What is the minimum salary you would take to stay in Medicine?

[voxveritatisetlucis]

Since it seems like there will be a lot of factors in the next 10+ years that depress physician wages, what would be the absolute minimum that you would take as an attending salary to not leave medicine? This is just out of curiosity given that most medical students have alot of loans but could also just do IBR if salaries got really low

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[mistafab]

When you say salary - do you mean as an employed position? Is this inside or outside academia? Does VA count? I have a much higher bar for employment (and different for different settings) than I would working for myself outpatient in PP.

 

[voxveritatisetlucis]

That is true. I worded the question poorly. I guess, what would be the minimum comp pack you would take as an employee physician (let’s say community hospital with very minimal/no teaching) working ~50 hours per week

 

[DO2015CA]

I’m interested but I honestly have no clue. I think I’m willing to take less money in private practice compared to employed so I don’t have to deal with the BS but what that is idk. I think realistically, it would be where a transition to another career with 9-5 hours and less stress/liability is only a 30-40k drop. Also factoring in climbing CoL

 

[deleted1139416]

I’m interested but I honestly have no clue. I think I’m willing to take less money in private practice compared to employed so I don’t have to deal with the BS but what that is idk. I think realistically, it would be where a transition to another career with 9-5 hours and less stress/liability is only a 30-40k drop. Also factoring in climbing CoL

I thought it was the opposite - people like employment because of all the BS in private practice?

 

[whoknows2012]

Since it seems like there will be a lot of factors in the next 10+ years that depress physician wages, what would be the absolute minimum that you would take as an attending salary to not leave medicine? This is just out of curiosity given that most medical students have alot of loans but could also just do IBR if salaries got really low

God I have deja vu from when I joined SDN back in May 2008. Carry on!

 

[voxveritatisetlucis]

I thought it was the opposite - people like employment because of all the BS in private practice?

In my experience, this is what the suits say to make it seem like the erosion of private practice over the past 30 years has been a good thing for physicians

 

[whoknows2012]

In my experience, this is what the suits say to make it seem like the erosion of private practice over the past 30 years has been a good thing for physicians

Many many physicians are happily employed by hospital systems, however imperfect, and would never want private practice or the issues that come with it. To each their own.

Erosion of private practice and the bureaucratic changes that have occurred in medicine are never painted as positive by the physicians employed by these huge conglomerates. It has been uniformly bad. On the other hand it has been uniformly true since the dawn of time that many physicians would prefer to be employed as opposed to being owners.

 

[DO2015CA]

I thought it was the opposite - people like employment because of all the BS in private practice?

Depends on your personality. For me, I would take less to have something to call my own and is my lifeblood than to be working for the man. It’s easier for me to put those sweat and tears in for something that’s mine.

 

[operaman]

I’m a happily employed doc and my number would depend heavily on the job itself and the area I was living. It also depends on how much I could make doing something else. All those things are relative. Currently I’m in a coastal very high COL area, so I feel like I need a lot more than I would if I lived in flyover country.

My subspecialty lends itself very well to an employed model because it’s very capital intensive. My hospital has spent a LOT of money on my practice; hanging my own shingle would be very challenging simply due to the capital costs involved and servicing that debt. It would be doable but it would be a few years before the number worked out in my favor. Being employed on a base/rvu model with no cap on earnings, I’m now one of the busiest most productive docs at my hospital and making more than double what my last dept chair made. My potential earnings definitely plateau compared to PP, but I’m not that great at the admin and business stuff to really make a go of the entrepreneur angle where some docs make it big. I’m a very good clinician though, and this lets me play to my strengths.

Sure I sacrifice autonomy, but so far have been blessed with admin that leaves me alone other than to bring donors and board members around to see the cool new stuff I’m doing. If/When that changes and they start making my life miserable, I’ll reassess.

 

[Dr. Anonymouss]

350k. Any less and it’s not worth the time commitment and sacrifice.

 

[mrbreakfast]

Of course, this question assumes a physician could easily transition to a comparable career outside of medicine, something many medical students seem to believe.

So, assuming those alleged six-figure consulting jobs everyone assumes they could get would get quickly saturated, and factoring in how much time has passed since I held a non-medical job (and the quality of that job, and of my non-medical CV), I'd take a 75%+ pay cut, or even go back to my resident salary (at my current hours, which are relatively low) to stay in medicine, as that would still be, by far, the best job I could get. Regardless of what other people say on this thread, realistically we'd all do the same.

To more directly answer your question, later in life I'd consider a relatively low-paying, very chill VA job or something.

 

[Dr. Anonymouss]

Of course, this question assumes a physician could easily transition to a comparable career outside of medicine, something many medical students seem to believe.

So, assuming those alleged six-figure consulting jobs everyone assumes they could get would get quickly saturated, and factoring in how much time has passed since I held a non-medical job (and the quality of that job, and of my non-medical CV), I'd take a 75%+ pay cut, or even go back to my resident salary (at my current hours, which are relatively low) to stay in medicine, as that would still be, by far, the best job I could get. Regardless of what other people say on this thread, realistically we'd all do the same.

To more directly answer your question, later in life I'd consider a relatively low-paying, very chill VA job or something.

The majority of career paths don’t take unparalleled genius, they only take lots of hard work and sacrifice. I think it’s very fair to say that medical students could have easily gone into law or business had they put their minds towards those fields instead. If the financial incentive ceases to be in the medical field then you will see a mass exodus into other fields, but for the time being this is the only field where once you graduate residency you are guaranteed a 250k+ job.

 

[Splenda88]

200k

 

[mrbreakfast]

The majority of career paths don’t take unparalleled genius, they only take lots of hard work and sacrifice. I think it’s very fair to say that medical students could have easily gone into law or business had they put their minds towards those fields instead. If the financial incentive ceases to be in the medical field then you will see a mass exodus into other fields, but for the time being this is the only field where once you graduate residency you are guaranteed a 250k+ job.

The question asked "what would be the absolute minimum that you would take as an attending salary to not leave medicine?" While some medical students may have instead chosen law or business, I don't think many attendings are very eager to go to law school in their 30s, 40s, or 50s.

If given the choice between going to (and paying for) law school and trying to get a decent job as a lawyer vs a 75% pay cut at my current job, I'd take the latter. I know plenty of people in business and law. I'd take my job, even at a lower salary than them.

 

[Dr. Anonymouss]

The question asked "what would be the absolute minimum that you would take as an attending salary to not leave medicine?" While some medical students may have instead chosen law or business, I don't think many attendings are very eager to go to law school in their 30s, 40s, or 50s.

If given the choice between going to (and paying for) law school and trying to get a decent job as a lawyer vs a 75% pay cut at my current job, I'd take the latter. I know plenty of people in business and law. I'd take my job, even at a lower salary than them.

I know I was only addressing a small portion of your argument, specifically the “Of course, this question assumes a physician could easily transition to a comparable career outside of medicine, something many medical students seem to believe.” Your statement just made it seem you don’t believe medical students could easily transition to other high paying careers.

 

[Splenda88]

350k. Any less and it’s not worth the time commitment and sacrifice.

You must be in a high paying specialty.

200k still put one in the top 5% of income earner.

 

[voxveritatisetlucis]

You must be in a high paying specialty.

200k still put one in the top 5% of income earner.

Eh I’m not sure how true this will hold up in the future. I know people from below average state schools getting 100k base + bonus finance analyst offers. Every job besides medicine has seen a pay increase since the pandemic

 

[whoknows2012]

Eh I’m not sure how true this will hold up in the future. I know people from below average state schools getting 100k base + bonus finance analyst offers. Every job besides medicine has seen a pay increase since the pandemic

In the Race Against Inflation, Half of Medical Specialties Are Left Behind

Inflation outpaced physician salary growth for nearly half of all medical specialties over the past five years, according to surveys of more than 1...

www.doximity.com

From an analysis in 2022. It’s a bit of a mixed bag, medicine has seen pay increases it’s been uneven and not for every specialty

A 2023 analysis from the same source showed 2% reduction in pay 2021-2022 overall with again variations in specialty including some with 3-4%+ gains in some specialties and others showed reductions in the 2-3% range

https://press.doximity.com/reports/doximity-physician-compensation-report-2023.pdf

 

[whoknows2012]

I’m a happily employed doc and my number would depend heavily on the job itself and the area I was living. It also depends on how much I could make doing something else. All those things are relative. Currently I’m in a coastal very high COL area, so I feel like I need a lot more than I would if I lived in flyover country.

My subspecialty lends itself very well to an employed model because it’s very capital intensive. My hospital has spent a LOT of money on my practice; hanging my own shingle would be very challenging simply due to the capital costs involved and servicing that debt. It would be doable but it would be a few years before the number worked out in my favor. Being employed on a base/rvu model with no cap on earnings, I’m now one of the busiest most productive docs at my hospital and making more than double what my last dept chair made. My potential earnings definitely plateau compared to PP, but I’m not that great at the admin and business stuff to really make a go of the entrepreneur angle where some docs make it big. I’m a very good clinician though, and this lets me play to my strengths.

Sure I sacrifice autonomy, but so far have been blessed with admin that leaves me alone other than to bring donors and board members around to see the cool new stuff I’m doing. If/When that changes and they start making my life miserable, I’ll reassess.

I agree with essentially all of this post and personally have a very similar situation.

 

[pierty]

Since it seems like there will be a lot of factors in the next 10+ years that depress physician wages, what would be the absolute minimum that you would take as an attending salary to not leave medicine? This is just out of curiosity given that most medical students have alot of loans but could also just do IBR if salaries got really low

The assumptions embedded in this question are exceedingly alarming.

Medicine is difficult, and we've seen just how much of a toll it can take on some of us in recent years. That's undeniable. But for a M1 student to start school assuming they will want to leave medicine as an attending - and to question what dollar amount they would need to be "bought out" or "in" to do their job years down the line - is sad. This cynicism - and the conversations it generates - is damaging to our field.

We can talk about what changes need to be made to enable a better life quality on our end and for our patients. We can talk about how we can feel less fatigued and more attached to our training environments and workplace, and how we can create better outcomes and more secure futures for all of us. We should aggressively pursue measures to make life better - both for us, and for those we treat. We can find separate careers if we've truly felt we've exhausted all other options, or learn throughout our training that we are better suited for other roles.

But we should never create the expectation that you go to medical school to become a consultant, and to become a doctor is the "alternate path" if we can be bought out. It isn't why we do this.

 

[DO2015CA]

The assumptions embedded in this question are exceedingly alarming.

Medicine is difficult, and we've seen just how much of a toll it can take on some of us in recent years. That's undeniable. But for a M1 student to start school assuming they will want to leave medicine as an attending - and to question what dollar amount they would need to be "bought out" or "in" to do their job years down the line - is sad. This cynicism - and the conversations it generates - is damaging to our field.

We can talk about what changes need to be made to enable a better life quality on our end and for our patients. We can talk about how we can feel less fatigued and more attached to our training environments and workplace, and how we can create better outcomes and more secure futures for all of us. We should aggressively pursue measures to make life better - both for us, and for those we treat. We can find separate careers if we've truly felt we've exhausted all other options, or learn throughout our training that we are better suited for other roles.

But we should never create the expectation that you go to medical school to become a consultant, and to become a doctor is the "alternate path" if we can be bought out. It isn't why we do this.

I don’t think most of us who responded ever planned on practicing clinically as a back up. Those willing to leave given the right environment have exhausted all other options. Inertia would keep them there unless there is such significant noxious stimulus to change course. The moral injury in this field is high. We have recognized the system needs to change for at least 10 years but despite many peoples hard work it continues to trend in the wrong direction.

But alas I’ve only seen inside of training centers so it could be different in other environments. One thing that makes me question that is each step of the way people have said that next step gets better. Which is true in some aspects but in others it becomes worse

 

[Dr. Anonymouss]

The assumptions embedded in this question are exceedingly alarming.

Medicine is difficult, and we've seen just how much of a toll it can take on some of us in recent years. That's undeniable. But for a M1 student to start school assuming they will want to leave medicine as an attending - and to question what dollar amount they would need to be "bought out" or "in" to do their job years down the line - is sad. This cynicism - and the conversations it generates - is damaging to our field.

We can talk about what changes need to be made to enable a better life quality on our end and for our patients. We can talk about how we can feel less fatigued and more attached to our training environments and workplace, and how we can create better outcomes and more secure futures for all of us. We should aggressively pursue measures to make life better - both for us, and for those we treat. We can find separate careers if we've truly felt we've exhausted all other options, or learn throughout our training that we are better suited for other roles.

But we should never create the expectation that you go to medical school to become a consultant, and to become a doctor is the "alternate path" if we can be bought out. It isn't why we do this.

Medicine does not have to be a life long career. It is not a “calling” it is a job like all others. Those who pursue medicine just have a more natural response to help others.

 

[voxveritatisetlucis]

The assumptions embedded in this question are exceedingly alarming.

Medicine is difficult, and we've seen just how much of a toll it can take on some of us in recent years. That's undeniable. But for a M1 student to start school assuming they will want to leave medicine as an attending - and to question what dollar amount they would need to be "bought out" or "in" to do their job years down the line - is sad. This cynicism - and the conversations it generates - is damaging to our field.

We can talk about what changes need to be made to enable a better life quality on our end and for our patients. We can talk about how we can feel less fatigued and more attached to our training environments and workplace, and how we can create better outcomes and more secure futures for all of us. We should aggressively pursue measures to make life better - both for us, and for those we treat. We can find separate careers if we've truly felt we've exhausted all other options, or learn throughout our training that we are better suited for other roles.

But we should never create the expectation that you go to medical school to become a consultant, and to become a doctor is the "alternate path" if we can be bought out. It isn't why we do this.

It’s mainly just that there is such a long opportunity cost associated with medical training. I’m not sure how many people without family money would sacrifice 8+ years of earnings if it meant making 150k in the end

 

[AnonymousDoctorGuyPerson]

200k, if the hours are good and my schedule is flexible

 

[Ho0v-man]

Too variable of a question and would come down to specialty. $250k in gen peds is actually pretty solid. But that’s terrible for a surgeon.

 

[whoknows2012]

It’s mainly just that there is such a long opportunity cost associated with medical training. I’m not sure how many people without family money would sacrifice 8+ years of earnings if it meant making 150k in the end

My comment from earlier in the thread was said in jest of course but I was actually serious. These posts were common back in the day and sure one of these times it may end up coming true (ie reimbursements tank) but so far changes have been modest and somewhat predictable. It’s an n=1 but I make way more starting my 4th year of practice than I ever imagined I would. The doom and gloom portrayed by the sdn trolls in the late 2000’s and early 2010’s has also not come to fruition. Any time something major happened (new policy like Aca, new administration, changes to student loans) lots of pessimism reigned supreme on this site. In addition as I have 2 payments to get to 120 i was also told pslf would never work out it was too good to be true. Maybe I’ve lived a 2nd golden age of medicine or possibly things aren’t always as bad as some make them seem. These comments aren’t necessarily directed at you I’m just venting at many years of frustration with sentiment on sdn that gets way out ahead of what reality likely is. Anyway…

I never made a decision based on money (turned down the pp job for the academic one) but am wide eyed enough to know that for a variety of reasons that day may eventually come. If and when it does I’m not exactly sure what I’ll do and if clinical medicine remains in the cards but for now I love what I do and get compensated fairly.

 

[mistafab]

For me, psych is really fun.

I would accept 300k for being an employed cog, 250k for academic goon, or as low as 200k working for myself in PP.

Anything lower than that and I would pivot to business, which I also enjoy.