Over the last couple of years I have received feedback from time to time that I may be alienating people who have a lower than average physician income or who have fewer retirement account options than I have. Here's a good example (but certainly not the only one) from a comment left a few months ago:
As a Pediatrician, I don’t make a salary of $200k a year and likely never will so the whole “You too can own a mansion in the mountains, go heliskiing in Japan, drive a luxury car, and give all you want to charity, if you only delay your gratification” pitch is a little hard to listen to. We do delay gratification in all the ways listed above but putting $200k towards retirement a year will never be our reality short of getting another source of income. I think what is hitting me the most this morning is the question of why my time as a Pediatrician is so much less valuable than every other specialty out there. Do I need all the things discussed in the blog? Absolutely not, but it would be nice to be more equally compensated for the work I do. Throwing out numbers that are unattainable for most in primary care does ostracize a significant portion of the potential audience.
In My Defense
Before moving on to the subject of this post, I'd like to give a few points in my defense:
# 1 This is a website directed at high-income professionals.
That generally encompasses a range of income from about $100K to about $1.5 Million. Some posts are aimed more at the $100K PA and some are aimed more at the dual specialist couple with the 7 figure income. Most probably fall somewhere in between. I do not apologize that my posts aren't directed at “Average Joe” who lives in a household making $55K a year. There is probably some useful information for Average Joe on this website, but he isn't the target audience of the blog. There are plenty of financial blogs out there aimed at those who are not high-income professionals. What makes this one unique and useful to its readers is the fact that it isn't. I tell guest posters the same thing and reject guest posts that aren't squarely aimed at high earners.
# 2 Like with any blog, take what is useful to you and leave the rest without feeling offended by it.
The fun thing about reading a blog is the personal aspect of it. You get a glimpse into the personal life of the blogger that you'll never get reading the Wall Street Journal or Forbes. But nobody else is in my EXACT financial situation. Not a single one of my readers. So figure out those ways in which you can relate, and apply them in your life. Some of you are poorer than me. Many of you are richer than me. That's okay. I can deal with it and so can you.
# 3 I am a little unique among attending physicians in that I have been in every single tax bracket.
As an attending. You don't think I can relate to you with your sub $50K taxable income? It wasn't that many years ago that I WAS YOU. Trust me, I haven't forgotten what it was like. We might have a fancy new dining room table, but the couches are all hand me downs. Still. 11 years out of residency.
# 4 Why do I talk about what we spend money on?
Because I am trying to demonstrate a simple point–that if you “take care of business” early on in your professional career, you can enjoy “the good life,” which I defined in The White Coat Investor book as
“…a life free from financial worries, a career where you make a real contribution to society, a few luxuries along the way, the ability to help others financially throughout your life, and a comfortable retirement at a time of your choosing.”
I talk about my boat or my car or my latest vacation to show readers that there is light at the end of the tunnel. I'm not advocating a Mustachian spartan existence here where you live like a resident for decades (although it would probably help the planet if I did.) You may define “the good life” a little differently than I do, and you likely are interested in different luxuries than I am and that's perfectly fine. But my point is that you CAN have them, eventually.
# 5 Why do I talk about my retirement accounts knowing that I have access to more than the vast majority of my readers?
Is it just humble-bragging? No. I view it as teaching. Every time I mention I have more than one 401(k), someone emails or comments to ask “How do you have more than one 401(k)?” Every time I mention a defined benefit/cash balance plan, someone asks, “What's that?” If I casually drop the words “Backdoor Roth IRA,” all of a sudden there is one more physician family who can squirrel away $11K a year in an asset protected account that will never be taxed again.
The Wealthy Pediatrician
Enough of that. Let's move on to the point of this post–pediatricians. I love pediatricians. They are some of the nicest and most dedicated professionals I've ever met. I am particularly in awe of the many pediatric subspecialists who voluntarily underwent years of additional training without any significant income increase for their efforts. But I'm going to be real frank here and just tell it like it is.
Financially speaking, pediatricians are a lot like employee dentists. While medicine generally makes financial sense even if you have to borrow the entire cost of your education, it is getting to the point where that is not the case for dentistry. $500-600K in student loans for a career that might pay $120K? Not wise. As the big squeeze between dropping salaries and rising tuition affects medicine more and more, pediatricians, as the lowest paid physicians, are going to get hit first. This is not surprising to anyone who steps back and takes an objective look at the finances. In fact, I know of at least one physician-focused financial advisory firm who deliberately avoids picking up new pediatrician clients. They know the money isn't there.
Life Isn't Fair
I tell my kids repeatedly- “Life isn't fair.” They don't always get what I'm saying. They usually take it as “I'm getting hosed because life isn't fair,” but at least half the time I use that phrase, I'm indicating something else entirely — “Life isn't fair to your benefit, the more you can do to make it even more unfair, the better off you'll be, and your mother and I are working very hard to keep life unfair for your benefit.” Don't take this the wrong way.
I'm not advocating racism or anything like that. What I am advocating is a worldview where one realizes that not only is life not fair, but it isn't going to be fair any time soon and in reality, when you really think about it, you don't WANT life to be 100% fair in the way most kids think about it–i.e. equality of outcome. Sure, we want everyone to have equal opportunity and should work toward that, but it isn't going to happen anytime soon. Especially with all of us parents trying to give our kids more than their equal share of opportunity.
Choice and Consequences
If you're a pediatrician sitting in your office at 7 pm finishing charts and wondering why that orthopedist makes four times what you do, it may be worthwhile considering a few points. First, that orthopedist had to bust his butt a lot more than you did to get into an ortho residency. Second, he spent 2-3 more years in training than you did. Third, he gets sued more frequently than you do. Fourth, there was no one keeping you from going into orthopedics. Presumably, you chose pediatrics because you love it and I think it is a very rare medical student who isn't aware that most pediatricians make less than most orthopedic surgeons. You get to make the choices in your life, but they are connected to the consequences like two ends of a stick. You can't help but pick up the far end of that stick once you pick up the near one. You can't divorce the consequences from the choices.
How Much Do Pediatricians Make?
Yes, you can earn more than $200k. A lot of relatively low-income professionals such as pediatricians, family docs, dentists, or advance practice clinicians (hopefully that's still the correct term by the time this post runs) have a bit of a defeatist, nihilistic attitude toward their income. “I'll never make more than $200K. Wo is me!” I would submit these two counterpoints:
First, I have always been impressed that the intraspecialty income differences are so dramatic compared to the interspecialty income differences. In the 2017 Medscape Physician Compensation Report, it lists the average orthopedic income as $489K and the average pediatrician income as $202K. That's a pretty big difference, but that's as big as it gets, and there's almost no difference between an ophthalmologist and an oncologist. But I am far more impressed that some orthopedists make $1.3 Million and some make $130K. That's a HUGE range.
So if you're a pediatrician who thinks he'll “never make $200K,” the question you should be asking isn't why orthopedists get paid so much more than you, but why some pediatricians make so much more than you and what you can do to be like them. I mean, Medscape says the average pediatrician salary is $202K. Why can't you be at least average again? That doesn't seem like a big hurdle to me. I mean, you might need a different job, you might need to move, and you might have to work a little harder, but an average salary certainly seems doable. As an example, when I mentioned I was writing this post, a pediatrician sent me this:
Saw you are writing a post about the wealthy pediatrician…a lot don't think it's possible – they are WRONG. I am a pediatrician. 3 years out of residency. Partner in a group of 12 pediatricians in midwest. Made a $490K salary last year and more this year. It's possible and I have a fantastic practice and lifestyle (work 3.5 days per week) and call q11. The most important things that have aided in my success: be in private practice, become a partner, own your building, have mid-levels to help see sick patients, market yourself to healthy patients with good insurance (I do a few prenatal classes at our big hospital per year and get tons of new patients from there – all good parents with good insurance), monitor your sick:well ratio, do procedures.
This doc might be an outlier, but why can't you be an outlier too? (And yes, I asked for a guest post, but that paragraph may be all you get.)
Second, your decision to put bread on your table by working as a pediatrician is not irrevocable. Now, I'm not talking about entering the match and trying to get into an orthopedics residency. I'm talking about changing careers entirely, preferably gradually. I had a conversation with an emergency doc recently who was working 16 nights a month and felt like she was locked into that in order to maintain her family's lifestyle. I pointed out that she was intelligent, hard-working, and apparently willing to endure a great deal of pain in her career and that if she applied those same characteristics to ANY OTHER FIELD such as business, finance, real estate, selling insurance, giving financial advice, etc that she could eventually be making as much or more than she is making shepherding drunks around the ED at 3 am.
The less you make, the more likely it is that you can boost your income or make more doing something else. You don't even have to quit pediatrics. While medicine might not be a great business, it will always remain a great profession and even a calling. I obviously don't have to see patients anymore, and yet I do. Why? Because being a doctor is awesome. Not quite awesome enough to do it for free, but certainly still awesome enough to do part-time if you choose to support your family in another way.
I want YOU to be a pediatrician!
Uncle Sam Loves Pediatricians
Here's another point that most people don't get until they've been there. I always chuckle when I get an email from residents asking what they can do to decrease their tax burden. They have no idea what is coming in a year or two when they'll be paying their entire resident salary plus in taxes. It is the same way for some pediatricians. They see that orthopedist surgeon making $489K and look at their measly $202K salary and assume the orthopedist is making 2 1/2 times as much as them.
In reality, once you start applying that progressive tax code and realize the pediatrician may be paying 24% of $200K ($48K) in taxes and the orthopedist is paying 34% of $489K ($171K) in taxes, the difference still exists, but isn't nearly as big as you might think, especially when you consider the orthopedist's student loans compounded for an extra 3 years during training. To make matters worse, the orthopedist will need to save a larger percentage of his take-home income to maintain his lifestyle because his tax burden in retirement will be larger. And she'll have to do it with less assistance from tax-protected retirement accounts. Bottom line–you always come out ahead with a higher income, but it isn't as far ahead as you might imagine.
You Can Still Be Wealthy as a Pediatrician
But at the end of the day, whether the pediatrician is making a salary of $150K, $180K, $200K, or $230K, that is still PLENTY of money to pay off your student loans, eventually move into your dream house, and retire early as a multi-millionaire. 20% of $150K = $30K. $30K compounded at 5% real for 30 years = $2 Million. $2 Million = $80K in retirement spending + $30K in Social Security = a very comfortable retirement.
You might be worse off than 95% of the house of medicine, but you're still better off than 95% of the US population and 99.5% of the world population. It isn't going to be as easy for you as it might have been in another specialty or if you had married another high-income professional or if you had received a big inheritance, but it is still certainly well within your grasp to be very financially successful.
What do you think? What would you say to your classmates who went into pediatrics? If you're a pediatrician, what do you have to say about finances to the rest of the house of medicine? Can a pediatrician sole earner become a multi-millionaire? Why or why not? Are you a wealthy pediatrician? Tell us your story. Comment below!
I get frustrated by people complaining about salaries in pediatrics for several reasons, but one of them is that people do not push back enough. I was offered a moonlighting opportunity at my hospital the other day for $50/hr. I said I would do it if they would pay me more, and they offered $85/hour. But, they had gotten about 10 people to agree to it for $50/hr and they didn’t go back to those people and offer them more.
In terms of advice for students, I still hear people advising students all the time to “do what you love.” I tell them to find a few things they love, and then really consider the financial and lifestyle realities of those specialties. Especially if they are going to be the primary bread winner for their family. I told a student the other day not to go into pediatric oncology if there was anything else he could be happy doing. The people in my gen peds class going into that field either can’t get jobs due to over-saturation or they are getting paid $80K. Conversely, pediatric neurology is so IN demand that if you are flexible about where you live you can get a very good salary for a pediatric specialty. Students deserve to know these things before making their specialty choices. That being said, I see myself practicing my specialty for a long time because I do truly love it, so hopefully I will feel like it was still a positive financial choice.
Don’t be quite so discouraging for Ped Hem/Onc. I started at $235K straight out of fellowship. I had another offer in the same city for $140K, so there’s definitely a lot of variability. The big academic centers pay slave wages.
The big academic centers are still the main places of employment for peds heme/onc. There are alternatives for sure, but I know of places that recently were paying $100k for peds heme/onc, which just doesn’t compute at all.
That is good to hear! I hope that becomes more common!
I personally did not think WCI was being rude. I think he was just being strictly objective and maybe without expressing much sensitivity to affected Pediatricians.
I specialized in Nephrology and just finished my Fellowship almost 4 years ago which was brutal by the way. After analyzing the work load, life style and reimbursement for Nephrologist, I decided to work full time as a Hospitalist and do PRN Nephrologist Locums and I prefer it. My spouse is not a physician and so her annual income is barely up to $40k and we seem to get along just well. We have more than $100,000 saved up in Retirement, more than $150,000 equity n our house by putting 20% down and doing a 15 year mortgage while trying to pay off in 5 years by doing additional Locums both Nephrology and Hospitalist. My annual income roughly $280k. Fortunately only $4k left n student loan after aggressive debt pay off using the Dave Ramsey snowball plan.
I think one should take from WCI what can apply to you and discard the rest. WCI is way more buoyant than I am but can’t bet it’ll be dat way for life. Looking sideways at other specialties or comparing yourself with others can only produce envy, dissatisfaction and covetousness. For me I’d say “ Godliness with Contentment is great gain”. Learn what u can, do your best and hope for progress and increase.
Strong work knocking out that debt. Congratulations!
Thanks Newbie!
“According to a poll put up on the site, more than 30% of you have more than $200K in tax-protected space each year and 70% of you have more than $50K”
I think the numbers may be off from what I can see of the survey. It looks like 3% have 200k+ and 32% have 50k+. Still jealous of the 200k+ people…
Shoot, that was the old survey. I thought I deleted that paragraph last night. Will fix.
Dan Ariely would say that the comparison is everything. I would encourage the pediatrician not to compare herself to the ortho doc. She should compare herself to the ortho doc that takes her money and socks it away with a high fee advisor that places her into high load funds with high turnover ratios and low returns in comparison to the S and P index. The “poor” pediatrician likely has more money than the “rich” ortho doc. I actually see this a lot. It is not so much your salary, but what you do with your salary. Warren Buffett has a salary of $100,000. But he invested well into Berkshire. Although a silly example, I just want to point out that a salary of 150k well invested will make you richer than a salary of 600k that is poorly invested. The financially literate pediatrician should compare her net worth to the financially illiterate NFL player. Many make millions a year but 78 percent are either bankrupt or in severe financial distress after only 2 years of retirement. Additionally, I see a lot of physicians pick the high paying specialty but then get burned out and wind up doing poorly financially. Slow and steady wins the race. If you like coming to work every day for a “lower” salary it is well worth it.
Completely agree with and wanted to emphasize your last paragraph. “Slow and steady wins the race!” No competition, no comparison! Everyone has a unique journey, but we can learn better finance tactics and choices from WCI and others. Some physicians are met with chronic illnesses which can change their plans and potential. Slow and steady trusting God for health and wisdom is the best way to go!
Kinda of a ridiculous comparison though. Not only can the ortho guy invest more in the same manner they can afford to lose multiples of that money and still come out farther ahead. They can also follow the same path of wise investing and come out even further.
Theres no need to make pithy statements etc…they are simply different. Its still good money that will afford a good life and build a very nice retirement. We dont need to make stuff up.
It does get a little frustrating to see more physician finance blogs popping up written by highly paid specialists who woke up one day and realized they were suddenly FI (what is it about Radiology that makes them want to write blogs?) Yeah, I would have a really hard time not becoming FI on some doc’s salaries. My lifestyle is modest but massive student loans, five years of private school for a learning challenged kid and poor financial management by overspending ex-husband has me way behind my colleagues, not to mention fulfilling the stupid childhood dream of being a family doc. Oh, throw in HCOL NJ ($8500 property taxes) and no, you can’t just up and move to a cheaper area when your kids are in middle school/high school. It’s hard not to feel a little bitter but mostly I am frustrated that my medical school did not adequately inform me how much debt I would be coming out with and how long it would take to pay it off (all I knew is I went in to the Bursar’s office twice a year, signed some papers, and it all got paid for) and that the Family Medicine faculty did not warn me of how low my salary would be doing what I do. Then again, they probably did not have the student loans I ended up with. All in all, I would NOT do it again, this was not worth it. Trying to get out as soon as I can (in practice 17 years now) by socking it away and we also started flipping houses on the side this year, which is proving to be a lot more fun and lucrative than medicine!
Wow! Not sure what to say to that. I’m going to chalk your comment up to a bad morning as I don’t recall ever seeing one like that from you before. You’re mad at the bloggers, your ex-husband, your medical school, your mentors, and the bursar’s office. I’ll bet there’s a good guest post in there somewhere. And you’re not even a pediatrician or dentist!
I too have felt that level of frustration and that no one told me, etc…and have made mistakes that means I dont have the disposable income to throw towards my massive loans as others…but getting knowledge and some level of control has made that mostly go away.
Whats killed it in the end is that even in the events that were you very wronged, and someone else is absolutely at fault, unless there is some insurable aspect….it doesnt make any of the issues go away. Its pretty useless. You can recognize it, but no one pays your loans off because of it. Just have to be better in the future and control what you can.
Im still amazed and its wild how things go down at times, but does no good for the soul to dwell too long, and certainly doesnt help you take control of the present.
I also think it is interesting that in nearly every satisfaction/salary survey, peds docs are at or near the top of job satisfaction. And almost without fail, the ortho docs largely respond that they do not think they are compensated well for the work they do!
Job satisfaction would be even higher if kids didn’t have parents.
Haha, that is so true. Even in ophth, when I was rotating thru peds ophth, if I could kick the parents out the exam part always went so much smoother. As the old saying goes “medicine would be great if it wasn’t for the patients”….or parents
As usual, another good straight-talking post. As a non-physician it was very educational – I actually had no idea that there was that much of a difference between specialties, also didn’t realize that pediatricians were among the lowest paid.
I especially like the line about comparing intra-specialty differences relative to inter-speciality. For what it’s worth, this is not limited to just doctors. For example, my field of engineering has a median annual salary of around $110K. However, with my base salary and bonuses, I actually make well over double that. And I’m not a manager of people or anything either, nor am I close to normal retirement age or anything. I’m literally just a very high-ranking individual contributor engineer who has built a wide base of knowledge and demonstrated experience ,and who has constantly driven himself to perform at a high level at work. I’ve also been willing to change jobs (and even move when needed) to keep my salary moving up. At the end of the day, it’s all up to you as an individual to take what you have and make it work.
I really like this blog overall and have learned a lot here. However, I was a little disappointed that most of this felt like a lecture on why choosing peds means making less and that we should just deal with it, with only a little bit of actual advice (which is what I actually read the post for). We would be in a lot of trouble with no pediatricians or primary care docs.
I also disagree with a lot of the reasons you state for poor pay in peds compared to ortho. You say an “orthopedist had to bust his butt a lot more than you did to get into an ortho residency,” but one of the main reasons residencies in Ortho or derm are so hard to get are precisely because they pay so well. Arguing they deserve to get paid more because it’s hard to get into is just circular logic. There are also plenty of pediatricians who “busted their butts” in school and graduated highly ranked in their class (about half of the top third of my med school class went into peds and family med, though I admit my class was a bit of an outlier that way). As far as “2-3 more years in training” that argument falls apart for anyone who does extra training for a peds subspecialty (which rarely increases your salary to Ortho levels). I do agree about the lawsuit issue and that we choose to go into peds, but the variation in compensation between specialties is too extreme and simply accepting that “life isn’t fair” and sucking it up won’t fix that …. And I wouldn’t recommend creating a world where all docs were orthos.
Just so you don’t think I’m just complaining, I make in the $400k range as a private specialist in an oddly lucrative market, but I have friends who are struggling to keep their primary care practices open due to poor reimbursement if they don’t serve an affluent community (and the middle class and poor need docs too).
I agree there are plenty of people at the top of their medical school class who went into peds, just like there are plenty who went into EM. But I don’t think it is a stretch to say that on average, it is more difficult to match into Derm or Ortho, for whatever reason. That’s not circular logic.
I agree that extra training in peds doesn’t necessarily come with an increase in pay. Kind of like EM that way. There is no financial reason to do a 4 year EM residency or an EM fellowship.
I tell you what though, I’m going to name specialties more often. This post has the pediatricians, the orthopedists, and the dentists all riled up. Maybe in my next post I’ll talk about issues with ENT and Nephrology. I simply picked Peds and Ortho because they routinely show up at the top and bottom of salary surveys. And Peds salaries tend to be similar to those of dentists.
I agree the middle class and poor need docs too. I just walked out of a patient room where the thing the patient needed most was a better paying job. He was just fine with the medical treatment he’d been getting for years, he just couldn’t afford it. I wish I could solve the US medical issues with this blog (and actually have a post on that that will run in a few months) but I kind of limit myself to solving the first world financial problems the docs deal with. Boosting their income is one solution to those issues.
Sorry if you feel lectured. There was at least one other doc offended by the post, but 2 out of 10,000 isn’t bad. Apologies for offending; that wasn’t the intent.
I appreciate that though I wasn’t actually offended (I may have worded that too strongly). Its more the point that we as pediatricians can’t ever expect the unreasonable (in my opinion) gap between specialties to be corrected if we just accept it as life being unfair. We need to be the squeaky wheel and point out that we work just as hard and if we do a specialty spend just as long in training as other docs. Others have pointed this out as well here (such as neurodoc). If we don’t “whine” about it, it’ll just be accepted as reasonable that we get Medicaid rates instead of Medicare rates just because some politician said so …. And it’s not. This will not be fixed by the free market either, as our salaries work outside of that to a large extent and are dependent on government set reimbursement rates. It was a choice to go into this field, and one I’d make again, but it’s important to recognize the reimbursement difference does not make sense. The article points out “reasons” why peds makes less and I do not most believe those are valid except the one about malpractice (though when we do get sued it’s for a lot more given a kids life expectancy). To clarify the Ortho residency point, I’m not saying it’s not harder to get an Ortho spot. It is harder. The point is it being harder to get a spot is not a justification for a higher salary in itself, particularly because the Ortho salary is one of the main drivers of why it is so competitive in the first place. The salary is high so everyone wants those few residency spots, but then you use that in reverse saying the competitiveness justifies a higher salary.
Maybe I should have just left it at the fact that there are pay differences, we all know there are pay differences, and those differences are likely to persist for most or all of our careers without offering any sort of reason why they might exist. Is that the part that is so offensive?
That I fully agree with. It’s something you know going into peds and have to accept the possibility it will persist your entire career; however that does not mean we have to be ok with it, think it’s fair, or make excuses for it. Thanks.
Left off one sentence. If you flipped reimbursement rates and payed peds $500k and Ortho $200, you suddenly have it be much more competitive to get a peds residency spot and much easier to get one in Ortho.
It’s not just pay. Lifestyle is a huge factor in competitiveness. Even if things were flipped and pediatrics paid on average twice as much as ophthalmology (what I do), I would still go with eyes just based on lifestyle alone. It is inherently a much different, less stressful specialty. Same with Derm.
Is that why the optho and derm residents are the least grumpy when I call for advice or a consult?
You’ve called Derm for a consult? 🙂
I think I can count the number of derm consults I’ve called in 14 years on one hand. And that’s a hand that has been through a band saw.
lol — derm consults for 2 general things: really sick kids with SJS or SSSS type pictures who will be admitted (so don’t always see in the ED), and very rarely for families with no resources when the kid has god awful eczema that needs fancy meds that I won’t Rx on my own. Idk what you see, but I see a lot of kids who don’t see a PMD and who have chronic medical conditions that aren’t being addressed (usually by family, but occasionally by PMD). Imagine the average adult population, then apply it to kids. I see a lot of kids where I am concerned they may never make it to outpatient specialists.
So I call Derm to ED 3-4x a year.
lol — call derm for 2 general things: really sick kids who likely have SJS or SSS and are likely going to be admitted (so may not see in the ER but where confirming the diagnosis makes a difference in care), and for kids with god awful eczema that needs some fancy med that I am not going to
Rx myself.
Idk what your peds population is like, but I see a lot of children with chronic conditions that are doing poorly and need immediate treatment, and where f/u outpatient is far from guaranteed due to family/social circumstances. Imagine your average adult population with out of control COPD and diabetes, but apply it to common pediatric issues like asthma, eczema, etc.
Actually I do know what the general Utah population is like — Utah has one of the healthiest populations in the US, one of the most integrated healthcare systems in the country, and Intermountain helps drive high quality pediatric care across numerous hospitals. Also apparently Mormons are really health people (https://catalyst.nejm.org/why-does-utah-rank-so-high-in-health-care/). Not exactly the case everywhere. 🙂
So I end up calling derm to the ED a few times a year, because it’s the right thing for the patient. Sometimes I’ve called just to ask a question and help connect with f/u and they just show up in the ED anyway even when I didn’t want them to and the residents are amazingly pleasant.
Are the salary comparisons adjusted in any way to account for benefits, or are we just strictly comparing the base salary? I would assume a fairly high percentage of pediatricians or other primary care docs making around $200k are in employed positions and receive benefits such as health insurance, malpractice, paid time off and 401k matches. If the orthopedist making over $450k is assuming all those costs herself then between that and the tax difference (employed docs don’t pay self employment taxes either) the discrepancy is certainly smaller than it first appears.
These are just broad salary survey averages. There is so much intraspecialty difference that stuff like benefits pales in comparison. That said, I would assume that they treat the pediatricians and the orthopedists the same with regards to benefits.
But yes, of course if one job has benefits and another doesn’t, an adjustment must be made.
Pediatrician here. 3.5yrs out of residency, salaried, full time (which means no nights and 1 weekend of urgent care/month) and have a 250k salary. My wife is not a physician, makes 50k/yr, so between us we’re over 300k. Not too bad! I don’t know if being a pediatrician was a bad financial decision or not for me; I graduated near the top of my med school class, great board scores, tons of debt (nearly 2:1 debt:income when I finished residency) and if I wanted to probably could have been competitive in lots of fields, but always wanted to do pediatrics and other than surgery didn’t particularly enjoy any med school rotations (but didn’t like rounding at 0430 on the vascular service so surgery was quickly out). Those scores did help get a coastal residency, which can be pretty competitive even in peds. I picked what I wanted to do and thus far really like my job, so think I will have longevity (easy to say 3.5 years out I guess) even with a little income hit.
I’m amazed how few of my colleagues in our large group work full time: it’s no more than 15%. Not sure how much of a national trend that is for peds.
The other thing that works well for us: Hang out with non-medical folks who are probably in the same income ballpark. That really takes away any “keeping up with the Jones'” temptations.
Re some of the comments re doctors net worth etc was curious re what the actual numbers are,
the medscape 2016 data doesnt seem real , or are they?
I suspect MGMA data is more accurate, but it also costs a lot more than Medscape data.
See, you have MGMA data, medscape data etc. We don’t have anything like that in dentistry. Ok, I’ll shut up now.
As a pediatric intensivist, I’ll say that even within pediatrics there are differences. I was one in a compensation discussion with my chair and they were saying how the “department was the 99% and the 1%” (basically saying that me wanting more money is a hard sell since there are those in the dept making 1/2 as much as me). As you say, life’s not fair. It’s not fair in both directions. I can whine about not making as much as my adult critical care colleagues but know that the starting for intensivists is twice what it is for generalists. It’s all relative.
Your posts are objective and I think what is ruffling feathers is the lack of “touchy feeliness” which thankfully is a trait we pediatricians have. The basic message (which I agree with it) is you made your choice to do a low paying field now work with the hand you are dealt. I guess you could say that you think it’s unfair that general pediatricians make as little as they do and you feel like they should make more. That would make people feel better. However, given the mission of your blog/forum/empire it’s not going to help their finances. Its more important to give them the tools which you do.
I also think there’s a inherent trade off in pediatrics. 40% of kids are on medicaid. Most of the sickest kids have medicaid vs private insurance. I’m sure the pediatricians in my hospital’s clinic who see complex kids with med lists that rival the average adult nursing home patient are more intellectually stimulated than the suburban private practice MDs who see runny noses. Also, for subspecialities especially on the coasts hospital employment is the only option which limits your salary.
Just to challenge you a little, I think you talk a lot about giving physicians a “fair shake” on wall street which is noble. Perhaps there could be advocacy for physicians getting a fair shake with the salaries. Unfortunately, this falls on deaf ears since the world things we’re all rich! I do think you have an opportunity as the lead MD finance blogger to do this. Much like Dr. Wes and his work with MOC.
I find NJFPs comment interesting. While it’s true you’ve been in all tax brackets, when you look at yourself and other MD finance bloggers you don’t see academic low paying fields in there. It’s mostly folks with higher paying fields in low COL areas. Nothing wrong with that but makes it hard to relate for some. I’m always fasciated by the Debt Free Scream calls on Dave Ramsey. Some folks call in and aren’t doing too bad and using a hefty salary get out of their debt (as dave says when you have a big hole you need a big shovel). Others (the ones that impress me) are the ones who make liek 30-40k a year, have like 4 kids and end up debt free with no payments.
I’ll stop rambling. Keep up the good work. I’m surprised how much buzz this post recieved!
PICU MD — maybe I need to spend more time writing about life in academic pediatrics on my blog 🙂 True I am in peds EM so within my own institution I am paid more than many others in peds, but the place I work is not known for breaking the bank on salaries for most.
How do you propose I advocate for increased pay for doctors other than teaching them business and negotiation skills and encouraging them to be their own bosses whenever possible and helping those who don’t wish to practice any more become financially independent so they don’t have to work increasing incomes for those left behind?
I was in academics in NYC for my first two years of attending life and made peanuts compared to other dermatologists. We just moved to a cheaper city and will be going into private practice – but I am currently taking a 17 week maternity leave. Most of which is unpaid.
I had no idea how little I was being paid (and paying ridiculous rent and state & local taxes). Also, my fiance was unemployed for a full year in NYC. What I have learned is, you can still do it. You just need to be willing to make some sacrifices.
PICUMD, based on the comments here, peds docs are an interesting bunch who, despite their high rankings on job satisfaction surveys, seem to harbor a great deal of envy and resentment towards other physicians as evidenced by pretty much every comment here referencing some variation of ‘it’s not fair other doctors make more than us’. My favorite are those expressing suprise by this, as if the pay scales recently changed dramatically and they had no way of knowing they were choosing a relatively lower paying specialty.
‘When you look at physician finance blogs, you don’t see many from low paying academic fields’. And when you look at college football blogs, you don’t see many written by concert pianists from Eastern Europe. Maybe all the low paying academic bloggers just get overwhelmed by all the angry comments taking offense to simple facts. Or, maybe, do you think there might be some correlation between those with a personal interest in personal finance gravitating towards higher-paying specialties?
@Rogue Dad MD: Where I work peds EM is in the dept of emergency medicine not pediatrics which results in higher pay. From what I hear the starting salaries for peds EM fellowship trained docs and adult EM resident trained docs are the same.
For me personally as an intensivist I feel I’m paid fairly for what I do. I have no complaints about lifestyle/money. I don’t heli-ski but I’m about to see Hamilton for the 2nd time, have eaten in most of the 3 Michelin Star restaurants in NYC, travel, buy the toys and still save for retirement, college funds, etc, etc. I feel bad for the others who are following their dreams and being punished financially for doing it.
@WCI: Not to patronize you, but you are the leading voice for physician financial matters out there. I think the work you do here is needed and helps us all one doc at a time with our individual issues. Thanks to this blog I bought disability insurance a few years ago, learned about the backdoor roth, bogelheads, and have started to think about things like could I actually retire early.
That being said, with the power of your voice (backed the rest of us) I think you could really advocate for the lower paid physicians out there. You commented somewhere that you’ll have a post about the health care system. I think there are systemic issues that affect compensation such as RVUs, etc, etc I think as payments shrink you’ll see less and less folks going into primary care. With more fair income this wouldn’t be the case.
@ZC I don’t think the 2 are mutually exclusive. You can love what you do, feel like you make a difference and still feel underpaid (try talking to a teacher some time).
I’m still not understanding what you hope I’ll do. Are you hoping I’ll write a post that says, “Pay family docs more!” Or that I run to serve as one of the 29 docs on the RUC? Or that I petition states to fund Medicaid at a higher level? Or negotiate on behalf of individual doctors with insurance companies? I mean, I’d love to see all doctors get paid more, but I’m completely at a loss as to what I can do to actually affect that.
I think writing a post that outlines the income disparities between various specialities and how that affects the health care system would be a good start. Shedding light on the crappy Medicaid reimbursements would be another. I feel like the public at large does feel that all doctors are “rich”. Looking beyond the individual physicians and the health care system I think having poorly paid generalists is going to a negative on peoples health overall. Like I said earlier I feel like the anti-MOC movement has gained traction due to physician dissatisfaction going more mainstream.
Obviously, this is your site and I agree that you are working hard to improve all of our financial lives. I just think looking broader may impact the system.
I haven’t had time to read all the latest comments on this thread but I think one thing that was mentioned earlier that is worth reiterating is that we need to do a better job of informing medical students what type of income they can actually expect to see in a given specialty in a given regional area. I just recently graduated from family practice residency and I can easily say that only 1 or 2 attendings ever talked to me openly regarding earnings. It’s time stop making money a taboo subject with medical students. They need to make informed decisions when picking a specialty and finances have to be a part of that decision. I am in the process of getting credentialed to start precepting 3rd & 4th year students at our local DO school and I plan on making The White Coat Investor required reading. I also plan on fostering open communication about realistic earnings for each specialty in the region in which I live.
You know what makes it worse, I think it’s MORE TABOO in lower paying specialties. That tabooness just gets passed down generation to generation.
Couldn’t agree more. When looking for a job everyone knew the typical academic salary, but nobody could tell me about private salaries. I had to go on several interviews to find what a huge range there was between private jobs. For some money as a consideration was seen as all or nothing. If you are concerned about it at all, it is assumed it’s all that matters to you (though you’d think going into peds in the first place would clear that misconception up!). For many though I’m not sure it was taboo as much as lack of knowledge. My attendings had simply never looked for private jobs themselves (and many asked me about what was offered to me in terms of pay and hours when I took my first private gig, which was an unusual thing to do coming out of my program).
So true. I think the trade off especially for peds subspeciality comes at the expensive of clinical complexity. I’ve been in my current job since fellowship in a “community” PICU. Although we’re pretty busy and the acuity can rival what you see in some academic places. Taking the extra $$ to come here meant giving up on post op cardiacs, ECMO patients, transplant patients. At the time it was a rather difficult decision. I think there was some disappointment from a few of my attendings that I “sold out”. However, in retrospect when I realize there’s more to life than the PICU, 3 children are born, 529s, property taxes and mortgage in the north east, I made the right call. I have a colleague who left here to a different institution after being here a few years to get back to those patients. They took a mid 5 figure pay cut…
That’s the unfortunate part of the academic nature of medicine, with some institutions being worse than others. At the bigger name places, they seemingly want to shove academics down your throat and make you think academics is the only career choice and that private practice is bad or selling out. I come from a private-practice medical environment and went to school that was more PP culture, so doing PP wasn’t a difficult decision. However, I have colleagues that only know academic medicine through med school and residency and are somewhat ignorant of the PP world and feel conflicted over pursuing a PP career despite having no academic interests at all. However, in the end, people are always uncomfortable talking about money, even amongst friends to a certain degree.
Taboo or not (and I must say I love “tabooness”), there are certain specialities that people will go into regardless of what the compensation is, and certain specialties that no one will go into unless it pays well. There is an emotional gratification to a traditional peds practice that we anesthesiologists rarely if ever experience. Some people choose Ob/gyn because of a philosophical commitment to women’s health. No one goes into radiology because of a philosophical commitment to imaging or ionizing radiation. When I was a second year Anesthesia resident, the job market imploded, and salary offers plunged. The next year, the entire city of Philadelphia failed to match a single Anesthesia residency spot.
And so, there is an inescapable element of the law of supply and demand. If people are willing to enter a field irrespective of the compensation, it’s very difficult to drive up the compensation. It’s hard to sell something that someone else is giving away for free.
I wonder how much of an effect that has on peds or gyn salaries. I can’t imagine it is that large though.
When Anesthesia salaries briefly became the same as Peds salaries, the number of people going into Anesthesia residency plummeted. The ensuing shortage of anesthesiologist corrected the market in a couple of years, and Anesthesia salaries went back up. Based on the experience in Anesthesia in the mid 1990s, I suspect it has a considerable effect. Economically speaking, there is just no point paying someone more than you would have to pay to replace them.
The difference now is that NPs have achieved massively expanded scope of practice (half of states allow unsupervised practice). There are actually pediatric subspecialists who are being fired or not being hired because the hospital thinks a midlevel is a sufficient replacement. And often the salary difference isn’t even that much. Anesthesia is seeing the problem with CRNAs. This has drastically changed the market and will only cause all salaries to be at risk of decreasing.
Think it won’t happen to procedural specialties? Think again. See the nurse in U.K. doing solo surgeries, Hopkins training NPs to do endoscopies, and countless others.
Hospitals, insurance companies, and state legislators don’t seem to understand the difference in patient safety compared to a physician. This is something WCI and other physicians interested in personal finance as well protecting the field of medicine should be interested in.
As a dentist who graduated 15 years ago I think you are spot on when it comes to dentistry, I am a solo practice owner and I am around the 300 mark, and the majority of solo guys I know are around there, very few get to the 300+ mark. I graduated easily with 150K loans at 2.5% interest, reasonable imho. The reality is a huge number of kids now are leaving dental school easily at 350+ and over. Don’t believe me pull up the tuition on all the private schools out there its insane. The few state school that charge a reasonable tuition are so competitive most cant get in, go military you say? Getting an HSPH to pay is more competitive ever, they have become very picky. YES being a business owner is the way to make money in this field, but after graduating with 400+ at 6% interest, put down another 500K+ to get a practice or start one, and don’t forget about life, you know, wife, house, vacations? The field getting more and more saturated, reimbursements going down, at 300+ I don’t think I’m would make the same decision. I suppose if you are a businessman first and intend on opening up multiple practices and selling off to DSO you will be happy with this field. Specialists still tend to do well but even they have complaints, for Oral Surgeons, their biggest concerns is that wisdom teeth eventually get wrapped into medical then it gets interesting for them.
“No one goes into radiology because of a philosophical commitment to imaging or ionizing radiation.” Well, perhaps no one has a philosophical devotion to radiation, but there is a lot of fascinating work going on in imaging. The radiologists I know, all academic types, will tell you that it is by far the most interesting and fastest moving field in medicine.
When I was a medical student, a long time ago, it was not that easy to get information about relative incomes across specialties. I went looking actively to find it and it was a major consideration in choosing a residency. Income was not the only consideration, I also thought about whether the work would be interesting, tried to guess what might happen to the market long term, thought about the geographic flexibility and other pragmatic issues. Although “interesting” was on the list and some fields were downrated severely because I thought they would be boring, I definitely did not follow the advice to choose something I would love.
Many of my classmates were scandalized by the openness with which I considered income in evaluating potential careers. Several told me, with the supreme confidence of moral superiority, that they were choosing their careers based on far more noble factors.
I did not go into the highest income field I could. In my thinking I have always, absent reason to believe otherwise, assumed my experience would be about the same as the typical student or doctor as the case may be. So I was more interested in the median than the average income across fields. As I said, it was not easy to get that information, but I came away with the impression that the very high averages in some surgical fields were distorted by a few outliers with enormous incomes. But what if I were “typical” rather than an outlier on the high side? Would it still be a good deal?
In today’s market one would wonder whether the incomes of cardiac surgeons and spine surgeons are similarly distorted. Yes, there are people in those fields with multi-million dollar incomes. But they are far from typical.
I agree that primary care docs are underpaid. It is a hard job with different challenges than the high paid specialties. I can sympathize with their desire to earn more. Where I get lost is the whole “but you knew this when you picked this job”, thing.
It would make sense to me to have picked the highest paying field available and then wish higher paying fields had offered a slot. I would not make sense to me to be bitter about it unless one thought the criteria were unfair or arbitrary. I could see a woman resenting the, apparently continuing, discrimination against them in orthopedics. But I could not understand someone boasting that they chose their field without considering compensation and then complaining about the compensation. People who do not consider the financial consequences of decisions are rarely happy with those financial consequences.
People have been complaining about the differences in incomes across specialties for a very long time, without any movement. A few weeks ago I was talking with an academic physician who was complaining that academics made less than private practitioners in his field. He proposed documenting this and surely once they realized it, Congress would demand that Medicare reform its payment practices to equalize the compensation???. And he was in one of the high paying fields! Maybe if you get spine surgeons and cardiac surgeons together after work each will complain that the other field is overpaid and they should get that money instead.
“‘No one goes into radiology because of a philosophical commitment to imaging or ionizing radiation.’ Well, perhaps no one has a philosophical devotion to radiation, but there is a lot of fascinating work going on in imaging.”
I agree wholeheartedly. There is a ton of fascinating developments happening in Radiology. It is no doubt an interesting and gratifying field. But it is quite unusual to see a medical student so passionate about the field that they’d be willing to go into it to earn the salary typical of a pediatrician or a family practioner.
Similarly, I often call Anesthesiology “the most fun allowable by law”, and I mean that. But no one I know is so devoted to the field that they’d do it regardless of the compensation. One need only look at the aftermath of the anesthesia job market crash in the mid-1990s – when Anesthesia and Pediatrics salaries were transiently at parity – to see the impact of compensation on the appeal of Anesthesia. The number of American graduates applying to match in Anesthesia decreased 90% year-over-year. I suspect the same would be true in Radiology.
Re: “Lifestyle” specialties. The ophthalmologists I know are routinely in house in the middle of the night dealing with trauma and infections and often in the OR trying to save someone’s eye. Same for the spine orthos, the hand surgeons… And while they are in the OR all of those patients need anesthesia. Almost all of them get imaging before heading to surgery, so the radiologists are at work, too.
I suppose there must be fields in which one can sustain a pure outpatient 9-5 practice, but the “lifestyle” docs I know work long hours.
” The number of American graduates applying to match in Anesthesia decreased 90% year-over-year. I suspect the same would be true in Radiology.”
I suspect so. In fact, I gather Radiology is recovering from a mini-crash, where the number of applicants fell to the point that some, a few, programs did not fill, which was unheard of up to that point. It was driven by a downturn in the job market for new hires, although average radiologist incomes did not decrease.
Enough med students are sensitive to incomes and job prospects that the higher income specialties are the most difficult to get residencies. The relative demand for positions shifts with short term changes in income and employment rankings.
Apparently there is a cohort of people who do not consider this when making career plans as students. Later, apparently, at least some of these people realize the positions in which they have put themselves and are upset about it. I assume others went in with their eyes open, or really meant it when they said they did not care about compensation. But they are not the ones complaining, so we don’t hear from them.
As for what to do about it for those who are in lower income specialties and want to make more money? I don’t know of any moves that could be widely adopted. Control your spending, minimize investment expenses and taxes is good advice to everyone. Try to get into leadership, running a practice or a department. That lets one get compensated at a higher hourly rate than the average person in such a field. Some people, not many, will find entrepreneurial opportunities that build upon their clinical expertise.
There are only a few such jobs and most people in the lower paid fields are going to get paid for the time they spend delivering clinical care. That pay will be at the relatively low hourly rate of primary care.
Not many ambitious, risk loving, entrepreneurial types will be interested in medicine as a career. Much too long doing the standard thing, under layers of supervision, before you can get out on your own. They are more likely to found a business while in college than sign on for another 8-10 years of low pay and no autonomy before ever having the chance to use their backgrounds to build a fortune.
WCI You just put salt in the wound by writing this column. Talking about bold posts. It was an excellent and a very entertaining one. But, I understand why some would get upset. They feel there should be some some equality in compensation across the specialties, but life is not fair, is it?
While many readers will not agree, most of your comments made sense. We are the result of our choices. I believe one should choose the specialist that you like the most if and only if you are comfortable with the average wage. Otherwise go to your second, third etc until you find the right balance.
In the end this is capitalism, there will always be differences in the compensation based on the free market.
Just wondering what you think the “free market” is in medicine? Medicine is the EXACT opposite of the free market. The federal government tells us not only what we should get paid in our jobs, but how we should DO our jobs. It is THE WORST in pediatrics because up to 70% of the population is medicaid in some areas. Most ped practices cannot afford to not take medicaid because we would lose our number 1 payer which by the way pays about 50% on billables – yep a 99213 is only $67 reimbursed by medicaid. So we don’t get to have a free market in our jobs. Most of us cannot go to a cash pay system or a concierge system. I joke that we actually ARE a concierge system bc pediatricians are on the phone 30% of their time taking mommy calls uncompensated. Why are we uncompensated? Medicaid refuses to pay us for mommy call time. We get ridiculous calls about potty training at 3 am at no compensation bc how can you legally “fine” a medicaid patient for an inappropriate phone call? You can’t. This is why the above arguments are offensive to pediatricians and come across as smug. Because the WCI is giving an opinion on something he literally has no experience or knowledge about. “Just save more.” “Sorry you get paid less because you’re a ped; you chose this.” Instead, the argument should have said… this is a disgrace you guys are paid so poorly. We should try to lobby for better payment and appreciation for pediatricians. It’s not just unfair, it is a slap in the face. But as 26 peds were just replaced by nurse practitioners in a state in this country, we are told more every day how we are undervalued. And when there are no pediatricians left (because who in their right mind would choose this field???) , please don’t complain when your child is actually REALLY sick and needs an MD at the bedside. Because we all know those 500 hours of shadowing (in all specialties combined) that NPs have really compares to my 10,000 hours of training and 2500 hours of fellowship.
Medicaid reimbursement varies by state so while you may be getting $67 for a level 3, someone else might be getting $100 and a third doc may be getting $45. I agree that medicine is not a free market.
I’m sorry this post came across as “smug,” “pretentious,” or “a slap in the face.” I’m also sorry that it appears I have no experience or knowledge about this subject. Here are the guest post guidelines if you, having far more experience than I on this subject, would like to better explain to WCI readers how pediatricians can build wealth despite being paid less than the vast majority of physicians: https://www.whitecoatinvestor.com/contact/guest-post-policy/
WCI, your post is neither smug nor pretentious nor a slap in the face. Certainly not in my opinion.
PrivatePED, I agree that medicine in general is not a free market, and peds in particular is certainly not. If I personally could control things, I would change the universe so that pediatricians got paid more and football players got paid less. Sadly, I can’t.
That being said, I think the point that was intended in there was that although medicine is far from a free market (to its detriment), the supply of various specialties of docs, and of docs in general, and the compensation of various specialities of docs, and of docs in general, ARE subject to market forces. Freshly minted MDs choosing a specialty consider various advantages of each. Some specialties offer tremendous emotional gratification. Some offer far less. You can fairly consider the amount of emotional gratification to be part of the “pay package” of each specialty. In my field – Anesthesia – as much as I enjoy it and find it fascinating, most people do not see the same degree of emotional gratification as people do in peds or Ob/gyn. If average compensation decreased markedly (as happened in the mid-1990s), the supply of anesthesiologists would respond by plummeting (as happened in the mid-1990s), until the reduced supply of anesthesiologists caused compensation to increase back to nearly where it started (in the early 1990s). If the same thing happened in peds, there would be no similar crash in the supply of pediatricians because people go into peds substantially for other parts of the “pay package”.
So, you can certainly complain that peds are inadequately compensated in the overall scheme of things (I agree). But understand that the problem is not WCI’s lack of angry letters to Congress. Rather, the problem is the ready supply of newly minted MDs willing to train in peds because of the non-monetary aspects of their compensation. And these peds-leaning med students will more likely listen to you, a pediatrician, than to an Emergency Medicine doc or an anesthesiologist.
Also a peds intensivist here- a few observations on pay disparity across peds fields
1) As a general rule, peds docs (with likely the highest proportion of female members for any specialty) are far less likely to be confrontational, ask for raises, or make their discontent with their pay known to others. I believe administrators and others take advantage of the altruistic and non-confrontational nature of most pediatricians, and give then less pay accordingly.
2) Many folks go into general pediatrics to have a more flexible lifestyle than other specialties- many folks only work 3 or 4 days a week, and faint at the thought of having to work nights or weekends, or any in-hospital type of call. Those that choose part-time pediatrics often are willing to accept less pay in return for that convenience.
3) As noted previously, most Medicaid reimbursement is terrible, which is linked to declining pay for employed physicians.
4) I think the growing levels of discontent are much more due to the fact that employed physician salary is generally decided by administrators who are by-and-large oxygen thieves who generate zero income for the hospital/clinic themselves. These folks generally also don’t work nights or weekends, and certainly don’t have to make snap judgments in life/death scenarios.
5) I am personally content (for now) with my current income, but bust my butt on call for 2 different hospital systems in order to do so. I believe part of the answer to improved income for generalists overall is more transparency among colleagues regrading what they are making, and taking course in negotiation- if enough hospitals and clinics are told ‘NO’ by physicians when they make low-ball offers, I think we’d all be better off.
I enjoyed reading this conversation. It hardly matters whether you are talking to a salaried primary care physician or a entrepreneurial surgical subspecialist; debt has a corrosive effect on wealth generation. The same magic of compounding works to the favor of someone else when you are the debtor rather than the note holder.
Just like the the social and economic consequences of a teen pregnancy, the social and economic consequence of piling up educational debt has a profound influence on your options and choices down the line. It’s worth remembering that a few years of service to Uncle Sam, or in a critical access locale with incremental debt forgiveness or debt assumption can make a mountain of debt turn into more of a molehill. Its also worth remembering that it’s easier to work like a slave and curtail your lifestyle a bit in your 30’s than it is in your 40’s, 50’s and 60’s. Older physicians with debt may not have the stamina to take on side jobs, or even take on extra night/weekend call within the primary employment to supplement income.
I have to agree with some of the things Babydoc said. I think pediatricians get slighted in their value and pay because “its for the kids.” Personally, this is taking advantage of some really good natured people. I have no doubt if most pediatricians went on strike in this country, we’d get paid more…a lot more. Society would care the most about kids getting medical care. I’m a well compensated pediatrician, but I’m self employed partner in a larger group practice. We’re paid well because we keep overhead down. But, I also bust my tail. I see lots of patients daily, work in the hospital, do my own fracture care, suturing, xray in the office. I am a “REAL” doctor. I think what you missed in the original post is not that pediatricians can’t be smart with our $ and have a good retirement, but that we feel that other doctors undervalue us too. I think other specialties should be going to bat for us and other primary care doctors. If the high paying specialties have no primary care docs, there’s no one to feed their clinics with patients. But we generally feel most other specialties look down on us as the “dummies” in med school. But this logic is just plain wrong. I was top grad in my class. Most of us went into peds because we love it and because kids are important. They are the future. We should be compensated better and we should have the support of all other specialties in say so very loudly on our behalf. We shouldn’t have to suck it up and sulk that our retirement capabilities are less.
Horrible, pretentious arguments. Never coming back to this website.
We’ll miss you. You’re welcome back any time.