S/O Healthcare thread--physician salary

[Moxie]

Warning-huge generalizations based on zero facts in this thread!!

 

Thinking of the 5 physicians I know (pediatrician, 2 family docs, surgeon and one who works in a hospital) being a physician appears to be quite lucrative (based on house size, cars, etc.). Is being a physician in another country the same? Are doctors all over the world doing well??

[umsami]

In general, doctors always do better than average.... partially because of the length of training it takes to become a doctor no matter where you are.  But, usually, not as well as the US.  In some countries, there is more prestige offered with being a physician than salary, although they still will do better than somebody without college/grad school.  One thing to point out, though, is the US is pretty unique in the debt that our physicians carry as well as malpractice issues.  Other countries are less litigious.

 

I'll just add that medical school in Egypt is close to free and in English. A lot of kids of Egyptian-Americans will go do medical school there (plus it's like an Interflex program here....no BBA/BBS first..it's a six year all in one type program)... then try and score internship/residency in the US.  It's gotten harder to do that, too, but the advantage is that you are basically debt-free (or close to it).  Many other countries are similar.  An additional benefit is that you get a lot more hands on patient care because basically people come to teaching hospitals for close to free care because it's provided by supervised med students, residents, fellows.  (No real malpractice issues.)

 

But...when DH was a resident, he made I want to say $200/month (Egyptian)? US pay is horrible too, especially if you're married, but it's not that bad.  US fellowships (however) can pay less than residents depending.  Some ophthalmology fellowships he looked at paid roughly $30k/year.  That's after med school, internship, 3 year residency, plus being fully licensed and often passing one's boards, too.

Edited August 1, 2016 by umsami

[gardenmom5]

it varies greatly on location and specialty - and you are leaving out their expenses.  like malpractice insurance.  which can be outrageous.  my ob's malpractice insurance was so high - he finally just gave up and moved to another state with a much lower cost.  oh - and he's NEVER been sued.

 

eta: and they have fewer grants and more loans for school which must be paid back.  (the logic is drs will make lots of money to pay back loans)  training is longer. - sometimes MUCH longer.  (dd was asked by her grad admissions board why she didn't apply to the medical school - 'becasue I want to be done in four years')

1ds was in 4th grade when his new friend in his class - moved into his school area.  his dad had finally finished his medical training and was no longer incurring student debt.

I'm watching this now with 1ds's childhood friend who is in dental  school.  he will have lots of loans to be paid off after he graduates.

Edited August 1, 2016 by gardenmom5

[G5052]

We are "frequent fliers" in the medical world, and I wouldn't say that the ones we know are doing as well as they once were.

 

Locally, all of the primary care practices but one have had to merge into the hospital network for financial reasons. They're all on salary now and haven't had a raise in years. They're still paid more than some, but I wouldn't say that financially it's what it used to be. Our former internist also commented once that they're having a horrible time recruiting primary care doctors to that network because of a combination of student loans and a high cost-of-living area. The salaries are good, but not great.

 

One of DH's specialists also sold out to a larger group, and he actually took a pay cut. But it was that or close his clinic.

 

Another one said that he was thinking of moving to the West Coast and interviewed at a clinic there, but the pay was actually quite a bit less than he is making now with a similar cost-of-living.

 

And a surgeon was asking me about homeschooling in March because he had to take his kids out of private school this year. His wife's hours were cut back to part-time because her employer couldn't afford to be paying for health insurance for everyone, and he hasn't had a raise since 2012.

 

Yes, they usually make more than most, but they're being squeezed quite a bit too.

Edited August 1, 2016 by G5052

[Arcadia]

It depends. My friends who are doctors in my home country does well regardless of whether they work for the government or they work for private practice or they open their own clinic. However, except for one ex-classmate who is on full ride due to family income at poverty level, all my other friends were from upper middle income family to start with. The kind that could gift a new car and and pay the full college tuition at citizens rate for public university (only one U in my home country with medical school). Also no insurance is required so medical cost is quite decent as eveyone can pick any doctor they like. No such thing as in network or out of network.

 

In some asian countries, working in medical tourism pays well but working in a public hospital does not. It still pays better than other non-sales job but it is not as luxurious. For example, doctors from Philippines came over to Singapore to work as nurses and their pay as nurses are much higher so they could send money to relatives back home in Philippines.

 

Litigation is a lot crazier here for doctors and dentists.

[MaeFlowers]

I think drs used to make more but insurance costs have decreased their income. I know my GYN said that she doesn't make money off the surgeries she does because,basically, they cover the cost of her malpractice insurance.

 

My family physician said that under the new system, specialist income would come down to what most family practitioners are making.

 

I think the biggest cost for doctors is taking insurance. The staff they need to do the filing etc is expensive. I read an article last year about a doctor who stopped taking insurance. She was seeing half the patients and making twice as much. My dh's step-dad is a Dr (alternative) and they say insurance keeps reducing the payments they receive.

 

I've come to the conclusion that nursing and dentistry are the most lucrative these days.

[Ali in OR]

If you're thinking about possible careers for the next generation, this isn't one I would pick for a lucrative future. It's less and less rewarding, particularly for primary care doctors. Add on huge amounts of student debt, long work hours, dealing with insurance companies trying to get paid...it's not the career it used to be. I think I read somewhere that a huge percent of Princeton grads (perhaps other Ivy League schools) head to investment banking. Not sure if they ever headed to medicine in droves, but I think the realization is there that it is not what it once was. That said, specialists still do well. There are ways to get the degree with less debt by serving in rural areas. If it's what you love, go for it. But I'm thinking that the cost/benefit analysis would favor nurse practitioner or physician assistant over doctor for many people.

[MEmama]

I am friends with several doctors of various specialties. None would agree it is a lucrative career choice as far as money is concerned.

[Crimson Wife]

Warning-huge generalizations based on zero facts in this thread!!

 

Thinking of the 5 physicians I know (pediatrician, 2 family docs, surgeon and one who works in a hospital) being a physician appears to be quite lucrative (based on house size, cars, etc.). Is being a physician in another country the same? Are doctors all over the world doing well??

 

I was an au pair for a general physician in France the summer between high school and college. He worked 6 days per week and made the equivalent of $60k/yr. (1995 dollars). But he didn't have to pay for any malpractice insurance or student loans because his schooling (6 years post-high school) had been free. So his take-home was probably not that much less than an American GP. 

 

[Crimson Wife]

 But I'm thinking that the cost/benefit analysis would favor nurse practitioner or physician assistant over doctor for many people.

 

This is why DH's cousin chose to become a PA rather than a primary care pediatrician. She just needed a 2 year master's degree and then she was fully licensed and able to make a decent salary. Becoming a pediatrician would've required 4 years of med school and then 3-5 years of residency working crazy hours and making a very low salary.

 

[poppy]

I keep hearing about how doctors don't make much. But I know a few specialists and surgeons through my church and they are all wealthy. Not mega rich, but wealthy by any reasonable standard . I have no idea what their income is but they live in a very HCOL town with huge professionally decorated houses with kids in private schools . And they give very generously to the church as well. There are all people in their 40s . Maybe it is different for people just starting out?

[Laura Corin]

Pretty well, but most current doctors in the UK didn't pay university fees, so they don't have such debts to deal with.  Salary scales here:

 

https://www.healthcareers.nhs.uk/about/careers-medicine/pay-doctors

 

Many consultants have private patients in addition to NHS ones, so there pay will be higher in effect.

[G5052]

I keep hearing about how doctors don't make much. But I know a few specialists and surgeons through my church and they are all wealthy. Not mega rich, but wealthy by any reasonable standard . I have no idea what their income is but they live in a very HCOL town with huge professionally decorated houses with kids in private schools . And they give very generously to the church as well. There are all people in their 40s . Maybe it is different for people just starting out?

 

It could be different areas of the country. We tend to deal with doctors who are 50+ years old because of the complexity of problems, and most of them are struggling.

[Ailaena]

 

I have a few numbers for you:

 

Doc 1 is a newly-practicing hospitalist in a suburb of Denver earning $280k for 18 days/month of work. All insurance and paperwork is paid for and handled by the group she works for and loans will be forgiven after 120 payments.

 

Doc 2 is a pediatrician working 3 days/wk at a low-income practice in a suburb of Denver. She makes 140k and her loans were small and forgiven after 5 years. The group pays her malpractice.

 

Doc 3 is a neurosurgeon far away from Denver. He was making $450k for 5days/wk work a couple of years ago, but I can't remember if he had to pay his own malpractice insurance. He has been practicing since 2005 and his loans were minimal and paid off quickly.

 

Doc 4 is a newly-practicing hospitalist in Phoenix. She makes 390k for 18 days but pays her own insurance. Has no loans.

 

Doc 5 is a pediatric emergency room physician who just got hired in LA for $410k, insurance handled by hospital. I don't know how many days she is required to work, but she will have loan-forgiveness in 120 payments. .

 

Doc 6 is family doc getting ready to retire. Works at a low-income clinic 4 days/wk for 250k, insurance paid for by group.

 

And just to compare:

Nurse 1 in Phoenix makes $34/hr after 15 years of working.

 

Nurse 2 in Denver makes $28/hr after 2 years of working

 

PA in same low-income practice as pediatrician above is $80k, which is low, but she works 18 days/mo

 

Not sure nursing/Pa is actually more lucrative at the end of the day, but I know I would never, ever be a nurse. They don't make near enough money for what they do.

[The Girls' Mom]

We have friends that are doctors.  The wife doesn't practice right now, and he's a family doc.  They do fairly well, but are also paying back some pretty hefty student loans.  I would say it has been comfortable for them, but not lucrative.  

[luuknam]

Not sure nursing/Pa is actually more lucrative at the end of the day, but I know I would never, ever be a nurse. They don't make near enough money for what they do.

 

The place we went to in TX was owned by a nurse. She had a PhD in nursing, and had a doctor on staff just because she legally had to in order to prescribe medications. I think she was doing pretty well financially, but I never asked her her income. I thought it was sort of brilliant.

 

My main financial problem with medical school is that you have to go into so insanely much debt, and then something can happen that makes it impossible to practice but you'd still be stuck with the huge amount of debt. Obviously, something can happen that makes any particular career impossible, but the assumption that you'll be able to pay off hundreds of thousands of dollars of debt after you get your MD is more risky than pretty much any other career. If my kids want to become MDs I'd send them to med school in NL (6 years immediately following high school, and much cheaper too).

Edited August 1, 2016 by luuknam

[Crimson Wife]

I keep hearing about how doctors don't make much. But I know a few specialists and surgeons through my church and they are all wealthy. Not mega rich, but wealthy by any reasonable standard . I have no idea what their income is but they live in a very HCOL town with huge professionally decorated houses with kids in private schools . And they give very generously to the church as well. There are all people in their 40s . Maybe it is different for people just starting out?

 

In looking through all our Explanation of Benefits statements, the insurance pays the specialists my daughter sees WAAAAAAAY more than they pay the general pediatrician. The pediatrician is lucky to get $100 for an office visit while the specialists often get $700-$1000 for an office visit.

[Pam L in Mid Tenn]

Even the lower figures quoted in this thread are still much higher than a whole lot of people make. Anyone in any career than makes $100K a year is doing well!!!!  Many many many families.... are making $50K a year or MUCH less than that!  So yes, seems doctors make more money ( have more expenses probably) but we have to be careful when we compare salaries and cost of living.

[Crimson Wife]

Even the lower figures quoted in this thread are still much higher than a whole lot of people make. Anyone in any career than makes $100K a year is doing well!!!!  Many many many families.... are making $50K a year or MUCH less than that!  So yes, seems doctors make more money ( have more expenses probably) but we have to be careful when we compare salaries and cost of living.

 

$100k/yr with a quarter million $ plus in student loans is not better off than $50k/yr. with little to no student loans.

[MinivanMom]

I have a few numbers for you:

 

*snip*

 

How do you know so many doctors who graduated without debt? Did they have wealthy parents . . . a trust fund . . . ? I'm curious about having their loans "forgiven". I've never heard of that for a doctor unless they were working in a rural or low-income area through an official loan forgiveness program, but that usually comes with a much lower income than your average doctor.

 

All the doctors I know graduated with massive amounts of student debt. So they made a large income on paper, but had very limited disposable income for the first 10 or more years after they began practicing. And of course, most don't begin practicing until 30+ yrs old, because of all the years in school & residency. It can be lucrative to be a doctor, but most don't start to see it until their 40's.

 

 

The place we went to in TX was owned by a nurse. She had a PhD in nursing, and had a doctor on staff just because she legally had to in order to prescribe medications. I think she was doing pretty well financially, but I never asked her her income. I thought it was sort of brilliant.

 

My main financial problem with medical school is that you have to go into so insanely much debt, and then something can happen that makes it impossible to practice but you'd still be stuck with the huge amount of debt. Obviously, something can happen that makes any particular career impossible, but the assumption that you'll be able to pay off hundreds of thousands of dollars of debt after you get your MD is more risky than pretty much any other career. If my kids want to become MDs I'd send them to med school in NL (6 years immediately following high school, and much cheaper too).

 

We have some friends in this situation. The husband had a catastrophic medical situation shortly after finishing his residency. He survived, but has permanent brain damage and will never be able to practice.

[poppy]

Even the lower figures quoted in this thread are still much higher than a whole lot of people make. Anyone in any career than makes $100K a year is doing well!!!! Many many many families.... are making $50K a year or MUCH less than that! So yes, seems doctors make more money ( have more expenses probably) but we have to be careful when we compare salaries and cost of living.

This I can't agree with - in that it's regional. If you live where starter homes are $50k, $100k/yr is a lot. If you live where starter homes are $500/yr it is pretty much standard. I'd estimate almost everyone in my circle is 2 income making $50-$120 each. Nurses , teachers, analysts , administrative assistants, low level managers, engineers.

[eternalsummer]

$100k/yr with a quarter million $ plus in student loans is not better off than $50k/yr. with little to no student loans.

?

 

5 years of $50k pays off the loans, right?  (assuming no interest, so maybe add another year for interest)

[eternalsummer]

This I can't agree with - in that it's regional. If you live where starter homes are $50k, $100k/yr is a lot. If you live where starter homes are $500/yr it is pretty much standard. I'd estimate almost everyone in my circle is 2 income making $50-$120 each. Nurses , teachers, analysts , administrative assistants, low level managers, engineers.

 

https://en.wikipedia.org/wiki/List_of_highest-income_counties_in_the_United_States

 

Unless you are talking about the top 5 counties in the US, I think places like this are actually pretty rare.

 

In your circle of people, or your neighborhood, maybe - but in more general terms, there are always poorer people somewhere in your area rounding out the income averages.

 

Someone has to run the cash register at your grocery store :)

[Crimson Wife]

?

 

5 years of $50k pays off the loans, right?  (assuming no interest, so maybe add another year for interest)

 

So the person has $0 in expenses (not even taxes) and can devote 100% of his/her GROSS income to paying off the loans???????

[SparklyUnicorn]

?

 

5 years of $50k pays off the loans, right?  (assuming no interest, so maybe add another year for interest)

 

Yeah someone making 50K would have a much harder time paying half that amount per year to pay down a loan fast. 

 

Although to be fair this is an oversimplification of the situation because while the average salary might be X amount, a person just out of school is unlikely to be making that amount to start.  Still the person making the much higher salary is going to have more money available to pay the loan verses someone who makes an amount where paying too much towards a loan would literally make it difficult to afford necessities. 

 

But kids' of doctors often become doctors and at that point in time a lot of doctors can help their kids out and often do.  Not always the case of course!  My cousin is married to a doctor.  Not only did he graduate with no debt, his parents gave him a large sum of money to buy an expensive house.  My cousin is a PA.  They are not hurting. 

Edited August 1, 2016 by SparklyUnicorn

[poppy]

https://en.wikipedia.org/wiki/List_of_highest-income_counties_in_the_United_States

 

Unless you are talking about the top 5 counties in the US, I think places like this are actually pretty rare.

 

In your circle of people, or your neighborhood, maybe - but in more general terms, there are always poorer people somewhere in your area rounding out the income averages.

 

Someone has to run the cash register at your grocery store :)

They come in by bus.

 

It's not my neighborhood I'm talking about - it's a few dozens of towns circling Boston. Same thing in other high COL regions. Yes there are poor neighborhoods pocketing around it , of course, but my point is just that $100k certainly doesn't feel well off for lotsa people. Hundreds of thousands .

[Evan]

With the caveat that how IBR/REPAYE and all of the other subsidized loan repayment programs will actually work for physicians (and other graduate level professionals) is not completely clear. I do think that physicians who come out of medical school with around 300K of debt (which my surgical resident son has colleagues who have) and then watch that debt grow exponentially while they are doing their residency (and making mid five figures or perhaps a bit less depending on geographic region they choose to train in) may have a hard time getting out from under their loans. 

 

My wife was able to come out of medical school without loans so working part time and grossing mid six figures looks pretty good.  She isn't complaining about the salary. Beyond that, she works very hard, shoulders a lot of liability, and deals with a lot. She loves what she does and she saves lives but when you look at the big picture I think she would never recommend medicine as a lucrative career for those reasons.

 

My son was also able to come out of medical school without loans so when he finishes his surgery residency I suspect he will be doing very well financially.  His family has sacrificed quite a bit to allow him to pursue this career and  I can think of other careers he has the abilities and skills to excel in which would be much more lucrative in the long term, and much more family friendly. 

[December]

So the person has $0 in expenses (not even taxes) and can devote 100% of his/her GROSS income to paying off the loans???????

 

 

No, the person was talking about making 100k and paying 50k a year in student loans.  So they would have 50k a year to live on, just like the person making 50k a year with no student loans.  But then after 6 years or so, the student loans will be paid off and that person will have a full 100k to live off of while the other person will still be making 50k.  So how do the loans make it not worth it to make twice as much?  Even if the person with 100k and loans made the min payment they'd still come out ahead (min payment on $250,000 at 6% is $2,776 a month or around $33k a year).

Edited August 1, 2016 by December

[SparklyUnicorn]

To add, it's not like amount of school loan debt is in line with how well the potential career pays.  That's absolutely not the case.  So I don't know why it would be assumed that someone making 50K ish would have no or low debt. 

[magnificent_baby]

I'm just curious how you know all of their salaries and loan information? (not being rude, just truly curious!) We have several friends that are physicians and I can guesstimate what they might make, but would never know all of these details. 

 

I have a few numbers for you:

Doc 1 is a newly-practicing hospitalist in a suburb of Denver earning $280k for 18 days/month of work. All insurance and paperwork is paid for and handled by the group she works for and loans will be forgiven after 120 payments.

Doc 2 is a pediatrician working 3 days/wk at a low-income practice in a suburb of Denver. She makes 140k and her loans were small and forgiven after 5 years. The group pays her malpractice.

Doc 3 is a neurosurgeon far away from Denver. He was making $450k for 5days/wk work a couple of years ago, but I can't remember if he had to pay his own malpractice insurance. He has been practicing since 2005 and his loans were minimal and paid off quickly.

Doc 4 is a newly-practicing hospitalist in Phoenix. She makes 390k for 18 days but pays her own insurance. Has no loans.

Doc 5 is a pediatric emergency room physician who just got hired in LA for $410k, insurance handled by hospital. I don't know how many days she is required to work, but she will have loan-forgiveness in 120 payments. .

Doc 6 is family doc getting ready to retire. Works at a low-income clinic 4 days/wk for 250k, insurance paid for by group.

And just to compare:
Nurse 1 in Phoenix makes $34/hr after 15 years of working.

Nurse 2 in Denver makes $28/hr after 2 years of working

PA in same low-income practice as pediatrician above is $80k, which is low, but she works 18 days/mo

Not sure nursing/Pa is actually more lucrative at the end of the day, but I know I would never, ever be a nurse. They don't make near enough money for what they do.

 

[magnificent_baby]

Yes, it is a lucrative career. But it is also comes with an incredible amount of responsibility, so I think it is well deserved. Malpractice insurance for one, is very, very expensive. The main reason why primary docs rarely deliver babies anymore. I also agree there is a wide range of pay depending on specialty, which also correlates with degree of risk. Being a surgeon comes with worse hours and I'm assuming a higher likelihood of being sued, not to mention the skills needed to perform surgery. Primary care physician gets paid considerably less but can enjoy better hours and perhaps slightly less stressful situations (though far from an easy job for sure!!). They also get the benefit of patient/family relationships that is very rewarding. 

Edited August 2, 2016 by magnificent_baby

[sassenach]

I can't speak for salaries, but one thing that I learned after being friends with a doctor is that she has much less control over her schedule than I realized. I always thought of doctors as being top dog, but in a hospital setting, there are a lot of very inflexible demands put on their time. Yes, she seemingly gets paid well, but she also works super hard. Not to mention the emotional toll. 

[luuknam]

No, the person was talking about making 100k and paying 50k a year in student loans.  So they would have 50k a year to live on, just like the person making 50k a year with no student loans.  But then after 6 years or so, the student loans will be paid off and that person will have a full 100k to live off of while the other person will still be making 50k.  So how do the loans make it not worth it to make twice as much?  Even if the person with 100k and loans made the min payment they'd still come out ahead (min payment on $250,000 at 6% is $2,776 a month or around $33k a year).

 

Afaik you can only tax deduct the interest on loans, so the person making $100k would have to pay a LOT more in taxes than the person making $50k, so no, you cannot repay $50k in student loans every year and come out the same as someone making $50k. Also, you can make $50k with only a few years of education after finishing high school, so you'd be several years * $50k/year ahead.

 

Not arguing doctors are in poverty or anything, but it doesn't really start paying off until you're middle aged, so if you had kids in your early twenties that's a lot of sacrificing compared to someone who became a plumber or something and had kids in his/her early twenties.

Edited August 1, 2016 by luuknam

[NoPlaceLikeHome]

I have a few numbers for you:

 

Doc 1 is a newly-practicing hospitalist in a suburb of Denver earning $280k for 18 days/month of work. All insurance and paperwork is paid for and handled by the group she works for and loans will be forgiven after 120 payments.

 

Doc 2 is a pediatrician working 3 days/wk at a low-income practice in a suburb of Denver. She makes 140k and her loans were small and forgiven after 5 years. The group pays her malpractice.

 

Doc 3 is a neurosurgeon far away from Denver. He was making $450k for 5days/wk work a couple of years ago, but I can't remember if he had to pay his own malpractice insurance. He has been practicing since 2005 and his loans were minimal and paid off quickly.

 

Doc 4 is a newly-practicing hospitalist in Phoenix. She makes 390k for 18 days but pays her own insurance. Has no loans.

 

Doc 5 is a pediatric emergency room physician who just got hired in LA for $410k, insurance handled by hospital. I don't know how many days she is required to work, but she will have loan-forgiveness in 120 payments. .

 

Doc 6 is family doc getting ready to retire. Works at a low-income clinic 4 days/wk for 250k, insurance paid for by group.

 

And just to compare:

Nurse 1 in Phoenix makes $34/hr after 15 years of working.

 

Nurse 2 in Denver makes $28/hr after 2 years of working

 

PA in same low-income practice as pediatrician above is $80k, which is low, but she works 18 days/mo

 

Not sure nursing/Pa is actually more lucrative at the end of the day, but I know I would never, ever be a nurse. They don't make near enough money for what they do.

I agree. Doctors make more than enough money IMHO and actually in most cases have easier working conditions than they did 30 years ago.

[Ali in OR]

I agree. Doctors make more than enough money IMHO and actually in most cases have easier working conditions than they did 30 years ago.

 

I'll disagree that working conditions are easier--perhaps differently rigorous. The primary care doctor in my book club is very frustrated with what her job has become. She takes home work every night--usually charting that in the past would have been done by a medical transcriber. Those jobs have been cut. With electronic charting, the doctors in her group are expected to do it all, but there isn't enough time in the work day. She is also frustrated by the need to keep patient visits short and fighting insurance companies. She does not get to focus on patient care which is what made it a rewarding career for her--she just seems very unhappy with it now. And primary care just isn't that highly paid.

[December]

Afaik you can only tax deduct the interest on loans, so the person making $100k would have to pay a LOT more in taxes than the person making $50k, so no, you cannot repay $50k in student loans every year and come out the same as someone making $50k. Also, you can make $50k with only a few years of education after finishing high school, so you'd be several years * $50k/year ahead.

 

Not arguing doctors are in poverty or anything, but it doesn't really start paying off until you're middle aged, so if you had kids in your early twenties that's a lot of sacrificing compared to someone who became a plumber or something and had kids in his/her early twenties.

 

Well, then make the minimum payments at 33k a year, pay an extra 12k in taxes and that still leaves you with 5k more than the person earning 50k (actually more, depending on how much student loan interest you have to deduct) and in 10 years you'll be done making student loan payments.

 

Now yes, being a plumber is probably a better deal than being a doctor but no one specified that the person making 50k was a plumber in his early 20s.  Maybe the person making 50k spent 5 years in college working on a bachelors and then worked low paying jobs for five years before finally landing this 50k a year job.  Which in that case the doctor is better off financially. 

[JFSinIL]

My family physician said that under the new system, specialist income would come down to what most family practitioners are making.

Which might be a good thing, since I have read that more med students head into specialties that pay far more than being a family doctor...and we NEED more family doctors!

[MinivanMom]

Afaik you can only tax deduct the interest on loans, so the person making $100k would have to pay a LOT more in taxes than the person making $50k, so no, you cannot repay $50k in student loans every year and come out the same as someone making $50k. Also, you can make $50k with only a few years of education after finishing high school, so you'd be several years * $50k/year ahead.

 

Not arguing doctors are in poverty or anything, but it doesn't really start paying off until you're middle aged, so if you had kids in your early twenties that's a lot of sacrificing compared to someone who became a plumber or something and had kids in his/her early twenties.

 

Not only would the person earning 100k pay far more in taxes than a person earning 50k, but I believe the student loan interest deduction phases out at 80k per yr. So I don't think our theoretical doctor making 100k per year could even deduct that interest.

 

You also have to imagine that a newly practicing doctor is just starting to earn an income at age 30+ with massive debt and no retirement savings whatsoever. So part of their income has to go toward playing catch up on retirement compared to the person who was able to start saving straight out of college at 22.

 

Older doctors are probably doing very well, but it's a hard road to get there. It's not the career I would suggest to my children if they just wanted a good income. You have to love it enough to sacrifice all those years and all that money to your education. 

[Guest]

Not only would the person earning 100k pay far more in taxes than a person earning 50k, but I believe the student loan interest deduction phases out at 80k per yr. So I don't think our theoretical doctor making 100k per year could even deduct that interest.

 

You also have to imagine that a newly practicing doctor is just starting to earn an income at age 30+ with massive debt and no retirement savings whatsoever. So part of their income has to go toward playing catch up on retirement compared to the person who was able to start saving straight out of college at 22.

 

Older doctors are probably doing very well, but it's a hard road to get there. It's not the career I would suggest to my children if they just wanted a good income. You have to love it enough to sacrifice all those years and all that money to your education.

Plus, unless the medical student had a high earning spouse, he/she probably doesn't own a home yet and is in need of a decent car.

[luuknam]

Well, then make the minimum payments at 33k a year, pay an extra 12k in taxes and that still leaves you with 5k more than the person earning 50k (actually more, depending on how much student loan interest you have to deduct) and in 10 years you'll be done making student loan payments.

 

Now yes, being a plumber is probably a better deal than being a doctor but no one specified that the person making 50k was a plumber in his early 20s.  Maybe the person making 50k spent 5 years in college working on a bachelors and then worked low paying jobs for five years before finally landing this 50k a year job.  Which in that case the doctor is better off financially. 

 

The question I saw being debated was "is being a doctor financially lucrative". So, not really, compared to e.g. being a plumber (in our $100k/year scenario).

 

The other issue is that if you're an M.D. there will be a lot more pressure on you from peers, colleagues, family, etc to spend more than if you're a plumber. Which sure, you *could* ignore, but ignoring those kinds of pressures can be stressful, so that's an additional stress a plumber or w/e doesn't have.

Edited August 2, 2016 by luuknam

[kbutton]

I'll disagree that working conditions are easier--perhaps differently rigorous. The primary care doctor in my book club is very frustrated with what her job has become. She takes home work every night--usually charting that in the past would have been done by a medical transcriber. Those jobs have been cut. With electronic charting, the doctors in her group are expected to do it all, but there isn't enough time in the work day. She is also frustrated by the need to keep patient visits short and fighting insurance companies. She does not get to focus on patient care which is what made it a rewarding career for her--she just seems very unhappy with it now. And primary care just isn't that highly paid.

 

Primary Care docs and emergency physicians are getting harder and harder to find. PAs and NPs are filling the gap, but it's not like they can everything the docs do.

 

A lot of things are making primary/emergency care less appealing, and that's NOT a good thing. 

 

I have to say that the charting isn't just about not having transcription--some places still have it, and those that do not often have digital transcription (Dragon, for instance). Charting is getting more complicated in some ways--it has to do with coding and not getting sued. I am sure that's always been the case, but now, lots of medical staffing companies actually factor in cost recovery in practitioner ratings and have systems to analyze every charge possible from a chart. 

 

I think one big change is that more and more primary docs are leaving private practice. I think that's going to have some repercussions, not the least of which is people not liking working for big corporations. There are pros and cons, but working for the big corporation means a lot of stuff that makes the job rewarding is out of practitioner control. 

[Zinnia]

The primary care docs that I know don't seem  to be making hugely large salaries, but they are making enough that they feel like they can have the lifestyle/practice style they want.  Limited practice size (so few crazy, overbooked days), maybe only working 4 days a week, letting hospitalists deal with most of the on-call stuff....things like that.  That sort of limited practice still leaves them able to afford to buy in the better neighborhoods, maybe private school, etc.

 

Nurses where I live?  $25/hour is the salary of 10+ years experience, and an advanced practice nurse can make in the $35/hour range.  Ten years ago, as a midwife, I was making the exact same thing as nurses.  This area of the country does not pay well for some careers.  

[Excelsior! Academy]

I know in Oklahoma we can take a homestead exemption on our main residence.  Doctors often purchase more house than they can afford, because if something does happen like a bankruptcy or lawsuit their house is protected.  It can appear they are doing better than they are.

[Frances]

The place we went to in TX was owned by a nurse. She had a PhD in nursing, and had a doctor on staff just because she legally had to in order to prescribe medications. I think she was doing pretty well financially, but I never asked her her income. I thought it was sort of brilliant.

 

My main financial problem with medical school is that you have to go into so insanely much debt, and then something can happen that makes it impossible to practice but you'd still be stuck with the huge amount of debt. Obviously, something can happen that makes any particular career impossible, but the assumption that you'll be able to pay off hundreds of thousands of dollars of debt after you get your MD is more risky than pretty much any other career. If my kids want to become MDs I'd send them to med school in NL (6 years immediately following high school, and much cheaper too).

Agreed. And since medical schools are now increasing the number of grads, but Congress hasn't increased funding for residency positions forever, more and more med schools grads are not getting residencies, which means that can't practice.

[AimeeM]

....

Edited August 2, 2016 by AimeeM

[AimeeM]

Which might be a good thing, since I have read that more med students head into specialties that pay far more than being a family doctor...and we NEED more family doctors!

Are we only going to require specialists work the same hours as family care MDs? 

 

 

Edited August 2, 2016 by AimeeM

[creekland]

Not arguing doctors are in poverty or anything, but it doesn't really start paying off until you're middle aged, so if you had kids in your early twenties that's a lot of sacrificing compared to someone who became a plumber or something and had kids in his/her early twenties.

 

I know you're merely talking money, but having seen oodles of students at school, I can't see any one particular student contemplating a future and choosing between plumber or doctor...

 

I also like to think any student choosing doctor merely because of the money won't have the drive to be as competitive as it gets now to get into med school.

 

OTOH, if a student is potentially interested in "something" medical due to interest and knowing there tends to be decent job security, then it makes sense to discuss finances vs hours, etc.

 

My middle son is applying to med schools now... he's been driven/called to this job since third grade.  Money/hours involved don't phase him at all and he already has considered other medical options and not changed his mind - even with parents who try to ensure he really knows what we're talking about.

 

We plan on supporting him through med school and beyond if need be.  We can't pay for med school (though if he's fortunate enough to get MSTP, it will be paid for him), but we can help with living expenses, etc.  In return, we get free consults for life.  ;)  (He tells me other pre-med students have been told the same from their parents.)

 

Of course, we'll also help support our other kids beyond college if necessary for them to launch too.  Oldest has done fine - he's fully launched and doing well.  Time will tell on the other two, but I'm not expecting major problems - just the time of the final flight might vary.

[Guest]

I know you're merely talking money, but having seen oodles of students at school, I can't see any one particular student contemplating a future and choosing between plumber or doctor...

 

.

I have met two, one in each of my children's cohort. One is a child of a plumber, one a child of an electrician. Neither parents recommend those careers...plumber is hard on the knees and electrician has limitations bc of the union. What they suggest is that the kid own a larger business that provides those services...and a mechanical engineering degree is a good compliment to the business ojt they recieved growing up. The kids get to college, and found they could get the grades for pre-med, and biomedical looks good. Surgeon or dentist looks good. So, if they cant get in to med or dental school, they have a backup plan. If they can, there is a side business possibility.

[littlebug42]

I work in our areas level 1 trauma center and work directly with the radiologists and ER physicians.  I don't know what they make but I think they earn every penny.  I do not know how our ER docs manage to come to work every day and see the things they see and put up with the things that they put up with.  The level of responsibility carried by both sets of docs in mind-boggling and incredibly stressful.

 

I know the radiologists do well enough financially but I wouldn't really consider any of them rich.   

Edited August 2, 2016 by littlebug42

[OhioMomof3]

Creekland,

What does MSTP mean?