Medicine for Money

<p><a href="http://forums.studentdoctor.net/showthread.php?t=398385%5B/url%5D"&gt;http://forums.studentdoctor.net/showthread.php?t=398385&lt;/a&gt;&lt;/p>

<p>Relevant with this thread.</p>

<p>i was always the impression that it really doesnt matter what major you do, like if you are to do a business finance or economics degree how would lower your chances to get into med school, as long as you have the required pre med courses.</p>

<p>If I were on a medical school admissions committee, I would wonder about an applicant's committment to a medical career if he or she majored in business as an undergraduate.</p>

<p>Economics, History, Physics, English, Biology, Chemistry: these are all liberal arts subjects, and you can see from the data that (at least to a first approximation) they're all the same.</p>

<p>Business, nursing, auto mechanics -- these have the potential to be "vocational" in nature and run the risk (I do not have any concrete data) of being looked down upon.</p>

<p>Is there a reason why so many people are misspelling "medicine"? Is medecine some term I don't know about?</p>

<p>Again, I think entering any profession for the money is one of the stupidest things you can possibly do. For all of you doing this, I say spend your youth in school, go in debt, realize medicine isn't what you truely want to do, then get depressed. Just remember this discussion 20 years down the line. Please.</p>

<p>Cardene: We know doctors make a lot of money but that's not what we're trying to debate here. We're wondering whether or not it is worth the money in terms of how much time, effort, and energy, goes into the process of becoming a doctor and staying a doctor. I personally don't think it's worth it if you're after the money alone.</p>

<p>All jobs have the possibility of being vocational. With nursing there has been great strides in education and leadership, with many nurses going on to get their PhD or DNSC. Now the ANA has come out with a clinical doctorate called the doctor of nursing practice. Individuals who get a Bachelors in Nursing Science can go directly for their DNP after graduating for a 4 year program which includes choosing specialty of choice anesthesia, acute care, womes health, midwifery, gerontology, pediatrics and more. These individuals would take classes and have advanced practice residency in their perspective field. While taking advanced classes in pharm, patho, assessment, guidance in a scholarly project and so on. The ANA wants to establish this as a terminal clinical degree like the terminal clinical degree in medicine is a MD or DO Dentistry DDS and Law JD. People are enrolled in programs currently. Nursing is a different approach and model of patient care.</p>

<p>economics is a liberal arts degree at most uni's i know, but im pretty sure at my uni the only offer economics as part of the business program, so would that degree be still considered more vocational?</p>

<p>A Contrarian on Retirement Says Wait
From the May 12, 2007 New York Times.</p>

<p>
[quote]
Mr. Kotlikoff relies on financial planning software he has been developing called ESPlanner. It has been used by a number of economists and academics who are studying retirement savings. Mr. Kotlikoff used it recently to reach the startling conclusion that over a lifetime a plumber has a higher standard of living than a physician with a general practice because the doctor starts earning later, pays higher taxes and high malpractice insurance premiums.

[/quote]

<a href="http://www.nytimes.com/2007/05/12/business/12money.html?pagewanted=2&ei=5087%0A&em&en=6dec9f6eec370077&ex=1179288000%5B/url%5D"&gt;http://www.nytimes.com/2007/05/12/business/12money.html?pagewanted=2&ei=5087%0A&em&en=6dec9f6eec370077&ex=1179288000&lt;/a&gt;&lt;/p>

<p>As usual .02 comes in with a good post. In general it comes down to what you will be happier doing, or let me rephrase that, what you think you will be happier doing. If you look at the stats for medicine satisfaction goes down extremely quickly for physicians once they start practicing. Everyone who is mentioning 400k or 200K earnings. Yeah the earnings might be that high pre-taxes, take taxes from that, and malpractice insurance and other costs divide that into hours worked and you aren't making much. Then consider the hours you work to earn that large some of money, and all the years of training. In something like business you can say I don't feel like working for this company anymore and go and change if you are good. In medicine you can't just say I don't like this anymore I want to change. You can't abandon patients, you can't just take time away because "you need it." In theory you can, in reality it will greatly hurt your patients.
All this is just food for thought...</p>

<p>all this self-righteousness... i think that money is an extremely important consideration holding all other factors equal. being in the same boat as the original poster, i am actually going to try my luck in banking or something of the sort, see if i really like it, and then go to med school if i don't. i know some people who have done it and are glad for the experience... so don't fret!</p>

<p>I don't think there's been any self-righteousness or moral indignation on this thread. (There has on others, and I think justifiably so.)</p>

<p>All that's happened here is an economic discussion of whether medicine is the most financially lucrative field or not. And the answer is clearly no.</p>

<p>OK, I have several relatives in healthcare, and all i can say is, if you think those three specialties are the only ones that make money based on "salary reports" you've read, you're an idiot. no offense, but seriously, do your homework. If you want to make money as a doctor, and by money I mean big money, becoming a surgeon is the way to go. But if you do internal medicine, you don't make a killing being hospital based, as the salary reports will tell you, but if you specialize in internal medicine, beyond just general medicine, like say in gastroenterology or asthma and allergy, you can make a lot of money with your own practice. Even in general internal medicine you can make alot of money in private practice. Radiology (unless you don't want to deal with patients too much) and Anesthesiology I'd personally avoid because they're hospital based and you don't really get to make your own hours. The other thing with anesthesiology is you don't have the monopoly on anesthesiology, at least not in the operating room (look up nurse anesthetist) But if you don't think you're disciplined enough to manage your own practice, being hospital based would be better then. But my point is, making money in medicine isn't about what kind of doctor you are, it's about how business smart you are. You said you wanted to be a businessman or a doctor. To make big money as a doctor, you have to be a good businessman. If you're a surgeon, you'll make money. It doesn't matter really if you're an opthalmologist, dermatologist, nephrologist. In private practice, your salary isn't capped based on your specialty, but your business smarts. We know internists making much higher than the average salary reported online, even though according to salary websites they technically make less than most other specialties. Unlike being hospital based, in private practice, at the end of the year you don't just get a check for 5 Gs because you're a certain specialty. Remember medicine is a business, nothing more, nothing less.</p>

<p>On a sidenote, if you want a healthcare career with the same title, same pay as physicians, consider dentistry, you can specialize in prosthodontics, orthodontics. Less hours, not as much insane malpractice insurance, you still get called "Doctor", you still get to wear those latex gloves and a labcoat, and good money if you can manage a good practice</p>

<p>^ knows what he is talking about</p>

<p>(puts on a polite tone) NWJ's post has a few points which could use some clarification.</p>

<p>1.)
[quote]
if you think those three specialties are the only ones that make money based on "salary reports" you've read, you're an idiot.

[/quote]
For one thing we've been talking about four specialties, not three -- I'm not sure which one he's omitting. For another thing, the point is not that those are the "only" specialties which make money -- the point is that those are the *best *specialties in terms of allowing you to balance a good income with relatively short hours.</p>

<p>2.)

[quote]
If you want to make money as a doctor, and by money I mean big money, becoming a surgeon is the way to go.

[/quote]
Well, sure. Some surgical specialties make more than others, but surgery hours and lifestyle are by far the worst and malpractice premiums can be pretty high. Plus the training is the longest, meaning your discount values get pretty high.</p>

<p>3.)
[quote]
Radiology (unless you don't want to deal with patients too much) and Anesthesiology I'd personally avoid because they're hospital based and you don't really get to make your own hours.

[/quote]
A.) Just because they're hospital based doesn't mean they're actually employed BY a hospital -- i.e. they're not necessarily salaried, they can still be private-practice. B.) Radiology in particular is notorious for having great hours. The only better one is probably dermatology.</p>

<p>5.)
[quote]
But my point is, making money in medicine isn't about what kind of doctor you are, it's about how business smart you are.

[/quote]
This is a tautology. Obviously making money is about how business smart you are. If you mean to suggest that the variance in incomes in medicine is not solely due to specialty choice, then you're obviously correct. If you mean to suggest that your specialty has nothing to do with your eventual income, you're clearly incorrect. And in any case your hours will vary a lot depending on your specialty.</p>

<p>6.)
[quote]
If you're a surgeon, you'll make money. It doesn't matter really if you're an opthalmologist, dermatologist, nephrologist.

[/quote]
I'm going to give you the benefit of the doubt here and assume you didn't just refer to dermatologists and nephrologists as surgeons.</p>

<p>7.)
[quote]
We know internists making much higher than the average salary reported online

[/quote]
Again, what a nice tautology. Obviously some internists make more than the average internist. About half of them, in fact.</p>

<p>8.)
[quote]
Remember medicine is a business, nothing more, nothing less.

[/quote]
First, different specialties in business make different amounts of money on average. Private equity pays better than investment banking, which is better than consulting, which is better than marketing, etc. Do some marketing people make more than some private equity people? Obviously, yes. Does this depend partly on their business saavy? Obviously. But if you're suggesting that field of medicine has nothing to do with average income, then you're being ridiculous. If you're just thinking of medicine as a business, then I would think it would be pretty spectacularly obvious that some "fields" within this business pay better than others.</p>

<p>9.) This is a repeated point because it's so important. Your income in ANYTHING is capped by your business saavy. An auto mechanic who repairs a few cars, builds up some loyal customers, borrows money to open a gas station, and eventually buys a few more gas stations, etc. will outearn a physician who thinks the Lotto is a good investment. Duh. And yet lifetime earnings for auto mechanics are lower -- on average -- than lifetime earnings for physicians. Similarly, your expected returns as a family practitioner are lower than your expected returns as a plastic surgeon. Some more, some less, but the average is lower. So you're saying business saavy matters, and I'm not arguing the point, but it's clearly not the ONLY thing that matters.</p>

<p>10.) Finally, if you mean that medicine is only a business -- as in, it's purely a means by which you can earn an income -- then it's clearly the wrong choice of an occupation, since its lifetime earnings are lower by a good deal than certain business and even certain legal fields.</p>

<p>That's not to say that medicine is the wrong choice of an occupation, since it has components to it which, to me, are worth giving up some (or a lot) of my possible future lifetime earnings. Playing the role of a physician in a person's life, being with them when they need you the most, is a valuable experience and I'd gladly give up lifetime earnings to pursue that.</p>

<p>But if I were in my job purely to make money, trust me: I'd be pursuing a six-figure job on Wall Street and using that time value of money to my advantage rather than paying out tuition.</p>

<p>thank you, i'm well aware of what an average is, of course there's some higher and some lower. if we could avoid the semantic arguments and such, my point is simply this- alot of people go into college having no idea what they want to do except for the fact that they want to make tons of money, so they major in business. but to put yourself through four years of medical school and further medical training just looking for money, and especially given the state of healthcare and the uncertainty of the future, is not a good idea. if you want a field that's basically immune to managed care, go into cosmetic surgery- no insurance, and people pay you cash. that is, if you can put up with the people. i'm thinking of going a similar route, majoring in Finance and doing the premed track. As much as I am interested in medicine, though, it will come down to weighing one against the other; there are only so many years i have, so taking a job offer from Goldman Sachs even compared to Hopkins medicine. The way I see it, I'd hate to go into medicine if i wasn't 100%. if i don't like what i do with my finance major, i can always go back to school, maybe get a JD</p>

<p>by the way, saying that earning potential in private practice is not capped by specialty and is based on business smarts is not tautological, not in this context, i don't know the OP, i don't know if he was choosing specialties based on a salary survey he found online, my point, which i failed to expand upon, is choose a field of medicine that compels you and be smart about it. nephrologists are internists, but clearly you've never heard of dermatologic surgery, its part of every residency. granted, it may not be very invasive, but still. the shortest residency you can do i believe is general internal medicine, beyond that its an extra year or two for subspecialties, about as long as most surgery residencies</p>

<p>other than that, i apologize for the rambling posts and failing to read the rest of the replies before posting a response.</p>

<p>wow! i haven't read through all of the posts but i just wanted to put my own two cents in for the original poster--apologies if it's been repeated. if you are going into a field strictly for money, go into some sort of banking or law. in new york city, where my husband and i live, its the bankers and lawyers that dominate in terms of money. these are the people who are making half a million plus. unless you're a highly successful, business saavy ROAD (and let me also mention that the ROAD is ruthlessly competitive... will you be at the top of your medical school class?) doctor with your own practice and huge patient/referral base--doctors and doctor salaries are pretty unremarkable here. but that's new york city for ya. </p>

<p>otherwise, truly, going into medicine solely for the money really IS laughable to me. four years of medical school + 4-9 years of residency/fellowship (making around 40k, on top of all those loans)... medicine is, for the most part, a calling of sorts. yes, many people do become doctors thinking about the STABILITY it will likely provide (i.e. will own a home, own a car, be able to send kids to college), but i can't think of one doctor that i know (and i know A LOT! my husband, included), that doesn't also genuinely ENJOY what they do. on the other hand, when I ask my banker and lawyer friends who make millions the same question, they typically don't. but it's okay for them... b/c... well, they make millions. and it seems like you want to make a lot.</p>

<p>bottom line, if you go into medicine, your salary will likely plateau off at some point. with law and banking, the sky is the limit. my advice is to choose something the one that you wouldn't mind spending a potential lifetime doing. But, really, if you're going to choose medicine for that rockstar lifestyle, you will likely be in for a rude awakening.</p>

<p>I am pleased to see that my thread has sown the seeds of discord on collegeconfidential. </p>

<p>Anyways, just to clarify a bit, to be honest, I am not just considering medicine for the money; I also feel that medicine would suit my temperament more. I have some difficulty picturing myself as a banker on Wall Street, but the money nevertheless tugs at my heart. Still, the prospect of medicine tempts me as well, not just because of the stability, money, prestige, but also the fact that you are providing a valuable service to the world (not that banking is useless). While this may be a naive fantasy, I have always dreamt of becoming a doctor since I was younger until I learned about residencies, the length of medical school, tuition, HMOs, etc. I would usually always imagine the same scenario: I am on an airplane or in the mall. Suddenly, a man grasps his heart; he is undergoing cardiac arrest. He needs emergency treatment - on the spot. A woman cries out for a doctor, and I answer her call. The man is saved, and I stand up, sweating, tired, but positively beaming with the knowledge that I have saved one man's life. </p>

<p>Even now, I am still considering a career in medicine, but my prime motivation for posting this thread was to not only stir up a bit of discord and debate but also to see what the knowledged members of CC think about the compensation for medicine. I am still uneasy about medicine, but for now, I will keep a foot on the premed path so that when I finally decide, I would be ready to start medical school.</p>

<p>Still, my ego demands that I at least live better than most others in America.</p>

<p>Medicine differs from most other businesses in that most physicians do not set their own fee schedules. For instance, in medicine physicians give mandatory discounts to senior citizens and the disabled (Medicare) of 50-70%, depending on specialty; physicians give mandatory discounts to the poor (Medicaid) of 50 - 90%, depending on specialty. In order to maintain hospital privileges, physicians take call, generally without extra compensation, which results in an obligation to treat emergency patients regardless of ability to pay.</p>