Looking at money in medicine .. for pre meds

[mcat_taker]

The opportunity cost aspect of medicine cannot be overstated. Ten years of very hard work is one thing. It's another beast altogether when 4 of those years you are plummeting your net worth to -$250k or worse and then merely trying to stop the bleeding from compound interest with a job that amounts to slightly above what the high-schooler flipping burgers makes. Only then do you get the opportunity to continue working a high stress job ~50h/wk with additional call for the salary. Every cent is earned. Compare this to an engineer etc where if they work an equivalent number of hours they are getting ahead and benefiting from the 10 most important years of compounding interest.

For me the financial dissatisfaction comes from the feeling of abuse and lack of positive feedback from this hard work. I've worked the past 10 weekends and came in around ~85h/wk as an intern (they can and will do this to you, even if there are "rules"). Yet despite this I make less than the new nurse working three 12s, and half of what a new PA or NP does working a lifestyle schedule. Throw in the differential that comes with nights/weekends and the gap widens. So in your late 20s/early 30s not only do you have zero financial flexibility but also extremely minimal work-life balance. It's a huge sacrifice. That same sacrifice gets rewarded handsomely in other fields. It just constantly feels like you are getting taken advantage of as a med student and as a resident because you are effectively handcuffed to the process if you want to eventually practice. I have friends who are in IB, engineering, law etc and when I tell them that I have to work the weekend overnights after a full week and don't get any additional compensation or vacation they have a look of disbelief or pity. If they did that it would be greatly rewarded with a bonus, overtime, promotion or more vacation. I'm not suggesting everyone is cut out for any of those professions but they just all seem to get treated much fairer than in medicine.

I think working 40 years doing something else for $80k but being able to consistently enjoy the evenings and weekends offers a much more rewarding life than medicine. If money is your prerogative then at least you can choose to sacrifice some extra hours on your own terms. You also pay a premium to live in an urban area in the way of lower salaries... which is in direct contrast to almost any other white collar profession. Not to mention the stability of medicine is nowhere near the generations of lore. With private equity and business types calling the shots attendings can and do get laid off. Anyone going into medicine for "the money" is a fool. But by the time you realize it you already have there golden handcuffs. Caveat emptor.

Well said. Not only all this but I think it cannot be overstated that there are midlevels literally in every field of medicine with powerful lobbyist groups. These midlevel providers are smart and good at what they do. The suits in charge look for every opportunity to replace docs with more NPs/PAs when they can because it is a cheaper option towards their bottom line. For those that keep saying medicine offers stability it really doesn't.

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[notretired]

I've had way too many discussions about this and way too many (vast majority) of pre meds (even med students/residents often have no clue) have no idea what they are talking about (in real life and here). I decided to start a thread to help you pre meds understand the money in medicine a bit better.

To keep it short, here are the take away points for MDs (I dont know DO's situation)

1) Doctors make good annual salary. But it is only ONE number. To determine financial health, or to compare financial health, you need a lot more than 1 number. A college student making 250k at age 22, is not the same as a doctor making 250k at age 33. The difference is MUCH MUCH larger than you think.

2) The cost to become a doctor is massive. More than you think. Because theres lost wages, and compounding on interests

3) It takes a lot to become a doctor, even if you might not agree. To become an attending, you wouldve already gone thru MANY selection processes. Many of you were top students in HS to get into good college, then excel in college, then do well on MCAT, get into MD, be smart/diligent enough to graduate and pass exams, get into residency/specialty of choice, +/- get into fellowship, then FINALLY find a job. Too many of you see a starting salary of 250k, then compare it to starting salaries in other fields. It's NOT comparable. At every step of the way, people get weeded out. Becoming an attending is perhaps comparable to someone getting promoted multiple times at another job so comparing our starting salary to an entry level salary is ******ed.

4) if you can make it all the way thru residency/fellowship, and become an attending making 250k. You are probably smart enough to do OK in other fields too. You probably wont be that person getting fired from a company cause you suck.

5) Your salary as a doctor will depend heavily on insurance reimbursement rates, which for sure wont be making large increases out of no where, but can have large decreases out of no where. Therefore, you wont be getting significant raises even after years of practice unless you increase your volume/hours worked. This differs from most other fields in that they reward you for your experiences which result in significant raises.

6) Where you want to live matters. Living in NYC will be a lower salary than middle of no where. For most other high paying fields, large city wages are higher to adjust for cost of living. Not true for medicine.


Not knowing this stuff will leave you very disappointed in the future if you care about $$$.

Also, every field is changing quickly. Medicine is not static. Asking your parents or some old attending about how much they liked the finances of medicine is not comparable to the current situation (yes the current may not apply to the future as well but it's more likely than the past). Those physicians lived in an era of very different purchasing power. Their salary went a long way. Plus no 250k debt dragging them down.

My advice to pre meds who care about $$. Consider it from all angles, not just a annual #, cause that # only tells a very small part of the story.

I'll go through this point by point to offer a slightly different perspective.

1) Hardly any college grads are making $250k at age 22. There is tremendous bias on SDN towards individuals hailing from the top 20 or so undergrads - by and large these individuals will have a higher % of friends who are starting out in higher income brackets - but regardless, even making $150k directly out of ug is exceedingly rare. I went to a state school, the only people I know making >$100k now are engineers, and all of them signed initial offers for $50-75k. I don't know anyone 5years out from my ug making >$150k.

2) This is true, but with the arguable exception of HYPSM grads or those with very well connected/wealthy parents, few would be better off financially than they would be as an attending 5-10yrs out of residency.

3) Do you think people don't get weeded out in business/consulting/finance world? Anyone making $250k in any field faced an extensive weeding out process. Less than 1.5% of HOUSEHOLDS across all age groups make that kind of money. Once you're accepted to a US medical school - the risk of not following through to one day see that kind of money is negligible.

4) This is not necessarily true - outside of engineering most fields require skillsets that are far more nuanced and subjective than what it takes to get through med school + residency. You won't be seeing >$250k if you don't get promoted, and most don't get promoted(at least to that level). There's no simple track in business/consulting/finance, no one checks boxes to get promoted. Nepotism notwithstanding, it's risk takers that move into the higher income brackets - and by the very nature of that risk - far more fail than succeed. It is in the interest of large corporations to pay employees as little as possible. If you want to move up you have to move out (or at least challenge your company to keep you). Flirting with other companies to make your employer jealous is a little like playing Russian roulette, you could end up with a promotion or get the axe - add in mortgage, car payments, kids and wife, and most prefer to stay put at their "ok but not great" salary.

5) "This differs from most other fields in that they reward you for your experiences which result in significant raises." LOL (see point 4). True that as a doc insurance rates will cause ebbs and flow in salary, but at the end of the day you're still a doc and the job security is second to none. In the business world your entire livelihood can come crashing down at the whims of economic shifts, trash leadership, mergers, or force reductions.

6) True, but I have no sympathy for those people. We don't need more docs in NYC.

 

[LizzyM]

at the end of the day you're still a doc and the job security is second to none.

Several have commented on the job security of physicians... I just want to point out that physician job security is very much dependent on your willingness to take care of patients. I know of at least three, maybe four, physicians in their 50s who have been laid off from academic positions because they were not satisfied with the mix of clinical and administrative work assigned them and in most cases because they were not happy doing anywhere from 50-90% clinical work (in part, I think because "half time" is a time sink that will gobble up all your time). So, before you decide that a career in medicine will make it possible for you to earn more than in any alternate career, be sure that you really want to do the day-to-day work of clinical service.

 

[DrRealistic]

The return on investment for becoming an internist/FM physician > becoming a specialist (years of compounding lost, and the salary increase isn't offsetting the money gained while doing GP medicine during the fellowship years) or getting into finance/law//pro athlete/lliterally any other field for two reasons: 1. This path is guaranteed to be achieved if you're working hard. Being a lucky idiot constitutes the major part in the concoction of success in the non-academic fields so sure, while they rake in 100 million USD by acting 10-15 hours a week (if stretched out) for a blockbuster movie (didn't iron man actor rake in 110 million from the latest avenger?) the reason why they're in those positions in the first place is because they happened to be in the right place the right time (while being homeless and being drug addicts and lazy at the same time too, pretty sure you're all familiar with the story of Robert Downey jr and the likes of him but yea).

The other reason is that the flexible nature of the GP schedule allows you to actually devote time into the methods that allow you to rake in those 7 figure + salaries. Hospitalists with the 7x7 schedule can definitely leverage this.

So if you're set on money (like I am, but not only) and want to hit those 50m+ net worths < age of 50 you NEED to be aware of the above. Because if you are you would know that there is literally no method that guaranteedly will lead you to that kind of money (hence your physician job to retract back to if the luck-requiring methods fail. Robert downey would still inject himself with heroin and live in the streets if not for his luck for example) and worst case scenario is you live the upper-middle class life style. And hopefully the side-hustles you devote time into while working your flexible schedule happen to be done the right time and the right place so you may reach FI with 50m+.

I plan myself to, during my 7 days off as a hospitalist, try coming up with some kind of product that will hopefully blow up. I've heard about the great potentials in the game industry so maybe that's where I'll focus.

 

[RangerBob]

Set your own hours? Most of the attendings I know work the hours they need to work for FTE salary or they get replaced like a cog in the machine that is EVERY DOCTOR in every big healthcare system. That means weekend call, working holidays, phone calls to other teams in the afternoons, calling patient's family members, notes and more notes after hours, teaching residents, going deeper into the medical chart on a more challenging case that hasn't revealed an answer yet, the list goes on. Becoming an attending doesn't automatically make your life awesome. You finally get paid a decent wage after a a decade of school and training but don't think for a second you can just make your own decisions on when you can work. Even strictly outpatient you need to generate enough RVUs to justify them paying you. You need to maintain availability and a patient panel, etc.

Yes most high income professionals work a lot to justify what they are being paid. Being a doctor is no different or better and is certainly not a "lifestyle" career unless you do a certain select few elite specialities that are difficult to match into.

That’s why physicians should go into solo or group practice like me, and own their business/be their own boss. Salary is better, and you can set your own hours-to a reasonable degree of course. There are always going to be some baseline requirements depending on your field, if you’re contracted to provide call coverage to the hospital, etc.

 

[notretired]

Several have commented on the job security of physicians... I just want to point out that physician job security is very much dependent on your willingness to take care of patients. I know of at least three, maybe four, physicians in their 50s who have been laid off from academic positions because they were not satisfied with the mix of clinical and administrative work assigned them and in most cases because they were not happy doing anywhere from 50-90% clinical work (in part, I think because "half time" is a time sink that will gobble up all your time). So, before you decide that a career in medicine will make it possible for you to earn more than in any alternate career, be sure that you really want to do the day-to-day work of clinical service.

To be fair, job security goes out the window when you refuse to do said job. That said, this comment highlights the influence of corporate culture in medicine - and one could argue that as long as schools continue to burden their students with tremendous debt - the power shift will continue to favor the hospital corporations. If there wasn't so many debt ridden new attendings willing to jump on those positions detailed above, those older docs might've had the power to push back against their employers demands without being shown the door.

 

[907914]

Thought this might be relevant:

Went on a med school tour yesterday, and the tour guide (an M2) said “as you can tell, all of the buildings are named after people smart enough not to go into medicine so that they could make enough money to buy a building for us.”

 

[Engrailed]

Thought this might be relevant:

Went on a med school tour yesterday, and the tour guide (an M2) said “as you can tell, all of the buildings are named after people smart enough not to go into medicine so that they could make enough money to buy a building for us.”

Preach

 

[anbuitachi]

That’s why physicians should go into solo or group practice like me, and own their business/be their own boss. Salary is better, and you can set your own hours-to a reasonable degree of course. There are always going to be some baseline requirements depending on your field, if you’re contracted to provide call coverage to the hospital, etc.

Agree but in many fields its either very difficult, or more difficult in todays environment

 

[PikminOC]

Agree with you. but its much easier to believe 'dont do medicine for the money' if you understand where its coming from. too many pre meds are told 'dont do it for money' but they dont know why, and they see the 300k pay and they think why not, and do it anyway. ive met so many med students/residents who understand later on why it is and regret it. not saying do medicine just for the money but for a lot of people who have many interests, that 300k # may sway ppl to a side. i can tell you when i was pre med, i certainly didn't consider the power of compounding, lost wages, tuition cost etc. i was just a dumb undergrad.

also i think the high security job is becoming more of a thing of the past. again if we are comparing to avg americans going into XYZ field, sure, but if we are comparing equally smart individuals in other fields (finance/tech), how many become unemployed and stay so? There are SOOO many companies out there in finance/law/tech. Dont forget that those who become attendings have already survived the weed so it's not a fair comparison to compare their entire field with ours

Also in some specialties, the jobs are not as stable as pre meds think anymore. many hospitals are closing or have closed in the past decade, groups bought out by large employers/companies, healthcare changes and the future is still pretty unpredictable right now with so many politicians aiming for medicare for all. its very unlikely to be unemployed, but its not that unlikely to be forced to change employers

Regarding stability, the mid-level infiltration is important as well

 

[PikminOC]

Fair enough



I don’t have numbers to back this up, but I’m going to shoot from the hip and disagree with you anyway. We’re in a decades long bull market. Economic times are great right now. When the S&P plummets 15-20%, as it inevitably will at some point in the next century, I don’t see the physician workforce being cut as much as any other sector we’re talking about.

I think that if we were in 2008, you would have a different perspective on the financial value of being a physician compared to other professions.



OK - agreed that the future is unpredictable. In my opinion, that’s a poor reason to avoid medicine.

In every career I’ve ever been interested in, I’ve been told by veterans of said career that “this job isn’t wasnt it used to be” or “you should become an xyz instead.” They see other options with rose tinted glasses; I think this is a human universal.

It's very different with med school now regarding the amount of loans, interest, and compounding interest.
Older docs did not have such massive loans. It's not just about saying things are different now blithely.
And now It's much harder to even get residency

 

[PikminOC]

I agree with you in some parts. I dont think you'll ever not have jobs for physicians. As a society we NEED physicians because we provide an invaluable service. What will change with economy is physician reimbursement. We will always live thru ups and downs in economy. Finance took a hit in 2008, but its back stronger than ever. Its again important to remember that to become attendings you already survived thru a lot of weed off process. The people like you are probably not the ones to get fired and stay unemployed. Most peoples bonus will go down of course

Mid-levels have minimal debt, much shorter education, start younger, and hospitals love them. They can hire many of them for the same price as the doc. Bill under the doc, and get doc level reimbursement

 

[PikminOC]

As mentioned above, most law grads are in miserable conditions. There have been numerous articles from papers like the NYT discussing this. Grads from anything other than top schools rarely make six figures and a huge percentage are working jobs that don’t require a JD. All with debt that isn’t that much lower than an MD’s.

Those making big salaries at top firms have miserable work-life balance. Think residency, but for your entire life.

Coders/tech may make good money-generally if you’re in Silicon Valley, where a “decent” home will cost you over $1 million (and often run closer to 2). My childhood home (an average home) is worth almost $2 million now. In the Midwest, it’d be $250,000 or so. Tech people are often limited to where they can live-remote work is typically for those who have been with the company a long time.

Finance? Most don’t make what we think they do. Entirely dependent on how the market is doing. Terrible work-life balance if you’re making big money.

None of those jobs are even close to “recession-proof” like being an RN or MD is. It is actually scary how bad of a doctor you can be and still find a good-paying job somewhere. Try talking to some of your friends’ parents who lost their jobs in the great-recession. Many were bright people, at the top of their fields, and very dedicated. They were going to job fairs to take any job that would hire them.

MDs are guaranteed a great salary (hoe many fields can say that?). We have amongst the best job stability of any field. We are needed, and wanted. The public respects us. When you’re an attending, you can be your own boss and set your own hours, and still make good money.

I cannot think of any other field that offers what medicine can. Firefighting? Almost, but there all all the on-the-job hazard. Great pay, great pension and early retirement. Everyone loves them too. Probably make more over their lifetime than I will...

Medicine is extremely highly regulated. Can lose everything if any license problem, malpractice cases, bad outcomes, etc

 

[993444]

Medicine is extremely highly regulated. Can lose everything if any license problem, malpractice cases, bad outcomes, etc

I mean.... it took a while before someone did something about Christopher Duntsch or Carmen Puliafito, or Larry Nassar.

Sure, they got what they deserved in the end but only after years/decades of red flags and alarms until someone had the decency to say "let's do something about this guy before another person dies or gets psychologically damaged for life".

 

[PikminOC]

I mean.... it took a while before someone did something about Christopher Duntsch or Carmen Puliafito, or Larry Nassar.

Sure, they got what they deserved in the end but only after years/decades of red flags and alarms until someone had the decency to say "let's do something about this guy before another person dies or gets psychologically damaged for life".

Please look at the medical board discipline in your state. Not everyone is Duntch or Nasser. Those are the just the highly publicized ones

 

[PikminOC]

My patients applying to med school are told the reality of getting residency slots as the school doesn't want to be sued for not giving out accurate information

 

[Lampy]

My patients applying to med school are told the reality of getting residency slots as the school doesn't want to be sued for not giving out accurate information

What is the reality?

 

[tri99]

The Top 1 Percent: What Jobs Do They Have?

Explore the occupations and industries of the nation's wealthiest households.

archive.nytimes.com

Physicians are the most likely profession to be in the top 1%. Yes I understand a physician will never net 5 million+ but in the grand scheme of things, complaining about an annual salary of $200,000+ is distasteful imo.

 

[PikminOC]

What is the reality?

Med School Enrollment Expands, Concern for Residency Slots Lingers

Enrollment in US medical schools has grown by 31% since 2002, but averting a physician shortage hinges on boosting the number of residency training slots.

www.medscape.com

I don't think the ratios will improve over time.

 

[CidHighwind]

Keep in mind 250k is on the lower end. 400-500k isn’t out of the question for a lot of specialists, and even more depending on how successful the practice is.

 

[BorderlineQueen]

Keep in mind 250k is on the lower end. 400-500k isn’t out of the question for a lot of specialists, and even more depending on how successful the practice is.

Most physicians are hospital employees most don’t own private practices anymore . If you go to a DO school you will most likely end up in primary care/psych/EM you can only hit those numbers in those specialties by working 60+ hours a week. Most students aren’t matching into derm, plastics, ENT because it’s so competitive.

 

[CidHighwind]

Most physicians are hospital employees most don’t own private practices anymore . If you go to a DO school you will most likely end up in primary care/psych/EM you can only hit those numbers in those specialties by working 60+ hours a week. Most students aren’t matching into derm, plastics, ENT because it’s so competitive.

So then why are we telling students to go into other fields with the assumption that they’ll be the top percentile in those fields? We assume that people will get into a top law school, graduate top of their class to earn less than a PCP. Why not do the medicine equivalent and say someone gets into a top 40 medical school, kills Step, matches Derm and does a Mohs fellowship and earns 1 mil a year? The same way you instantly felt the urge to bark back about how hard that is and how unrealistic it is a similar %tile that make it big in law or business. Since the correlary in law is the lawyer making 50-60k a year or the person in middle management making 40-50k a year.

 

[BorderlineQueen]

So then why are we telling students to go into other fields with the assumption that they’ll be the top percentile in those fields? We assume that people will get into a top law school, graduate top of their class to earn less than a PCP. Why not do the medicine equivalent and say someone gets into a top 40 medical school, kills Step, matches Derm and does a Mohs fellowship and earns 1 mil a year? The same way you instantly felt the urge to bark back about how hard that is and how unrealistic it is a similar %tile that make it big in law or business. Since the correlary in law is the lawyer making 50-60k a year or the person in middle management making 40-50k a year.

People should do whatever they want. I think one who gets a 3.9 and gets into a top 20 law school will do great. Average salary for a lawyer is 128k and if you go to a top 20 you’ll be making more. I think you have some magical thinking going on. Every M-1 says they’ll be going into derm,ortho, plastics after step 1 like 90% of people change what specialty they want to go into. Because they didn’t do as well on step 1 as they liked. Only 172 plastics position and like 400 derm positions Everyone thinks that will be them but it probably won’t be. Not everyone gets to be a dermatologist or plastic surgeon.

 

[CidHighwind]

People should do whatever they want. I think one who gets a 3.9 and gets into a top 20 law school will do great. Average salary for a lawyer is 128k and if you go to a top 20 you’ll be making more. I think you have some magical thinking going on. Every M-1 says they’ll be going into derm,ortho, plastics after step 1 like 90% of people change what specialty they want to go into. Because they didn’t do as well on step 1 as they liked. Only 172 plastics position and like 400 derm positions Everyone thinks that will be them but it probably won’t be. Not everyone gets to be a dermatologist or plastic surgeon.

And not everyone crushes the LSAT, graduates in the top 25% of their law class and makes it to partner in a law firm. I think you have some magical thinking going on with the assumption that it’s a lot easier to make money as a lawyer than as a doctor. Be a lawyer because you want to be one, but most wont make what a physician makes. Heck, you’ll make more as a dentist at around 200k a few years out vs 120k as a lawyer.

 

[BorderlineQueen]

And not everyone crushes the LSAT, graduates in the top 25% of their law class and makes it to partner in a law firm. I think you have some magical thinking going on with the assumption that it’s a lot easier to make money as a lawyer than as a doctor. Be a lawyer because you want to be one, but most wont make what a physician makes. Heck, you’ll make more as a dentist at around 200k a few years out vs 120k as a lawyer.

I’m not saying it’s easier I’m just saying do whatever you want to do. I don’t care some lawyers do make more money than physicians. To be an MD/DO you have to be okay with being poor for 7-10 years while training. If you’re solely going in for the money you’ll be unhappy. If someone is capable of matching derm they are more than likely to also be able to graduate 25% of their class at a top 20 school. Also average income for a dentist is 150k and dental school is 80-100k per year.

 

[CidHighwind]

I’m not saying it’s easier I’m just saying do whatever you want to do. I don’t care some lawyers do make more money than physicians. To be an MD/DO you have to be okay with being poor for 7-10 years while training. If you’re solely going in for the money you’ll be unhappy. If someone is capable of matching derm they are more than likely to also be able to graduate 25% of their class at a top 20 school. Also average income for a dentist is 150k and dental school is 80-100k per year.

What dental school is that expensive? Most state schools are closer to 30-40k a year. Also my point is that there’s no job that has a better ROI than medicine. You should also have an interest in science, helping people, etc, but to act as if going for a job where you’re making 250k a year and can move basically anywhere in the country is “terrible” is silly. I always feel like posts like yours are just gunners trying to get other premeds to apply to other stuff so that it’s easier for “the people that really want to be a doctor” (I.e you)

 

[BorderlineQueen]

What dental school is that expensive? Most state schools are closer to 30-40k a year. Also my point is that there’s no job that has a better ROI than medicine. You should also have an interest in science, helping people, etc, but to act as if going for a job where you’re making 250k a year and can move basically anywhere in the country is “terrible” is silly. I always feel like posts like yours are just gunners trying to get other premeds to apply to other stuff so that it’s easier for “the people that really want to be a doctor” (I.e you)

Average Dental School Debt 2018 - Student Debt Relief Average debt of someone who went to dental school is 287k. I’m not even pre-med anymore so ... That does not explain your theory.

 

[CidHighwind]

Average Dental School Debt 2018 - Student Debt Relief Average debt of someone who went to dental school is 287k. I’m not even pre-med anymore so ... That does not explain your theory.

Your own link says that tuition costs were 145k over 4 years. Here’s a link showing that lawyers have around 200k in debt when they graduate:

The Verdict is in: Law School Student Debt is Criminally High

Law school student debt is criminally high. However, the range of the offense is large and varies from 3rd degree misdemeanor to 1st degree murder.

www.studentloanplanner.com

Debt isn’t something unique to medical school. If you’re going to professional school, most likely you’ll have debt.

 

[BorderlineQueen]

Your own link says that tuition costs were 145k over 4 years. Here’s a link showing that lawyers have around 200k in debt when they graduate:

The Verdict is in: Law School Student Debt is Criminally High

Law school student debt is criminally high. However, the range of the offense is large and varies from 3rd degree misdemeanor to 1st degree murder.

www.studentloanplanner.com

Debt isn’t something unique to medical school. If you’re going to professional school, most likely you’ll have debt.

Your own link says that tuition costs were 145k over 4 years. Here’s a link showing that lawyers have around 200k in debt when they graduate:

The Verdict is in: Law School Student Debt is Criminally High

Law school student debt is criminally high. However, the range of the offense is large and varies from 3rd degree misdemeanor to 1st degree murder.

www.studentloanplanner.com

Debt isn’t something unique to medical school. If you’re going to professional school, most likely you’ll have debt.

Yeah but if you read further the average debt is 287k. Average tuition and average debt are too different things.

 

[Chibucks15]

Did I miss the memo about medicine guranteeing a 5 mil net worth at age 35? Because damn people complaining about 240k minimum guaranteed salary are either jaded as hell or really are out of touch with how 99% of the country lives. Sure the debt is insane but there aren't docs who can't afford a decent life unless they do something stupid. It's a lot harder than people realize to be making 100k even at age 25. I mean come on people

 

[CidHighwind]

Here’s my argument. Okay, tell people don’t go into medicine for money, but the question is what’s a better option. There’s easier options to upper middle class lifestyle, but I don’t know any path for a >240k job anywhere in the country. All these “top law school” things are kind of silly when you keep in mind someone from a no-name med school that graduates at the bottom of their class and barely passes boards has better job prospects than someone from a top law school that graduates in the lower third of their class. People on SDN talk about a field being “saturated” if they can’t get a job in Boston or San Fran, in other fields saturation means going long periods of not being able to get any job. There’s a reason everyone wants to be a doctor growing up. It’s the best job in the world. You can talk about all the negatives, but whatever field you see as “greener” is probably worse. Like even the tired high finance jobs don’t compare to medicine since they have such high turnover, residency hours, mean bosses, and many still aren’t going to make more than a specialist would.

 

[PikminOC]

Average Dental School Debt 2018 - Student Debt Relief Average debt of someone who went to dental school is 287k. I’m not even pre-med anymore so ... That does not explain your theory.

You are right. The expenses for dental school are MUCH higher given their clinical years, labs, etc.
And some of their residencies are not paid. You have to pay for residency in prostho, endo, perio, oral radiology/pathology, dental public health...

 

[PikminOC]

Did I miss the memo about medicine guranteeing a 5 mil net worth at age 35? Because damn people complaining about 240k minimum guaranteed salary are either jaded as hell or really are out of touch with how 99% of the country lives. Sure the debt is insane but there aren't docs who can't afford a decent life unless they do something stupid. It's a lot harder than people realize to be making 100k even at age 25. I mean come on people

Let us know when youve practiced for 10 years.

 

[Chibucks15]

Let us know when youve practiced for 10 years.

I mean sure that's an easy response, but I fail to see how that has any bearing on my response. I mean hell given the jobs I've worked before med school for minimum wage a MINIMUM salary of 240k is amazing. Its more double what my parents made combined and I grew up fine. I can be practicing for 20 years and my mindset won't change on that. It sounds jaded and out of touch, regardless of how bad a certain practice situation is. If you didn't have at least a general idea of what you were getting into with this crazy ride that's on you

 

[BorderlineQueen]

I mean sure that's an easy response, but given the jobs I've worked before med school a MINIMUM of 240k is amazing. Its more double what my parents made combined and I grew up fine. I can be practicing for 20 years and my mindset won't change on that. It sounds jaded and out of touch, regardless of how bad a certain practice situation is. If you didn't have at least a general idea of what you were getting into with this crazy ride that's on you

I'm not complaining about a minimum physician salary of 240k. I just think it's a poor choice financially. Think about this psych NPs get paid around 165k I've seen jobs around 200-250k for them. They only went to school for 2 years while probably still working full time. Your average psychiatrist is around 240-280k with significantly more debt and they also started practicing later.

 

[Chibucks15]

I'm not complaining about a minimum physician salary of 240k. I just think it's a poor choice financially. Think about this psych NPs get paid around 165k I've seen jobs around 200-250k for them. They only went to school for 2 years while probably still working full time. Your average psychiatrist is around 240-280k with significantly more debt and they also started practicing later.

I think NPs are gonna bust themselves out of jobs. Once a few lawsuits happen with independent practice and if theyre actually trying to achieve even pay, there will be zero reason for systems to take the risk. Why hire an NP over an internist if you have to pay them the same?

Its definitely not as good of financial decision as it used to be, but the sentiment of 'nobody should practice it anymore because no money' is absurd

 

[deleted876933]

.

 

[PikminOC]

I think NPs are gonna bust themselves out of jobs. Once a few lawsuits happen with independent practice and if theyre actually trying to achieve even pay, there will be zero reason for systems to take the risk. Why hire an NP over an internist if you have to pay them the same?

Its definitely not as good of financial decision as it used to be, but the sentiment of 'nobody should practice it anymore because no money' is absurd

Its not an easy answer. Its just not something thats easily explainable until it happens to you.
And nurses are held to a nursing standard. Bar is different for a lawsuit than for a physician.
And I never said dont go into medicine.

 

[BorderlineQueen]

If I am going to work for my whole life I want to do something that makes me feel like I did not waste my time on this earth. I think medicine is one of the best vocations to have a high likelihood of accomplishing this while allowing me to provide for my family. I do not want nice cars or watches, but I do want a decent house and to be able to give my children the option to do whatever their passions tell them to do. If this is all I want from medicine am I entering into it naively? If I can make 8k take home a year I would be happy(after paying my loans of course) which at 25-35K a month seems very realistic., I think I am pursuing the right career am I wrong? I will admit PA NP would also accomplish this and would be easier, but I want a challenge and I want to push myself to see how great I can be. I am really interested in some feedback as I have a family and I care more about their happiness than my own. If you want to make the most money possible and win the video game cause you have the most points obv medicine is not for you, but who wants those people to be their doctor.

Only you can make that decision for yourself.

 

[PikminOC]

I mean sure that's an easy response, but I fail to see how that has any bearing on my response. I mean hell given the jobs I've worked before med school for minimum wage a MINIMUM salary of 240k is amazing. Its more double what my parents made combined and I grew up fine. I can be practicing for 20 years and my mindset won't change on that. It sounds jaded and out of touch, regardless of how bad a certain practice situation is. If you didn't have at least a general idea of what you were getting into with this crazy ride that's on you

The level of responsibility of a physician is much more than most any other job.
And I'm not jaded. I love my job.

 

[CidHighwind]

Let us know when youve practiced for 10 years.

This seems to be your go to response. What’s your agenda?

 

[Chibucks15]

Its not an easy answer. Its just not something thats easily explainable until it happens to you.
And nurses are held to a nursing standard. Bar is different for a lawsuit than for a physician.
And I never said dont go into medicine.

I wasn’t talking to you in particular but those are valid points. I was speaking in generalities about some of the complaints on here is all

 

[PikminOC]

This seems to be your go to response. What’s your agenda?

No agenda. Don't know where medicine will be at that point for yall. It changes all the time.

 

[CidHighwind]

I hope no one is so naive to think there are no downsides to medicine. The only thing I and other posters take umbrage with is the notion that other fields have it “so much easier”. Only in that it’s somewhat condescending to those other fields, and doesn’t take into account the different skill sets needed for different jobs.

 

[DrStephenStrange]

I'm not complaining about a minimum physician salary of 240k. I just think it's a poor choice financially. Think about this psych NPs get paid around 165k I've seen jobs around 200-250k for them. They only went to school for 2 years while probably still working full time. Your average psychiatrist is around 240-280k with significantly more debt and they also started practicing later.

If we consider 240k salary for a physician and 165k salary for a NP (although most NPs don't make that much), about 300k and 100k in loans for physicians and NPs respectively, and let's say about 40 years of total time in the workforce.

Physician total lifetime income = (240k × 40) - 300k = $9.3 Mil.
NP total lifetime income = (165k × 40) - 100k = $6.5 Mil.

Looks like the lowest paid Physician still makes about $2.8 Mil. more in their lifetime than the highest paid NP, and that's being generous to NPs because most sources I have checked put NP salaries between 92k and 125k.

 

[BorderlineQueen]

If we consider 240k salary for a physician and 165k salary for a NP (although most NPs don't make that much), about 300k and 100k in loans for physicians and NPs respectively, and let's say about 40 years of total time in the workforce.

Physician total lifetime income = (240k × 40) - 300k = $9.3 Mil.
NP total lifetime income = (165k × 40) - 100k = $6.5 Mil.

Looks like the lowest paid Physician still makes about $2.8 Mil. more in their lifetime than the highest paid NP, and that's being generous to NPs because most sources I have checked put NP salaries between 92k and 125k.

True but NPs start working 6 years earlier than a physician so it's around $7.5k total lifetime income. Only around 1.8 million dollars less. Psych NPS make excellent money. I've seen some jobs for psych nps where starting pay is around 200-250k. Also the lowest paid doctors are pediatricians at around 205k per year. 205*40-300 is $7.9 million lifetime income. So it's not a huge difference compared to psych NPs and CRNAS.

 

[907914]

I like to put things in perspective a bit to understand how much money even “just” $240K is...I bought my car in 2015 at $21,000 when I was making around $40/hr on average. 5 year finance, 2.6% interest rate - good deal, good payment plan, good car. At $240,000 annually, I could pay cash for my car every 6 weeks post tax. That is insane. And that is just Salary income, not passive from owning property or stocks or whatever. Not wealth, just straight up income.

Having grown up how I have and now loved how I have, all middle class to upper middle class in lifestyle, I genuinely cannot understand how financial compensation is an issue. Medicine most certainly has its problems and complaints about the profession are genuine, justified, and valid...but to have income as one of those complaints is petty.

 

[Select All That Apply]

Note: There was enough interesting content that I decided to post. Sorry.

I think NPs are gonna bust themselves out of jobs. Once a few lawsuits happen with independent practice and if theyre actually trying to achieve even pay, there will be zero reason for systems to take the risk. Why hire an NP over an internist if you have to pay them the same? Its definitely not as good of financial decision as it used to be, but the sentiment of 'nobody should practice it anymore because no money' is absurd

Individual lawsuits are not likely to impede the growth of NPs. If patient litigation becomes a recurrent issue, then hospital networks will simply treat NPs like they do physicians who they feel have committed malpractice after doing their own internal investigations with HR and attorneys. Basically the patient files a case against the hospital and then the hospital can open their own lawsuit against the physician to recoup damages to the patient and also to preserve the reputation of the hospital network.

Compensation patterns for FNPs and PMHNPs will not reach physician salary levels. If the ANA or the AANP are pushing this through legislation, then it is a cover play to get something else they want through Congress/Senate. Mid levels are keenly aware that the reason they are present is because hospital networks and private practice groups can pocket the difference from having to hire another physician or partner. IIRC the reason why CRNAs are well compensated is because of how Medicare provides the same funding to both an anesthesiologist and a nurse anesthetist as it funds based on service provided and not on practitioner proficiency. For this reason, private practice groups and hospitals can pocket the differential in operating costs by choosing a more efficient model.

I'm not complaining about a minimum physician salary of 240k. I just think it's a poor choice financially. Think about this psych NPs get paid around 165k I've seen jobs around 200-250k for them. They only went to school for 2 years while probably still working full time. Your average psychiatrist is around 240-280k with significantly more debt and they also started practicing later.

Being absolutely non-sarcastic, I would love to see where these jobs are if they are not in San Fran, New York, or some area with a ridiculously high cost of living. My understanding was that average comp for Psych NP was $90-$110k with the higher end of payment being reflective of desirable coastal areas where expenses are high.

I like to put things in perspective a bit to understand how much money even “just” $240K is...I bought my car in 2015 at $21,000 when I was making around $40/hr on average. 5 year finance, 2.6% interest rate - good deal, good payment plan, good car. At $240,000 annually, I could pay cash for my car every 6 weeks post tax. That is insane. And that is just Salary income, not passive from owning property or stocks or whatever. Not wealth, just straight up income.

Having grown up how I have and now loved how I have, all middle class to upper middle class in lifestyle, I genuinely cannot understand how financial compensation is an issue. Medicine most certainly has its problems and complaints about the profession are genuine, justified, and valid...but to have income as one of those complaints is petty.

People on both ends of this discussion are too interested in polarizing hypothetical circumstances that its frankly not an accurate point of direction and unfortunately many premeds are going to be misdirected by conversations like this. You put the point that you earned $40/hr working 5 10's which not a common situation in terms of hours required or payment out. I agree on many levels with CidHighwind, however his statement in his original thread of people working 50-60 hours for $50,000 is analogous to me writing that I worked 70 hours a week, lived out of my car, and still made less than $40,000 a year for at least three years. There are better options that people can achieve with an associates degree and one specialty rather than encouraging people to pursue several different specialties. It seems like people forgot Planes2Doc's Final Fantasy thread where pursuing all the mini games and raising chocobos should not be conflated with completing the actual game (this is not directed at you or what you wrote, rather this post is somewhat of my own tangent).

Is working 50 hours a week solely from work, is the work mentally taxing or menial, how much in commute time gets lost from that time involvement, and what is the education level of these people who are working these hours? There's different qualifying factors for hours and income that people intentionally don't caveat because there's an intrigue with approaching these questions from a low-context perspective. For instance, a data scientist or a computer programmer may be tasked with working together to flesh out an API or UI. They may think about the question when they are home, commuting, or they may even communicate through Slack when they are at home in order to guide the team towards different approaches. Are those considerations also factored into hours if the work is cerebral? On the other end, some people with two jobs are working a second job through ride fair or Grubhub type jobs that involve relatively low responsibility and performance expectations. Maybe coming out before ride sharing apps is clouding my thinking on adding in 10 hours with a mix of it being waiting for the app to pick up customers v. actually driving customers to be a conflation of actually working a second job for all 10 hours. However, I have found people to frequently over report the hours they have worked and like to under report the pay they have earned.

 

[PikminOC]

I hope no one is so naive to think there are no downsides to medicine. The only thing I and other posters take umbrage with is the notion that other fields have it “so much easier”. Only in that it’s somewhat condescending to those other fields, and doesn’t take into account the different skill sets needed for different jobs.

The only thing I know with medicine is the level of responsibility.

 

[PikminOC]

If we consider 240k salary for a physician and 165k salary for a NP (although most NPs don't make that much), about 300k and 100k in loans for physicians and NPs respectively, and let's say about 40 years of total time in the workforce.

Physician total lifetime income = (240k × 40) - 300k = $9.3 Mil.
NP total lifetime income = (165k × 40) - 100k = $6.5 Mil.

Looks like the lowest paid Physician still makes about $2.8 Mil. more in their lifetime than the highest paid NP, and that's being generous to NPs because most sources I have checked put NP salaries between 92k and 125k.

Np start work earlier in life so can work more years...less loans...less responsibility as held to nursing standards..