What are you going to buy with your first real Doc paycheck?

[glee123]

@dudebroguyman : Agreed, I wish tech organizations would be the targets for more cuts in salaries rather than physicians (who are actually saving lives) being the scapegoats for everything. And ironically it looks like COVID only pushed the latter further along...so much for calling us "heroes" lol

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[readmypostsMD]

@dudebroguyman : Agreed, I wish tech organizations would be the targets for more cuts in salaries rather than physicians being the scapegoats for everything. And ironically it looks like COVID only pushed the latter further along...so much for calling us "heroes" lol

Tbh no one is rly targeting physician salaries directly, Bernie and his commie pack never talk about them, and there’s been like 2 articles I’ve seen about doc salaries

 

[stickgirl390]

I’m going to buy a nice touch-screen espresso machine

 

[getfat]

Car is getting close to 200,000. Don't want to risk it breaking down during intern year so probably a down payment.

 

[Kuratz]

@dudebroguyman : Agreed, I wish tech organizations would be the targets for more cuts in salaries rather than physicians (who are actually saving lives) being the scapegoats for everything. And ironically it looks like COVID only pushed the latter further along...so much for calling us "heroes" lol

Tech companies make money by selling products and services at prices they set. Physicians make money based on Medicare reimbursement set by the government, and subsequent private insurance rates. When you are beholden to someone else, and especially in physicians’ case the government, who sets your reimbursement schedule then they can “cut” salaries. More accurately they just cut Medicare reimbursement which translates to decreased income. Contrast this to a tech company like Apple that can charge whatever the market is willing to pay for an IPhone or Mac; or even contrast this to a cash only plastic surgery practice that can do the same. They operate in a more free market system. Who exactly is going to “target” tech workers salaries? Not the government and not society at large unless we collectively stop buying their products. They only stop making good money when their business model fails. Engineers are paid well at FAANG because those companies are extremely successful. There is no one out there in the ether dictating that physicians deserve X while 22 year old engineers deserve Y.

Medicine is a business. But it is often a business run by MBAs in office suites that no physician ever sees. This is why it feels like we have a lack of agency when it comes to compensation. You can augment this by learning how a physician gets paid (yes the details matter) and going out and starting your own practice. But most med students are so strapped with debt and other opportunity costs that hanging a shingle is much easier said than done.

 

[kopftonmd]

Besides the obvious loans/financial security spiel, I want to go to Vegas. Splurge a little, realize I'm gonna lose money, and try out a buffet that's better than the Old Country Buffet (which I do love but I hope there's better quality in the world...)

 

[Neopolymath]

I'll build my second side business. Passive income is the only way to not be a slave to physician salaries, build or continue generational wealth, and have a career without stress from admin (FU money) or the government ruining healthcare.

The sooner med students realize that physicians, unlike typical business grads, must actually produce something at work each day to make a living like all blue collar trade jobs (which we are) the sooner we will stop being taken advantage of and making terrible financial decisions as a group. The goal is to enjoy medicine but not live the terrible lifestyle of an eat what you kill small business owner who can't take vacation ever but gets to puff out their chest and say "I'm My OwN BoSS."

The main financial advantage of physician wages is heavy cash flow. Use that to own something and make money off of other people working for you in other business ventures.

But yeah, in spirit of the thread, I'm going to buy some new BBS wheels for my project car.

 

[MedicineZ0Z]

Pay off loans. Save up for a downpayment on a home. Put away money for retirement. Save for kids' college.
Hard to think about what luxury item to spend on myself when I likely won't be in the black until late 30s and have others depending on my income. I also think it is important to make hay while we can because it's not a totally unreasonable outlook to assume that physician's salaries may not stay near this level. I'd much rather have my loans paid off than the albatross of a new $60k car or whatever.

Balance is key. Don't just defer spending on yourself until you're old. We should know better than everyone that as age goes up, so does the probability of poor health.

 

[libertyyne]

@dudebroguyman : Agreed, I wish tech organizations would be the targets for more cuts in salaries rather than physicians (who are actually saving lives) being the scapegoats for everything. And ironically it looks like COVID only pushed the latter further along...so much for calling us "heroes" lol

What does that even mean? Tech companies pay their employees what it needs to retain them. Its not like there is medicare reimbursement associated with tech companies.

 

[Neopolymath]

Balance is key. Don't just defer spending on yourself until you're old. We should know better than everyone that as age goes up, so does the probability of poor health.

Agreed. This is why I think FIRE fanatics miss the point a lot when they shame other people for making 400k and buying a 40k car. They are welcome to live in a 150k house with no material goods as a multimillionaire twiddling their thumbs until they die all they want but they shouldn't speak like they are a better person than someone who chooses to spend their own hard-earned money in moderation. I'm ready for FIRE to come back to earth a bit.

 

[libertyyne]

Agreed. This is why I think FIRE fanatics miss the point a lot when they shame other people for making 400k and buying a 40k car. They are welcome to live in a 150k house with no material goods as a multimillionaire twiddling their thumbs until they die all they want but they shouldn't speak like they are a better person than someone who chooses to spend their own hard-earned money in moderation. I'm ready for FIRE to come back to earth a bit.

i think there is an aspect of time. Retire at 45 and live at median income level or retire at 65 and live at 3x median income level. There are tradeoff's and nothing wrong with people trading time for material comforts and vice versa.

 

[MedicineZ0Z]

Agreed. This is why I think FIRE fanatics miss the point a lot when they shame other people for making 400k and buying a 40k car. They are welcome to live in a 150k house with no material goods as a multimillionaire twiddling their thumbs until they die all they want but they shouldn't speak like they are a better person than someone who chooses to spend their own hard-earned money in moderation. I'm ready for FIRE to come back to earth a bit.

I'd personally prefer to live in luxury during my better years and just work longer (after all, I do enjoy this work) + still save for retirement. Otherwise, what's the point of working so hard when I could have had the same lifestyle with an average career?

 

[ExcitatorySynapse]

Tbh no one is rly targeting physician salaries directly, Bernie and his commie pack never talk about them, and there’s been like 2 articles I’ve seen about doc salaries

They weren't talking about them because it's easier to focus on "greedy insurance companies" but IIRC, Warren's plan was explicit in stating a decrease in doctor salaries.
The people who bash physician salaries most directly are "healthcare policy experts" from think tanks that get a ton of funding from insurance companies. They want to lift licensing restrictions and suggest "fixes" to surprise billing that hurt physicians.

The moral of the story is that no one is our friend and doctors need to learn how to play the game.

 

[thepoopologist]

I'm three years out of training now. I played it fast and loose the first six months until mass consumption started to feel repetitive. Bought a watch or two. Ate out all the time.

Then for six to 10 months I went the opposite direction, hit the loans hard and went bread and water diet. Then the three to six months after I saved up for a townhouse cause I needed something to relieve the tax burden on my paycheck.

Now I put 10% of my take home toward retirement. Have a rainy day fund. I occasionally splurge at a nice restaurant. I'll buy nice things but only occasionally. When I pay my mortgage or student loans sometimes I pay the minumum, sometimes extra. That's where I am so far.

 

[MedLife20]

$2 million home

 

[deleted804295]

My mom told me to give my entire first paycheck to her (not even half) so I guess I'll be doing that.

 

[RTC19]

My dad was very handy and loved carpentry. He made my brother and I a treehouse when we were kids. I don't know anything about carpentry, but if/when I have the money, I'd like to pay a professional carpenter to build the kids a treehouse like the one my brother and I loved.

 

[deleted50541]

I aggressively paid off my students loans (~$220K) in the first two years after training. Made the final payment last month. Felt great.

The biggest splurge I've made as an attending was taking the family to Disney World earlier this year (before COVID hit). It was also part honeymoon, which my wife and I never properly did when I was resident.

Now I'm funneling more into my retirement and investments. The rest is saving for kids' schooling and keeping a nice cushion of cash for rainy days.

 

[PikminOC]

Do they still have the pizza bar? Cholesterol filled awesomeness

Not anymore due to Covid

 

[Dr.K124]

Yea you can tell all the lay people that you are already a “real doctor”. However, your first “real doctor paycheck” wasn’t intern year. Alas, after paying the “real doctor taxes” your first paycheck won’t buy you too much more anyways haha

"Won't buy you too much more" is complete nonsense. Let's look at low end and high end starting attending pay and set them as $200,000 and $400,000. Obviously there is lower and higher, but this is a good guess. Then let's look at resident intern year pay and assume it's approximately $60,000.

Even if you're single and in California (worst possible tax outcome) you STILL take home $132,000 compared to $46,000 as a first year resident. Quite literally THREE times the take-home pay. If you're in Texas instead, and married? $158,000 versus $51,000. Again, THREE times the take-home pay.

But that's the low end of starting pay. Let's instead look at the $400,000 situation. Single in Cali? $237,000 vs the $46,000. Over FIVE times the pay. Texas and married? $301,000 versus the $51,000. That's SIX times the pay.

 

[Dr.K124]

They weren't talking about them because it's easier to focus on "greedy insurance companies" but IIRC, Warren's plan was explicit in stating a decrease in doctor salaries.
The people who bash physician salaries most directly are "healthcare policy experts" from think tanks that get a ton of funding from insurance companies. They want to lift licensing restrictions and suggest "fixes" to surprise billing that hurt physicians.

The moral of the story is that no one is our friend and doctors need to learn how to play the game.

None of this policy could EVER pass in congress anyways. Do I see doctor income dropping in the future? Sure. Do I see a sudden drop of 20-50% in the next 20 years? No. We'll just probably not keep up entirely with inflation.

Warren's plan was explicit, but Biden's is not (although it comes with higher taxes we'll obviously have to pay). And if Biden's plan actually works, there will be a LOT less people demanding a Medicare for All style system because less people will complain about insurance.

People have been doom and gloom about doctor salaries for a long time. Even with actual reimbursements dropping, we're still finding ways to keep our income up with inflation (or at least relatively the same) AND slightly dropping our average hours. It depends on the specialty. In ophthalmology, cataract reimbursement has dropped ridiculously, but some surgeons can complete cataract surgery in 8 minutes, compared to 30 mins+ back when they were much higher! Meanwhile, other specialties are actually making more money now than they ever have before. Emergency Medicine, for example. Doctors will always be doing well.

 

[ACSurgeon]

"Won't buy you too much more" is complete nonsense. Let's look at low end and high end starting attending pay and set them as $200,000 and $400,000. Obviously there is lower and higher, but this is a good guess. Then let's look at resident intern year pay and assume it's approximately $60,000.

Even if you're single and in California (worst possible tax outcome) you STILL take home $132,000 compared to $46,000 as a first year resident. Quite literally THREE times the take-home pay. If you're in Texas instead, and married? $158,000 versus $51,000. Again, THREE times the take-home pay.

But that's the low end of starting pay. Let's instead look at the $400,000 situation. Single in Cali? $237,000 vs the $46,000. Over FIVE times the pay. Texas and married? $301,000 versus the $51,000. That's SIX times the pay.

Oh sorry I didn’t realize you found a job where your first “real paycheck” is an entire year worth of pay.

More likely the first pay check for a doctor making 200k a year after taxes and retirement savings is about $4000 every two weeks. That’s not bad money by any means, but if you think you’re gonna take the first “paycheck” and go feel rich, you’ll be disappointed. Once you’ve paid any credit card/moving debt or paid your mortgage/rent/student loan payment, that first paycheck will feel like an upgrade, sure, but it won’t buy you much.

 

[Dr.K124]

Oh sorry I didn’t realize you found a job where your first “real paycheck” is an entire year worth of pay.

More likely the first pay check for a doctor making 200k a year after taxes and retirement savings is about $4000 every two weeks. That’s not bad money by any means, but if you think you’re gonna take the first “paycheck” and go feel rich, you’ll be disappointed. Once you’ve paid any credit card/moving debt or paid your mortgage/rent/student loan payment, that first paycheck will feel like an upgrade, sure, but it won’t buy you much.

Yes, you are correct I used yearly earnings instead of first paycheck. But that changes nothing. Just divide every number by 26. The THREE, FIVE, and SIX times multipliers stay the exact same.

I already took my first paycheck and felt rich. I'm several years into practice. Your $4000 assumes the worst possible tax and income scenario and a very generous retirement savings rate.

EDIT: Intern paycheck is about $1700-$2000 post-tax. First attending paycheck is $5000-$12,000.

I understand your logic here, but I guess I was just on the luckier side. My first paycheck was on the higher end of the above range, I had no credit card debt, my working spouse helped bring my student loans down during residency and pay for living during medical school, and I already had a small but respectable amount of savings from compound interest early on. I also received a relocation allowance for the move-in.

 

[Mad Jack]

I'm not buying anything until my student loans are paid off.

Then I'm buying a new car, since mine'll be like, 14-15 years old at that point, and likely have 250k+ miles. Something that's a sedan with four wheel drive and a sub-35k price tag..

Then maybe a small house. 200k, tops, and not a part of a HOA, so I can build a greenhouse out back and learn to take care of some plants.

After that, piling away money in investments and real estate until I can retire, hopefully by 5o or 55.

Now that I'm closer to being an attending: I already replaced my car with something far sportier that I plan to keep forever. Probably going for a 350-400k house because of the places I would like to live. Still avoiding HOAs and planning to retire early. First paycheck is probably going to pay off my car.

 

[ACSurgeon]

Yes, you are correct I used yearly earnings instead of first paycheck. But that changes nothing. Just divide every number by 26. The THREE, FIVE, and SIX times multipliers stay the exact same.

I already took my first paycheck and felt rich. I'm several years into practice. Your $4000 assumes the worst possible tax and income scenario and a very generous retirement savings rate.

EDIT: Intern paycheck is about $1700-$2000 post-tax. First attending paycheck is $5000-$12,000.

I understand your logic here, but I guess I was just on the luckier side. My first paycheck was on the higher end of the above range, I had no credit card debt, my working spouse helped bring my student loans down during residency and pay for living during medical school, and I already had a small but respectable amount of savings from compound interest early on. I also received a relocation allowance for the move-in.

You probably faired much better than average. I guess my point was that it takes some time as an attending before you feel “rich” because of student loans, other debts, and starting from zero with savings. Having a working spouse and starting with a higher than average take home pay, I can understand why you felt rich faster than I did haha.

 

[dienekes88]

First few years. Live like a resident. Save save save.

Having said that... With my first attending paycheck i'm guessing I might buy:
Omega speedmaster for myself
A fancy pair of shoes for my wife

 

[qwerty89]

I’m going to buy a nice touch-screen espresso machine

Phillips LatteGo 3200

 

[Dr.K124]

First few years. Live like a resident. Save save save.

Having said that... With my first attending paycheck i'm guessing I might buy:
Omega speedmaster for myself
A fancy pair of shoes for my wife

I'd never heard of an Omega Speedmaster and immediately assumed it was a Jet Ski. Google proved me wrong

 

[LoGo]

First few years. Live like a resident. Save save save.

Having said that... With my first attending paycheck i'm guessing I might buy:
Omega speedmaster for myself
A fancy pair of shoes for my wife

Can’t go wrong with a speedy.

 

[Sleepingdoc]

Paying off student loans for the next 10-15 years should be the goal.. So living like a med student for next few years should be yours again if you have student loans..

 

[odyssey2]

Stop using my ex’s Netflix account

 

[XannyFairy]

hair transplant

 

[Splenda88]

I'd personally prefer to live in luxury during my better years and just work longer (after all, I do enjoy this work) + still save for retirement. Otherwise, what's the point of working so hard when I could have had the same lifestyle with an average career?

I think I would prefer to be a minimalist for 10 yrs to reach FIRE quickly...

I think there is nothing more enjoyable when one can walk away from a job without thinking how you gonna pay the bills in the next 20+ years...

Most docs can reach FIRE in 10-12 yrs if they want to and then have a middle class lifestyle.

 

[Dr.K124]

I think I would prefer to be a minimalist for 10 yrs to reach FIRE quickly...

I think there is nothing more enjoyable when one can walk away from a job without thinking how you gonna pay the bills in the next 20+ years...

Most docs can reach FIRE in 10-12 yrs if they want to and then have a middle class lifestyle.

I understand wanting to reach financial independence, but retiring after 10 years kind of defeats the whole purpose of becoming a doctor. If retiring early was the goal, investment banking would be a better career. I couldn't imagine becoming a doctor to retire to a middle class lifestyle after 10 years, but that could just be me.

However it's quite possible I misinterpreted you, and you were just using FIRE as a substitute for FI and didn't mean to include the RE.

Personally my goal is to keep working until I die, even if it's just 1 day a week. Reach FI after 15 or so years while living an upper class lifestyle. But I'm in a specialty that allows this, and I know not everyone has that luxury.