# GENERAL FORUM > IN THE NEWS >  For all those who think doc's are super rich!

## Lemonada8

http://money.cnn.com/2012/01/05/smal...doctors_broke/

This is a real issue, with increasing debt due to loans and rising education costs then the cuts in payment from medicare is really putting docs in a pinch. 

What do yall think about this?

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## JohnnyVegas

I know it is happening, and I have been reading about it for few years. Having said that, all the doctors I know are rich. If I could do it all over again I would become an anesthesiologist.

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## Nooomoto

Yep. Down here in South FL (up in Broward county mainly) there is a big problem with doctors being broke, so they open up pill shops and get paid shit tons of cash on the spot to write scripts to junkies for tons of pills. I think it's like $500 bucks for the initial appointment and then another couple hundred for hundreds of hardcore pills like oxys and shit. They do everything on the spot in these places. You go in, pay the cash, get seen by the doctor for your "chronic pain" problem, walk out with tons of pills.

When becoming a doctor becomes something that puts you in debt for the rest of your life, you can kiss our top-notch medical care and advan***ents good-bye.

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## Times Roman

"Rich" is a relative term. My perception of rich and yours may not agree.
When I was coming up through public accounting, we did tax returns for professionals also. Some were docs. I remember this cardiologist (Indian fella) i calculated the taxes for. He had a palatial home, and every room looked like straight out of better homes and garden. After doing his taxes, i felt sorry for the dude. All flash, no cash. He had great income (300+k/yr), but he was up to his armpits in debt.

To me, Rich is cash in the bank, no need to work, and no debt. Cash in bank = all you'll need the rest of your life. Notice i didn't mention any material items like houses and cars?

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## lovbyts

Yup, rich to me means titles in hand, not at the bank, debt free and able to enjoy life. You are not rich if you work 80hr a week, that is poor in my books. The more you enjoy life the richer you are.

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## Tigershark

The other thing that is killing docs is the mal-practice insurance. I have heard of some doctors paying as much as $80k a year as a heart surgeon. Sure they make $200k but holy crap almost half your pay to insurance is rediculous.

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## Lemonada8

^^ Yup... and thats not even the worst ones. OBGYn is insane. 

Then think, if its a private practice, the 80k/year isnt taken out of what is figured you make in your taxes so then throw another 35% tax rate in there... its not surprise how corporate medicine is getting. All those who want a social healthcare system ran by a big corporation is getting their wish and they dont even realize it and how it is skyrocketing the costs of basic medical care.

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## JohnnyVegas

> Yup, rich to me means titles in hand, not at the bank, debt free and able to enjoy life. You are not rich if you work 80hr a week, that is poor in my books. The more you enjoy life the richer you are.


Agree that rich means owning. The two docs I really know are those kinds of guys. They both love what they do, so they work a lot of hours because that is what the industry demands. One is an anesthesiologist and one actually runs the ER at a hospital in WA. The other doctors I know seem to be living well, but could be up to their armpits in debt, I have no idea. 

If your definition of "rich" is "doesn't need to work" then these guys don't qualify. They still depend on their incomes. One of them was thinking about retiring, but his retirement investments were cut in half when the stock marketing and real estate markets took a big dump. That was a big bummer.

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## thegodfather

Moral of the story is, get a good Step 1 score, and match into the right specialty. Also, avoid all primary care specialties like the fu**ing plague. And whoever mentioned a 'surgeon' only making $200,000 a year, he must be a pretty shitty surgeon, because gen surg without subspecialty in the NE is making at least $325k, anything sub spec is in the 400k+ range. 

All of this aside, doctors in the primary care specialties are being squeezed the hardest. Medicare/Medicaid cut reimbursements further and further, this is creating a situation where doctors have opted out of EMTALA all together, and those patients on Medicare/Medicaid cant find a doctor who is even taking these patients. Additionally, the LOW reimbursements that some group of government dipshits get together and decide a doctors time for a routine checkup is only worth $28 dollars (and 45 minutes worth of paperwork in order to get paid for that one patient) causes other health insurers to lower their reimbursements, afterall, why should Bluecross pay that same doctor $75 for a routine checkup when Medicare/Medicaid is paying them $28? This is called artifically manipulating the market. Laws which forbid healthcare practioners from advertising their fees for service prevent free market competition. The free market is not failing healthcare, government intervention is destroying healthcare with a bulldozer.

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## JohnnyVegas

^^^^^ Nice to hear from someone in the industry. Are you headed to med school, or done? Either way, good job and good luck.

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## Lemonada8

> Moral of the story is, get a good Step 1 score, and match into the right specialty. Also, avoid all primary care specialties like the fu**ing plague. And whoever mentioned a 'surgeon' only making $200,000 a year, he must be a pretty shitty surgeon, because gen surg without subspecialty in the NE is making at least $325k, anything sub spec is in the 400k+ range. 
> 
> All of this aside, doctors in the primary care specialties are being squeezed the hardest. Medicare/Medicaid cut reimbursements further and further, this is creating a situation where doctors have opted out of EMTALA all together, and those patients on Medicare/Medicaid cant find a doctor who is even taking these patients. Additionally, the LOW reimbursements that some group of government dipshits get together and decide a doctors time for a routine checkup is only worth $28 dollars (and 45 minutes worth of paperwork in order to get paid for that one patient) causes other health insurers to lower their reimbursements, afterall, why should Bluecross pay that same doctor $75 for a routine checkup when Medicare/Medicaid is paying them $28? This is called artifically manipulating the market. Laws which forbid healthcare practioners from advertising their fees for service prevent free market competition. The free market is not failing healthcare, government intervention is destroying healthcare with a bulldozer.



exactly, thats partly a reason why hospitals are getting soooo huge nowadays. Healthcare is turning into a damn corporation, and at what cost? 

Dentists were smart and stayed out of the whole insurance thing, and look at where they are now.. they can do pretty much w/e they want to.

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## thegodfather

> exactly, thats partly a reason why hospitals are getting soooo huge nowadays. Healthcare is turning into a damn corporation, and at what cost? 
> 
> Dentists were smart and stayed out of the whole insurance thing, and look at where they are now.. they can do pretty much w/e they want to.


Dentristy is a far different animal bro. It's within the realm of possibility to pay cash for services rendered, the majority of people can afford $75-$100 cleanings, and $200-$300 fillings. Most people cannot afford $250,000 for an Anterior Cervical Dissection and Fusion of a herniated C3. But this brings up yet ANOTHER problem with healthcare and modern day health insurance. People think of health insurance as some sort of free service, that covers everything under the sun, this is one factor driving healthcare costs through the roof. Health insurance, if it were treated like all other insurances, would in reality be very affordable to 90% of Americans. Insurance is typically reserved for catostrohic instances. When you car crashes, insurance covers it, when your house burns down, insurance replaces it. When your car requires a tune up and oil change, insurance doesn't cover it, when your house needs to be cleaned, or your water heater breaks, homeowners doesn't cover it. If we treated health insurance this way, we would only cover catastrophic health events, heart attacks, spinal fusions, traumas, etc, and so on. We would not use health insurance to cover every runny nose and cold. The problem with making doctors visits $5, is that there is no incentive NOT to see the doctor as often as possible. When a person percieves a service as 'almost free,' they use it with no degree of frugalness in mind, and this inevitably drives up costs for everyone else. 

We also need to mention that general practice Dentists are not required to do residencies, and those that are, are typically very short in the 1-3 year range, for things such as Orthodontics, with the majority of Dentists going right from Dental school and directly into paid practice. This is an extra 4-7 years where they are earning income, instead of deferring loans and accruing interest. The only exception to this of course is OMFS residency&fellowship (Oral Maxillo Facial Surgeon), which is obviously much closer to medicine than dentristry, but which requires a DMD/DDS. I actually also have two friends doing Podiatry residencies, the longest of which is 36 months, which allows them to do rear foot reconstructive surgery, as opposed to 24 month residencies which allow for only front foot surgery. I think that profession has actually come along way, with the integration of DPM's into some Ortho practices, and rear foot surgeons earning as much as $200,000/year.

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## gixxerboy1

> Moral of the story is, get a good Step 1 score, and match into the right specialty. Also, avoid all primary care specialties like the fu**ing plague. And whoever mentioned a 'surgeon' only making $200,000 a year, he must be a pretty shitty surgeon, because gen surg without subspecialty in the NE is making at least $325k, anything sub spec is in the 400k+ range. 
> 
> All of this aside, doctors in the primary care specialties are being squeezed the hardest. Medicare/Medicaid cut reimbursements further and further, this is creating a situation where doctors have opted out of EMTALA all together, and those patients on Medicare/Medicaid cant find a doctor who is even taking these patients. Additionally, the LOW reimbursements that some group of government dipshits get together and decide a doctors time for a routine checkup is only worth $28 dollars (and 45 minutes worth of paperwork in order to get paid for that one patient) causes other health insurers to lower their reimbursements, afterall, why should Bluecross pay that same doctor $75 for a routine checkup when Medicare/Medicaid is paying them $28? This is called artifically manipulating the market.* Laws which forbid healthcare practioners from advertising their fees for service prevent free market competition.* The free market is not failing healthcare, government intervention is destroying healthcare with a bulldozer.


I never understood that. What is the reasoning behind that law?

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## Nooomoto

> All of this aside, doctors in the primary care specialties are being squeezed the hardest. Medicare/Medicaid cut reimbursements further and further


Funny you mention this. I was just at my primary yesterday and she told me she's closing her practice and leaving town as she isn't making any money and can't afford an office here. She told me she hasn't taken home a pay check in almost a year trying to keep the office here open. She speculated more specialists are going to start becoming GPs, as specialists are no longer allowed to bill procedures that aren't under their specialty any more. IE You can't have your cardiologist check your glands real quick any more, etc. I don't know much about the inner workings of it, but thats the example she gave.

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## thegodfather

> Funny you mention this. I was just at my primary yesterday and she told me she's closing her practice and leaving town as she isn't making any money and can't afford an office here. She told me she hasn't taken home a pay check in almost a year trying to keep the office here open. She speculated more specialists are going to start becoming GPs, as specialists are no longer allowed to bill procedures that aren't under their specialty any more. IE You can't have your cardiologist check your glands real quick any more, etc. I don't know much about the inner workings of it, but thats the example she gave.


One way in which doctors can keep their practices open are by going to concierge practices. You take your practice down to 600 patients, and they each pay $1,000/year for your services. This entitles them to a visit with you X number of times per year, and you spend an hour with each patient. So it gives the person a much higher level of care. My PCP has been offered this, but has declined it, because he cares about his patients and doesn't want to cut them off. That is one of the weaknesses with a lot of doctors, their altruism, which got them into medicine in the first place.

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## Dytum

All docs CAN be rich...your doing something financially wrong if ur a doc and not "rich " also depends on ones definition of rich

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## Armykid93

> All docs CAN be rich...your doing something financially wrong if ur a doc and not "rich " also depends on ones definition of rich


All docs are rich lol. If you make more than 100k a year your rich

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## Lemonada8

http://benbrownmd.wordpress.com/

really eye opening when its all put on the same scale...

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## russian434

what about pharmacist?

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## tcw

One of my Uncles *(mom's side) is anesthesiologist.

He was making so much money at one time,....he bought a house next to the San Antonio Center Dave Robinson. But then...his wife broke him. He had to file BK...had too many houses and spoiled kids to support. He's still makin $...but not like before. 




> I know it is happening, and I have been reading about it for few years. Having said that, all the doctors I know are rich. If I could do it all over again I would become an anesthesiologist.

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## Lemonada8

the cost of having your own practice is getting way to much, thats why hospitals are so appealing now (and they pay off some loans :-) )... which its just basically turning healthcare into a business ran by a businessman, not a doctor running a business. (not saying that they cant, but the primary focus is different).. .then docs basically become employees and have a boss... WHich, personally, i wanna be my own boss not have a boss.. .

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## AD

like all professions, there are rich drs and there are poor ones. medical school tend to attract the more academically inclined candidates, who may not be as strong in the business/money sense. i know a doctor who makes US$220k a year, and his clinic is not even busy at all. 

but i know a futures day trader who makes 20k a day. 5 days a wk. average.

if you want to get bloody rich, medicine is not really right the thing to do.

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## juellz

Although medicine might not be the "greatest" thing to do. It is a GREAT starting point to become wealthy if you invest your funds properly. I know a Doctor who has been living very frugally and his biggest expenses revolve around the basics + his student loans. 

He has 500,000$ saved in his bank account, which he just received back after flipping an appartment building which he bought for 200,000$ in 2001. Now, he would have probably not been able to do this if he was living on a salary of 30,000$ back then when he purchased it.

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## Carter Dwayne

I think it’s important for doctors to have a plan B. I mean with malpractice insurance increasing, it’s almost impossible to live lavishly. My cousin recently graduated from John Hopkins and now she has $240,000 in debt, but with out doctors where would we be.

Thank you to all of the doctors

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## DB1982

My wife works in a major hospital . Trust me Doctors are not hurting for money. Maybe small practices but that's the way business goes some make it and some don't . 

Imagine if you went to work and you could tell the place you work for what you will and will not do. Well this is what Doctors do. So you may go to a hospital that accepts your insurance only to receive a bill later because the Dr that helped doesn't accept your insurance. Pure Bullshit

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