salaries, expenses, and malpractice

[drboris]

So, let's say an internist makes 170k per year (based on some surveys). Is that figure after expenses and malpractice, or do docs have to pay malpractice by themselves? Also, how much of that 170k is taken away by taxes and how much does the doc keep?

I am getting a little paranoid about my 200k+ loan!

Thanks

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[EctopicFetus]

It is post expenses. That is take home pay.

 

[EctopicFetus]

Also, often times the salaries are under reported. Talk to a doctor you know and ask what his friends make they will usually tell you.

 

[juddson]

It is post expenses. That is take home pay.

well, it is post expenses but NOT post taxes. This stands to reason as an accurate estimation of taxes is difficult, particular if the earner is wealthy or has "passive" income assets. Obviously things like the size of the mortgage interest deduction can have a huge impact as well. Published salary figures are before taxes, but after expenses such as malpractice and office overhead.

On 170k a year, your total tax burden should be around 40-45% of your gross income (meaning, the sum of federal, state, local and payroll taxes normally approaches 40 to 45% of income at this level). Hence, you can expect to see a monthly paycheck (or draw) of about $8,500 after taxes. Assuming you owe $200k in loans amortized over 10 years is about $2100 a month. That leaves you $6400 a month to live on. Assuming you consolidate your loans and amortize them over 20 years, your monthly payment is more like $1300 a month, leaving you $7200 a month to live on.

let's assume you don't consolidate for the time being. $6400 a month to live on isn't too bad - but it's not "rich" either. Let's pretend you buy a house and want two cars. Assuming a $500,000 house, your monthly mortgage payment will be something like $3600 assuming a 30 year loan at 8% (not out of the question). That leaves you $2800. An expensive house also means a lot of property tax. We pay $300 a month for a $220,000 house. Expect to pay a bit more than twice that for your more expensive home - perhaps more depending on where you live. Let's go with $800, to bring you down to a nice even $2000 left to spend.

Our house is about 2000 square feet. It costs about $80 a month to heat and $100 a month to keep the lights on. Double or triple these for larger modern homes with two story entryways on 4000 square feet, as is common in our area for $500,000 homes. Say $500 for utilities a month. That leaves you with $1500.

You want kids? Assuming you have two, and want them to go to college. If current private school costs are about $25000 a year (not uncommon) and you have 18 years to save, you will have to put away about $900 a month assuming costs go up about 6% a year for the next 18 years. That's PER CHILD, of course. That's $1800 a month just to save for college.

Already you are broke ($300 in the hole, actually) and you have not eaten yet, saved for retirement, bought a car, purchase life or health insurance, braces for the kids, vacations, telephone, etc.

Now I'm depressed.

Judd

 

[Idiopathic]

You want kids? Assuming you have two, and want them to go to college. If current private school costs are about $25000 a year (not uncommon) and you have 18 years to save, you will have to put away about $900 a month assuming costs go up about 6% a year for the next 18 years. That's PER CHILD, of course. That's $1800 a month just to save for college.

I agree with most of what you say, but this is simply silly. If you can save nearly 2K a month for almost 20 years and you dont have over a million dollars in the bank when it is all said and done, you have made some serious mistakes.

If you hid this money under your mattress, then yes...you might need to save this much.

 

[drboris]

Judd,

No offense, but reading your reply has really frustrated me. It seems like you don't know how to live or save money very practically. I do agree with you that looking at how you break down the numbers, it is depressing to be so broke. However, first of all I kind of question the amount of taxes that you took off. As far as I know, taxes are built up on a scale so that prior to 100k you pay less and then pay a higher percent only on the income over 100k. So I would argue that taxes would not exceed over 35-40% of that income. Actually, my boss (VP of sales and marketing) told me that, so I hope he's right). Second, I plan on consolidating my loan for 30 years to lower payment. Third, nowadays it is easy to find a mortgage for ~4-5% and then keep refinancing to save money (trust me on this one). On a mortgage that high it is worth it to keep refinancing.

Also, you break down a salary like that assuming that you would live in a 500k home by yourself. My wife would also work and bring home a decent income. So, I guess we are not going to be broke on a 170k doc salary. Even without the second income, with the aforementioned changes it is possible to afford everything (well, kind of sort of).

I just sometimes get frustrated because make it seem like docs can't make it anymore unless they make at least 300k! That is ridiculous.

~Boris

 

[!dr_nick!]

Judd,

However, first of all I kind of question the amount of taxes that you took off. As far as I know, taxes are built up on a scale so that prior to 100k you pay less and then pay a higher percent only on the income over 100k. So I would argue that taxes would not exceed over 35-40% of that income. Actually, my boss (VP of sales and marketing) told me that, so I hope he's right).
~Boris

Your boss is absolutely correct. Only a portion of your income could be taxed at each bracket.
http://partners.financenter.com/abcnews/learn/guides/itaxbasics/itaxbracket.fcs
That will give you a good idea of how much federal income tax is taken out. But remember!! Also Social Security and state income tax.

 

[DrTex?]

Judd,

Third, nowadays it is easy to find a mortgage for ~4-5% and then keep refinancing to save money (trust me on this one). On a mortgage that high it is worth it to keep refinancing.


~Boris

I hope you can give better medical advice than you can financial advice. Inflation is heating up worldwide and rates will move up soon. One rule of life is that if anyone ever says, "trust me on this one," they probably don't know what they are talking about.
By the time that most people that read this page finish med school, residency, find a long term position and are ready to buy a home, the financial markets will be totally different. These things change fast.
http://www.economist.com/world/na/displayStory.cfm?story_id=2794173
Even the future salaries of doctors are not certain. Current salaries are below their inflation adjusted levels in the 1980's. With the sky rocketting number of those that are uninsured, and the growing power of corporate medicine, (HMO's) the picture is likely to change more.
If you are getting into medicine for the money, you're making a big mistake. The debt incurred in medical education. The four years of no salary as a student and then the years of low salary as a resident don't balance out the better than average money you will make later in life.

 

[drlisa0318]

$6400 a month to live on isn't too bad - but it's not "rich" either. Let's pretend you buy a house and want two cars. Assuming a $500,000 house, your monthly mortgage payment will be something like $3600 assuming a 30 year loan at 8% (not out of the question). That leaves you $2800. An expensive house also means a lot of property tax. We pay $300 a month for a $220,000 house. Expect to pay a bit more than twice that for your more expensive home - perhaps more depending on where you live. Let's go with $800, to bring you down to a nice even $2000 left to spend.

Geez, people, have you ever heard of the concept of living within your means? Just because you now have that MD or DO after your name, does that mean you have to go right out and buy that new home or car? Currently, my total family income (including my husband's) is 50k - that's gross, not net. I still have to finish premed AND med school yet, so I have no idea what my income will be once I'm finished. However, I doubt very seriously that it will anywhere near as low as now. We live in an 85k house (in Tulsa, that's a nice 1500 sf brick house.) I don't anticipate "upgrading" to a nicer/newer/more expensive one for at least several years after I've started practicing.

On another thread here, someone suggested after residency to continuing living like a resident for 5-7 years. With the assumed boost in income after residency, that would leave plenty to save/invest/reduce current debt.

More importantly, people, in all likelihood NONE of you are accountants. I'd be willing to bet the vast majority of you have had any NO training or experience in it beyond balancing your checkbook or buying a home or car. I've been in accounting for 25 years, 12 of that in public accounting. Even I am not going to rely on my own business acumen. Personally, I plan on making good use of a reputable CPA/financial planner. Just because you have the science/math acumen to be a doctor, does NOT mean you have the BUSINESS acumen to run a successful business or understand tax planning or financial planning.

You want to know how best to treat an illness? Ask a doctor. You want to know how to run a business or handle tax issues? Ask a CPA.

 

[redstorm]

there is a lot of splitting hairs on judds mathematics.. I happen to think he is right..

WHat i think he was getting at was.. you bust your ass for so long 8-10 years thats after college.. Not to mention how hard you worked before college
for what.. To graduate with an MD and earn less thant he radiology techs. and after you graduate there are all sorts of tricks that insurance cos, hospitals, do to low ball you.. ANd to be honest we did it to ourselves.. I feel really sorry for us, unless something changes.. Then board exams cost 2-3000 a pop. Licensure is minimum 500 dollars per state. 1000 dollars in california. Step exams are not cheap. not to mention review books, cme courses et al. the amount of time to study..

You would think after all that hard work, you would make a million dollars..

IF the rewards were people respected you.. but thats not even true.. Ask anybody who has spent time in the ER or anyplace else..
i should have gone to law school or business school..

 

[Febrifuge]

I'm a postbac, and a non-trad. The career I will be giving up is one where I started out in 1989 earning like $19000 a year; I got up to $28k and quit in 1994 to finish my BA. After school, I've traded cash for a good environment, and making in the low '30s I'm not really paid what I'm "worth" with my experience.

I sat down and mapped out the progression of my projected income, year by year, two ways. One, if I chuck it all and go back to school, eventually finishing residency and earning doctor money. Two, if I just keep plugging away in cubicle land, making modest little raises ($35k for a few years, $40k for a few, $45k for a few, and levelling off someplace near $50 or so).

Since my income for postbac + med school is zero for approximately seven years (I didn't count it as negative, though really it would be in a practical sense) and my income in residency is tightly capped, as of even 2014 I'm nowhere near where I would have been if I'd stayed in the workforce, even at the paltry earning power the marketplace gives me. And that's just for that 'current' year of 2014.

Overall and in the aggregate, I'm way in the hole until more than a few of the years when I (hopefully) earn $175k to $200k. I catch up to myself after I've been out of residency for... I think it was five or six years.

And that's without considering the $210k to $240k in student loans.

Yeah, it's not about the cash. I'm really counting on the sense of power, and of course the chicks.

 

[wytosk]

I had a professor who also gave "financial tips to become a millionaire". 1 thing he mentioned was to live a few years behind your current position. Meaning, (IF YOU CAN MANAGE) ur first few years as a practicing physician u should still rent the inexspensive apt and drive ur old car. Use this time to put a major dent into ur loans and save for a big downpayment on ur house. I think it would be pretty hard to do, because who wants to live in an apt into their 30s when they are a doc. Also if you are married with a family that complicates the matter more.

 

[drlisa0318]

I had a professor who also gave "financial tips to become a millionaire". 1 thing he mentioned was to live a few years behind your current position. Meaning, (IF YOU CAN MANAGE) ur first few years as a practicing physician u should still rent the inexspensive apt and drive ur old car. Use this time to put a major dent into ur loans and save for a big downpayment on ur house. I think it would be pretty hard to do, because who wants to live in an apt into their 30s when they are a doc. Also if you are married with a family that complicates the matter more.

Darlin', I hate to break it to you, but MILLIONS of people of ALL ages (including those that are married with a family, even) live in apartments and do just fine thank you. My husband and I lived in apartments for 18 years before we were finally able to afford a house. "Want" has nothing to do with it. You do what you can do with the money you have. You don't live beyond your means (been there, done that....and the aftermath is no fun at all). Unless you're a trust baby or win Publisher's Clearinghouse Sweepstakes, or manage to inherit tons of money, you'll have to work a few years paying off the med school loans, the undergrad loans, the credit card bills, and all the other stuff you unwisely chose to buy when you didn't have the money to pay for it. You won't be able to buy that big house you've been dreaming of, or that new fancy car, or go on those great vacations UNTIL you take care of your prior debt. And even then, you've got to budget, spend wisely, work at setting aside money for retirement, for your kid's education, etc, etc, etc. Face it, there just aren't that many Donald Trumps in the world who can afford to spend whatever they want, whenever they want. It's not unheard of for a doctor to go bankrupt. Why? you ask? In all likelihood, because of a combination of unsound business practices/choices (it IS a business, even if you aren't in private practice) and living beyond one's means. This isn't Lifestyles of the Rich and Famous. This is being a grownup. Welcome to the REAL world.

 

[LovelyRita]

Darlin', I hate to break it to you, but MILLIONS of people of ALL ages (including those that are married with a family, even) live in apartments and do just fine thank you. My husband and I lived in apartments for 18 years before we were finally able to afford a house. "Want" has nothing to do with it. You do what you can do with the money you have. You don't live beyond your means (been there, done that....and the aftermath is no fun at all). Unless you're a trust baby or win Publisher's Clearinghouse Sweepstakes, or manage to inherit tons of money, you'll have to work a few years paying off the med school loans, the undergrad loans, the credit card bills, and all the other stuff you unwisely chose to buy when you didn't have the money to pay for it. You won't be able to buy that big house you've been dreaming of, or that new fancy car, or go on those great vacations UNTIL you take care of your prior debt. And even then, you've got to budget, spend wisely, work at setting aside money for retirement, for your kid's education, etc, etc, etc. Face it, there just aren't that many Donald Trumps in the world who can afford to spend whatever they want, whenever they want. It's not unheard of for a doctor to go bankrupt. Why? you ask? In all likelihood, because of a combination of unsound business practices/choices (it IS a business, even if you aren't in private practice) and living beyond one's means. This isn't Lifestyles of the Rich and Famous. This is being a grownup. Welcome to the REAL world.

Why get so angry? Everyone's situation is different. Way different. There are indeed daunting amounts of money in loans that are to be dealt with, but each person will deal with it differently, as is their right to do so. I think most people are comprehending of the real world.

I'm borrowing every cent possible to get thru school. My debt WILL be >200K. But I will also live a dignified lifestyle as I see it when I'm finally working.

 

[MacGyver]

drlisa,

ditch your husband and run away with me instead!

 

[drlisa0318]

Why get so angry? Everyone's situation is different. Way different. There are indeed daunting amounts of money in loans that are to be dealt with, but each person will deal with it differently, as is their right to do so. I think most people are comprehending of the real world.

I'm borrowing every cent possible to get thru school. My debt WILL be >200K. But I will also live a dignified lifestyle as I see it when I'm finally working.

I'm not angry...not even the least little bit. Just trying to inject a little reality into this. I've noticed so many posts mostly from younger students who seem to think that once they've got that MD or DO behind their name that they're on Easy Street. Most of these kids haven't been out on their own for very long. They don't seem to realize that even if you command a large salary, there's a great deal of responsibility that comes with it. The most experience the majority of the younger students have had in managing money is balancing a checkbook and maybe buying a car. Even with that large salary it is ridiculously easy to bury yourself in debt so far that bankruptcy is the only way out. Been there, done that. I would like to be able to prevent others from having to go that route. For us, credit cards were the the biggest problem. My husband never met a credit card he didn't like. Then when we bought our house we wound up incurring even more debt (even beyond the mortgage). It's an older home with plenty of problems to be repaired. My older brother once told me never to buy the most expensive house you qualify for because then you'll be house-rich and cash-poor. He was right.

You may possibly think I'm rich or well-to-do, but I'm not. Just experienced enough in poor money choices to know what I'm talking about. I make $25k as does my husband. Rich, we ain't. Yes, I'm looking forward to the much greater income I'll be able to make as a doctor. However, I won't be making the same mistakes I've made before. I plan on making very good use of a reputable CPA and financial planner. I hope I've injected enough reality here to impress upon the premeds (most particularly the younger ones) the need for good money management.

 

[drlisa0318]

drlisa,

ditch your husband and run away with me instead!

Hmmmmmm!!! Best offer I've had in a long, LONG time!

 

[E Z Daring]

Wow, I guess the saying is true, no matter how much you make, you can still think you're poor.

I probably have lived with under $1000/mo expenses for the last 8 years, not including medical school. It's not so tough. I make my lunch everyday. I do all my own car repairs. I'm driving the same car I had in college, paid it off before starting medical school. I love my car, and hate german POS sedans, 5000lb SUVs everyone in so cal drives. Almost every cent I have made has gone towards school loans so far.

I will come out with my MD but am choosing to go into a profession making 60-90K, b/c I enjoy it. Probably start up something on the side. I will survive and that's with $140K of med school debt, b/c the majority of my income will go to that in the beginning. In my 30's, life should be comfortable. Won't be balling, just chilling.

You can survive on $6000 mo! If I had that income, I would live on 25-33% of that, and invest/payback loans with the rest!

 

[drlisa0318]

Wow, I guess the saying is true, no matter how much you make, you can still think you're poor.

I probably have lived with under $1000/mo expenses for the last 8 years, not including medical school. It's not so tough. I make my lunch everyday. I do all my own car repairs. I'm driving the same car I had in college, paid it off before starting medical school. I love my car, and hate german POS sedans, 5000lb SUVs everyone in so cal drives. Almost every cent I have made has gone towards school loans so far.

I will come out with my MD but am choosing to go into a profession making 60-90K, b/c I enjoy it. Probably start up something on the side. I will survive and that's with $140K of med school debt, b/c the majority of my income will go to that in the beginning. In my 30's, life should be comfortable. Won't be balling, just chilling.

You can survive on $6000 mo! If I had that income, I would live on 25-33% of that, and invest/payback loans with the rest!

Wow! I'm impressed! Especially so since you apparently live in California. The cost of living there is soooo much higher than here in Oklahoma. You must be frugal! I'm guessing you're single with no kids. Amazing how expensive the little buggers are! I've got one, a son, turning fifteen on the 10th. He's the greatest kid - couldn't imagine my life without him.

 

[Hudson]

I'm not angry...not even the least little bit. Just trying to inject a little reality into this. I've noticed so many posts mostly from younger students who seem to think that once they've got that MD or DO behind their name that they're on Easy Street. Most of these kids haven't been out on their own for very long. They don't seem to realize that even if you command a large salary, there's a great deal of responsibility that comes with it. The most experience the majority of the younger students have had in managing money is balancing a checkbook and maybe buying a car. Even with that large salary it is ridiculously easy to bury yourself in debt so far that bankruptcy is the only way out. Been there, done that. I would like to be able to prevent others from having to go that route. For us, credit cards were the the biggest problem. My husband never met a credit card he didn't like. Then when we bought our house we wound up incurring even more debt (even beyond the mortgage). It's an older home with plenty of problems to be repaired. My older brother once told me never to buy the most expensive house you qualify for because then you'll be house-rich and cash-poor. He was right.

You may possibly think I'm rich or well-to-do, but I'm not. Just experienced enough in poor money choices to know what I'm talking about. I make $25k as does my husband. Rich, we ain't. Yes, I'm looking forward to the much greater income I'll be able to make as a doctor. However, I won't be making the same mistakes I've made before. I plan on making very good use of a reputable CPA and financial planner. I hope I've injected enough reality here to impress upon the premeds (most particularly the younger ones) the need for good money management.

To all of the young "kids" out there that have no idea how to manage money nor any sense of the financial responsibilities that one will assume once they have thier MD and think they are on their way to "easy street" I say this: Take the above opinions with a grain of salt. A lot of salt. If you have taken the normal track through medical school you will be 29-33 years old once you finish your residency. Their are plenty of specialties out their that clear onver 250K. Be economically conscious and take the economic trends in medicine into account when making the decision on which specialty to chose. I think Dr. Lisa has a skewed perspective of things.

Remember that it takes money to make money and if you invest your capital wisely you will have plenty of money to do most of what you want. Primary care does not pay well. Doctors do not get paid well to think, they get paid well to do procedures. Therefore if income is an issue, pursue a field that is procedure oriented. It is not unreasonable to want to live in a 500K home, have kids send them to private school and college, have nice cars, and take nice vacations.

On another note, Dr. Lisa, you said you make 25K a year as an accountant. I have many friends wha are accountants and their entry level salary out of college at 22years old is 45-50K. Partnership track is around 10-15 years at which time salaries jump to 400-600K. All along with a 5% increase in income/year plus great benefits. This is of course unless you jump ship and take a high paying corporate position along the way. I don't know what its like in tulsa, but 25K is WAAYY below the average salary for an accountant.

Make no mistake that the road to becoming a doctor is full of sacrafices both financial and personal. However, if you make intelligent choices you will enjoy your job more than your non-medical friends enjoy theirs and you will earn plenty of money. Think about becoming something that ends with "ologist" and you will be alright.

 

[Heeed!]

I've been in accounting for 25 years

Wow...you're old.

 

[bobbigboote]

You got it right for sure DrLisa.

It's amazing how many students have no sense of reality when it comes to money. You can have a great life without a 500,000 house and 25k private schools for your kids. It's strange that so many people develop these unrealistic expectations about their lifestyle and income.

 

[Hudson]

You got it right for sure DrLisa.

It's amazing how many students have no sense of reality when it comes to money. You can have a great life without a 500,000 house and 25k private schools for your kids. It's strange that so many people develop these unrealistic expectations about their lifestyle and income.

Why do you think that these are unrealistic expectations? If you were intelligent enough to get into medical school then you were probably intelligent enough to make a hell of a lot more money doing something else. Why don't Doctors have the right to expect/desire the same lifestyle that other professionals (laywers, accountants, MBA's(from respected schools not some internet degree), Dentists, etc) have. I most certainly believe that we deserve the same incomes as other professionals. Hell, the Stryker reps that you see with the orthopedic surgeons make more than most primary care docs. CRNA's make more than or as much as pediatricians and FP docs. Too many in the medical profession let the system walk all over them.

We go through 7-10 years of training beyond college. I do not think it is unrealistic to expect a way above average lifestyle since we have way above average educations and carry way above average liability with what we do. 500K will buy you a very small house in most upscale metropolitan suburbs.te school for around 10-15k/year. Is it "unrealistic" that I'd like to live near a large city in a house large enough for every member of my family to have a room of their own. God forbid the house be in a nice safe neighborhood where other professionals live. Hell if I'm really unrealistic maybe I'll wish for a pool as well. Most public schools in larger cities provide low quality education, therfore it is often necessary to send your kids to private school. Is it "unrealistic" for me to want my children to recieve the best education that there is to offer? The same education the children of the above mentioned professionals will receive. Maybe I should just home school my kids. Oh I forgot I'll be working my ass off, doing something I truly enjoy, in attempts to fund my unrealistic house so I won't have time to home school my kids.

If you want to live in a very rural area, which most do not, then a docs salary will treat you just fine. If you want to live in or around the city and educate your children well then you will need to make a lot more than 150K/yr. It annoys the hell out of me to hear people pacify the deteriorations in the medical system. Stand up for what we deserve: fair compensation for our services, and a practice enviornment free of frivilous lawsuits. Everyone does deserve medical care, but not at the expense of Physicians income. Don't feel bad for having high expectations for you and your family. Remember we are not asking for anymore than other professionals enjoy with comparable educational experiences.

 

[zinjanthropus]

I'm not angry...not even the least little bit. Just trying to inject a little reality into this. I've noticed so many posts mostly from younger students who seem to think that once they've got that MD or DO behind their name that they're on Easy Street. Most of these kids haven't been out on their own for very long. They don't seem to realize that even if you command a large salary, there's a great deal of responsibility that comes with it. The most experience the majority of the younger students have had in managing money is balancing a checkbook and maybe buying a car. Even with that large salary it is ridiculously easy to bury yourself in debt so far that bankruptcy is the only way out. Been there, done that. I would like to be able to prevent others from having to go that route. For us, credit cards were the the biggest problem. My husband never met a credit card he didn't like. Then when we bought our house we wound up incurring even more debt (even beyond the mortgage). It's an older home with plenty of problems to be repaired. My older brother once told me never to buy the most expensive house you qualify for because then you'll be house-rich and cash-poor. He was right.

You may possibly think I'm rich or well-to-do, but I'm not. Just experienced enough in poor money choices to know what I'm talking about. I make $25k as does my husband. Rich, we ain't. Yes, I'm looking forward to the much greater income I'll be able to make as a doctor. However, I won't be making the same mistakes I've made before. I plan on making very good use of a reputable CPA and financial planner. I hope I've injected enough reality here to impress upon the premeds (most particularly the younger ones) the need for good money management.

if you have been a CPA for 25 years and are only making 25K, you're doing something wrong.

 

[drlisa0318]

To all of the young "kids" out there that have no idea how to manage money nor any sense of the financial responsibilities that one will assume once they have thier MD and think they are on their way to "easy street" I say this: Take the above opinions with a grain of salt. A lot of salt. If you have taken the normal track through medical school you will be 29-33 years old once you finish your residency. Their are plenty of specialties out their that clear onver 250K. Be economically conscious and take the economic trends in medicine into account when making the decision on which specialty to chose. I think Dr. Lisa has a skewed perspective of things.

Remember that it takes money to make money and if you invest your capital wisely you will have plenty of money to do most of what you want. Primary care does not pay well. Doctors do not get paid well to think, they get paid well to do procedures. Therefore if income is an issue, pursue a field that is procedure oriented. It is not unreasonable to want to live in a 500K home, have kids send them to private school and college, have nice cars, and take nice vacations.

On another note, Dr. Lisa, you said you make 25K a year as an accountant. I have many friends wha are accountants and their entry level salary out of college at 22years old is 45-50K. Partnership track is around 10-15 years at which time salaries jump to 400-600K. All along with a 5% increase in income/year plus great benefits. This is of course unless you jump ship and take a high paying corporate position along the way. I don't know what its like in tulsa, but 25K is WAAYY below the average salary for an accountant.

Make no mistake that the road to becoming a doctor is full of sacrafices both financial and personal. However, if you make intelligent choices you will enjoy your job more than your non-medical friends enjoy theirs and you will earn plenty of money. Think about becoming something that ends with "ologist" and you will be alright.

First, let me clarify: I said I have been in accounting for 25 years, not that I'm a CPA. Yes, a CPA can command a much higher salary than 25k. I was a voice major in my previous college life and never took any accounting courses. I'd have to have essentially a masters in accounting to be able to sit for the CPA exam in Oklahoma. All that I've learned about accounting has been on the job. I know my limitations there. I certainly know when to say, "that's beyond my scope of knowledge, you need to check with the CPA." I'm a full-charge bookkeeper, which means that I can do every aspect of a company's books from start to finish. I know how to read a financial statement and what it means (which, by the way, the vast majority of small-business owners do not know or understand.) I've done personal tax returns, C-Corp returns, S-Corp returns, trust returns, as well as payroll (including all the various payroll tax returns).

Second, I did not intend for anyone to think that making an excellent salary as a doctor and being able to afford a 500k house is next to impossible. What I DID say is that when you're fresh out of school and saddled with those loans, you need to take care of that as much as possible BEFORE you take on MORE debt. I do not want ANYONE to have to go through what I'm going through now because of living beyond one's means. If it means postponing buying that 500k house for a few years, then at least you'll know that when you DO buy that house you won't be encumbered by very large old debt.

Third, I'd like to emphasize that just because we have the science and math acumen to be physicians does not mean that we have the BUSINESS acumen to make wise business and financial choices without at least consulting a CPA. I know enough about accounting to know that I DON'T know enough to make it through the maze of business and financial decisions that I'll have to make as a doctor (particularly in private practice.) I'm certain that others of you will have that knack for business that I don't have. You will certainly fare better than me without a CPA.

 

[drlisa0318]

Wow...you're old.

Wow...you're rude.



I'm 48. While that's old by premed standards, I don't feel the least bit old. Well, except for the fact that my arms aren't long enough anymore....and my joints creak more....and a very large number of you are young enough to be my kids.....and my son tells me "if it's too loud, you're too old"......and I didn't learn about Kennedy being assassinated from a history book (I was in 2nd grade in a suburb of Dallas).....OH, NO!!! I AM old!!!!!

Nah!

 

[CJMPre-Med]

Why do you think that these are unrealistic expectations? If you were intelligent enough to get into medical school then you were probably intelligent enough to make a hell of a lot more money doing something else. Why don't Doctors have the right to expect/desire the same lifestyle that other professionals (laywers, accountants, MBA's(from respected schools not some internet degree), Dentists, etc) have. I most certainly believe that we deserve the same incomes as other professionals. Hell, the Stryker reps that you see with the orthopedic surgeons make more than most primary care docs. CRNA's make more than or as much as pediatricians and FP docs. Too many in the medical profession let the system walk all over them.

We go through 7-10 years of training beyond college. I do not think it is unrealistic to expect a way above average lifestyle since we have way above average educations and carry way above average liability with what we do. 500K will buy you a very small house in most upscale metropolitan suburbs.te school for around 10-15k/year. Is it "unrealistic" that I'd like to live near a large city in a house large enough for every member of my family to have a room of their own. God forbid the house be in a nice safe neighborhood where other professionals live. Hell if I'm really unrealistic maybe I'll wish for a pool as well. Most public schools in larger cities provide low quality education, therfore it is often necessary to send your kids to private school. Is it "unrealistic" for me to want my children to recieve the best education that there is to offer? The same education the children of the above mentioned professionals will receive. Maybe I should just home school my kids. Oh I forgot I'll be working my ass off, doing something I truly enjoy, in attempts to fund my unrealistic house so I won't have time to home school my kids.

If you want to live in a very rural area, which most do not, then a docs salary will treat you just fine. If you want to live in or around the city and educate your children well then you will need to make a lot more than 150K/yr. It annoys the hell out of me to hear people pacify the deteriorations in the medical system. Stand up for what we deserve: fair compensation for our services, and a practice enviornment free of frivilous lawsuits. Everyone does deserve medical care, but not at the expense of Physicians income. Don't feel bad for having high expectations for you and your family. Remember we are not asking for anymore than other professionals enjoy with comparable educational experiences.

This is an absolutely fantastic post, which echoes my sentiments on such matters almost to the letter (which is usually how people determine something to be a "fantastic post" ).

 

[bobbigboote]

Let's do a reality check.

Most people in this country make far less than 150k a year. Somehow they manage to survive, raise families, have happy lives, and contribute to society.

If you say that you can't live in a decent house, go to a decent school, etc. on 150k, then you are essentially saying that most Americans don't live in good places, don't go to good schools, etc. So either you have an incredibly warped sense of what kind of money most people have or you are putting down every hard working American making less than 150k. This includes just about every member of my family, who btw all live in big cities (DC, Dallas, Seattle, Denver, etc.), own nice houses, send their kids to great schools, etc.

 

[Hudson]

Let's do a reality check.

Most people in this country make far less than 150k a year. Somehow they manage to survive, raise families, have happy lives, and contribute to society.

If you say that you can't live in a decent house, go to a decent school, etc. on 150k, then you are essentially saying that most Americans don't live in good places, don't go to good schools, etc. So either you have an incredibly warped sense of what kind of money most people have or you are putting down every hard working American making less than 150k. This includes just about every member of my family, who btw all live in big cities (DC, Dallas, Seattle, Denver, etc.), own nice houses, send their kids to great schools, etc.

Heres your reality check:
If you make 150K/yr. you will pay around 34,700$ in income taxes and another ~4% in medicare and social security=40,700 total taxes. Therefore your take home income after taxes is 109,300$.

Lets say your home cost 450,000$ a 30year mortage at 8%(I know this is higher than what is currently available) will cost you 3,301$/mo=39,612$/year. Add 1.5% for property taxes=6750$. Say you have 450$/mo in bills to run your house=5400$/year. Grand total to own and run house/yr= 51,762.
Your disposable income is now $57,538.

Ok, now we are going to buy cars. Since you want your family to be safe and you have to haul the kids around we are going to buy 2 Ford Explorer XLT's which will end up costing 35K each after taxes. With 10% down on each one and ~5% financing over 5 years you will pay $14,266 a year for your vehicles. Add about $2000/year for gas and another $1500 a year for insurance. Grand total of owning two cars/year= 17,766.
Your disposable income is now $39,772.

Now lets send our Kids to Private School. Lets say 8000/year/kid= $16,000/yr.
(This may or may not be an expense depending on your location) For me it would be.
Disposable income is now is $23,772.

Now we will buy clothes and food(with two kids) lets just say~$1000/month.= $12,000/year.
Disposable income is now $11,772/year.

If you have $120,000 in student loans then you will be paying I think around $1200/month = 14,400/year.
Disposable incom is now -$2628.

Keep in mind we have not insured anything but our cars. We have not saved a cent for retirement. We have not taken a vacation, bought anything "extra." We have not given to charity or grabbed season football tickets to your alma malter. We have not saved for college either or made a single investment on the side.

I have not taken into account that some people will be dual income and therefore will have some help. In addition, I know that houses in small medium size cities are much less than 450K/year. I also assumed zero debt forgiveness when joing a group. My point with the above numbers was to show that 150K is not that much money once you acccount for all your expenses. I do not find anything in the above to be "unrealistic," yet the above lifestyle is unrealistic on 150K/year. People need to sit down and see what they want out of life and how financially comfortable they want to be. This is more important to some than others, but still important none the less.
Also keep in mind that most non-primary care physicians make well over 200K/year.

 

[bobbigboote]

Cars--
Putting aside the fact that you don't NEED 2 brand new Ford Explorers and they actually are NOT particularly safe (size does not equal safety), here's the current breakdown of car cost:
(Found on Carsdirect.com)
Brand new 2004 Explorer (#3 in the list, not the stripped one): 23,928
Current monthly payment (including %10.7 sales tax in my area + 2500 down on each + 60 month term): $410
Yearly total for 2 using your estimated gas/ins costs: 13340.

House--
Here's a more realistic price of a very large (2190 ft.) very nice place in a Seattle suburb. Note that you can easily get a nice place for 220-240k but i'm erring on the side of more space and better location.
$299,000, %10 down, 8% interest rate = $1974 a month for P/I
There are VERY few places in the country where you can't get a house like this for this kind of price (San Fran, NY, LA, and a few others).
Lets use your 6750 tax and and 450 a month in bills:
$2536 a month in housing.

School--
Because you live in such a nice neighborhood with good schools, you send your kids to public schools like most people in the world.
$0

Clothes / Food--
We'll stick with yer 1000 a month.

Student loans--
We'll stick with yer $1200 a month.


--So adding all this up--

Salary 150k
Take home 109,300
Public school 0
Student Loan 1200
House bills 450
House 2536.5
Explorer 1 410
Explorer 2 410
Food & Clothes 1000
Car Insurance 125
Gas 166.6666667

Year total 75578
Amount remaining: 33722

So we are left with $33k of unspent income per year.

This number would increase with a few tweaks like getting a slightly less expensive house and using the actual current interest rate (6%), buying safer cars and getting them used (like a CRV which is safer, gets better mileage, and you can easily get a 2002 for 17k). Just these changes alone would increase the total remaining to at least 40k.

Where did you get the idea that you should be able to buy a big house and two brand new cars first year out of school? Most people acquire those things by working for years and saving money.

And forgetting all the math for a moment, you're missing the point: Most Americans live on far less income and have good lives. You are directly insulting them by claiming that you'd be in the poor house by living on their salary.

 

[Annette]

Don't forget the tax breaks for: the kids, the house, and if you insist on the behemouth, a tax break on the SUV (but you'll probably spend that and more for gas!)

 

[Hudson]

I know plenty americans that live well on less than this. It largely depends on where you live. I never said that you could not live a good life on less than 150k. I just said you could not do the things that a lot of people in medicine expect to be able to do.

The fact that you like to put words in my mouth is directly insulting. I am not insulting anyone with this discussion and I never said that you are in the "poorhouse" if you make less than 150k. If it makes you feel better to interpret my post that way and attempt to insult me, then more power to you. I'm just telling it like it is. Sure you numbers work out. I already said you could do it for less if you lived in an area with a moderate cost of living. However, physicians salaries do not increase in areas with higher costs of living like most other jobs do. They actually decrease.
Where I am living and planning on practicing a 1500 sq ft house 2bed/1-2bath with run you about 300K, and it goes up from there.

I got the car costs from the Ford Website http://www.fordvehicles.com/suvs/ex...p=2270311br=IE&ver=6&pfrm=WinXP&consp=2270311

Some areas don't have the great public schools that you plan on being so easily accessible to your children. In the event you end up somewhere that has subpar public education then I bet you will send your kids to private school. Even with you current numbers you are still hard pressed to save for retirement and college education for two kids. You have not provided for leisure spending, life insurance, donated to charity, or taken any vacation. All I am saying is that 150K is not as much money as most people think it is.

 

[bobbigboote]

I apologize if I'm misinterpreting your posts. I'm sure I'm reacting to more than just your specific posts in this thread.

Here is a quote from you that seems to sum up what you had been saying:

"If you want to live in or around the city and educate your children well then you will need to make a lot more than 150K/yr."

I believe this statement does not accurately reflect the lived reality of average americans. I've attempted in my previous post to outline what I believe are more "normalized" numbers for a well off lifestyle.

"It is not unreasonable to want to live in a 500K home, have kids send them to private school and college, have nice cars, and take nice vacations."

I agree. It is not unreasonable to want these things. However: 1) No one owes us anything no matter how much education we have. 2) You can still have a great life without em.

Point number 2 is actually debatable since each person has their own definition of "a great life". This is perhaps what bothers me the most. What someone people seem to be saying is required for a "great life" exceeds what I percieve to necessary. Given that docs have a much higher than average divorce rate, stress levels, work hours, etc., I believe that it is clear that more money does not equal a better quality of life. I think it's useful for people to do their own deep thinking about what really matters to them in life. When I do, I come to the conclusion that my salary will far exceed what I need to have my own "great life". How we define our goals and expectations is a choice. If we choose to define them with big houses, expensive cars, etc., then we are choosing the stress and hassle that goes along with those things.

Again, I apologize for ratcheting up the heat of this thread. I should take a 5 minute break to cool off before posting

 

[Amicus]

"If you want to live in or around the city and educate your children well then you will need to make a lot more than 150K/yr."

I believe this statement does not accurately reflect the lived reality of average americans. I've attempted in my previous post to outline what I believe are more "normalized" numbers for a well off lifestyle.

"It is not unreasonable to want to live in a 500K home, have kids send them to private school and college, have nice cars, and take nice vacations."

I agree. It is not unreasonable to want these things. However: 1) No one owes us anything no matter how much education we have. 2) You can still have a great life without em.

Point number 2 is actually debatable since each person has their own definition of "a great life". This is perhaps what bothers me the most. What someone people seem to be saying is required for a "great life" exceeds what I percieve to necessary. Given that docs have a much higher than average divorce rate, stress levels, work hours, etc., I believe that it is clear that more money does not equal a better quality of life. I think it's useful for people to do their own deep thinking about what really matters to them in life. When I do, I come to the conclusion that my salary will far exceed what I need to have my own "great life". How we define our goals and expectations is a choice. If we choose to define them with big houses, expensive cars, etc., then we are choosing the stress and hassle that goes along with those things.

Again, I apologize for ratcheting up the heat of this thread. I should take a 5 minute break to cool off before posting

freaking hippie....you will change your tune soon enough.

I tend to think you have not spent any/much time in medical school yet.

What could be worse for doctros wages than a whole choir of docs arguing about how cheaply they could live. Who in their right mind works this hard, and excersized this much self dicipline only to settle for a quality of life for them and their kids/wife that they could have had by working their way up from a cashier at walmart.

i hate hippie liberals

 

[Sessamoid]

freaking hippie....you will change your tune soon enough.

I tend to think you have not spent any/much time in medical school yet.

What could be worse for doctros wages than a whole choir of docs arguing about how cheaply they could live. Who in their right mind works this hard, and excersized this much self dicipline only to settle for a quality of life for them and their kids/wife that they could have had by working their way up from a cashier at walmart.

i hate hippie liberals

I agree with the hippy liberal, and I've been working out in the world for a few years already. Happiness doesn't result from money. I know lots of miserable rich people.

 

[deleted4401]

I don't get the need to send the kids to private schools. That part that people keep bringing up drives me nuts. There is a ton of great public high schools. Even here in New Orleans where the schools are absolutely abhorrent, there's some great public high schools (i.e. Ben Franklin).

And the house, geez. The expectation of a $500,000 house post residency is a little grandiose. Why not get a starter home or a condo for a little bit less money and build up a little capital, and then put it down on a bigger house?

And, if nice cars are so important, why not just lease them? I know some people hate leasing, but if that Explorer or Lex RX300 or whatever is that important, just get a lease. Much more affordable and convenient, IMO.

And, I also think the most people are going to have two incomes, especially by the time they are done with residency. Even if it is only $30,000 or $50,000, that much extra will go a long way for the little things like vacations and other fun stuff.

I know the loans sound crippling and there is a lot of expenses, but it's do-able. If you don't rush in and start at $150,000-200,000, by the time you're 10 years in, you'll have accumulated a nice house and probably have a decent amount of stuff (cars, clothes, etc.). You won't live like a pauper, I don't think.

It's not so bad, people ... Don't think that the law or business field is always better. We have something that they won't ever have - total job and income security. We haven't calculated how much that is worth.

Later,
Simul

 

[Amicus]

I agree with the hippy liberal, and I've been working out in the world for a few years already. Happiness doesn't result from money. I know lots of miserable rich people.

The statment, "happiness doesnt result from money" is 100% true.
But that does not mean that hapiness is some how less likey with more money, or that in general a person who makes 200K a year is not happier than if he made 40K a year. I belive money can make people happier. I dont belive that money forces you to be happy. See the difference?

Here is my deal. We (most of us) are young. We have the ability to create whatever life for ourselves we want. So ask yourself, do you want the freedom to do what you want? Do you want to be able to give your children a secure future? Do you want to be able live with the peace of mind that you dont have to worry about running out of money? (something that 100K doesnt give) Or heck...Do you want to be able to GIVE money to the charities you choose? Bill gates just gave 150 mill to an AIDS organization that the US gov only sent like 2-300 mill to.
People have this idea that money is bad. That you do bad things to get it and once you get it you do bad things with it.
The only bad thing i have done to get it is bust my butt in med school and have become a pretty knowledgable person because of it. This in contrast to the people who feel that a 70 is good enough for them (and their patients apparently).


If you are 40-50 and are in the stage of your life when change is tough. When you have a family and bills and cannot go back to school to change your earing potential ect, FINE. fine. You have every right to try and look at your life with rosy glasses and convince yourself that the way things are is the best way for you. If people didnt do that they would go crazy. People do it when they dont get into the med school they hoped. They do it when they are 20 years into a marriage that is soured and they are to old to start again.
when the time for change has past a great desire for that change in as usless as cancer pain once a pateint is already terminal. But for gods sake, dont try and convince the young and full of potential and energy that they should trow in the towel now and resign themselves to a life of mediocraty.
FIGHT! FIGHT! FIGHT! For money or for the job you want or for anything. You are DYING, dont wander through life not getting what you want.

 

[ucsfer]

I think the thing is that for all that we go through - 7-14 years after undergrad, working 80+ hours a week, emotional/physical stress, etc., it seems like one deserves to come out of that earning a lot - lot being imho 500k +. because there are other professionals as has been said above, who have less education, less emotional/personal sacrifice, etc make at least that much, and long before we even start our first real jobs. And because I truly believe that we deserve to earn that much, it is annoying that most of us won't. This is not to say that we CANNOT live without that much - of course we can, we are all doing fine on loans and no money right now. But I don't think we should have to put up with lower salaries than other such professionals later on. We should make enough to make up for all these years of non-earning, when our education and potential could have made us much more comfortable had we chosen a different path.
Also, the thing that adds extra annoyance to all of this is that everyone who is not in medicine thinks that we make tons and tons and tons of money.
I recently had a conversation with a friend of mine in finance who was absolutely shocked that even surgeons only make 250-300k. She couldn't believe that after so many years of working hard to get to that level and doing something that is so imp to society surgeons make less than she will be making in a few years after only 2 years of study after undergrad.
Let me say again that none of this says that we can't live ok lives (even in SF, NY, etc) on less, of crs we can. just should we?

 

[Voxel]

No one owes you anything. Pining about what should be instead of what is, without doing something about it, is a waste of energy. If you didn't do your homework and now realize what medicine entails and the potential salaries out there then you have made a big mistake. And for all mistakes in life we have to pay. Medicine offers protection from recession (job security) and an income in the top 10% of all US income earners. If you *need* more money than what medicine can offer you, get out now and find another profession.

*In reality you don't understand how the people with a sizeable net worth, ie wealthy, really live*.

The people I am talking about are those who have started with not much and have made something of themselves, (the majority of which are not rock stars, professional athletes, top notch I-Bankers, etc and are not making >500K).

All you see is MTV cribs and your neighboors the Joneses (sp?). That is NOT reality.

If you think the lifestyle you describe is going to make you wealthy or happy, then you are sadly mistaken.

1st) you are not a rock star. 2) A majority of your neighboors are in debt, have a negative net worth, or have not saved much of anything for retirement, college education for kids, etc.

After a majority of the basic needs have been met, you have to be happy from the inside. Driving that new benz feeling wears off after a few months, cause they are always coming out with newer, better benzes. If you are a miserable SOB, you will continue to be one. Albeit one who earns a lot of money (plays good offense).

Not only that, but you are unreasonable in your choice of where you want to live and practice. There are plenty of opportunities but if your geographic choice is so narrow, then you have no one to blame but yourself.

 

[MacGyver]

I see a bunch of hypocrisy on this thread. If Voxel or sessamoid found out tomorrow that they are going to be capped at 100k, they'd be absolutely outraged, DESPITE the fact that 150k is in the top 5% of all income earners in the United States.

 

[DrQuinn]

I see a bunch of hypocrisy on this thread. If Voxel or sessamoid found out tomorrow that they are going to be capped at 100k, they'd be absolutely outraged, DESPITE the fact that 150k is in the top 5% of all income earners in the United States.

The sky is falling and the PAs are taking over!

Q, DO

 

[DrQuinn]

My wife and I combined make ~ 90k a year (I, 39k, her, 50-52k), we live in an 11th story 2 br 2 bath condo overlooking downtown Tampa, 1200 square feet. She drives a Hyundai Elantra (not paid off), I drive a Ford Explorer (paid off). She has ~60k in student loans (being currently paid off ~800 a month), I have ~190k in student loans (on economic hardship deferment for 3 years), and when I am done in 2 years, will be paying them back at <2% at 700 a month for 30 years. We took a one week ski trip to Austria last year, I am buying a new car in 6 months, we plan on going skiing in Canada in March, and I just got a new laptop. We usually go out to eat at nice restaurants 1-3 times a week. On 90k a year. We live comfortably, almost too comfortably!

The sky is not falling. If she did not have her student loans, we would have even more money to spend on what we like. Sure, I hope to be pulling in 200k a year. You can bet within my first year I will be buying myself a nice toy (40k car). I cannot even IMAGINE what it would be like to have a household income of twice what we have (180k).

And I am extremely happy in my life right now... making a paltry 90k combined. Even though that's *only* twice the MEDIAN income of the average American household. I suspect the majority of people in this thread are either pre-meds or still in medical school.

Q, DO

 

[Amicus]

No one owes you anything.

No one is asking for salary ganuntees. But when you have a proffesion where you have to put in ten years to be able to make any money at it that is a hell of an investment of time to not have some sort of assurances about earning potential.
You say getting into medicine is a choice and a smart person weighs the pros and the cons. But unfortunatly the pros and cons of today are not the pros and cons ten years from now. you will invest ten years of your life and alot of debt based on the economics of a proffession a DECADE out of date.
Would you invest in a company today based on info ten years old?
Would you marry a girl you had not seen in ten years?
Doctors are asked to make that huge comitment and with out any reasonable assurance of anything. Think of what can happen in ten or twenty years.
It is a gamble unlike anyother. The costs in terms of time and money are stageering and so should the potential rewards.
No other proffession on the planet asks so much from those persuing it.

 

[drlisa0318]

I think we can all agree that doctors' incomes are generally not commensurate with their training. Many things play into that: the overall economy, insurance companies' reimbursement policies, the public's inability and/or unwillingness to pay "their fair share", etc. Regardless of the cause, the fact remains that we will in all likelihood earn less than we "should."

Where our opinions seem to begin to diverge is what we do at this point. Do we accept our income limitations (whether rightly or wrongly placed), or do we fight to change our limitations? Some of the things that play into our income limitations are beyond our control (ie. the economy). Some things are within our power to effect at least some sort of change (ie. tort reform).

Whether you like it or not, medicine is by and large a business. And like any business, there will be fluctuations in the market which affect our income and expenses. A great number of things which can adversely affect our business will be completely out of our control. For example, the business where I'm currently working, a supply company for fire protection companies, was badly affected by the recent steel shortage. Our costs for steel pipes and fittings doubled, tripled, even quadrupled. When we would order pipe, (1) the vendor could not guarantee when or even if they would ship the pipe (we lost a lot of business that way, thereby reducing our income) and (2) the price quoted could not be a guarantee of the price billed to us (if their costs increased during the time between our order and their shipping of that order, our bill would increase accordingly, thereby increasing our costs) and (3) we could only pass on those cost increases to a certain point (thereby limiting our income) before the customer would take his business elsewhere and reduce our income even more. This sort of thing affects every aspect of a business. If you are an employee, the company starts paring back on overhead costs, and payroll is generally the largest single expense and the first place to start. If you are a business owner, you may end up reducing your own draw from the company. Medicine, being a business, is not immune from this scenario.

The lesson to be learned from this is that all our years of training is not a guarantee of the income we want (or deserve.) Our income level is not a right, at least not in the US, since this is a market-based economy and our income will not be higher than the market will bear. There are things we can do to increase our income and reduce our expenses. Most notably these are dealing with the insurance industry behemoth regarding insurance reimbursements and malpractice insurance premiums and the legal industry regarding tort reform.

The other main area where our opinions diverge is what to do with our money personally. If you feel your income isn't high enough, then you first do all that you can to increase it (ie. lobbying to change tort laws, streamlining your practice to reduce expenses, etc.) Those things that are out of your control, you just simply have to accept. With all your efforts, your income may or may not increase (there's no guarantee, either way.) Then you have to deal with whatever the results are. If your income has increased, then YEA for you! You can reap the additional benefits of your labor. If your income has not increased, then you can choose to continue fighting the good fight or not. In any case, you still are left at the end of the day with XXX dollars.

It is here at this point that I become most passionate. For it is here where what happens to your money is completely YOUR responsibility. There is no one else to lay the blame on when at the end of the day you're a dollar short. No blaming the insurance company for the poor reimbursement schedule (did they make you buy the $500k house?) No blaming the pharms for the high cost of meds (did they make you buy that Mercedes?) No saying it's not fair that you're not paid what you deserve. It's not fair that teachers, police, and firefighters are underpaid, too. "Fair" has nothing to do with it. So, when you start practicing medicine and your income has increased dramatically from your student and residency days, don't forget all that you learned about handling money when you didn't have very much. If your income is 120k (which, by the way, is a fortune to me - it's almost 5 times what I make now), don't try to live your life like your income is 240k (a mega-fortune to me!) If you do, then the blame lies at YOUR doorstep for not having enough money to pay the mortgage, or the car payment, or the credit card bills.

 

[Sessamoid]

Dang, you don't really have much real world experience do you? Let me correct a few things.

Heres your reality check:
If you make 150K/yr. you will pay around 34,700$ in income taxes and another ~4% in medicare and social security=40,700 total taxes. Therefore your take home income after taxes is 109,300$.

How long have you been making this theoretical 150K? Given the many deductions you can take (and you obviously didn't include the largest deduction--mortgage interest payments), if you're paying 40K in taxes on 150K in income, you're giving the government money more than you need to. Lots more.

Lets say your home cost 450,000$ a 30year mortage at 8%

Why don't we just say you're gonna buy a million dollar house? Nobody said you must buy a 450K house, nor did anybody tell you that you were entitled to one. Buy what you can afford. If you can't afford to buy yet, then rent until you can.

Ok, now we are going to buy cars. Since you want your family to be safe and you have to haul the kids around we are going to buy 2 Ford Explorer XLT's

What, you're going to buy 2 expensive SUVs (which despite what you believe aren't any safer than station wagons) as soon as you graduate? And you're going to buy them new? That shows amazingly lack of control in managing your finances. Used vehicles make much more financial sense and cost a fraction.

Now lets send our Kids to Private School. Lets say 8000/year/kid= $16,000/yr.

Or you could just move to a neighborhood where there are decent schools. I went to public schools my entire life, and I don't think I'm financially challenged..

In addition, I know that houses in small medium size cities are much less than 450K/year.

Hell, even in LA county which has seen obscene increases in real estate prices, houses are available for less than that.

I do not find anything in the above to be "unrealistic,"

Maybe not "unrealistic", but certainly unreasonable. Two expensive SUVs? Sure you could realistically buy them, but that wouldn't be reasonable.

 

[drlisa0318]

If you are 40-50 and are in the stage of your life when change is tough. When you have a family and bills and cannot go back to school to change your earing potential ect, FINE. fine. You have every right to try and look at your life with rosy glasses and convince yourself that the way things are is the best way for you. If people didnt do that they would go crazy. People do it when they dont get into the med school they hoped. They do it when they are 20 years into a marriage that is soured and they are to old to start again.
when the time for change has past a great desire for that change in as usless as cancer pain once a pateint is already terminal. But for gods sake, dont try and convince the young and full of potential and energy that they should trow in the towel now and resign themselves to a life of mediocraty.
FIGHT! FIGHT! FIGHT! For money or for the job you want or for anything. You are DYING, dont wander through life not getting what you want.

Sigh...youth. I'm 48, have a family, bills, blah, blah blah. And yet, here I am, back in school, looking forward to 2 years of prereqs, 4 years of med school, and 3 years of residency. Which means I'll be starting my practice at 57 or 58. I and oh so many others of us "old fogies" are not too old to start over again. And if my 22 year marriage sours, I won't be too old to start that part of my life over, either. All I'm suggesting is that those of you with less "real-world" experience take off YOUR rose-colored glasses. The money you earn (whether it is as much as you feel you deserve or not) should be managed wisely, so that it works for you. It will be completely your responsibility to see that it grows, not dwindles. When you begin your practice, if you can afford a $500k house, great! If not, don't worry about it. Since you're just starting your practice, if you manage wisely, you'll be able to afford it soon enough. Practice patience, and err on the side of conservative with your money, and you'll do great.

Oh, and if someone applies the label "liberal hippie" to me, I'll laugh my head off. I am oh so conservative, both in financial matters and politics. My husband, on the other hand, is liberal in politics, and very liberal in financial matters, at least when it comes to spending our money - which perhaps explains why we're bankrupt! (Okay, I really can't lay all the blame at his feet - I certainly could have said no to many of the purchases he made.)

 

[Amicus]

Sigh...youth. I'm 48, have a family, bills, blah, blah blah. And yet, here I am, back in school, looking forward to 2 years of prereqs, 4 years of med school, and 3 years of residency. Which means I'll be starting my practice at 57 or 58. I and oh so many others of us "old fogies" are not too old to start over again.

Oh, and if someone applies the label "liberal hippie" to me, I'll laugh my head off. I am oh so conservative, both in financial matters and politics. My husband, on the other hand, is liberal in politics, and very liberal in financial matters, at least when it comes to spending our money - which perhaps explains why we're bankrupt! (Okay, I really can't lay all the blame at his feet - I certainly could have said no to many of the purchases he made.)

Belive me, I respect what you are doing. I dont belive it is ever to late to follow your heart. My point was that many many older people have lied themselves into accepting their lives as they are beacuse changing it is to hard. People with far less balls than you.

The downside to your courage is this. You truly are up against a major obstacle. The bottom line is that our tuition does not pay for a fraction of our medical education. It is alot of tax payer money. It takes millions to run a medical school and there are limited spots. So who do you invest in? A person who will practice for 10 years, 20 at the most, or somone who will practice 35 or 45 years? Im not saying people your age dont get in, but you have the uneviable position of trying to convince an admissions commite why they should let you in. This is probably the harshest thing i have ever writen but either its not true and you can blow me off, or it is true and better you know now that the deck is overwhelmingly stacked against you.

your other post was great by the way.

 

[Amicus]

Call a dozen med schools and ask them what they think about your plans.
In truth, worst case scenario is you cough up 200K to go to a caribean school and you still get to be a doc. But you will have to convince a bank you will work long enough to pay them back.

 

[Voxel]

It's not hypocrisy. There are no garuntees in life. You make the best with what you can. Sure no one would be happy if salaries magically went down or were capped. No one is claiming that. What I am saying is that everything in life is a risk. You take your chances knowning that things may be different when you get out and you are personally willing to take that chance. No one forces you to become a physician.

Do not make assumptions about life, it will make you very unhappy when things do not go according to your plans (both in your personal and professional life).

If you are unwilling to sacrifice time, money, energy and to risk what it takes to become an attending, by all means go do something else. Noone is twisting your arm. Your posts reek of entitlement, which may be the way you feel, but not the way real life works.

There are still plenty of ways to make decent money in the medicine, but there is no garuntee you will be the one doing it, or that the money will stay the same.

 

[med_stud_07]

Belive me, I respect what you are doing. I dont belive it is ever to late to follow your heart. My point was that many many older people have lied themselves into accepting their lives as they are beacuse changing it is to hard. People with far less balls than you.

The downside to your courage is this. You truly are up against a major obstacle. The bottom line is that our tuition does not pay for a fraction of our medical education. It is alot of tax payer money. It takes millions to run a medical school and there are limited spots. So who do you invest in? A person who will practice for 10 years, 20 at the most, or somone who will practice 35 or 45 years? Im not saying people your age dont get in, but you have the uneviable position of trying to convince an admissions commite why they should let you in. This is probably the harshest thing i have ever writen but either its not true and you can blow me off, or it is true and better you know now that the deck is overwhelmingly stacked against you.

your other post was great by the way.

35 or 45 years.