would this be wrong to mention in an interview ??

[flip26]

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You spoke earlier as someone who had some experience in the 'real world'. This makes me doubt that. If you were out there, you'd realize that shrinking pay, increased hours, high amounts of education debt and again, long hours are not hallmarks of medicine as a career: They're hallmarks of where we are in general.

This is affecting all fields, not just medicine. Medicine is not a unique set of circumstances in anything except residency, which frankly isn't as back breaking as people make it seem when you're earning mid 40's to low 50's pay during that period.

The difference with medicine is that the current ceiling is very high. It can fall quite a bit and still dominate the best paid profession list.

I agree that money shouldn't be the motivator. I strongly disagree that money as a motivator or consideration however is wrong. In fact, I think it's utter BS for most everyone working in medicine. Health care is a huge field. If money wasn't a factor, there would be a lot more nurses, PAs, and everything else. People would join the Peace Corps, Red Cross, or some other organization and really get out there and do some immediate good for the world. They wouldn't spend eight years in school, three years or more in residency, and then get to the 'passion' they've been striving for.

I likely won't bring up money in an admissions interview, but it has nothing to do with being ashamed of my feelings on the matter. It's because I think it's as common a motivating factor as "I would like to help people, to connect with them and help them at a point where they could really use some help from someone capable of delivering it." It's like mentioning I like Latin food because I'm hungry... isn't everyone?

There is one aspect of physician compensation that makes it different from dentists as well as other non medical professions, and that is the role of the government in setting reimbursement rates. And that role is increasing with Obamacare, and the downward trend in compensation that has been going on for the last decade plus is going to continue downward, while the cost to obtain a medical education continues upward. How someone entering this profession at this point in time isn't deeply concerned about these trends amazes me.

As for your statement that "there would be more nurses and PAs," well, look around. Plenty of people who want a career as an allied health professional weigh the pros and cons and are choosing those fields exactly for the reasons I have given - it is a shorter, lower debt path, and the pay in those fields is actually rising, and should continue to rise, relative to physician compensation as more primary care functions shift to them and the government raises the reimbursement rates for them.

In addition, somewhat similar to dentists, nurses and PAs typically have better control of the hours they work, one of the factors that some of you are overlooking in the compensation debate over dentists vs doctors - dentists work on average 40 hours per week - doctors work on average something like 55 hours a week, and many consistently top 60 hours a week.

I know someone who was accepted at Vanderbilt Med, turned it down, and entered PA school. I don't know all of her reasons, but I was told it was a "lifestyle" decision, the ability to have a family, more control of work hours, etc. The PA pay and lifestyle have become far more interesting with all the changes going on.

 

[flip26]

Correct me if I am missing something here, but according to the BLS data, the mean salary for dentists is $75.71/hour, and that for general practitioners is $81.03/hour. Doesn't this mean that general practitioners and dentists make about the same amount of money for putting in about the same # of hours of work?

Of course, I am not taking factors such as length of schooling and upward/downward salary trends into consideration. I am just wondering about the assertion that dentists can make at least the same amount of money as general practitioners while working fewer hours.

Take a close look at the BLS data, in the footnotes. The hourly wage rates computed are based on a 2,080 hour work year, or 40 hours per week. But doctors are working 55 hour work weeks - to be truly comparable to dentist wages, the doctor numbers should be computed on a 55 hour basis, which would result in a lower hourly rate. Thus while on an annual basis the doctor wage is in line with the dentist averages, the doctor has to work a longer week to make roughly the same...don't know about you, but I would rather work a shorter week and make the same money as the doctor next door who has to work a much longer work week, but whatever.

 

[AllOptionsOpen]

How so? This is a shockingly naive view about the world around us.

Speaking of naive...

Name a few professions that you feel are better equipped to provide someone with a upper middle class lifestyle and above.

 

[flip26]

Speaking of naive...

Name a few professions that you feel are better equipped to provide someone with a upper middle class lifestyle and above.

I know real estate appraisers who make $250k a year working 40 hours a week.

Open your eyes, dude. You have the pre med blinders on.

 

[AllOptionsOpen]

How someone entering this profession at this point in time isn't deeply concerned about these trends amazes me.

I didn't say I wasn't deeply concerned. I am. I'm just not of the mindset that you have to be a financial martyr to enter medicine.

As for your statement that "there would be more nurses and PAs," well, look around. Plenty of people who want a career as an allied health professional weigh the pros and cons and are choosing those fields exactly for the reasons I have given - it is a shorter, lower debt path, and the pay in those fields is actually rising, and should continue to rise, relative to physician compensation as more primary care functions shift to them and the government raises the reimbursement rates for them.

The cost of eduction between the two is not significant over a person's lifetime in comparison to the differences in their earning power. In fact, you're better off financially becoming a physician. Even if rates are cut significantly in the future for all except for the lowest paid specialties.

In addition, somewhat similar to dentists, nurses and PAs typically have better control of the hours they work, one of the factors that some of you are overlooking in the compensation debate over dentists vs doctors - dentists work on average 40 hours per week - doctors work on average something like 55 hours a week, and many consistently top 60 hours a week.

Dentists work an average of 40? If true, that's pretty impressive. I'd like to see the information. I don't know of many jobs that pay anything above six figures that operates on 40 hour work weeks in the States. Software development (a field I'm intimately familiar with, having worked in it for the last twelve years of my life) routinely reaches the 55 hour a week mark. My own level required many more hours than that.

I know someone who was accepted at Vanderbilt Med, turned it down, and entered PA school. I don't know all of her reasons, but I was told it was a "lifestyle" decision, the ability to have a family, more control of work hours, etc. The PA pay and lifestyle have become far more interesting with all the changes going on.

Yet, here we are on a site trafficked mainly by people doing the opposite. More than capable of going that route, yet they don't, and they aren't committing financial suicide.

 

[AllOptionsOpen]

I know real estate appraisers who make $250k a year working 40 hours a week.

Open your eyes, dude. You have the pre med blinders on.

You do? Even if true, you think this is common for real estate appraisers? Looks like the median is closer to 40-50k.

Everyone brings up some random person they know that's earning half a million dollars working part time as an example of a field that pays better, yet it simply doesn't as a whole. Yes, there are software developers making twenty million dollars a year. I've had lunch with them, email them, but they're hardly representative of the industry as a whole. Most developers make less than six figures. Seniors that branch into management or a specialty like finance or health care software, they start breaking that six figure barrier. After that, it's management or your salary has plateaued and is only stable so long as it's not easy to outsource your work to cheaper sources elsewhere.

I have no premed blinders on. I'm too old. I'm just also too old (or too cynical) to buy into the idea that everyone entering medicine now needs to prepare for a life of poverty when the data we have shows it's quite the opposite.

 

[flip26]

You do? Even if true, you think this is common for real estate appraisers? Looks like the median is closer to 40-50k.

Everyone brings up some random person they know that's earning half a million dollars working part time as an example of a field that pays better, yet it simply doesn't as a whole. Yes, there are software developers making twenty million dollars a year. I've had lunch with them, email them, but they're hardly representative of the industry as a whole. Most developers make less than six figures. Seniors that branch into management or a specialty like finance or health care software, they start breaking that six figure barrier. After that, it's management or your salary has plateaued and is only stable so long as it's not easy to outsource your work to cheaper sources elsewhere.

I have no premed blinders on. I'm too old. I'm just also too old (or too cynical) to buy into the idea that everyone entering medicine now needs to prepare for a life of poverty when the data we have shows it's quite the opposite.

I know dozens of appraisers making this kind of money.

Real estate appraisal is an example of just one profession that offers huge opportunities to people with some initiative, hustle, and business acumen. There is a fairly low barrier to entry to the field, thus there is opportunity to be a smarter and more efficient appraiser. There are lots of older appraisers who still don't know how to use a computer. Their shop is labor intensive, requires full time secretarial staff, etc.

Younger appraisers who are computer / tech savvy have figured out they don't need any secretaries or other staff. They have figured out how to crank out the work at a much faster pace, and a higher quality, than their competitors.

 

[gravitywave]

as with so many threads on this board, we're suffering from a lack of input from actual practitioners..... bearing that in mind:

someone correct me if i'm wrong here, but my impression was that dentist's potential earnings were far more vulnerable to swings in the business cycle. a lot of the extra income some dentists make is due to high volume in lucrative elective procedures. if you are a regular ol' dentist someplace, then you aren't making as close to family practice type numbers. you're just getting the typical work done that every insurance pays for. you aren't working as much as a FP either, though. dentistry is just more of a cottage industry that way.

now, if that's true, it goes a lot toward explaining why dentists incomes haven't risen as fast as those for FP's since 2000 (fed gov't numbers). i bet there's a nice hefty negative skew in the dentist salary histo too, more so than for the FP's anyway.

don't dentists have to do some kind of internship too? that would decrease the number of years difference on accruing loan interest, anyway. pretty sure that dental school tuition tends to be more expensive than for medical school as well.

armybound used the term "financial security" with regard to a medical career, and i agree that it will always be part of the profession. being able to afford a 27k mortgage, perhaps not. anyhow, "financial security" is a better term than the one that i used ("income security"); although i believe we were both trying to express the same idea, he just did a better job of it 👍

 

[flip26]

Dentists work an average of 40? If true, that's pretty impressive. I'd like to see the information.

This is a perfect example of the need to "open your eyes." You have the ability to see this for yourself, yet somehow you are puzzled.

For example, what are the hours at your dentist's office? 8 - 5? 9 - 6? Something like that?

Dentists don't have to show up at 5:30 AM for rounds, nor do they have to stop in to see patients at 9 pm, either. Dentists have very few emergencies to tend to outside of office hours, too.

The 40 average hours was cited in one of the many links posted higher up in the thread - may have been from an ADA survey.

 

[AllOptionsOpen]

I know dozens of appraisers making this kind of money.

Then there must be a LOT of appraisers out there making almost nothing, considering the median for all appraisers is as low as it is. The primary care median is 3-4 times higher than that of appraisers.

Younger appraisers who are computer / tech savvy have figured out they don't need any secretaries or other staff. They have figured out how to crank out the work at a much faster pace, and a higher quality, than their competitors.

Let me know when the actual data backs up that real estate appraisal is a better paying field than medicine. Anecdotes are worthless, and we all know exceptions. In my and my wife's circle of friends we have a boat captain making mid 100's, a banking exec making less than 100, a lawyer just barely breaking 100, a math teacher making 60, a pharm rep making nearly 200, and a elementary school teacher earning 40'ish.

These aren't ways to judge an entire field's pay. They're just what our friends make. I wouldn't suggest to most high school students or those changing fields to consider becoming a boat captain as it required no education yet he makes mid 100's.

If you really want to have an easy path to wealth, I suppose you should become a professional basketball player. Right out of high school you can earn millions. Right?

Focus on the data for the entire population, not a cherry picked selection you have in front of you.

 

[flip26]

as with so many threads on this board, we're suffering from a lack of input from actual practitioners..... bearing that in mind:

someone correct me if i'm wrong here, but my impression was that dentist's potential earnings were far more vulnerable to swings in the business cycle. a lot of the extra income some dentists make is due to high volume in lucrative elective procedures. if you are a regular ol' dentist someplace, then you aren't making as close to family practice type numbers. you're just getting the typical work done that every insurance pays for. you aren't working as much as a FP either, though. dentistry is just more of a cottage industry that way.

now, if that's true, it goes a lot toward explaining why dentists incomes haven't risen as fast as those for FP's since 2000 (fed gov't numbers). i bet there's a nice hefty negative skew in the dentist salary histo too, more so than for the FP's anyway.

don't dentists have to do some kind of internship too? that would decrease the number of years difference on accruing loan interest, anyway. pretty sure that dental school tuition tends to be more expensive than for medical school as well.

armybound used the term "financial security" with regard to a medical career, and i agree that it will always be part of the profession. being able to afford a 27k mortgage, perhaps not. anyhow, "financial security" is a better term than the one that i used ("income security"); although i believe we were both trying to express the same idea, he just did a better job of it 👍

2 points:

Dental students do internships during the 4 year program.

That you believe FP pay has risen faster than dentist pay since 2000 is mind boggling.

 

[flip26]

Then there must be a LOT of appraisers out there making almost nothing, considering the median for all appraisers is as low as it is. The primary care median is 3-4 times higher than that of appraisers.



Let me know when the actual data backs up that real estate appraisal is a better paying field than medicine. Anecdotes are worthless, and we all know exceptions. In my and my wife's circle of friends we have a boat captain making mid 100's, a banking exec making less than 100, a lawyer just barely breaking 100, a math teacher making 60, a pharm rep making nearly 200, and a elementary school teacher earning 40'ish.

These aren't ways to judge an entire field's pay. They're just what our friends make. I wouldn't suggest to most high school students or those changing fields to consider becoming a boat captain as it required no education yet he makes mid 100's.

If you really want to have an easy path to wealth, I suppose you should become a professional basketball player. Right out of high school you can earn millions. Right?

Focus on the data for the entire population, not a cherry picked selection you have in front of you.

I never claimed that the average appraiser makes more than the average doctor. Never.

I haven't cherry picked anything. The only thing holding back low paid appraisers from being high paid appraisers is their initiative, hustle, and business acumen.

Maybe you will find a cure for the myopia you suffer from...

 

[AllOptionsOpen]

This is a perfect example of the need to "open your eyes." You have the ability to see this for yourself, yet somehow you are puzzled.

Well, maybe because if you took a look at the office hours of our software dev house you'd see that we respond to the phone from 9-5. Eight hours a day, five days a week. Yet, the average hours worked for an employee there that isn't a receptionist is in the upper 50's, with management routinely breaking 80-90.

Maybe I assume that like most business owners, their days don't stop or start when patients show up for their appointments. I assume they work to do outside the visits of patients. 40 with patients, 10-15 dealing with the day to day operations.

The 40 average hours was cited in one of the many links posted higher up in the thread - may have been from an ADA survey.

I'll take a peek. Looks like it could be a shorter path to the level of pay for a PCP/GP without the need of a residency if you're interested in that type of healthcare, with the added benefit of nice hours.

 

[gravitywave]

Real estate appraisal is an example of just one profession that offers huge opportunities to people with some initiative, hustle, and business acumen.

Yep. The key idea here is that there are a lot of ways to make money out there. For the most part, they all involve business smarts. Most millionaires are businesspeople.

On the other hand, most businesses aren't huge successes - in fact, most fail. These guys all took big risks. The financial payoff in medicine isn't the promise of huge money, it's the promise of being comfortable if one is able to tolerate the process. As I said, that isn't changing. The calculus for determining whether that deferred compensation is worth the career timeline probably is changing, as flip says it is. Anyone considering a medical career is a fool if they didn't at least seriously consider going the PA route instead. That goes double for those of us who are a little older.

The older ones have seen a little more of the world too. We've worked on the outside and seen how difficult it really is to get ahead. I don't think that's going to change over the next couple decades either. I believe there's going to be a lot less oppurtunity out there, for everyone. When I saw that more people took the MCAT last year than since I think 1990, i wasn't surprised. Students are voting with their feet.

 

[AllOptionsOpen]

I never claimed that the average appraiser makes more than the average doctor. Never.

I haven't cherry picked anything. The only thing holding back low paid appraisers from being high paid appraisers is their initiative, hustle, and business acumen.

Maybe you will find a cure for the myopia you suffer from...

I'm not sure why you're bashing me for not buying into the Dr's as Martyr's mantra?

You gave real estate appraisal as a field that pays as well or better than medicine. Here, I'll requote it all for you so you can see.

Originally Posted by AllOptionsOpen
Speaking of naive...

Name a few professions that you feel are better equipped to provide someone with a upper middle class lifestyle and above.

Originally Posted by flip26
I know real estate appraisers who make $250k a year working 40 hours a week.

Open your eyes, dude. You have the pre med blinders on.

No need to backpedal.

Also, being able to earn more through hard work and innovation is hardly exclusive to real estate. If this didn't apply to medicine, there wouldn't be so many private practices. Everything could change based on how the health care changes come out, but as it stands today this is true of Physicians as much as it's true for real estate appraisers.

Again, the data, the median for PCPs is much higher than that of appraisers, despite this vast ocean of opportunity you say exists based on a little sweat and grunting.

 

[gravitywave]

2 points:

Dental students do internships during the 4 year program.

That you believe FP pay has risen faster than dentist pay since 2000 is mind boggling.

sigh I could post the links from the BLS but they're extremely easy to find. Suffice to say that in 2000, they actually still had the dentists making more. Five years ago, from the article you cited in the WSJ, yes I'd believe that the dentists might still have been ahead. In 2010, not so much.

Thanks for clarifying the dental track though, my bad.

 

[delhies]

I know real estate appraisers who make $250k a year working 40 hours a week.

Open your eyes, dude. You have the pre med blinders on.

Speaking of naive....Are you kidding me even stating anything in the real estate market? Have you even looked at how bad the overall market is right now? Most of the economic bubbles have already popped. Real estate was a huge one that popped just a few years ago.

ANYTHING that makes a great income will require a large sacrifice. That's not taking into consideration being in the right place at the right time, which sounds like your "appraiser".

 

[flip26]

Speaking of naive....Are you kidding me even stating anything in the real estate market? Have you even looked at how bad the overall market is right now? Most of the economic bubbles have already popped. Real estate was a huge one that popped just a few years ago.

ANYTHING that makes a great income will require a large sacrifice. That's not taking into consideration being in the right place at the right time, which sounds like your "appraiser".

You are quite ignorant, and I will enlighten you, help you peel back those pre med blinders.

Appraisers are not salesmen on commission, not subject to the vicissitudes of bubbles, etc.

Real estate appraisal is as close to recession proof or is as immune to business cycles as any business gets. Appraisers are busy when things are overheated (bubbles), and they are busy when bubbles burst, too, because regulations require lenders who have taken back properties to get frequent appraisals.

 

[Kaustikos]

I'll throw nursing into the mix. Work 36 hours for 50k+. Let's make it 55 hours, per physician average, and OMG - 76k. Let's go even crazier - the Nurse is smart and works in a hospital that's in a completely different community/organization - MORE money (I don't know the exact percentage, but it's noticeable). And how much is Nursing school? And is there still a demand for Nurses? Congratulations, you have a career with a good income, high demand, job security, AND low debt.