Making money in peds

[ihatesurgery]

Hi. I am a PGY3 doing peds and although most of us are abashed at saying it I will: One of the primary reasons I chose to go into medicine is knowing that I will be able to support my family VERY COMFORTABLY and live a good life. Now, making 140,000-200K dollars as a gen pediatrician or 130,000-180K as a peds specialist just doesn't cut it. After taxes, after paying your kids school tuition and camp, car payments, insurance, mortgage, food, health insurance, general costs of living, (forget about school debt now) you are practically left with close to nothing to put away for your future and retirement. This is not going to work for me.

The way I see it, there are several ways to make more:
1) Do ER and bust your balls off moonlighting and doing urgis and this might pop you over 300.
2) Do A&I fellowship and work hard, this might bring in 300-500K eventually.
3) Do gen peds and hope that one day you will be the partner of a big, bustling practice and hope that reimbursements don't drop. (You know that new fee-for-performance everone's talking about, peds will get screwed as per my director, since many routine CBC's, throat cx, and follow-up visits will be deemed unnecessary) You can top off at 300K if you are in a really busy practice and work 5-6 FULL days a week, seeing 80-90 patients a day. Crazy!
4) Drop peds and do rads, anesthesia, etc..
5) Go into business.
6)marry rich (too late for me)

Let me know what you guys think.

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[dr.z]

6)marry rich (too late for me)

Let me know what you guys think.

I'm always hoping for this one.

 

[banner]

What about Botox or "diet medicine"??

Our society's obsession with superficial perfection will surely trickle down to the 8 year olds... .

 

[kiddoc20]

why you posted peds speciality salary in lower range? private practicing peds specialist like.....NICU, a and i,critical care docs and those lucky peds cardio docs who got private jobs are earning a lot more. i thought especially NICU guys earn atleast 200k. correct me if i am wrong. i see a lot of adds with 200k jobs for peds specialist..are they rubbish?

 

[iatrosB]

Hi. I am a PGY3 doing peds and although most of us are abashed at saying it I will: One of the primary reasons I chose to go into medicine is knowing that I will be able to support my family VERY COMFORTABLY and live a good life. Now, making 140,000-200K dollars as a gen pediatrician or 130,000-180K as a peds specialist just doesn't cut it. After taxes, after paying your kids school tuition and camp, car payments, insurance, mortgage, food, health insurance, general costs of living, (forget about school debt now) you are practically left with close to nothing to put away for your future and retirement. This is not going to work for me.

The numbers for general peds sound inflated, but if that is how much you can make and that is not enough for you, go cry elsewhere. It would be different if the specialty paid sub 100K but it doesn't. That is more than enough to live comfortably, sounds like you should down-grade VERY COMFORTABLY and be happy about your vocation. If you go into something for the money, you will be unhappy. If you work crazy hours in something you like, you will be unhappy. Just change your priorities to happiness instead of material things and your good to go

 

[tatabox80]

Just out of curiosity, can you be a gen pediatrician and make 140- 200,000 a year working 40-50 hours a week. I've always heard the pediatricians often make under 100,000 a year

 

[edmadison]

Now, making 140,000-200K dollars as a gen pediatrician or 130,000-180K as a peds specialist just doesn't cut it.

Wow, and I though I was doing well making 50K a year. The way to maximize your lifestyle may be to move. Docs make more outside the major urban areas an the cost of living is lower too. I don't know where you are from, but for me I also consider the quality of life better.

The items you listed that you worried about affording are easily obtainable even making less than 100K, its all about making choices. The advantage about making more is that you don't have to.

Ed

 

[14022]

Hi. I am a PGY3 doing peds and although most of us are abashed at saying it I will: One of the primary reasons I chose to go into medicine is knowing that I will be able to support my family VERY COMFORTABLY and live a good life. Now, making 140,000-200K dollars as a gen pediatrician or 130,000-180K as a peds specialist just doesn't cut it. After taxes, after paying your kids school tuition and camp, car payments, insurance, mortgage, food, health insurance, general costs of living, (forget about school debt now) you are practically left with close to nothing to put away for your future and retirement. This is not going to work for me.

The way I see it, there are several ways to make more:
1) Do ER and bust your balls off moonlighting and doing urgis and this might pop you over 300.
2) Do A&I fellowship and work hard, this might bring in 300-500K eventually.
3) Do gen peds and hope that one day you will be the partner of a big, bustling practice and hope that reimbursements don't drop. (You know that new fee-for-performance everone's talking about, peds will get screwed as per my director, since many routine CBC's, throat cx, and follow-up visits will be deemed unnecessary) You can top off at 300K if you are in a really busy practice and work 5-6 FULL days a week, seeing 80-90 patients a day. Crazy!
4) Drop peds and do rads, anesthesia, etc..
5) Go into business.
6)marry rich (too late for me)

Let me know what you guys think.

I read nothing about student loan payments. If you cannot make ends meet with $140,000 per year without student loan payments then the problem is you, not your salary. Millions of people live well with half this salary.

 

[ihatesurgery]

I happen to live in NYC and want to stay around here. Here is a crude breakdown of expenses:
Suppose I make 150k DOING GEN PEDS OR SUBSPECIALTY, after taxes that's about 85K, after mortgage payments (~2000/month on a 300K mortgage =24K) so now we are down to about 60K, prvt. school tuition for three kids and camp expenses is about 15K per year (EVEN MORE), now we are down to 45K. Electricity/gas/phone is about 5k per year, now we are at 40K. Health insurance for my family is 8-9K, down to 32k. 2 leased midsized vehicles for me and my wife with car insurance/GAS is about 10k per year, now we are at 22K. I pay student loans about 700 per month =8k, now we are at 14K. Food costs (well over, but lets say) 5k, 9K left in the bank. THEN, I have general costs of living (a bit of charity, eating out once a month, movies, cable, DSL fees, journal and club fees, etc.. pretty much brings me close to 0.

As you can see I live life comfortably, not luxuriously. I do not want to move from where I live, (family reasons). I do want to save some money for a rainy day and for my family/retirement. This is very difficult in peds. Dont get me wrong, I love peds, but I am just trying to find a way to practice it and be comfortable.

 

[14022]

I happen to live in NYC and want to stay around here. Here is a crude breakdown of expenses:
Suppose I make 150k DOING GEN PEDS OR SUBSPECIALTY, after taxes that's about 85K, after mortgage payments (~2000/month on a 300K mortgage =24K) so now we are down to about 60K, prvt. school tuition for three kids and camp expenses is about 15K per year (EVEN MORE), now we are down to 45K. Electricity/gas/phone is about 5k per year, now we are at 40K. Health insurance for my family is 8-9K, down to 32k. 2 leased midsized vehicles for me and my wife with car insurance/GAS is about 10k per year, now we are at 22K. I pay student loans about 700 per month =8k, now we are at 14K. Food costs (well over, but lets say) 5k, 9K left in the bank. THEN, I have general costs of living (a bit of charity, eating out once a month, movies, cable, DSL fees, journal and club fees, etc.. pretty much brings me close to 0.

As you can see I live life comfortably, not luxuriously. I do not want to move from where I live, (family reasons). I do want to save some money for a rainy day and for my family/retirement. This is very difficult in peds. Dont get me wrong, I love peds, but I am just trying to find a way to practice it and be comfortable.

I understand your dilemma. I will have the same on my hands in a few years. I want to do peds cards and I have 200K+ in student loans. I am getting married and want to have kids and have my wife be a stay at home mom (as does she). I tried to consider other specialties but had a hard time justifying going into something that I kind of liked for the money versus something I love.

In terms of your suggestions, peds rads and anesthesia are possibilities for you. It would be another 5+ years of PGY pay, so this may be highly undesireable. Can your wife work at all? Can she work a few hours a week while kids are in school? Even if she only makes $10K per year, that would take care of your student loan payment and free up a ton of income.

 

[14022]

I happen to live in NYC and want to stay around here. Here is a crude breakdown of expenses:
Suppose I make 150k DOING GEN PEDS OR SUBSPECIALTY, after taxes that's about 85K, after mortgage payments (~2000/month on a 300K mortgage =24K) so now we are down to about 60K, prvt. school tuition for three kids and camp expenses is about 15K per year (EVEN MORE), now we are down to 45K. Electricity/gas/phone is about 5k per year, now we are at 40K. Health insurance for my family is 8-9K, down to 32k. 2 leased midsized vehicles for me and my wife with car insurance/GAS is about 10k per year, now we are at 22K. I pay student loans about 700 per month =8k, now we are at 14K. Food costs (well over, but lets say) 5k, 9K left in the bank. THEN, I have general costs of living (a bit of charity, eating out once a month, movies, cable, DSL fees, journal and club fees, etc.. pretty much brings me close to 0.

As you can see I live life comfortably, not luxuriously. I do not want to move from where I live, (family reasons). I do want to save some money for a rainy day and for my family/retirement. This is very difficult in peds. Dont get me wrong, I love peds, but I am just trying to find a way to practice it and be comfortable.

I understand your dilemma. I will have the same on my hands in a few years. I want to do peds cards and I have 200K+ in student loans. I am getting married and want to have kids and have my wife be a stay at home mom (as does she). I tried to consider other specialties but had a hard time justifying going into something that I kind of liked for the money versus something I love.

In terms of your suggestions, peds rads and anesthesia are possibilities for you. It would be another 5+ years of PGY pay, so this may be highly undesireable. Can your wife work at all? Can she work a few hours a week while kids are in school? Even if she only makes $10K per year, that would take care of your student loan payment and free up a ton of income.

 

[sdnetrocks]

Hi. I am a PGY3 doing peds and although most of us are abashed at saying it I will: One of the primary reasons I chose to go into medicine is knowing that I will be able to support my family VERY COMFORTABLY and live a good life. Now, making 140,000-200K dollars as a gen pediatrician or 130,000-180K as a peds specialist just doesn't cut it. After taxes, after paying your kids school tuition and camp, car payments, insurance, mortgage, food, health insurance, general costs of living, (forget about school debt now) you are practically left with close to nothing to put away for your future and retirement. This is not going to work for me.

The way I see it, there are several ways to make more:
1) Do ER and bust your balls off moonlighting and doing urgis and this might pop you over 300.
2) Do A&I fellowship and work hard, this might bring in 300-500K eventually.
3) Do gen peds and hope that one day you will be the partner of a big, bustling practice and hope that reimbursements don't drop. (You know that new fee-for-performance everone's talking about, peds will get screwed as per my director, since many routine CBC's, throat cx, and follow-up visits will be deemed unnecessary) You can top off at 300K if you are in a really busy practice and work 5-6 FULL days a week, seeing 80-90 patients a day. Crazy!
4) Drop peds and do rads, anesthesia, etc..
5) Go into business.
6)marry rich (too late for me)

Let me know what you guys think.

1. What about peds cards?

2. What about an "executive" practice, where pts pay a membership fee (~$2k/yr) out of pocket for superior service (same day appointments, etc.)?

3. What about a cash-based peds specialty... adolescent medicine?

 

[kidmd44]

I'm a third year peds resident. I came to a crossroads over the winter last year. Was planning to apply to PICU fellowships. Have 2 kids. Wife's tired of working full time. I missed my family.

PICU, although one of the better paying specialties, can offer a horrendous lifestyle. I needed to be honest with myself, though, and loyal to my interests. I love physiology, sick kids, critical care, blood gases, etc. I wanted to do all of this stuff, but only during business/banker hours. After talking with many of my mentors in PICU who were sick of being on call q 5 while they are 50 years-old, and after them telling me that, "If I had it all to do over, I would have chosen anesthesia," I took a shot and went the anesthesia route.

Best of luck to all of you. As a pediatrician myself, the most noble, in my mind, are those that choose primary care. There is such a need for good PMDs out there. It takes grit, smarts, patience, and love of social issues (i.e. pediatrics) for one to do primary care peds well. I respect all of you who choose this path. For me, I need more time and a little more money for my family. Moreover, I want to save some of my smarts, patience, etc. for my two beautiful boys at home, not the 30-40 patients within a busy peds practice.

Again, best of luck to all of you.

 

[HOLLYWOOD]

I happen to live in NYC and want to stay around here. Here is a crude breakdown of expenses:
Suppose I make 150k DOING GEN PEDS OR SUBSPECIALTY, after taxes that's about 85K, after mortgage payments (~2000/month on a 300K mortgage =24K) so now we are down to about 60K, prvt. school tuition for three kids and camp expenses is about 15K per year (EVEN MORE), now we are down to 45K. Electricity/gas/phone is about 5k per year, now we are at 40K. Health insurance for my family is 8-9K, down to 32k. 2 leased midsized vehicles for me and my wife with car insurance/GAS is about 10k per year, now we are at 22K. I pay student loans about 700 per month =8k, now we are at 14K. Food costs (well over, but lets say) 5k, 9K left in the bank. THEN, I have general costs of living (a bit of charity, eating out once a month, movies, cable, DSL fees, journal and club fees, etc.. pretty much brings me close to 0.

As you can see I live life comfortably, not luxuriously. I do not want to move from where I live, (family reasons). I do want to save some money for a rainy day and for my family/retirement. This is very difficult in peds. Dont get me wrong, I love peds, but I am just trying to find a way to practice it and be comfortable.

you forgot life insurance,parking,tolls. you really need an suv or mini van b/c you have 3 kids. also have you taken your kids to the movies lately? 40 to 50 dollars for a family of 5. And since you live in the city with kids the may want to go to a show or the circus and you may have to take a cab. Some people don't get it!! I feel your pain, btw you forgot about birthday parties and clothes!!

 

[sdnetrocks]

I'm a third year peds resident. I came to a crossroads over the winter last year. Was planning to apply to PICU fellowships. Have 2 kids. Wife's tired of working full time. I missed my family.

PICU, although one of the better paying specialties, can offer a horrendous lifestyle. I needed to be honest with myself, though, and loyal to my interests. I love physiology, sick kids, critical care, blood gases, etc. I wanted to do all of this stuff, but only during business/banker hours. After talking with many of my mentors in PICU who were sick of being on call q 5 while they are 50 years-old, and after them telling me that, "If I had it all to do over, I would have chosen anesthesia," I took a shot and went the anesthesia route.

I matched into my first choice for anesthesia. I am thrilled about it! I will finish my peds and ultimately do peds anesthesia. The final result will be kids, physiology, and (almost) banker hours. Oh, by the way, everyone knows that anesthesiologists are coming out of residency starting at 350K, right? Yeah, that's just a bonus.

Best of luck to all of you. As a pediatrician myself, the most noble, in my mind, are those that choose primary care. There is such a need for good PMDs out there. It takes grit, smarts, patience, and love of social issues (i.e. pediatrics) for one to do primary care peds well. I respect all of you who choose this path. For me, I need more time and money for my family. Moreover, I want to save some of my smarts, patience, etc. for my two beautiful boys at home, not the 30-40 patients within a busy peds practice.

Again, best of luck to all of you.

Does this mean that you can do an anesthesia fellowship after peds and become a pediatric anesthesiologist (similar to emergency fellowship after peds)?

If so, is it a lot harder to get into peds gas from peds vs. gas residency?

 

[kidmd44]

Does this mean that you can do an anesthesia fellowship after peds and become a pediatric anesthesiologist (similar to emergency fellowship after peds)?

If so, is it a lot harder to get into peds gas from peds vs. gas residency?

No, no. I have to do a full anesthesia residency, minus the transitional year, of course. A full anesthesia residency equals 3 years. Afterwards, I will do a 1 year peds anesthesia fellowship. In total, it will be 4 additional years of training beyond my peds residency. The way I look at it, it is similar to doing a peds chief year, then doing a peds fellowship. The big difference, however, is that anesthesia residency is much nicer (in terms of hours-worked) compared to peds residency, by a matter of 25-30 hours per week less. DAMN I'm excited!!

 

[dara678]

my parents brought up my sister and I on much much MUCH less than $140,000/year, and we both went to private school. granted costs in nyc are much different than where i lived, but maybe the reason you can't save money away for a rainy day is that your significant other isn't working. even part time stay-at-home stuff can bring in a salary that will be good to save for emergencies and vacations -- maybe your wife should look into it.

it seems like nowadays it's increasingly difficult for families to subsist with only one parent working. if you want a luxurious lifestyle and great vacations, i think you're going to need two salaries -- which sucks but is the unfortunate truth.