Physician Retirement Savings

Non-investing personal finance issues including insurance, credit, real estate, taxes, employment and legal issues such as trusts and wills.
am
Posts: 4296
Joined: Sun Sep 30, 2007 9:55 am

Re: Physician Retirement Savings

Post by am »

snowday2022 wrote: Sat Oct 21, 2023 8:19 am
EnjoyIt wrote: Fri Oct 20, 2023 10:34 am
er999 wrote: Thu Oct 19, 2023 8:25 pm
goodenyou wrote: Thu Oct 19, 2023 1:57 pm
Nice to see that a post of mine from 7 years ago was resurrected.

Medicine has changed dramatically in the past 20 years. Not only the science of medicine, but the business of medicine. Medical school costs are dramatically higher and the debt-load of graduates are staggering. That is just for medical school and not including undergraduate debt that has also skyrocketed. Very few Residents can afford to start a practice or private practices able compete with institutions for new Residents so institutions now have a stronghold on many markets. This has created a crisis for succession planning in private practices that are aging. In comes PE and the consolidation of medical practices even further.

I make less for procedures nominally than I did 25 years ago. Add inflation to the mix, and it’s a fraction of what I made for the same procedure in the past. Continuing to practice because “I love what I do” is much more palatable with tens of millions of assets and no debt. That will be very hard to achieve short of spine surgeons, fraudsters or physicians that give people what they want and not what they need (plastics, cosmetic dermatologist and the like). The talk of FI and retirement in young physicians stems from digging out of a very deep hole with half the shovel that physicians had in the past.
Any yet there are many physicians posting in bogleheads about their multimillion dollar net worth in their 40s. Not as good financially as tech at the top tier companies, but hard to think of other fields with a similar income floor open to thousands of people willing to work hard. While you need a good academic record, you don’t require an Ivy League education to get a position.

I’m a doctor myself so aware of the downsides, but for someone who’s geographically flexible and specialty flexible they will do well financially. Not if you’re a part time pediatrician in San Francisco or New York, but if you are somewhat financially savvy (particularly with the loan forgiveness programs) it’s a great financial choice.

There may be other reasons not to pick medicine — loss of personal time particularly in your twenties, weird work hours, depressing to be around sickness all the time, can’t switch jobs after borrowing all that money, etc. but you are almost guaranteed to be in the top 10% of incomes in the US, maybe top 5%. Ceiling isn’t too high though so no lottery like possibility of private jets and yachts like tech and finance.

There is great need for your services so while every patient encounter isn’t worthwhile you’re providing a valued and respected service to people.
There are very few people in medicine that can amass millions in their 40s. Not many career paths allow one to do that in 10-15 years out of residency while still enjoying the fruits of one’s labor. What you are seeing here is self selected because bogleheads are a poor representation of the general population of physicians. Every year it is getting harder and harder as reimbursement is lower while the cost of education and school related debt is higher.

As for respect, that has been dwindling also. Don’t get me wrong, it is still there but fewer and fewer patients respect you. Some down right expect you to wait in them like we owe them something. The C-suite doesn’t respect you and thinks you’re easily replaceable. The insurance industry down right takes advantage of you.

Despite that, I am still happy with my career choice but then again I figured out how to be financially independent in my 40s and only work about 2 days a week now. I would be miserable if I had to work full time.
With all due respect, I disagree with some of this. There was a nice WaPo series recently showing the average doctor 40-55 makes 400K. Top 10% make 1.3M. Almost all wages for the average, more business income as you go up the scale.

Average grad finishes training maybe age 32. Earlier if you don’t do a long specialty training path. Maybe a bit later if you are non trad and do NSG or something. Longer training path tends to compensate better with obvious exceptions like peds sub specialties.

Even those with huge loans (many do not have them because of family help, MD PHD, working spouse) should be able to kill them off within a few years. At that point you’re in your mid 30s with a secure, perhaps 300K salary, or you’re in your late 30s with a secure, perhaps 500K salary. Yes you are behind the tech bros, but LBYM and saving, one can easily amass millions in their 40s and be financially secure in ones 50s.

I’m not saying most docs DO this, but it’s not that hard to do it and the path does not constrain you from doing so.

I am not sure where you practice. In flyover country where I do, Pts are extremely appreciative and respectful. Very rare to have a rude Pt and that’s usually somebody with drug or mental health issues.

Insurance industry sucks. No arguments there.

Admins are generally frauds and do treat docs with disrespect in general but the cold reality is that you have a lot more job security than they do and can find 50 other jobs around the country if you want to within a few weeks. When the rubber really meets the road, docs can prevail in these battles by invoking this reality but most are too conservative to do battle at all.

Part time practice, or full time with some non clinical work (eg research, teaching) seems most sustainable. The most burned out and lowest quality docs I know go full bore clinical 5 days a week. Given our tax code and incomes, I the opportunity cost of cutting back clinically by 1-2 days per week is quite low.

Admittedly I am still early in my career, but by earning/picking a lucrative specialty and working hard at it, I make very good money with a pretty good lifestyle and excellent job satisfaction. Many in my specialty who are worth tens of millions work into their 70s because of the work, and I plan to do the same.
Most doctors are primary care and never brake 300k. Look at medscape networth surveys to get a feel on how bad doctors are amassing wealth.

https://www.medscape.com/slideshow/2023 ... -6016481#3
joesmo
Posts: 15
Joined: Sun Oct 08, 2023 3:37 pm

Re: Physician Retirement Savings

Post by joesmo »


With all due respect, I disagree with some of this. There was a nice WaPo series recently showing the average doctor 40-55 makes 400K. Top 10% make 1.3M. Almost all wages for the average, more business income as you go up the scale.

Average grad finishes training maybe age 32. Earlier if you don’t do a long specialty training path. Maybe a bit later if you are non trad and do NSG or something. Longer training path tends to compensate better with obvious exceptions like peds sub specialties.

Even those with huge loans (many do not have them because of family help, MD PHD, working spouse) should be able to kill them off within a few years. At that point you’re in your mid 30s with a secure, perhaps 300K salary, or you’re in your late 30s with a secure, perhaps 500K salary. Yes you are behind the tech bros, but LBYM and saving, one can easily amass millions in their 40s and be financially secure in ones 50s.

I’m not saying most docs DO this, but it’s not that hard to do it and the path does not constrain you from doing so.

I am not sure where you practice. In flyover country where I do, Pts are extremely appreciative and respectful. Very rare to have a rude Pt and that’s usually somebody with drug or mental health issues.

Insurance industry sucks. No arguments there.

Admins are generally frauds and do treat docs with disrespect in general but the cold reality is that you have a lot more job security than they do and can find 50 other jobs around the country if you want to within a few weeks. When the rubber really meets the road, docs can prevail in these battles by invoking this reality but most are too conservative to do battle at all.

Part time practice, or full time with some non clinical work (eg research, teaching) seems most sustainable. The most burned out and lowest quality docs I know go full bore clinical 5 days a week. Given our tax code and incomes, I the opportunity cost of cutting back clinically by 1-2 days per week is quite low.

Admittedly I am still early in my career, but by earning/picking a lucrative specialty and working hard at it, I make very good money with a pretty good lifestyle and excellent job satisfaction. Many in my specialty who are worth tens of millions work into their 70s because of the work, and I plan to do the same.
What specialty did you go into?
EnjoyIt
Posts: 8839
Joined: Sun Dec 29, 2013 7:06 pm

Re: Physician Retirement Savings

Post by EnjoyIt »

snowday2022 wrote: Sat Oct 21, 2023 8:19 am
EnjoyIt wrote: Fri Oct 20, 2023 10:34 am
er999 wrote: Thu Oct 19, 2023 8:25 pm
goodenyou wrote: Thu Oct 19, 2023 1:57 pm
Nice to see that a post of mine from 7 years ago was resurrected.

Medicine has changed dramatically in the past 20 years. Not only the science of medicine, but the business of medicine. Medical school costs are dramatically higher and the debt-load of graduates are staggering. That is just for medical school and not including undergraduate debt that has also skyrocketed. Very few Residents can afford to start a practice or private practices able compete with institutions for new Residents so institutions now have a stronghold on many markets. This has created a crisis for succession planning in private practices that are aging. In comes PE and the consolidation of medical practices even further.

I make less for procedures nominally than I did 25 years ago. Add inflation to the mix, and it’s a fraction of what I made for the same procedure in the past. Continuing to practice because “I love what I do” is much more palatable with tens of millions of assets and no debt. That will be very hard to achieve short of spine surgeons, fraudsters or physicians that give people what they want and not what they need (plastics, cosmetic dermatologist and the like). The talk of FI and retirement in young physicians stems from digging out of a very deep hole with half the shovel that physicians had in the past.
Any yet there are many physicians posting in bogleheads about their multimillion dollar net worth in their 40s. Not as good financially as tech at the top tier companies, but hard to think of other fields with a similar income floor open to thousands of people willing to work hard. While you need a good academic record, you don’t require an Ivy League education to get a position.

I’m a doctor myself so aware of the downsides, but for someone who’s geographically flexible and specialty flexible they will do well financially. Not if you’re a part time pediatrician in San Francisco or New York, but if you are somewhat financially savvy (particularly with the loan forgiveness programs) it’s a great financial choice.

There may be other reasons not to pick medicine — loss of personal time particularly in your twenties, weird work hours, depressing to be around sickness all the time, can’t switch jobs after borrowing all that money, etc. but you are almost guaranteed to be in the top 10% of incomes in the US, maybe top 5%. Ceiling isn’t too high though so no lottery like possibility of private jets and yachts like tech and finance.

There is great need for your services so while every patient encounter isn’t worthwhile you’re providing a valued and respected service to people.
There are very few people in medicine that can amass millions in their 40s. Not many career paths allow one to do that in 10-15 years out of residency while still enjoying the fruits of one’s labor. What you are seeing here is self selected because bogleheads are a poor representation of the general population of physicians. Every year it is getting harder and harder as reimbursement is lower while the cost of education and school related debt is higher.

As for respect, that has been dwindling also. Don’t get me wrong, it is still there but fewer and fewer patients respect you. Some down right expect you to wait in them like we owe them something. The C-suite doesn’t respect you and thinks you’re easily replaceable. The insurance industry down right takes advantage of you.

Despite that, I am still happy with my career choice but then again I figured out how to be financially independent in my 40s and only work about 2 days a week now. I would be miserable if I had to work full time.
With all due respect, I disagree with some of this. There was a nice WaPo series recently showing the average doctor 40-55 makes 400K. Top 10% make 1.3M. Almost all wages for the average, more business income as you go up the scale.

Average grad finishes training maybe age 32. Earlier if you don’t do a long specialty training path. Maybe a bit later if you are non trad and do NSG or something. Longer training path tends to compensate better with obvious exceptions like peds sub specialties.

Even those with huge loans (many do not have them because of family help, MD PHD, working spouse) should be able to kill them off within a few years. At that point you’re in your mid 30s with a secure, perhaps 300K salary, or you’re in your late 30s with a secure, perhaps 500K salary. Yes you are behind the tech bros, but LBYM and saving, one can easily amass millions in their 40s and be financially secure in ones 50s.

I’m not saying most docs DO this, but it’s not that hard to do it and the path does not constrain you from doing so.

I am not sure where you practice. In flyover country where I do, Pts are extremely appreciative and respectful. Very rare to have a rude Pt and that’s usually somebody with drug or mental health issues.

Insurance industry sucks. No arguments there.

Admins are generally frauds and do treat docs with disrespect in general but the cold reality is that you have a lot more job security than they do and can find 50 other jobs around the country if you want to within a few weeks. When the rubber really meets the road, docs can prevail in these battles by invoking this reality but most are too conservative to do battle at all.

Part time practice, or full time with some non clinical work (eg research, teaching) seems most sustainable. The most burned out and lowest quality docs I know go full bore clinical 5 days a week. Given our tax code and incomes, I the opportunity cost of cutting back clinically by 1-2 days per week is quite low.

Admittedly I am still early in my career, but by earning/picking a lucrative specialty and working hard at it, I make very good money with a pretty good lifestyle and excellent job satisfaction. Many in my specialty who are worth tens of millions work into their 70s because of the work, and I plan to do the same.
Not sure what video you watched, but the reality is that most physicians don't break $300k. I used to live in the NE and moved away for better income and lower cost of living which allowed us our financial success. We live in Texas.

There is one thing you nailed right on the head. Physicians have way more power than they are willing to exercise. We actually hold all the cards but:
Residency has trained us to shut the hell up and work hard. No complaining.
Physicians usually over extend themselves financially and cant afford to fight
So here we are being taken advantage of by the insurance industry and corporate medicine.

If we actually were willing to join together and fight for real meaningful change we can make it happen. But we are pansies so here we are instead complaining on bogleheads or reddit or wherever.
A time to EVALUATE your jitters: | viewtopic.php?p=1139732#p1139732
joesmo
Posts: 15
Joined: Sun Oct 08, 2023 3:37 pm

Re: Physician Retirement Savings

Post by joesmo »

I agree, but we are only powerful when unified. There are always doctors who will throw each other under the bus. Some doctors have entire careers testifying against doctors as expert witnesses. It pays good money, so screw everyone else as long as I win. In the long run, we all lose.
herks
Posts: 11
Joined: Sat Oct 29, 2011 10:10 pm

Re: Physician Retirement Savings

Post by herks »

Age 41 working in academic medicine and spouse same age also MD works part time, 3 kids
Current Retirement Savings $2.4mm
Cash $500k
Real Estate Rental Property x 6: equity $7.6mm
TNW: $10.5mm not including primary residence
+529/UTMA: $750k
User avatar
Yesterdaysnews
Posts: 964
Joined: Sun Sep 14, 2014 1:25 pm
Location: Sugar Land, TX

Re: Physician Retirement Savings

Post by Yesterdaysnews »

47 yo. Been in practice ~16 years. Approx $8.5M net worth including paid off primary house. Debt free.

Recently cut back my hours. 2 middle school aged kids and wife doesn’t currently work.

Try to keep my portfolio around 85/15 to 80/20.
Jimsad
Posts: 977
Joined: Mon Mar 20, 2017 5:54 pm

Re: Physician Retirement Savings

Post by Jimsad »

herks wrote: Sat Oct 21, 2023 2:53 pm Age 41 working in academic medicine and spouse same age also MD works part time, 3 kids
Current Retirement Savings $2.4mm
Cash $500k
Real Estate Rental Property x 6: equity $7.6mm
TNW: $10.5mm not including primary residence
+529/UTMA: $750k
That is impressive at 41y age and being in academic
medicine!
You are an exception to the many here who only invest in stocks and not much real estate
Is your real estate residential or commercial rentals and are they inherited assets ?
protagonist
Posts: 9869
Joined: Sun Dec 26, 2010 11:47 am

Re: Physician Retirement Savings

Post by protagonist »

livesoft wrote: Thu May 12, 2016 6:11 pm
coalcracker wrote:What would you consider a "high-net-worth" physician :shock: ?
That's easy: Anybody with a net worth more than ours. :)
That is my thinking. If I couldn't afford a car, I would consider anybody who owned one rich.
Also, anybody who plays music better than I do is a master, anybody who windsurfs better than I do is an expert, and anybody smarter than me is a genius.

Don't all people think that way??
snowday2022
Posts: 1092
Joined: Sun Jan 16, 2022 1:48 pm

Re: Physician Retirement Savings

Post by snowday2022 »

EnjoyIt wrote: Sat Oct 21, 2023 1:27 pm
snowday2022 wrote: Sat Oct 21, 2023 8:19 am
EnjoyIt wrote: Fri Oct 20, 2023 10:34 am
er999 wrote: Thu Oct 19, 2023 8:25 pm
goodenyou wrote: Thu Oct 19, 2023 1:57 pm
Nice to see that a post of mine from 7 years ago was resurrected.

Medicine has changed dramatically in the past 20 years. Not only the science of medicine, but the business of medicine. Medical school costs are dramatically higher and the debt-load of graduates are staggering. That is just for medical school and not including undergraduate debt that has also skyrocketed. Very few Residents can afford to start a practice or private practices able compete with institutions for new Residents so institutions now have a stronghold on many markets. This has created a crisis for succession planning in private practices that are aging. In comes PE and the consolidation of medical practices even further.

I make less for procedures nominally than I did 25 years ago. Add inflation to the mix, and it’s a fraction of what I made for the same procedure in the past. Continuing to practice because “I love what I do” is much more palatable with tens of millions of assets and no debt. That will be very hard to achieve short of spine surgeons, fraudsters or physicians that give people what they want and not what they need (plastics, cosmetic dermatologist and the like). The talk of FI and retirement in young physicians stems from digging out of a very deep hole with half the shovel that physicians had in the past.
Any yet there are many physicians posting in bogleheads about their multimillion dollar net worth in their 40s. Not as good financially as tech at the top tier companies, but hard to think of other fields with a similar income floor open to thousands of people willing to work hard. While you need a good academic record, you don’t require an Ivy League education to get a position.

I’m a doctor myself so aware of the downsides, but for someone who’s geographically flexible and specialty flexible they will do well financially. Not if you’re a part time pediatrician in San Francisco or New York, but if you are somewhat financially savvy (particularly with the loan forgiveness programs) it’s a great financial choice.

There may be other reasons not to pick medicine — loss of personal time particularly in your twenties, weird work hours, depressing to be around sickness all the time, can’t switch jobs after borrowing all that money, etc. but you are almost guaranteed to be in the top 10% of incomes in the US, maybe top 5%. Ceiling isn’t too high though so no lottery like possibility of private jets and yachts like tech and finance.

There is great need for your services so while every patient encounter isn’t worthwhile you’re providing a valued and respected service to people.
There are very few people in medicine that can amass millions in their 40s. Not many career paths allow one to do that in 10-15 years out of residency while still enjoying the fruits of one’s labor. What you are seeing here is self selected because bogleheads are a poor representation of the general population of physicians. Every year it is getting harder and harder as reimbursement is lower while the cost of education and school related debt is higher.

As for respect, that has been dwindling also. Don’t get me wrong, it is still there but fewer and fewer patients respect you. Some down right expect you to wait in them like we owe them something. The C-suite doesn’t respect you and thinks you’re easily replaceable. The insurance industry down right takes advantage of you.

Despite that, I am still happy with my career choice but then again I figured out how to be financially independent in my 40s and only work about 2 days a week now. I would be miserable if I had to work full time.
With all due respect, I disagree with some of this. There was a nice WaPo series recently showing the average doctor 40-55 makes 400K. Top 10% make 1.3M. Almost all wages for the average, more business income as you go up the scale.

Average grad finishes training maybe age 32. Earlier if you don’t do a long specialty training path. Maybe a bit later if you are non trad and do NSG or something. Longer training path tends to compensate better with obvious exceptions like peds sub specialties.

Even those with huge loans (many do not have them because of family help, MD PHD, working spouse) should be able to kill them off within a few years. At that point you’re in your mid 30s with a secure, perhaps 300K salary, or you’re in your late 30s with a secure, perhaps 500K salary. Yes you are behind the tech bros, but LBYM and saving, one can easily amass millions in their 40s and be financially secure in ones 50s.

I’m not saying most docs DO this, but it’s not that hard to do it and the path does not constrain you from doing so.

I am not sure where you practice. In flyover country where I do, Pts are extremely appreciative and respectful. Very rare to have a rude Pt and that’s usually somebody with drug or mental health issues.

Insurance industry sucks. No arguments there.

Admins are generally frauds and do treat docs with disrespect in general but the cold reality is that you have a lot more job security than they do and can find 50 other jobs around the country if you want to within a few weeks. When the rubber really meets the road, docs can prevail in these battles by invoking this reality but most are too conservative to do battle at all.

Part time practice, or full time with some non clinical work (eg research, teaching) seems most sustainable. The most burned out and lowest quality docs I know go full bore clinical 5 days a week. Given our tax code and incomes, I the opportunity cost of cutting back clinically by 1-2 days per week is quite low.

Admittedly I am still early in my career, but by earning/picking a lucrative specialty and working hard at it, I make very good money with a pretty good lifestyle and excellent job satisfaction. Many in my specialty who are worth tens of millions work into their 70s because of the work, and I plan to do the same.
Not sure what video you watched, but the reality is that most physicians don't break $300k. I used to live in the NE and moved away for better income and lower cost of living which allowed us our financial success. We live in Texas.

There is one thing you nailed right on the head. Physicians have way more power than they are willing to exercise. We actually hold all the cards but:
Residency has trained us to shut the hell up and work hard. No complaining.
Physicians usually over extend themselves financially and cant afford to fight
So here we are being taken advantage of by the insurance industry and corporate medicine.

If we actually were willing to join together and fight for real meaningful change we can make it happen. But we are pansies so here we are instead complaining on bogleheads or reddit or wherever.
https://www.medicaleconomics.com/view/d ... ost-report#

I couldn’t view the linked Netscape report. Is it true majority of docs are PCP? If they have a 3 year residency that means they are 29-30 when they start making 200-300K. That’s good money. You really think most people can’t amass millions in their 40s making that kind of money?
snowday2022
Posts: 1092
Joined: Sun Jan 16, 2022 1:48 pm

Re: Physician Retirement Savings

Post by snowday2022 »

joesmo wrote: Sat Oct 21, 2023 11:31 am

With all due respect, I disagree with some of this. There was a nice WaPo series recently showing the average doctor 40-55 makes 400K. Top 10% make 1.3M. Almost all wages for the average, more business income as you go up the scale.

Average grad finishes training maybe age 32. Earlier if you don’t do a long specialty training path. Maybe a bit later if you are non trad and do NSG or something. Longer training path tends to compensate better with obvious exceptions like peds sub specialties.

Even those with huge loans (many do not have them because of family help, MD PHD, working spouse) should be able to kill them off within a few years. At that point you’re in your mid 30s with a secure, perhaps 300K salary, or you’re in your late 30s with a secure, perhaps 500K salary. Yes you are behind the tech bros, but LBYM and saving, one can easily amass millions in their 40s and be financially secure in ones 50s.

I’m not saying most docs DO this, but it’s not that hard to do it and the path does not constrain you from doing so.

I am not sure where you practice. In flyover country where I do, Pts are extremely appreciative and respectful. Very rare to have a rude Pt and that’s usually somebody with drug or mental health issues.

Insurance industry sucks. No arguments there.

Admins are generally frauds and do treat docs with disrespect in general but the cold reality is that you have a lot more job security than they do and can find 50 other jobs around the country if you want to within a few weeks. When the rubber really meets the road, docs can prevail in these battles by invoking this reality but most are too conservative to do battle at all.

Part time practice, or full time with some non clinical work (eg research, teaching) seems most sustainable. The most burned out and lowest quality docs I know go full bore clinical 5 days a week. Given our tax code and incomes, I the opportunity cost of cutting back clinically by 1-2 days per week is quite low.

Admittedly I am still early in my career, but by earning/picking a lucrative specialty and working hard at it, I make very good money with a pretty good lifestyle and excellent job satisfaction. Many in my specialty who are worth tens of millions work into their 70s because of the work, and I plan to do the same.
What specialty did you go into?
A competitive surgical specialty with one of the higher but not highest comp. Not derm or plastics, I treat people who need my help and take Medicaid insurance like the next guy. Employed. Not maximizing my income at all, as I do part time clinical and shunned PP.
snowday2022
Posts: 1092
Joined: Sun Jan 16, 2022 1:48 pm

Re: Physician Retirement Savings

Post by snowday2022 »

https://www.amjmed.com/article/S0002-93 ... 0134-1/pdf

According to this article about 1/3 of physicians in US practice primary care. Anecdotally, a sizable number of them practice part time (eg moms, academics, etc).
trugs
Posts: 75
Joined: Mon Dec 20, 2021 8:40 pm

Re: Physician Retirement Savings

Post by trugs »

whitecoatinvestor.com publishes statistics on this.
EnjoyIt
Posts: 8839
Joined: Sun Dec 29, 2013 7:06 pm

Re: Physician Retirement Savings

Post by EnjoyIt »

snowday2022 wrote: Sat Oct 21, 2023 6:54 pm
EnjoyIt wrote: Sat Oct 21, 2023 1:27 pm
snowday2022 wrote: Sat Oct 21, 2023 8:19 am
EnjoyIt wrote: Fri Oct 20, 2023 10:34 am
er999 wrote: Thu Oct 19, 2023 8:25 pm

Any yet there are many physicians posting in bogleheads about their multimillion dollar net worth in their 40s. Not as good financially as tech at the top tier companies, but hard to think of other fields with a similar income floor open to thousands of people willing to work hard. While you need a good academic record, you don’t require an Ivy League education to get a position.

I’m a doctor myself so aware of the downsides, but for someone who’s geographically flexible and specialty flexible they will do well financially. Not if you’re a part time pediatrician in San Francisco or New York, but if you are somewhat financially savvy (particularly with the loan forgiveness programs) it’s a great financial choice.

There may be other reasons not to pick medicine — loss of personal time particularly in your twenties, weird work hours, depressing to be around sickness all the time, can’t switch jobs after borrowing all that money, etc. but you are almost guaranteed to be in the top 10% of incomes in the US, maybe top 5%. Ceiling isn’t too high though so no lottery like possibility of private jets and yachts like tech and finance.

There is great need for your services so while every patient encounter isn’t worthwhile you’re providing a valued and respected service to people.
There are very few people in medicine that can amass millions in their 40s. Not many career paths allow one to do that in 10-15 years out of residency while still enjoying the fruits of one’s labor. What you are seeing here is self selected because bogleheads are a poor representation of the general population of physicians. Every year it is getting harder and harder as reimbursement is lower while the cost of education and school related debt is higher.

As for respect, that has been dwindling also. Don’t get me wrong, it is still there but fewer and fewer patients respect you. Some down right expect you to wait in them like we owe them something. The C-suite doesn’t respect you and thinks you’re easily replaceable. The insurance industry down right takes advantage of you.

Despite that, I am still happy with my career choice but then again I figured out how to be financially independent in my 40s and only work about 2 days a week now. I would be miserable if I had to work full time.
With all due respect, I disagree with some of this. There was a nice WaPo series recently showing the average doctor 40-55 makes 400K. Top 10% make 1.3M. Almost all wages for the average, more business income as you go up the scale.

Average grad finishes training maybe age 32. Earlier if you don’t do a long specialty training path. Maybe a bit later if you are non trad and do NSG or something. Longer training path tends to compensate better with obvious exceptions like peds sub specialties.

Even those with huge loans (many do not have them because of family help, MD PHD, working spouse) should be able to kill them off within a few years. At that point you’re in your mid 30s with a secure, perhaps 300K salary, or you’re in your late 30s with a secure, perhaps 500K salary. Yes you are behind the tech bros, but LBYM and saving, one can easily amass millions in their 40s and be financially secure in ones 50s.

I’m not saying most docs DO this, but it’s not that hard to do it and the path does not constrain you from doing so.

I am not sure where you practice. In flyover country where I do, Pts are extremely appreciative and respectful. Very rare to have a rude Pt and that’s usually somebody with drug or mental health issues.

Insurance industry sucks. No arguments there.

Admins are generally frauds and do treat docs with disrespect in general but the cold reality is that you have a lot more job security than they do and can find 50 other jobs around the country if you want to within a few weeks. When the rubber really meets the road, docs can prevail in these battles by invoking this reality but most are too conservative to do battle at all.

Part time practice, or full time with some non clinical work (eg research, teaching) seems most sustainable. The most burned out and lowest quality docs I know go full bore clinical 5 days a week. Given our tax code and incomes, I the opportunity cost of cutting back clinically by 1-2 days per week is quite low.

Admittedly I am still early in my career, but by earning/picking a lucrative specialty and working hard at it, I make very good money with a pretty good lifestyle and excellent job satisfaction. Many in my specialty who are worth tens of millions work into their 70s because of the work, and I plan to do the same.
Not sure what video you watched, but the reality is that most physicians don't break $300k. I used to live in the NE and moved away for better income and lower cost of living which allowed us our financial success. We live in Texas.

There is one thing you nailed right on the head. Physicians have way more power than they are willing to exercise. We actually hold all the cards but:
Residency has trained us to shut the hell up and work hard. No complaining.
Physicians usually over extend themselves financially and cant afford to fight
So here we are being taken advantage of by the insurance industry and corporate medicine.

If we actually were willing to join together and fight for real meaningful change we can make it happen. But we are pansies so here we are instead complaining on bogleheads or reddit or wherever.
https://www.medicaleconomics.com/view/d ... ost-report#

I couldn’t view the linked Netscape report. Is it true majority of docs are PCP? If they have a 3 year residency that means they are 29-30 when they start making 200-300K. That’s good money. You really think most people can’t amass millions in their 40s making that kind of money?
Sure they could. Someone making $150k a year and only spends $50k a year can be financially independent in their 40s. That’s not what I am saying. Also I agree Medicine is a guaranteed well paying job if one can get to the end.

I will add if my kids decide to go into medicine knowing everything I know I will gladly support their decision.
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herks
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Re: Physician Retirement Savings

Post by herks »

Jimsad wrote: Sat Oct 21, 2023 4:51 pm
herks wrote: Sat Oct 21, 2023 2:53 pm Age 41 working in academic medicine and spouse same age also MD works part time, 3 kids
Current Retirement Savings $2.4mm
Cash $500k
Real Estate Rental Property x 6: equity $7.6mm
TNW: $10.5mm not including primary residence
+529/UTMA: $750k
That is impressive at 41y age and being in academic
medicine!
You are an exception to the many here who only invest in stocks and not much real estate
Is your real estate residential or commercial rentals and are they inherited assets ?
Mine are all residential
I inherited 2 SFH
Forgot to add taxable brokerage account is ~$330k
hmw
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Re: Physician Retirement Savings

Post by hmw »

hmw wrote: Fri May 13, 2016 12:53 am Age 41
Wife is a SAHM
Retirement savings: 2 million
Retirement Goal: 5 million with a paid off house by age 55.
I found my old post from 7 years ago.

Thanks to somewhat unexpected higher income and favarable stock market returns, my retirement saving is well past the $5 million goal. Still working full time. Unfortunately there isn't a lot of opportunities for part time work in my specialty.
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DrPayItBack
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Re: Physician Retirement Savings

Post by DrPayItBack »

This has been an interesting read and bumping for the sake of keeping it going for another decade.

38yo employed (non-academic) sub-specialist
Basically banker's hours, no call
Practicing for 5 years
$180 debt coming out, paid off in ~3 years after training
Current comp $400-450k, spouse mostly SAH, two elementary-aged kids

NW: $1.5m
Retirement: $1.1m
Difference in cash and 529s and primary home equity

I try to save 30-40% of gross
Goal spend ~$150k in current dollars
So $150k x 30 = $4.5m liquid in current dollars (maybe $6-7m nominal?), hopefully achievable by around age 50 which is close to empty nest
Kinda pathetic pension assuming it even sticks around (~$35k if started at 55 to ~$70k if taken at 65, nominal dollars, no COLA) so not really factoring it in at this point
+ some amount of SS
I would hope to be able to pull the plug entirely at empty nest, early 50s. Biggest thing per usual is health insurance. I don't think I would go substantially part time bc it seems like less money for largely the same stress/liability. Maybe something like 0.9 or 0.8 sooner than later, rather than 0.4-0.6 in 50s and 60s like some here have talked about.

I like my job fine right now, but I think that the docs here who "can't understand" why someone would want to retire from medicine in their 50s clearly aren't employees. That said I am also trying to enjoy the now, not climbing any more ladders, not joining useless committees etc.
yougotitdude
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Re: Physician Retirement Savings

Post by yougotitdude »

JDCarpenter wrote: Thu May 12, 2016 9:09 am We are in mid-50s. DW is compensated better than the norm for an OBG and I do better than the median lawyer. She entered private practice at 29 (also did lots of moonlighting in residency) and, due to our age, my scholarships, and my paying the last year of med school, our combined student loan load was less than $65,000.

We have given notice to retire next year. Excluding house, we expect to have 12 times last year's AGI, which will provide retirement spending at or above level we've planned for many years--and 60% higher than our current spending after taxes and soon-to-be-retired mortgage.

Note that our journey has been meandering. We raised three kids through private colleges, paid a 200K tail, lost over a year's income on a house sale at the same time as that tail, and had me as SAHD for well over a decade. As a result, our present free cash flow and AGI are substantially more than we had for most of our working lives and the "12x" is much larger than meets the eye.

What is a tail?
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DrPayItBack
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Re: Physician Retirement Savings

Post by DrPayItBack »

yougotitdude wrote: Sun Oct 20, 2024 11:21 am
JDCarpenter wrote: Thu May 12, 2016 9:09 am We are in mid-50s. DW is compensated better than the norm for an OBG and I do better than the median lawyer. She entered private practice at 29 (also did lots of moonlighting in residency) and, due to our age, my scholarships, and my paying the last year of med school, our combined student loan load was less than $65,000.

We have given notice to retire next year. Excluding house, we expect to have 12 times last year's AGI, which will provide retirement spending at or above level we've planned for many years--and 60% higher than our current spending after taxes and soon-to-be-retired mortgage.

Note that our journey has been meandering. We raised three kids through private colleges, paid a 200K tail, lost over a year's income on a house sale at the same time as that tail, and had me as SAHD for well over a decade. As a result, our present free cash flow and AGI are substantially more than we had for most of our working lives and the "12x" is much larger than meets the eye.

What is a tail?
It’s a malpractice policy endorsement that covers claims made after the policy has been allowed to expire. So I retire today and in 3 months I get sued for something that happened last year.
yougotitdude
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Re: Physician Retirement Savings

Post by yougotitdude »

DrPayItBack wrote: Sun Oct 20, 2024 11:26 am
yougotitdude wrote: Sun Oct 20, 2024 11:21 am


What is a tail?
It’s a malpractice policy endorsement that covers claims made after the policy has been allowed to expire. So I retire today and in 3 months I get sued for something that happened last year.
ahhh thanks!
malabargold
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Re: Physician Retirement Savings

Post by malabargold »

Specialist. Older(60''s)
My net worth is zero.
Spousal net worth well over 75 x our yearly income.

Have passed a significant sum to our now adult children already just by us maxing annual gifting limits from day 1 and then letting it stew in the broad ETF's

Doing same for grandkids now

Still navigating estate tax "problems"

Still working full time , btw
AS7911
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Re: Physician Retirement Savings

Post by AS7911 »

malabargold wrote: Sun Oct 20, 2024 5:42 pm Specialist. Older(60''s)
My net worth is zero.
Not sure I understand this comment...
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ElBarto
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Re: Physician Retirement Savings

Post by ElBarto »

Late 40's
Net worth as of my recent check is $5.5 million liquid although we do not own a house at this time. Actively looking with plan to pay cash somewhere in the $1.5-$2 million range. We are looking in a high cost of living area.
Work part time with no intention of increasing that. I make $200k per year +/- $20k.
Spending is under $120k/yr excluding current rent but includes paying for health insurance without subsidies or employer benefits. With rent it is closer to $160k/yr. This number also includes all the child care related stuff which I hope will disappear if we are to be successful parents.
We have a well funded 529

I love working part time. It was the best decision I ever made. I plan on working part time until I get tired of it. We are essentially financially independent and I can retire at any time. I would at least like to have a house and see what our budget is then before I pull the plug. Depending on how much I continue to enjoy work, I will continue as is.

One nice thing about one more year syndrome is that we are 1 year closer Medicare, Social Security, and 1 year closer to being empty nesters.
snowday2022
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Re: Physician Retirement Savings

Post by snowday2022 »

AS7911 wrote: Sun Oct 20, 2024 6:21 pm
malabargold wrote: Sun Oct 20, 2024 5:42 pm Specialist. Older(60''s)
My net worth is zero.
Not sure I understand this comment...
I am assuming that for asset protection he has titled all the assets in his spouses name. This can be useful for especially taxable accounts. If the money was commingled, you still get half in case of divorce. But if you are sued for malpractice, it can’t be part of the settlement.
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Re: Physician Retirement Savings

Post by White Coat Investor »

snowday2022 wrote: Sun Oct 20, 2024 8:21 pm
AS7911 wrote: Sun Oct 20, 2024 6:21 pm

Not sure I understand this comment...
I am assuming that for asset protection he has titled all the assets in his spouses name. This can be useful for especially taxable accounts. If the money was commingled, you still get half in case of divorce. But if you are sued for malpractice, it can’t be part of the settlement.
That's a super overkill technique of asset protection given that docs are 10,000 times more likely to lose money to their spouse than a patient.

I'm hoping he just means he has a SLAT for estate tax purposes which also has asset protection benefits.
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Tundrama
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Re: Physician Retirement Savings

Post by Tundrama »

Gosh, for a retired Community College graduate and career as a cop, I feel pretty dang good at 3.3.

What got me there….simple, investing hard and gas station coffee. Docs taking the same philosophy will fare much better, I assume.

Good luck! I truly respect doctors and all the education, long hours and commitment required for your careers. You folks are great!

Best piece of advice I got is this…many times, the Jones are broke. If you want a lot of money at retirement, don’t do what broke people do.
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Re: Physician Retirement Savings

Post by Parkinglotracer »

Tundrama wrote: Mon Oct 21, 2024 4:17 am Gosh, for a retired Community College graduate and career as a cop, I feel pretty dang good at 3.3.

What got me there….simple, investing hard and gas station coffee. Docs taking the same philosophy will fare much better, I assume.

Good luck! I truly respect doctors and all the education, long hours and commitment required for your careers. You folks are great!

Best piece of advice I got is this…many times, the Jones are broke. If you want a lot of money at retirement, don’t do what broke people do.
Yes the Joneses are broke! Don’t be like the Joneses.

Retired military / defense industry guy bogkhead who enjoyed skimming the thread too - it sounds like our own market savy whitecoatinvestor has his work cut out for his group. He was smart when he started his following. Money doesn’t come with instructions! I’d guess society and spouses expect docs to live like docs and spend like docs not save like boglehead’s. Thanks for all you Drs do to keep the rest of us healthy and productive.
SpaghettiLegs
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Re: Physician Retirement Savings

Post by SpaghettiLegs »

I read the first page of this thread, feeling pretty good about myself, before I realized it was from 2016! Very interesting to see updates from some of the early posters and thank you to them for doing so.

I am an emergency physician who is essentially backing into retirement at age 56. I am a “late bloomer”, graduating medical school age 35, serving as a Navy physician before training in emergency medicine. I quit EMED a year ago and don’t expect to go back. Numerous factors went into the decision but primary among them was recognition that the job was shortening my lifespan (sleep disruption, workplace stress). A seed of simmering anger was planted when my hospital employed group was given a 15% pay cut at the beginning of the pandemic, along with instructions to only request a new N95 mask when the old one was visibly dirty. I could go on but not the point here.

My peak earning was $400k in the mid 2010’s. This was through hustling during a 10-12 hour work day (or night), no paid vacations and the longest stretch of time off over a 12 year period being 11 days, and that only via a complex shell game of shift manipulation.

Retirement savings $3.6M, still owe $700k on a ~$1.3M home. We expect to downsize the home in a few years to get that debt off the books.Wife works part time in public sector in what is essentially a paid hobby but she does cover our health care.

I feel regret in walking away from a profession that I’m very good at; I miss being the guy that everyone knew, when things were going badly in the middle of nowhere, in the middle of the night, would take care of things but it’s just not worth it anymore.
afan
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Re: Physician Retirement Savings

Post by afan »

Interesting story. Did you find that EM was different from what you expected? Or that things like 12 hour shifts and night coverage more onerous than you had assumed they would be?

If those were the issues, did you consider working at urgent care centers or doing other medical work as an alternative to quitting altogether?
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SpaghettiLegs
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Re: Physician Retirement Savings

Post by SpaghettiLegs »

afan wrote: Mon Oct 21, 2024 10:11 am Interesting story. Did you find that EM was different from what you expected? Or that things like 12 hour shifts and night coverage more onerous than you had assumed they would be?

If those were the issues, did you consider working at urgent care centers or doing other medical work as an alternative to quitting altogether?
The specialty has changed over the past 10-15 years, so not different from what I expected but different from when I started out. Age 50 was a big threshold as well as the long days and sleep disruption are much harder than when younger. I don’t have any trouble staying up all night and working hard but it’s much harder to recover - and I’m pretty physically fit. My time off had become more about recovering and preparing for the next shift rather than living a normal life. There are options for working much less, and I did that for a short while, but didn’t enjoy the work any more, whereas I used to love it (that would be Burnout) and it was a case of me not wanting to suffer so some administrator making more per hour than I do builds a resume for the next step on their ladder. So there was a bit of “I’m taking my ball and going home”.

I do a little bit of consulting work. EM isn’t a good specialty for non-clinical careers, other than health care administration, and that ship has sailed for me. I can work urgent care if needed but prefer not to be someone else’s RVU generator anymore.
katnok
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Re: Physician Retirement Savings

Post by katnok »

snowday2022 wrote: Sat Oct 21, 2023 8:19 am
EnjoyIt wrote: Fri Oct 20, 2023 10:34 am

There are very few people in medicine that can amass millions in their 40s. Not many career paths allow one to do that in 10-15 years out of residency while still enjoying the fruits of one’s labor. What you are seeing here is self selected because bogleheads are a poor representation of the general population of physicians. Every year it is getting harder and harder as reimbursement is lower while the cost of education and school related debt is higher.

As for respect, that has been dwindling also. Don’t get me wrong, it is still there but fewer and fewer patients respect you. Some down right expect you to wait in them like we owe them something. The C-suite doesn’t respect you and thinks you’re easily replaceable. The insurance industry down right takes advantage of you.

Despite that, I am still happy with my career choice but then again I figured out how to be financially independent in my 40s and only work about 2 days a week now. I would be miserable if I had to work full time.
With all due respect, I disagree with some of this. There was a nice WaPo series recently showing the average doctor 40-55 makes 400K. Top 10% make 1.3M. Almost all wages for the average, more business income as you go up the scale.

Average grad finishes training maybe age 32. Earlier if you don’t do a long specialty training path. Maybe a bit later if you are non trad and do NSG or something. Longer training path tends to compensate better with obvious exceptions like peds sub specialties.

Even those with huge loans (many do not have them because of family help, MD PHD, working spouse) should be able to kill them off within a few years. At that point you’re in your mid 30s with a secure, perhaps 300K salary, or you’re in your late 30s with a secure, perhaps 500K salary. Yes you are behind the tech bros, but LBYM and saving, one can easily amass millions in their 40s and be financially secure in ones 50s.

I’m not saying most docs DO this, but it’s not that hard to do it and the path does not constrain you from doing so.

I am not sure where you practice. In flyover country where I do, Pts are extremely appreciative and respectful. Very rare to have a rude Pt and that’s usually somebody with drug or mental health issues.

Insurance industry sucks. No arguments there.

Admins are generally frauds and do treat docs with disrespect in general but the cold reality is that you have a lot more job security than they do and can find 50 other jobs around the country if you want to within a few weeks. When the rubber really meets the road, docs can prevail in these battles by invoking this reality but most are too conservative to do battle at all.

Part time practice, or full time with some non clinical work (eg research, teaching) seems most sustainable. The most burned out and lowest quality docs I know go full bore clinical 5 days a week. Given our tax code and incomes, I the opportunity cost of cutting back clinically by 1-2 days per week is quite low.

Admittedly I am still early in my career, but by earning/picking a lucrative specialty and working hard at it, I make very good money with a pretty good lifestyle and excellent job satisfaction. Many in my specialty who are worth tens of millions work into their 70s because of the work, and I plan to do the same.
I realize that this is from a year ago, but just wanted to chime in as a pediatrician, whose base salary never hit $200,000 working full time. Including bonuses and employer contributions to retirement accounts, rarely >$250,000.

I’m not complaining about my salary, but it’s hard for me to understand how pediatrician salaries are rarely taken into account while talking about physician salaries. Unfortunately, much higher income from other specialties skews the “average” much higher despite the fact that there are about 60,000 pediatricians in the US earning an average of $200,000.
EnjoyIt
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Re: Physician Retirement Savings

Post by EnjoyIt »

katnok wrote: Tue Oct 22, 2024 8:56 am
snowday2022 wrote: Sat Oct 21, 2023 8:19 am

With all due respect, I disagree with some of this. There was a nice WaPo series recently showing the average doctor 40-55 makes 400K. Top 10% make 1.3M. Almost all wages for the average, more business income as you go up the scale.

Average grad finishes training maybe age 32. Earlier if you don’t do a long specialty training path. Maybe a bit later if you are non trad and do NSG or something. Longer training path tends to compensate better with obvious exceptions like peds sub specialties.

Even those with huge loans (many do not have them because of family help, MD PHD, working spouse) should be able to kill them off within a few years. At that point you’re in your mid 30s with a secure, perhaps 300K salary, or you’re in your late 30s with a secure, perhaps 500K salary. Yes you are behind the tech bros, but LBYM and saving, one can easily amass millions in their 40s and be financially secure in ones 50s.

I’m not saying most docs DO this, but it’s not that hard to do it and the path does not constrain you from doing so.

I am not sure where you practice. In flyover country where I do, Pts are extremely appreciative and respectful. Very rare to have a rude Pt and that’s usually somebody with drug or mental health issues.

Insurance industry sucks. No arguments there.

Admins are generally frauds and do treat docs with disrespect in general but the cold reality is that you have a lot more job security than they do and can find 50 other jobs around the country if you want to within a few weeks. When the rubber really meets the road, docs can prevail in these battles by invoking this reality but most are too conservative to do battle at all.

Part time practice, or full time with some non clinical work (eg research, teaching) seems most sustainable. The most burned out and lowest quality docs I know go full bore clinical 5 days a week. Given our tax code and incomes, I the opportunity cost of cutting back clinically by 1-2 days per week is quite low.

Admittedly I am still early in my career, but by earning/picking a lucrative specialty and working hard at it, I make very good money with a pretty good lifestyle and excellent job satisfaction. Many in my specialty who are worth tens of millions work into their 70s because of the work, and I plan to do the same.
I realize that this is from a year ago, but just wanted to chime in as a pediatrician, whose base salary never hit $200,000 working full time. Including bonuses and employer contributions to retirement accounts, rarely >$250,000.

I’m not complaining about my salary, but it’s hard for me to understand how pediatrician salaries are rarely taken into account while talking about physician salaries. Unfortunately, much higher income from other specialties skews the “average” much higher despite the fact that there are about 60,000 pediatricians in the US earning an average of $200,000.
Same goes for internal medicine/family practice.
What about general surgeons who work days, nights, weekends working an equivalent of 1.5-2 jobs to make the $300k+ income.

The poster you replied to happens to be in a sub specialty that is paid well and probably has a good work life balance as well. There are few specialties that have both. I'm curious what that specialty is.

Reality is that most physicians do not amass millions even with their high income. Much of it has to do with their ego and lack of personal finance knowledge. Believe me, I work on the admin side as well and I see plenty of physicians working into their 70s not because they love what they do, but because they simply can't retire.

Also, a $400k income physician who buys a house that is 3x salary, has $300k school loan, leases 2 entry level luxury cars (his and hers), and sends their 2 kids to private school has almost nothing left over for savings. For most physicians this is the expected and normal lifestyle of a doctor family. This is what many of their colleagues do. This is why so many of us are broke despite awesome income potential.
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darrvao777
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Re: Physician Retirement Savings

Post by darrvao777 »

darrvao777 wrote: Thu Mar 15, 2018 9:56 am
Age: early 30s
Current: $1.5M
Goal: $10M
it is interesting to look back and see how much can change in 6 years

age is now in my late 30s
retirement savings at 5.5M
net worth is at 10M + thanks to wife's real estate investments/holdings
along the way, we have sort of lost the goal number. we both enjoy what we do, we don't work very long arduous hours, my goal is to continue for as long as i can and for as long as i still enjoy the work
protagonist
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Re: Physician Retirement Savings

Post by protagonist »

livesoft wrote: Thu May 12, 2016 6:11 pm
coalcracker wrote:What would you consider a "high-net-worth" physician :shock: ?
That's easy: Anybody with a net worth more than ours. :)
+1.
My definition as well.
Likewise, I consider anybody who plays saxophone better than me a maestro and anybody who windsurfs better than me is an expert.
This has been my attitude since I first started playing sax or first started windsurfing. And anybody I knew in college who owned a car and didn't have to hitchhike I considered rich.
It's been a moving target ever since.
Last edited by protagonist on Tue Oct 22, 2024 6:08 pm, edited 1 time in total.
protagonist
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Re: Physician Retirement Savings

Post by protagonist »

joesmo wrote: Sat Oct 21, 2023 1:44 pm I agree, but we are only powerful when unified. There are always doctors who will throw each other under the bus. Some doctors have entire careers testifying against doctors as expert witnesses. It pays good money, so screw everyone else as long as I win. In the long run, we all lose.
Wow, have doctors have changed that much since I retired ?

I found the vast majority of my physician colleagues (in the Northeast) very affable and supportive. Of course, the "bad apples" tend to stand out.

The doctors I knew who had financial problems tended to be in that situation because of either spending beyond their means, bad divorces or bad investments, or some combination thereof (often the three, or at least two out of three, seem to go hand in hand). But it was almost always, from my perspective, self-inflicted. Most have comfortable retirements.

Sadly, the profit motive and concern for quality of patient care are often in conflict. For that reason, being "unified" may never happen...it really hasn't since probably the 1960s when I imagine if you were a doctor you almost certainly were an AMA member. Doctors often have to choose their priorities, and those are different for different individuals.
Box of Rain
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Re: Physician Retirement Savings

Post by Box of Rain »

czeckers wrote: Sat May 14, 2016 6:35 pm I'm much happier, less tired, and able to tolerate the politics at work much better.
I thought about going part time, just to have enough money to pay for my pre-65 health care, but I can afford that anyway without working after next summer, and more importantly the few physicians in our Department that went to part time found that it is part time pay for full time aggravation.
Box of Rain
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Re: Physician Retirement Savings

Post by Box of Rain »

kcxie wrote: Sun May 15, 2016 5:50 pm one physician (neurosurgeon) drive 1979 Toyota Camry
A neurosurgeon should know that the vehicle safety features on a recent vehicle exceed that of his 1979 car by leaps and bounds. When he gets head injury in a car accident, he'll know better (or, not?) then.
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Re: Physician Retirement Savings

Post by White Coat Investor »

katnok wrote: Tue Oct 22, 2024 8:56 amI realize that this is from a year ago, but just wanted to chime in as a pediatrician, whose base salary never hit $200,000 working full time. Including bonuses and employer contributions to retirement accounts, rarely >$250,000.

I’m not complaining about my salary, but it’s hard for me to understand how pediatrician salaries are rarely taken into account while talking about physician salaries. Unfortunately, much higher income from other specialties skews the “average” much higher despite the fact that there are about 60,000 pediatricians in the US earning an average of $200,000.
EnjoyIt wrote: Tue Oct 22, 2024 11:47 amSame goes for internal medicine/family practice.
What about general surgeons who work days, nights, weekends working an equivalent of 1.5-2 jobs to make the $300k+ income.
I hear this stuff a lot out there and try to push back on it from time to time. Hope that's not too offensive.

# 1 The latest Medscape salary survey has the following average incomes for various specialties:
Peds: $260,000
FM: $272,000
IM: $282,000
Gen Surg: $423,000

https://www.medscape.com/slideshow/2024 ... -6017073#3

If you're making less than average in your specialty, you need to ask yourself why and what it would take to change and whether you're willing to do that.

# 2 The intraspecialty pay variation in medicine dwarfs the interspecialty average pay variation.

As an example in my specialty, there was a survey a few years ago that showed the 10th percentile for employees made something like $213,000 a year and the 90th percentile for partners made something like $510,000 per year. That's a lot of variation.

I know pediatricians, family physicians, and internists who make more than $1 million a year. It isn't impossible. Yes, they work hard. Yes, they have to deal with the hassle and risk of running a business. Yes, other docs and APCs work under them. If you don't make anywhere near the average for your specialty, in many ways you are CHOOSING to do that. That's fine. I currently choose to make about 1/3 of the average in my specialty. In exchange for that, I practice only 6 days a month, only during the day, and at a very sustainable # of patients per hour. Maybe you have chosen something similar, I don't know. If so, that's fine. But if you feel like you're being run ragged to make less than average, it's time to look around and make a change to a new place or at your current place.

It's just a lot easier to save money, pay off debt, live it up, give generously, and build wealth when you make more money. Boosting your income is an important part of managing finances. You don't want to do it in some unethical way, but ignoring what you make is a pretty good way to set yourself way back financially over the decades.
1) Invest you must 2) Time is your friend 3) Impulse is your enemy | 4) Basic arithmetic works 5) Stick to simplicity 6) Stay the course
Sho
Posts: 559
Joined: Wed Nov 24, 2021 8:38 am

Re: Physician Retirement Savings

Post by Sho »

White Coat Investor wrote: Sat Oct 26, 2024 10:03 am
katnok wrote: Tue Oct 22, 2024 8:56 amI realize that this is from a year ago, but just wanted to chime in as a pediatrician, whose base salary never hit $200,000 working full time. Including bonuses and employer contributions to retirement accounts, rarely >$250,000.

I’m not complaining about my salary, but it’s hard for me to understand how pediatrician salaries are rarely taken into account while talking about physician salaries. Unfortunately, much higher income from other specialties skews the “average” much higher despite the fact that there are about 60,000 pediatricians in the US earning an average of $200,000.
EnjoyIt wrote: Tue Oct 22, 2024 11:47 amSame goes for internal medicine/family practice.
What about general surgeons who work days, nights, weekends working an equivalent of 1.5-2 jobs to make the $300k+ income.
I hear this stuff a lot out there and try to push back on it from time to time. Hope that's not too offensive.

# 1 The latest Medscape salary survey has the following average incomes for various specialties:
Peds: $260,000
FM: $272,000
IM: $282,000
Gen Surg: $423,000

https://www.medscape.com/slideshow/2024 ... -6017073#3

If you're making less than average in your specialty, you need to ask yourself why and what it would take to change and whether you're willing to do that.

# 2 The intraspecialty pay variation in medicine dwarfs the interspecialty average pay variation.

As an example in my specialty, there was a survey a few years ago that showed the 10th percentile for employees made something like $213,000 a year and the 90th percentile for partners made something like $510,000 per year. That's a lot of variation.

I know pediatricians, family physicians, and internists who make more than $1 million a year. It isn't impossible. Yes, they work hard. Yes, they have to deal with the hassle and risk of running a business. Yes, other docs and APCs work under them. If you don't make anywhere near the average for your specialty, in many ways you are CHOOSING to do that. That's fine. I currently choose to make about 1/3 of the average in my specialty. In exchange for that, I practice only 6 days a month, only during the day, and at a very sustainable # of patients per hour. Maybe you have chosen something similar, I don't know. If so, that's fine. But if you feel like you're being run ragged to make less than average, it's time to look around and make a change to a new place or at your current place.

It's just a lot easier to save money, pay off debt, live it up, give generously, and build wealth when you make more money. Boosting your income is an important part of managing finances. You don't want to do it in some unethical way, but ignoring what you make is a pretty good way to set yourself way back financially over the decades.
Well said !
I chose to work in Academics for a much lower salary . It has been my choice and I don’t blame anyone for that . I am behind financially , but I enjoy certain aspects of my job .

But still if I remain healthy , I will have enough to retire by 60 and potentially leave inheritance too .
I made much less than average when I started , now I make more than average you mentioned for my specialty . But I will never catch up for those lost years .
EnjoyIt
Posts: 8839
Joined: Sun Dec 29, 2013 7:06 pm

Re: Physician Retirement Savings

Post by EnjoyIt »

White Coat Investor wrote: Sat Oct 26, 2024 10:03 am
katnok wrote: Tue Oct 22, 2024 8:56 amI realize that this is from a year ago, but just wanted to chime in as a pediatrician, whose base salary never hit $200,000 working full time. Including bonuses and employer contributions to retirement accounts, rarely >$250,000.

I’m not complaining about my salary, but it’s hard for me to understand how pediatrician salaries are rarely taken into account while talking about physician salaries. Unfortunately, much higher income from other specialties skews the “average” much higher despite the fact that there are about 60,000 pediatricians in the US earning an average of $200,000.
EnjoyIt wrote: Tue Oct 22, 2024 11:47 amSame goes for internal medicine/family practice.
What about general surgeons who work days, nights, weekends working an equivalent of 1.5-2 jobs to make the $300k+ income.
I hear this stuff a lot out there and try to push back on it from time to time. Hope that's not too offensive.

# 1 The latest Medscape salary survey has the following average incomes for various specialties:
Peds: $260,000
FM: $272,000
IM: $282,000
Gen Surg: $423,000

https://www.medscape.com/slideshow/2024 ... -6017073#3

If you're making less than average in your specialty, you need to ask yourself why and what it would take to change and whether you're willing to do that.

# 2 The intraspecialty pay variation in medicine dwarfs the interspecialty average pay variation.

As an example in my specialty, there was a survey a few years ago that showed the 10th percentile for employees made something like $213,000 a year and the 90th percentile for partners made something like $510,000 per year. That's a lot of variation.

I know pediatricians, family physicians, and internists who make more than $1 million a year. It isn't impossible. Yes, they work hard. Yes, they have to deal with the hassle and risk of running a business. Yes, other docs and APCs work under them. If you don't make anywhere near the average for your specialty, in many ways you are CHOOSING to do that. That's fine. I currently choose to make about 1/3 of the average in my specialty. In exchange for that, I practice only 6 days a month, only during the day, and at a very sustainable # of patients per hour. Maybe you have chosen something similar, I don't know. If so, that's fine. But if you feel like you're being run ragged to make less than average, it's time to look around and make a change to a new place or at your current place.

It's just a lot easier to save money, pay off debt, live it up, give generously, and build wealth when you make more money. Boosting your income is an important part of managing finances. You don't want to do it in some unethical way, but ignoring what you make is a pretty good way to set yourself way back financially over the decades.
I stand corrected with regard to the general surgeon salary. Thanks for the clarity. I will stand by that general surgeons also have one of the worst work life balances to be able to make that kind of money. Frankly, I think they should make more considering what they are asked to do, but I'm not on the RUC (RVS Update Committee) that decides how to distribute RVUs. Somehow the orthopedists got a good grip on that committee.

As for docs who make those $1 million a year salaries, yeah, one needs to start their own practice and then get others to practice medicine for them while they take a cut. Kind of like the mega corps do but on a smaller scale. Not something employed physicians such as anesthesia, hospitalist or emergency docs can do. Specialty definitely matters. The only way they can make that kind of money is to either work double shifts which will burn them out soon enough, or climb the corporate ladder.

Medicine is a great field and I am glad I chose this path. I chose a reasonable speciality with a reasonable work life balance and income. I climbed the corporate ladder until I made enough money to go part time and enjoy my practice of medicine. If I had to make a choice between working full time or retire. I would retire without a second thought. It isn't a calling or some nonsense like that. It is a job I enjoy and hopefully will continue to enjoy for years to come.
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spacecadet610
Posts: 152
Joined: Sun Aug 26, 2012 1:41 pm

Re: Physician Retirement Savings

Post by spacecadet610 »

I just saw this thread for the first time.

Me: 48 yo

Income: average from $350 - $450k per year

NW $7.2 million ($3.17 million taxable investment, $1.94 million retirement accounts, $2.1 million real estate)

I am burned out and would like to retire soon but have 2 young kids (4 and 7 years old) in a VHCOL area.

I think i may have reached my goal but it's borderline reached based on my current expenses and unknown future child expenses.

I will cut down my hours in 2025 to 0.9 FTE, and probably further cut down after that. Ideally fully retired by 50 yo
Wannaretireearly
Posts: 5688
Joined: Wed Mar 31, 2010 4:39 pm

Re: Physician Retirement Savings

Post by Wannaretireearly »

spacecadet610 wrote: Sun Oct 27, 2024 7:56 pm I just saw this thread for the first time.

Me: 48 yo

Income: average from $350 - $450k per year

NW $7.2 million ($3.17 million taxable investment, $1.94 million retirement accounts, $2.1 million real estate)

I am burned out and would like to retire soon but have 2 young kids (4 and 7 years old) in a VHCOL area.

I think i may have reached my goal but it's borderline reached based on my current expenses and unknown future child expenses.

I will cut down my hours in 2025 to 0.9 FTE, and probably further cut down after that. Ideally fully retired by 50 yo
You’ve done really well to be almost/at FI. Especially if yours is the only family income!
“At some point you are trading time you will never get back for money you will never spend.“ | “How do you want to spend the best remaining year of your life?“
DDGD432
Posts: 15
Joined: Sat Jul 22, 2023 9:07 pm

Re: Physician Retirement Savings

Post by DDGD432 »

Dual doc family, both started late, graduated residency in our mid 30s. Finished residency about 10 years ago with combined almost 800k in student loans. Both middle of road pay, non surgical specialties.
Nw: probably about 2.3 million.
We're not all that thrifty but do manage to save almost 30 percent of our gross income into retirement each year. Might cut that back soon and take bigger vacations.
Medicine is a tough job, but provides a nice path to financial stability.
JustGotScammed
Posts: 291
Joined: Fri Jun 09, 2017 10:16 pm

Re: Physician Retirement Savings

Post by JustGotScammed »

tludwig23 wrote: Wed May 11, 2016 10:49 pm Most physicians I know don't make $400k-$800k. Some busy specialists do, but most do not.
The average doctor in my city makes $360k. About a third of them fall within OP's band.
helloeveryone
Posts: 1341
Joined: Sun Sep 04, 2016 5:16 pm

Re: Physician Retirement Savings

Post by helloeveryone »

texasdiver wrote: Thu May 12, 2016 9:51 am My wife is a family physician. I'm a former Federal employee now teaching HS.

Honestly our lifestyle is closer to my teacher colleagues than her physician colleagues except that we travel more. We have 3 kids, the first of whom is approaching college age and are just now reaching 7 figures in our combined retirement savings with about 15 years to go. We are aiming to hit between 2 and 3 million in combined retirement savings by our target retirement date in 15 years. With our combined social securities and my three small pensions, even $2 million will give us more that we would likely need to maintain our current lifestyle. Since we live more like teachers than doctors anyway we feel we are pretty much on track.

We know doctors who have basically saved nothing and are counting on their employer's profit sharing plan and their real estate holdings (personal estate and acreage not rental properties) to retire. I suspect they are in for a world of hurt and will be working into their 70s.
Isn’t their employer profit sharing plan basically a retirement plan though? I thought it was basically a SEP so can save up to $66,000 a year?
spacecadet610
Posts: 152
Joined: Sun Aug 26, 2012 1:41 pm

Re: Physician Retirement Savings

Post by spacecadet610 »

Wannaretireearly wrote: Sun Oct 27, 2024 8:42 pm
spacecadet610 wrote: Sun Oct 27, 2024 7:56 pm I just saw this thread for the first time.

Me: 48 yo

Income: average from $350 - $450k per year

NW $7.2 million ($3.17 million taxable investment, $1.94 million retirement accounts, $2.1 million real estate)

I am burned out and would like to retire soon but have 2 young kids (4 and 7 years old) in a VHCOL area.

I think i may have reached my goal but it's borderline reached based on my current expenses and unknown future child expenses.

I will cut down my hours in 2025 to 0.9 FTE, and probably further cut down after that. Ideally fully retired by 50 yo
You’ve done really well to be almost/at FI. Especially if yours is the only family income!
Thanks. Yes mine is the only income covering all the expenses.

I've been lucky that my parents covered all my schooling tuition, i've been heavily invested in the stock market, and bought my real estate at opportune times with low interest rates.
snowday2022
Posts: 1092
Joined: Sun Jan 16, 2022 1:48 pm

Re: Physician Retirement Savings

Post by snowday2022 »

spacecadet610 wrote: Sun Oct 27, 2024 9:54 pm
Wannaretireearly wrote: Sun Oct 27, 2024 8:42 pm

You’ve done really well to be almost/at FI. Especially if yours is the only family income!
Thanks. Yes mine is the only income covering all the expenses.

I've been lucky that my parents covered all my schooling tuition, i've been heavily invested in the stock market, and bought my real estate at opportune times with low interest rates.
why not cut back more now in the sake of longevity since your finances are in such great shape? You could even move to a MCOL area and be FI, then practice only if/when you wanted.
spacecadet610
Posts: 152
Joined: Sun Aug 26, 2012 1:41 pm

Re: Physician Retirement Savings

Post by spacecadet610 »

snowday2022 wrote: Mon Oct 28, 2024 12:00 pm
spacecadet610 wrote: Sun Oct 27, 2024 9:54 pm

Thanks. Yes mine is the only income covering all the expenses.

I've been lucky that my parents covered all my schooling tuition, i've been heavily invested in the stock market, and bought my real estate at opportune times with low interest rates.
why not cut back more now in the sake of longevity since your finances are in such great shape? You could even move to a MCOL area and be FI, then practice only if/when you wanted.
I keep asking myself that very question but the fear of the unknown and worries whether i will have enough keep me chugging along.

Going to 0.9 is a baby step for me and then maybe go to 0.5 following year if I don't quit medicine by then
er999
Posts: 1677
Joined: Wed Nov 05, 2008 10:00 am

Re: Physician Retirement Savings

Post by er999 »

spacecadet610 wrote: Tue Oct 29, 2024 11:47 am
snowday2022 wrote: Mon Oct 28, 2024 12:00 pm

why not cut back more now in the sake of longevity since your finances are in such great shape? You could even move to a MCOL area and be FI, then practice only if/when you wanted.
I keep asking myself that very question but the fear of the unknown and worries whether i will have enough keep me chugging along.

Going to 0.9 is a baby step for me and then maybe go to 0.5 following year if I don't quit medicine by then
If you have 7 million and are worried about running out of money likely no amount of money will remove that fear. 0.5 FTE seems like a good compromise as I assume you could always go back up to 1.0 if had money problems and still gives a lot of time off.
Enolacs
Posts: 66
Joined: Sat May 08, 2021 8:04 am

Re: Physician Retirement Savings

Post by Enolacs »

protagonist wrote: Tue Oct 22, 2024 6:08 pm The doctors I knew who had financial problems tended to be in that situation because of either spending beyond their means, bad divorces or bad investments, or some combination thereof (often the three, or at least two out of three, seem to go hand in hand). But it was almost always, from my perspective, self-inflicted. Most have comfortable retirements.
I couldn't agree more. Usually it was from all 3.

With the help of the white coat investor and more financial literacy for young physicians no reason physicians should not be able to retire early and comfortably.
protagonist
Posts: 9869
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Re: Physician Retirement Savings

Post by protagonist »

er999 wrote: Tue Oct 29, 2024 11:56 am [
If you have 7 million and are worried about running out of money likely no amount of money will remove that fear.
Well said.
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