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.snowday2022 wrote: ↑Sat Oct 21, 2023 8:19 amWith 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.EnjoyIt wrote: ↑Fri Oct 20, 2023 10:34 amThere 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.er999 wrote: ↑Thu Oct 19, 2023 8:25 pmAny 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.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.
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.
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.
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.
https://www.medscape.com/slideshow/2023 ... -6016481#3