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  • Antares
    replied
    It may be an ongoing battle, but mindfulness and a strong sense of gratitude can significantly help to moderate covetousness.

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  • q-school
    replied
    the only concerning part was that coming on this forum gives you anxiety.  i would hope it would give you confidence in that you are preparing yourself well for the future.

    let me assure you that the hard habits to learn are saving habits, which you already are on top of.  as long as you are savers by nature, you will be fine.  my wife and i had lots of educational debt and were paying it down while we were residents.  no one helped us.  we didn't have wci to guide us.

    if by some circumstance, you want to make more someday, you can certainly change jobs and make much much more within pediatrics.

    as Donny pointed out, there are a lot of things outside your control right now.  don't worry about those.  enjoy the moments you can right now.  you have already planned the parts you can plan.  finish training.  learn as much as you can.  don't feel overwhelmed.

    generally, i hate to disagree with vagabond, because it almost always means i'm wrong.  but i'm going to disagree slightly and say i don't think you are conflicted as much as stressed.  i don't think you need to rethink your choices but remind yourself that you can occasionally wonder what if, but owner of material stuff isn't a primary focus.   you can at least be confident that most of the posters on the board think there are many ways for you to be just fine financially.

    i can't remember what it was like to be as young as you, but i do remember being worried about the finances.  i wish someone had been around to calm my crazy ****************** down and tell me it would be ok.  

    best wishes.

    enjoy your youth.

     

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  • wideopenspaces
    replied





    And finally I am tired of all the BS advice of doing a job that makes you happy when you get up and keeps a smile on your face. Those are most likely said by people who already have the money in the bank. They may be envious of your lifestyle but if they were to be given a chance of switching to your $150K, no one will do it. Many will talk the talk, but not walk the walk.

     

     

     

     
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    For another perspective, I walk the walk . . . I've never made 150k (right now I make about half that, working 0.34 FTE) and I'm very happy. 3 years out of residency. My husband makes about double what yours does, we live in a MCOL area, only had 70k in student loans but had the first kid in med school (so we have childcare costs). I'm guessing you'll finish around age 28 or so, whereas I was 33. And I still say you should pick something you like because even with all that, we live a great life! And you will too. We are very much in a good place financially and if you keep doing what you're doing, you are not going to have to give up nearly as much as you think, to get the things you want. You're already on track with good habits-putting money into retirement and paying down loans. You won't be able to do or have everything at once, but if you sit down and figure out what is important to you, you will be able to have whatever you value most in your life. If I were in your shoes, I would strongly consider moving to the midwest or down south for 5 years so that you could keep living on your current salary (and living well in those areas) and save whatever extra you make once you are an attending. Then move back to that HCOL area near family in whatever job suits you the best.

    For what it's worth, comparing yourself to those around you is a recipe for lifelong unhappiness. I'd start working now to get out of that mindset as that will bring more grief into your life than any low-ish paying job ever could.

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  • hightower
    replied
    If you love your job, most docs will envy you. Some of the highest paying specialties also have the lowest physician satisfaction scores on surveys. Follow what excites you and makes you happy. It wont seem like a job if you enjoy it and the money wont matter much.

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  • Beesee
    replied
    Wow everyone, this was a really wonderful conversation. Thank you so much for your varied and thoughtful responses. It really does help to hear so many perspectives from people with more experience and wisdom about these things!

    Lots to think about but certainly less to worry about overall, it seems. I don't care that much about having tons of money and I think a lot of my feelings do come down to the basic covetousness/envy--when I don't necessarily even want the things other people have! That'll be an important insight to hold on to.

    Thank you so much for your comments and suggestions and criticisms!

    Leave a comment:


  • jz
    replied
    What do docs value in their work? To my observation:

    1st 10 years.........passion and interest in their field

    2nd 10 years........income

    3rd 10 years........lifestyle

    I trust you will be mostly satisfied with your choices.

     

     

     

     

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  • jlee9531
    replied
    no you aren't.

    i've come to realize that job satisfaction is what matters the most.

    i turned down private practice jobs to work in the academic system which essentially cuts your earning potential a significant amount. The difference in salary between between what i turned down and what I took my first year was 70K. but i know myself and know what would not burn me out. i needed flexibility in seeing patients, teaching, and doing program building for residents and students. for me it was an acceptable sacrifice to be happy with what i do and know that i can do for many many years.

    i'm probably more stressed out about our financial situation now that my wife has finished fellowship, than when she was still in training. with more money, people naturally end up doing more things that incur costs (kids and associated daycare costs just to mention a few). but at least we don't have to worry about our job satisfaction and having an unsatisfying job on top of other general financial concerns we all have.

    but like some of the posts have said, perspective wise, especially working with underserved patients, i feel extremely fortunate that i have this opportunity...especially i come from that low SES background and it's hard to escape that set up. So that sort of perspective and mindfulness i keep with me and try to follow the sound financial advice on this website to help me enjoy my later years of life.

    Leave a comment:


  • Sneezy
    replied
    Life is full of trade-offs, although many appear unaware of this fact.

    1. The decision you make about your first job post-residency is not a life-long commitment!  Lots of people start off in one setting and move to another or even go back for fellowship.  Someone I know spent his first several years of practice on a Native American reservation.  He saved a lot of his income (northing to spend it on) and had most of his loans paid off.  Once he got used to it he loved it, honed his clinical skills and is now back in primary care pediatrics in an academic setting

    2. Agree with others who say to work hard/moonlight early on.  The money saved will have many years to compound.  This will get harder when/if you have kids.  Excelling where you are may lead to other, more lucrative opportunities (medical director, "easy" moonlighting opportunities, etc)

    3. Don't worry so much about everyone else.  Already your peer group (other pediatric residents) isn't going to do that well financially and if you end up in a community health center like setting the other docs won't be making much either.

    4. Accept you may have to work until "usual" retirement age. Liking your job will make that easier

    5. Social security replaces a lot higher % of income for those who work many years at not so high paying jobs

    Leave a comment:


  • Craigy
    replied
    A few people above used the word covet.  Considering the first post, that's apt.

    If you feel particularly covetous of your colleagues/classmates, or just other docs with a higher income in general, you're probably never going to shake that.  You have to make the choice to either pursue a higher income specialty, job, area, etc. now, or choose to live with what you have and somehow convince yourself to be happy about it.

    If you're going to covet your peers income, things, vacations, etc., at least in the biblical sense of the word, it could ruin your life.  No matter how rewarding your career is.  You could find yourself one day becoming a spendthrift to try to keep up, ruining your financial future, looking to divorce your spouse, or just being tremendously regretful and unhappy in general.

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  • q-school
    replied
    is it expected that all docs earn $300k now?  dang, things have changed since i went to medical school.

     

     

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  • beagler
    replied
    I second the moonlighting recommendation. I wish I worked more early on in my career. Extra dollars saved early + compounding does wonders. Just finishing residency you're used to working a bit more anyway.

    For medicaid population, be an employee of large system with commercial pricing power (pediatric monopoly). Then the $/RVU averages up due to commercial rates. Or own a hyper-efficient medicaid mill..

    Also, one can be a good doctor while keeping productivity up, so focus on being an efficient productive doctor as well.

    Leave a comment:


  • PhysicianOnFIRE
    replied
    You said your husband won't make more than $50k unless something wild happens. Perhaps he should make something wild happen.

    In a high cost of living area, lots of jobs pay more than $50k per year. If he can boost his income, perhaps you'll be less conflicted about taking a lower paying job in peds.

    Leave a comment:


  • MPMD
    replied






     
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    Just because you love the community clinic in your residency does not mean that is the type of practice that you have to lead for the rest of your life to have a rewarding career. We all went through residencies and many of our patients were uninsured or flat out poor. That does not mean we did not like seeing them and yet at the same time we were paid a fixed amount and did not realize that seeing only such patients forever is not feasible.
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    If you were my resident I would advise you to really mull over this before settling into a career in underserved primary care.

    It is among the noblest thing a doc can do, but I already have med school friends who wanted to save the world in FP working in the poorest neighborhoods and who have already given up and are doing urgent care full time. A career in primary care has many challenges and working Medicaid/uninsured pts adds to those challenges it doesn't take them away. Sad but true.

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  • antheus
    replied
    I think it's only natural to covet. We're physicians. A majority of our peers are also physicians. As a result we have a distorted view of reality. I'm in a field where I will probably start out making 350-400k working 40 hours a week with essentially no call and no emergencies. The other day I heard about an ENT friend who was going to join his father's practice and start at 750k. I couldn't help but feel like a failure but I also acknowledge what a ridiculous sentiment that is.

    A lot of people will say that you make far more than the average American and you should be grateful, but for obvious reasons that's an unfair comparison. The average American is not a highly intelligent, driven, high achiever who has spent 30 years and 200k+ on getting to this point.

    The thing to focus on is that you will live incredibly well with what you have. The things people buy with all that extra money rarely gives them much happiness and a lot of those things give more heartache than we care to admit. Boats, mansions, and vacation homes are things that it's always better to have friends with than to own your own.

    My SO and I currently make a combined 100k a year in an MCOL. There are very few things that we cannot afford on that. We travel often (domestically and internationally), live in a nice apartment complex, and we're still able to save. In the grand scheme of things you will be very happy with what you're going to make. If you stretch it as far as you can and follow a lot of the principles espoused over here you will be far ahead of many of your peers despite earning less.

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  • Kamban
    replied




    Pediatrics and have fallen in love with primary care pediatrics, especially in my continuity clinic where I see an underserved population that is probably 99% Medicaid. Fortunately everyone in Pediatrics gets paid on the low end so most fellowships are a wash. I do have colleagues doing second residencies in better paying fields and I can’t help but feel jealous of the pay, though I absolutely love this field and feel lucky that this is my job.
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    There is a myth that pediatricians are the starving artists of the physician world. People who are poorly paid choose to be poorly paid.

    Just because you love the community clinic in your residency does not mean that is the type of practice that you have to lead for the rest of your life to have a rewarding career. We all went through residencies and many of our patients were uninsured or flat out poor. That does not mean we did not like seeing them and yet at the same time we were paid a fixed amount and did not realize that seeing only such patients forever is not feasible.

    I have few friends who are pediatricians who make good money. One is in Primary care employed by a health system. One is a sub specialist in pediatrics in PP in Florida. My child's pediatrician makes good money and sees a mix of patients - poor, middle class and rich.

    Your spouse makes only $50K. You can easily make $250K and live in your HCOL provided you plan it well. You need to get a job that pays decently and that means seeing a mix of patients, including better paying ones. If you choose not to do it, you might still have the anxiety attacks at 45, since at that time you will have kids and their expenses ( most likely).

    And finally I am tired of all the BS advice of doing a job that makes you happy when you get up and keeps a smile on your face. Those are most likely said by people who already have the money in the bank. They may be envious of your lifestyle but if they were to be given a chance of switching to your $150K, no one will do it. Many will talk the talk, but not walk the walk.

    I am not asking you to take a high stress job but choose one that will support your future family comfortably. Taking care of the underserved is nice but is not your mission in life unless you are called Mother Teresa. It is the job of our government. You need to find your work, lifestyle and income balance going forward.

    Good luck.

     

     

     

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