(Part of an ongoing series Should I Become A Doctor?)
People rarely ask about income directly, but Doctor D gets a lot of wink-wink nudge-nudge questions about his finances such as,
“So what you drive, doc, a BMW?”
or
“It’s hard making ends meet sometimes, but you wouldn’t know about that, would you doc?”
"Where'd I get the money? Med School, Bitches!"Last year Dr. D made about 150,000 dollars, which is a lot of money. (The Medical Mafia makes sure MD's get paid well in exchange for our souls!) Uncle Sam and student loans took a pretty large chunk of that, but still Doctor D has more than every non-medical person he knows, and he is a Primary Care Doctor, which is one of the lowest paying specialties!
Now before you start filling out medical school applications dreaming of big money let me warn you about the downside: You spend about a decade of your life working for free and amass a mountain of debt to get here.
Dropping Out and Adding Up
Everyone considering the financial benefits of medical school should calculate their drop-out sibling equation:
Doctor D has a brother about his age. Brother D was a smart dude, but he never liked school so he dropped out in high school. Brother D immediately started making money working at low-skilled but steady jobs while Dr. D was toiling away at medical education.
Brother D’s lifetime earning was very gradually rising while Dr. D’s debt was increasing, until one day Dr. D started making big bucks. Dr. D and Brother D sat down and did the math problem.
The answer: 41
Doctor D will be 41 years old before his MD catches up with his drop-out brother's GED in lifetime income!Our paths diverged at about 17 years old. Doctor D is 32 now so he has another 9 years till he’s made as much money in his life as Brother D.
Medical School isn’t exactly the quick way to riches.
But in this economy who can complain about making six figures? Doctors do it all the time, but nobody is listening.
Doctors work hard and we get rewarded. It just isn’t as rewarding as some pre-med students and patients think.
"You know you laidies can't resist!"
By the way, Dr. D drives the cheapest car Toyota makes—it’s the first new car he ever owned.What do you think?
Pre-meds and Med Students: Did the financial rewards of affect your career choice?
Patients: Do you think income differences between you and your doctor harms your doctor-patient relationship?
Doctors: Are you satisfied with your income? Do you feel you deserve more or less?
Doctor D always loves to read your thoughts in the comments.
40 comments:
I drive a cheapass car. And I pay twice as much per pay in debt repayment than rent. Living the dream!!
My tax return shows a salary about double the figure you cited. Why would the income difference harm the relationship between me and my doctor?
I really don't think about income disparity when talking with my doctors. As long as my doctor is listening to me, I don't care how large the income disparity might be.
Of course, as someone collecting a disability pension, anyone in almost any full-time position will have a gross income much higher than mine. So thinking about income disparities is a waste of my time and emotional energy.
Doctors should make lots of money. I don't have a problem with that. By the way, once you surpass your brother, you're going to pull way ahead of him very, very quickly... :) L
But what kind of car does your brother drive?
My brother drives an old hand-me-down Ford that's constantly breaking down. Just because Brother D's made more money in his life than me doesn't mean he saved it.
In fact, he tried to live like a doctor on a waiters salary, not a great strategy for financial stability
I'm a doctor who also runs a course helping prospective applicants get into medical school here in the UK. One of the common misconceptions these students initially have about medicine (even here where salaries are, on average, a bit lower than the USA) is that you'll be rolling in money and living a very extravagant lifestyle.
It just isn't true. However, as your post highlights, it can offer enough income to afford you a comfortable upper middle-class level of income. Though depending on how you structure your career, you may not have the time/ability to actually enjoy the money you earn!
If you want seriously big money, medicine isn't right for you, unless you're willing to do certain highly competitive specialities and work some seriously long private practice hours (or get very lucky with your client base).
I would actually argue that given the calibre of people entering medicine, choosing it as a career probably LIMITS your lifetime earning total and the potential lifestyle you could live. There are MUCH easier ways to get very rich than medicine, after all!
PS. Talking of cars, I did splash out on a nearly new Audi S4 which is pretty cool, but it's now more than 5 years old with nearly 70k miles on the clock, and I'm not likely to change it soon. :)
I think docs don't make enough money. I also think the training is abusive and I wish they would create a sane training program to help mitigate burnout that I think is half the problem.
In China, physicians are barely over poverty level. In the Dominican Republic, doctors have second jobs teaching English because they aren't earning enough as doctors (my mom is a colleague, the docs write RX for her in between classes so she can get her BP meds).
Really, there's never enough money no matter what you do. The most anyone can hope for is a decent enough cushion between what comes in and what goes out.
M
I'm a second year med student, and while I'll really have to worry about money once I'm an attending, I see my 2 best friends who just finished law school starting jobs making 130-140k- right out of school- and think about I'll be making like 40-50k after even more schooling. I don;t know how many people go into med school thinking they'll make a lot of money, but I think that unless you also have a passion for it there are much easier ways to make the same or more money.
Being a doctor is hard work. You're responsible for pretty much everything along with inhumane hours and loooonnnnng years in school. You deserve a reward for that. I too would like to make a 6 figure salary but I know I'm not willing to put in that much work so I'll just go clean my house and then go enjoy the fall weather!
I heartily support high salaries for doctors. I've never felt that my doctors respected me less or misunderstood something important about my situation just because I make about 10 percent of what they earn. (I have the specialists in mind here.) They deserve every penny and then some.
But your statement, "You spend about a decade of your life working for free" puzzles me. The residents who cared for me in the hospital recently earn from $54,000 to $68,000 annually, plus a seemingly generous package of stipends and fees and benefits and time off. This is more than I make as a mid-career professional and it's more than the median HOUSEHOLD income in the United States (based on 2007 figures), so it's not just pocket change (although it's true that the hourly rate isn't so good, given the horrible work hours). I understand that one piles up scary amounts of debt in med school, but you do make SOME $$ as a resident, no? I have no idea if the teaching hospital where I was a patient pays unusually high salaries to residents.
Hm, I work for a bunch of orthopaedic surgeons so maybe my opinion is a little different. I rarely hear them complaining about their pay!
As a patient though, I don't really care how much my doctor is being paid. In fact, I think they deserve to be paid well. I won't take the long hours and (sometimes) abusive patients for anything.
Anonymous 2:35,
In college and medical school you pay to study, and that counted as 8 years when I didn't make a penny and my brother made money.
The residents in your hospital make a much better salary than I got in residency. Hopefully resident salaries have gone up in the last few years. I once added it up in residency ('cause Dr. D loves that math) and by the hour I was making about a dollar over minimum wage.
So yeah, I sort of counted working long hours in a demanding medical field and making about what a cashier at McDonald's makes as still "working for free."
I'm glad to hear that residents are being reimbursed a little better now.
This is Anon 2:35 again:
Oh, yes, that makes sense. I was thinking the ten years was for med school + residency + maybe a fellowship. I forgot about the college part. Your math indeed adds up. The hourly rate of resident pay sounds demoralizing to calculate, but I bet most every resident does that! Thanks, Dr D.
heh. Hey Dr. D. When I saw the title of this post, I laughed. Mightily. Heartily. I'm still laughing. Ok, now I'm wiping a tear from my eye.
Did I mention I was a MSI who's about 50k in debt? Yeaaaah.
For those who think MD=Money..... In actuality, MD=hard work=lots of up front debt=sleepless nights=eventual work at very low wage=a very secure profession where you get to touch and heal. MD is not = money. Bear Stearns=Money, even if you bring an economy down with you. (You'll still get your bonus... I promise!)
nik
Oh. And I forgot to answer the question, "Pre-meds and Med Students: Did the financial rewards of affect your career choice?"
Well, here goes nothing.
Even though I'm not the most enthused about med school right now (I know only 2 months in an no longer impressed-how sad) I couldn't see myself doing much of anything else before. I was thinking about a lab job (yeah, in undergrad I was a bit of a chem nerd) but I was told that it really didn't fit with other skills that I had. And some research is boooorrrring. I was fortunate enough to get in. I feel like I could have been good at quite a few things (as long as I worked hard enough), but I'm a bit of a sap and a matyr.
Don't get me wrong-I know how much different professions make. And every once in a while I think about making $500,000 in plastics doing boob jobs till I die. But that doesn't interest me.
I'm not sure where I'll end up, but physicians make too little in my opinion (and insurance companies are evil). Some physicians crack your abdomen and excise rotting bowel. Some deliver children and deal with complications that arise during this process. Some (like D) are not nearly appreciated enough and edge people away from disease, often dealing with complex (and multiple) illness.
So, no. The monetary rewards of medicine are pretty far in my mind. Seriously, who would put themselves through this only to be making $150,000? $200,000? As I said, if you want money, try working your way into mid/senior pharmaceutical management. Or crash an economy while cashing in. Either one might work. Med will not.
nik
My brother never liked high school. he didn't really apply himself in university. got a commerce degree, started to do well in co-op placement, and will ALWAYS make more money than me.
If a person gets into medicine to make money, they are probably too dumb to even do the job hahaha. That's a bit of a joke, but honestly, for the amount of training, the intensity of the work, and the hours we put in, it really doesn't pay.
The average med student enters residency with 120-150k of debt (depending on which study you look at) in Canada. This a significant stressor while in residency and will take many years to pay off. It has occasionally been shown that it affects specialty choice (either picking a shorter residency or a more well-to-do profession).
Solution? Make med school cheaper, with a mandatory return-of-service agreement.
So, most doctors are not rich. At least, not us lowly primary care peeps!
Doctor D: Wow! You impress me again by tackling this sensitive topic! (I know it's easier given that you're fairly anonymous than if we knew your name and where you work, etc., but still impressive, imo.)
I don't know the answer. I think the debt doctors are forced to rack up is ridiculous, and is the reason we face a shortage in PCPs and pediatricians, especially in rural areas. And yet, I cringe at the idea of just endorsing higher compensation, especially since money is finite in an economy. I like the idea of debt forgiveness for docs who might certain criteria, such as working in rural areas for x years or doing primary care type work.
Fwiw, I think my PCP deserves way more compensation than she gets, which I get the impression is in Doctor D's ballpark. I'm frequently stunned by the long hours she works despite having young kids and a husband who frequently travels for work. I don't really know how she does it! But I'm grateful she sticks with it.
Much depends, of course, on the definition of "rich." People earning roughly $150K or more fall into the top 5 percent income bracket in the United States. They earn more than the other 95 percent of the country each year, which makes them "rich" in my eyes and those of many economic theorists. (A household earning about $250K a year falls into the top 1.5 percent of American household by income.)
How to factor in debt load is complicated. I don't know how economists calculate household income relative to household debt. But don't lawyers have to pay for college and law school? Is law school cheaper than medical school? I really don't know. There's no question that many corporate attorneys make much much more than PCPs, but in my opinion they are not an enviable group to which one should aspire, and the rising concentration of wealth in the hands of a few is a problem, not an ideal. I cringe whenever doctors say they wish they'd become lawyers or CEOs so they could make the financial killing they deserve by right of their intelligence and hard work.
In any case, it's all a matter of how you define rich and whose statistics you use. This is not a comment on the value of doctors or how much compensation they should receive. (I [heart] doctors and would be happy for them to trade salaries with those of corporate attorneys.) It's just a discussion of whether the term "rich" is accurately applied to them.
I'm a premed student and income has nothing to do with my decision. I want to be a doctor regardless of the compensation (as long as I'll be able to get those pesky loans paid off).
$150K means you have enough to pay your bills and set aside money for savings if you're careful. It also means that your kids won't qualify for any financial aid when it's time for them to attend college. The rest of the country gets tax rebates, but your income prices you out of that refund. Other people might get to deduct medical expenses on their taxes, but your income is high enough that you can't take that deduction. You pay both a higher dollar amount and a higher percentage of your income in taxes. It's great that you can earn a comfortable living, but nowhere close to rolling in millions.
Do you think income differences between you and your doctor harms your doctor-patient relationship?
I'm a stay-at-home-mom; I don't earn one cent. That doesn't have any impact on how I view my doctors. Is your relationship with your patients affected by what you think their income is? Would it matter to you if your patient was a programmer earning $180K a year, or a tax accountant earning $250K, or a mechanical engineeer making $95K, or a company president taking home $500,000, or a school teacher making 40K?
My view of my doctors is based on how they treat me. Are they respectful? Do they take time with me? Do they listen? Do they answer my questions? When I consult them for medical help, does their treatment get me feeling better? If I was unhappy with how my doctors treated me, then I might resent how much they make off of me. But I am very happy with how my doctors treat me, and don't begrudge them making a good living.
When I decided to try and become a doctor, the money wasn't on my mind for a while...and when I did start thinking about it, amassing a mountain of wealth was not of any particular interest. I just want a stable financial base so that my family, if I end up with one, will be comfortable. It's hard to find a more stable job than as a physician, so there you have it.
...although, I must admit, having the means to build a little 9-hole golf course behind my home does have a certain appeal. haha
I worked full time after graduation for a few years, stayed home for a few years with my kids and planned to go back to work full-time when my children grew up. After living on one salary (a lot less than what Dr. D is making) for a long time, the kiddies were old enough to take care of themselves & I looked forward to having two full-time salaries. Instead, I worked several more years part-time and cared for my beloved’s Mom part-time. When she passed, we’d lived on a lower income than we could have for years but I was able to spend time with my kids and my MIL, something I wouldn’t trade for any amount of money. We paid off our house in less than 15 yrs, paid cash for our vehicles, have enough to donate to others less fortunate, and I still only work part-time. We had to scale back our early expectations somewhat but it’s worked for us. I guess we all make choices based on where life takes us. It’s not always what we wanted or expected but being jealous of someone else’s wealth or lifestyle isn’t worth the stress.
Spending 15 min. with my doctor once a year isn’t enough to have any relationship anyhow and she’s much too busy during my appointments for us to worry about each other’s salary.
I've never cared how much money my doctor makes, but I DO care about how he or she treats me as a human being. I've had doctors that barely spoke to me and rushed through the appointment -- those docs earned no respect from me, and I fired them. The doctors I see now are great, and because they give so much of themselves, and seem to genuinely care about me and their other patients, I hope they're making a terrific living.
I'm with Warm Socks. If my doctor doesn't care how much money I make, why should I care how much he or she makes. It all comes down to how we treat each other. Compassion and respect go a long way.
I 'm with Warm Socks & Wren too :D
I've unchecked Doctors who rushed me out the door shows no Empathy, tells me Pains, Headaches & Aches are in my head or I'm suffering post op anxiety disorder from two major post. I stick with doctors who make me feel good & I do not mind if they drive big cars or earns big salary coz they have Passion to help heal, that matters most.
I know this is random, but i am anorexic, and in need of critical care, will you please read my blog and tell me if i am fooling myself that i can survive for two more months without care...and also tell me your perspective on how a person without money or insurance may get help. So far no one has been able to provide me with any way to get help now, and I cannot find any affordable options. Only 1 out of every 10 people with an eating disorder are able to get care, and I dont even want to bother listing the mortality rates as Im sure you are already well aware of them.
Any feedback would be appreciated...or support even I can always use that too.
I currently make just north of $60,000 a year and only have a couple thousand in student loan debts from my undergrad years. I work as a physicist for an aerospace contractor. I hate cubical life and and discovered an interest in medicine about a year ago, so I'm planning to apply to medical school in June 2012.
From my perspective, I'm actually LOSING money to become a physician, since A) I'll incur around $200,000 in debt, B) leave a career with high job security and income, and C) put my earning potential on pause for the better part of 10 years.
I've thought about the income, but I'd much rather do something that made me happy and interested me, instead of building bombs or launching rockets.
I am an RN, my husband is a shipper/receiver and due to investments (not my regular income) we now have enough money invested to retire comfortably whenever we choose, and right now we are in our mid 50s. We own several income properties and I have travelled extensively since I was in my 20s. We have a luxury car and a truck and assorted other "toys" and we enjoy our vacations immensely. I didn't need an MD to do any of it......and my education was affordable.
These huge debts you US doctors incur, in addition to the epidemic of lawsuits in America must make medicine a very unattractive option.
In Australia, (where we have "socialised" healthcare and education), a medical degree costs $42,000. As a low interest government loan. That's it.
(Also high quality, free healthcare for all. But that's a separate topic)
Sure, we have slightly longer training (5 year undergraduate medicine, 2 years as house medical officer, plus specialist training). But it sure seems like a more sensible way of doing things.
Yes, please Dr. D, if there is any help or advice you could give to Jadedchalice, it would be soooo appreciated. She is in a very scary situation. Thank you!
JADEDCHALICE:
First of all I need to say that I can neither physically or psychologically treat anyone over the internet. All the thoughts I give are perspective from my experience with the Anorexics I have treated.
I can't say anything about the resources for uninsured Anorexics in your area other than that I suspect they are far from ideal. This is the case about everywhere. As JadedChalice pointed out on her blog the cost of one month of inpatient treatment for Anorexia is $30,000 which isn't something you find lying around in a country that is broke.
A huge reason that Anorexia is so hard to treat is that, as in many addictions, the ill person is often fighting the treatment designed to save them. JadedChalice, you mention in your blog that your have sought out help and then missed following through when help was offered.
Another reason Anorexia is difficult is that as a general rule Anorexics are extremely intelligent. The intelligent mind under the sway of an addiction is capable of very powerful self-sabotage. Reading JadedChalice's blog I can tell that she is articulate, artistic, and thoughtful. I'm certain that she knows more about her illness than I. She is also likely more intelligent than most of her doctors.
Anorexics have been some of my most intelligent patients. They have also been my most manipulative, using their keen intelligence and the fear surrounding their disease to manipulate those who try to help them and themselves.
Smart, artistic anorexics feel isolated from those around them. They often assume that the rules of addiction that apply to drunks don't apply to their situation. "I am brilliant and different, and my pain is unique. No one is qualified enough to help me. I'm not even like the others with Anorexia. I need individual care. I need a whole new field of psychology just to study me and my unique pain!"
Would it be ideal to have a $30,000 a month team of experts treating each Anorexic? Absolutely! Is JadedChalice going to get that right now? Doesn't sound like it.
Sounds like your best option now is to get into the imperfect mental health system. There are resources for uninsured people with mental health issues. You may have to sit in a waiting room with smelly alcoholics and schizophrenics. You may have a psychiatrist that isn't as smart as you. You may overhear jaded nurses complain about you along with all the “other junkies.” It may be far from ideal, but in the end the willingness to cure you has to come from you. Even the most perfect million-dollar celebrity clinic won't cure you without your participation.
If you have to, go to the ER and tell them you are suicidal. (Starving yourself to death is definitely a method of killing yourself.) You might end up with a few days on a locked psychiatric ward, but that may be what you need to get you plugged into help.
JadedChalice you are in a house that is burning down! If the inexperienced volunteer fire department is all that’s available then don't wait for the firefighting world experts. Get over your pride! Your pain is not as unique as you think. Fire kills brilliant, artistic people just as easily as anyone else. Get over your pride and unlock the door. Get out of the house and let anyone with a fire hose in!
As I said at the onset: I am not a psychiatrist, an expert in Anorexia, or know anything at all about JadedChalice. I simply know that the people in her situation I have been able to save have often responded best to tough love. So there you have it. It's the best I have to offer. Now get help wherever you can!
Thank you for replying, Dr. D.
JADEDCHALICE:
Dr. D is right - start the process. Get help wherever you can.
The hardest thing you will do is fight for yourself and keep fighting for yourself. As painful and exhausting it can be I promise it is worth it.
There is nothing that compares to getting your life back.
Thank you for replying with a thoughtful, and honest response. I very much appreciate the time you took and the energy you put into responding to me. The truth may not be pretty however to deny the truth would be to ruin my chances for true recovery. I will take the steps I need to in order to get help immediately.
I took no offense to your "tough love" as you presented your points compassionately, and non judgmentally. Anything you said was fact based and I appreciate that.
The situation is not easy, but ultimately its going to be up to me if I want to survive this, with or without the guidance and help I feel I need.
I talked to my human resources department and though they do not offer insurance to my department, they are looking into creating an employee assistance program for me, and seeing if they can help me find a way to get some kind of immediate care, if that doesn't work I will go to the ER.
As someone with a good job that at 32 is returning to school to hammer out the Med-School requirements. While compensation is a part of the decision making equation, it certainly is not at the top. When I am all done I need to be able to make enough (over time) to balance the sacrifices my wife will make getting there.
There are better ways to make the bank, if money is the primary motivation.
hell my dad and my mom make about 900k put together both doctors;)
My parents make $3000 for just sitting around. I make 10 bucks a hour.
Doctors are stinking rich.
After med school show some restraint and avoid buying the 40k car and house or luxury condo. Paying down debt should be your primary concern. 150k of debt can be quickly paid off on a 150k salary. Doctors may be smart but the splurging occurring after getting a job shows they don't know the simple math about becoming debt free and independent.
A lot of doctors such as Dr. D play the "poor
me" card. I'm not trying to be mean, but don't believe it. The part that doctors always conveniently leave out is that once they pay off their debt, they are making significantly more than most people and most professionals for 20-25 years.
The simple truth is... The average professional will earn about 1 to 1.5 million in their lifetime. On the other hand, a doctor earns 4-5 times that amount putting their lifetime earnings at a minimum of 4 million.
That's a conservative estimate of 2.5 to 3 million more than most professionals. All that to say.. Doctors are already paid well and they deserve some of it but lets not start talking about wage increases for doctors in a recession unless we are actually going to get something for the extra tax dollars we would be giving them. Did anybody notice that people are looking jobs lately????
Just banked 400k this year as a dentist!! You docs should have chosen dentistry instead!
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