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      02-15-2013, 07:44 PM   #67
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Originally Posted by jpan08 View Post
UConn Dental!
What a small world. I did my IM residency at Uconn. Though I must admit I hated any rotation at Dempsey. That place is so antique in regards to their computer system. You guys are pretty lucky nowadays with the way blue back square was redone. I feel like half of the NY Sports club members are Uconn dental kids. Are people still going to Murphys? Its been years..

But back to OP... Personally I wouldnt get into an M3 unless you have someone that is going to make sure the payments for the car and Insurance are going to be payed on time everymonth. I couldnt imagine having had to spend all that time concentrating on getting honors or doing well on the steps, knowing that I had to make sure the monthly finance/lease payment were going to be paid. You also have to consider that you are gonna spend all/most of your free time in class/lab/library and not really have time to enjoy your car. It really is relevant to you personal situation. Remember that the initial honeymoon period of ownership is great but once its over the monthly payments can really become a significant burden/ stressor.
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      02-15-2013, 07:50 PM   #68
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100K seems extremely hight for an RN. The only Rn's Ive heard of making close to that much are CRNA's working for a busy practive.
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      02-15-2013, 07:52 PM   #69
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Easy for you to say when its not your money.
Ditto.. That kind of thinking/living for the present and not planning for the future is what lands you in bankrupcy court.. when the future does actually come.
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      02-15-2013, 08:18 PM   #70
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Those numbers are a little low for SoCal, but you have to work HARD to make more than that. That includes seen patients in the hospitals, which means working weekends and getting called at night.
People have to wonder who's better off. The Primary doc who makes $150k a year working 60 hours a week and getting calls from the ER in the middle of the night. He/she has had to study their ass off to get into Medschool- college wasn't nearly as fun as it could have been. Then pay $60,000/yr for medschool. Or the Pharmacist who makes $150k/yr working 40-50 hours a week and never gets called when they're off. Or the nurse who makes $100k/year who only has to do 2 years of JC, then 4 yrs of nursing school and works 3.5 to 4 twelve hour shifts a week and starts making money at age 24?



It's not allowed. We'll get sued for anti-trust!!! That's how screwed we are.

.
Okay, I will hire for 165k a yr with a signing bonus. plus production base (practice in east los angeles)
hospitalist and clinic work combined.
never thought of going to an M3board to look for staff haha

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      02-15-2013, 11:00 PM   #71
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100K seems extremely hight for an RN. The only Rn's Ive heard of making close to that much are CRNA's working for a busy practive.
Experienced ICU nurses can make around $100k or slightly more. CRNAs generally make in the $120-150k range ( I am an anesthesiologist).

To address some of the other stuff that has been mentioned in this thread, I would start by saying that physicians have been preaching the doom, gloom, and demise of medicine ever since I can remember. It still remains a very fulfilling, and financially secure profession. You may never become truly wealthy, but you will always be affluent. Very few professions and jobs will give this overall level of inherent job satisfaction and financial security IMO.

I am very much in favor of the employed physician model. It allows me to focus on being a doctor. The administrators deal with all the crap. I am paid a decent salary. It isn't top dollar, but it isn't bottom dollar either.

And for those of us who have saved a human life, what greater thing is there in this world that one could possibly do?
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      02-16-2013, 12:05 AM   #72
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100K seems extremely hight for an RN. The only Rn's Ive heard of making close to that much are CRNA's working for a busy practive.
That's not the case at all in Cali. We have set ratios for nurse/pt ratios and they're in demand, though the market has cooled down a bit. A registry nurse can make well over $150k if they're will to work hard and the hospitals had a need for them. They put in long hours for that but they're not all that smart and didn't go to school for very long.
The nursing schools in Cali generally pick students by lottery, so it's not the best and brightest that get picked to be a nurse. It's pretty scary. Most can barely speak English.

.
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      02-16-2013, 12:33 AM   #73
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To address some of the other stuff that has been mentioned in this thread, I would start by saying that physicians have been preaching the doom, gloom, and demise of medicine ever since I can remember. It still remains a very fulfilling, and financially secure profession. You may never become truly wealthy, but you will always be affluent. Very few professions and jobs will give this overall level of inherent job satisfaction and financial security IMO.

I am very much in favor of the employed physician model. It allows me to focus on being a doctor. The administrators deal with all the crap. I am paid a decent salary. It isn't top dollar, but it isn't bottom dollar either.

And for those of us who have saved a human life, what greater thing is there in this world that one could possibly do?
You should realize the doom and gloom is VERY MUCH different than in the past. The Government knows there won't be enough Physicians, so they came up with the term "healthcare provider" that cheapens a Physician and elevates an NP/PA to the Physician level. This is particularly concerning for PCP's.

As for employed Physicians, I'd have to disagree with you on that unless there's some provision for compensation based on productivity. I've worked at Kaiser and work with Physicians employed by major HMO's and there's a HUGE difference in how things get done. You have a LOT more productivity in private practice. The only down side is you guys a few bad apples who can't figure out when to discharge someone; and the hospital can't just fire them.

.
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      02-16-2013, 12:45 AM   #74
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100K seems extremely hight for an RN. The only Rn's Ive heard of making close to that much are CRNA's working for a busy practive.
Ive seen many make over 100k. Just look at any Kaiser RN and you will know what im talking about.
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      02-16-2013, 06:43 AM   #75
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You should realize the doom and gloom is VERY MUCH different than in the past. The Government knows there won't be enough Physicians, so they came up with the term "healthcare provider" that cheapens a Physician and elevates an NP/PA to the Physician level. This is particularly concerning for PCP's.

As for employed Physicians, I'd have to disagree with you on that unless there's some provision for compensation based on productivity. I've worked at Kaiser and work with Physicians employed by major HMO's and there's a HUGE difference in how things get done. You have a LOT more productivity in private practice. The only down side is you guys a few bad apples who can't figure out when to discharge someone; and the hospital can't just fire them.

.
Maybe some of this depends on the particulars of a given situation. I work for an independent hospital that has moved to hiring many of its physicians. I am actually chief of staff at my hospital and have pushed this model with our CEO and Board of Directors.

As far as incentives go, I take care of the hospital and it takes care of me. Basically, you need to feed the hand that feeds you. Given this model, we have had no trouble keeping people motivated and productive. Overall our staff turnover is extremely low.

Treat people well, provide a pleasant and respectful work environment, give them a reasonable wage, and you will go far. Long term sustainability in practice only occurs when you balance income, workload and lifestyle. If you try to favor any one of these over the other, you will lose something.

Come to think of it, this is exactly what I said about the M3 !!! It exists in a perfect balance. If you try to find a car that does any one thing better, you will almost certainly have to compromise on some other aspect !!
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      02-16-2013, 08:36 AM   #76
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To the OP here's my two cents

1- my loans are 220k, I went to a state med school and my 30 year payoff is 2k a month for those 30 years. I drove a 5 year old ford focus at the time and looking back waiting to get a BMW was worth it - I used it as motivation to work really hard to better myself to eventually get an M

2- if you're going into medicine for money (which it doesn't sound like you're doing but if you are) stay the hell away. You can make at shit ton more in business or finance- work one tenth as hard and not sacrifice anything. As a resident working 100 hr weeks (the 80 hr rule is bs and many residencies don't follow it- hell my family medicine residency didn't follow it) for 3 plus years gets really old quick and you sacrifice time away from family and friends

3- Some of the doom and gloom that everyone is talking is true but hard work can payoff. Medicine is changing quickly and I agree with everyone that ObamaCare will kill off the current system but pay for procedure based medicine needs to be changed anyways. The cuts are going to redirect money away from specialty care and direct towards primary care (I hope). Either way love what you do and make sure you're doing it because you can't see yourself doing anything else

4- to summarize- work hard, don't go into medicine (ESP for the $), drive a shitty car for med school if you do, all of our reimbursements are being cut so our salaries are going down, win the lottery, the govt is always going to f&k you in taxes, get a wife in radiology, then buy a M
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      02-16-2013, 08:52 AM   #77
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I would honestly wait if I were you.
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      02-16-2013, 08:53 AM   #78
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Bimmer magazine had a mention of an older 5 series needing a fuel pump and it cost $8,600 because the entire gas tank had to be replaced. A friend talks re some light or sensor on his dad's 7 series that cost $3K to replace cause the dashboard had to come apart(this was after consulting several indie shops).

Phect- anything like this and you are PHUCT!
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      02-16-2013, 10:05 AM   #79
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I'm an anesthesiologist in the northeast. Don't go into medicine for the money!!! I've been in practice for 7 years and each year my salary has been declining at least 10 percent per year. At this rate I will be looking for a jeep pretty soon. I still make a decent amount of money but you need to be happy with what you do. I just happen to love sticking laboring woman with a 5 inch needle which is what I am doing tonight.
that's probably the only part of my practice that I could do without.
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      02-16-2013, 10:15 AM   #80
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To the OP here's my two cents

1- my loans are 220k, I went to a state med school and my 30 year payoff is 2k a month for those 30 years. I drove a 5 year old ford focus at the time and looking back waiting to get a BMW was worth it - I used it as motivation to work really hard to better myself to eventually get an M

2- if you're going into medicine for money (which it doesn't sound like you're doing but if you are) stay the hell away. You can make at shit ton more in business or finance- work one tenth as hard and not sacrifice anything. As a resident working 100 hr weeks (the 80 hr rule is bs and many residencies don't follow it- hell my family medicine residency didn't follow it) for 3 plus years gets really old quick and you sacrifice time away from family and friends

3- Some of the doom and gloom that everyone is talking is true but hard work can payoff. Medicine is changing quickly and I agree with everyone that ObamaCare will kill off the current system but pay for procedure based medicine needs to be changed anyways. The cuts are going to redirect money away from specialty care and direct towards primary care (I hope). Either way love what you do and make sure you're doing it because you can't see yourself doing anything else


4- to summarize- work hard, don't go into medicine (ESP for the $), drive a shitty car for med school if you do, all of our reimbursements are being cut so our salaries are going down, win the lottery, the govt is always going to f&k you in taxes, get a wife in radiology, then buy a M
Totally agree. You need to go into medicine because you love it. Hardwork does pay off in the end and like Larthal stated as a physician you will always make enough money to live comfortably. Now on the other hand any person going into medicine really needs to realize the amount of their future debt will be. Like you I went to a state school in NY and am paying.... to be exact $2,037.50 per month for the next 24 years, which really does make a significant impact on your lifestyle. It literally is a mortgage for a very nice house albiet without the house. Now you factor in kids, their school, living expenses and your actual mortgage and you really can put yourself into a rather tight situation. I really have to admit that Iam very envious of our foreign trained colleagues, who have ZERO student debt and basically pocket their full post tax salary.
Increasing taxes, with decreased reimbursments is a fact that we can not ignore. In regards to being hospital employed which appears to be the wave of the future, now that has its pros and cons. The hospital where I work provides base pay, malpractice and all over head, as well as an RVU based productivity system. Though through this model you will have a relative stable income it is at the cost of finacial autonomy which can be good but wont ever let your significantly exceed your salary as otherwise would a very productive private practice.
Healthcare reimbursments have always followed a rollercoaster like pattern so I have heard. Im sure some of the more seasoned physicians on this board can provided better insight into the reimbursments trends through out the years as Iam relatively young in the field to really give any info.
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      02-16-2013, 01:17 PM   #81
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Totally agree. You need to go into medicine because you love it. Hardwork does pay off in the end and like Larthal stated as a physician you will always make enough money to live comfortably. Now on the other hand any person going into medicine really needs to realize the amount of their future debt will be. Like you I went to a state school in NY and am paying.... to be exact $2,037.50 per month for the next 24 years, which really does make a significant impact on your lifestyle. It literally is a mortgage for a very nice house albiet without the house. Now you factor in kids, their school, living expenses and your actual mortgage and you really can put yourself into a rather tight situation. I really have to admit that Iam very envious of our foreign trained colleagues, who have ZERO student debt and basically pocket their full post tax salary.
Increasing taxes, with decreased reimbursments is a fact that we can not ignore. In regards to being hospital employed which appears to be the wave of the future, now that has its pros and cons. The hospital where I work provides base pay, malpractice and all over head, as well as an RVU based productivity system. Though through this model you will have a relative stable income it is at the cost of finacial autonomy which can be good but wont ever let your significantly exceed your salary as otherwise would a very productive private practice.
Healthcare reimbursments have always followed a rollercoaster like pattern so I have heard. Im sure some of the more seasoned physicians on this board can provided better insight into the reimbursments trends through out the years as Iam relatively young in the field to really give any info.
Da fuck? Thats nearly 600k
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      02-16-2013, 01:49 PM   #82
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I was wondering if there are any current or graduated med students here that could just lend a bit of advice. I'm hopefully going into med school soon and wondering how you paid for insurance, gas, and any other miscellaneous fees. I'm aware that loans are the main crutch. Although seeing as though whoever answers this has already experienced it, I just wanted to know if you had any advice without going too much into dept. Currently I'm about to go into the EMT field for some decent money and preparation for med school. But I doubt I will be able to continue that while I'm studying to be a doctor. I know the M3 is a relatively expensive car to maintain and curious on how you guys got through it. Thanks any replies in advance!
I didn't buy my m3 until after fellowship, after I started saving for retirement, after I started paying off my loans, after I bought a house, after I started saving for my kids college. My take home message is that an m car is very low on. He priority level when it comes to life. Don't work while in med school, you don't want to have to work to support a car that you will never use anyways and take you away from more important things like studying .... Keep your eye on the ball.
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      02-16-2013, 01:52 PM   #83
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Where did you borrow your money? Vegas? I have about $220,000 in med school debt and my monthly payment is $900.00. Yes it hurts but it's not $2000. I consolidated at a rate of 3.25% ... Down to 2.25% because I have made 36 on time payments. You are being ripped off, money is cheap right now, you need to refinance your loans. It's my cheapest debt and am making min payments until I get higher interest debt paid off first ......
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      02-16-2013, 01:58 PM   #84
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Originally Posted by jpan08 View Post
UConn Dental!
What a small world. I did my IM residency at Uconn. Though I must admit I hated any rotation at Dempsey. That place is so antique in regards to their computer system. You guys are pretty lucky nowadays with the way blue back square was redone. I feel like half of the NY Sports club members are Uconn dental kids. Are people still going to Murphys? Its been years..

But back to OP... Personally I wouldnt get into an M3 unless you have someone that is going to make sure the payments for the car and Insurance are going to be payed on time everymonth. I couldnt imagine having had to spend all that time concentrating on getting honors or doing well on the steps, knowing that I had to make sure the monthly finance/lease payment were going to be paid. You also have to consider that you are gonna spend all/most of your free time in class/lab/library and not really have time to enjoy your car. It really is relevant to you personal situation. Remember that the initial honeymoon period of ownership is great but once its over the monthly payments can really become a significant burden/ stressor.


I was at UCONN from 2002 to 2005, IM, not the primary care IM program at new Britain.... When were you there?
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      02-16-2013, 02:19 PM   #85
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I almost went to med school; went to law school instead (and became an intellectual property attorney). some days I think that I made the right decision, others I don't.

The grass is always greener, etc.

To the OP: med school is a monumental olibgation - an obligation that requires a lot of time (~10 years) and, unfortunately, an absurd amount of money (some schools are apparently now charging 70k a year in base med school tuitition?).

whether or not you should be buying a M3 should really be the last thing on your radar.
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      02-16-2013, 02:22 PM   #86
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Totally agree. You need to go into medicine because you love it. Hardwork does pay off in the end and like Larthal stated as a physician you will always make enough money to live comfortably. Now on the other hand any person going into medicine really needs to realize the amount of their future debt will be. Like you I went to a state school in NY and am paying.... to be exact $2,037.50 per month for the next 24 years, which really does make a significant impact on your lifestyle. It literally is a mortgage for a very nice house albiet without the house. Now you factor in kids, their school, living expenses and your actual mortgage and you really can put yourself into a rather tight situation. I really have to admit that Iam very envious of our foreign trained colleagues, who have ZERO student debt and basically pocket their full post tax salary.
Increasing taxes, with decreased reimbursments is a fact that we can not ignore. In regards to being hospital employed which appears to be the wave of the future, now that has its pros and cons. The hospital where I work provides base pay, malpractice and all over head, as well as an RVU based productivity system. Though through this model you will have a relative stable income it is at the cost of finacial autonomy which can be good but wont ever let your significantly exceed your salary as otherwise would a very productive private practice.
Healthcare reimbursments have always followed a rollercoaster like pattern so I have heard. Im sure some of the more seasoned physicians on this board can provided better insight into the reimbursments trends through out the years as Iam relatively young in the field to really give any info.
I'm not a fan of being a hospital employee. One of the biggest perks for me is autonomy. Not only financial, but personally. If I want to make more, I work more. If I want to take a vacation, I take it off. There's nobody telling me how hard to work or how to work. Also you know that the hospital is making money off you.

In my practice, the difference in pay from the lowest earner to the highest earner is astronomical. The guy who makes the most, takes a ton of call and goes to 3 separate locations. That's the way it should be. You should be rewarded for hard work.

A friend of mine is chief of Ortho at one of the Kaiser's in Cali. The problem there is that there are surgeons in his group who are barely working, but they all make the same. He says he can't fire them, because they are shareholders and have been there a long time. Over time it really builds up animosity between the physicians.

I paid off all my student loans in 1 1/2 years. I took call from my partners and was basically on call 5 of 7 days during the week. I was averaging 15 cases/week. I'm grateful that I was able to ramp it up to pay off those loans. I'm also grateful now that I can ramp down and live the lifestyle I see fit.
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      02-16-2013, 02:30 PM   #87
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Da fuck? Thats nearly 600k
umm..agreed. that's either a decimal point error or something went horribly wrong. with 160k in loans, i am at 700 per month. annoying, but not really something i have to financially plan around.
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      02-16-2013, 02:53 PM   #88
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Originally Posted by HighandDry View Post
I'm not a fan of being a hospital employee. One of the biggest perks for me is autonomy. Not only financial, but personally. If I want to make more, I work more. If I want to take a vacation, I take it off. There's nobody telling me how hard to work or how to work. Also you know that the hospital is making money off you.

In my practice, the difference in pay from the lowest earner to the highest earner is astronomical. The guy who makes the most, takes a ton of call and goes to 3 separate locations. That's the way it should be. You should be rewarded for hard work.

A friend of mine is chief of Ortho at one of the Kaiser's in Cali. The problem there is that there are surgeons in his group who are barely working, but they all make the same. He says he can't fire them, because they are shareholders and have been there a long time. Over time it really builds up animosity between the physicians.
I left my 'autonomous', fee for service, private practice group for Kaiser...I am a Chief at Kaiser...and while I agree with your point that the more you work (production) in fee for service equals more pay...I had partners that made more and less than me based on how much they wanted to work...and that our system at Kaiser can have the opposite effect...The reality is that with good Chiefs and leadership there is no better system. Shareholders can and do get fired...Pay and bonuses are withheld if you do not meet certain goals...and the 'model' you work in, and that I used to work in, is short-lived with Obamacare and ACOs around the corner...Work-Life balance is one of our mottos in our Permanente medical groups...For the most part 40hr work weeks...with health and malpractice insurance covered 100%, paid vacation, matched 401Ks, and a pension...plus many other benefits...We can practice patient-centered medicine and know that we have job, income, and retirement security...and leaving us plenty of time for our families, hobbies, etc...

I would be happy to discuss in more details the benefits of working at Kaiser with anyone...just PM me...
Sandman99 is offline   United_States
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