Why in the world do people say dont go into medicine for the $$$???

[Chris127]

optho surgeons can have really nice hours and bring in million+ a year.

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[YouDontKnowJack]

I'm (gonna be) rich, biaaaatch!

 

[OnMyWayThere]

I'm (gonna be) rich, biaaaatch!

 

[Psycho Doctor]

"Why in the world do people say dont go into medicine for the $$$???"

because they really don't...???

 

[vtrain]

optho surgeons can have really nice hours and bring in million+ a year.

Yes, LASIK surgeons and maybe even retina surgeons can clear this mark. However, at least with LASIK, there are only a few of these docs in each community that control the market and if you want to make those kind of dollars you will have to join their practice and buy in when the opportunity arises.

 

[Ross434]

If you want to get filthy rich and you think medicine is a cool career - go for it.

However, if you want to get rich, period, medicine might not be the *best* way. Consider your personality and your other life goals. Medicine as a career is not a decision to take lightly.

 

[YouDontKnowJack]

remember folks, you can be a doctor AND a businessman. without the worthless MBA.

cash only. up front. if you can't pay for it, get out of my office.

 

[Callogician]

In my opinion, the financial insentive of a potential career is related not to the inflation-adjusted expected value in total lifetime earning potential but rather to the age at which one can expect to attain a degree of wealth sufficient to sustain an acceptable [financial] lifestyle. I estimate that elusive level of wealth for myself at about $60,000/yr in 2005 dollars in a major metropolitan area with no debt. With this amount of money, I will be able to...

1) Live in comfortable housing
2) Pursue my hobbies
3) Control my diet/exercise habits
4) Save enough money to plan for the future and to avoid finacially related stress
5) Attract a wife who is a) sexy, b) smart, and c) nice (I call this the "trifecta," and I will explain these terms in detail if pressed)

I am a 22 MS1 student, and I will probably attain this degree of wealth about three years out of residency-when I am about 28-30. After this crucial age, I will become wealthier and wealthier, and money will become less and less important to me.

In contradistinction, if I had become a computer scientist, I could be earning $60+ K right now, so my paradigm suggests that I am giving up 6-8 years of financially comfortable life to become a physician as compared to a computer scientist. To me, this is a very real and significant saccrifice, and I believe that males in our society experience a disproportionate amount of pressure to build wealth during youth. However, I believe that medicine will be a rewarding career for me in other ways as to override these disadvantages.

 

[fun8stuff]

Actually, pharmacy and dentistry do guarentee that. And doggie is correct, when it comes to all out money and lifestyle, nothing beats dentistry.General dentists average salary are equal to that of family practice physicians, and orthodontists/oral surgeons are averaging what surgeons make, working much less hours mind you. This doesn't even take into account the fact that you have many less years of schooling in dentistry, and that most of your work is cash upfront/private insurance, eliminating many of the hassles of modern medical practice.

did you take into consideration on how the ADA came up with those numbers? surveys. everybody knows that this method is flawed because the people with the higher salaries are more likely to respond than the others. plus, a lot of people lie. perhaps you are more familiar with MDapplicants. I shadowed dentists and seriously looked into it (As a back up) before i got into med school. for the most part the salary of a dentist is not going to compare to a family docs until (10-15 years). a dentist either has to borrow money to start the practice or buy a retirees practice. then he has to establish a patient base (if he doesn't buy the practice). trust me, starting up and running a business is not as easy as it sounds.

 

[bulletproof]

In my opinion, the financial insentive of a potential career is related not to the inflation-adjusted expected value in total lifetime earning potential but rather to the age at which one can expect to attain a degree of wealth sufficient to sustain an acceptable [financial] lifestyle. I estimate that elusive level of wealth for myself at about $60,000/yr in 2005 dollars in a major metropolitan area with no debt. With this amount of money, I will be able to...

1) Live in comfortable housing
2) Pursue my hobbies
3) Control my diet/exercise habits
4) Save enough money to plan for the future and to avoid finacially related stress
5) Attract a wife who is a) sexy, b) smart, and c) nice (I call this the "trifecta," and I will explain these terms in detail if pressed)

I am a 22 MS1 student, and I will probably attain this degree of wealth about three years out of residency-when I am about 28-30. After this crucial age, I will become wealthier and wealthier, and money will become less and less important to me.

In contradistinction, if I had become a computer scientist, I could be earning $60+ K right now, so my paradigm suggests that I am giving up 6-8 years of financially comfortable life to become a physician as compared to a computer scientist. To me, this is a very real and significant saccrifice, and I believe that males in our society experience a disproportionate amount of pressure to build wealth during youth. However, I believe that medicine will be a rewarding career for me in other ways as to override these disadvantages.

....maybe I am missing something but you say you will be "three years out of residency by 28-30?" As I see it, you are 22 now, so you will be 26 when you grad. med. school, 30 when you graduate residency ( older if you go into surgery etc.) Don't mean to rain on your parade. Just curious as to where you are coming up with those figures. oh btw...contradistinction????...you aren't per chance related to our phrase-coining president are you?

 

[Callogician]

....maybe I am missing something but you say you will be "three years out of residency by 28-30?" As I see it, you are 22 now, so you will be 26 when you grad. med. school, 30 when you graduate residency ( older if you go into surgery etc.)

I turned 22 on August 28th. I'll be 25 when I graduate from medical school. If I do a 3 year residency, I'll finish at age 28. If I do a 5 year residency, I'll finish at age 30.

oh btw...contradistinction????...you aren't per chance related to our phrase-coining president are you?

From www.dictionary.com:

con·tra·dis·tinc·tion ( P ) Pronunciation Key (kntr-d-stngkshn)
n.
Distinction by contrasting or opposing qualities.

 

[YouDontKnowJack]

this gamble has better odds than vegas.

I'd give up 8 years to make $300000+ per year, rather than working $50000 and hoping for a raise.

 

[bulletproof]

I turned 22 on August 28th. I'll be 25 when I graduate from medical school. If I do a 3 year residency, I'll finish at age 28. If I do a 5 year residency, I'll finish at age 30.



From www.dictionary.com:

con·tra·dis·tinc·tion ( P ) Pronunciation Key (kntr-d-stngkshn)
n.
Distinction by contrasting or opposing qualities.

well I guess that solves that then. Although is the "contra" not kind of superfluos. I mean if something is distinct from something else...it is different qualitatively........no?. Not that it matters....Guess I learnt my word of the day.Good luck.

 

[Mman]

Dentists make a ton of cash. Anybody saying 150K is lowballing it. My father is a dentist in the middle of nowhere in the midwest and his gross salary usually averages around $300-400K/year. He could make more if he wanted to (his rates are much lower than the other guys in town), but he doesn't need the money. And this is general dentistry at about 40 hrs/week. I've met plenty of other dentists from other parts of the country that are making well north of $500K/year (yes, still general dentistry).


IMHO, a dentist would have to work hard to make less than $250 K per year with their own practice. Sure, just starting out they might work with a more experienced dentist and only take in $150K or so, but that isn't for long.


If I wanted the money, I would not have gone to medical school. As it is, I can't stand the thought of drilling teeth for a living.

 

[Hoya11]

I turned 22 on August 28th. I'll be 25 when I graduate from medical school. If I do a 3 year residency, I'll finish at age 28. If I do a 5 year residency, I'll finish at age 30.



From www.dictionary.com:

con·tra·dis·tinc·tion ( P ) Pronunciation Key (kntr-d-stngkshn)
n.
Distinction by contrasting or opposing qualities.

Cite any source you want, "In contradistinction" as you used it makes you sound like a robot or non-native english speaker. As a general rule, better writers typically make what they are trying to say easier for all readers to understand.


And as far as this dentist vs. doctors thing.... How many huge neon signs saying "family practice doctor" have you seen in strip malls lately? I have seen plenty of large inflatable teeth and neon signs advertising what appear to be hole in the wall dental offices. And you are telling me this person has to work hard to not bring in 250k?

I would be surprised if these dentists working in these kind of offices make 150. There are oral surgeons who make millions and GPs who make 250, but the averages are the averages, and you dont see these outliars on the extreme low side with medicine as you do with dentistry.

ALso, its my impression that becoming a dental SPECIALIST is more selective than getting into medical school. You either have to go to a TOP school where most grads become specialists or you have to be tops in your class. SO comparing specialists to MDs isnt apples to apples, cuz its not like the option is there for everyone.

 

[YouDontKnowJack]

well I guess that solves that then. Although is the "contra" not kind of superfluos. I mean if something is distinct from something else...it is different qualitatively........no?. Not that it matters....Guess I learnt my word of the day.Good luck.

yes. superfluous like an English major writing a 5-page essay. God I hate reading those people's papers..... trying to sound all sophistamajacated.

Also, my impression is that contradistinction is used not to compare apples (doctor) to oranges(computer scientist), but one type of apple (oral surgeon) to another type of apple (ortho surgeon).


anyway, back on topic.

 

[Chris127]

I'd give up 8 years to make $300000+ per year, rather than working $50000 and hoping for a raise.

Exactly.

And lets say dental and medical surgeons both bring in about the same, since we are getting conflicting reports here. If thats the case, I would much rather have the MD behind my name simply for the prestige factor.
How many medical shows are on TV? How many dental shows are on TV? 'Nuff said. Physicians are no doubt respected and honored by the majority of our society, as this is evident in not only their paychecks but in the media.

But hey if you like teeth, go drill them the rest of your life. Fortunately for me, I love medicine, and surgery even more.

 

[norbster56]

So....

On this thread we've established that the level of income earned doesn't depend on specialty, but rather on personal attributes/circumstances/hard work.

Good work guys! I look forward to more of your fascinating dialogues!

 

[DrBowtie]

I'll take government data over your anecdotes on your father, brother, neighbor.

http://www.bls.gov/oco/home.htm

For all of your salary question needs.

 

[DOCTORSAIB]

Whatever, have you looked into anesthesia, derm or opthamology. You can start at 300K + and work less than 45 hrs/week. Radiologists are in demand too.

Philo

Hippocritis.com <--- satire for residents and the like

It's spelled "Ophthalmology." Don't worry, most people make the same mistake.

 

[YouDontKnowJack]

It's spelled "Ophthalmology." Don't worry, most people make the same mistake.

no way. that spelling is rediculous

 

[bulletproof]

It's spelled "Ophthalmology." Don't worry, most people make the same mistake.

Indeed. Opthalmology is contradistinct from opthamology.

 

[DOCTORSAIB]

Indeed. Opthalmology is contradistinct from opthamology.

Spelling errors bother me. This thread is becoming pointless. Later.

 

[Andrew_Doan]

While senior physicians may maintain good incomes, it is more difficult for younger physicians to make as much. Thus, don't think it is easy when people say I know docs who make $300K/year. The doctor may be a 51 y.o. physician who owns his/her practice. In contrast, a new grad will have to work several fold harder to make the same amount in 3-4 years because reimbursements are declining each year.

Consider this blog: http://www.medrounds.org/blog/2005/06/crisis-in-academic-publishing-and.html

 

[YouDontKnowJack]

While senior physicians may maintain good incomes, it is more difficult for younger physicians to make as much. Thus, don't think it is easy when people say I know docs who make $300K/year. The doctor may be a 51 y.o. physician who owns his/her practice. In contrast, a new grad will have to work several fold harder to make the same amount in 3-4 years because reimbursements are declining each year.

Consider this blog: http://www.medrounds.org/blog/2005/06/crisis-in-academic-publishing-and.html

so...... dr. doan. in what range does your income lie?

 

[synapse lapse]

Exactly.

And lets say dental and medical surgeons both bring in about the same, since we are getting conflicting reports here. If thats the case, I would much rather have the MD behind my name simply for the prestige factor.
How many medical shows are on TV? How many dental shows are on TV? 'Nuff said. Physicians are no doubt respected and honored by the majority of our society, as this is evident in not only their paychecks but in the media.

But hey if you like teeth, go drill them the rest of your life. Fortunately for me, I love medicine, and surgery even more.

Actually, there are 2 types of oral surgery residencies for a dentist to go through, a 4 year that leads to being a specialist, and a 6-year that grants an M.D as well as specialty. Thank about that, after 10 years you have earned 2 doctorates degrees and finished a surgerical specialty. Nothing in medicine can touch that, nothing.

 

[Andrew_Doan]

so...... dr. doan. in what range does your income lie?

I admire your boldness.

First off, let me say that money is a tool. Money can be made quickly, and lost quickly. Money is neither evil nor good. Wealth depends on how you live your life. Read the Millionaire Next Door, study it, and implement it.

I decided with my wife that we only need around $60,000 to live. I don't need fancy cars or fancy homes.

I plan to stay with academics. I decided to join the Navy because I don't want to fight for a diminishing pie that the NIH controls.

As a Navy ophthamlologist, I make ~$110k/year. However, because about 1/3 of my income is not taxed, and I don't have to pay states taxes being that I am from Oregon, my take home will be equivalent to some one making $140K/year (my colleagues start at $100-$140K/year for ophthalmology and then make about $200K/year after three years -- how much you make really depends on how much you bill). $140K/year is about how much I'd make as a junior faculty in ophthalmology.

Within the last year however, I've started three corporations. Business is a much easier way to make money. Being a physician-scientist is my day job, business is my hobby. Currently, I'm looking for ways to turn my research into biotech ventures.

 

[davvid2700]

I admire your boldness.

First off, let me say that money is a tool. Money can be made quickly, and lost quickly. Money is neither evil nor good. Wealth depends on how you live your life. Read the Millionaire Next Door, study it, and implement it.

I decided with my wife that we only need around $60,000 to live. I don't need fancy cars or fancy homes.

I plan to stay with academics. I decided to join the Navy because I don't want to fight for a diminishing pie that the NIH controls.

As a Navy ophthamlologist, I make ~$110k/year. However, because about 1/3 of my income is not taxed, and I don't have to pay states taxes being that I am from Oregon, my take home will be equivalent to some one making $140K/year (my colleagues start at $100-$140K/year for ophthalmology and then make about $200K/year after three years -- how much you make really depends on how much you bill). $140K/year is about how much I'd make as a junior faculty in ophthalmology.

Within the last year however, I've started three corporations. Business is a much easier way to make money. Being a physician-scientist is my day job, business is my hobby. Currently, I'm looking for ways to turn my research into biotech ventures.

dude

do you have any idea how much you should be paid in an ideal world... Ophtho is an extraordinarily technical field I mean every eye md should be getting at minimum.. 400,000 for someone who maybe does 10 cataracts a week.. mildly busy... but 110 is reall y not good... sorry andrew

 

[YouDontKnowJack]

dude

do you have any idea how much you should be paid in an ideal world... Ophtho is an extraordinarily technical field I mean every eye md should be getting at minimum.. 400,000 for someone who maybe does 10 cataracts a week.. mildly busy... but 110 is reall y not good... sorry andrew

some people don't need the money............ yet.

I'm sure his lifestyle is pretty laid back. the ophthamology part, that is.

 

[Andrew_Doan]

dude

do you have any idea how much you should be paid in an ideal world... Ophtho is an extraordinarily technical field I mean every eye md should be getting at minimum.. 400,000 for someone who maybe does 10 cataracts a week.. mildly busy... but 110 is reall y not good... sorry andrew

Thanks for educating me on the salaries for a cataract surgeon.

You don't get it dude. Wealth is in the mind, not in how much you make. Physicians, even ones that make $400K/year, can still be in debt to their ears and have accumulated minimal wealth.

Look at my background. Do you think my training and education was for private practice? Do you think all the years of a MD-PhD degree, post-doc, and 5 years of undergraduate research was preparation to be a cataract jockey?

I don't want to be a cataract mill. It's boring. I don't want to make $400K/year as a private practice doctor. I think working in private practice and being a puppet of the insurance and malpractice industry is torture. You couldn't pay me enough to do it.

I am an academic physician, who after this year in ophthalmic pathology fellowship/post-doc, will teach and train the Navy's ophthalmology residents. I will continue doing basic science research. In fact, I picked the lowest paying sub-specialty in ophthalmology and pursued ophthalmic pathology. I am probably the only ophthalmology graduate this year who is doing an ophthalmic pathology fellowship. While I could have picked retina and make $750K/year to $1 million/year seeing 60-80 patients a day with 2 days of OR, I picked a sub-specialty where I'll be 'stuck' in the lab, have time to think, and paid a 'really bad salary of $110K/year' to create.

With the time I have to think, create, and do research, I will and am doing things that will pay far greater than being any private practice physician.

There are two books I recommend that you read: Millionaire Next Door and Rich Dad, Poor Dad.

My friend, you think to small and only see as far as the carrot in front of your face.

 

[Hoya11]

Thanks for educating me on the salaries for a cataract surgeon.

You don't get it dude. Wealth is in the mind, not in how much you make. Physicians, even ones that make $400K/year, can still be in debt to their ears and have accumulated minimal wealth.

Look at my background. Do you think my training and education was for private practice? Do you think all the years of a MD-PhD degree, post-doc, and 5 years of undergraduate research was preparation to be a cataract jockey?

I don't want to be a cataract mill. It's boring. I don't want to make $400K/year as a private practice doctor. I think working in private practice and being a puppet of the insurance and malpractice industry is torture. You couldn't pay me enough to do it.

I am an academic physician, who after this year in ophthalmic pathology fellowship/post-doc, will teach and train the Navy's ophthalmology residents. I will continue doing basic science research. In fact, I picked the lowest paying sub-specialty in ophthalmology and pursued ophthalmic pathology. I am probably the only ophthalmology graduate this year who is doing an ophthalmic pathology fellowship. While I could have picked retina and make $750K/year to $1 million/year seeing 60-80 patients a day with 2 days of OR, I picked a sub-specialty where I'll be 'stuck' in the lab, have time to think, and paid a 'really bad salary of $110K/year' to create.

With the time I have to think, create, and do research, I will and am doing things that will pay far greater than being any private practice physician.

There are two books I recommend that you read: Millionaire Next Door and Rich Dad, Poor Dad.

My friend, you think to small and only see as far as the carrot in front of your face.

Doesnt the fact that you are in the navy limit your annual income anyway? ie, why chose the higher paying one, you are not seeing the money?

This post sounds very self-righteous, I wouldnt go giving life lessons on here. Just because you are a successful physician doesnt imply you know anything about a "rich" life, I mean after all you are in the navy.

 

[Andrew_Doan]

Doesnt the fact that you are in the navy limit your annual income anyway? ie, why chose the higher paying one, you are not seeing the money?

This post sounds very self-righteous, I wouldnt go giving life lessons on here. Just because you are a successful physician doesnt imply you know anything about a "rich" life, I mean after all you are in the navy.

I chose the Navy because I want to serve. I actually joined during my ophthalmology residency. I also knew that I can have my academic career in the Navy without fighting for a diminishing pie controlled by the NIH. I had a choice during residency to either join or choose the bigger income. I had all options open to me during residency in regards to the types of sub-specialties to pursue. Thus, I did pick the lower paying day job for the reasons I discussed above.

I don't mean to sound self-righteous. I just want to encourage others to look beyond salaries and income. I do have a 'rich' life and my blessings are more than income, salaries, or my degrees.

I wish you luck in your professional endeavors.

 

[davvid2700]

I chose the Navy because I want to serve. I actually joined during my ophthalmology residency. I also knew that I can have my academic career in the Navy without fighting for a diminishing pie controlled by the NIH. I had a choice during residency to either join or choose the bigger income. I had all options open to me during residency in regards to the types of sub-specialties to pursue. Thus, I did pick the lower paying day job for the reasons I discussed above.

I don't mean to sound self-righteous. I just want to encourage others to look beyond salaries and income. I do have a 'rich' life and my blessings are more than income, salaries, or my degrees.

I wish you luck in your professional endeavors.

I wasnt lookign down on you for choosing what you chose.. I was just simply stating that somebody is taking advantage of you. somebody is probably making some money on you.. I mean, if I had an office and hired you to see eye patients and paid you 100,000 a year and made 200,000 a year on you, you would not like that. Thats all Im saying. Physicians are notoriously taken advantage of because they are altruistic and will do it for free.. I say if anybody is making the money.. we should be..

 

[Andrew_Doan]

Physicians are notoriously taken advantage of because they are altruistic and will do it for free.. I say if anybody is making the money.. we should be..

I completely agree Davvid2700! We can make a difference if we stick together, however. I have been lobbying for ophthalmology for the last two years in Washington D.C. Things I learned there opened my eyes to the reality of politics and medicine. The people who run this country are mainly concerned about two things: 1) money and 2) votes.

As physicians, we give on average $100 per doctor to our political action committees even though we have one of the greatest earning potentials of all professional degrees.

One of the strongest lobbies are the lawyers who out number us several fold. They give thousands of dollars on average.

In my field, optometrists out number ophthalmologist 3:1 and give $1000 each.

Pharmaceutical companies armed with billions of dollars influence laws that protect their earnings and intellectual property, while we get influenced to prescribe their expensive medications. The huge influence of the pharmaceutical companies on the practice of medicine via their lobbies and money depletes an already diminishing pie for health care spending. While we take a 5% Medicare reimbursement cut every year, drugs increase in cost yearly.

Why don't physicians band together? Why don't physicians give more money to political action committees and lobbies? It's frustrating for me to listen to young doctors complain about how bad things are; however, it is more frustrating for me to see when physicians become established and happy with their incomes that they give very little back to protect the upcoming generation of physicians. I think senior physicians may feel burnt out from a system that's designed to wear them down, and they don't have anymore energy to fight or incentive. Why fight and give money when it doesn't benefit the individual now and directly?

I have long term plans, politically, professionally, and personally. In my journey, I continue to find others with similar dreams and goals. Together, we will make changes and hopefully make things better.

In regards to someone taking advantage of me, I know that. Even in private practice someone is taking advantage of you. If you have a senior partner, that partner may be charging you 70% overhead (this happens). This means if you bill $1 million per year, then you earn $300K/year. The other $700K/year goes to the practice as 'overhead'. A smart senior partner will recruit several eager young doctors. Imagine 10 doctors working under you who are all contributing to 'overhead'. The senior doctor essentially becomes a CEO and President of his own company.

For those who want and need to make tons of money, this is my advice. Start your own practice. Take the risk and start from scratch. Be the senior partner. My current mentor is a business genius. This is his advice:

1) Move to a city where others don't want to live, e.g, growing cities in the Mid-West.

2) Pick up a phone book and call the doctors' offices in the area and ask for an appointment.

3) If they can see you in 1-2 weeks, then cross them out.

4) If there is a waiting time of greater than 1-2 months, then highlight the practice.

5) Study the location and build a practice next door. You'll have a busy practice in no time.

Keep in mind that even as a physician who owns the practice, you're still working for someone else: the insurance companies and Medicare.

To truly be financially independent, you need to invest and build wealth that generates passive income. When you have the passive income to support your family, then you are free to practice medicine the way you want. You may even decide to charge a flat rate and run a cash practice at that point, or even better, recruit young eager doctors and have them pay you 'overhead'.

 

[YouDontKnowJack]

oh man!!!! you're right

I forgot about political donations.

I'm gonna send $5000 to my senator as soon as i get my first paycheck in the next decade.

We seriously need the same power that Rx companies have.

For those who want and need to make tons of money, this is my advice. Start your own practice. Take the risk and start from scratch. Be the senior partner. My current mentor is a business genius. This is his advice:

1) Move to a city where others don't want to live, e.g, growing cities in the Mid-West.

2) Pick up a phone book and call the doctors' offices in the area and ask for an appointment.

3) If they can see you in 1-2 weeks, then cross them out.

4) If there is a waiting time of greater than 1-2 months, then highlight the practice.

5) Study the location and build a practice next door. You'll have a busy practice in no time.

I will totally keep this in mind. This is even better than an MBA program.

 

[synapse lapse]

Thanks for educating me on the salaries for a cataract surgeon.

You don't get it dude. Wealth is in the mind, not in how much you make. Physicians, even ones that make $400K/year, can still be in debt to their ears and have accumulated minimal wealth.

Look at my background. Do you think my training and education was for private practice? Do you think all the years of a MD-PhD degree, post-doc, and 5 years of undergraduate research was preparation to be a cataract jockey?

I don't want to be a cataract mill. It's boring. I don't want to make $400K/year as a private practice doctor. I think working in private practice and being a puppet of the insurance and malpractice industry is torture. You couldn't pay me enough to do it.

I am an academic physician, who after this year in ophthalmic pathology fellowship/post-doc, will teach and train the Navy's ophthalmology residents. I will continue doing basic science research. In fact, I picked the lowest paying sub-specialty in ophthalmology and pursued ophthalmic pathology. I am probably the only ophthalmology graduate this year who is doing an ophthalmic pathology fellowship. While I could have picked retina and make $750K/year to $1 million/year seeing 60-80 patients a day with 2 days of OR, I picked a sub-specialty where I'll be 'stuck' in the lab, have time to think, and paid a 'really bad salary of $110K/year' to create.

With the time I have to think, create, and do research, I will and am doing things that will pay far greater than being any private practice physician.

There are two books I recommend that you read: Millionaire Next Door and Rich Dad, Poor Dad.

My friend, you think to small and only see as far as the carrot in front of your face.

I have actually read the millionare next door, and numerous other books abotu wealth building vs. high income. I agree that physicians certainly have a problem when it comes to understanding financial management. While physicians have among the highest income in this country, they have one of the lowest averages of wealth, largely due to overextending themselves. However, you are still getting screwed on pay. Sure, you are smart and save a large portion of youre money, but if you made that 400k a year you would be saving even more, and counting for compund interest at an avg rate of 10%, you would have millions more by retirement age if you saved at the same rate you do now at a 400k a year salary. This is not to mention that since you are in the Navy you have no way to grow your salary substantially, and that you are paid the same as anyone else of your rank, regardless of your 15+ years of education. Oh, and all your research discoveries are properties of the US government, as are any patents you get. And then you say that you don't want to be the pawn of an insurance company, yet you are in teh Navy and a government employee, as well as academic physician. I would contend that the military/government are far more restrictive and controlling than any insurance company. Afterall, in opthalmology with your training by this age you could perform largely cash up front elective procedures and be that senior partner you suggested becoming, and be completely autonomous in your practice. I understand different strokes for different folks, but you really can't come on here saying your 110k salary is competitive, because its not, as I am sure you know.

 

[ms1finally]

I have actually read the millionare next door, and numerous other books abotu wealth building vs. high income. I agree that physicians certainly have a problem when it comes to understanding financial management. While physicians have among the highest income in this country, they have one of the lowest averages of wealth, largely due to overextending themselves. However, you are still getting screwed on pay. Sure, you are smart and save a large portion of youre money, but if you made that 400k a year you would be saving even more, and counting for compund interest at an avg rate of 10%, you would have millions more by retirement age if you saved at the same rate you do now at a 400k a year salary. This is not to mention that since you are in the Navy you have no way to grow your salary substantially, and that you are paid the same as anyone else of your rank, regardless of your 15+ years of education. Oh, and all your research discoveries are properties of the US government, as are any patents you get. And then you say that you don't want to be the pawn of an insurance company, yet you are in teh Navy and a government employee, as well as academic physician. I would contend that the military/government are far more restrictive and controlling than any insurance company. Afterall, in opthalmology with your training by this age you could perform largely cash up front elective procedures and be that senior partner you suggested becoming, and be completely autonomous in your practice. I understand different strokes for different folks, but you really can't come on here saying your 110k salary is competitive, because its not, as I am sure you know.

Well, what you are forgetting is that Andrew_Doan is guaranteed a pension and health benefits for life after 20 yrs. That's still early enough for a second career, or to continue working in the private sector. No, he won't accumulate millions upon millions working for the military, but after 20 years he will be able to kick back, relax, travel, hang out with family, while those of us who didn't choose the military path (such as myself) could possibly JUST be finishing with their student loans (although that's not my plan).

 

[YouDontKnowJack]

but after 20 years he will be able to kick back, relax, travel, hang out with family, while those of us who didn't choose the military path (such as myself) could possibly JUST be finishing with their student loans (although that's not my plan).

What? you're only planning to pay off $10000 per year on your loans?

Who takes 20 years to pay off their loans?

 

[curious1]

Well, what you are forgetting is that Andrew_Doan is guaranteed a pension and health benefits for life after 20 yrs. That's still early enough for a second career, or to continue working in the private sector. No, he won't accumulate millions upon millions working for the military, but after 20 years he will be able to kick back, relax, travel, hang out with family, while those of us who didn't choose the military path (such as myself) could possibly JUST be finishing with their student loans (although that's not my plan).

As a person with a parent who served as a military physician for 30 years I feel compelled to point out that the "health benefits for life" are really only worth a lot of money if you retire early, which military physicians can rarely do. This is because at 62 you lose your military health care and they move you over to medicare with everybody else. So if you retire from the military in your 50s the health care isn't worth much. OTOH the pension can be a nice plus but a) your spouse has to pay a monthly insurance premium just to qualify to receive 1/2 of the pension if you die (whereas in the case of a private 401k-type account it's an asset which would pass entirely to your spouse) and b) on a private sector salary you can save much more due to an increased salary. For example, my older brother's group puts 40k/year pre tax into a retirement account for him. After ten years, he will have acculumated about $700k in assets, which is equivilant to the pension that my father receives after 30 years of service.

The reason the join the military is to do things that civilian docs will never do, ie jump from airplanes, dive with the Navy, and so on. From a financial point of view, you will lose every time.

p.s. Also until recently, when you qualified for social security, that amount was taken out of your military pension. So if your pension was 50k/year and then you started social security at 10k/year, this would reduce your pension to 40k/year. Fortunately I think this has been changed now (at least for recently retired officers).

 

[Hoya11]

As a person with a parent who served as a military physician for 30 years I feel compelled to point out that the "health benefits for life" are really only worth a lot of money if you retire early, which military physicians can rarely do. This is because at 62 you lose your military health care and they move you over to medicare with everybody else. So if you retire from the military in your 50s the health care isn't worth much. OTOH the pension can be a nice plus but a) your spouse has to pay a monthly insurance premium just to qualify to receive 1/2 of the pension if you die (whereas in the case of a private 401k-type account it's an asset which would pass entirely to your spouse) and b) on a private sector salary you can save much more due to an increased salary. For example, my older brother's group puts 40k/year pre tax into a retirement account for him. After ten years, he will have acculumated about $700k in assets, which is equivilant to the pension that my father receives after 30 years of service.

The reason the join the military is to do things that civilian docs will never do, ie jump from airplanes, dive with the Navy, and so on. From a financial point of view, you will lose every time.

p.s. Also until recently, when you qualified for social security, that amount was taken out of your military pension. So if your pension was 50k/year and then you started social security at 10k/year, this would reduce your pension to 40k/year. Fortunately I think this has been changed now (at least for recently retired officers).

The military sounds awesome...

 

[synapse lapse]

As a person with a parent who served as a military physician for 30 years I feel compelled to point out that the "health benefits for life" are really only worth a lot of money if you retire early, which military physicians can rarely do. This is because at 62 you lose your military health care and they move you over to medicare with everybody else. So if you retire from the military in your 50s the health care isn't worth much. OTOH the pension can be a nice plus but a) your spouse has to pay a monthly insurance premium just to qualify to receive 1/2 of the pension if you die (whereas in the case of a private 401k-type account it's an asset which would pass entirely to your spouse) and b) on a private sector salary you can save much more due to an increased salary. For example, my older brother's group puts 40k/year pre tax into a retirement account for him. After ten years, he will have acculumated about $700k in assets, which is equivilant to the pension that my father receives after 30 years of service.

The reason the join the military is to do things that civilian docs will never do, ie jump from airplanes, dive with the Navy, and so on. From a financial point of view, you will lose every time.

p.s. Also until recently, when you qualified for social security, that amount was taken out of your military pension. So if your pension was 50k/year and then you started social security at 10k/year, this would reduce your pension to 40k/year. Fortunately I think this has been changed now (at least for recently retired officers).

yeah, I think the extra 100k + a year in salary in the private sector will more than pay for adequate benefits covered by the military. And if you want to jump from airplanes and dive the ocean, you can use your extra bank to do that as well. Anyway you slice it, being a military doc sucks, unless you just like the military. I stand by the fact that being a pawn to idiotic political/military officer wishes is actually worse than being inibited by insurance, atleast you can up and leave medicine in the private sector if you want, something you can't do in the military.

 

[bananachip]

i think andrew doan is not concerned about money because he will parlay his academic accomplishments and knowledge into starting his own business.

He's not an idiot. He doesnt need to hear 110k is low. He doesnt need more now, and when his stuff comes together, he'll probably blow most docs out of hte water.

Not everyone thinks 400k a year is alot either. Or 700k. Tons of people make more. Why sell your soul to be the top 1%, when there are 30 million just like you in this country alone? Doan would rather do what he loves now and plan for the big payoff, then get paid only twice-three times as much, whilst selling his soul and losing the time and energy he has for planning/starting businesses that will make him very rich.

I dont think what he is doing is crazy. He is living fine now, and he will be wealthy enough in the future. He is happy with what he has, financially and career wise, and will probably have some business in the future that will pay him tons.

Honestly, life is too short to open a private practice so you can live in the suburbs, shop at nordstroms and saks, drive a benz. Its boring. Your whole career, which you got to by studying and working hard and killing yourself, should not just be so you can buy some crap, be bored to death by your job, and point and laugh at everyone else who is doing what they love.

Anyway, back to studying. Doan rocks. You guys dont.

 

[curious1]

i think andrew doan is not concerned about money because he will parlay his academic accomplishments and knowledge into starting his own business.

He's not an idiot. He doesnt need to hear 110k is low. He doesnt need more now, and when his stuff comes together, he'll probably blow most docs out of hte water.

Not everyone thinks 400k a year is alot either. Or 700k. Tons of people make more. Why sell your soul to be the top 1%, when there are 30 million just like you in this country alone? Doan would rather do what he loves now and plan for the big payoff, then get paid only twice-three times as much, whilst selling his soul and losing the time and energy he has for planning/starting businesses that will make him very rich.

I dont think what he is doing is crazy. He is living fine now, and he will be wealthy enough in the future. He is happy with what he has, financially and career wise, and will probably have some business in the future that will pay him tons.

Honestly, life is too short to open a private practice so you can live in the suburbs, shop at nordstroms and saks, drive a benz. Its boring. Your whole career, which you got to by studying and working hard and killing yourself, should not just be so you can buy some crap, be bored to death by your job, and point and laugh at everyone else who is doing what they love.

Anyway, back to studying. Doan rocks. You guys dont.

A military officer can just as easily live in the suburbs and shop at nordstroms and drive a benz as a private practice physician. 110k may be sufficient for Doan's current lifestyle (and I am low maintenance myself, so I can understand where he comes from). But in my mind, there are other expenses to take into account: private lower middle and upper school for his kids ($10k/year+ per kid) if they don't want to attend public school, and in some areas of the country public school is not an option IMO; university education (150k per kid now and headed up quickly, and on 110k/year salary you do not qualify for any financial aid), other expenses related to kids (travel, car insurance, birthdays, weddings, etc). Plus there is the cost of housing that has skyrocketed in the last few years (ie a vacation house for his family). So yes not everyone may think that 400k and 700k is a lot, but objectively it's enough to cover all the basic expenses.

When I contemplate my own income expectations for when I am in practice, it is not with a shopping list for myself in hand, but with a realistic (i hope) understanding of how expensive everything has gotten these days. That said, I think Doan has an understanding of these things and that is why he is exploring his entrepreneurial ventures. Personally I would take the less risky road of a guaranteed higher income than the riskier road of startups. But that is a totally personal decision!

 

[lexrageorge]

Good post. A couple of points I would like to add to this thread:

1.) The sacrifice required in terms of time, effort, and emotional investment to practice medicine is immense. You absolutely must love doing it, or you will find that the money (whether it is $120K or $500K) is simply not worth it.

2.) Please don't justify your career decision by simply looking at opportunity costs, future wages, etc. Make sure you pick a career that at least seems compatible with your interests.

3.) One of the best things about living in the US is that you do have freedom to switch careers later on in life (don't believe me? try doing that in Japan). If you decide to go for the MD/DO, and later decide that seeing patients is not for you, you could get a JD and become a patent or malpractice attorney. You could go to work for Big Pharma. You could get an MBA and become an analyst tracking biotech firms. You could teach high school science (don't laugh, it's been done). No, none of these alternatives are easy. But neither is medicine, nor life in general for that matter.

4.) You will always hear stories from people who got into real estate or finance and raked in serious coin. Just remember that these are the ones that succeeded. It's one thing to make a decent living in these fields; it's far harder to exceed physician salaries, despite what anyone tells you. Yes, your friend's friend, the investment banker, may have made $1.5M one year. What you don't hear is that the following year, the stock market tanked, trading volume fell as a result, and your friend's friend is looking for work. It is much harder to get back into I-banking once you've been laid off; the newly minted crop of MBA's come in much cheaper.

5.) Also, the skills required to succeed in the above fields are different from those required to succeed in medicine. That one post that claims otherwise is almost laughable.

Bottom line: If you really want to go into medicine, do it. Ignore the curmudgeons that tell you that you will be poor; trust me, you won't be.

OTOH, if your heart is not into it, don't do it just because the money is decent. You will probably be miserable, and will be truly jealous of your friend's friend.

 

[bananachip]

It always disappoints me to read a post like Dr. Pink's, who is telling one doctor how to live his life. He, if anyone, should know the value of Doan's commitments. I have a tremendous amount of respect for physicians and its disappointing when one's true colors are... just so pale.

jeers to you pink.

And for those going to med school just to make money...you'll hate your life, but i dont feel sorry for you. There are, and will be people worse off. Like your patients.

Professionalism, people. Breath it, live it, be it.

you pre meds have no idea what you're in for. Better start picking the color of your benzes now...even though you're gonna hit the showroom floor in about 15 years, you're not going to have time to pick the colors!

 

[curious1]

It always disappoints me to read a post like Dr. Pink's, who is telling one doctor how to live his life. He, if anyone, should know the value of Doan's commitments. I have a tremendous amount of respect for physicians and its disappointing when one's true colors are... just so pale.

jeers to you pink.

And for those going to med school just to make money...you'll hate your life, but i dont feel sorry for you. There are, and will be people worse off. Like your patients.

Professionalism, people. Breath it, live it, be it.

you pre meds have no idea what you're in for. Better start picking the color of your benzes now...even though you're gonna hit the showroom floor in about 15 years, you're not going to have time to pick the colors!

The pre-meds I know who say they want to get into medicine to 'help people' and seem to really mean it, are generally the most ignorant when it comes to what medical school and the practice of medicine really involve. The 'greedy' ones have generally done their homework and understand the realities of medical school and residency and the economic future of the field (and even various specialties). Just my two cents...

Do I want to help people? Yes. Will I act unprofessionally to try and earn more money? No. Do I expect to be well compensated for being called into the hospital in the middle of the night/sleeping at the hospital 1x or 2x a week when I am in my 40s and 50s? Yes. Do I expect to be well compensated for risking all of my assets on a daily basis simply by performing my job ("helping people"). Yes!

It's okay to be greedy. Who do you think suffers when a physicians salary drops from 300k to 100k? His or her patients. How does someone who makes 700k/year and is very comfortable feel about providing free care to indigent patients? Now how do they feel being asked to provide that care when they are making 150k/year? Go ask a heart surgeon. If you really want patient care to improve the best way is to raise physician pay to give them some breathing room. It's clear that no one is going to do that for me, so I am going to try and do it myself.

 

[Andrew_Doan]

Great discussions. I want to emphasize that one must love the job, or the money really becomes a burden preventing people to be happy. The more money involved, the more trapped a person becomes.

Sure, you are smart and save a large portion of youre money, but if you made that 400k a year you would be saving even more, and counting for compund interest at an avg rate of 10%, you would have millions more by retirement age if you saved at the same rate you do now at a 400k a year salary. QUOTE]

True, I can accumulate wealth quickly with a higher income. However, seeing patients, doing surgery, and working more to make $400K/year is living my life in the rat race. The real key to wealth is passive income. At this point, I rather focus on the three companies I own because the payout will far exceed the numbers discussed here. Time will tell, but I am not afraid of failure either. I'll still have my day job, and I'll learn not what to do for my next company.

Oh, and all your research discoveries are properties of the US government, as are any patents you get.

Yes and no. In the Navy I am allowed to have my own businesses as long as I maintain my duties as an officer. This is why I've assembled teams that I trust, and I can guide the teams while on active duty. Also, my current research is being done at a university, and my business partners can do the research while I act as a 'consultant'. Stocks are nice here too, and the Navy can't prevent me from being a stock holder and consultant on my off-duty hours. Although the Navy may receive the majority of patents, inventors still receive royalties: http://www.nrl.navy.mil/content.php?P=TECHTRANSFER

"The license authorizes the licensee to manufacture and market the product while allowing government inventors and the laboratories where they work to share the royalties generated by commercial licensing of their inventions."

I qualify for a 'government inventor' I believe. Regardless, even if they take my research ideas, I still have other businesses.

I would contend that the military/government are far more restrictive and controlling than any insurance company.

Yes and no. Like any managed care organization, there are some treatments I can't do. However, unlike the real world, ALL my patients receive care. If they come into my office, then I will treat. In the real world, you'll be punting the non-paying patients to the University. I'd rather work as a physician to heal my patients rather than playing triage for my pocket book.

I understand different strokes for different folks, but you really can't come on here saying your 110k salary is competitive, because its not, as I am sure you know.

I never said $110K is competitive, but it's enough for me to work as a physician in the Navy and teaching residents. I said my wife and I decided that $60K/year is what we need to have a home, food, and the basics. Everything else is gravy. If you live with the mind set of abundance, then you'll achieve a sense of 'wealth'. Wealth is relative. Teachers are wealthier than the grocery clerk. My salary looks great to 90% of the US. I adjust my thinking to that of a teacher making a salary of $40K/year, then man... $100K/year is great. While $400K/year or even $1/million may seem to be a lot of money, for some it is not enough.

When Pippen was playing basketball in Portland. He was looking up at the bleachers admiring and wishing he was the billionaire watching him. For Pippen, he didn't have enough money. How sad that a multi-million dollar athlete lives in the mind set of poverty and yearning for more. It's far easier to have the mind set of simplicity and feel Blessed to make $110K/year.

Business is really a hobby for me. It's actually a lot of fun. In medical school it was a blast moving $500K/year in inventory via eBay and my e-commerce store. What I really enjoy, however, is working with my teams, and planning to give money back to academic programs. Personally, I want to fund medical missions and give scholarships to students. This will provide much more satisfaction than just watching money accumulate in my bank account.

 

[synapse lapse]

True, I can accumulate wealth quickly with a higher income. However, seeing patients, doing surgery, and working more to make $400K/year is living my life in the rat race. The real key to wealth is passive income. At this point, I rather focus on the three companies I own because the payout will far exceed the numbers discussed here. Time will tell, but I am not afraid of failure either. I'll still have my day job, and I'll learn not what to do for my next company.


Yes and no. Like any managed care organization, there are some treatments I can't do. However, unlike the real world, ALL my patients receive care. If they come into my office, then I will treat. In the real world, you'll be punting the non-paying patients to the University. I'd rather work as a physician to heal my patients rather than playing triage for my pocket book.

I never said $110K is competitive, but it's enough for me to work as a physician in the Navy and teaching residents. I said my wife and I decided that $60K/year is what we need to have a home, food, and the basics. Everything else is gravy. If you live with the mind set of abundance, then you'll achieve a sense of 'wealth'. Wealth is relative. Teachers are wealthier than the grocery clerk. My salary looks great to 90% of the US. I adjust my thinking to that of a teacher making a salary of $40K/year, then man... $100K/year is great. While $400K/year or even $1/million may seem to be a lot of money, for some it is not enough.

Business is really a hobby for me. It's actually a lot of fun. In medical school it was a blast moving $500K/year in inventory via eBay and my e-commerce store. What I really enjoy, however, is working with my teams, and planning to give money back to academic programs. Personally, I want to fund medical missions and give scholarships to students. This will provide much more satisfaction than just watching money accumulate in my bank account.

Sorry, I thought that when you wrote:

As a Navy ophthamlologist, I make ~$110k/year. However, because about 1/3 of my income is not taxed, and I don't have to pay states taxes being that I am from Oregon, my take home will be equivalent to some one making $140K/year (my colleagues start at $100-$140K/year for ophthalmology and then make about $200K/year after three years -- how much you make really depends on how much you bill). $140K/year is about how much I'd make as a junior faculty in ophthalmology.

it was clear that you were claiming your salary was competitive. And actually,wealth is not a state of mind, but is precisely a quantitative measurement of net worth. So, while you may say you feel wealthy or have a reasonable salary of life with savings that can support this quality of life after retirement and excellent benefits from the government, you can't really claim that you will be truly wealthy on your salary. In reference to al your patients recieving care, again, this is true, but may not matter to some physicians in private practice who prefer to refer patients who can't pay to the universities/county hospitals. It all depends on the preferance of your practice/ compensation system. I agree with the resy of what you sad, and business is obviously the real way to build wealth. You won't get wealthy having that 300k a year if you spend it all and dont invest, and I agree that most people could accumulate plenty of wealth if they shared your acumen/interest in saving for the future/investments.

 

[synapse lapse]

It always disappoints me to read a post like Dr. Pink's, who is telling one doctor how to live his life. He, if anyone, should know the value of Doan's commitments. I have a tremendous amount of respect for physicians and its disappointing when one's true colors are... just so pale.

jeers to you pink.

And for those going to med school just to make money...you'll hate your life, but i dont feel sorry for you. There are, and will be people worse off. Like your patients.

Professionalism, people. Breath it, live it, be it.

you pre meds have no idea what you're in for. Better start picking the color of your benzes now...even though you're gonna hit the showroom floor in about 15 years, you're not going to have time to pick the colors!

I did not once tell Dr. Doan how to live his life, what I did was challeneg some of the points he made in the interest of attainting truth. People may choose to live/practice how they want. It is funny that you accuse me of telling someone how to live and then immediately move on to tell people not to go into medicine for money, and why/how they should live their lives. In addition, there is nothing unprofessional about wanting to get paid to do work, as a matter of fact this is the esseence of capitalism. If you don't support such an econimic system you can either lobby to change it or move to a socialistic country. And what does it mean that you will hate your life going into medicine for money? If you are saying that you will be disapointed if money is your only motivation, I will agree with you, but if you are saying that you will be disapointed if money is a motivation, I disagree. And, in response to my "true colors being pale", how can you make such a determination? You have neither met me, nor engaged in enough discusison to guage my philosophical belief system or my arguments for it. And who said I don't have respect for physicians? I am obviously on my way to becoming one, so I must respect the profession; but guess what, physicians aren't special, they just do a job. Sure it's an important one, but it is still just a job, and it is one that after all the hard work and crap yopu have to go through in the business of medicine you deserve to be well compensated for, and I would be happy to argue this anytime

 

[synapse lapse]

The pre-meds I know who say they want to get into medicine to 'help people' and seem to really mean it, are generally the most ignorant when it comes to what medical school and the practice of medicine really involve. The 'greedy' ones have generally done their homework and understand the realities of medical school and residency and the economic future of the field (and even various specialties). Just my two cents...

Do I want to help people? Yes. Will I act unprofessionally to try and earn more money? No. Do I expect to be well compensated for being called into the hospital in the middle of the night/sleeping at the hospital 1x or 2x a week when I am in my 40s and 50s? Yes. Do I expect to be well compensated for risking all of my assets on a daily basis simply by performing my job ("helping people"). Yes!

It's okay to be greedy. Who do you think suffers when a physicians salary drops from 300k to 100k? His or her patients. How does someone who makes 700k/year and is very comfortable feel about providing free care to indigent patients? Now how do they feel being asked to provide that care when they are making 150k/year? Go ask a heart surgeon. If you really want patient care to improve the best way is to raise physician pay to give them some breathing room. It's clear that no one is going to do that for me, so I am going to try and do it myself.

Good post, though I don't think expecting to be compensated is greedy, and though I am not sure what greedy means really (I know what some people think greedy is, but am not sure if we could all agree on what it is), I don't think greed is ok (again, my definition I am sure differs). Overall, I think this post gets at the heart of it. Probably about half of my class is idealistic now, thinking health care is a human right, etc. Go talk to residents and docs, and see how they feel about it after dealing with the realities of medicine, and you will see how different their attituedes are about this.