isn't higher, I may have made a mistake or maybe I found a really high number for average hours per week. If I ever get around to a revision I will probably change this.

 

[TRAMD]

The short hours and no call is made up for with night shifts and patients who bite you.

Bingo. If you can handle the shift work (I couldn't) it would be a lot higher.

 

[TRAMD]

If you're close enough to a town big enough for a movie theater and a Walmart, I'll be your neighbor in about 4 years

The town I live in has a 24 screen movie theater, a mall and one of the busiest Wal-Marts in the country (they are building a second one because it is way too busy). It is the second largest city in SD and has a population of about 60k.

 

[TRAMD]

I could be an OB/GYN in SD for $750K for a few years

That is a very busy and very well-established doc. He also makes millions more in real estate investments in the area. The more average OB/GYN doc here makes about 300k-400k.

There are many places like this across the country if you are willing to venture away from the coasts and big cities.

 

[PeepshowJohnny]

Sweet, I'm moving to Fargo! I loved that movie!

*Whisper Whisper?*

What? North Dakota? Aw, crap!

 

[TRAMD]

Sweet, I'm moving to Fargo! I loved that movie!

*Whisper Whisper?*

What? North Dakota? Aw, crap!

Same kind of thing there basically except I don't know if they have a state income tax. The weather is colder and there is no Black Hills.

 

[Miami_med]

The town I live in has a 24 screen movie theater, a mall and one of the busiest Wal-Marts in the country (they are building a second one because it is way too busy). It is the second largest city in SD and has a population of about 60k.

See ya soon neighbor.

My wife's obsessed with Deadwood, but I think that the whole twice as much money thing might also convince her.

 

[TRAMD]

See ya soon neighbor.

My wife's obsessed with Deadwood, but I think that the whole twice as much money thing might also convince her.

I live very close to Deadwood. Has your wife ever been there or are you talking about the show?

What specialty do you want to go into?

 

[Miami_med]

I live very close to Deadwood. Has your wife ever been there or are you talking about the show?

What specialty do you want to go into?

I'm either EM or Surg. I'm an MS-3, so nothing's quite set in stone. She's never been to Deadwood, but she's studied up on it alot (obsessed with old gold rushes, the wild west, all that good stuff). We were both pretty fond of the show until it started to suck in the third season.

 

[TRAMD]

I'm either EM or Surg.

Do orthopedic hand surgery and I guarantee you can make 1 mil here. ENT and Urology are also in need. I am not sure about gen surg. The main ER here is pretty busy but all the ER docs make pretty good money and seem really happy. There are also the typical smaller ER jobs spread around.

I'm an MS-3, so nothing's quite set in stone. She's never been to Deadwood, but she's studied up on it alot (obsessed with old gold rushes, the wild west, all that good stuff). We were both pretty fond of the show until it started to suck in the third season.

Maybe I have just been desensitized from living in South Dakota or Wyoming my entire life but the "wild west" really isn't that prominent here anymore. They do their best for the tourists but Deadwood is really just a bunch of casinos now. There are still plenty of rodeos in the summer I guess. Deadwood is considered to be an undesirable town to live in and in many ways is sort of the "slum" of western South Dakota. If you were to visit sometime you would see what I mean, but there is still Mount Rushmore and the beautiful Black Hills to see in the area. Spearfish and Rapid City are the best places to live (Deadwood is between them geographically). They both have your movie theater and your Wal-Mart. They are the two largest towns in western South Dakota. Rapid is #2 and Spearfish #9 overall. The rest of the larger towns are all in eastern South Dakota. The two sides of the state really almost seem like separate entities and are separated by 300 miles of sparsely populated grasslands with only our state capital in the middle.

 

[Miami_med]

Do orthopedic hand surgery and I guarantee you can make 1 mil here. ENT and Urology are also in need. I am not sure about gen surg. The main ER here is pretty busy but all the ER docs make pretty good money and seem really happy. There are also the typical smaller ER jobs spread around.

I better do EM then, since I doubt any of the ENT, URO, Ortho programs would let me in.

Maybe I have just been desensitized from living in South Dakota or Wyoming my entire life but the "wild west" really isn't that prominent here anymore. They do their best for the tourists but Deadwood is really just a bunch of casinos now. There are still plenty of rodeos in the summer I guess. Deadwood is considered to be an undesirable town to live in and in many ways is sort of the "slum" of western South Dakota. If you were to visit sometime you would see what I mean, but there is still Mount Rushmore and the beautiful Black Hills to see in the area. Spearfish and Rapid City are the best places to live (Deadwood is between them geographically). They both have your movie theater and your Wal-Mart. They are the two largest towns in western South Dakota. Rapid is #2 and Spearfish #9 overall. The rest of the larger towns are all in eastern South Dakota. The two sides of the state really almost seem like separate entities and are separated by 300 miles of sparsely populated grasslands with only our state capital in the middle.

Yeah,

No one really thinks that it's still the "Wild West." My wife's a history buff. On the other hand, I sincerely doubt that anything in South Dakota would seem too run down and crappy after spending the last 4 years surrounded by the Miami ghetto.

Now, I know that the hills aren't exactly mountains, but is there any halfway decent skiing nearby? While we're completely off topic

 

[TRAMD]

No one really thinks that it's still the "Wild West." My wife's a history buff. On the other hand, I sincerely doubt that anything in South Dakota would seem too run down and crappy after spending the last 4 years surrounded by the Miami ghetto.

Now, I know that the hills aren't exactly mountains, but is there any halfway decent skiing nearby? While we're completely off topic

There is some pretty decent skiing. That comes with the frigid temps and plentiful snowfall during the winter.

I haven't been to Miami but the worst parts of western South Dakota are palatial compared to the south side of Chicago.

 

[Puffle]

I know they are hurting for psychiatrists back West, but do you anything about Pathology? My soon-to-be spouse and I are both from Rapid, in Sioux Falls doing our respective residencies. We're looking to head back when we're done, but from what I understand, Path jobs are seldom advertised, and hard to come by. Any ideas?

 

[TRAMD]

I know they are hurting for psychiatrists back West, but do you anything about Pathology? My soon-to-be spouse and I are both from Rapid, in Sioux Falls doing our respective residencies. We're looking to head back when we're done, but from what I understand, Path jobs are seldom advertised, and hard to come by. Any ideas?

I have no idea about pathology positions here. I don't hear much from the pathologists . . . nobody does.

Did you go to USD for med school?

 

[Puffle]

I have no idea about pathology positions here. I don't hear much from the pathologists . . . nobody does.

Did you go to USD for med school?

Ah, yes....2005.

Thanks anyway.

 

[TRAMD]

Ah, yes....2005.

Thanks anyway.

Sorry I am no help.

2006 here.

 

[Miami_med]

There is some pretty decent skiing. That comes with the frigid temps and plentiful snowfall during the winter.

I haven't been to Miami but the worst parts of western South Dakota are pallatial compared to the south side of Chicago.

I understand that you could be equally run down, but we've got ghettos larger than 60,000 people. I just don't see ghetto in the same way if you can see the forest from the ghetto .

Of course, I've never been to SD. I've been to south side Chicago, but I guess you're the only one that can compare the two. South side was definitely NASTY and every bit as bad as Miami. Ah well. Just keep on shattering my dreams of perfection .

 

[TRAMD]

I understand that you could be equally run down, but we've got ghettos larger than 60,000 people. I just don't see ghetto in the same way if you can see the forest from the ghetto .

Of course, I've never been to SD. I've been to south side Chicago, but I guess you're the only one that can compare the two. South side was definitely NASTY and every bit as bad as Miami. Ah well. Just keep on shattering my dreams of perfection .

Sorry, I misspelled 'palatial'. Basically I am saying that the worst parts of South Dakota are still VERY nice compared to the worst parts of many cities. I would walk alone at night just about everywhere in South Dakota.

 

[mslall]

reading all of these posts makes me think that if you're in medicine the amount of money you make depends on how good of a business person you are or how good your business manager is. I dont really know how it works for surgeons or surgeons groups.

For instance i know a pulmonary/critical care doc (which was rated last) who makes over 600k a year, and he's not the highest paid one is his group. I know ER docs also here also make 500k+ a year (although they see a huge huge volume of patients here)

just my input

 

[Blesbok]

Where did you get your numbers from?

I have always been interested in the difference in income between different fellowship subspecialities.

 

[jkjkjk]

A few questions


1) Is interventional pain the same as pain management

2) Is spine surgery ranked so high because of the salary or the lifestylee

 

[radslooking]

A few questions


1) Is interventional pain the same as pain management

2) Is spine surgery ranked so high because of the salary or the lifestylee

im not an expert, but to 1) I think of those as the same, yes
2) salary

 

[USFjoe]

I was wondering, when you look at these numbers for average income for the different specialties is that before or after malpractice expenses?

 

[Anfield rd]

The AVERAGE salary for dermatopathologists is 1.2 million. I wish I could be a pathologist. Seriously, they're the biggest nerds in the hospital... I love the scope of IM too much to compromise.

Dude,

Dermpath >>> you.

Even with all the slides I look at daily, in a club/bar I could still get digits in half the time it takes average IM resident to work up an awkward pickup line.

And to the kid sporting ManU player as avatar-- die.

 

[DrNicholas]

How do you think this list might change in the next 5-10 years as a result of medical advances, supply/demand trends, etc.?

 

[Dirt]

How do you think this list might change in the next 5-10 years as a result of medical advances, supply/demand trends, etc.?

Not at all. The list is going to change as a result of changing medicare reimbursements.

 

[Jwax]

Agree 100%. One of those most valuable thing our pathology department did for our med school is a "What does a Pathologist do?" lecture. Covered a lot of the different options in the field, from those who ran cytology type stuff to surgical path to some forensic pathologists.

One of the areas in med that I am quite interested in that I feel they have really given us no substantial information on is forensic path. I watched a lot of Law & Order as a kid, which made me want to be a lawyer at first. Once I figured out I wanted to be a doctor, I still really liked the idea of working in some capacity with the law. In general I'm a bigger fan of living people and I absolutely hate looking in microscopes, but forensic path still intrigues me. I am probably 90% sure I'm going into EM, but I've still got a list of alternatives.

Family 375k, occ med 450k, pathology 500k, ER 400k, radiology 850k, anesthesia 750k, derm 1.2 mil, ophthal 800k, ENT 800k, OB/Gyn 750k, spine surg 2 mil, interventional pain 700k, Ortho 1 mil, Cardiology 800k.

WoW. Who says doctors don't make good money any more? Spinal surgeons get 2 million a year? Loans paid off in one year; work 10 or 15 more and retire. Done deal. 80+ hrs for 15 years then 30 or 40 years of rich retirement sounds super to me. Plus if your airplane ever crashes on an island in the middle of nowhere, you can become the groups leader and diagnose all the survivors.

 

[vtucci]

These are no where near the average salaries for those fields. In fields that pay bonuses for revenue-generating units (RVU), pay is often based on number of patients seen. How many patients can you see though before it starts becoming a liability with patient care?

Generally, reported salaries are gross (i.e., does not include taxes, overhead and malpractice).

 

[turkeyjerky]

These are no where near the average salaries for those fields. In fields that pay bonuses for revenue-generating units (RVU), pay is often based on number of patients seen. How many patients can you see though before it starts becoming a liability with patient care?

Generally, reported salaries are gross (i.e., does not include taxes, overhead and malpractice).

Not true at all. This is one of the biggest misconceptions on sdn. Reported salaries are always net, which is income after expenses (yes, including malpractice) but before taxes. The same way someone reports their salary.

However, that doesn't negate the fact that these reported salaries do seem somewhat inflated...

 

[badasshairday]

Yeah, "somewhat" inflated... not totally inflated. But if you want to make serious cash like that you better be ready to go practice out in places lik the boonies in South Dakota.

 

[GoBuckeyes913]

I think a good deal of path does deal with live patient slides... the autopsy rate has fallen dramatically in the last few decades and it is my understanding that pathologists spend the majority of their time looking at specimens from live patients.

I think this is a common misunderstanding that medical students have.

A surgeon's unsung hero is a pathologist. At least, in my opinion!

 

[aam53]

What are lifestyles like in neurosurgery or cardiothoracic surgery, for a woman?

 

[badasshairday]

What are lifestyles like in neurosurgery or cardiothoracic surgery, for a woman?

The same as for men . . . Nonexistent.

 

[Cp22kjer]

The same as for men . . . Nonexistent.

Lol. I've heard this from numerous attending physicians. In addition I've read that they are considering lengthening the neurosurgery residency too...if its not already long enough!

 

[Buddhasmash]

Sorry about the thread necromancy. Are the OP's assessments still accurate, or has anything changed dramatically in the 3 years since this was written?

 

[2012mdc]

Sorry about the thread necromancy. Are the OP's assessments still accurate, or has anything changed dramatically in the 3 years since this was written?

Curious as well

 

[sunset823]

Nice to know that my interest (critical care) is dead last. But no spouse, no kids, no life, no problem. Also, CC is moving more towards shift work (like EM), so that may have helped the lifestyle a bit.

 

[penguin24]

Nice to know that my interest (critical care) is dead last. But no spouse, no kids, no life, no problem. Also, CC is moving more towards shift work (like EM), so that may have helped the lifestyle a bit.

Yeah, but you're young right now. What happens when you get older? Won't you want a life at some point?

 

[sunset823]

Yeah, but you're young right now. What happens when you get older? Won't you want a life at some point?

neh. I'm old enough. I've got Ryan Bingham syndrome (Up in the Air, one of my favorite movies), no matter what I do "settling down" isn't in my future. Besides, it's not like it's trauma or transplant surgery.

 

[bomgd3]

Lollerskates @ the family med salary

I didn't realize pathology was comparable to derm salary wise. I know path is a great lifestyle, but I always heard derms made in the $400k range. What's the discrepancy?

 

[ButImLETired]

Lollerskates @ the family med salary

I didn't realize pathology was comparable to derm salary wise. I know path is a great lifestyle, but I always heard derms made in the $400k range. What's the discrepancy?

Maybe they include dermpath in the calculation? Their absurdly high salary would bring up the average, for sure.

And as far as derm, my understanding was always that their main appeal is the lifestyle- easy hours, no emergencies, patients rarely die on you (and by then they have an oncologist anyway), plus short training. If you do a lot of cosmetic work, give Botox, prescribe Latisse and do peels all day, you can probably bring up your salary quite a bit. But then, you know, you're THAT guy.

I may have to rethink a couple of my interests based on that list...

 

[AlexMorph]

Derm is nasty. I can't go through a derm book without being severely grossed out.

 

[Mace1370]

Derm is nasty. I can't go through a derm book without being severely grossed out.

Sounds like your true calling is forensic pathology!

 

[TexasPhysician]

Lollerskates @ the family med salary

I didn't realize pathology was comparable to derm salary wise. I know path is a great lifestyle, but I always heard derms made in the $400k range. What's the discrepancy?

Pathology is one of the worst paid field in medicine.

Derm-path is usually entered as a fellowship post-dermatology residency.
Pathologists can try to land a derm-path fellowship but it ain't easy

 

[TexasPhysician]

I used numbers I found online and elsewhere. I know people making 2x+ what I have for median salaries in all of these specialties and nobody that makes less than the numbers I posted. I seems odd to me, too. I think the key is to use the numbers as a comparison between the specialties, not necessarily as an absolute number of what you can expect to make as this varies significantly in most specialties. It may be that the area I live in pays better than most (I know it does), that people underreport their salary to surveys or that you only hear stories about high salaries that make these numbers look small.

Here are some examples of what some docs in my area are making:

Family 375k, occ med 450k, pathology 500k, ER 400k, radiology 850k, anesthesia 750k, derm 1.2 mil, ophthal 800k, ENT 800k, OB/Gyn 750k, spine surg 2 mil, interventional pain 700k, Ortho 1 mil, Cardiology 800k

There are not so many rich CEOs and large corporations around here so the docs are among the richest people in town and the cost of living is low.

While all of these numbers are possible, this is no where near average and requires incredible business skills. For example, my friend's father is FM boarded but runs a large clinic to make his $300,000. Pathologists making $500k are VERY FEW and would almost have to be fellowship trained in derm-path. Overall, very hard to make good money in pathology. If you own a large cosmetic clinic, derm can make a killing. If you live in the right area and work hard, you can make over $400k in ER. Interventional pain pay is dropping quick - reimbursements aren't what they used to be. If you own a surgery center, the numbers you mentioned are low.

Making big money in medicine is not what field you are in, but how good your business skills are. I've seen psychiatrists make twice what surgeons do in the same city. The likelihood of landing any of the salaries mentioned above is about 0.1% in a salaried position. If you practice and own a medical center while overseeing mid-level providers, your income will obviously be much greater than average. Then again, you likely won't be working only 40 hours/week as well.

 

[MossPoh]

Plus, being in South Dakota helps a bit. I'm sure the patient's options are limited as to who they can go see. Cuts down on the marketing bill.

 

[bomgd3]

Pathology is one of the worst paid field in medicine.

Derm-path is usually entered as a fellowship post-dermatology residency.
Pathologists can try to land a derm-path fellowship but it ain't easy

I'm not sure where you're getting that path is poorly paid. All of the private practice pathologists I know make at least $200k, and one of my family members makes $250k working 7-ish hour days. That seems like pretty good money to me.

 

[TexasPhysician]

I'm not sure where you're getting that path is poorly paid. All of the private practice pathologists I know make at least $200k, and one of my family members makes $250k working 7-ish hour days. That seems like pretty good money to me.

I'm not saying that there aren't any good paying path jobs. There are. Just fewer than many other fields. Below you see the link to MH's most recruited fields. Primary care and lifestyle fields fill most of the list. Pathology isn't a very recruited field. It is one of the most oversatured comparatively. -
http://www.merritthawkins.com/uploadedFiles/MerrittHawkings/Surveys/mha2010incentivesurvPDF.pdf

Check most public med schools. You can find actual salaries of current physicians. Its sad when you look below and find most of the path department on pages 6 and 7. Nurse anesthetists make more than some pathologists and most of those path docs are fellowship trained.
http://www.texastribune.org/library...ech-university-health-sciences-center/?page=7

If you love path, you will always find a job (just like any other MD), but financially there are many better paths than path in my opinion.

 

[MagicDrumSticks]

What happened to gas docs? (anesthesia) I know a doc who works for Baylor (Texas) and every time I was at the hospital volunteering, he'd always be on google earth looking at pics of different places or be on facebook chatting it up with 5 ppl at once. I also remember *tactfully* asking him so how much do anesthesiologists make around here? I'm sure he said something like $280k