Maximum compensation pathway offered during first three years as attending?

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Nocturnist said:
You won't see any advertisements on TV for Ferrari, either.

Great nocturnist jobs dont need to advertise- they fill quickly and stay filled.

There's a great deal of selection bias here. Crappy jobs that advertise and keep advertising on practicelink do so because they can't be filled and have a high turnover.

it may mean you have to find the the great nocturnist jobs yourself by networking and emailing your CV to department directors, but they are definitely out there.
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could you work as a nocturnist until your loans are paid off, then switch to a normal schedule?
 
robinson annulation said:
could you work as a nocturnist until your loans are paid off, then switch to a normal schedule?
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The world is your oyster after residency, my friend. But beware, you may never wanna go back to days once you're used to the money, lifestyle, and not dealing with all the day time bs.
 
I have not checked, but what's the locum rate out there (especially in the SE)?

I plan to do some locum after settling into my main gig. I won't do it for anything below $200/hr
 
Splenda88 said:
I have not checked, but what's the locum rate out there (especially in the SE)?

I plan to do some locum after settling into my main gig. I won't do it for anything below $200/hr
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then you won't be doing any moonlighting...that is a unicorn

the typical SE IM locums rate, day is $155-175, overnight about $165-185.
The NE is even lower, esp in larger cities...BOS is about $120-140.

EM locums isn't even paying >$200 anymore.

can't you just do extra shifts where you are?
 
rokshana said:
then you won't be doing any moonlighting...that is a unicorn

the typical SE IM locums rate, day is $155-175, overnight about $165-185.
The NE is even lower, esp in larger cities...BOS is about $120-140.

EM locums isn't even paying >$200 anymore.

can't you just do extra shifts where you are?
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I am already getting $150 ($175 night) in my regular gig, so I dont think it will make sense to go to an unfamiliar territory for <$200

I would prefer to have a 1099 side gig

EM is almost dead. When PE is completely done with EM, they will turn to the next specialty, which I think is hospital medicine.
 
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sallyhasanidea said:
Hey everyone,

I had a quick question regarding job prospects as a first-year private practice subspecialty internal medicine attending. I understand that compensation depends on many factors, including but not limited to, partnership, location, volume, compensation model, days/week, etc, but I’m curious what your opinions on the pathways that will lead to the highest possible salary after training. Is cardiology or GI more lucrative, keeping into consideration saturation concerns such as oversupply of interventionalists in cardiology after training, please support your answer with anecdotal evidence of salaries you have seen for first year attending salary.

The reason I ask is because I will have a hefty student loan debt burden at the completion of my training. My spouse and I will have a combined debt burden of $1.1 Million upon completion of fellowship training. Yes I have made financial mistakes in the past when I was a student (expensive undergrad, expensive masters, expensive medical school, for both spouse and myself). Spouse going into pediatrics and wants to do subspecialty training so I am expecting realistically 150k after tax for their income. Location does not matter, days/week does not matter, and honestly satisfaction with my work environment does not matter as this would be a temporary position as I work to build a sizable nest egg and pay off debt. My goal would to work as hard as possible, even if that includes 120 hr weeks in order to pay off our debt. Eventually, I would transition to a work environment and location that I desired, but this would be at least several years down the line. How can I maximize my income in internal medicine?

Thanks for any insight,
Sally
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Nocturnist with 20 shifts plus a month should get you over 500k quickly if not more. I have one attending who did week on week off at two different jobs and made >700k.

For max income I think interventional Cards is the chief with GI right there. I would pick the one you like. Either can hit 1 million a year, GI better lifestyle but also harder to match.
 
Splenda88 said:
I have not checked, but what's the locum rate out there (especially in the SE)?

I plan to do some locum after settling into my main gig. I won't do it for anything below $200/hr
Click to expand...
$200 is the most I've ever heard about for locums in the northeast, and thats at only 2-3 places- They are all in pretty remote locations. 25th-75th percentile seems to be $140-175. This is for nights, can't speak for days.
My hospital often (every 2-4 weeks) will pay $200 for extra shifts when its busy and rarely (couple times a year) $250 when they're desperate.
Splenda88 said:
I have not checked, but what's the locum rate out there (especially in the SE)?

I plan to do some locum after settling into my main gig. I won't do it for anything below $200/hr
Click to expand...
 
BorntobeDO? said:
Nocturnist with 20 shifts plus a month should get you over 500k quickly if not more. I have one attending who did week on week off at two different jobs and made >700k.

For max income I think interventional Cards is the chief with GI right there. I would pick the one you like. Either can hit 1 million a year, GI better lifestyle but also harder to match.
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How can we make 1 Million a year as GI or interventional cards? Are these jobs after making partner or straight out of fellowhsip? I don't mind working 24/7 call as interventional cards if that's needed for this type of income
 
sallyhasanidea said:
How can we make 1 Million a year as GI or interventional cards? Are these jobs after making partner or straight out of fellowhsip? I don't mind working 24/7 call as interventional cards if that's needed for this type of income
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You can get 500k out of fellowship if you are willing to work outside of metro areas, but a million straight out of fellowship? I don’t think even ortho spine gets that.
 
sallyhasanidea said:
How can we make 1 Million a year as GI or interventional cards? Are these jobs after making partner or straight out of fellowhsip? I don't mind working 24/7 call as interventional cards if that's needed for this type of income
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Very, very few people in medicine make 1M a year. They certainly are not making it anywhere close to out of fellowship. These tend to be well established physicians in their 50s-60s, usually department heads or in upper management of the hospital. Some neurosurgeons and ortho-spine surgeons, certainly- but as far as non surgical specialties, it's quite rare.

Feel free to look for yourself- every hospital reports its top 20 earners every year through a 990 filing. It won't reflect salaries of physician groups that aren't directly employed by the hospital, or privately employed MDs- but check out enough of them you'll start to get a good sense of just how rare that is.

Also- do not forget to factor the 3-5 year opportunity cost that that comes with interventional cardiology or GI training, and don't underestimate the diminishing returns of having so much income taxed at the highest bracket. It is far from negligible.

Lastly, ask yourself why? If your identity depends on one day being able to brag at cocktail parties you make a mil a year- cool, play on, playa'. But its quite attainable to make 400-600k while still maintaining a good quality of life even without subspecialty training. Other than retiring (or, burning out) early, what does 1m a year buy you that 500 or 600k won't? You're living in a nice house, driving a nice car, going on any vacation you want, maxing out your retirement accounts, and saving for your kid's college. I totally get the novelty of it but personally would much rather find a career I can put up with 30-40 years than restrict myself to the one or two I'd maybe, MAYBE, one day be lucky enough to pull a mil some year.
 
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sallyhasanidea said:
How can we make 1 Million a year as GI or interventional cards? Are these jobs after making partner or straight out of fellowhsip? I don't mind working 24/7 call as interventional cards if that's needed for this type of income
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You probably can make that after a few years... I know one interventional card who got ~670k/yr right out of fellowship, but it's 1 hr outside of a big metro.
 
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$1M as a cardiologist isn't unheard of but not common either. I know of a few and they hustle. It takes a lot work and a favorable setup to get there.
 
cards67 said:
$1M as a cardiologist isn't unheard of but not common either. I know of a few and they hustle. It takes a lot work and a favorable setup to get there.
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This is helpful- we need more GIs and cardiologists on this forum to weigh in. Would you kindly elaborate?

-General? Interventional? EP?
-'Isn't unheard of but not common either'...would you say, top 1%?...5%?...10%?
-when you say they hustle, how many hours a week are they working...70?80? 100?
-'It takes alot of work'- I assume you mean to say they're not getting this straight out of fellowship, rather many years down the line? If so, when? What would you say they were making in the years before that. It's great to make 1m a year as a partner some day, but important to know if it took a decade of 250k a year to get there.
-'favorable setup'...What kind of setup does it take? Can any cardiologist have this setup if they just wanted to make 1m badly enough?

Anecdotally, one of the cardiology fellow i know from residency took an attending job at the same hospital (community, non-academic) I'm working at was complaining he was only making 250k- the same as a 1FTE day time hospitalist.
 
Nocturnist said:
This is helpful- we need more GIs and cardiologists on this forum to weigh in. Would you kindly elaborate?

-General? Interventional? EP?
-'Isn't unheard of but not common either'...would you say, top 1%?...5%?...10%?
-when you say they hustle, how many hours a week are they working...70?80? 100?
-'It takes alot of work'- I assume you mean to say they're not getting this straight out of fellowship, rather many years down the line? If so, when? What would you say they were making in the years before that. It's great to make 1m a year as a partner some day, but important to know if it took a decade of 250k a year to get there.
-'favorable setup'...What kind of setup does it take? Can any cardiologist have this setup if they just wanted to make 1m badly enough?

Anecdotally, one of the cardiology fellow i know from residency took an attending job at the same hospital (community, non-academic) I'm working at was complaining he was only making 250k- the same as a 1FTE day time hospitalist.
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sallyhasanidea said:
How can we make 1 Million a year as GI or interventional cards? Are these jobs after making partner or straight out of fellowhsip? I don't mind working 24/7 call as interventional cards if that's needed for this type of income
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The guys I know that did this were both private practice. The GI guy was the only guy at his hosp and had NPs for clinic. He was pretty much always on call but since the hosp was small he didn’t get called in often as really unstable where shipped to trauma center. He had an inpatient service were he would be primary on all his patients and he scoped every day of the week (excluding Sunday) in the morning 10-20 a day with combo of upper/lower and ERCP. He had a great work ethic but also seemed to really enjoy his life. He was 20 years into practice so not a fresh guy.

the interventional cards guy was also established private practice and basically the only guy doing carbs at his shop. He had significant call as well, but the difference was he came in a lot. He made more than the GI without midlevels, but worked closer to resident style. I don’t think it was worth it as he was well over a mil a year, but he was used to it and would take vacations to go on mission trips and stuff.

anyway, if you hustle yeah a million is possible either way and in the GIs guys case he made it comfortably. Needless to say these guys kept the notes short or dot phrased. Both of these where in smaller hosp about 30 minutes outside a 300kish metro
 
Above post pretty much nailed it. Often interventional or EP. PP or employed doesn't really matter. I think mgma data basically 90th percentile are $1M+, anecdotally it seems fewer than that. You're not gonna get there seeing patients in clinic. Lots of procedures, good referral base, sick patients with good insurance, low competition, etc. Takes lots of production and favorable $/rvu. Doesn't happen overnight nor everywhere.
 
Here's medaxiom's salary survery, and a snippet from MGMA attached.

According to these, EPs 90th percentile is just scraping 1m, interventional is in 900s, General is around 750.

Overall roughly around one in a hundred General cardiologist, one in 20 interventionalists, and one in ten EPs.

What i find fascinating is there are only 1922 practicing EPs in the country, nearly around the same number of active NFL players. 10 percent of them is 192 electrophysiologists in the entire country supposedly making over 1M. There are 3 times as many active NBA players.
Similarly there are around 5000 practicing interventional cardiologist, so statistically less than 500 in the country making over 1M, possibly as few as 200-300.
Assuming around 25k gen cards, another 250 or so. Overall, less than 1000 cardiologists in the entire country.

444 out of 564 NBA players made more than $1 million and the NFL's median salary is 860k.
So the fun fact here is: Between the NFL and NBA alone there are more professional athletes than cardiologists in the US making 1M or more.

That's enough math for one day, back to watching Netflix on my sub 1M job I go..
 

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Pro tip- Re apply to anesthesia for pgy2 spot so your Pgy1 IM counts as prelim. Then find a general anesthesia job after 4 years of residency and pick up call shifts in an undesirable area.
 
cards67 said:
Above post pretty much nailed it. Often interventional or EP. PP or employed doesn't really matter. I think mgma data basically 90th percentile are $1M+, anecdotally it seems fewer than that. You're not gonna get there seeing patients in clinic. Lots of procedures, good referral base, sick patients with good insurance, low competition, etc. Takes lots of production and favorable $/rvu. Doesn't happen overnight nor everywhere.
Click to expand...

This gonna be a rant but w/e. I’m free. Going to part time starting this fall, and thinking maybe just no-time (retiring forever) next year depending how I feel.

4 yr med school, 3 yr IM +/- 1 yr chief, 3 yr cards, 2 yr EP? While working or studying 60-70 hr a week the whole time, just so you can grind for 1 mil income a year at 50-60 hr work week?

Nah. I’m good.
Eff that. Eff the grind. I’m so happy I made the nocturnist choice.

4 yr med school, 3 yr IM, 3 yr moonlighting like crazy.

Done.

Paid off loans asap and built up capital to work with. That capital is what you need to free yourself. You can then decide how you want to deploy that capital but for me it’s stocks/trading.

Stock market is 9:30a-4p. No weekends or holidays. You can analyze stocks on your own f***ing terms. You can do it at home in bed on your smartphone. And it’s unlimited time off, you can take whole vacations any time! If you wanted to be super cautious you can sell all your positions and go away for months.

Plus it has that end game. You climb the ladder high enough, you can go easy mode and shove your millions into bonds or index funds or what have you and walk away the rest of your life, never needing to lift a finger to generate self sustaining income.

With stocks. No admin telling you this or that. No ER paging you. No patients crying at you for dilaudid. No upset family member calling to speak to you. No one can sue you. No notes to write. No billing. No parking or traffic to deal with.

With paid off house and over 2 million in liquidity, this was only possible going the shortest route to stacking cash, and having the free time at work as a nocturnist to learn the market on my own.

My trading accounts: https://i.imgur.com/1Onir5j_d.webp?maxwidth=640&shape=thumb&fidelity=medium
 
sallyhasanidea said:
Hey everyone,

I had a quick question regarding job prospects as a first-year private practice subspecialty internal medicine attending. I understand that compensation depends on many factors, including but not limited to, partnership, location, volume, compensation model, days/week, etc, but I’m curious what your opinions on the pathways that will lead to the highest possible salary after training. Is cardiology or GI more lucrative, keeping into consideration saturation concerns such as oversupply of interventionalists in cardiology after training, please support your answer with anecdotal evidence of salaries you have seen for first year attending salary.

The reason I ask is because I will have a hefty student loan debt burden at the completion of my training. My spouse and I will have a combined debt burden of $1.1 Million upon completion of fellowship training. Yes I have made financial mistakes in the past when I was a student (expensive undergrad, expensive masters, expensive medical school, for both spouse and myself). Spouse going into pediatrics and wants to do subspecialty training so I am expecting realistically 150k after tax for their income. Location does not matter, days/week does not matter, and honestly satisfaction with my work environment does not matter as this would be a temporary position as I work to build a sizable nest egg and pay off debt. My goal would to work as hard as possible, even if that includes 120 hr weeks in order to pay off our debt. Eventually, I would transition to a work environment and location that I desired, but this would be at least several years down the line. How can I maximize my income in internal medicine?

Thanks for any insight,
Sally
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Peds subspecialties means higher likelihood of working in academics and I hate to break it to you but the after tax salary could definitely be lower than that.
 
@wamcp

I guess that's the motivation I need today. What's your house worth? Your account shows only 1.5 mil (lol), so you are not at the 2+ mil mark yet.

You will still make bank (150k+/yr) working PT. It seems like being a hospitalist/nocturnist is arguably one of the better jobs in medicine these days. Every hospitalist that I know is making >350k and are traveling all the time. The nocturnists that I know even make more (>400k/yr).
 
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Splenda88 said:
@wamcp

I guess that's the motivation I need today. What's your house worth? Your account shows only 1.5 mil (lol), so you are not at the 2+ mil mark yet.

You will still make bank (150k+/yr) working PT. It seems like being a hospitalist/nocturnist is arguably one of the better jobs in medicine these days. Every hospitalist that I know is making >350k and are traveling all the time. The nocturnists that I know even make more (>400k/yr).
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House 700k. Other 500K liquidity include spouse IRA that I trade with ( https://i.imgur.com/gtcJQXs_d.webp?maxwidth=640&shape=thumb&fidelity=medium) and her mutual fund only 401k, 457b accounts, and our cash.
(Note she only became an attending this past year so she wasn’t making bank until recently. She did not take the hospitalist route)
 
wamcp said:
House 700k. Other 500K liquidity include spouse IRA that I trade with ( https://i.imgur.com/gtcJQXs_d.webp?maxwidth=640&shape=thumb&fidelity=medium) and her mutual fund only 401k, 457b accounts, and our cash.
(Note she only became an attending this past year so she wasn’t making bank until recently. She did not take the hospitalist route)
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It helps that you finished at a time when the market is booming. You should continue to work part time so you can keep up with your skills. Financially, medicine is still a good profession regardless of what people in SDN have been saying.
 
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wamcp said:
This gonna be a rant but w/e. I’m free. Going to part time starting this fall, and thinking maybe just no-time (retiring forever) next year depending how I feel.

4 yr med school, 3 yr IM +/- 1 yr chief, 3 yr cards, 2 yr EP? While working or studying 60-70 hr a week the whole time, just so you can grind for 1 mil income a year at 50-60 hr work week?

Nah. I’m good.
Eff that. Eff the grind. I’m so happy I made the nocturnist choice.

4 yr med school, 3 yr IM, 3 yr moonlighting like crazy.

Done.

Paid off loans asap and built up capital to work with. That capital is what you need to free yourself. You can then decide how you want to deploy that capital but for me it’s stocks/trading.

Stock market is 9:30a-4p. No weekends or holidays. You can analyze stocks on your own f***ing terms. You can do it at home in bed on your smartphone. And it’s unlimited time off, you can take whole vacations any time! If you wanted to be super cautious you can sell all your positions and go away for months.

Plus it has that end game. You climb the ladder high enough, you can go easy mode and shove your millions into bonds or index funds or what have you and walk away the rest of your life, never needing to lift a finger to generate self sustaining income.

With stocks. No admin telling you this or that. No ER paging you. No patients crying at you for dilaudid. No upset family member calling to speak to you. No one can sue you. No notes to write. No billing. No parking or traffic to deal with.

With paid off house and over 2 million in liquidity, this was only possible going the shortest route to stacking cash, and having the free time at work as a nocturnist to learn the market on my own.

My trading accounts: https://i.imgur.com/1Onir5j_d.webp?maxwidth=640&shape=thumb&fidelity=medium
Click to expand...
Nice man. I would keep working though to some degree. I wouldn’t feel comfortable going by trading and stocks only until I had more set aside in case the market crashes and goes sideways for a few years. Trading is nice because you can keep making money either way, but long term holds can take a hit and stay that way for a long time.
 
@wamcp, i see the value of your stock grew almost by fivefold since January 2021. Were you pumping cash during this time or all the result of 'day trading'?
Kudos to you! The more financial savvy physicians become, the less corporate gangbangers jerking around physician and their practices.
 
Mehena said:
@wamcp, i see the value of your stock grew almost by fivefold since January 2021. Were you pumping cash during this time or all the result of 'day trading'?
Kudos to you! The more financial savvy physicians become, the less corporate gangbangers jerking around physician and their practices.
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Both, although cashflow from work income has dropped significantly due to not moonlighting anymore for the past several months. >90% of the portfolio value increase is from investment gains.
When my portfolio value swings in a single day several times what I make in 1 night shift, i'ts now way better to spend my time at home with kids than being at the hospital for money
 
Splenda88 said:
It helps that you finished at a time when the market is booming. You should continue to work part time so you can keep up with your skills. Financially, medicine is still a good profession regardless of what people in SDN have been saying.
Click to expand...

If nothing else think of it as buying insurance.
 
wamcp said:
This gonna be a rant but w/e. I’m free. Going to part time starting this fall, and thinking maybe just no-time (retiring forever) next year depending how I feel.

4 yr med school, 3 yr IM +/- 1 yr chief, 3 yr cards, 2 yr EP? While working or studying 60-70 hr a week the whole time, just so you can grind for 1 mil income a year at 50-60 hr work week?

Nah. I’m good.
Eff that. Eff the grind. I’m so happy I made the nocturnist choice.

4 yr med school, 3 yr IM, 3 yr moonlighting like crazy.

Done.

Paid off loans asap and built up capital to work with. That capital is what you need to free yourself. You can then decide how you want to deploy that capital but for me it’s stocks/trading.

Stock market is 9:30a-4p. No weekends or holidays. You can analyze stocks on your own f***ing terms. You can do it at home in bed on your smartphone. And it’s unlimited time off, you can take whole vacations any time! If you wanted to be super cautious you can sell all your positions and go away for months.

Plus it has that end game. You climb the ladder high enough, you can go easy mode and shove your millions into bonds or index funds or what have you and walk away the rest of your life, never needing to lift a finger to generate self sustaining income.

With stocks. No admin telling you this or that. No ER paging you. No patients crying at you for dilaudid. No upset family member calling to speak to you. No one can sue you. No notes to write. No billing. No parking or traffic to deal with.

With paid off house and over 2 million in liquidity, this was only possible going the shortest route to stacking cash, and having the free time at work as a nocturnist to learn the market on my own.

My trading accounts: https://i.imgur.com/1Onir5j_d.webp?maxwidth=640&shape=thumb&fidelity=medium
Click to expand...
Good for you? Lol. But in all seriousness, looking back I'd probably have a lot more money had I done hospitalist vs fellowship. But I don't know how long I'll have to work to break even but a lot of that too is due to the monster bull market we've been in. But hindsight is 20/20 and there was no way to know, could've gone poorly too. But I hated hospital medicine. At the very least I enjoy what I do and make good money and have a good life, can't complain. I don't think someone should do cards/GI for money only. I always tell people if they have lukewarm feelings about it, undecided or medicine is a means to an end, then gen med is a fine pathway with so many routes to take. Hospitalist, primary care, part-time, nocturnist, urgent care, nursing home, or even specialize later.
 
wamcp said:
Both, although cashflow from work income has dropped significantly due to not moonlighting anymore for the past several months. >90% of the portfolio value increase is from investment gains.
When my portfolio value swings in a single day several times what I make in 1 night shift, i'ts now way better to spend my time at home with kids than being at the hospital for money
Click to expand...

yeah just tell me what to invest each paycheck in and I'll do it, dude. I don't panic sell, which I think makes me a catch.
 
Possible to make 300k base as a IM nocturnist without killing yourself (not in California) ?
 
wamcp said:
This gonna be a rant but w/e. I’m free. Going to part time starting this fall, and thinking maybe just no-time (retiring forever) next year depending how I feel.

4 yr med school, 3 yr IM +/- 1 yr chief, 3 yr cards, 2 yr EP? While working or studying 60-70 hr a week the whole time, just so you can grind for 1 mil income a year at 50-60 hr work week?

Nah. I’m good.
Eff that. Eff the grind. I’m so happy I made the nocturnist choice.

4 yr med school, 3 yr IM, 3 yr moonlighting like crazy.

Done.

Paid off loans asap and built up capital to work with. That capital is what you need to free yourself. You can then decide how you want to deploy that capital but for me it’s stocks/trading.

Stock market is 9:30a-4p. No weekends or holidays. You can analyze stocks on your own f***ing terms. You can do it at home in bed on your smartphone. And it’s unlimited time off, you can take whole vacations any time! If you wanted to be super cautious you can sell all your positions and go away for months.

Plus it has that end game. You climb the ladder high enough, you can go easy mode and shove your millions into bonds or index funds or what have you and walk away the rest of your life, never needing to lift a finger to generate self sustaining income.

With stocks. No admin telling you this or that. No ER paging you. No patients crying at you for dilaudid. No upset family member calling to speak to you. No one can sue you. No notes to write. No billing. No parking or traffic to deal with.

With paid off house and over 2 million in liquidity, this was only possible going the shortest route to stacking cash, and having the free time at work as a nocturnist to learn the market on my own.

My trading accounts: https://i.imgur.com/1Onir5j_d.webp?maxwidth=640&shape=thumb&fidelity=medium
Click to expand...
Pushing $3 mil liquid today. F*** you medicine. Freedom.


 
Gonzalo de Montalvo said:
Congrats! Wow.

How many years have you been an attending now? You gonna retire, switch to days, fewer shifts, or keep stacking paper for a while as a nocturnist?
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I’m in my fourth year out as an attending. Doing part time now and maybe quitting entirely next year. Will see. And if hospital admin suddenly makes job too annoying then I can simply say bye bye and walk (well, with a 90 day notice as per contract).
Just really freeing, knowing I can do w/e I want at this point.

I went to a 6 yr program so am 30 years old. My youth doesn’t last forever. Especially we have kids I want to spend the day with. Time is our most limited resource. A healthy body has a ticking clock too. F*** spending 30-40 hours at work each week for 30 more years, when not one second of that time is ever going to be what I think about on my deathbed. F*** giving up half my weekends and holidays to the hospital.
 
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wamcp said:
I’m in my fourth year out as an attending. Doing part time now and maybe quitting entirely next year. Will see. And if hospital admin suddenly makes job too annoying then I can simply say bye bye and walk (well, with a 90 day notice as per contract).
Just really freeing, knowing I can do w/e I want at this point.

I went to a 6 yr program so am 30 years old. My youth doesn’t last forever. Especially we have kids I want to spend the day with. Time is our most limited resource. A healthy body has a ticking clock too. F*** spending 30-40 hours at work each week for 30 more years, when not one second of that time is ever going to be what I think about on my deathbed. F*** giving up half my weekends and holidays to the hospital.

I dream of one day running my own family office, if I ever grow my investments to nine figs ($100 mil+). That’ll be the amount I like to make serious perpetual impact on my community and enable my own philanthropic efforts in the future. Saving a 90 year old gomer’s life for a few more months as a hospitalist or caring for a 3000 patient panel as a PCP is valuable, yes, but it’s never gonna stack up to what 9 figs in charitable efforts can do for humanity.
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Medicine has been good to you.
.
Could not agree more with you. Once my house is paid off and I also have 1.5 mil in liquid asset, I will cut back to 1 week per month. 120k-150k/yr is very good money to live on, especially if you dont have a mortgage payment.
 
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rokshana said:
then there would be no nocturnist in practically every major metropolitan city on the east coast...especially the north east.
Click to expand...
If we're talking academic medical centers, I agree. You're paid in pristige, and for some godforsaken reason some folks are willing to take a 100k+ haircut just to have some fancy emblem on their patagucci. But for most nocturnist that could care less, nobody should ever be making under 300k. I firmly believe no nocturnist should be getting out of bed for less than $150/hr. Heck, for years they've been paying midlevels $100 an hour at my shop just to do some crosscoverage The going rate is now widely around $175, my per diem job recently raised their rates to $220 due to burn out and short staffing (and still, very few are picking up extra shifts), and my primary job now regularly offers $250. Both places in the northeast, I can see the skyline from both hospitals. It doesn't take that many shifts a month to add up to 300k and thats before any bonuses. No nocturnist I know/work with makes less, average is close to 350-400k, and 500k quite achievable. It's not a bad time to be a hospitalist.
 
rokshana said:
then there would be no nocturnist in practically every major metropolitan city on the east coast...especially the north east.
Click to expand...
If my shop is giving ~400k/yr (385k to be exact) for an average of 20 admissions at night for 2 nocturnists and they are about add a midlevel to do cross cover, why would anyone accept less than 340k/yr anywhere in the US if it's not academia?

MY shop offered me $2.5k/day to work 4 days extra before the December holidays. I said thank you, I can only do it for 3k. They found a sucker that accept that 2.5k.

The $150/hr on @Nocturnist post happens to be close to 340k that I am talking about. I agree with him/her that no nocturist should be working for less than that given the nature of the job market right now.
 
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