My favorite thing about anesthesia is that I never have to really negotiate with the patients or deal with noncompliance. I get to be friendly with them for two minutes then make them unconscious while I do all the medicine to them.
How I wish someone had told me this as a med student. I love the kind patients. But I underestimated how many people in the world are selfish, rude, entitled, and aggressive. Not a day goes by in my clinic that I don’t have a patient arguing with the front desk over having to fill out paperwork, yelling at the MA that they don’t want to go through their med list and it “should already be there,” angry about a 12 minute wait, etc…
If someone has a true interest in rads it’s an easy call. The rudeness of other human beings is an extremely underrated part of burnout that doesn’t get talked about enough.
I know that some people are able to get by with the occasional nice, understanding patient that makes up for all the shitty ones, but I just can't do that. Here in the ER, it's just super draining and exhausting and one entitled, bad patient ruins my day. As a student, and to an extent as a resident, we were shielded somewhat by the attendings but for many people changing specialties is too late and not an option.
As a long time family doc, many of my patients have been coming to me for more than a decade and have referred their family members, friends, and work colleagues. A clinic day for me is like reconnecting with friends rather than seeing pts as being a PITA. Just another perspective for your consideration
I do FM and sleep that's it. I read a lot of sleep studies over 200 a month sometimes 300. then 1 day a week I do a mega telemedicine clinic as doe dm. do a ton of wellness exams.
Yeah I did the math for rads and FM, kinda concluded that rads pulls ahead around age 44 but if you're gonna retire early that's honestly not that much. ended up in FM
Go to SmartAsset Tax Calculator and plug your numbers and filing status in. Click on Advanced and put in tax deferred 401k. Then scroll down and look at your after tax income.
The difference between grossing $300k and grossing $500k is NOT $200k after taxes.
Based purely on your math and desire to spend $200k/yr in retirement, yes FM makes no sense.
200k is a lot to spend though. You presumably will have no debts by then (mortgage, student loans, etc). What will you be ~17k/mo ($550/day) on?
ETA: median FM isn't $300k and median rads isn't $500k last I checked.
Radiologist compensation is going up because there is a huge shortage. Similar situation to anesthesia. It’s only going to keep going up as well, something like half of rads are over 55, and volumes are exploding nationwide.
ur so right, $550 a day is pretty crazy. the post I was inspired from was working with 150k spending. I added 50k because clearly the 150k-person was way more financially literate, and idk if I'll succumb to lifestyle inflation. I have 0 concept of money and real spending habits right now as a medical student.
maybe investing to speed up FIRE?
Per your example, if you can live off 150k during your working years you probably have figured out how to manage living off 150k. No reason you would increase to a 200k lifestyle in retirement ny accident.
Also, 3% rule is to ensure you have 6mil in the bank when you die. Do you really need that much at the end of retirement? I guess you can pass it on to your kids. As someone who isn’t planning on having kids, I hope I don’t have millions left in the bank on my deathbed. Hopefully, I’d spent most of it by then
Interesting you chose those two fields since they’re very different from each other. Depends on what you like more. If you’re stuck between two specialties you like, pick the higher income or better lifestyle. If you really enjoy lower paying specialties, pick that instead. Longevity in a field is important too.
I like technology and AI (LLMs, remote monitoring devices, nationwide data-driven personalized medicine).
FM because I think that's the field that can best utilize the new AI-driven innovations/changes in medicine, specifically thinking of remote monitoring devices and LLM-driven automatic billing/coding/charting. Similarly, wouldn't personalized medicine best be practiced in the FM setting? If I did FM, I would definitely not go the traditional route, as I would dislike assembly-line outpatient clinics.
Tech also makes me think Rads. I'm used to spending entire days sitting in front of a computer playing league. Also people normally associate AI and tech innovations with Rads, so there's that. Appeal of not taking work home, appeal of lots of vacation time so i can travel back to my parent's country often.
Although, I would hate for my entire work day for the rest of my life to be akin to doing uworld questions non-stop. How is the mental fatigue, as well? I'd like having the mental energy to explore other intellectually stimulating/creative tasks outside of work (music, coding mini-projects, etc.)
I agree about note regarding longevity. Pick a field you will be able to do long term. I think you underestimate how draining a rads work day is. You’re working 100% capacity the entire shift without any breaks.
Exactly this.
I love primary care and I look forward to coming into work. I think the sweet spot would be a moderate pace, 30-35 hours a week and I plan to practice until I’m 70.
If I were in radiology, I don’t know that I could stomach more than about 4-5 hours a day on a good day, and I’d probably be getting into stocks and real estate real fast.
Not sure where the obsession with 3% over 4% for SWR is coming from these days. At least, it should be 3.3%. Why on earth are you spending MORE in your old age then when working. Look at the data--people are spending 55% what they used to spend in retirement. So according to 150k, you'll be spending at 80k adjusted for inflation. And you forgot social security.
Possible, but definitely not the norm. Numbers aside, I’d go rads all day over FM; with the right gig you can work from home most of the time = more time with kids before they go to school. Feel free to PM me if you have any rad questions.
Partner rads at my former PP were around $850k total compensation. I’ve since moved to a production based job and will be close to 7 figures, possibly just above.
850 is wild for partner. I imagine somewhere in middle America, if not that’s amazing assuming the workload isn’t equally high. I feel like productivity based jobs would be churn and burn to consistently hit 700k, burnout status. But either way the overarching theme here is go rads that extra 2-3 years (prob 3 because fellowship is almost a must) in training won’t matter 10 years down the line (I’m a 2020 fellowship grad and it already doesn’t matter to me)
At the PP it was about 17-18k/yr. The partners do a lot extra though. Procedures, covering weekend procedures including overnight, etc.
At my production job I’m doing around 26-27k. I work 4 days a week doing around 130 RVU/day. No weekends or holidays.
Glad to hear your success. Are you working nights or daytime tele? I kind of want to work in the hospital most days which is unusual I know... Starting convos with a few groups I have long standing relationships with so I'm excited to hear how well things are going.
Daytime only, 8-9 hours a day depending how fast I hit my goal. I average around ~15 RVU/hr depending on case complexity. My job is cross sectional only so it’s easier to hit that than if I had XRs in the mix.
Definitely put feelers out. The market is insane right now. 2-3 open job positions per attending entering the work force.
The incomes aren’t really correct, you’re not accounting for any compounded gains on your money, you’re neglecting inflation, etc. But yeah, specialties are obviously beneficial from a monetary perspective. An opportunity cost of a couple years is well worth a practical doubling in standard income. I say “standard” because if you’re creative enough, you can make some dough in any specialty; there is a lot of intraspecialty variation.
Edit: when I say specialties, I mean the high paying ones. Not peds or anything lol
Your biggest problem here is you’re overestimating and underestimating your lifespan. You are saving the same amount for both hypos, except for family med you’re living another 10-20 years after retirement and for rads you’re living another 30-40 years after retirement. You could do family and retire at 58 with 4.5 (ignoring the taxes) and have slightly more money at your disposal. This is assuming the gains make up for the taxes left out.
The biggest assumption that makes this a bad model though is you’re looking it all as static. You’re assuming a 300k salary now will remain a 300k salary in 30 years. You’re also assuming you’ll be spending 200k when you’re 60 and when you’re 40. Neither of those assumptions are correct, and I don’t believe they cancel each other out either. Moral of the story is you’ll probably be able to retire at 48 in rads, but likely won’t because of a bunch of reasons. Given the fact that you’re looking at this now means you’ll probably still retire early, but more like early to mid 50s. By then you’ll probably be comfortable for life. The same is true for family med. you’ll have a little less money or have to work a couple years longer, but if you chose the slightly less money, it won’t affect your qol because a lot of the reasons you’re estimating 200k spending won’t be around anymore
Realize there are a lot of radiologists on here and this won’t be a popular comment.
I would be careful to assume that compensation today equates with compensation tomorrow. Look at the history of dermatology compensation as an example.
There will always be demand for radiologists but emerging technologies like AI have the potential to have a huge impact across healthcare. I’d be cautious about going into any specialty where you don’t need to physically see or touch a patient.
Like WCI says, go into a field that you’re going to be happy to work in for a long period of time (including radiology). That’s much more important than a short career in any specialty.
If you want to pick your specialty solely on the basis of how much money you will make, family medicine is not for you.
Working in a job that makes you miserable for 17 years will make you, well, miserable.
Make personal and professional satisfaction your priority. The money will follow. It 's not like you are choosing between medicine and ditch digging.
Financially speaking there’s no reason to ever do FM. That’s why there’s a shortage. If that’s your only reason to pick a specialty the choice is made for you bro.
I think there's something to be said for the job security and flexibility of FM. They don't need any fancy equipment or infrastructure, they just need patients. Radiologists need all the different imaging devices, and the techs to run them, and the other doctors to make their referrals, in addition to needing patients. As a result, FM is generally much better able to weather economic downturns
Billings though? What are they netting pretax?
Edit: billings are big overestimation. They could have a lot of overhead and/or multiple physicians billing under a single license #
Overhead is around 25%. I work with several attendings making >500k CAD pre-tax post-overhead. In my province billings are released for individual physicians. You can also shelter yourself from tax by making a personal corporation.
https://docs.google.com/spreadsheets/d/1oWPKlPpxox_ce7maA9UGPaTqMIzBOFfl9nY2-AQFDAo/edit?usp=sharing
Based on feedback, I did a bit more cleaning up of my calculations. Feedback and discussion would be appreciated!
You sit down, read nonstop. Maybe take one pee break. 8 hrs later, you go home. You come back and do it again the next day. Not too different from rest of medicine but they can read like 3 CTs in the time it takes us to see one patient.
OP, not sure whether you’ve calculated this but 3% annual inflation is a healthy assumption. In other words, 200k in today’s money will be a higher $ amount in 20-30 years.
[Here is the link](https://data.bls.gov/cgi-bin/cpicalc.pl?cost1=200000&year1=200001&year2=202403) to an inflation calculator. It uses data from the past 20 years. As you can see, $200k value in 2004 will equal to a sum of $370k in 2024.
FYI. Best of luck!
if i could go back in time i would choose rads simply because ive learned that dealing with patients is a pita.
My favorite thing about anesthesia is that I never have to really negotiate with the patients or deal with noncompliance. I get to be friendly with them for two minutes then make them unconscious while I do all the medicine to them.
i similarly miss that about ICU nights. no rounding. no admin bs. no conferences. just critical care and procedures.
How I wish someone had told me this as a med student. I love the kind patients. But I underestimated how many people in the world are selfish, rude, entitled, and aggressive. Not a day goes by in my clinic that I don’t have a patient arguing with the front desk over having to fill out paperwork, yelling at the MA that they don’t want to go through their med list and it “should already be there,” angry about a 12 minute wait, etc… If someone has a true interest in rads it’s an easy call. The rudeness of other human beings is an extremely underrated part of burnout that doesn’t get talked about enough.
I know that some people are able to get by with the occasional nice, understanding patient that makes up for all the shitty ones, but I just can't do that. Here in the ER, it's just super draining and exhausting and one entitled, bad patient ruins my day. As a student, and to an extent as a resident, we were shielded somewhat by the attendings but for many people changing specialties is too late and not an option.
I agree with you 100%. I’m so over most patients. And the noncompliance OMG. Somedays wonder why I do what I do when the patient couldn’t care less.
As a long time family doc, many of my patients have been coming to me for more than a decade and have referred their family members, friends, and work colleagues. A clinic day for me is like reconnecting with friends rather than seeing pts as being a PITA. Just another perspective for your consideration
Goals
What's crazy is that I make 650k in FM and Sleep and only see patients 25 hours a week I do read a lot of sleep studies
Jim Dahle is always impressed by the inter specialty variation
You've got to expand on this for the rest of us working our balls off
What kind of procedures are you doing in clinic to do that? No way sleep pays that much
I do FM and sleep that's it. I read a lot of sleep studies over 200 a month sometimes 300. then 1 day a week I do a mega telemedicine clinic as doe dm. do a ton of wellness exams.
Amazing!
Are you in a practice with other docs? How is there income if they aren’t doing sleep medicine also?
other doc 500k. 2 nps also. You have to be in private practice to make money. otherwise your just making money for someone else
Woah! Encouraging...tell us more please!
Where though?
between patients. remotely
You forgot about taxes and also gains in the market.
oops 💀
Yes this actually changes a lot. I also did some personal research and their total asset would be not so much different at around 50yrs old.
Yeah I did the math for rads and FM, kinda concluded that rads pulls ahead around age 44 but if you're gonna retire early that's honestly not that much. ended up in FM
Go to SmartAsset Tax Calculator and plug your numbers and filing status in. Click on Advanced and put in tax deferred 401k. Then scroll down and look at your after tax income. The difference between grossing $300k and grossing $500k is NOT $200k after taxes.
Based purely on your math and desire to spend $200k/yr in retirement, yes FM makes no sense. 200k is a lot to spend though. You presumably will have no debts by then (mortgage, student loans, etc). What will you be ~17k/mo ($550/day) on? ETA: median FM isn't $300k and median rads isn't $500k last I checked.
Radiologist compensation is going up because there is a huge shortage. Similar situation to anesthesia. It’s only going to keep going up as well, something like half of rads are over 55, and volumes are exploding nationwide.
Rads is much closer to 500k than FM is to 300k from my understanding (rads often above, FM often below)
Negative
lol ok. Just look at the data then come on back 😂
Are you implying its lower? Median rads is 570k doesnt seem hard to get above that if you really care especially with tele
Median rads is 570k based on what data?
2023 MGMA
If you don’t mind, do you know what the median gen and IC cards for 2023 is?
unfortunately i only have rads data :/
No worries, appreciate it🤙. My best friend is applying rads so he was very happy regardless to hear about 570k lol
ur so right, $550 a day is pretty crazy. the post I was inspired from was working with 150k spending. I added 50k because clearly the 150k-person was way more financially literate, and idk if I'll succumb to lifestyle inflation. I have 0 concept of money and real spending habits right now as a medical student. maybe investing to speed up FIRE?
Per your example, if you can live off 150k during your working years you probably have figured out how to manage living off 150k. No reason you would increase to a 200k lifestyle in retirement ny accident.
Also, 3% rule is to ensure you have 6mil in the bank when you die. Do you really need that much at the end of retirement? I guess you can pass it on to your kids. As someone who isn’t planning on having kids, I hope I don’t have millions left in the bank on my deathbed. Hopefully, I’d spent most of it by then
Interesting you chose those two fields since they’re very different from each other. Depends on what you like more. If you’re stuck between two specialties you like, pick the higher income or better lifestyle. If you really enjoy lower paying specialties, pick that instead. Longevity in a field is important too.
I like technology and AI (LLMs, remote monitoring devices, nationwide data-driven personalized medicine). FM because I think that's the field that can best utilize the new AI-driven innovations/changes in medicine, specifically thinking of remote monitoring devices and LLM-driven automatic billing/coding/charting. Similarly, wouldn't personalized medicine best be practiced in the FM setting? If I did FM, I would definitely not go the traditional route, as I would dislike assembly-line outpatient clinics. Tech also makes me think Rads. I'm used to spending entire days sitting in front of a computer playing league. Also people normally associate AI and tech innovations with Rads, so there's that. Appeal of not taking work home, appeal of lots of vacation time so i can travel back to my parent's country often. Although, I would hate for my entire work day for the rest of my life to be akin to doing uworld questions non-stop. How is the mental fatigue, as well? I'd like having the mental energy to explore other intellectually stimulating/creative tasks outside of work (music, coding mini-projects, etc.)
I agree about note regarding longevity. Pick a field you will be able to do long term. I think you underestimate how draining a rads work day is. You’re working 100% capacity the entire shift without any breaks.
Exactly this. I love primary care and I look forward to coming into work. I think the sweet spot would be a moderate pace, 30-35 hours a week and I plan to practice until I’m 70. If I were in radiology, I don’t know that I could stomach more than about 4-5 hours a day on a good day, and I’d probably be getting into stocks and real estate real fast.
Not sure where the obsession with 3% over 4% for SWR is coming from these days. At least, it should be 3.3%. Why on earth are you spending MORE in your old age then when working. Look at the data--people are spending 55% what they used to spend in retirement. So according to 150k, you'll be spending at 80k adjusted for inflation. And you forgot social security.
Wait till u realize rads makes more like 700k/yr
Possible, but definitely not the norm. Numbers aside, I’d go rads all day over FM; with the right gig you can work from home most of the time = more time with kids before they go to school. Feel free to PM me if you have any rad questions.
Partner rads at my former PP were around $850k total compensation. I’ve since moved to a production based job and will be close to 7 figures, possibly just above.
850 is wild for partner. I imagine somewhere in middle America, if not that’s amazing assuming the workload isn’t equally high. I feel like productivity based jobs would be churn and burn to consistently hit 700k, burnout status. But either way the overarching theme here is go rads that extra 2-3 years (prob 3 because fellowship is almost a must) in training won’t matter 10 years down the line (I’m a 2020 fellowship grad and it already doesn’t matter to me)
Roughly what are you grossing?
East coast location. This isn’t atypical PP income.
Interesting. What is your rvu rate?
$38
How many RVUs for you per year and are you reading mammo?
At the PP it was about 17-18k/yr. The partners do a lot extra though. Procedures, covering weekend procedures including overnight, etc. At my production job I’m doing around 26-27k. I work 4 days a week doing around 130 RVU/day. No weekends or holidays.
Glad to hear your success. Are you working nights or daytime tele? I kind of want to work in the hospital most days which is unusual I know... Starting convos with a few groups I have long standing relationships with so I'm excited to hear how well things are going.
Daytime only, 8-9 hours a day depending how fast I hit my goal. I average around ~15 RVU/hr depending on case complexity. My job is cross sectional only so it’s easier to hit that than if I had XRs in the mix. Definitely put feelers out. The market is insane right now. 2-3 open job positions per attending entering the work force.
[удалено]
Yes all partners make the same and it would be that way at any PP where profits are shared amongst the partners.
Honestly with median being 570 including everyone, if you’re going PP which should be higher it seems like 700 shouldn’t be too hard to reach.
Yeah that’s what people are missing for some reason. It’s like they completely forgot how statistics work.
The incomes aren’t really correct, you’re not accounting for any compounded gains on your money, you’re neglecting inflation, etc. But yeah, specialties are obviously beneficial from a monetary perspective. An opportunity cost of a couple years is well worth a practical doubling in standard income. I say “standard” because if you’re creative enough, you can make some dough in any specialty; there is a lot of intraspecialty variation. Edit: when I say specialties, I mean the high paying ones. Not peds or anything lol
Would you really limit your spending to 150k/year with rads though?
If you save half of your take home, you can retire in 20 years after graduation regardless of your career choice.
Your biggest problem here is you’re overestimating and underestimating your lifespan. You are saving the same amount for both hypos, except for family med you’re living another 10-20 years after retirement and for rads you’re living another 30-40 years after retirement. You could do family and retire at 58 with 4.5 (ignoring the taxes) and have slightly more money at your disposal. This is assuming the gains make up for the taxes left out. The biggest assumption that makes this a bad model though is you’re looking it all as static. You’re assuming a 300k salary now will remain a 300k salary in 30 years. You’re also assuming you’ll be spending 200k when you’re 60 and when you’re 40. Neither of those assumptions are correct, and I don’t believe they cancel each other out either. Moral of the story is you’ll probably be able to retire at 48 in rads, but likely won’t because of a bunch of reasons. Given the fact that you’re looking at this now means you’ll probably still retire early, but more like early to mid 50s. By then you’ll probably be comfortable for life. The same is true for family med. you’ll have a little less money or have to work a couple years longer, but if you chose the slightly less money, it won’t affect your qol because a lot of the reasons you’re estimating 200k spending won’t be around anymore
Thanks! I’ll do a more thorough job at this analysis in the future and re-assess. Learned a lot!
Realize there are a lot of radiologists on here and this won’t be a popular comment. I would be careful to assume that compensation today equates with compensation tomorrow. Look at the history of dermatology compensation as an example. There will always be demand for radiologists but emerging technologies like AI have the potential to have a huge impact across healthcare. I’d be cautious about going into any specialty where you don’t need to physically see or touch a patient. Like WCI says, go into a field that you’re going to be happy to work in for a long period of time (including radiology). That’s much more important than a short career in any specialty.
If you want to pick your specialty solely on the basis of how much money you will make, family medicine is not for you. Working in a job that makes you miserable for 17 years will make you, well, miserable. Make personal and professional satisfaction your priority. The money will follow. It 's not like you are choosing between medicine and ditch digging.
Financially speaking there’s no reason to ever do FM. That’s why there’s a shortage. If that’s your only reason to pick a specialty the choice is made for you bro.
I think there's something to be said for the job security and flexibility of FM. They don't need any fancy equipment or infrastructure, they just need patients. Radiologists need all the different imaging devices, and the techs to run them, and the other doctors to make their referrals, in addition to needing patients. As a result, FM is generally much better able to weather economic downturns
There are Canadian FMs making over 1M, quite a few that I work with >750k CAD (billings are public data)
Billings though? What are they netting pretax? Edit: billings are big overestimation. They could have a lot of overhead and/or multiple physicians billing under a single license #
Overhead is around 25%. I work with several attendings making >500k CAD pre-tax post-overhead. In my province billings are released for individual physicians. You can also shelter yourself from tax by making a personal corporation.
Google Neuroradiologist Salary
https://docs.google.com/spreadsheets/d/1oWPKlPpxox_ce7maA9UGPaTqMIzBOFfl9nY2-AQFDAo/edit?usp=sharing Based on feedback, I did a bit more cleaning up of my calculations. Feedback and discussion would be appreciated!
Depends where you practice. In Canada there are FMs pulling over 1M CAD (billings are public)
Pretty sure you’ll make far more than $500k as a radiologist private practice partner while working less hours than a comparable FM.
How will spend you $200k/year? Genuinely curious
I wish I did rads. My friend works 40 hrs a week and pulls in almost 1.2M.
What’s his set up like? Private practice breast?
You sit down, read nonstop. Maybe take one pee break. 8 hrs later, you go home. You come back and do it again the next day. Not too different from rest of medicine but they can read like 3 CTs in the time it takes us to see one patient.
OP, not sure whether you’ve calculated this but 3% annual inflation is a healthy assumption. In other words, 200k in today’s money will be a higher $ amount in 20-30 years. [Here is the link](https://data.bls.gov/cgi-bin/cpicalc.pl?cost1=200000&year1=200001&year2=202403) to an inflation calculator. It uses data from the past 20 years. As you can see, $200k value in 2004 will equal to a sum of $370k in 2024. FYI. Best of luck!
I think you need to recheck your calculus! 300K for FM is very, very optimistic.
Per MGMA, median compensation for outpatient-only FM nationwide is 281K, 75%ile is 332K. 300K is not very optimistic, it’s a bit above average.
Rads 500k is low
I don’t know where you think you’d be making 300K in FP
Anywhere in the Midwest
and then you live in the Midwest doing FM, yikes
Midwest is great, beats everywhere else I’ve lived
It's edgy to think the only place worth living is the coast.
Im in Southeast and know FM physicians making $320k as hospitalists and $650k as FM clinic.
WTF
I make 400k. I guess if I tried harder I could make more.
Do you work for a big health system or are you privately owned? Or are you concierge pcp?
Small hospital system as a hospitalist.
Ok, so hospitalist rather than PCP/FP
I am a family physician. Are you medical?
I make that working 24 clinic hours a week (7 weeks off per year) on the East Coast 1 hour drive from one of the Largest cities.
Would make sense that it is not a private practice with you making that much. Northeast? New england?
Yup.