The passion is there.Please help me understand the cost of being a pediatrician

[DOODDENT]

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Hi, I haven't been able to find a specific enough answer anywhere else on this site so I hope no one minds that I'm making my own thread. Hopefully I can get this sorted out. I'm sure I'm not the only one with this concern.

I have a real interest in pediatrics.
I see my future financial situation as such (correct me where I'm wrong. Please. I'm counting on your input):

350K in loans at 8.7%- That's for school, expenses, my current post-bacc and anything I might not be able to foresee. I may be over or underestimating by 50k or so but that's not too vital right now.

SO: With that debt load I'm looking at 2500-3000 a month in student loan payments.

Then there's taxes. 25% of 130000= 32,500/12=2700 a month

THEN there's malpractice insurance. Which will run about 30-50k a year...right? I live in California and hope to keep it that way- at least after school. As far as I can tell the only discount is during the first year. There's also the chance that I'll work in a hospital or as an associate in a clinic or private practice however, autonomy is pretty important to me. Regardless, I can't count on knowing anything that far ahead in the future so I'd rather just keep my estimates prudent and conservative.

Just to sum it all up, this level of pre-personal expenses/month comes to:

2500-loans
2700-taxes
3750- malpractice (at 45k/year)

TOTAL: 8950$/month! Rounded to an even 9000 thats 108000$/ year leaving me with 22000$ to live and (one day) support a family.

What am I missing? How can this be? Are my estimates wrong? My student debt will be high because I'm going at this alone. I feel a calling for medicine especially in the field of pediatrics. I'm sure that many people are in my shoes and have made 'it' work. Financial matters wont dissuade me from pursuing medicine but this cannot be right. Where am I going wrong here? At 22k a year I'll be living below the poverty line. What do doctors who have chosen the less lucrative routes do?? I want to be a physician but I also want to be able to live.

I simply cant believe that my numbers are right. Someone please HELP.

Thank you sincerely,
Shoni.

 

[8744]

Hi, I haven't been able to find a specific enough answer anywhere else on this site so I hope no one minds that I'm making my own thread. Hopefully I can get this sorted out. I'm sure I'm not the only one with this concern.

I have a real interest in pediatrics.
I see my future financial situation as such (correct me where I'm wrong. Please. I'm counting on your input):

350K in loans at 8.7%- That's for school, expenses, my current post-bacc and anything I might not be able to foresee. I may be over or underestimating by 50k or so but that's not too vital right now.

SO: With that debt load I'm looking at 2500-3000 a month in student loan payments.

Then there's taxes. 25% of 130000= 32,500/12=2700 a month

THEN there's malpractice insurance. Which will run about 30-50k a year...right? I live in California and hope to keep it that way- at least after school. As far as I can tell the only discount is during the first year. There's also the chance that I'll work in a hospital or as an associate in a clinic or private practice however, autonomy is pretty important to me. Regardless, I can't count on knowing anything that far ahead in the future so I'd rather just keep my estimates prudent and conservative.

Just to sum it all up, this level of pre-personal expenses/month comes to:

2500-loans
2700-taxes
3750- malpractice (at 45k/year)

TOTAL: 8950$/month! Rounded to an even 9000 thats 108000$/ year leaving me with 22000$ to live and (one day) support a family.

What am I missing? How can this be? Are my estimates wrong? My student debt will be high because I'm going at this alone. I feel a calling for medicine especially in the field of pediatrics. I'm sure that many people are in my shoes and have made 'it' work. Financial matters wont dissuade me from pursuing medicine but this cannot be right. Where am I going wrong here? At 22k a year I'll be living below the poverty line. What do doctors who have chosen the less lucrative routes do?? I want to be a physician but I also want to be able to live.

I simply cant believe that my numbers are right. Someone please HELP.

Thank you sincerely,
Shoni.

I don't know how many times I have to point this out: Salary surveys show your actual, pre-tax take-home pay. In other words, if you are offered a job with a pediatrics group for $130,000 per year, the understanding (and reality) is that they will pay not only your malpractice insurance but also things like CME and the traditional benefits. It's only when and if you want to become a partner in a group that you generally need to worry about the business end of things...but then you will make more as a partner.

Additionally, if you are sure you want to be a pediatrician in private practice and have no interest in academics, by all means go to the least expensive medical school to which you are accepted. I'm married with four kids and my loans aren't even as much as you are projecting. More reasonably, if you go to an inexpensive state school you will probably get out with less than $180,000 in debt, not $300,000 (assuming you went to an inexpensive undergraduate school, I mean).

As for taxes, well, everybody pays 'em so this is not specific to medicine. If you don't like it then vote for conservative candidates and hope for the best.

Also, you may find that pediatrics blows. As I said, I have my own kids so I had a running start at disliking it but you also may find it as intolerable as most people do. Don't get fixated on it and do well in medical school in case you decide that sitting in a dark room looking at pictures and counting your doubloons (radiology) is more to your tastes.

You would be, by the way, a fool to undertake This Mother****er if you only made $22,000 a year...or $60,000 or some other ridiculously low number. Even $130,000 is going to be a big disappointment to you by the time you finish residency unless the job has awesome benefits, killer location, and a lot of time off. When my wife thought I might end up in Family Practice she cried because the folly of our decision to pursue medicine was obvious. Seven years of medical school and residency for the medical equivalent of chump change. Fortunately I managed to switch to Emergency Medicine.

 

[Bradstein]

I don't know how many times I have to point this out: Salary surveys show your actual, pre-tax take-home pay. In other words, if you are offered a job with a pediatrics group for $130,000 per year, the understanding (and reality) is that they will pay not only your malpractice insurance but also things like CME and the traditional benefits.

I don't understand where people got the idea they have to pay their own malpractice.

 

[pianola]

I don't understand where people got the idea they have to pay their own malpractice.

Many of us don't have physicians in the family? We hear stories about the high cost of malpractice? 😕 Is that the kind of answer you were looking for? 😕

 

[Bradstein]

Many of us don't have physicians in the family? We hear stories about the high cost of malpractice? 😕 Is that the kind of answer you were looking for? 😕

I guess, but I don't have any doctors in my family. I was just wondering why people don't understand what "average income" means.

 

[DOODDENT]

I appreciate your candor and your input. If I understand you correctly, family practice and any of the other primary care specialties are going to leave me with 'chump change?' If I've missed your point, I'm sorry. Are you still saying that unless you're in a higher paying field, financially you're going to be struggling? Like I said, I'm not in it for the money but medicine is a profession as well as a serious financial and temporal investment. I just want to be able to find a middle ground where I can still contribute positively to the health and well being of my patients while living a lifestyle that allows me to enjoy the little free time I'll have off. I might find that radiology or anesthesiology appeals to me more than pediatrics while in med school but I can't assume anything right now. My question simply is still how does a primary care physician afford a decent lifestyle with all the overhead expenses that come with being a doctor?

I'll look into what average income means. Thank you for that. I had no idea that the stated figures where after malpractice..
That's the kind of stuff that helps. Thank you and if this topic has already been covered please just link me over there. I don't want to waste anyone's time.

 

[8744]

I don't understand where people got the idea they have to pay their own malpractice.

Oh, you pay it. Don't be mistaken about that. It's just more or less transparent depending on your situation.

 

[Bradstein]

My question simply is still how does a primary care physician afford a decent lifestyle with all the overhead expenses that come with being a doctor?

Your numbers are fine except for malpractice. If pediatricians average 120k a year, that means your checks will have that much listed (not that you'll have that to put in the bank, cause of taxes, etc.) but your overhead will ONLY be taxes, social security and such and paying back your loans.

I'm not sure where you got your number for student loans, but you can set it up to pay them back over 30 years, also. Sure, you end up paying more, but in 20 years how much is 1000 a month going to bother you?

Finally, clearing 22k is not living under the poverty line, because the poverty line is before taxes and such. But you don't really have to worry because you'll make more than that as a doctor.

Actually, one last thing. I hear pediatric hospitalists make about $1000/day. If you work 3 days a week you're going to make $150k a year. I don't know where people get there numbers. Maybe most people can only imagine practicing in SF or NYC. More power to you but you're going to get paid less and houses cost more.

Oh, you pay it. Don't be mistaken about that. It's just more or less transparent depending on your situation.

I know, but I mean, if someone says "I'm making x dollars per year" they're probably not talking prior to all of their operating expenses.

 

[8744]

General pediatrics is incredibly boring by the way. I did a few months of outpatient pediatrics when I was an intern and things like well child checks, the bread-and-butter of many pediatric practices, as well as the usual basically healthy children with minor, self-limiting ailments were enough to make me want to gouge out my eyes and rip out my tongue...just so it would stop.

 

[8744]

...I appreciate your candor and your input. If I understand you correctly, family practice and any of the other primary care specialties are going to leave me with 'chump change?' If I've missed your point, I'm sorry. Are you still saying that unless you're in a higher paying field, financially you're going to be struggling?

"Struggling" is not the word. Typically, pediatricians who make in the low 100s work four-and-a-half days a week, do a little bit of home call, and have mostly routine and therefore low stress and incredibly boring patients. They probably get home on time every night, enjoy their weekends, are respected in the community, and generally can easily live an upper-middle class lifestyle provided they don't get too crazy with discretionary spending.

All I'm saying is that you may look back ten years from now and wish you had done something with better earning potential. $120,000 seems like a lot now, an unimaginable bolus of money that you cannot possibly spend, but it might not seem like that much after a few kids, the usual responsibilities of adult life, and your eventual disillusionment with the medical profession, particularly with pediatrics which is now all about reaping the bounty of CHIPs.

 

[UVAbme2009]

General pediatrics is incredibly boring by the way. I did a few months of outpatient pediatrics when I was an intern and things like well child checks, the bread-and-butter of many pediatric practices, as well as the usual basically healthy children with minor, self-limiting ailments were enough to make me want to gouge out my eyes and rip out my tongue...just so it would stop.

So I hear. I'm looking at pediatric cardiology. Or actually any pediatric specialty.