<p>Hello everyone. I am about to start my freshman year of college and I am certain that I will be a physician. I currently had my mind set on mainly becoming an Emergency Med doc with a subspecialty in Peds. Interestingly, I was reading a premed forum on anither site, and someone mentioned the fact that people will only get paid for one residency. Now let me clarify that I am NOT all about money; however, I have heard that residency can be incredibly demanding and I just want to know how are residents supposed to support themselves if they aren't making money. I find it unlikely that I will be able to work as an ER doc (or any other job) during a Peds residency to support myself. This was confirmed by several people on that site and I just wanted to know if anyone here knows about this? To the doctors here, do you have any suggestions? How can I specialize in both fields? Is it something realistic or pretty idealistic? Please, be honest, I don't want any surprises!:)</p>
<p>You can do emergency peds. Thats not a residency though. There might be a fellowship like that but I really have never heard of it. The pay is the pay, you manage to live off of it. Most residents try to get jobs on the weekends in the hospital on call where they are paid overtime which can be over $100 an hour. Thats how most residents make their money. If not for that hopefully the residents spouse is able to help pay the bills, if not it becomes quite difficult. While you are a ped res. you can work in the ER on weekends for extra money, at some residency programs. Some will let you work overtime in other jobs within the hospital, other programs won't.</p>
<p>do u actually believe that crapola... i know a doc... had emergency ectopic tubal rupture... girl was going to die... he saved her... took out the tube... which was extremely scarred by the way from a history of std's and p.i.d... and he got sued for messing with her ability to reproduce... and because of some scum bag lawyer.. hes no longer a surgeon... everyone has a story like this... this is common... and playing defensive medicine is very compromising... theres no solution but ALL doctors get sued.. whether they screw up or not... its reality</p>
<p>Just over 50% of students who make it through Pre-med get in. Those are the facts. I was part of the less than 50% who didn't make into Med school way back in the late 70s. The scariest part was that I had no back up plan.</p>
<p>I got lucky and got a job in healthcare! Worked, got credentialed, traveled the world, went back to grad school, got my doctorate in physiology, did research, and now am Chair of an Allied Health program (Respiratory Therapy) at a medical university.</p>
<p>My point- have a back up plan (even though you have to be focused on getting in to medical school). A good number of my students come from where I've been. Some try again and get into medical school and that's great. Others stay in the allied health profession they got a degree in and are really making a real difference for their patients.</p>
<p>Many of the allied health professions make a great entry-level career into health care. From there you can see if practicing as a physician is worth the extra sacrifices and benefits.</p>
<p>The worst option, from my point of view, is to lose someone who has completed their degree and has the aptitiude and attitude to contribute to the healthcarfe of people in need because they didn't get into medical school. There are options. Explore them.</p>
<p>I am a Gynecologist in my 20th yr of practice. I dropped OB several yrs ago because I became a single parent of two young kids when their dad died of cancer. I was in a large group but went solo when I dropped OB. I have a busy practice but can set my own hours since I am solo. I am on call one night a week and 1-2 weekends a month as I trade with other Gyns.
I wonder about some of the things I am reading on this thread! I have seen my income go down every year since about 1995. Last year I was down about 15%. This is without cutting back on hours or more than two weeks vacation a year. My overhead goes up exponentially, with salaries (I have a very stable staff, one nurse with me for 18 yrs, and I pay well to have this loyalty and competence), the cost of health insurance for my employees and their families, my rent in a medical building, and my malpractice premiums which all go up each year. I am paying about 40K a year and if I did OB it would be about double that. My state is not considered to be one with an imminent malpractice crisis, like Pa. or Nevada, but this is a huge expenditure and a large threat always hanging overhead. Whoever said that only the bad docs are sued is misled; in my field over 75% of us have been sued (not always successfully) and you can't tell me that 75% of ObGyns are incompetent. Anyone with a grudge can file a lawsuit. But a big part of the problem is the insurance industry, which has no restrictions on it and can basically charge whatever. There is only one insurer in my state so it is not like we can shop around. You can't have hospital priveleges without malpractice ins.
That said, I derive great satisfaction from my work, I feel that I help people everyday and get to use my intellect every day too. I am a surgeon and love to operate. I have received resident teaching awards for sharing my surgical skills with drs in training. Although I feel like my career had a bit of "bait and switch" in the financial dept, and I will never become wealthy, I can't imagine what else I would do. By the way, the person who touted job security is wrong; my friend from medical school (we went to Duke) has now been "downsized" from two primary care positions, when financial consultants come in and recommend closure of clinics that are not sufficiently profitable. We are well-trained and competent, but that is not always enough in the financial world of healthcare. We also have a unique cash-flow feature: basically I can charge whatever I want but the insurance companies can pay me whatever they want, and if I have a contract with them I have to accept it. That amount gets lower every day. I have no way to create a cash business as people aren't motivated to pay cash for their hysterectomy or their ruptured ectopic pregnancy surgery.
Sorry for this lengthy posting but I read lots of weird speculation here and I want to meet some of these general practitioners making $300K+ a year. Maybe before expenses? Go into medicine because you derive great satisfaction from helping others and keeping the intellectual juices flowing. There are way easier ways to make $$$$$!!!!!</p>
<p>Isn't it true that many practices include malprac insurance as part of the benefits package??</p>
<p>
[Quote]
Isn't it true that many practices include malprac insurance as part of the benefits package??
[/Quote]
</p>
<p>Perhaps for a salaried associate, but once you're an owner or partner, you are paying those expenses.</p>
<p>I find this thread very interesting. SO much misinformation!! But some good info as well. As a practicing gastroenterologist in my 19th year of practice married to an MBA banker, I have a few thoughts, especially on the economics that have been discussed. </p>
<p>First of all, America is a capitalist economy. If you are at the top of your profession, and do your job well, you should be paid for it. This is true in all other fields besides medicine, and it should be true in medicine as well. Physicians perform duties that require high intelligence, tremendous dedication, and years of training. They should receive income commensurate with the complexity and difficulty of the tasks they perform. In some cases they do, and in many cases they do not. You should not go into medicine just for the money, but once you dedicate your life to it and work hard to succeed, you deserve to be paid for it (just like everyone else in our society). Your income in medicine is not just dependent on your specialty (although there certainly are lower and higher paying specialties), but a host of other factors, including the geographic area you practice in, whether there is a high concentration of managed care, whether you are in private practice or a full time academic (hired by a medical center), and how good a businessman you are if you are in private practice. Nobody has really discussed the fact on this site that almost all private practitioners are really running small businesses. And these small businesses have to deal with issues that other businesses don't.. most of your fees are controlled by outside sources (insurance companies and the government..i.e. Medicare). However your expenses (i.e. malpractice staff costs etc.) rise on a yearly basis. Most of us never realized when we went to medical school that we would have to deal with all these issues. We have three partner physicians, and 10 employees including an office manager, a full time billing specialist, and several nurses and technicians. We deal on a regular issue with things like salaries, hiring and firing of staff, health insurance for employees, rent, equipment, decisions regarding managed care contracts, and many other business issues. In the present economic environment, if you are not good at dealing with these issues, you will not be financially successful in private practice. You can be skilled, respected, and busy, but you might not do very well financially if your practice is not well run from a business standpoint. </p>
<p>Another point about income that is not mentioned. Most of the salary figures bandied about are for doctors in practice for 5-10 years. In most private practices you start out with an initial salary which is usually considerable lower than what you might earn as a full partner. In addition a partnership contract is usually not signed until after the physician has been there for a year and the other partners agree that they want he or she to stay on. Typical partnership contracts allow the new physician to gradually become a full partner over 3-5 years, and the new physician may have to buy in to the assets that the practice already owns. Also I would like to make a comment regarding a message in this thread. I have never met or heard of a family doctor making $300,000 a year unless they are doing something illegal, or have a business unrelated to medicine. It is virtually impossible to make that much when you are paid $40-$50 maximum per office visit.</p>
<p>Now lets get to the MBA thing. My wife started business school the same year I started medical school (1978). She got an MBA from a top 10 school (not Harvard but definitely up there). After she graduated in 1980 she started in the training program of a money center bank for corporate banking (not investment banking). She has had several jobs during her career, and took off a total of about a year to have two children. She has had quite a bit of success in her career, but she is not an investment banker, and she is not a CEO. As far as a comparison financially... there is none. She has made more money than me every single year of the 25 years since she graduated. On average I would say she has made at least double my income in every one of those years, and in many years higher multiples. If she had chosen investment banking, the multiples would be much higher. Just as an aside, as a gastroenterologist, income would be significantly higher than the median for all physicians... usually higher than general surgery and general internal medicine, slightly lower than invasive cardiology, much lower than neurosurgery, plastic surgery, or cardiac surgery.</p>
<p>So in summary if you are interested in a career where you want to make a lot of money, then chose an MBA. I don't think you can really argue the contrary. Are there neurosurgeons and plastic surgeons making big bucks out there?... Yes there are... but they still make way less than a Goldman Sachs partner (the equivalent status level in the banking world). </p>
<p>Having said all this though... and this is really the point... There is a big difference between the two careers. If you go into Medicine just for the money you will be unhappy no matter how much or how little of it you make. You have to be motivated by other factors or you will be miserable. I feel it is the most challenging and difficult career of all.. because of the training, the responsibility, the trust people put in you. If you mess up, people's lives are on the line... we're not just talking about a deal going sour. You affect people's lives every single day you go to work, and most of the time much more than you realize. These are the things that make it worthwhile, not the money. Although I have at times been jealous of my classmates in college that went into business and made a lot more money than me, working in the corporate world is very different than working as a physician, and I doubt I would have been happier following that route. Although I have had many worries over the 18 plus years of practice, being out of a job is not one of those. After every Wall Street crash there are tons of unemployed bankers walking the streets of NYC, not to mention all the high techies that were left unemployed in Silicon Valley after the last crash. </p>
<p>In summary.... follow your calling, and do what you think will make you happy!
If you feel you have a calling to be a physician do it. Don't expect to get rich, but do expect to have a challenging, at times difficult, but in general rewarding life.</p>
<p>rds,</p>
<p>You summed it up beautifully!</p>
<p>thanks audiophile, appreciate the feedback!</p>
<p>I agree with everyone who has posted saying that money shouldn't be your drive to become a physician. If your looking to be a millionaire medicine isn't for you, but thats not to say you wont be living comfortably. Just check out some of these salary surveys....</p>
<p>Great post rds 248! </p>
<p>What an eloquent way to describe our (physician's) journey!! I too began med school in 1978, and feel a little like a bait-and-switch has occurred in my career path; incidentally, my best friend has now lost two positions due to down-sizing and elimination of primary care clinics by big medical centers, so even job security isn't quite what we expected. I too have been surprised to find myself a small-business owner and have to pay my MBA office manager quite well to do that which I find completely uninteresting. (Like everything related to business.)<br>
I also really like the intellectual side of our job, the fact that we need to look things up and solve diagnostic puzzles. I don't dread going to work and still learn new things every day, and I help lots of people with my knowledge. But my accountant keeps telling me to raise my fees, and I keep explaining that it wouldn't matter what I charge, I will get paid what the insurers deign to dole out to me. He doesn't think that is a way to run a business, and I agree. </p>
<p>By the way, do you send Katie Couric a ham at Christmas? Because she seems to have made colonoscopy a common and routine procedure! Maybe she will need a hysterectomy one day.......</p>
<p>What do you people mean by "living comfortably"? You guys have used this term so much that you have beaten it the **** out of it and the blood is all over you and the organs are flying across the room (bit too graphic?). Comfortably is a relative term and to some people (at least me) I don't know what you guys are referring to. Does comfortably mean that I can live in a 4 bedroom house or 1 bedroom apartment? Does it mean that I can eat out almost everyday and watch a movie or a play at least once a week or that I'll have to rely on ramen noodles and watch movies for $.99 from video center? </p>
<p>But yeah, I'm planning to become something in the medical field (haven't really decided what yet) but I would like to know that I will be able to live a pretty "humble" life. In my case I plan to live in a 2 bedroom apartment with (maybe) a wife but no kids. Will the pay cover for rent, insurance, bills, ect. while I'll still be able to buy some of the necessities such as food, clothing ect. while still have enough money left for enjoyment such as an ipod, a movie at a theater at least once a week, a hi-def tv, ect. </p>
<p>This is what comfortable means to me and if I can obtain this then I know I've picked the right career for me because I can help people while not worrying about other life necessities.</p>
<p>I graduated with a BA in 96 and had a 3.0 average. Since then I have been working my way up the ladder in Information Services and am earning about 80K a year. I should finish my MBA in just over 1 more year. In addition I have a family (spouse and 2 children). My current GPA for my masters is a 3.8 and I have a very strong desire to become a Family Practice Physician but do now want my family to suffer for wanting to help take care of other people. I have read many posts and want feedback from those that mantained a job and went to Medical School (is there anyone?) I work for a medical system and interact with Physician on almost a daily basis. I had a long conversation the other day with a Physician that I respect and she both encouraged and discouraged my entering the profession due to the state of my career. I wondered if there were any other suggestions or feedback?</p>
<p>Thanks,
C</p>
<p>"What do you people mean by "living comfortably"?"</p>
<p>"Comfortable life" mean sthat you won't have to butt heads at work with a-holes day in and day out. Take engineering for example, where they have to deal with marketing, sales, business folks that run all over them in meetings and make them wish they never entered engineering....that's not a comfortable life. Having 5 meetings a day is not a comfortable life...being told to "step up", "think bigger", "network more" by your boss is not a comforatble life....Doctors live a COMFORTABLE life!!! ....do you get it now? People tend to talk in riddles...I like to spell it out.</p>
<p>
[Quote]
Doctors live a COMFORTABLE life!!!
[/Quote]
</p>
<p>OK, if you call being woken up in the middle of the night, getting called out of family functions, taking responsibilty for someones life or death, constantly being under the threat of being sued if things don't go perfectly, working 80+ hours/week, having insurance company MBAs who earn more than you deciding your income and second guessing your decisions, seeing more & more patients each year for less income comfortable, then I guess you're right!!!!</p>
<p>I would agree with the "comfortable" statement. Comfortable as in you will have a job and you'll never go hungry.</p>
<p>If you're looking for multi-millionaire status, you might want to look elsewhere.</p>
<p>A couple more benefits of medicine: more job stability than in the business world, less of a glass ceiling than the business world (it still exists but if you were to have your own private practice, you can circumvent that), and I would like to think, more job satisfaction than most jobs out there!</p>
<p>"if you call being woken up in the middle of the night, getting called out of family functions,"</p>
<p>Which doctors get called in the middle of the night?...the on-call ones, who're getting paid big bucks to be on-call at home watching TV(half-time pay is big-bucks if you odn't get a call), and if you ARE called, you get an additional full-time pay for a minumum number of hours!</p>
<p>Getting pulled out of familiy functions when you're on-call is to be expected...maybe you shouldn't plan a wedding when you're on-call.</p>
<p>"MBAs who earn more than you deciding your income and second guessing your decisions,"</p>
<p>That's a true negative, unlike the first statement...the fact that MBAs have a say in your medical decision can be frustrating, but that only happens in a corporate environment (i.e. big hospital)...smaller clinics and such don't have such problems, and if you have your own practice, there's none of that.</p>
<p>"seing more & more patients each year for less income comfortable"
yes, but how far will the salaries drop? Doctors have had stable incomes for the last two decades....as long as the AMA cartel controls the supply of doctors, you'll always make more money than the joe-blow engineer who's competing with indian and chinese labor markets.</p>
<p>u guys r missing 1 big important factor.</p>
<p>Doctors will always have a job, a career in business, however, is not always guarenteed. You may be making a hell of alot of money now, have a great job, but as weve seen with Enron and MCI, who knows what tomorrow holds. Business is cut throat and uncertain. You can be dropped whenever they feel like cuttings costs, and your 6 figure pay check goes bye bye. </p>
<p>However, with doctors, you have a skill that no one can take from you. You will always be able to get a paycheck, and will never be out of the job.</p>
<p>
[Quote]
that only happens in a corporate environment (i.e. big hospital)...smaller clinics and such don't have such problems, and if you have your own practice, there's none of that.
[/Quote]
</p>
<p>Not true. The MBAs who are running the insurance companies determine reimbursement levels (almost all doctors performing non elective procedures depend on insurance reimbursement) and insurance procedure denials are legendary.</p>
<p>
[Quote]
you'll always make more money than the joe-blow engineer who's competing with indian and chinese labor markets.
[/Quote]
Do "Joe-Blow" engineers do an additional 7-10 years of school & residency beyond undergrad?</p>