Making 6K/mo with 2K/mo loans...And primary care aint looking so good

crys20

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I'm such a planner. Through salary.com I figure baseline primary care, not business mogul type docs will pull in about 6K after taxes. Now, me, I'm at the high, high end of total student loan debt due to paying undergrad alone, etc. So I figure probably about $2K in loans/mo unless I want to be paying them off for upwards 30 years. 4K is sort of not what I envisioned by doctor life to be. :)

I guess my question is how many people do you think in similar situations pursue a field of medicine JUST for the $$$ and of course bigger picture ease of life after the long haul of medicine. Of course if I end up marrying someone with a decent income, I could easily pay that $2k and still live a very comfortable life but it's funny...If I'm comfortably married in late med school, I'll choose the primary care field I probably most prefer...If not, gas to pay the bills. :) Is there an error with my logic here? :)
 

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crys20 said:
I'm such a planner. Through salary.com I figure baseline primary care, not business mogul type docs will pull in about 6K after taxes. Now, me, I'm at the high, high end of total student loan debt due to paying undergrad alone, etc. So I figure probably about $2K in loans/mo unless I want to be paying them off for upwards 30 years. 4K is sort of not what I envisioned by doctor life to be. :)

I guess my question is how many people do you think in similar situations pursue a field of medicine JUST for the $$$ and of course bigger picture ease of life after the long haul of medicine. Of course if I end up marrying someone with a decent income, I could easily pay that $2k and still live a very comfortable life but it's funny...If I'm comfortably married in late med school, I'll choose the primary care field I probably most prefer...If not, gas to pay the bills. :) Is there an error with my logic here? :)
No glitch. It's somewhat of a guess to know what salaries will be then and what taxes will be (especially since you don't even know what state you will be in and there are state and city tax components). It could even potentially be even lower than that if you are at the lowest end of the FP salary range. But your estimate is probably not too far outside the probable range. And you can live a decent life on that kind of after tax income. You won't be rich, but if you enjoy what you are doing, it's fine.
 

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crys20 said:
Is there an error with my logic here?
Yes. If your loans are so enormous that an 10-year payment plan is untenable, take the 30-year plan. As your income increases over time (or if you marry well), you can always pay it off early.
 
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t33sg1rl

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And, everyone will believe that you're overpaid. It is a little depressing. OK, a lot depressing.
My strategy: I'm going to try like heck to pay the interest during residency. I figure that will come out to about $700-800 monthly, which on a resident's salary should be just barely doable.
I came up with this goal after realizing that during a three-year residency, $150,000 of loans will balloon up to $183,000 (at 6.8% interest). Yikes! And, I'm pondering interventional cardiology, which would be seven years... so my 150K of loans is now 238K!!!

But, in all honesty, I'm not unhappy with this scenario-at least this way, we all know that none of us are here for the money.
 

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t33sg1rl said:
And, everyone will believe that you're overpaid. It is a little depressing. OK, a lot depressing.
My strategy: I'm going to try like heck to pay the interest during residency. I figure that will come out to about $700-800 monthly, which on a resident's salary should be just barely doable.
I came up with this goal after realizing that during a three-year residency, $150,000 of loans will balloon up to $183,000 (at 6.8% interest). Yikes! And, I'm pondering interventional cardiology, which would be seven years... so my 150K of loans is now 238K!!!

But, in all honesty, I'm not unhappy with this scenario-at least this way, we all know that none of us are here for the money.
You'd better be living and eating awfully cheap to be paying $800 per month on a residents salary.
 
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saradoor

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You'd better be living and eating awfully cheap to be paying $800 per month on a residents salary.
Other alternatives :(

1. Go back and live with parents
2. Borrow from your well-off siblings if you have any
3. Marry someone well-off
4. Commit insurance fraud and get to live in jail for free
5. Skip town and never to return to the US
6. Become a TV personality

None looks too good but are alternatives
 

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crys20 said:
Through salary.com I figure baseline primary care, not business mogul type docs will pull in about 6K after taxes.
Why settle for low pay? You'll have put in an incredible amount of effort to get your MD and make it through residency; you may as well put in a bit more effort to develop a more lucrative practice. Physicians can increase their income through practices such as hiring and effectively utilizing physician extenders (NP, PA), offering cosmetic procedures in office, etc., to increase their take-home pay. That does mean that you'll have more administrative work, but you can hire consultants/office managers to handle most, if not all, of the non-medical aspects of the field. :thumbup:
 

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Law2Doc said:
You'd better be living and eating awfully cheap to be paying $800 per month on a residents salary.
some quick math:

35K salary (low end)
-taxes
-----------
24k

that's 2k/month
-900 rent (you live in a major city)
-------------
1100k
-800 loans
------
~300/month for gas, food, and living. Eee Gads!!
 

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BAM! said:
that's 2k/month
-900 rent (you live in a major city)
-------------
1100k
-800 loans
------
~300/month for gas, food, and living. Eee Gads!!
In a lot of major cities, unless you are willing to have multiple roommates or live way out of the beaten path and commute from far out (in which case gas will be higher and car payments relevant), you are going to spend more like $1500 for rent for a studio or small bedroom. That puts you at negative $300 for gas food and living. thank goodness for mastercard. :D
 

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My sister and her roommates all shared apartments/houses during residency, to spread the cost of living. In Philly, that came out to around $500 each for a townhouse (I think).

Still, I agree with Law2Doc on how frugal you'd have to be to pay$800/mon during residency. Mmmm.... ramen, again. And again. And again.
 

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Church said:
My sister and her roommates all shared apartments/houses during residency, to spread the cost of living. In Philly, that came out to around $500 each for a townhouse (I think).

Still, I agree with Law2Doc on how frugal you'd have to be to pay$800/mon during residency. Mmmm.... ramen, again. And again. And again.
Just get all your food at the zillion department lunch meetings they have throughout the hospital daily. There's always some drug rep sponsoring something. So what if you have to sit through a lecture of some obscure new GI drug you will never prescribe as a budding neurologist. Free eats are where it's at. :laugh:
 

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SanDiegoSOD said:
Why settle for low pay? You'll have put in an incredible amount of effort to get your MD and make it through residency; you may as well put in a bit more effort to develop a more lucrative practice. Physicians can increase their income through practices such as hiring and effectively utilizing physician extenders (NP, PA), offering cosmetic procedures in office, etc., to increase their take-home pay. That does mean that you'll have more administrative work, but you can hire consultants/office managers to handle most, if not all, of the non-business aspects of the field. :thumbup:
I'd have to agree with SD here. You gotta be ambitious, and business savvy to make $$. Thats why so many practices hire physicians using base salaries with production bonuses.

I just think that most of us are extremely pessimestic about our financial futures, which is good.. it does no good to be overly confident on our potential earnings.

If you become a PCP and truly enjoy what you do, you'll make everything come together and make enough money to live happy.
 

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Personally, I think living on $4k/month is doable. Assuming 70% taxation, that's what you would take home if you make $68k/year, and $68k/year is way above the poverty line and is definitely a living wage. If you want a super nice house and car, it might be tough, but you can buy a house, a car, go out, take vacations and eat well on those wages. Admittedly, NYC would be out of the question. :)
 
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exlawgrrl said:
If you want a super nice house and car, it might be tough, but you can buy a house, a car, go out, take vacations and eat well on those wages. Admittedly, NYC would be out of the question. :)
In a number of cities (NYC is not the only one) you could perhaps choose to do any one of these on this wage, but not all. And probably not the house.
 

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Law2Doc said:
You'd better be living and eating awfully cheap to be paying $800 per month on a residents salary.
Depending on where you live, it'd be doable. If you want to move to say scenic Oklahoma City, you'd be set. :) Of course, the other question is whether or not it makes sense to pay that much on loans when you're likely forgoeing things like putting money into retirement accounts, buying a home, etc. I paid ahead on some of my student loans, and it was completely stupid on my part since my interest rate is less than a conservative estimate of return on my retirement savings account. With 6.8% interest (and 8.5% for grad plus loans), I guess it might make sense to prepay, but it still might not.
 

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Law2Doc said:
In a number of cities (NYC is not the only one) you could perhaps choose to do any one of these on this wage, but not all. And probably not the house.
Sure, not just NYC, but you could still live in a nice city and buy a house on that wage. Also, by eating well, I don't mean going to really expensive restaurants, and by vacations, I don't mean taking cruises, etc. In Portland, you could buy a decent house with a mortgage payment of $2k/month. You then could live pretty easily on the remaining $2k. Sure, you can't have everything you want, but you can have a good life.
 

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Get your parents to pay for your education.
 

SanDiegoSOD

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exlawgrrl said:
Personally, I think living on $4k/month is doable. Assuming 70% taxation, that's what you would take home if you make $68k/year, and $68k/year is way above the poverty line and is definitely a living wage. If you want a super nice house and car, it might be tough, but you can buy a house, a car, go out, take vacations and eat well on those wages. Admittedly, NYC would be out of the question. :)
$4k/month is doable, sure, and the average American lives off less than that. But who wants to do that after 11 years of higher education? (and in your case, I suppose 14 years of higher education :))
 

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SanDiegoSOD said:
$4k/month is doable, sure, and the average American lives off less than that. But who wants to do that after 11 years of higher education? (and in your case, I suppose 14 years of higher education :))
True, but if you really like your job, it could be worth it. If you hate your job, then yeah, it sucks. Living on that amount might be worth not hustling for more money. It all depends on what you want out of life.
 

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Most FP's that I know made between $9K-$12K a month after taxes. Don't know where this whole $6K thing is coming from. If you don't do ANY procedures, have no hospital privledges, and work 3 days a week I can see $6K. Considering the average FP makes $151,000/year, and if you consider you lose 40% income, that's still $7500/month. If you are a smart businessman/woman you can do much better.
 

SanDiegoSOD

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OrnotMajestic said:
Most FP's that I know made between $9K-$12K a month after taxes. Don't know where this whole $6K thing is coming from. If you don't do ANY procedures, have no hospital privledges, and work 3 days a week I can see $6K. Considering the average FP makes $151,000/year, and if you consider you lose 40% income, that's still $7500/month. If you are a smart businessman/woman you can do much better.

Amen. I know a part-time pediatrician, working 20-25 hours a week the rural South, that pulls in over $6k/month after taxes. Which, by the way, is her personal spending allowance, because her husband is pulling in just short of seven figures a year. Nice chunk of change to spend on yourself every month, huh? :laugh:
 
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SanDiegoSOD said:
Amen. I know a part-time pediatrician, working 20-25 hours a week the rural South, that pulls in over $6k/month after taxes. Which, by the way, is her personal spending allowance, because her husband is pulling in just short of seven figures a year. Nice chunk of change to spend on yourself every month, huh? :laugh:
"Now accepting applications for financially affluent females..."

:D
 

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Law2Doc said:
Or Washington DC, Boston, LA, SF, and probably others.
If they choose to live in those places, it's their choice...I will never get over people crying about how much housing is in those cities..as there are plenty of nice places to live that are much more affordable..and not as congested.

I can understand paying big housing expenses to live in Manhattan, but not Long Island, for instance.
 
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saradoor

MJB said:
If they choose to live in those places, it's their choice...I will never get over people crying about how much housing is in those cities..as there are plenty of nice places to live that are much more affordable..and not as congested.

I can understand paying big housing expenses to live in Manhattan, but not Long Island, for instance.
For some folks it is about family, friends, and the community that they care deeply about that drive their decision to stay in a place regardless of how much more they can make.
 

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Law2Doc said:
You'd better be living and eating awfully cheap to be paying $800 per month on a residents salary.
Oh, ye of little faith and less budgeting.

Here's some food for thought for all of you:

My partner and I live comfortably on her salary of 33,000 yearly. She brings home about 1,800 a month. And we're doing just fine.

We live in a nice 2 bedroom apartment and drive a reliable, paid-for car. I don't have to borrow any living expenses-only tuition and academic expenses (books, etc). No, we don't eat out much, our vacations all consist of visiting extended family, and neither of us are currently contributing to a retirement plan, but we're fine, and most months we're able to put aside a little bit into our savings.

So, if two people can live on 33 yearly, then I can't help but notice that most PGY-1 positions in my city pay 40 yearly. I refuse to think that I won't be able to find the 800/month to pay my student loan interest.
 

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Law2Doc said:
Or Washington DC, Boston, LA, SF, and probably others.
Actually, that's probably pretty close to it. Maybe add San Diego and Miami, but after that, you could probably live in any other major city on $4k/month and still do the things I mentioned above. I know for a fact that you could live in Portland, Seattle, Chicago, Austin, Atlanta, Minneapolis, Denver, Salt Lake City, and pretty much every other less desirable city (Houston, Dallas, Kansas City, St. Louis .... ).

If you limit your options to approximately five American cities, it won't work, but that's not exactly a huge limit for most people. If you want one of those major super-expensive cities, you have to adjust your lifestyle or your specialty. Actually $68k/year would probably be a doable salary for all those cities provided that you don't buy a house -- I know people who live in those cities who make that amount or less.
 
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saradoor

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Actually, that's probably pretty close to it. Maybe add San Diego and Miami, but after that, you could probably live in any other major city on $4k/month and still do the things I mentioned above. I know for a fact that you could live in Portland, Seattle, Chicago, Austin, Atlanta, Minneapolis, Denver, Salt Lake City, and pretty much every other less desirable city (Houston, Dallas, Kansas City, St. Louis .... ).

If you limit your options to approximately five American cities, it won't work, but that's not exactly a huge limit for most people. If you want one of those major super-expensive cities, you have to adjust your lifestyle or your specialty. Actually $68k/year would probably be a doable salary for all those cities provided that you don't buy a house -- I know people who live in those cities who make that amount or less.
Houston is not less desirable! :)
 
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saradoor

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Houston sucks. The only decent big cities to live in Texas are Fort Worth and Austin.
Sorry you were not accepted by either one of the MD schools in Houston. I know how much you wanted to attend one in Houston. :(
 

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saradoor said:
Many people prefer the *warm* weather over the cold weather ;)
Plus the Texas Medical Center is awesome! Check this out: http://en.wikipedia.org/wiki/Texas_Medical_Center
That's what Texans tell themselves. :) Personally, I hate really hot weather. I thought Austin was pretty darn miserable, and I'm sure Houston would be worse.
 

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Considering the average FP makes $151,000/year, and if you consider you lose 40% income, that's still $7500/month.
Check out Physicians Practice magazine this month. There was an article about a Merritt, Hawkins and Associates survey of FPs, General Internists and Pediatricians. The average income among generalists was $150,000 BUT they acknowledge that that is high because they counted all pediatricians - they did not exclude subspecialists with markedly higher incomes. They broke it down as follows:

Income range: FP: IM:
<100,000 14.7% 15.8%
100,001-125,000 18.2% 18.7 %
125,001-150,000 16.4% 14.4%
150,001-175,000 14.2% 10.1%
175,001-200,000 8.4% 11.5%
200,001-225,000 6.2% 5.8%

Current averages nationally for internists are about $125,000. And all of this is before taxes! I was in primary care and I made $125,000/year. In my gloriously overtaxed area I took home $88,000 after taxes. I have $250,000 in student loan debt plus $10,000 in car debt (a 2003). At debt payments of $4000 per month that leaves me with $40,000 a year for two of us. I do not own a home and can't afford one - my rent is $12,000/yr. Now we are down to $28,000. Now think about my medical expenses - equipment, professional clothes, CME, conferences, memberships, etc.
Do yourselves a big favor: specialize! I left primary care and I will never go back.

Same study:
Average salary for anesthesia: $303,000
Cards: $320,000
GI: $298,000
Ob/gyn: $247,000
Rads: $355,000
GenSurg: $220,000

And remember, that $125,000-$150,000 is for 60-80 hours per week, not including call and possible inpatient responsibilities.

Just my $0.02.....now give it back damn it, I need it!
 

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signomi said:
Check out Physicians Practice magazine this month. There was an article about a Merritt, Hawkins and Associates survey of FPs, General Internists and Pediatricians. The average income among generalists was $150,000 BUT they acknowledge that that is high because they counted all pediatricians - they did not exclude subspecialists with markedly higher incomes.
The MGMA (Medical Group Management Association) data is more reliable, IMO. Per the 2005 survey based on 2004 data, the mean compensation for non-hospital owned FPs was $158,721.
 

signomi

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The MGMA (Medical Group Management Association) data is more reliable, IMO. Per the 2005 survey based on 2004 data, the mean compensation for non-hospital owned FPs was $158,721.
Even so, that is not a great deal of money when one factors in debts and the hours required of FPs/General Internists. The reality of today's graduates is that they want to work less and have a better quality of life. Today's grads want to be more involved with their families, not working 60-80 hours per week. For the same time commitment they would rather make the big bucks in specialty fields. I know this all to well, since in my group primary care practice recruitment was a nightmare. Three docs left in 6 months and I think we interviewed 3 people, all of whom took jobs in more lucrative areas. After 7 months of doing the work of 4 docs, I quit too. They have yet, four months later, to find a single full time replacement FP or internist.
 

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signomi said:
Even so, that is not a great deal of money...Today's grads want to be more involved with their families, not working 60-80 hours per week.
Well, only you can decide how much money you require. The average income for the primary care physicians in my group is well above the MGMA average. Most of us work around 40 hours per week, and have plenty of time to spend with our families. Primary care is what you make it.
 

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Aren't loan payments tax deductible, atleast for federal loans? So if a significant amount of your salary is going to paying for your loans, you'll also be taxed significantly less. When you do the calculation, you should first subtract your loan payments, then do the tax calculation. If you already took that into consideration, I apologize.
 

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sponge said:
Aren't loan payments tax deductible, atleast for federal loans? So if a significant amount of your salary is going to paying for your loans, you'll also be taxed significantly less. When you do the calculation, you should first subtract your loan payments, then do the tax calculation. If you already took that into consideration, I apologize.
Only the interest is tax deductible. I've been out of school for three years, and at this point, my pretax pay is a little over $4k a month. I'm not living like a princess, but I pay all my bills on-time and have spending money left over. It does depend on where you live. But we need to remember that neither loan payments nor residency last forever. You shouldn't expect to be living the high life right out of school, but given time to pay off debt and slowly build a life, you'll be fine.
 

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sponge said:
Aren't loan payments tax deductible, atleast for federal loans? So if a significant amount of your salary is going to paying for your loans, you'll also be taxed significantly less. When you do the calculation, you should first subtract your loan payments, then do the tax calculation. If you already took that into consideration, I apologize.
Just FYI, it's only the interest on loans that is deductible, not necessarilly the whole payment.
 

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Even the interest is not deductible if you make over a certain amount-- I know-- this was an issue when I was a practicing lawyer.

Has anyone considered the cost of malpractice insurance and office overhead too?

If you are family practice and opening your own practice, you need to take care of this as well as office overhead.

I lived in Queens renting a 2Br/1Bath for 1200/month. It is possible to live near Manhattan but commuting could be challenging depending on what NYC hospital you want work at. The NYC and Boston hospital give a pay differential that makes a lot of PG-1 make 45K plus whereas some places in lower costing areas are paying 35K.
 

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signomi said:
Check out Physicians Practice magazine this month. There was an article about a Merritt, Hawkins and Associates survey of FPs, General Internists and Pediatricians. The average income among generalists was $150,000 BUT they acknowledge that that is high because they counted all pediatricians - they did not exclude subspecialists with markedly higher incomes. They broke it down as follows:

Income range: FP: IM:
<100,000 14.7% 15.8%
100,001-125,000 18.2% 18.7 %
125,001-150,000 16.4% 14.4%
150,001-175,000 14.2% 10.1%
175,001-200,000 8.4% 11.5%
200,001-225,000 6.2% 5.8%

Current averages nationally for internists are about $125,000. And all of this is before taxes! I was in primary care and I made $125,000/year. In my gloriously overtaxed area I took home $88,000 after taxes. I have $250,000 in student loan debt plus $10,000 in car debt (a 2003). At debt payments of $4000 per month that leaves me with $40,000 a year for two of us. I do not own a home and can't afford one - my rent is $12,000/yr. Now we are down to $28,000. Now think about my medical expenses - equipment, professional clothes, CME, conferences, memberships, etc.
Do yourselves a big favor: specialize! I left primary care and I will never go back.

Same study:
Average salary for anesthesia: $303,000
Cards: $320,000
GI: $298,000
Ob/gyn: $247,000
Rads: $355,000
GenSurg: $220,000

And remember, that $125,000-$150,000 is for 60-80 hours per week, not including call and possible inpatient responsibilities.

Just my $0.02.....now give it back damn it, I need it!
Interesting info, but notwithstanding the reasonably low sounding salary figures and range for FP/IM, survey data as this has to be looked at with a grain of salt, if you are using it as a gauge for what you can expect to earn.. Frequently, only the highest earners respond to surveys. There is no legal requirement to respond to any survey (other than the US Census). Someone not proud, or embarrassed about their earnings would not respond. You saw this a lot in law -- folks like to keep up with the Joneses, and if you haven't, you pitch the survey in the trash. I received many such surveys as a lawyer and that was certainly my and my peers thought processes when responding/not. So most salary survey data is skewed high.
Second, is this an average of all people no matter what seniority? If so the changes over the last couple of decades, making it more difficult to start a practice would suggest you need to truncate out from the data those folks who got in decades ago as too dissimilar. You really need to look at average salaries of people of the same seniority, knowing what percentage of the recipients didn't answer (and assuming many who didn't would bring down the average). :)
 
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crys20

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FYI i was pulling my 6K/mo figure from the salary.com website; i think with an avg FP salary i believe. this was in OH though.

and gas is looking better and better. :) i think i just need to hope to marry well ("well" being just "ok", really) and then i can go IM with no worries. :)
 

benyjets23

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Hey,

There is one alternative that no one has discussed yet. That is being a "Lonely Planet Doctor" or the "Travel Friendly Doctor".

I have often thought of a career in Medicine, esp. the ER. I have usually predicted my after tax MONTHLY income would be around 7K - 9K. My monthly budget (fantasy budget would be):

MONTHLY INCOME: $8,000
- RENT: $725
- PHONE: $75
- CABLE: $51
- GYM: $49
- GROCERIES: $450
- INTERNET: $25
- CHARITY: $600
- CAR INSURANCE: $125
- INSURANCE Etc.: $300
- SPENDING: $450
- TRAVEL: $1,000
- SAVINGS / RRSP's Etc: $4,150 ($2,150 until loans paid off)

I would be driving a small used economy car. Hidden expenses will be lifted from my savings. I will prioritize experience over things. My travels will consist of weekend sailing as practice for my big round the world sailing trip. When I travel I will travel "budget". $20 U.S.D. a day on the Indian sub continent, bush camp in Austrailia and pray for my life in the DRC and Somalia.

When I retire things will be reversed. I will live my life out of a sail boat in Port Moresby (As an example) and vacation in my home country.

So often we link up Doctors with Things (Cars, homes, boats Etc.). Why don't we start linking up being a doctor with passion and experience.

Ben
 

Law2Doc

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benyjets23 said:
My monthly budget (fantasy budget would be):

MONTHLY INCOME: $8,000
- RENT: $725
- PHONE: $75
- CABLE: $51
- GYM: $49
- GROCERIES: $450
- INTERNET: $25
- CHARITY: $600
- CAR INSURANCE: $125
- INSURANCE Etc.: $300
- SPENDING: $450
- TRAVEL: $1,000
I like your sentiment, but some of the items on your fantasy budget are pure fantasy, at least in a lot of parts in the country, and it assumes your lifestyle will stand still forever. First, you will not be earning enough to sock away 30-50k per year in untouched savings for quite a few years. Your budget sounds nice on paper until you actually get there and try to implement it. Many residents of major US cities spend as much as twice what you have indicated for most of those expenses you listed. (Rent, gym, cable, car insurance all cost a whole lot more here than you indicated). And you certainly didn't list all the expenses you will have -- you assume negligible entertainment/restaurant/dating expenses, negligible clothes purchases, negligible car or transportation payments -- probably not too realistic for a young professional. Most people are surprised to learn that their living expenses quickly rise to meet their income level. Someone earning 100k is going to have and "need" bigger and better living quarters, clothes, car, restaurants, toys, than someone earning $50k. It's a tried and true fact - you will be earning a decent living but not really sure why you don't have more in the bank..
And having to support a spouse, kids, while earning this income is also not inconcievable in the future, and will quickly drain away the supposed 60k per year you are anticipating putting away for savings/travel. And certainly if you have a spouse of girlfriend, there is no way she is going to do the $20 per day version of a foreign vacation -- camping/backpacking sounds cool when you are 20ish, but not so much when you get a few years older and attached. And let's not even get into the cost of vacations when kids are involved. There are also other potential unforseable expenses -- allimony, child support, needing to provide for old/infirm family members that you cannot plan for. Life happens -- you can't plan it away. So expect the savings to be pretty minimal, until the loans are gone, and then significantly more modest than you anticipated for a while after that, as your expenses rise faster than your salary will (probable savings in the hundreds, not thousands a month, ideally in a 401k or other retirement vehicle).
Marry rich. :)
 

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signomi said:
... At debt payments of $4000 per month...

Good Lord. I consolidated my $160,000 or so student loan debt and am paying something like $400 per month for the next three which is going to jump to about $700 after that. I have some private loans which are deferred but which will tack on another $600 (for ten years) once I start paying them back. So let's say that in three years Im going to be paying $1300 a month for debt service for the rest of my working life.

No big deal. Just a cost of doing business. Maybe we'll go through a period of stagflation which will effectively wipe out my fixed interest rate loans. Maybe an asteroid will hit the earth. Maybe I'll die tomorrow or in the next few years. It seems like you're paying an awful lot for debt service. Are you trying to suck it up and pay them all back sooner? IF you can lock in a low interest rate for federal loans it makes no sense to pay them back quickly. Being afraid of debt is irrational in this case because these loans are relatively benign. Youd probably be better off making smaller payments and investing the difference in something conservative.

But I hear you about low salaries. That's one of the reasons I ran, not walked, away from family practice and why my wife gave me the green light to match into Emergency Medicine. EM salries are in the mid 200s with some ridiculously high outliers here and there. There is a huge difference between $125,000 and $225,000. Duh. You can live well on either salary but my wife would like to drive a nicer car and go on a vacation to Europe where we're not staying at Hostels and eating at supermarkets to save money. I'd also like to save a lot because I am way, way, behind in planning for retirement.

I don't buy that there is a high demand for primary care physicians. If there was then the salaries would reflect this. Rather, there may be a demand but the reimbursement for the services does not reflect it...meanig that there is a great demand but only for people who will work at a low salary.
 

Law2Doc

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Panda Bear said:
I don't buy that there is a high demand for primary care physicians. If there was then the salaries would reflect this. Rather, there may be a demand but the reimbursement for the services does not reflect it...meanig that there is a great demand but only for people who will work at a low salary.
I think you answered your own question here. There is absolutely high demand. But the laws of supply and demand do not apply where the market is not free, so high demand is meaningless in terms of salary. Where there is effectively only one customer (insurance and government coverage), and it sets the salaries (via reimbursements) based wholly on what it feels it wants to pay, not on demand for services or the number of doctors available, then the fact that demand for medical services exceeds supply is really not relevant. Patients with busy PCPs just have to wait during high demand periods. The reimbursement amount is what it is.
 
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