4 ms·

> working those extra 3 to 4 hours per day might mean you're making enough money to retire in your early 40s. The only way you could retire in your 40s as a do

> working those extra 3 to 4 hours per day might mean you're making enough money to retire in your early 40s. The only way you could retire in your 40s as a doctor these days is if you were already independently wealthy before becoming a doctor. If you go into medical school today, you're looking at finishing off your student loan payments in your 40s (depending of course on which school you go to, where you do your residency, whether you do a fellowship, and what specialty you choose). The pre-tax, pre-insurance, pre-expenses, gross pay looks high on paper, but the lifetime ROI on going into medicine is nowhere near as good as what you describe, no matter how many hours you work.

TuringNYC 10y ago
That is a gross generalization. It is true in the US if you are a primary care physician or one of the lower-paid/lifestyle specialists. It is far from true if your are a higher-paid specialist or sub-specialist. Also consider that unlike tech, where you get paid more for working in higher-cost-of-living cities -- in medicine you get paid more for working in lower-cost-of-living cities. Also note that unlike tech, the peaks and valleys are much less pronounced.
- chimeracoder 10y ago
  > Also note that unlike tech, the peaks and valleys are much less pronounced. The point is that, unlike tech, you have to take on massive amounts of debt before you can even begin to work[0]. And even after that, there's a really high latency before you're earning enough to make more than the minimum payments. Six-figure debt compounded over a decade or more really adds up. > That is a gross generalization. It is true in the US if you are a primary care physician or one of the lower-paid/lifestyle specialists. It is far from true if your are a higher-paid specialist or sub-specialist. It's actually more true if you're a specialist or subspecialist. People who don't practice medicine tend to overestimate what specialists get paid, and to underestimate what PCPs get paid. It also doesn't help that, in the last ten years, the relative reimbursement rates have changed dramatically, and to top it all off, private practices have been rapidly going the way of the dodo - so it's understandable that the public perception would be out-of-date. Overall, reimbursement rates for specialists have been slashed far faster than they have for primary care (with some specialties hit harder than others). Combine that with the fact that they have to spend even more time in training (during which time their debt compounds > Also note that unlike tech, the peaks and valleys are much less pronounced. Quite the opposite - tech salaries are relatively flat and stable compared to most other industries, and we get to take home pretty much 100% of our salary, less taxes. Yes, the industry as a whole has booms and busts, but so does literally every private industry. In medicine, unlike tech, even if you're salaried, you're oftentimes paying for a large chunk of your business expenses out of your "salary". This is one of the reasons why looking at listings of what doctors make is incredibly misleading. The insurance rates vary dramatically between fields of medicine (and practice locations), as does the necessary equipment and mandatory continuing medical education expenses (again, even salaried doctors will oftentimes have to cover these out-of-pocket). In tech, we don't have to worry about any of that. We have it pretty easy. > in medicine you get paid more for working in lower-cost-of-living cities. This used to be the case. It still is, for some fields like emergency medicine. It's a lot less the case in other fields, partly because of the consolidation of practice groups and the downward pressure on reimbursement rates across the board. [0] Unless, as I said in my previous comment, you're independently wealthy beforehand, in which case this whole discussion of early retirement is moot.
  - TuringNYC 10y ago
    With respect - you are comparing apples vs oranges. You are comparing independent/priv-practice doctors vs salaried technologists. If you had an independent contractor technologist, they also have to eat all the overhead (Liability insurance, E&O insurance, benefits, office, supplies.) Similarly, if you have a doctor working at the hospital, just like a salaried technologist they don't have to pay the overhead. To be fair, doctors' overhead is higher for certain practices, but remember that facility fees can be billed back to the insurance or directly to the patient and even sent for collection. Those are extra fees on top of the doctor's pay -- essentially a form of rent forwarded to the patient for the doctor's facility costs. Finally, we're not comparing tech salaries to other industries, we're comparing them to doctors. I've rarely seen doctors face a 2001 market crash or 2008 market crash and mass unemployment or had their entire training wiped out when JE22 went south. Tech is very volatile. Also consider that doctors generally make more as they age, whereas technologists often face increasing age discrimination. Yes, MLK in LA and St Vincent's in NYC did shut down, but have you ever seen the equivalent of a Lucent or Lehman or IBM or Intel in medicine? Rare... You are right that I don't practice medicine, but I work 75hrs a week in hospitals since my startup sells to hospitals. I've seen the relative function and dysfunction of both American and single-payer overseas systems. And BTW, i pay gigantic liability insurance bills for my diagnostic technology product , and it effectively comes out of my salary.
pkaye 10y ago
I do think doctors have a hard and stressful job but they are mostly well compensated. A while back I was wondering who were owning the most expensive homes in our city. Turned out 7 out of 10 were doctors and the others made money being a CEO/executive of a tech company. I was expecting more technology/engineering people given that is is in the middle of the bay area.

TuringNYC 10y ago

That is a gross generalization. It is true in the US if you are a primary care physician or one of the lower-paid/lifestyle specialists. It is far from true if your are a higher-paid specialist or sub-specialist. Also consider that unlike tech, where you get paid more for working in higher-cost-of-living cities -- in medicine you get paid more for working in lower-cost-of-living cities. Also note that unlike tech, the peaks and valleys are much less pronounced.

chimeracoder 10y ago
> Also note that unlike tech, the peaks and valleys are much less pronounced. The point is that, unlike tech, you have to take on massive amounts of debt before you can even begin to work[0]. And even after that, there's a really high latency before you're earning enough to make more than the minimum payments. Six-figure debt compounded over a decade or more really adds up. > That is a gross generalization. It is true in the US if you are a primary care physician or one of the lower-paid/lifestyle specialists. It is far from true if your are a higher-paid specialist or sub-specialist. It's actually more true if you're a specialist or subspecialist. People who don't practice medicine tend to overestimate what specialists get paid, and to underestimate what PCPs get paid. It also doesn't help that, in the last ten years, the relative reimbursement rates have changed dramatically, and to top it all off, private practices have been rapidly going the way of the dodo - so it's understandable that the public perception would be out-of-date. Overall, reimbursement rates for specialists have been slashed far faster than they have for primary care (with some specialties hit harder than others). Combine that with the fact that they have to spend even more time in training (during which time their debt compounds > Also note that unlike tech, the peaks and valleys are much less pronounced. Quite the opposite - tech salaries are relatively flat and stable compared to most other industries, and we get to take home pretty much 100% of our salary, less taxes. Yes, the industry as a whole has booms and busts, but so does literally every private industry. In medicine, unlike tech, even if you're salaried, you're oftentimes paying for a large chunk of your business expenses out of your "salary". This is one of the reasons why looking at listings of what doctors make is incredibly misleading. The insurance rates vary dramatically between fields of medicine (and practice locations), as does the necessary equipment and mandatory continuing medical education expenses (again, even salaried doctors will oftentimes have to cover these out-of-pocket). In tech, we don't have to worry about any of that. We have it pretty easy. > in medicine you get paid more for working in lower-cost-of-living cities. This used to be the case. It still is, for some fields like emergency medicine. It's a lot less the case in other fields, partly because of the consolidation of practice groups and the downward pressure on reimbursement rates across the board. [0] Unless, as I said in my previous comment, you're independently wealthy beforehand, in which case this whole discussion of early retirement is moot.
- TuringNYC 10y ago
  With respect - you are comparing apples vs oranges. You are comparing independent/priv-practice doctors vs salaried technologists. If you had an independent contractor technologist, they also have to eat all the overhead (Liability insurance, E&O insurance, benefits, office, supplies.) Similarly, if you have a doctor working at the hospital, just like a salaried technologist they don't have to pay the overhead. To be fair, doctors' overhead is higher for certain practices, but remember that facility fees can be billed back to the insurance or directly to the patient and even sent for collection. Those are extra fees on top of the doctor's pay -- essentially a form of rent forwarded to the patient for the doctor's facility costs. Finally, we're not comparing tech salaries to other industries, we're comparing them to doctors. I've rarely seen doctors face a 2001 market crash or 2008 market crash and mass unemployment or had their entire training wiped out when JE22 went south. Tech is very volatile. Also consider that doctors generally make more as they age, whereas technologists often face increasing age discrimination. Yes, MLK in LA and St Vincent's in NYC did shut down, but have you ever seen the equivalent of a Lucent or Lehman or IBM or Intel in medicine? Rare... You are right that I don't practice medicine, but I work 75hrs a week in hospitals since my startup sells to hospitals. I've seen the relative function and dysfunction of both American and single-payer overseas systems. And BTW, i pay gigantic liability insurance bills for my diagnostic technology product , and it effectively comes out of my salary.

pkaye 10y ago

I do think doctors have a hard and stressful job but they are mostly well compensated. A while back I was wondering who were owning the most expensive homes in our city. Turned out 7 out of 10 were doctors and the others made money being a CEO/executive of a tech company. I was expecting more technology/engineering people given that is is in the middle of the bay area.