Specialties that are 40 hours a week and pay well

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Fair enough, can’t say I don’t imagine myself being the same way. Does work feel like a grind pumping out so many RVUs or is it still enjoyable?
If I'm at work, I like being busy

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Lol I was on the fence about DR at the end of second year. Then I went into my FM rotation, but it was my IM rotation that really cemented it. All the alcoholics, the druggies, the diabetics, the hypertensives, etc and attempting to manage it all while they’re whining and not taking their medications is exhausting. Can’t care more about people than they care about themselves.
Many med students don’t understand this soon enough

Average yearly return from 2010-2020 was an insane 13.6% and that doesn’t even account for the post-COVID-crash run up, which was in large part from printing US dollars like we are Zimbabwe in 2008. So it’s no wonder people think amazing returns are to be excepted in the future
I wouldnt bank on being that high this decade
 
This is a great point and something you rarely see outside of the FIRE subreddit. Just poking fun but if you can get inflation adjusted 10% yearly return on your investments, let’s start a hedge fund! 7% over decades is more realistic, 10% consistently over 10 years requires a LOT of luck...just so happens that the last 10 years provided that type of luck so people think that is normal.

Also, unfortunately by the time we realize this, most of us are at least in a few hundred thousands in med school debt and kinda have to keep going. And as much as people seem to hate medicine on SDN and scoff at the idea that it can be spiritually rewarding, I don’t think I could emotionally survive working in tech or finance...absolutely 0 sense of purpose.
Fair point. I wasn't quite specific enough. The average annualized return on the S&P500 is 10%, but accounting for inflation lowers it to 7%. So you'll literally see a 10% return in your account, but of course inflation will drop that down, and over time it will "feel" like 7%. I was staying consistent with the rest of my post (no one really thinks about salary in terms of inflation), but you are definitely correct in saying it's not a "real" 10%.

That being said, clean energy, genomics, and IT all seem like pretty good bets for >7% returns for the next 10 years, and of course GameStop.
 
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Academic attendings love to have residents play social worker. In reality, it's not your horse, not your rodeo, not your job. You're not their therapist. Also, if you observe good therapists, they are very good at keeping patients on time and on topic, because whining and complaining is actually unhelpful to anyone.

Yah, I agree. I want to help them, but I need to keep my expectations grounded.
 
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You do realize that the average fam doc salary is not 300 right? I personally haven’t met any that make that much here I live in a large metropolitan city on the east coast. That’s prob more for FM In Midwest. The ones I know here make 200 working 45-50 hrs a week.
Lol. The ones you know suck at negotiating. I'm in a large urban center on the east coast (pop. near 1M) and I haven't met an FM who works more than 40 hours a week, and nearly all are near or above 300k.
 
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Because making 300K/yr as an FM doc is not all that common I mean making those figures in FM is certainly possible but at the expense of geographic location. FM docs also do a ****ton of charting and managing DM and HTN all day sounds like a giant yawn to me lol

It’s a shame that it’s hard to find out the breadth of what a family medicine career can be. I barely manage any htn or DM. I do a lot of procedures and I also don’t do work outside of my hours of being at work which is 9-5 4 days a week and I have 1 full day of admin because of my role in my organization.

I don’t make 300k because I choose to live in a city that doesn’t pay as much. But I love working 4 days a week and my days are never boring.

I have so many FM colleagues that do OB, inpatient, urgent care, school based health, university health, and the list goes on...it’s not all dm & htn.

Just as an FYI to others.
 
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It’s a shame that it’s hard to find out the breadth of what a family medicine career can be. I barely manage any htn or DM. I do a lot of procedures and I also don’t do work outside of my hours of being at work which is 9-5 4 days a week and I have 1 full day of admin because of my role in my organization.

I don’t make 300k because I choose to live in a city that doesn’t pay as much. But I love working 4 days a week and my days are never boring.

I have so many FM colleagues that do OB, inpatient, urgent care, school based health, university health, and the list goes on...it’s not all dm & htn.

Just as an FYI to others.
Thats good to now. thank you! this was just my experience during my FM rotation. I wish I had broader exposure to the field
 
From what I have read, telerads jobs require top tier productivity and they expect you to read studies for 8-10hrs with basically no breaks. To put it another way, there is a reason those jobs aren’t super competitive to get.
Well let’s not forget to mention the equipment that you need. It’s not like you can chill on the beach with a macbook and read studies.
 
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Well let’s not forget to mention the equipment that you need. It’s not like you can chill on the beach with a macbook and read studies.
Sort of. If not reading mammo then the criteria for the monitor changes drastically. It also depends on how you connect to the PACS. Are you rendering all images on your computer or is it done at home and ported to you? That determines if the pc needs to be powerful or not.

Internet is the biggest issue by far and not hardware for this type of work now.
 
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Sort of. If not reading mammo then the criteria for the monitor changes drastically. It also depends on how you connect to the PACS. Are you rendering all images on your computer or is it done at home and ported to you? That determines if the pc needs to be powerful or not.

Internet is the biggest issue by far and not hardware for this type of work now.

Good to know.

Also worth considering that med students interested in rads (like me) wouldn’t be done with fellowship until 7-9 years from now, and I’m sure technology will be even better and allow more opportunities for telerads. The two problems I see with that are 1) diagnostic radiology still seems to do quite a few procedures in many practices 2) out sourcing from Americans living in domestic or international areas with very cheap cost of living could cause a race to be bottom in terms of salary. (I know international reading isn’t possible for medicare/Medicaid currently but a heck of a lot can happen politically in 10-20 years).
 
Rads, path, derm, rheum, psych, endo, rad onc, EM, PM&R, occupational med, medical genetics, geriatrics, palliative, allergy, optho. Also outpatient peds, FM, IM, neuro.
 
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“Not surgery”
Not anything with surgery or a lot of call. Not inpatient IM, peds or neuro. Not certain subspecialties like cardio, GI, critical care, neonatology, or heme/onc. The one exception I can think of would be OBGYN => reproductive medicine fellowship
 
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Not anything with surgery or a lot of call. Not inpatient IM, peds or neuro. Not certain subspecialties like cardio, GI, critical care, neonatology, or heme/onc. The one exception I can think of would be OBGYN => reproductive medicine fellowship
I got ya, I was just poking fun at the long list.
 
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Rads, path, derm, rheum, psych, endo, rad onc, EM, PM&R, occupational med, medical genetics, geriatrics, palliative, allergy, optho. Also outpatient peds, FM, IM, neuro.

Not sure you can include EM on the list of <40hrs/week and pays well...being unemployed is a pretty low paying gig in most places.
 
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Not sure you can include EM on the list of <40hrs/week and pays well...being unemployed is a pretty low paying gig in most places.
If we're being cheeky then we can replace EM with admin I guess,
 
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Good to know.

Also worth considering that med students interested in rads (like me) wouldn’t be done with fellowship until 7-9 years from now, and I’m sure technology will be even better and allow more opportunities for telerads. The two problems I see with that are 1) diagnostic radiology still seems to do quite a few procedures in many practices 2) out sourcing from Americans living in domestic or international areas with very cheap cost of living could cause a race to be bottom in terms of salary. (I know international reading isn’t possible for medicare/Medicaid currently but a heck of a lot can happen politically in 10-20 years).
I sincerely doubt american medical graduates with 5-6 PGY years of training are going to be moving to low income countries just to read at home. We already have to pay much better just to recruit these people to the rural USA.
 
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I sincerely doubt american medical graduates with 5-6 PGY years of training are going to be moving to low income countries just to read at home. We already have to pay much better just to recruit these people to the rural USA.
Not to mention political suicide. Imagine the campaign ads.

"My opponent X says that he doesn't care if CHINA reads our x rays. He doesn't care about American healthcare."

It's legit political suicide. America is stupid but not that stupid.
 
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Sort of. If not reading mammo then the criteria for the monitor changes drastically. It also depends on how you connect to the PACS. Are you rendering all images on your computer or is it done at home and ported to you? That determines if the pc needs to be powerful or not.

Internet is the biggest issue by far and not hardware for this type of work now.
Thanks for the info. Good to know
 
Just to throw this into the conversation.

From an old paper: "Money and Happiness: Rank of income, not income, affects life satisfaction"

Excerpt from abstract: "We found that the ranked position of an individual’s income predicts general life satisfaction, whereas absolute income and reference income have no effect. Furthermore, individuals weight upward comparisons more heavily than downward comparisons. According to the rank hypothesis, income and utility are not directly linked: Increasing an individual’s income will increase his or her utility only if ranked position also increases and will necessarily reduce the utility of others who will lose rank."
 
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I sincerely doubt american medical graduates with 5-6 PGY years of training are going to be moving to low income countries just to read at home. We already have to pay much better just to recruit these people to the rural USA.

Buenos Aires, Prague, or Madrid are cheaper than any city in rural America and have 100x more things to do. I wouldn’t be so sure. The exact same thing has happened with tech jobs that can go remote (almost all of them). It’s called geographical arbitrage, I would read more about it if you think it’s far fetched.

I also said cheap domestic OR cheap international. Cheap domestic is the exact rural areas you mention...the kind of place were $700k buys you a 7,000 sq ft house only 90 minutes from an international airport.
 
Not to mention political suicide. Imagine the campaign ads.

"My opponent X says that he doesn't care if CHINA reads our x rays. He doesn't care about American healthcare."

It's legit political suicide. America is stupid but not that stupid.

Uh I said Americans for a reason. We will discover faster-than-light technology before non-US trained/boarded doctors are reading radiology studies.
 
Buenos Aires, Prague, or Madrid are cheaper than any city in rural America and have 100x more things to do. I wouldn’t be so sure. The exact same thing has happened with tech jobs that can go remote (almost all of them). It’s called geographical arbitrage, I would read more about it if you think it’s far fetched.

I also said cheap domestic OR cheap international. Cheap domestic is the exact rural areas you mention...the kind of place were $700k buys you a 7,000 sq ft house only 90 minutes from an international airport.
You are aware that rather than tons of radiologists flocking to rural america to live like kings off their telerads gigs, the exact opposite problem has always been the case? Those jobs are bottom of the barrel
 
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My dad is FM, 30+ years, 350k working 8-12 M-F (20 hours per week).

He used to work a lot harder, and made "more than anyone", but recently slowed down a lot.

Investment portfolio has dwarfed his income, I think he does it out of passion at this point.
 
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EM, last 20 yrs avg about 450K/yr working 35hrs a wk. Currently working 30 hrs a wk and this yr will be making Ortho+ salary.

The past does not predict the future for EM or any other field. Unemployed EM are unemployed b.c they chose a certain area, there are jobs.
 
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My dad is FM, 30+ years, 350k working 8-12 M-F (20 hours per week).

He used to work a lot harder, and made "more than anyone", but recently slowed down a lot.

Investment portfolio has dwarfed his income, I think he does it out of passion at this point.
Does he do a lot of clinic procedures? How is that even possible to make 350k/yr working 20 hrs/wk?
 
EM, last 20 yrs avg about 450K/yr working 35hrs a wk. Currently working 30 hrs a wk and this yr will be making Ortho+ salary.

The past does not predict the future for EM or any other field. Unemployed EM are unemployed b.c they chose a certain area, there are jobs.
Ortho+ salary is about ~500k/yr... Why aren't you retired yet?
 
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Psych NP:

6 year total schooling/training, doing telepsych from home and make 200k for 40 hr work week.
 
Psych NP:

6 year total schooling/training, doing telepsych from home and make 200k for 40 hr work week.
Why do that when I can be a psychiatrist and make an extra $20k a year in exchange for 6 more years of training and $300k more in debt?
 
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EM, last 20 yrs avg about 450K/yr working 35hrs a wk. Currently working 30 hrs a wk and this yr will be making Ortho+ salary.

The past does not predict the future for EM or any other field. Unemployed EM are unemployed b.c they chose a certain area, there are jobs.
Let’s say ortho+ means at least $550k/yr, with 30hrs/week and 0 weeks of vacation, you are making $352/hr? Do you also have a bridge in Brooklyn to sell?

To put this is perspective, this is $10 more per hour than a neurosurgeon who makes $900k/year working 55hrs/week and 4 weeks vacation (which I would actually believe).
 
Why do that when I can be a psychiatrist and make an extra $20k a year in exchange for 6 more years of training and $300k more in debt?
I got the point, but average salary for psych is ~300k/yr...
 
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Let’s say ortho+ means at least $550k/yr, with 30hrs/week and 0 weeks of vacation, you are making $352/hr? Do you also have a bridge in Brooklyn to sell?

To put this is perspective, this is $10 more per hour than a neurosurgeon who makes $900k/year working 55hrs/week and 4 weeks vacation (which I would actually believe).
No Bridge to sell and this year should be Ortho +++ this year with partnership/ownership. EM is not a bad gig. 3 yr residency vs 5+ surgical subspeciality. $325/hr was not that difficult to get 5 years ago and I was making twice as much on some shifts. Some places I moonlighted at I know docs making over $1M and working 60hrs/wk in the pits. Those days are mostly gone.
 
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Ortho+ salary is about ~500k/yr... Why aren't you retired yet?
I still like my work and maybe will slow down to 20 hrs/wk soon. Plus still have young kids so still busy being involved in their activities. Coaching my kids BB team this year which has been a blast but time consuming with practices twice a week and games twice a week.
 
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I still like my work and maybe will slow down to 20 hrs/wk soon. Plus still have young kids so still busy being involved in their activities. Coaching my kids BB team this year which has been a blast but time consuming with practices twice a week and games twice a week.
What has been your highest yearly salary so far?
 
What?

I don't get it. You made 100k in a month!
Yeah, my wife didn't let me make a shirt that said "6 figures" in the front and "one month" in the back. Not that I would ever wear it.

Don't worry how much you make as much as what you do with your money. If you want to retire then work towards passive income, otherwise you will be working until you are forced to retire.

I should hit 300K in passive rental income this year on top of EM work/business
 
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my thought reading it was maybe a practice owner employing other doctors/midlevels?

Yeah employs other doctors. Had a midlevel, and to be fair the midlevel helped make more money, but he worked more while they were around so he let the midlevel go.

He said biggest thing was getting overhead down to 20%
 
Yeah, my wife didn't let me make a shirt that said "6 figures" in the front and "one month" in the back. Not that I would ever wear it.

Don't worry how much you make as much as what you do with your money. If you want to retire then work towards passive income, otherwise you will be working until you are forced to retire.

I should hit 300K in passive rental income this year on top of EM work/business
Ownership and rental property is one thing, but making it sound like you are making $350/hr working shifts alone is just misleading. The average EM grad will be lucky to find $225/hr in a small city. With the growth in residencies that rate is high for current medical students planning on going into EM.
 
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I never said there are $350/hr jobs around but there are $225/hr jobs available if you are willing to move around. EM has changed and the days of working anywhere is over but that is what happens when you have a good gig.

But with any field, you can do very well if you are willing to take the risks/open up your own practices.
 
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I never said there are $350/hr jobs around but there are $225/hr jobs available if you are willing to move around. EM has changed and the days of working anywhere is over but that is what happens when you have a good gig.

But with any field, you can do very well if you are willing to take the risks/open up your own practices.
Is it possible to open up your own EM practice these days and compete with a CMG on price+productivity? I’ve always assumed that CMGs have taken over because they are able to offer the best prices to hospitals based on economies of scale. I’m curious what you think since as a practice owner you know much better than the average person that says 100% CMG employed docs are the future.
 
Is it possible to open up your own EM practice these days and compete with a CMG on price+productivity? I’ve always assumed that CMGs have taken over because they are able to offer the best prices to hospitals based on economies of scale. I’m curious what you think since as a practice owner you know much better than the average person that says 100% CMG employed docs are the future.
I’ve never heard of a private EM practice not directly attached to a hospital? Are they common? Seems logistically it would be tough to do
 
I’ve never heard of a private EM practice not directly attached to a hospital? Are they common? Seems logistically it would be tough to do
Private EM practice means a physician owned practice that a hospital or hospital system pays to work in their ED(s).

In 2021, it is colloquially known as a “unicorn”.
 
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I’ve never heard of a private EM practice not directly attached to a hospital? Are they common? Seems logistically it would be tough to do
Free standing emergency department (FSED) is an uncommon but existing business model for both CMGs and private practice ER groups.
 
Hospital Based is almost impossible to own - way too much start up $$ and rules you need to follow.

FSER is becoming difficult but profitable if you are able to find the right spot.

UC start up is on the low end and I know practices making 50K/mo with NPs running the show.

If you want to make more than the average you either have to be an owner or work more hours.

I still do not think you can find many fields that pays as much per hour and require 3 yr residency than EM even if you just work in the Pit.

NSG and ortho definitely deserve more b/c residency is harder and twice as long.
 
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Any specialty can be 40hrs or less. It all depends on your practice setup.

PM&R is another specialty with typically low hours.

I believe rheum and allergy/immunology have low hours, but I don’t know as much about the IM sub specialties.

Im not so sure optho belongs in the group, but perhaps my experience was biased by the academic ophthos I worked with.

EM may be another one with low weekly hours, but with all the shift changes it can feel longer.
Ophtho is 35-45 hours a week comprehensive and 40-50 retina in pp, which is 70% of practice. Pay is fantastic too.
 
You're wrong about both ophtho and plastic surgery.
no, he is not wrong about ophtho. where is this misinformation coming from?
 
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