Money, Prestige, and Lifestyle

[medigeek]

honestly, he's trying to help you, seriously, the last thing you want to do is be in 4th year med, hating every moment of it, and 150 k in dept... after pre-clin, life can be a living hell at times, and you've got to go through this for 7+ years, in addition to 6 years of pre-clin, and undergrad, thats 2/3's of the years you've lived, i don't think doctors are prestigious by any means, dealing with blood, guts, ****, suicides, screaming babies and occasionally death death all day, working inane hours on little sleep, it can be a rough life, on the other hands, i absolutely have the utmost respect for good docs who are also good people, respect and prestige, while sounding similar, are very different concepts, prestige means something different to everyone, i don't even know if i can even conceptualize prestige, what the hell is it? i'd feel comfortable sitting down with barrack and having a convo about foreign policy, he's just a human being, everyone is, watch rock stars videos on their tour busses, they're on their macbook's like i am right now, to be honest, i really look up to some of the big nano-tech guys here, foucault, nietschze, sarte, churchill, jack layton, steve jobs, deepak chopra, tim leary, ron paul (even though i don't agree with a lot of what he has to say), tim thomas comes to mind as a favourite because of his unwavering dedication, confidence in himself, and not-take-himself-too-seriously attitude to life, i've always looked up to richard kruspe from rammstein because of his openness about his insecurities and fears, despite the fact that woman view him as a sex god, that takes a lot of courage... if you want a sense of earnestness, i even respect dawkins, who argues gibberish, that's highly dogmatic, and philosophically weak, however, he has a better vocabulary than me, and speaks very well, in terms of his language, i watch a lot of his documentaries just to pick up on his speaking skills, even though his philosophical arguments are asinine

 

doctors also don't have the same prestige they use too, when i go to my fam doc, i usually have spent countless hours researching and know more about the issue than they do since they have to be mechanics for such a wide variety of things, the internet is really undermining the reverence we used to have for physicians, my adhd doc and me have conversations as equals and often explain complex topics too each other, there's not a hint of the traditional paternalism and reverence of the 60's, i can read ekg's (and have reference material i can look too since i understand the underlying theory), interpret abnormalities in my blood work just as well as my fp can, the only difference may be in physical exams skills, besides that i can teach everything they cursorily know to myself in detail.

 

i'm actually interested in this topic quite a bit, i have a real respect for 3 doctors that have treated me in my life, because they were good, and really kind, so having an md may be a necessary, but not sufficient clause for being viewed as prestigious (i think we're moving to an era where the individual physician is deemed as prestigious, rather than just having the md, especially with the heralding in of the information age.).

 

also, just because i'm not in medicine doesn't mean i don't read all my old med books (i think i prob have more than most med students, although my toronto notes is outdated), i don't necessarily trust all docs, some are good, some are hacks, and i want to be able to advocate for my own health... and if that means a hundred hours reading about a topic, so be it... i'm not sure, maybe it's my obsessive personality, i'm probably not a good representation of the average person in the population, but i think some of the generalities i bring up are certainly valid.

 

Well if I end up hating medicine, I may as well not bother working and be a bum... cause this is the only career I could ever do (after researching every legit field). debt is not an issue for me because parents are paying me all the way through, so I'm fine.

 

Also, why are you on this forum if you're not into med? constantly posting huge blocks of text.

[futurepediatric]

 

AH! soooooooooo cuteeeeeeeeeee hahaha

[medigeek]

The internet can be a great resource for patients and sometimes helps them help the doctor. Most of the time I think it just leads to patients coming in and thinking they have a variety of rare diseases. Someone told me that they had a patient come in and wanted testing for von willebrand deficiency because their periods were heavy.

 

No amount of internet knowledge can replace 4 years of medical school + residency and the actual hands-on clinical training where you actually put all that overwhelming knowledge together into a coherent package.

very true...but the average person doesnt even understand medical terminology so usually its irrelevant. Hence why walk in clinics are filled with people with colds.

I LOL'd at this thread.

 

I find it funny that making $200K per year is worth the 10+ years of studying, personal sacrifices and several thousands in debt.

 

Hell, owning a couple Tim Horton's franchises will make you more $$ the the average doctor.

 

My dad actually started in science because his parents wanted him to be a doctor but when he realized he couldn't stand the sight of blood he went a different way.He got his CA and now makes approx $800K/year. He also has several million in assets. And when you think that he's a rare case, he really isn't!

 

Look, don't get me wrong, the income you make as a doctor once done school, residency etc will certainly make you comfortable, but it won't make you really rich. To be honest, I don't think any of my dad's pre-med friends who ended up as doctors make more than he does. But plenty of his CA friends do - or much more.

 

But am I the only one who thinks that money shouldn't be a driver in becoming a doctor??? Its a HARD job, requires long hours, constant studying (doesn't medicine becomes obsolete every 5 years?) and a lot of sacrifices. Doctors have higher than average instances of depression, suicide and divorce. Is a measly $200K per year worth all that???

 

If you want to be a doctor you should really do it because of the love of the job. Because you can't imagine doing anything else. Something that you would do even if you got paid only $50K per year.

 

Well... tell that to this guy:

 

http://www.teamspeed.com/forums/garage-forum/38204-moved-into-new-garage-pics.html

 

(and he's only 38!)

 

but anyway... dont you need like 500k raw before getting a timmies?

And your dad's a rare exception, as in, he's more rare than someone who finishes a ROAD specialty with 0 dollars in debt.

It's all about the spread.

 

CAs have a huge spread. The ceiling is unlimited but the average income is less than six figures. Your dad is probably rarer than you think.

 

Medicine is fairly consistent. Few doctors if any earn less than six figures. On a per hour basis much of this is no better than being a teacher, which is why the ROAD (and i foresee path and radonc in the future) has so much competition right now.

this

You are absolutely right. The spread is much bigger. But I guess the point I'm trying to make is I don't get how anyone can go into medicine because of money being a main factor. You really can make a LOT of money in a LOT of different professions in a much simpler way.

 

I feel its actually quite sick and disgusting for people to put themselves through all that is required to become a doctor for just $200K per year. And besides, of graduating doctors how many ACTUALLY end up in ROAD?

The reason I want to do it is because I feel passionate about it (for various reason) but money is really one of the bottom priorities - don't get me wrong I want to be able to provide for my family but if money was a driving factor I'd totally put that drive and focus into something much more lucrative, where I wouldn't cap out at $200-300K per year (and deal with the insane pressures, higher risk of divorce, depression, insane hours etc).

lots of doctors make A LOT more than 200k/year, 200k/year is actually BELOW just the AVERAGE income of an MD in Ontario. I provided the link a few pages ago.

There seems to be a highly disproportionate number of super rich people on this board who love to bring up the notion, at every opportunity, that they could be easily be multimillionaires, but are going into meds cause they just love being helpers oh so much. Are there such people? Sure, but even so why would so many of them feel the need to bring up their circumstances on this board?

if one were thinking critically, they'd think half the people on here are full of sh*t.

[medigeek]

Actually, most Olympic athletes make very little money. You have to either be A)really hot or B)win a bunch of medals. Preferably both.

 

 

 

In my sport (track and field), there's quite a few sprinters with big sponsorshis and constantly getting 20-30k appearance wises on top of 50-60k for winning. Dont have to be usain bolt.

[medigeek]

It's just funny how people compare the average doctor salary to the top 5% of other professions. Comparing average salaries, MDs triple most things like engineering, chiro, physio, etc.

[BrendanJ]

http://en.m.wikipedia.org/wiki/Narcissistic_personality_disorder

[apache]

because i enjoy medical ethics, public health policy, anthropology and sociology of medicine, medical corruption, issues concerning imgs, and enjoy some peoples opinions on certain topics and writing about them. there's a lot more to medicine than being a doctor, and i'm really interested in a lot of the more broad scale issues that traverse health, economics, the intertwine between medicine and industry. read foucault on medicine and you'll get a lot of my interest. plus those huge blocks of text take me like 10 minutes to write, so it's not as big a time kill as you'd think.

 

Well if I end up hating medicine, I may as well not bother working and be a bum... cause this is the only career I could ever do (after researching every legit field). debt is not an issue for me because parents are paying me all the way through, so I'm fine.

 

Also, why are you on this forum if you're not into med? constantly posting huge blocks of text.

[rmorelan]

It's just funny how people compare the average doctor salary to the top 5% of other professions. Comparing average salaries, MDs triple most things like engineering, chiro, physio, etc.

 

At least triple is some cases

 

of course that being said it is more likely that someone capable of getting into medicine would also be capable of getting the higher levels of pay in other fields as well - or at least that seems logical to me.

[DOC_Ma]

You are absolutely right. The spread is much bigger. But I guess the point I'm trying to make is I don't get how anyone can go into medicine because of money being a main factor. You really can make a LOT of money in a LOT of different professions in a much simpler way.

 

I feel its actually quite sick and disgusting for people to put themselves through all that is required to become a doctor for just $200K per year. And besides, of graduating doctors how many ACTUALLY end up in ROAD?

 

The reason I want to do it is because I feel passionate about it (for various reason) but money is really one of the bottom priorities - don't get me wrong I want to be able to provide for my family but if money was a driving factor I'd totally put that drive and focus into something much more lucrative, where I wouldn't cap out at $200-300K per year (and deal with the insane pressures, higher risk of divorce, depression, insane hours etc).

 

 

So your dad makes 800k a year because he owns a business and you compared that to the salary of 200k? First of all, your dad is probably a super rare case. But even if I give you the benefit of doubt, lets say he is not that rare, 800k can be achieved by a LOT of specialties in medicine provided they practice by the time they reach your dad's age. Just off the top of my head Ophthalmology makes well over 1 million, Radiology makes around there etc. Also the average docs salary is NOT 200k jesus even fm makes more than that on average in Ontario and a LOT of them work part time as well. And if you want stats just simply look at the average income of the two professions. Also if you bring the argument that docs work super hard (true) then I gotta say if you wanna make the same kinda income as docs in other fields you probably will end up working as just hard if not harder (lawyers, investment bankers, etc). Lastly the risk of you not making docs income in other specialties is much much higher than when you actually get into med school (unless you do something huge otherwise you are guarenteed to make such income). Now I don't want you to get the wrong impression, all I am saying is there's money in medicine and everyone knows about it but most of them are afraid to talk about it in medicine for various reasons. One should always choose interest over money if the two conflicts, BUT if you have choices for a few professions and the pay varies quite a bit who would choose the one that pays less?

[larva]

This is from the link that medigeek posted: (http://www.cmaj.ca/content/170/5/776.1.full.pdf)

 

When the overhead estimates are applied to the CIHI gross billings, estimated 2001/02 average net incomes (before taxes) from fee-for-service payments were $124 103 for family physicians, $167 750 for medical specialists and $209 184 for surgical specialists. Net income is estimated at $183 775 for all specialists combined and $148 674 for all physicians

 

These aren't crazy salaries. Just wondering what information I'm missing. (For the record I'm being serious. I haven't looked into physician salaries much, I always just assumed I'd be making around 150 as family, which seems mostly in line with these figures)

 

Also, I agree with kasinut and rmorelan that most people in medicine are capable of making as much or more in other fields if they really wanted to. The whole "medicine vs everything else in the world" argument doesn't really work, because motivated smart people can do well in almost anything they choose. Perhaps that is why the number of people on this board who are "super rich" may seem to be disproportionate. Compared to the average, I'm sure it is.

[deeman101]

Well... tell that to this guy:

 

http://www.teamspeed.com/forums/garage-forum/38204-moved-into-new-garage-pics.html

 

(and he's only 38!)

 

I spy kentucky license plates. The US is a whole 'nother realm. Where if you're not scholarship smart, or you can't convince a bank to give you half a mil over 8yrs in loans, you absolutely need loaded parents to finance your way through UG+med. I suspect this guy has loaded parents.

 

but anyway... dont you need like 500k raw before getting a timmies?

And your dad's a rare exception, as in, he's more rare than someone who finishes a ROAD specialty with 0 dollars in debt.

 

All good businesses start with investors or a loan. No one throws down cash they hid under the mattress.

 

lots of doctors make A LOT more than 200k/year, 200k/year is actually BELOW just the AVERAGE income of an MD in Ontario. I provided the link a few pages ago.

 

if one were thinking critically, they'd think half the people on here are full of sh*t.

 

You need to read that link you provided more carefully. Specifically the last paragraph:

 

When the overhead estimates

are applied to the CIHI gross

billings, estimated 2001/02 average

net incomes (before taxes)

from fee-for-service payments

were $124 103 for family physicians,

$167 750 for medical specialists

and $209184 for surgical

specialists. Net income is estimated

at $183 775 for all specialists

combined and $148 674 for all

physicians. — Lynda Buske, Associate

Director of Research, CMA

 

According to your article only surgeons make the 200+k that you keep talking about (of course surgery also has the worst lifestyle of any specialty). Specialists avg 184k, FM is 124k, and avg for all doctors is 149k. I don't think you realize this but docs have overhead to pay. Especially radiologists and obstetricians (imaging equipment costs and insurance respectively). And especially in ON with the OMA.

 

I'll try to help your clearly lost cause though. Here is QC's payouts in 2009: http://www.google.ca/url?sa=t&rct=j&q=statistiques%20salariales%20medicale%202010&source=web&cd=1&ved=0CCcQxQEwAA&url=http%3A%2F%2Fdocs.google.com%2Fviewer%3Fa%3Dv%26q%3Dcache%3AjiWbYyW_NkMJ%3Awww.santeinc.com%2Ffile%2Fnov10-06.pdf%2Bstatistiques%2Bsalariales%2Bmedicale%2B2010%26hl%3Den%26gl%3Dca%26pid%3Dbl%26srcid%3DADGEESjnPqtL7_Hxm1foptg_0Rcol2fZ3NxQY7-6l2in_mk-beoHGKdnAuVJz_YIblBol1P2vJkEHUHY__4-dQit5-dpukNT4jkhgDDV8tGnQKEq6zL5K4kB-7JnobzZjMLiVB5TwwEd%26sig%3DAHIEtbRcmo5Sl0ZnN38QM8mamFi-rU_a0Q&ei=_z7YTqbcLcbi0QGd1YHuDQ&usg=AFQjCNEAy-fdkmFxOxNb0jO9oQ66dw9ivA&sig2=fkM_hT4XhsNPkFQGmw_2fw&cad=rja

 

Go to pg 4 and check out radiology. You can't do that in ON. Learn some French and come to Montreal.

 

 

EDIT: Dammit larva! You stole my thunder!

 

EDIT2: And along with what larva said, you're competing against a pretty smart bunch of people in this field. Takes quite a bit to rise to the top of whats already a talented heap.

[medigeek]

This is from the link that medigeek posted: (http://www.cmaj.ca/content/170/5/776.1.full.pdf)

 

 

 

These aren't crazy salaries. Just wondering what information I'm missing. (For the record I'm being serious. I haven't looked into physician salaries much, I always just assumed I'd be making around 150 as family, which seems mostly in line with these figures)

 

Also, I agree with kasinut and rmorelan that most people in medicine are capable of making as much or more in other fields if they really wanted to. The whole "medicine vs everything else in the world" argument doesn't really work, because motivated smart people can do well in almost anything they choose. Perhaps that is why the number of people on this board who are "super rich" may seem to be disproportionate. Compared to the average, I'm sure it is.

 

http://www.premed101.com/forums/showthread.php?t=57954&page=2

 

http://www.premed101.com/forums/showthread.php?t=57083&page=10

 

If you do it right, you can make >400k/year as an FM. you're actually maybe 20x more likely to make that much compared to the odds of making that much in other fields.

[Kasiunut]

So your dad makes 800k a year because he owns a business and you compared that to the salary of 200k? First of all, your dad is probably a super rare case. But even if I give you the benefit of doubt, lets say he is not that rare, 800k can be achieved by a LOT of specialties in medicine provided they practice by the time they reach your dad's age. Just off the top of my head Ophthalmology makes well over 1 million, Radiology makes around there etc. Also the average docs salary is NOT 200k jesus even fm makes more than that on average in Ontario and a LOT of them work part time as well. And if you want stats just simply look at the average income of the two professions. Also if you bring the argument that docs work super hard (true) then I gotta say if you wanna make the same kinda income as docs in other fields you probably will end up working as just hard if not harder (lawyers, investment bankers, etc). Lastly the risk of you not making docs income in other specialties is much much higher than when you actually get into med school (unless you do something huge otherwise you are guarenteed to make such income). Now I don't want you to get the wrong impression, all I am saying is there's money in medicine and everyone knows about it but most of them are afraid to talk about it in medicine for various reasons. One should always choose interest over money if the two conflicts, BUT if you have choices for a few professions and the pay varies quite a bit who would choose the one that pays less?

 

Look, I don't disagree with you that doctors can make a lot of money. But not every doctor is going to get into ROAD.

 

Plus, while my dad makes less than some of the doctors you listed above, he doesn't work as hard. He has not missed a SINGLE one of my or my sisters birthdays, has always been able to take time off for all our school holidays and important milestones (granted I know that if he were a lawyer or i-banker this wouldn't be the case). Does he get stressed out sometimes? Absolutely. Does he ever put in late hours? Of course.

 

But he also doesn't have to live with the knowledge that he killed someone (as many doctors do) or worrying if he ever will. He hasn't had to tell someone that their loved one is dying. He doesn't have to live with the burden of the secrets many doctors have to keep (incest, rape, child abuse etc) that many doctors do. Being a doctor is HARD work. In my opinion, I think that is much harder than working a 100 hour work week in the office, pouring over legal documents or financial reports.

 

That is why I get so annoyed when I hear about people wanting to go into medicine because it will make them rich. First of all, if they are that smart, they will likely make a lot of money (or at least almost as much depending on the specialty) as they would as a doctor. And if they are so shallow as to care about money more than about being a good doctor (which requires so much personal sacrifice) than how are they going to be able to deal with all that ugly side to being a doctor in the long run? Worse, how are the patients going to deal when they end up with that kind of *******?

 

Look, I'm not saying that a person won't do well financially as a doctor. Of course they will. I'm not even saying its not important. Hell, I think that doctors deserve to get paid a lot because of all they need to deal with. But it just shouldn't be the main reason. If someone's main goal is to make a lot of money than medicine shouldn't be their first choice. In fact, it shouldn't be a choice at all.

 

That being said I think that most people who make it to medical school are people who deserve to be there and really want to do a lot of good.

[medigeek]

I spy kentucky license plates. The US is a whole 'nother realm. Where if you're not scholarship smart, or you can't convince a bank to give you half a mil over 8yrs in loans, you absolutely need loaded parents to finance your way through UG+med. I suspect this guy has loaded parents.

 

 

 

All good businesses start with investors or a loan. No one throws down cash they hid under the mattress.

 

 

 

You need to read that link you provided more carefully. Specifically the last paragraph:

 

When the overhead estimates

are applied to the CIHI gross

billings, estimated 2001/02 average

net incomes (before taxes)

from fee-for-service payments

were $124 103 for family physicians,

$167 750 for medical specialists

and $209184 for surgical

specialists. Net income is estimated

at $183 775 for all specialists

combined and $148 674 for all

physicians. — Lynda Buske, Associate

Director of Research, CMA

 

According to your article only surgeons make the 200+k that you keep talking about (of course surgery also has the worst lifestyle of any specialty). Specialists avg 184k, FM is 124k, and avg for all doctors is 149k. I don't think you realize this but docs have overhead to pay. Especially radiologists and obstetricians (imaging equipment costs and insurance respectively). And especially in ON with the OMA.

 

I'll try to help your clearly lost cause though. Here is QC's payouts in 2009: http://www.google.ca/url?sa=t&rct=j&q=statistiques%20salariales%20medicale%202010&source=web&cd=1&ved=0CCcQxQEwAA&url=http%3A%2F%2Fdocs.google.com%2Fviewer%3Fa%3Dv%26q%3Dcache%3AjiWbYyW_NkMJ%3Awww.santeinc.com%2Ffile%2Fnov10-06.pdf%2Bstatistiques%2Bsalariales%2Bmedicale%2B2010%26hl%3Den%26gl%3Dca%26pid%3Dbl%26srcid%3DADGEESjnPqtL7_Hxm1foptg_0Rcol2fZ3NxQY7-6l2in_mk-beoHGKdnAuVJz_YIblBol1P2vJkEHUHY__4-dQit5-dpukNT4jkhgDDV8tGnQKEq6zL5K4kB-7JnobzZjMLiVB5TwwEd%26sig%3DAHIEtbRcmo5Sl0ZnN38QM8mamFi-rU_a0Q&ei=_z7YTqbcLcbi0QGd1YHuDQ&usg=AFQjCNEAy-fdkmFxOxNb0jO9oQ66dw9ivA&sig2=fkM_hT4XhsNPkFQGmw_2fw&cad=rja

 

Go to pg 4 and check out radiology. You can't do that in ON. Learn some French and come to Montreal.

 

 

EDIT: Dammit larva! You stole my thunder!

 

EDIT2: And along with what larva said, you're competing against a pretty smart bunch of people in this field. Takes quite a bit to rise to the top of whats already a talented heap.

 

Well according to an actual doctor on this forum, there is extreme potential to make big cash. Check out the links I provided. It goes like this:

 

See 40-60 patients per day

Bill minimum of 30$ (actually 34$) each, sometimes more, sometimes a lot more

End the 8 hour day

Make over 400k/year

 

 

And that guy I linked to, his friend is on SDN (an EM resident) and although he had minimal debt, he achieved that off EM alone (making under 400k/year, before taxes and everything else) at the age of 38 now.

[deeman101]

Well according to an actual doctor on this forum, there is extreme potential to make big cash. Check out the links I provided. It goes like this:

 

See 40-60 patients per day

Bill minimum of 30$ (actually 34$) each, sometimes more, sometimes a lot more

End the 8 hour day

Make over 400k/year

 

 

And that guy I linked to, his friend is on SDN (an EM resident) and although he had minimal debt, he achieved that off EM alone (making under 400k/year, before taxes and everything else) at the age of 38 now.

 

 

Obviously you didn't see my link there.

 

And 400k will NEVER get you what that guy has. Either that or hes financed everything for 35 yrs. One of those cars is 400k alone (the carrera GT).

 

And you're still ignoring the overhead. Try something along the lines of 75k/yr as an obstetrician in malpractice insurance. They you gotta pay out to CMA, then your provincial organization, and so on.

[larva]

http://www.premed101.com/forums/showthread.php?t=57954&page=2

 

http://www.premed101.com/forums/showthread.php?t=57083&page=10

 

If you do it right, you can make >400k/year as an FM. you're actually maybe 20x more likely to make that much compared to the odds of making that much in other fields.

 

From what I read in those threads, >400K in FM would mean working a heck a lot harder than I ever intend to work

[medigeek]

Obviously you didn't see my link there.

 

And 400k will NEVER get you what that guy has. Either that or hes financed everything for 35 yrs. One of those cars is 400k alone (the carrera GT).

 

Who said you can't get into investments while being a doctor and get rich off of that?

[deeman101]

Who said you can't get into investments while being a doctor and get rich off of that?

 

Who says you can't get into investments while being a taxi driver and get rich off of that?

 

 

^ true story, NY taxi driver became a millionaire. Moral: we should all drive a cab in NY.

[aaronjw]

Who said you can't get into investments while being a doctor and get rich off of that?

 

I think you come here to engage in some debate because your parents are sick of listening to you. Afterall, reading what you write is annoying enough that living with it must be pure hell.

[medigeek]

From what I read in those threads, >400K in FM would mean working a heck a lot harder than I ever intend to work

 

I didn't read anything other than a typical workday, working 8 hours or so. It is hard work seeing patients with high frequency and good quality, but it's a crapload less work becoming rich in any other field.

[medigeek]

Who says you can't get into investments while being a taxi driver and get rich off of that?

 

 

^ true story, NY taxi driver became a millionaire. Moral: we should all drive a cab in NY.

 

The taxi cab driver has less to work with, and if sh*t hits the fan, he has less money (salary money) to back him up.

[markov79]

medigeek,

 

i still don't understand how you find time to post here with such a frequency lol. i recognize that most of your posts are done at night and are short and such, but still, HOW DO YOU DO IT?!?!?!

[TheBoss]

Without some semblance of agreement on the degree of success med students would have in other fields, attempting to determine whether medicine is a good choice in the pursuit of wealth is futile

 

Perhaps that is why the number of people on this board who are "super rich" may seem to be disproportionate. Compared to the average, I'm sure it is.

 

Not just rich, but rich and wanting to express on the internet their desire to enter medicine and forgo alternate riches

[apache]

You're so important the president himself personally read this thread and has something to say:

 

[futurepediatric]

Without some semblance of agreement on the degree of success med students would have in other fields, attempting to determine whether medicine is a good choice in the pursuit of wealth is futile

 

 

 

Not just rich, but rich and wanting to express on the internet their desire to enter medicine and forgo alternate riches

 

Part of it is prob in response to the people talking about how 'rich and prestigious' doctors are