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My random thoughts on Money


ghost dog

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I was just perusing the salary thread, and couldn't help but think of a few docs at a large clinic down the street from my office.

 

One doc bills a ridonculous amount (I'm talking around $600 - 700,000 / year). He spends his money on a brand new porsche every year (and not a low end one either). This guy is an absolute work horse, killing himself at the walk in clinic + his own family pts working 6 days / week doing god knows how many hours. I don't think he has taken a day off in years.

 

A friend of mine working at this clinic bills around $ 300,000 with pretty reasonable hours. He works about 40 hours / week seeing 30 pts / day, and does the walk in clinic 1 - 2 days / week. The family health network model will increase his billings considerably this year.

 

I ask myself: why the hell is doc #1 killing himself like this ? It seems absolutely ludicrous (to me at least) for a person to have this sort of schedule ? This type of "conspicuous consumption" lifestyle doesn't necessarily translate into happiness (or at at least it wouldn't for me). I'd be to damn tired to enjoy it. I would think burn out would also play a significant factor in this guy's work ; I know it would if I was in his shoes. I don't think I would be able to keep this up for a week.

 

Anyways, I guess the message for students thinking of family practice is that the renumeration is generally pretty good.

 

That, and money does not = happiness.

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I agree.

 

Making more money just means you spend more. Doesn't make you happier.

 

You will live comfortably, as a doctor, I guarantee you, even if you work like the second guy (or are even lazier). Even if you live in a place like Vancouver.

 

Life is pretty sweet when you're choose between a Mercedes, a BMW, an Audi, and a Porsche.

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To quote Mr. West:

 

"Money isn't everything. Not having it is."

 

Yeah, as a mathematician, I would say, money is a necessary but not sufficient condition for happiness.

 

But as a doctor, trust me, the money you make will satisfy the necessity condition.

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Heard the sweet sound coming from a Porsche 997.2 GTS as I was driving to work last week. The things I would do to own one of those beauties. What a rear end! But I digress...

 

Seriously, maybe doc #1 is actually happy with his porsches, mansion and trophy wife?

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You're probably right. I'm still poor. Started off poor. I'll tell you if I agree when I finally have positive income.

 

 

My theory is that there are three strata to wealth:

 

1. The super poor: when you can't buy the basic necessities AND have a little left over to enjoy your life, you're in rough shape.

 

2. The middle class: this includes doctors. Enough money to be comfortable, even enough to weather some disasters, but not enough to declare total freedom. Even the richest doctor can't just quit his job and hop on a plane to travel the world for the rest of his life.

 

3. The rich: These people could just say to hell with it all, hop on a plane to Monaco, buy a Ferrari and bet six figures on poker on a daily basis, and not blink an eye. Total freedom.

 

Medicine, like most professions, leaves you at middle class. Rich people are basically only pro ballers, royalty, actors and musicians, hedge fund marvels and super-rich entrepreneurs and CEOs.

 

I was in the first group of people. Mom worked two jobs, Dad nowhere to be found. Mom selfish towards her own interests and if not for generous aunts and uncles feeding her and me money I would have starved and had wash my clothes by hand more often than I did.

 

Fast forward to some years later. Got in at the burgeoning internet commerce boom, made a name for myself in a distinct area that allowed to capitalize financially. Not rich by any stretch of the imagination but certainly haven't hurt for cash the past 10 years of my life either. Past 5 years have been misery realizing I was doing a job just for the sake of money. While I enjoyed the industry the passion to make rich people richer while ****ing over others was making me very unhappy.

 

Back in school and while I am struggling to regain the academic form, I couldn't be happier. I am leading towards a profession (either as a physician or in public health policy/management) that I am truly passionate about and envision a new career direction that's worthwhile and an actual contribution instead of just a leech to society.

 

Way off topic I know but I know I am not alone in my views within my peer group. I just happen to be VERY lucky that I am afforded an opportunity to change my situation. It's not easy but much easier than a lot of other people but they are so tied to the money the risk is too great for them to chance.

 

Sure for some people it is all about the bling but for a great majority it is not. It will be in the beginning as you build and establish yourself but once you start getting up there in salary you better be doing something you love and are passionate about because if not, all the money in the world won't make you happier.

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You're probably right. I'm still poor. Started off poor. I'll tell you if I agree when I finally have positive income.

 

 

My theory is that there are three strata to wealth:

 

1. The super poor: when you can't buy the basic necessities AND have a little left over to enjoy your life, you're in rough shape.

 

2. The middle class: this includes doctors. Enough money to be comfortable, even enough to weather some disasters, but not enough to declare total freedom. Even the richest doctor can't just quit his job and hop on a plane to travel the world for the rest of his life.

 

3. The rich: These people could just say to hell with it all, hop on a plane to Monaco, buy a Ferrari and bet six figures on poker on a daily basis, and not blink an eye. Total freedom.

 

Medicine, like most professions, leaves you at middle class. Rich people are basically only pro ballers, royalty, actors and musicians, hedge fund marvels and super-rich entrepreneurs and CEOs.

 

I'd partition this out into more categories

 

1) The super poor: as you said.

 

2) Low-middle class: folks who make about 20-45K a year. These folks are good, honest, hard working people but have to really watch their spending. They can pay their rent, and just get by in life. They may have enough left over to take a small trip here and there.

 

3) Middle class: The majority of folks. These guys make 45-75K a year. They're happy in life. They can afford a car, the occasionaly family vacation, but still watch their money. I grew up in this class.

 

4) Upper-middle class: These guys make 75-120K a year. These are the engineers, some nurses, and most PhDs who are faculty. I always say 75K is the magic number where people are happiest. They can afford what they want (as long as they don't go overboard) and can take a couple vacations a year.

 

5) Upper class: These are the majority of doctors and the lawyers. They make 120k - 250K a year. Very comfortable life, can buy a reasonable house in a good neighborhood, even in a place like west side of Vancovuer.

 

6) Elite upper class: These are the ophthalmologists, ENTs, dermatologists, radiologists, very hard working family docs,etc. They make 250K - 500K a year. In mid career they have enough money to invest in real estate and other things, allowing their money to grow and allowing them to become even richer. They buy what they want in terms of material goods and live a great life.

 

7) Super elite upper class: These are the CEOs, celebrities, professional athletes, etc. Yearly salaries don't matter to them as they have accumulated so much wealth they can do what they want

 

The mroe I go on in life the more I realize that yearly salary isn't the be-all end all when you're wealthy. Steve Jobs made $1 a year for the last few years he was CEO of Apple. For me, it's not about how much I make on a yearly basis, it's how I invest my money, and my other business ventures, which may or may not be related to medicine. I still enjoy being a family doctor (somewhat) and I love what I do in public health (despite its low pay) and will always probably continue to do medicine, even when I have amassed enough wealth. But like bb, I really think there is so much more to life than just medicine.

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  • 2 weeks later...
Does this apply to every medical specialty?

 

 

Or are there specialties where you just CAN'T make half a million dollars a year, no matter HOW hard or how long you work?

 

ahhh well I guess some of them are many salaried, so for those yeah you just cannot. There are also restriction on OR time that block you as well as surgeons depending on where you are, and for others I would say you couldn't do it at just one site.

 

I guess I am reaching a bit here as it is hard to say for most it is impossible, but rather just very, very difficult to the point of why would you do that just to make more money (i.e. you would have no time to spend any of it, and you are very likely to burn out and then earn nothing.)

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Money doesn't buy happiness. But, it does open a whole lot of doors for you. That sweet line of credit with a great interest rate is only offered to medical students because of future earnings. I have experienced the difference between the way banks treated me when I was making six figures compared to when I was making five figures. Night and day, and it only gets worse the less you make. It is one of many reasons why a progressive tax system is only fair.

 

I have no interest in living like an upper class person. I don't need to. The main appeal for me is that, like my previous six-figure earning days, I will no longer need to worry about finances and can concentrate on the things I enjoy. When you can't pay the bills for the basics it weighs on your mind.

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Please watch the above clip featuring Gordon Gekko. I think this short clip cleanly summarizes what my views are towards money. I understand that after a person's salary exceeds 100K or so, the rest won't necessarily be correlated to more happiness. However, as people accumulate more and more wealth, it becomes a numbers game. It's a game people want to win. I think I will greatly derive joy from the process of making myself rich and making money, not necessarily from the end result.

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Money doesn't buy happiness. But, it does open a whole lot of doors for you. That sweet line of credit with a great interest rate is only offered to medical students because of future earnings. I have experienced the difference between the way banks treated me when I was making six figures compared to when I was making five figures. Night and day, and it only gets worse the less you make. It is one of many reasons why a progressive tax system is only fair.

 

I have no interest in living like an upper class person. I don't need to. The main appeal for me is that, like my previous six-figure earning days, I will no longer need to worry about finances and can concentrate on the things I enjoy. When you can't pay the bills for the basics it weighs on your mind.

 

 

I don't know about the " progressive tax system" ; is it fair?

 

Peeps and big corporations who earn lots of money learn how to avoid the taxman (i.e. forming corporations, and thus decrease their net earnings / decrease taxes paid). Middle class screwing?

 

It's a complex issue, as some would argue than when taxes go up, spending and economic growth commensurately go down.

 

Another issue I have is the welfare system, and the way it encourages dependency on it.

 

For example, some people simply don't want to work. They are physically able to, but there is no incentive for them to do so, as they rapidly become accustomed to being taken care of by a welfare state. I believe this is more the case in Canada , than in the US.

 

Being a family MD, I see the above phenom quite a bit.

 

Ironically, the welfare state fails the people who deserve it the most; i.e. the people who are really physically unable to work (think endstage MS). Specifically, there is only a certain predetermined amount of disability money to go around, and the truly disabled receive a lesser portion due to the above issue.

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I don't know about the " progressive tax system" ; is it fair?

 

It always depends on how it is yet up, but yes, it is much more fair than a flat tax system.

 

The 10 grand: $80,001 - $90,000 that you earn goes much farther than the first 10 grand you earn that year. Even if no taxes were paid on the first 10 grand (which is not the case) and 50% taxes were paid on the ninth 10 grand (which is also not the case) that would still be the case. That first 10 grand pays for some of your necessities. Those upper ten grand pay for luxuries. But it is not just that those wages are more likely to go to discretionary spending, it is also that your money works for you for effectively. When you go into a bank you will get much better terms. You are far more likely to use the airport built with taxpayer money, go to a university highly subsidized by taxpayer, drive on roads paid for by taxpayer money and so on. The system works for you. You pay more, and you get more. Much evidence also shows that the less equal a society the less safe it is.

 

Peeps and big corporations who earn lots of money learn how to avoid the taxman (i.e. forming corporations, and thus decrease their net earnings / decrease taxes paid).

 

Get rid of the loop holes. Treat tax fraud the same way we treat crime committed by poor people.

 

Middle class screwing?

 

I don't see it, but you are welcome to present evidence. The hey-days of the middle-class in the US were from WWII until 1980 when the tax system was at it most progressive. The stagnation of middle-class income since 1980 has occurred at the same time in which the US tax system (especially with the large increase of contributions from employees for social security etc) became significantly more flat.

 

It's a complex issue, as some would argue than when taxes go up, spending and economic growth commensurately go down.

 

Sure. However, I didn't argue for or against higher total taxes.

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it's not about how much I make on a yearly basis, it's how I invest my money, and my other business ventures, which may or may not be related to medicine.

 

This right here is the key to becoming financially free. Living within your means, saving, and investing through diversification--real estate, medical practice, stock, etc. Over the course of a decade or so of adhering to a formula like this, one that has helped graduate many upper middle class (small business owners, etc) to millionaire status.

 

Many doctors make the mistake of buying everything they want right out of medical school school--sometimes on credit before the first year has even passed. Sort of like the pro athlete that goes hog wild immediately following the draft, but on a smaller scale.

 

Doctors are known as being prime targets for brokers, banks, and the like because they often don't know what to do with their money. Having been in school for so long--virtually shut off from the world--suddenly they are reintegrated with a large pot of money and spending seems like the next logical choice; especially considering they have been living on a strict budget through undergrad years and residency.

 

The key, like Moo stated, is developing a plan to have your money work for you. As a doctor, you only get paid when you work. If you have investments that generate capital on their own (ie. Real estate rental income), then the freedom really starts to come into play. Especially, if you can find other great investments, you have the potential to have your money increase exponentially. But regardless of how well you do on the market, smaller, more stable investments can be made along the way to supplement your income. Even if it means simply running your own clinic and having other doctors make you money, in addition to your own pay check.

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This right here is the key to becoming financially free. Living within your means, saving, and investing through diversification--real estate, medical practice, stock, etc. Over the course of a decade or so of adhering to a formula like this, one that has helped graduate many upper middle class (small business owners, etc) to millionaire status.

 

Many doctors make the mistake of buying everything they want right out of medical school school--sometimes on credit before the first year has even passed. Sort of like the pro athlete that goes hog wild immediately following the draft, but on a smaller scale.

 

Doctors are known as being prime targets for brokers, banks, and the like because they often don't know what to do with their money. Having been in school for so long--virtually shut off from the world--suddenly they are reintegrated with a large pot of money and spending seems like the next logical choice; especially considering they have been living on a strict budget through undergrad years and residency.

 

The key, like Moo stated, is developing a plan to have your money work for you. As a doctor, you only get paid when you work. If you have investments that generate capital on their own (ie. Real estate rental income), then the freedom really starts to come into play. Especially, if you can find other great investments, you have the potential to have your money increase exponentially. But regardless of how well you do on the market, smaller, more stable investments can be made along the way to supplement your income. Even if it means simply running your own clinic and having other doctors make you money, in addition to your own pay check.

 

 

You said it. Or, as Tom Vu says it:

 

"Are you man enough to get off your lazy American ass and go to Vu’s seminars?"[1]

"A lot of your friends will tell you, 'Don't come to the seminar. It's a get-rich-quick plan.' Well, tell them, it is a get-rich-quick plan because life is too short to get rich slow."

"Tom Vu says his system is different than other experts'."

"Okay. You've seen me make a lot of money. You've seen my students who are average people make a lot of money. Isn't it about time for you to go out and make a lot of money?"

"Don't say someday you will do it. Someday may never come. Come to my free 90-minute seminar now."

"There's two kinds of work in America: hard work and smart work. Which one are you doing now?"

"This is not a country club! This is my house!"

"Are you afraid to ask your Boss for the day off to come to my seminar? Well then you don't deserve to be rich"

"Today I'm gonna show you how to drive a sports car. First, you need a lot of money!"

"Don't listen to your friends. They're losers!"

"Do you think these girls like me? NO, they like my money!"

"At first I got lots of discouragement from friends and stranger who are loser! You know what these people kept telling me? They kept saying, 'Well Tom Vu, you a crazy nut, here you are, a poor immigrant, poor minority, speak no English, no contact, on and on, and you trying to be rich in America! You crazy, man! Look at people out there! They smarter than you are, they not even rich! Who are you to try?' And you know what? I have to keep telling these people every time, I kept saying, 'You are loser! Get out of my way! I make it somehow!'

 

 

http://en.wikipedia.org/wiki/Tom_Vu

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I don't know about the " progressive tax system" ; is it fair?

 

Peeps and big corporations who earn lots of money learn how to avoid the taxman (i.e. forming corporations, and thus decrease their net earnings / decrease taxes paid). Middle class screwing?

 

It's a complex issue, as some would argue than when taxes go up, spending and economic growth commensurately go down.

 

Another issue I have is the welfare system, and the way it encourages dependency on it.

 

For example, some people simply don't want to work. They are physically able to, but there is no incentive for them to do so, as they rapidly become accustomed to being taken care of by a welfare state. I believe this is more the case in Canada , than in the US.

 

Being a family MD, I see the above phenom quite a bit.

 

Ironically, the welfare state fails the people who deserve it the most; i.e. the people who are really physically unable to work (think endstage MS). Specifically, there is only a certain predetermined amount of disability money to go around, and the truly disabled receive a lesser portion due to the above issue.

 

 

 

People who physically able to do, but can't also make up the majority I believe. Especially in cities with higher unemployment rate than in rest of Canada.

They send in their resume all over the place...even those with high education (post grad) can't find decent research/academy position that they resort to retail job which they could have gotten when they were in highschool. But guess what? they are too educated and too 'old' for those sort of jobs. So what do they do? they continue to apply and wait for the 6 months to be up, so that they can apply for IE.

 

It is really sad. They want to work - even mindless job that does not have any affiliation to what they were educated/trained to do - yet they can't work.

They see their friends earning money and climbing the social ladder while they are stuck in their mom/pop's house because they don't have money to move out.

 

 

What kind of choice do they have? go teach English abroad.

 

This is also the reason why many Asians are starting to look down on foreigners, because they realized that the only reason why foreigners came to their country in the first place is because they couldn't get a job in their own country ("loser in that country"). Anyway, I think Canada, leaning towards socialist country should try to be more autonomous, more politically active (voter turn out was less than 50% for past elections - which allowed conservative to gain significant majority and now gun registry and prison bill occupies the precious little time politicians spend in parliament until it resumes again after <b>6 weeks of vacation <b>. ) Say the public - who pays one of the highest tax rate in the world, become more concerned and scrutinizing politicians and don't 'overpay' politicians (compare income of PM in Canada and Japan, Harpo makes significantly more, and for what? bringing Canada's image down? Just last couple of years I could really feel how internationally, Canada's good image was slowly deteriorating.... it was really upsetting as a Canadian and I couldn't really defend except talking about free health care.... I know it's not new, but living in another country, I came to understand why americans would look down on Canada, even though they were doing well... ) they are more productive and get paid according to the work they deliver like freelancers then there should be enough money to go around to hire more people, fund more research and feed children (One of Toronto mayor's decision to cut down on budget, excluding --giving raise to police force was eliminating the $1/meal subsidization for children in Toronto).

 

 

I know I got sidetracked, but I couldn't bear to see that when people see perfectly fine individual getting social assistance they first just assume that theose people are lazy arse, even though many have been trying to get into job market for a long time and sent more than hundreds of resume all over the place. I'm sure there are equally many others who take advantage of the system, but I think people would rather work than not,,,I mean what are they going to do with so much time in their hand? it would drive any physically apt person insane and too ashamed to do anything social.

 

 

Anyway that's my two cent, I didn't mean to offend anyone if I did.

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People who physically able to do, but can't also make up the majority I believe. Especially in cities with higher unemployment rate than in rest of Canada.

They send in their resume all over the place...even those with high education (post grad) can't find decent research/academy position that they resort to retail job which they could have gotten when they were in highschool. But guess what? they are too educated and too 'old' for those sort of jobs. So what do they do? they continue to apply and wait for the 6 months to be up, so that they can apply for IE.

 

It is really sad. They want to work - even mindless job that does not have any affiliation to what they were educated/trained to do - yet they can't work.

They see their friends earning money and climbing the social ladder while they are stuck in their mom/pop's house because they don't have money to move out.

 

 

What kind of choice do they have? go teach English abroad.

 

This is also the reason why many Asians are starting to look down on foreigners, because they realized that the only reason why foreigners came to their country in the first place is because they couldn't get a job in their own country ("loser in that country"). Anyway, I think Canada, leaning towards socialist country should try to be more autonomous, more politically active (voter turn out was less than 50% for past elections - which allowed conservative to gain significant majority and now gun registry and prison bill occupies the precious little time politicians spend in parliament until it resumes again after <b>6 weeks of vacation <b>. ) Say the public - who pays one of the highest tax rate in the world, become more concerned and scrutinizing politicians and don't 'overpay' politicians (compare income of PM in Canada and Japan, Harpo makes significantly more, and for what? bringing Canada's image down? Just last couple of years I could really feel how internationally, Canada's good image was slowly deteriorating.... it was really upsetting as a Canadian and I couldn't really defend except talking about free health care.... I know it's not new, but living in another country, I came to understand why americans would look down on Canada, even though they were doing well... ) they are more productive and get paid according to the work they deliver like freelancers then there should be enough money to go around to hire more people, fund more research and feed children (One of Toronto mayor's decision to cut down on budget, excluding --giving raise to police force was eliminating the $1/meal subsidization for children in Toronto).

 

 

I know I got sidetracked, but I couldn't bear to see that when people see perfectly fine individual getting social assistance they first just assume that theose people are lazy arse, even though many have been trying to get into job market for a long time and sent more than hundreds of resume all over the place. I'm sure there are equally many others who take advantage of the system, but I think people would rather work than not,,,I mean what are they going to do with so much time in their hand? it would drive any physically apt person insane and too ashamed to do anything social.

 

 

Anyway that's my two cent, I didn't mean to offend anyone if I did.

 

I teach IMGs, who typically work some pretty brutal jobs before ( or rather if) they gain entry into the Canadian medical system. Some jobs I have heard these foreign (fully qualified) physicians doing: waiter, cashier, security guard, taxi driver - the list goes on.

 

I had a patient come to see me a little while ago to fill out the " limitation to participation " / welfare renewal form. If you have practiced family med for any period of time, you know this form.

 

This guy had been "looking" for work as a truck driver for about 3 months, and told me he was unable to find any. I told him that I was indicating that he was physically able to work - off he went (none too pleased, I might add). End of free ride, hello and goodbye.

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I teach IMGs, who typically work some pretty brutal jobs before ( or rather if) they gain entry into the Canadian medical system. Some jobs I have heard these foreign (fully qualified) physicians doing: waiter, cashier, security guard, taxi driver - the list goes on.

 

 

I think they were incredibly lucky that they were able to find their ways to support themselves.

Have you ever earned below minimum wage in Canada because noone is hiring and you can't move because you don't have any money but debt, just living?

With the current state of economy... even if you want to, you can't and that' the saddest part. You don't know what the did and where they have been and can't just assumed that they are all lazy and 'didn't try hard'. that's what I meant to say. :)

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I teach IMGs, who typically work some pretty brutal jobs before ( or rather if) they gain entry into the Canadian medical system. Some jobs I have heard these foreign (fully qualified) physicians doing: waiter, cashier, security guard, taxi driver - the list goes on.

 

I had a patient come to see me a little while ago to fill out the " limitation to participation " / welfare renewal form. If you have practiced family med for any period of time, you know this form.

 

This guy had been "looking" for work as a truck driver for about 3 months, and told me he was unable to find any. I told him that I was indicating that he was physically able to work - off he went (none too pleased, I might add). End of free ride, hello and goodbye.

 

We have a similar form in BC. The worse is when you fill this out, the patient goes to some advocacy office and the advocacy office fills in what they think you should fill in and they want you to sign it. I'm like, WTF, I'm not going to say this just because your advocate thinks this is what you have.

 

Ridiculous.

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This guy had been "looking" for work as a truck driver for about 3 months, and told me he was unable to find any. I told him that I was indicating that he was physically able to work - off he went (none too pleased, I might add). End of free ride, hello and goodbye.

 

We have a similar form in BC. The worse is when you fill this out, the patient goes to some advocacy office and the advocacy office fills in what they think you should fill in and they want you to sign it. I'm like, WTF, I'm not going to say this just because your advocate thinks this is what you have.

 

Ridiculous.

 

And what happens after? I'm sure at least SOME of these people end up filing complaints, etc. How often does it happen and how do family docs deal with that? From what I've heard from preceptors so far, most threats to complain to the college or sue over things like that never actually materialize, but nevertheless, I am intrigued.

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And what happens after? I'm sure at least SOME of these people end up filing complaints, etc. How often does it happen and how do family docs deal with that? From what I've heard from preceptors so far, most threats to complain to the college or sue over things like that never actually materialize, but nevertheless, I am intrigued.

 

As a family doc, as long as you do your job honestly and with integrity you will NEVER have to worry about complaints like that....

 

These kinds of losers just make themselves look even more stupid by filing complaints -- which, as you said will never materialize anyway.

 

If you give in to their demands because you are afraid of a "complaint" then you need to take a good look in the mirror, because you are just becoming an accessory to what I consider fraud.

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