Income and Lifestyle

[Edict]

1 hour ago, booradley83 said:

This isn't an opulent lifestyle...........my point is that I expected life to be a lot easier after becoming an attending...............

Let's break it down a little further:

Expenses:

1. Considering that even a 1/2 livable POS house is $1 million - that's $4500 in mortgage payments

2. Fixed costs - Utilities/insurance/property taxes/car insurance/payment - $3k  - This assumes 2 reasonably nice cars for a husband/wife couple. (Toyota Sienna - $700 monthly; Toyota Camry $480 monthly; Car insurance - $600 monthly; Internet/tv-$160 Cell phone - $160 - Water - $40 Electric/gas - $300  Sewer/maintainence/miscellaeous - $600, car gas/maintaince-$400-500)  - WE ARE RIGHT OVER $3500

3. Spending money - $2000 (THIS IS EXTREMELY FRUGAL FOR MOST DOC FAMILIES) - Groceries/Food - 500-$1500, clothes/household essentials $200, 

4. Savings  - $2000 - FINE LET'S DO THE RRSP; THIS IS ESSENTIALLY NOTHING HERE............

 

HOW MUCH DO YOU HAVE LEFT OVER?  WHAT ABOUT CHILD CARE? WHAT ABOUT VACATIONS? WHAT ABOUT REAL SAVINGS?  WHAT ABOUT A FEW SPLURGES HERE AND THERE?

Most family doctors already lead an unbelievably good life, the fact that you have no boss, run your own small business that basically can't go bankrupt, choose your own hours, make 350k gross a year.... Please, contact CBC stat, your story must be heard....

[booradley83]

17 minutes ago, Edict said:

Most family doctors already lead an unbelievably good life, the fact that you have no boss, run your own small business that basically can't go bankrupt, choose your own hours, make 350k gross a year.... Please, contact CBC stat, your story must be heard....

Bro, 350k gross is billings................that's like 250k gross..............I don't know if this income is going to stay at this level forever; the government is making cuts and the 350k earnings gross is WORKING HARD.   Finish your Surgical residency and then talk...........it's not all easy peasy once you are out..........

Those are financing numbers on the cars BTW; not leasing..............it's a 5 year loan..............

Why would income go up relatively compared to the mortgage? If anything; the mortgage rates are at historic lows; the mortgage might go up................and the incomes might actually come DOWN with this stupid government..........

[brady23]

4 hours ago, goleafsgochris said:

 

Source: am a neurologist 2 years out, who makes more than a family dr but not a TON more (325-350k this year likely).

Is this 325-350k pre-tax and pre-overhead? 

 

[booradley83]

8 minutes ago, brady23 said:

Is this 325-350k pre-tax and pre-overhead? 

 

I'm assuming this is post-overhead..................pre-tax

[Edict]

24 minutes ago, booradley83 said:

Bro, 350k gross is billings................that's like 250k gross..............I don't know if this income is going to stay at this level forever; the government is making cuts and the 350k earnings gross is WORKING HARD.   Finish your Surgical residency and then talk...........it's not all easy peasy once you are out..........

Those are financing numbers on the cars BTW; not leasing..............it's a 5 year loan..............

Why would income go up relatively compared to the mortgage? If anything; the mortgage rates are at historic lows; the mortgage might go up................and the incomes might actually come DOWN with this stupid government..........

Okay, so your main complaint is, 250k is not enough? You are a business owner, there are plenty of tax benefits that come with it. Honestly, I'm not exactly sure what you expected when you applied to medical school, but in my estimation anyone making 250k is making plenty. You also simply cannot have it all. No, you cannot live in Bridal path, drive a ferrari, have a spouse who doesn't work and send two three kids through to private school while making it to the golf course with your buddies every weekend.

Look around you, a lot of healthcare professionals are struggling with a supply glut, some doctors cannot even find jobs, the vast majority of people work unstable jobs, fixed hours, have a boss that they may or may not get along with and still make only around 60-80k a year. If this is an issue for you, again, go to the CBC, please let the world know. Your struggles sound so real..

[F508]

ridiculous thread

I hope your preoccupation for money won't result in patient mismanagement for monetary gain

[Lactic Folly]

Yes, students who have worked in other careers prior to medicine often express a greater appreciation for the security and privilege it provides, compared to many other people who also work difficult hours in less desirable occupations for much less pay and job security.

[maplesyrup]

21 minutes ago, Lactic Folly said:

Yes, students who have worked in other careers prior to medicine often express a greater appreciation for the security and privilege it provides, compared to many other people who also work difficult hours in less desirable occupations for much less pay and job security.

I was going to say, I'm coming out of another career (hopefully) where I was going to be expected to work resident hours for $20,000 a year.

[BernieMac]

-

[rmorelan]

On 9/14/2018 at 9:05 PM, booradley83 said:

Bro, 350k gross is billings................that's like 250k gross..............I don't know if this income is going to stay at this level forever; the government is making cuts and the 350k earnings gross is WORKING HARD.   Finish your Surgical residency and then talk...........it's not all easy peasy once you are out..........

Those are financing numbers on the cars BTW; not leasing..............it's a 5 year loan..............

Why would income go up relatively compared to the mortgage? If anything; the mortgage rates are at historic lows; the mortgage might go up................and the incomes might actually come DOWN with this stupid government..........

well over the next 25 years I would say it would most likely go up unless doctors want to make 1/2 of what they are making now ha.  The mortgage rates can go up or down of course and int the short term may go up, but for most people long term their income will rise faster than their mortgage payments would. Like most things it is much harder starting off than longer term. 

Ahhh ok - those numbers happen to almost be exactly the standard lease rates for those cars as well. 

I would point out again just to be clear - none of this is really a family medicine issue. Important because people seem to sometimes avoid family medicine because they think the income is low. Not comparing apples to oranges if you do that   4-5 more years of training is a long time etc, etc. There really isn't much difference when you account for hours worked when done (the average family doctor works less than the average of most other things - we track that actually ), and cost of the extra training in a variety of ways, and potential savings during that difference in the training times. 

Eventually this spins around to what is the alternative? I mean most other jobs take a lot longer than 6 years post undergrad to high 250K in income. Granted there are loans, longer hours of training etc, etc but still. 

[booradley83]

7 minutes ago, rmorelan said:

well over the next 25 years I would say it would most likely go up unless doctors want to make 1/2 of what they are making now ha.  The mortgage rates can do up or down of course and int the short term may go up, but for most people long term their income will rise faster than their mortgage payments would. Like most things its it is much harder starting off than longer term. 

Ahhh ok - those numbers happen to almost be exactly the standard lease rates for those cars as well. 

I would point out again just to be clear - none of this is really a family medicine issue. Important because people seem to sometimes avoid family medicine because they think the income is low. Not comparing apples to oranges if you do that   4-5 more years of training is a long time etc, etc. There really isn't much difference when you account for hours worked when done (the average family doctor works less than the average of most other things - we track that actually ), and cost of the extra training in a variety of ways, and potential savings during that difference in the training times. 

Eventually this spins around to what is the alternative? I mean most other jobs take a lot longer than 6 years post undergrad to high 250K in income. Granted there are loans, longer hours of training etc, etc but still. 

Yeah my point is that after you become an attending....................I thought that I'd be able to live my lifestyle on 1/2 of this income...................you are right; there is no alternative and I'm definitely grateful for what I have......................it's just a weird feeling when you've "MADE IT" to still not feel like you have............and to still struggle..............

 

[medigeek]

Why don't you... not live in Toronto and also make more money. There are people doing that  Why not you? 

[indefatigable]

1 hour ago, rmorelan said:

I would point out again just to be clear - none of this is really a family medicine issue. Important because people seem to sometimes avoid family medicine because they think the income is low. Not comparing apples to oranges if you do that   4-5 more years of training is a long time etc, etc. There really isn't much difference when you account for hours worked when done (the average family doctor works less than the average of most other things - we track that actually ), and cost of the extra training in a variety of ways, and potential savings during that difference in the training times. 

But comparing what is probably the highest-paid specialty in ON, radiology, to FM shows a remarkably similar profile in terms of hours worked, call-time and even overhead according to the specialty profiles of the CMA.  Radiology is marginally higher, in terms of hours worked, but not by much.  Sure it's a five year residency and with possible fellowship(s), but given the great difference in staff income, at the very most after 10 years of work, the average radiologists would be greatly cumulatively out-earning the average FP in ON.  Sure, CMA numbers are an aggregate, but I definitely do think there can be quite a significant difference in income between different specialties.  
 

[rmorelan]

3 minutes ago, tere said:

But comparing what is probably the highest-paid specialty in ON, radiology, to FM shows a remarkably similar profile in terms of hours worked, call-time and even overhead according to the specialty profiles of the CMA.  Radiology is marginally higher, in terms of hours worked, but not by much.  Sure it's a five year residency and with possible fellowship(s), but given the great difference in staff income, at the very most after 10 years of work, the average radiologists would be greatly cumulatively out-earning the average FP in ON.  Sure, CMA numbers are an aggregate, but I definitely do think there can be quite a significant difference in income between different specialties.  
 

Sure but probably only for now - radiology's income will fall relatively and has been for the past 10 years - all while the work of radiology has continued to increase with more after hours work required. Not to say cry me a river etc but things are equalizing out a fair bit. That is something that not a lot of radiologists are happy about to say the least). Also only 2.5% of all doctors are radiologists so it isn't like there are an infinite number of spots there ha. 

The CMA profile of radiologist is a bit dated - well they are all a bit dated ha but radiology has been evolving faster than most fields. It is just that imaging is now so important that people really do need it 24/7 365. We lag but are starting to catch up to the US level of things where we need a system to handle these extra hour work flows. 

[rmorelan]

1 hour ago, booradley83 said:

Yeah my point is that after you become an attending....................I thought that I'd be able to live my lifestyle on 1/2 of this income...................you are right; there is no alternative and I'm definitely grateful for what I have......................it's just a weird feeling when you've "MADE IT" to still not feel like you have............and to still struggle..............

 

this is one area medical does tend to fall down a lot - we are always, always, always, putting things off until tomorrow in this field and ultimately that can magnify the reward at the end of things. It is a 15 year often pathway to follow - and not surprisingly having something to look forwards too is important. So we don't really do anything to suggest things won't be much better as staff as that is the final goal. Helping create a clear understanding of how things are I think is important. There will always be something that has to give somewhere.

[indefatigable]

4 minutes ago, rmorelan said:

Sure but probably only for now - radiology's income will fall relatively and has been for the past 10 years - all while the work of radiology has continued to increase with more after hours work required. Not to say cry me a river etc but things are equalizing out a fair bit. That is something that not a lot of radiologists are happy about to say the least). Also only 2.5% of all doctors are radiologists so it isn't like there are an infinite number of spots there ha. 

The CMA profile of radiologist is a bit dated - well they are all a bit dated ha but radiology has been evolving faster than most fields. It is just that imaging is now so important that people really do need it 24/7 365. We lag but are starting to catch up to the US level of things where we need a system to handle these extra hour work flows. 

That's speculation on the income level - no doubt the incomes could fall, but radiologists are going to clearly fight that.  For sure radiologists aren't the largest contingent of physicians, but I was responding to your comment regarding work-load and income level, etc..  This relatively small group does dominate the headlines when it comes to income.  

 I looked at latest profile, which was 2018 - could be it's based on aggregate info which somehow doesn't reflect some of the realities, and no doubt new technology is being introduced, but there are many other acute care specialties, which also have high demands.  

[Wachaa]

Not that hard actually. Just bill higher. Find your extra $50k.

That's one of the best things about fee for service. You do more service, get more money.

[rmorelan]

3 minutes ago, tere said:

That's speculation on the income level - no doubt the incomes could fall, but radiologists are going to clearly fight that.  For sure radiologists aren't the largest contingent of physicians, but I was responding to your comment regarding work-load and income level, etc..  This relatively small group does dominate the headlines when it comes to income.  

 I looked at latest profile, which was 2018 - could be it's based on aggregate info which somehow doesn't reflect some of the realities, and no doubt new technology is being introduced, but there are many other acute care specialties, which also have high demands.  

oh sure - it is a bit of speculation. But there have been a series of targeted reductions above all the other specialties for a few specific fields, including in particular radiology, over the several years and relative income for radiology has noticeably fallen as a result. They have been of course trying to fight that but not exactly successfully. Ha, in fact one way they have dealt with it is to work harder - which has limits and increased burnout in radiology quite a bit. It is in large part as you rightly point out it dominates the headlines (which is the exact opposite of what most radiologists want) that is increasingly vulnerable to being cut. 

Point I guess was so much what will happen to radiology but more that simply trying to go to one of these fields on the basis of high income is a lot more risky than it is often made out to be. Any income difference is not at all stable as it were

[booradley83]

8 minutes ago, Wachaa said:

Not that hard actually. Just bill higher. Find your extra $50k.

That's one of the best things about fee for service. You do more service, get more money.

I wish it was that easy buddy!  Billing $350k already requires a full-time committment..................it's already bordering on rushing patients out and doing a sloppy job sometimes...........

[Wachaa]

14 minutes ago, booradley83 said:

I wish it was that easy buddy!  Billing $350k already requires a full-time committment..................it's already bordering on rushing patients out and doing a sloppy job sometimes...........

I don't mean to put it bluntly but do you think the Ophtho or Derm aren't working full time or rushing patients out?

The examples given above for derm seeing a patient every 5 minutes or ophtho seeing a 10+ patients an hour and then bringing them back in 6 months to repeat the whole process. Or how about during surgery rounds when you go through 20+ patients in 1-2 hours.

In a fee for service model if you can't extend your work hours then you have to work more "efficiently". It's not necessarily sloppy either. It doesn't take that long to look at a rash or an eyeball. The patient can give a 2 minute or 20 minute story about their progressively declining vision when they watch TV... but if it's a non-significant early cataract with no other ocular findings then it's goodbye. In family practice if patient comes in for med refill - print the prescription, give them their test result, 5-10 minutes is plenty. Each day should have 20+ of those patients per day.

[booradley83]

32 minutes ago, Wachaa said:

I don't mean to put it bluntly but do you think the Ophtho or Derm aren't working full time or rushing patients out?

The examples given above for derm seeing a patient every 5 minutes or ophtho seeing a 10+ patients an hour and then bringing them back in 6 months to repeat the whole process. Or how about during surgery rounds when you go through 20+ patients in 1-2 hours.

In a fee for service model if you can't extend your work hours then you have to work more "efficiently". It's not necessarily sloppy either. It doesn't take that long to look at a rash or an eyeball. The patient can give a 2 minute or 20 minute story about their progressively declining vision when they watch TV... but if it's a non-significant early cataract with no other ocular findings then it's goodbye. In family practice if patient comes in for med refill - print the prescription, give them their test result, 5-10 minutes is plenty. Each day should have 20+ of those patients per day.

 

You don't bill $350k by not doing EXACTLY what you are talking about here. I live this ^^^^^^^ But I'm not interested in extending my work hours/patient load at this time......................the whole point of the thread is that even making a comfortable income; it's not an easy life without any financial worry..........

[booradley83]

The average family doctor in my group; and in my network is billing 300-400k annually........................the ones who are billing 400k annually are doing things that I DON'T WANT TO DO............I'm not interested in seeing 40-50 patients day in and day out.....................for 51 weeks a year....................

I see about 35-40 patients; and I work about 48 weeks............

[rmorelan]

8 hours ago, booradley83 said:

The average family doctor in my group; and in my network is billing 300-400k annually........................the ones who are billing 400k annually are doing things that I DON'T WANT TO DO............I'm not interested in seeing 40-50 patients day in and day out.....................for 51 weeks a year....................

I see about 35-40 patients; and I work about 48 weeks............

Yeah there are limits to working harder, getting more patients, in my case reading more studies or whatever to up your income. It can definitely be done but it isn't as automatic at sometimes it is made out to be. It also is one of the big reasons burnout can happen as well - which sneaks up on people. 

[goleafsgochris]

12 hours ago, booradley83 said:

I'm assuming this is post-overhead..................pre-tax

Yep, pre-tax post-overhead.

[GrouchoMarx]

being forced to work for free is a bigger source of burnout than working more and getting paid for that work.

in ontario pathologists dont even get paid to be on call.  residents in pathology get more pay for their call work than the staff do! 

the job markets bad enough in ontario that the only place thats consistently advertising positions is thunder bay, and i cant imagine being stuck there on a weekend without being able to drink myself into a coma, let alone not being paid for it!

the paradigm that pathologists lead idyllic lives is one of times past. government and admin pressures coupled with an overabundance of insourced cheap labor from india/pakistan/other has made the field one where you are looking over your shoulder constantly as your replacement may be just around the corner.