Pursue your dreams!

[Andrew_Doan]

If you have an idea, then go for it. You must think big in order to be big.

The last few months have been incredible for MedRounds Publications, Inc. Meetings with multi-million dollar investors and advisors have been a very positive experience! I am certain it is who you know as well as what you know that makes the difference in the long run.

You can read more about my dream here:
http://www.chinababyblog.com/content/view/22/39/

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[Shredder]

computer games...yeah ive seen many people get addicted, i had my share of it in late high school with counterstrike. the latest is world of warcraft. blizzardnet...that also sounds like warcraft. i guess im kinda in that loner, driven, focused phase you were once in. i tell ppl ill never wed...who knows. mustve been tough dealing with the parents in the harvard situation.

thats seems exciting to have those bigshot investors interested. good luck in raking it in, i understand the value of money. its a rocky road convincing others though. i agree with your analysis of research as well. it was a reason i decided to change from md phd track to md mba, but its good to see youre working to change that situation.

 

[Andrew_Doan]

the latest is world of warcraft. blizzardnet....

I've been tempted to play World of Warcraft, but I am too busy with my day job as a physician and working 40+ hours weekly on MedRounds to even consider touching video games ever again. I've seen players who dropped out of college with F's. It's not pretty.

In regards to the Angel Investors, this is a once in a life time opportunity. My team is very excited. I'm out to make "the situation" better for future academics.

We should reward the Michael Jordans in academics instead of draining their souls and energy for waiting to teach.

 

[housecleaning]

{from your blog}The starting salaries for physicians are already dropping to the $60,000-$80,000/year range. How many of you would be willing to work in a field where you must take a 5.5% pay cut yearly when inflation is climbing at about 4% yearly?

is this really true? $60-80K/yr? is this in a specialty or gen practice? which geographical area?

 

[Shredder]

If you have an idea, then go for it. You must think big in order to be big.

The last few months have been incredible for MedRounds Publications, Inc. Meetings with multi-million dollar investors and advisors have been a very positive experience! I am certain it is who you know as well as what you know that makes the difference in the long run.

You can read more about my dream here:
http://www.chinababyblog.com/content/view/22/39/

i saw a video today in my management class on Nidek--i was reminded of you!

 

[housecleaning]

is this really true? $60-80K/yr? is this in a specialty or gen practice? which geographical area?

that's what i thought. just more bs.

 

[Andrew_Doan]

is this really true? $60-80K/yr? is this in a specialty or gen practice? which geographical area?

Yes this is true.

In academia, physicians may start this low.

If you work for an HMO (which may be your most likely option if working in a big city), then the starting salary for general practice is around the $80-$100 mark.

For physicians in FP and internal medicine (even ophthalmology), being in a big city is a major disadvantage. Starting salaries can be under $100.

As Medicare cuts back 5% each year for physician reimbursements, don't expect things to improve.

 

[housecleaning]

Yes this is true.

In academia, physicians may start this low.

If you work for an HMO (which may be your most likely option if working in a big city), then the starting salary for general practice is around the $80-$100 mark.

For physicians in FP and internal medicine (even ophthalmology), being in a big city is a major disadvantage. Starting salaries can be under $100.

As Medicare cuts back 5% each year for physician reimbursements, don't expect things to improve.

academia has always been this low. you indicated this was a recent development.

 

[Andrew_Doan]

academia has always been this low. you indicated this was a recent development.

I didn't state this is a recent development.

However, at this point, if things don't change, few good people will stay in academia.
http://www.medrounds.org/blog/2005/06/crisis-in-academic-publishing-and.html

 

[JAMMAN]

is this really true? $60-80K/yr? is this in a specialty or gen practice? which geographical area?

This is quite an underestimate. I am in my first year of practice as a surgical subspecialist and my first year compensation will be at least 8x what I made as a senior fellow last year. In fact my monthly paycheck will almost be what I made during my entire intern year.

Although I am on call every third night, I only have to work 4 days/week.

Life is good...

 

[JAMMAN]

Yes this is true.

In academia, physicians may start this low.

If you work for an HMO (which may be your most likely option if working in a big city), then the starting salary for general practice is around the $80-$100 mark.

For physicians in FP and internal medicine (even ophthalmology), being in a big city is a major disadvantage. Starting salaries can be under $100.

As Medicare cuts back 5% each year for physician reimbursements, don't expect things to improve.

Physicians in academics are paid less than private practice physicians.

An academic pediatrician may start @ $90K, but $60-80K is too low of an estimate.

Opthalmologists do not generally make under $100K. Again, academic physicians do make less. One of my classmates is in optho. He started with a guarantee of $180K + bonus. He met that in his first quarter. Some of the colleagues make in the upper 6 to low 7 figures. His practice owns the local surgical center and is abble to generate additional income that way.

Every year medicare does try to decrease the reimbursement and every year congress has and will continue to veto it.

 

[housecleaning]

I didn't state this is a recent development.
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you did. not only did you indicate that it is a recent development, but you stated that the transition into this salary range is *presently occurring*!

andy: "The starting salaries for physicians are already dropping to the $60,000-$80,000/year range." then you only cite academia.

if salaries have always been in this range, then they can't be "already dropping" to it. (unless english is your second or third language, in which case all your base are belong to us.)

if your goal is to exaggerate & be as deceptive as possible about salaries, then why not include fellowship salaries & state that physician salaries are "already dropping" to $40K-60K/yr? this would also be incorrect, but no more so than your previous lie. fellows are also physicians & their salaries have also always been in this range.

keep it honest. that way we'll have more of a tendency to believe you when you rant about the optos taking over.

 

[Andrew_Doan]

you did. not only did you indicate that it is a recent development, but you stated that it is *presently occurring*!

andy: "The starting salaries for physicians are already dropping to the $60,000-$80,000/year range." then you only cite academia.

Although not a recent development, salaries ARE dropping. Do you deny Medicare cutting reimbursements by ~5% yearly for the next five years? I was in Washington D.C. this last Spring, and this is the current plan. Cataract surgeries were paid more than $2000 over a decade ago. Today, less than $600 in certain states. If the feds cut Medicare, then how do you expect salaries to rise?

http://www.ama-assn.org/ama/pub/category/6583.html

From my experience, here are some examples of salaries in academia:

A colleague of mine was offered $60K to start as a new faculty member in GI.

A good friend who is a Full Professor in Neurology made less than $95K/year.

Private practice ophthalmologists have also seen a drop in starting salaries. Starting salaries of $90-95k/year in major cities are not uncommon.

Defocus on the private practice salaries because these salaries have enough cushion to absorb the 5% yearly cuts by Medicare... for now.

My major concern is the health of academia. Who will train future physicians when the environment in academia becomes so horrible that most talented faculty leave? I'm concerned when research monies dry up, publishers take advantage of academic authors, and $$$ dry up to support academic institutions.

While Medicare cuts back 5% yearly and private practice physicians cherry pick all the paying patients, academic institutions take a significant financial hit.

 

[housecleaning]

so, to sum it up:
i. physician salaries are as low as $90K, which we already knew;

ii. your $60-80K/yr statement was a complete fabrication (fellows make $40K, new faculty $60K - nothing new here either); and

iii. you suddenly realized that Medicare is cutting reimbursements? they've been cutting reimbursements for the past 14 years! there's no way you could possibly be this out of touch with reality.

we're supposed to get all excited about your newfound healthcare crisis because you suddenly looked up and realized you need to find a job soon? try to keep up to date on what's going on around you as you go along. and stop making **** up to make it seem worse than it is.

 

[Andrew_Doan]

I don't understand your hostility.

I've been politically involved and been informed through out my medical training. These recent posts are not inspired by a sudden realization that Medicare is cutting reimbursements. I am rather trying to help others think outside the box and to take action.

I don't need a job. I have one as a Navy physician. I am happy with my $105K/year salary. I know what I will make for the next 5 years of my career and possibly for the next 20 years.

On the other hand, I am proactive and doing something to fix the problems I see in academia.

Are you doing anything to solve the problem or are you just sitting around pontificating?

 

[Will Hunting]

You are inspiring Andrew. It's great to see a doctor who is doing well in medicine and business. I agree, doctors need to be more versed in business. It will bring them more income and provide more power when dealing with HMO's, PPP, etc if they are independent.

 

[Kovox]

Thank you for the post Andrew!! It was truly needed

I hope you don't mind me asking you questions about this kinda stuff -- i LOVE business and the thought of just creating ideas and going with it. I haven't used SDN for awhile so I forgot how to priv message but here's a question:

How do you stay focus on your one idea? I have several ideas that I pursue and its so hard to stay focus on one idea!

 

[Andrew_Doan]

How do you stay focus on your one idea? I have several ideas that I pursue and its so hard to stay focus on one idea!

First, to stay focused on several ideas is difficult. One must budget time wisely. People make different salaries and have access to varying resources; however, the one thing we all have in common is the time available in a day. As we advance in our careers, our time becomes more valuable than at the beginning of our careers. For instance, as a medical student, mowing the lawn was a money saving venture because I made only $15,000/year. As a post-doctoral fellow drawing a Navy stipend, NEI grant, and Heed grant, mowing the lawn is a money losing proposition.

I've worked closely with Edward Stone, MD, PhD and this guy is amazing. He pulls in millions of dollars yearly for his genetic eye research, meets with politicians, and works with multi-million dollar investors while doing cutting edge research in genetics (http://webeye.ophth.uiowa.edu/eyeforum/Genetic-Testing-for-Inherited-Eye-Diseases.htm). Ed advised me to take my annual salary and divide by 2000, which is the average number of working hours yearly assuming an 8 hour day (however, some interns & residents will have to divide by 4000). Don't do anything that will cost you more than paying someone else to do it per hour, unless you enjoy doing it yourself. This simple concept allows one to spend more time on things that are important and high on our priority list, like family, church, and projects.

The second important element is team building. I am never pursuing these ideas alone. I introduce the idea to others and then excite them with the vision and the possibilities. With team building, the collection of talented individuals will result in exponential progress. This means 1+1=8 in a talented team. One example of this effectiveness in team building is a Navy Seal team. The Seals are deadly together; however, individually each member is vulnerable.

Although these projects were initiated by me, I now have several team members working together:

EyeRounds.org - 7
MedRounds Publications - 12
EyeOrbit.org - 2 + resources of the American Academy of Ophthalmology

The beautiful thing is after a project is self-sustaining with an effective team, then it requires less sweat equity from me and allows me to plan and organize.

 

[Energon]

Andy, that story was truly inspiring. I never knew that you had to endure such hardships in your personal life. I truly admire your intelligence and your goal to excell at anything you do... I now see that everyone no matter how "brilliant" has their own problems.

You are absolutely right about what is happening to academic medicine. With the current state or our economy, the fact that we are pouring billions of dollars into wars, our national deficit etc etc, the future of medical education (which is one of the most expensive) looks pretty bleak. You are right something has to be done and done quick.

 

[Andrew_Doan]

You are absolutely right about what is happening to academic medicine. With the current state or our economy, the fact that we are pouring billions of dollars into wars, our national deficit etc etc, the future of medical education (which is one of the most expensive) looks pretty bleak. You are right something has to be done and done quick.

Thank you for your kind words. After four years of listening to my faculty complain about salaries, insurance, lack of funds, ect... I realized that something needs to be done. The month before I graduated, a guest speaker came to talk about the Cornea. This speaker is a Dept. Chairman at another program. He didn't start talking about the Cornea, he began by discussing the bleakness of academic medicine. He emphasized that we need people to develop novel ways of bringing in non-clinical money to support the educational mission. If we don't find ways to support academic medicine, I can guarantee you that the quality of medical education will decline. Instead of the best of the best teaching future doctors, it'll be whoever needs a job teaching tomorrow's physicians.

As individuals, we either do something about it, or we can watch and point our fingers.

 

[Surgess]

Thank you for your kind words. After four years of listening to my faculty complain about salaries, insurance, lack of funds, ect... I realized that something needs to be done. The month before I graduated, a guest speaker came to talk about the Cornea. This speaker is a Dept. Chairman at another program. He didn't start talking about the Cornea, he began by discussing the bleakness of academic medicine. He emphasized that we need people to develop novel ways of bringing in non-clinical money to support the educational mission. If we don't find ways to support academic medicine, I can guarantee you that the quality of medical education will decline. Instead of the best of the best teaching future doctors, it'll be whoever needs a job teaching tomorrow's physicians.

As individuals, we either do something about it, or we can watch and point our fingers.

Hey Andy,
As I try to calm my anxiety and fears about the upcoming ophthalmology match, I find myself purusing these boards all of the time. Recently, I've started reading other threads. I was suprised to find you here on the combined degree side as well. I just want to say that I was moved by your honesty in this post. It is very refreshing to see someone not afraid to acknowledge what God has done in their life. I too have considered a lot of the problems that you raise in your comments. That is part of the reason that I chose to get an MD/MBA. I just hope that one day, I'll be able to make my own unique impact in the world of medicine as you have.

 

[Andrew_Doan]

Hey Andy,
As I try to calm my anxiety and fears about the upcoming ophthalmology match, I find myself purusing these boards all of the time. Recently, I've started reading other threads. I was suprised to find you here on the combined degree side as well. I just want to say that I was moved by your honesty in this post. It is very refreshing to see someone not afraid to acknowledge what God has done in their life. I too have considered a lot of the problems that you raise in your comments. That is part of the reason that I chose to get an MD/MBA. I just hope that one day, I'll be able to make my own unique impact in the world of medicine as you have.

Thanks for the post. After the dust settles and you match for ophthalmology, do you want to discuss some opportunities and collaborate together? I'm looking for someone with your MBA background to contribute articles for MedRounds. If you enjoy writing, which I think you do based on your posts on SDN and the ophthalmology forum, then I think you may want to consider the options that I have for you. It'll be fun, low stress, and will provide some compensation for your time.

email me: [email protected]

 

[Surgess]

Thanks for the post. After the dust settles and you match for ophthalmology, do you want to discuss some opportunities and collaborate together? I'm looking for someone with your MBA background to contribute articles for MedRounds. If you enjoy writing, which I think you do based on your posts on SDN and the ophthalmology forum, then I think you may want to consider the options that I have for you. It'll be fun, low stress, and will provide some compensation for your time.

email me: [email protected]

Sounds wonderful. Definitely after I am no longer a hostage to this year's match.

 

[kito]

Andrew, I think we both know that the wealthy aren't the ones who have the most, but the ones who need the least. A balanced life of physical, spiritual and emotional health minimizes those needs, and lets a good person do great things for others.

Reading your story was like reading my own, and though I am a few years younger than you I am glad that it all dawned on me early in life.