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Why all the money talk???

Discussion in 'Internal Medicine and IM Subspecialties' started by sbf, Feb 16, 2007.

  1. sbf

    sbf New Member

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    I'm a little confused folks, and please don't take this as an attack. But why is there so much talk about "how much can I make" and "will I earn more in x or y" and "what is the highest paying specialty for the least hours"??

    I think this represents a very ugly undercurrent, and appears as though people may well be choosing their specialties (wisely or unwisely) with a very heavy weighting on financial remuneration.

    Certainly this is a relevant factor, but is it really one of the factors that needs to be constantly raised?
    Surely a more appropriate question would be "why do you like GI/Cardiology/Endocrine? etc" or "what sort of work does a Chest physician do?" or "what will the future prospects for Radiology hold?"

    Isn't it more important that you pick something you truly enjoy, are good at, and are suited to?

    I've never encountered a "poor" subspecialist..... some make more than others, but all are comfortable and certainly in the "very well paid" bracket. In fact, the vast majority will tell you that you couldn't pay them enough money to make them do .............. (insert job) as a specialty. Doesn't this mean something?????

    At the end of the day would you rather be rolling in cash doing a job you don't like and working hours that don't suit your desired lifestyle, or would you prefer to enjoy getting up to go to work each day and comfortable in the fact that you'll be living a much better lifestyle both financially and personally that many other people?

    Food for thought
     
  2. turkleton

    turkleton Capeless Crusader
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    Don't mistake realism for lack of idealism. You're a new member and I don't know how far you are in your career yet, but you will see that on graduating many people have in excess of 100K in loans and very often are starting families. These are very real responsibilities which don't solve themselves. Most people still gravitate to the field which captures their intellectual and professional interests. However, it is important to know that if you will be spending another 6-8 years after you graduate medical school in training, that this kind of committment offers both satisfaction and fair reward. Don't be too quick to judge the motivations of many grounded students who want to better plan their future.
     
  3. skypilot

    skypilot 2K Member
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    I think people are dreaming of the day they can afford some luxuries as they enjoy their Ramen noodles and spaghetti dinners.

    Of course once you get a few bucks and buy a house payment, a car payment, and private school for the kids you might be dreaming about those Ramen noodle, futon sleeping, apartment living days! :)
     
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  4. PseudomonasPAO1

    PseudomonasPAO1 New Member
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    Go read the debt thread in the financial aid section..It will enlighten you as to why people start weighing salary into their field of choice. And another major factor is location, an internist making $150k in NYC is not going to do well (after mortgage, car, loan payments, etc). Heck, with the real estate boom of the last 5 years, 150k doesn't extend very far in most major cities. I say if you are going to give up almost a decade of your life to education, you should be justly compensated!
     
  5. medlaw06

    medlaw06 Just Medicine
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    My friend...will you pay off my $230,000 debt which is currently in deferrment and will probably be more when I do start paying it! I am an ethically sound person who treats their patients without bias of race, color, creed, orientation, etc. and I will continue to be that way, however when everything is said and done, only I can look out for myself and my debts, true? I realize that the counterargument of how much $$ does one need to be happy, and that $$$$ doesn't = happiness are very valid points, but these are COMPLETELY arbitrary and differ from one to another. For example, one person with no spouse and no kids will be very happy and live VERY comfortably with $200k and a $300k house, whereas another with a spouse and 3 kids in their teens will probably seek more since they ahve other things to worry about (saving $$ for college, more expenses, etc etc). There's also the idiosyncratic aspect as well. By that, I mean that someone may rightfully think that they have worked their butt off during college to get to med school and then worked their butts off in med school (boards, honors, etc.) to get into a good/competitive residency and then scutted themselves to get into a strong fellowship and then scutted some more in fellowship and now they should be entitled to some monetary priveleges that their friends who finsihed college and went straight to financial sector, consultant sector who have been working a third less and making $$$ for atleast 4 years while we spent out time not making a single penny while ADDING debts (med school), and now it's their time to relax and enjoy ALL that they have sacrificed for all that time!! (whoa....now THAT'S A run on sentence if I've ever seen one! ).

    The thing that bothers me about people who contantly criticize that we in medicine think about $$ all the time is that people may implicitly equate the pursuit of $$ with the notion that this is ALL that we think about, which is not true, or that $$ comes before patient care, which is also not true. I cannot say that there are not rogue physicians who DO indeed think about $$ over the fair and accurate practice of medicine, but the %age of "these people" I would bet are approximately similar to the %age of rogue lawyers (well....probably LOTS less than lawyers), or buisness people, or accountants, or car salesman, or anyone else. So then WHY is it that physicians get slammed with these questions!! OF course my patients come first, but that doesn't mean that we should play ostrich when it comes to thinking about $$! I may be naive, and I can only speak for myself, but I think that a good majority of physicians want to balance their mind set of money and patient care, at least that is what my view point is on this whole matter.

    Just another opinion...that's it!


    PS....this is a REPEAT thread....the same one exists in the GI forum, you troller!
     
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  6. msu_scutmonkey

    msu_scutmonkey New Member
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    These two are not mutually exclusive. I plan on doing very well financially and enjoying what I do for a living. Plus, chicks dig guys who make lots of money:D
     
  7. OP
    OP
    sbf

    sbf New Member

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    I think you're missing my point.......

    I'm not arguing that we deserve fair and equitable remuneration for study, ongoing lifetime learning, and the massive amount of responsibility that comes with a career in Medicine at all. But that's another thread..... would you still be a Doctor if it meant you couldn't afford all those things you desire ;)

    What I am saying is that the knee-jerk reaction seems to be..... right, I'm a Med student or I'm a junior doctor, now what do I do to make as much money as possible? AND THAT SORT OF THINKING IS WHAT BOTHERS ME SO MUCH.
    I might be wrong (I hope I am), but that's the sour undercurrent that permeates many of these threads, not just in the Internal Medicine board, but others as well.

    If you want to make big dollars then Medicine is NOT for you. Go into business.
    If you want to make a big difference, be adequately compensated, and in general have a great life while helping others - PLEASE COME TO MEDICINE, WE NEED PEOPLE LIKE YOU.

    I may be a junior member here, but I'm a chief resident in Gastroenterology/Hepatology. I see more and more senior medical students and junior doctors asking about Gastroenterology for the money - and it worries/bothers me a lot, because I think they are setting themselves up for disappointment. I agree fully with one of the posters above - the trends in Medicine are in constant ebb-and-flow...... What happens when your cash cow dries up?..... think about it. If you're only in it for the money then you could be in for a world of pain.

    Take it or leave it, I really don't care - it's your life. But think long and hard about what you will actually be doing day-to-day in your specialty before matching. The rest of your life is a long time.....

    And for all those posters who keep going on about Med school loans, home loans, car loans, getting married etc.... trust me, they take care of themselves. You didn't accrue them overnight, and you won't pay them off that way either.

    More food for thought.
     
  8. OP
    OP
    sbf

    sbf New Member

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    Yes it does. I initially posted there because that's the forum I read most of the time..... but thought it unfair to the GI group to just target my concerns at them. No trolling intended - this thread is nowhere else on the board (check it if you must).
    I don't think that constitutes trolling at all......
    Trolling is defined as deliberately posting false information in order to elicit responses from people who really want to help, or deliberately provoking arguments on newsgroups or bulletin boards, with no other intent than to gain attention for the sake of attention.
     
  9. phllystyl

    7+ Year Member

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    I don't see anything wrong with considering the financial aspects as part of the equation these days. The "glory days" of choosing medicine as a calling are being eroded by the fact that some of us are leaving traininng with $250k in debt and having lost 10 yrs of potential earning. Thats a fact.

    Now, to choose a field based solely on money might be in err, but to consider it as part of the equation is exactly how everyone else not in medicine picks their jobs, and why should we not be able to do that? To be honest, most of us would be mostly happy in most fields of Int Medicine. For instance, I am taking a hard look at GI, which you have mentioned. I love procedures, which several other subspecialties are heavy in as well. I like a wide variety of patients with varying degrees of severity; how many diff. subspecialties in medicine can boast that (answer: most). I like dealing with emergent cases (re: pulm, cards, GI).

    As you can see, there are several subspecialites that would foot the bill. Throwing financial or lifestyle considerations into the above equation would not, in any way, lead me to a "life of disappointment", IMO.
     
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  10. powermd

    Physician Lifetime Donor Verified Account 15+ Year Member

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    The reason is that medicine is very hard work, and in training, the rewards, personal, professional, and financial, are minimal. Medicine is very disillusioning once you begin clinical training. The professional and personal rewards are not what you thought they would be, and do not come often enough to balance the long hours, the tedious scut work, the humiliating assaults from people with more power than you, and the minimal or absent pay. It is only natural for those who are giving so much, and getting so little to say "hey, nothing I hoped for in my career is guaranteed, but pay is predictable- so at least I can make sure I get paid well for my work."

    It's not about Lambos, ski condos in Aspen, and trips to Bora Bora, although some people may hope to afford those things one day. The obsession with salary and lifestyle about finding a balance between work and life. Don't be so quick to judge people's motives. Some people may choose medicine for the wrong reasons, but plenty of people who chose it for 'noble' reasons are justly concerned about their return on investment.

    To answer your question above- if I had it do do over again, would I become a doctor if it meant I couldn't afford the lifestyle I want when I finish training?

    Knowing then what I know now about medicine? ABSOLUTELY NOT.
    I would not live a lifetime of sacrifice so that others can take advantage of my valuable hard work. I don't expect anyone else to either.
     
  11. Qafas

    Qafas Jarhead
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    What is the point of this line of questioning? Money is a huge consideration for most people in what career they pursue. And it is no different in medicine, nor should it be. I'm tired of people posing the question "would you rather make a lot of money in a field you don't like, or would you rather work in a field you like but get paid crap?" Why do those two parameters have to be presumed to be mutually exclusive?
    Most people are smart enough to figure out that if they don't like the field they are in they'll be unhappy, regardless of the amount of money they make. We don't need this juvenile idealism to come to that realization. Now, if I am torn between a few specialties that I like equally, why in the world wouldn't I take the lifestyle and pay into consideration when making a decision? Stop implying that getting into the highest paid specialty which I choose to get into will make me a horrible doctor by default because I considered the pay.
     
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  12. Astrocyte

    Astrocyte Member
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    I think the OP's points are well countered. I just want to add that the reason people talk about money here is that this is a forum for exchange of info about issues important to posters. I think even the OP would agree that money is an important issue. I don't agree with the OP that people don't talk about what they like about the specialty as much as they talk about money. Even if that's the case, it might be that people don't tend to discuss as much about 'why do you like your specialty?' because the answers to this question are more complicated and personal, and perhaps are found in doing rather than talking. Therefore, it might falsely appear that people here are excessively interested in financial compensation in specialties.
     
  13. Gastrapathy

    Gastrapathy no longer apathetic
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    What is a chief resident in Gastroenterology/Hepatology? Food for thought indeed.
     
  14. sdnetrocks

    sdnetrocks Senior Member
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    Agree with above. sbf, I call BS on you.

    There is no such thing as a "chief resident in gastroenterology/hepatology". While that sounds fancy, any third year student or higher knows such a rank doesn't exist.

    But since I'm kind, for your future lying, you could be:

    -chief medical resident (pgy 4)
    -gastroenterology fellow (pgy 4-6 or 5-7)
    -hepatology fellow (pgy 7 or pgy 8)

    ;)
     
  15. OP
    OP
    sbf

    sbf New Member

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    Who said I was in America?????????
     
  16. sdnetrocks

    sdnetrocks Senior Member
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    My apologies.

    Based on your previous post about ERCP and your clearly not-American spelling of "hyperbilirubinaemia", I take back my attack and am now actually quite comfortable that you are who you say you are.

    Now, given that, I suppose you must be either in Canada, UK, Australia, or New Zealand. My basic understanding - and I may be wrong on this - is that the health system in these counties is nationalized, and therefore physicians just get a salary from the government.

    If I am accurate so far, do specialists (like gastroenterologists / hepatologists) make more money than generalists? And if so, is the difference in salaries as great as in the US (where a FP makes $150k while a urologist can make $350+ and a neurosurgeon easily makes over $500k)?
     

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