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	<title>Comments on: Why physician salaries matter</title>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2006/06/why-physician-salaries-matter.html/comment-page-1#comment-71295</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Mon, 05 Feb 2007 05:08:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2006/06/why-physician-salaries-matter.html#comment-71295</guid>
		<description>This is an old thread, but I feel the need to add a few things. The problem isn&#039;t that a doc can or can not live a good life. The problem is that it is really not worth it to be a primary care physician. We &lt;i&gt;need,&lt;/i&gt; primary care, and with an aging population, we will need even more Internal medicine primary care docs. The salaries are not going up (not even with inflation) due to decreasing payouts (insurance companies follow medicare, and with medicare, there is the Sustainable Growth Rate (SGR) to contend with). Therefore, the compensation, in real value is going down while the costs of the education, and overhead to practice  are going up. At some point (some point soon) it will be unreasonable for a med school graduate to choose a primary care residency. These are very capable people. They can choose to do something else. If practicing medicine does not allow them to pay their debts, they will choose something else to do. Worse yet, when the word gets out about all this, we will not have the best and the brightest in medical school anymore. The shortage of doctors is on its way, and it is going to be very uncomfortable for all. The total amount of money spent on healthcare in the US is going up (much faster than inflation). I already discussed physician salaries. Where is the money going? This is really quite obvious: Big pharma. The cost of drugs is the one thing that doctors, insurance, and even medicare (part D) cannot control.</description>
		<content:encoded><![CDATA[<p>This is an old thread, but I feel the need to add a few things. The problem isn&#8217;t that a doc can or can not live a good life. The problem is that it is really not worth it to be a primary care physician. We <i>need,</i> primary care, and with an aging population, we will need even more Internal medicine primary care docs. The salaries are not going up (not even with inflation) due to decreasing payouts (insurance companies follow medicare, and with medicare, there is the Sustainable Growth Rate (SGR) to contend with). Therefore, the compensation, in real value is going down while the costs of the education, and overhead to practice  are going up. At some point (some point soon) it will be unreasonable for a med school graduate to choose a primary care residency. These are very capable people. They can choose to do something else. If practicing medicine does not allow them to pay their debts, they will choose something else to do. Worse yet, when the word gets out about all this, we will not have the best and the brightest in medical school anymore. The shortage of doctors is on its way, and it is going to be very uncomfortable for all. The total amount of money spent on healthcare in the US is going up (much faster than inflation). I already discussed physician salaries. Where is the money going? This is really quite obvious: Big pharma. The cost of drugs is the one thing that doctors, insurance, and even medicare (part D) cannot control.</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2006/06/why-physician-salaries-matter.html/comment-page-1#comment-68282</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Tue, 31 Oct 2006 05:03:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2006/06/why-physician-salaries-matter.html#comment-68282</guid>
		<description>Become a drug or device rep.  Work 4 hours a day.  Sit back and laugh at all of the disgruntled docs.  Make lots of money.  Retire early.</description>
		<content:encoded><![CDATA[<p>Become a drug or device rep.  Work 4 hours a day.  Sit back and laugh at all of the disgruntled docs.  Make lots of money.  Retire early.</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2006/06/why-physician-salaries-matter.html/comment-page-1#comment-65645</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Mon, 31 Jul 2006 18:09:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2006/06/why-physician-salaries-matter.html#comment-65645</guid>
		<description>Dear Anonymous 11:05 pm:&lt;br/&gt;&lt;br/&gt;I am a 17-year old high school student going into my senior year with decent grades and slightly above average SAT scores, and I have always had aspirations of a medicinal vocation. I know that I have the ability to get a 4.0, but I haven&#039;t always applied myself and wasn&#039;t given a good picture of how serious high school was my first few years. I accredit this to my dad, who I live with, who makes around $30,000 a year as a welder and has no experience with college life. Needless to say, I am in the process of devoting huge effort to trying to polish my high school career as best I can with all the advanced classes I can take and a raise in GPA with the hopes of being accepted into a semi-prestigious school where I plan to be at the top of my class and major in pre-med(easier said than done, I realize, but bear with me).&lt;br/&gt;&lt;br/&gt;I have a very close friend whose mother is a pediatrician and whose father, living in another state, is a cardiothoracic surgeon(my previous career dream) earning well in the upper half of six figures. Having spent considerable time with this person and having a fairly accurate insight into the more stressful, demanding side of the medical profession, I was wondering if you might give me any professional insight or advice as to some less-stressful, but equally lucrative specializations in the medical field such as your own.&lt;br/&gt;&lt;br/&gt;Until meeting this person I was under the impression that so many suffer from-that all doctors have wonderful family lives, ample free time and still receive the huge financial benefits-I know that these things, factors of life which I have always hoped for, are attainable within the medical field, but I am not sure exactly which professions would fit the profile. I have always recognized that significant family time, truly enjoyable and mostly stress-free work are more important than overall earnings, and hope to find these things in a career. Having briefly perused some physician salary charts, I know that there is a huge range of salaries(noting the top $1,352,000 for ORS-Spine Surgery) and that not all of these specializations are so time-demanding, and was just wonering if you could offer any advice on the subject. Thank you for your time.</description>
		<content:encoded><![CDATA[<p>Dear Anonymous 11:05 pm:</p>
<p>I am a 17-year old high school student going into my senior year with decent grades and slightly above average SAT scores, and I have always had aspirations of a medicinal vocation. I know that I have the ability to get a 4.0, but I haven&#8217;t always applied myself and wasn&#8217;t given a good picture of how serious high school was my first few years. I accredit this to my dad, who I live with, who makes around $30,000 a year as a welder and has no experience with college life. Needless to say, I am in the process of devoting huge effort to trying to polish my high school career as best I can with all the advanced classes I can take and a raise in GPA with the hopes of being accepted into a semi-prestigious school where I plan to be at the top of my class and major in pre-med(easier said than done, I realize, but bear with me).</p>
<p>I have a very close friend whose mother is a pediatrician and whose father, living in another state, is a cardiothoracic surgeon(my previous career dream) earning well in the upper half of six figures. Having spent considerable time with this person and having a fairly accurate insight into the more stressful, demanding side of the medical profession, I was wondering if you might give me any professional insight or advice as to some less-stressful, but equally lucrative specializations in the medical field such as your own.</p>
<p>Until meeting this person I was under the impression that so many suffer from-that all doctors have wonderful family lives, ample free time and still receive the huge financial benefits-I know that these things, factors of life which I have always hoped for, are attainable within the medical field, but I am not sure exactly which professions would fit the profile. I have always recognized that significant family time, truly enjoyable and mostly stress-free work are more important than overall earnings, and hope to find these things in a career. Having briefly perused some physician salary charts, I know that there is a huge range of salaries(noting the top $1,352,000 for ORS-Spine Surgery) and that not all of these specializations are so time-demanding, and was just wonering if you could offer any advice on the subject. Thank you for your time.</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2006/06/why-physician-salaries-matter.html/comment-page-1#comment-65524</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Fri, 28 Jul 2006 03:05:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2006/06/why-physician-salaries-matter.html#comment-65524</guid>
		<description>wow...let the bitterness roll huh? well i&#039;ll say this: it seems to me that everyone who has ventured to give an opinion here is extremely jaded when it comes to the medical profession and at the same time extremely misinformed. The fact is that being a physician is a highly rewarding job, both emotionally and financially. There are some specialties that demand a significant amount of dedication and average a very high work load. But as some here pointed out, you do, in-fact, know what you are getting into. If you manage to stay awake or attend you medical business and management classes then you are aware of the problems faced such as overhead, healthcare finance, insurance problems/headaches, and yes the ever-burdensome debt situation created by the cost a quality medical education. These things are not new and with the exception of an unfortunate few, they rarely actually stop graduating physicians from becoming relatively successful and financial “well of”, so to speak. You also know what you are getting into as far work load and family time goes. People that choose to be cardio-thoracic surgeons know that they will be forced to make many sacrifices when it comes to time and stress. If family time is not something you are willing to compromise, such as the gentlemen that chose pharmacy (RJS) instead of medicine, then you can simply choose a specialty that has a much less demanding schedule. Something like what I chose, Radiology. I racked up 150,000 dollars in debt, kept my grades high so that I could have my pick of residencies, chose radiology, finished my residency and started out at about 200,000 dollars a year. I lived as thought I made 100,000 dollars a year, for about 2 years, after which I was debt free and in a lucrative career where my salary did nothing but increase. I work 5 days a week, sometimes 4. I get home everyday around 6 and spend the evenings loving my wife and planning a family. Many of my friends are doctors and, while they’ve chosen different specialties, they have all managed to not let the debt incurred have a damaging affect on the life that they live. And well one friend is a surgeon, and works long hours, and another is a anesthesiologist and works about 6 hours a day, we all knew what we were getting into. Anyone that says that they were not aware of the demands and/or downsides of the business must have been living in a cave through medical school, because at every corner there is a doctor waiting to tell you what a tough road you have ahead of you and believe me they go into great detail. And as far as docs wanting more money…yes and no. so are not happy in their practice because of a bad insurance situation or a compliance and freedom issue or lots of other things that may take away from salaries. But they simply want what is due to them. Anyone would agree that spending 7+ years in school learning how to make the lives of other humans better and longer deserves to be in the top 5% of the country. Those of us that have produced good situations for ourselves don’t just want more money, in all honesty I often give my services away for free because a patient maybe having financial problems and I don’t necessarily need their 500 dollars, but they do really need that MRI guided biopsy. So my point I guess is well I guess I don’t have a point, just trying to shed some light from somewhere not as angry as all of you seem to be…</description>
		<content:encoded><![CDATA[<p>wow&#8230;let the bitterness roll huh? well i&#8217;ll say this: it seems to me that everyone who has ventured to give an opinion here is extremely jaded when it comes to the medical profession and at the same time extremely misinformed. The fact is that being a physician is a highly rewarding job, both emotionally and financially. There are some specialties that demand a significant amount of dedication and average a very high work load. But as some here pointed out, you do, in-fact, know what you are getting into. If you manage to stay awake or attend you medical business and management classes then you are aware of the problems faced such as overhead, healthcare finance, insurance problems/headaches, and yes the ever-burdensome debt situation created by the cost a quality medical education. These things are not new and with the exception of an unfortunate few, they rarely actually stop graduating physicians from becoming relatively successful and financial “well of”, so to speak. You also know what you are getting into as far work load and family time goes. People that choose to be cardio-thoracic surgeons know that they will be forced to make many sacrifices when it comes to time and stress. If family time is not something you are willing to compromise, such as the gentlemen that chose pharmacy (RJS) instead of medicine, then you can simply choose a specialty that has a much less demanding schedule. Something like what I chose, Radiology. I racked up 150,000 dollars in debt, kept my grades high so that I could have my pick of residencies, chose radiology, finished my residency and started out at about 200,000 dollars a year. I lived as thought I made 100,000 dollars a year, for about 2 years, after which I was debt free and in a lucrative career where my salary did nothing but increase. I work 5 days a week, sometimes 4. I get home everyday around 6 and spend the evenings loving my wife and planning a family. Many of my friends are doctors and, while they’ve chosen different specialties, they have all managed to not let the debt incurred have a damaging affect on the life that they live. And well one friend is a surgeon, and works long hours, and another is a anesthesiologist and works about 6 hours a day, we all knew what we were getting into. Anyone that says that they were not aware of the demands and/or downsides of the business must have been living in a cave through medical school, because at every corner there is a doctor waiting to tell you what a tough road you have ahead of you and believe me they go into great detail. And as far as docs wanting more money…yes and no. so are not happy in their practice because of a bad insurance situation or a compliance and freedom issue or lots of other things that may take away from salaries. But they simply want what is due to them. Anyone would agree that spending 7+ years in school learning how to make the lives of other humans better and longer deserves to be in the top 5% of the country. Those of us that have produced good situations for ourselves don’t just want more money, in all honesty I often give my services away for free because a patient maybe having financial problems and I don’t necessarily need their 500 dollars, but they do really need that MRI guided biopsy. So my point I guess is well I guess I don’t have a point, just trying to shed some light from somewhere not as angry as all of you seem to be…</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2006/06/why-physician-salaries-matter.html/comment-page-1#comment-64652</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Mon, 03 Jul 2006 17:54:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2006/06/why-physician-salaries-matter.html#comment-64652</guid>
		<description>The top 1% earn in excess of $374,000 per year.&lt;br/&gt;The top 5% earn $150,000 or more&lt;br/&gt;The median income in 2004 was somewhere around $43,000.&lt;br/&gt;&lt;br/&gt;I don&#039;t think you are in a position to be preaching to me or anyone what they should be knowing about what others do or don&#039;t earn. Any doctor in practice is well familiar with earning less than the median, as that is the scale usually paid to house officers. You are living in a delusional world if you think doctors live all their lives in a cocoon of a high-income lifestyle. &lt;br/&gt;&lt;br/&gt;You don&#039;t know what you are writing about. Why should I consider your advice?</description>
		<content:encoded><![CDATA[<p>The top 1% earn in excess of $374,000 per year.<br />The top 5% earn $150,000 or more<br />The median income in 2004 was somewhere around $43,000.</p>
<p>I don&#8217;t think you are in a position to be preaching to me or anyone what they should be knowing about what others do or don&#8217;t earn. Any doctor in practice is well familiar with earning less than the median, as that is the scale usually paid to house officers. You are living in a delusional world if you think doctors live all their lives in a cocoon of a high-income lifestyle. </p>
<p>You don&#8217;t know what you are writing about. Why should I consider your advice?</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2006/06/why-physician-salaries-matter.html/comment-page-1#comment-64648</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Mon, 03 Jul 2006 12:43:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2006/06/why-physician-salaries-matter.html#comment-64648</guid>
		<description>&quot;Not true. Probably not even the top 5% even. Subtract the variable-interest HEAL and other loan payments and you probably arent even in the top 20%.&quot;&lt;br/&gt;&lt;br/&gt;You need to get a better understanding of just how much the average American makes.</description>
		<content:encoded><![CDATA[<p>&#8220;Not true. Probably not even the top 5% even. Subtract the variable-interest HEAL and other loan payments and you probably arent even in the top 20%.&#8221;</p>
<p>You need to get a better understanding of just how much the average American makes.</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2006/06/why-physician-salaries-matter.html/comment-page-1#comment-64638</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Mon, 03 Jul 2006 01:08:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2006/06/why-physician-salaries-matter.html#comment-64638</guid>
		<description>&quot; But you&#039;re still the top 1% right now, whether you feel like it or not.&quot;&lt;br/&gt;&lt;br/&gt;Not true. Probably not even the top 5% even. Subtract the variable-interest HEAL and other loan payments and you probably arent even in the top 20%. And don&#039;t forget that while you were borrowing and not working while in medical school, you made no contributions to personal savings or retirement plans. Too bad that those contributions, now forgone, would have earned you substantially greater returns than most of the later and more accelerated contributions you will have to make so that someday you can retire. Oh don&#039;t forget, no defined benefits or company participation; retirement is 100% on your dime. Hope the late start doesn&#039;t get you down too much (Anonymous moron 3:56 p.m. hasn&#039;t thought of that though, too busy pimpin&#039; poverty).&lt;br/&gt;&lt;br/&gt;&quot;Why was that? Were your grades not high enough to get in to your local public in-state institution? If that was the case, whose fault was that?&quot;&lt;br/&gt;&lt;br/&gt;Who says grades are all that make up an admissions committee&#039;s decision? Maybe he isn&#039;t the desired sex or race or whatever for the committee? Maybe he was honest in his interview and said he wanted to do surgery, and the committee was seeking family practitioner wannabees. Acceptances are not just an exercise in intelligence and stamina, sometimes it comes down to luck, good and bad. Whose fault indeed, you idiot? Bakke didn&#039;t change anything, except for Dr. Bakke.&lt;br/&gt;&lt;br/&gt;&lt;br/&gt;&quot;If you feel like you have it bad, how do you think those who don&#039;t have free room and board and have to support a family on less than 1/3 of what you make feel.&quot;&lt;br/&gt;&lt;br/&gt;Sorry, I missed that free room and board part. Where do you get that? Silly me, I paid real money for those things. Think what I could have saved. Have to support a family? Isn&#039;t that the normal thing for people to do when they choose to have a family? And why is it any more a doctor&#039;s choice to seek a higher-paying career, time and costs notwithstanding, than it is for someone to choose something else that pays less? Or, Anon. 3:56, are those who choose not to delay starting a household and family and enter the work force with lesser or at least lesser-compensated skills somehow &quot;victims&quot; of their circumstances and others are not? No one says you have to be an underappreciated and low-paid kindergarten teacher either. So enough with your pimpin&#039; self.</description>
		<content:encoded><![CDATA[<p>&#8221; But you&#8217;re still the top 1% right now, whether you feel like it or not.&#8221;</p>
<p>Not true. Probably not even the top 5% even. Subtract the variable-interest HEAL and other loan payments and you probably arent even in the top 20%. And don&#8217;t forget that while you were borrowing and not working while in medical school, you made no contributions to personal savings or retirement plans. Too bad that those contributions, now forgone, would have earned you substantially greater returns than most of the later and more accelerated contributions you will have to make so that someday you can retire. Oh don&#8217;t forget, no defined benefits or company participation; retirement is 100% on your dime. Hope the late start doesn&#8217;t get you down too much (Anonymous moron 3:56 p.m. hasn&#8217;t thought of that though, too busy pimpin&#8217; poverty).</p>
<p>&#8220;Why was that? Were your grades not high enough to get in to your local public in-state institution? If that was the case, whose fault was that?&#8221;</p>
<p>Who says grades are all that make up an admissions committee&#8217;s decision? Maybe he isn&#8217;t the desired sex or race or whatever for the committee? Maybe he was honest in his interview and said he wanted to do surgery, and the committee was seeking family practitioner wannabees. Acceptances are not just an exercise in intelligence and stamina, sometimes it comes down to luck, good and bad. Whose fault indeed, you idiot? Bakke didn&#8217;t change anything, except for Dr. Bakke.</p>
<p>&#8220;If you feel like you have it bad, how do you think those who don&#8217;t have free room and board and have to support a family on less than 1/3 of what you make feel.&#8221;</p>
<p>Sorry, I missed that free room and board part. Where do you get that? Silly me, I paid real money for those things. Think what I could have saved. Have to support a family? Isn&#8217;t that the normal thing for people to do when they choose to have a family? And why is it any more a doctor&#8217;s choice to seek a higher-paying career, time and costs notwithstanding, than it is for someone to choose something else that pays less? Or, Anon. 3:56, are those who choose not to delay starting a household and family and enter the work force with lesser or at least lesser-compensated skills somehow &#8220;victims&#8221; of their circumstances and others are not? No one says you have to be an underappreciated and low-paid kindergarten teacher either. So enough with your pimpin&#8217; self.</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2006/06/why-physician-salaries-matter.html/comment-page-1#comment-64635</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Sun, 02 Jul 2006 22:59:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2006/06/why-physician-salaries-matter.html#comment-64635</guid>
		<description>Dear dum-dum,&lt;br/&gt;&lt;br/&gt;It is clear that you aren&#039;t interesting in sharing information and you are just trying to bait us.  Great attitude.  i&#039;m sure that will benefit you in the long run.&lt;br/&gt;b</description>
		<content:encoded><![CDATA[<p>Dear dum-dum,</p>
<p>It is clear that you aren&#8217;t interesting in sharing information and you are just trying to bait us.  Great attitude.  i&#8217;m sure that will benefit you in the long run.<br />b</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2006/06/why-physician-salaries-matter.html/comment-page-1#comment-64630</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Sun, 02 Jul 2006 19:56:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2006/06/why-physician-salaries-matter.html#comment-64630</guid>
		<description>&quot;The only school I got into was a private out of state school. I did not have a choice.&quot;&lt;br/&gt;&lt;br/&gt;Why was that?  Were your grades not high enough to get in to your local public in-state institution?  If that was the case, whose fault was that?&lt;br/&gt;&lt;br/&gt;And if you&#039;re paying $3000/mo on student loans, then you&#039;ve chosen a pretty aggressive payoff plan.  But you&#039;re still the top 1% right now, whether you feel like it or not.&lt;br/&gt;&lt;br/&gt;If you feel like you have it bad, how do you think those who don&#039;t have free room and board and have to support a family on less than 1/3 of what you make feel.</description>
		<content:encoded><![CDATA[<p>&#8220;The only school I got into was a private out of state school. I did not have a choice.&#8221;</p>
<p>Why was that?  Were your grades not high enough to get in to your local public in-state institution?  If that was the case, whose fault was that?</p>
<p>And if you&#8217;re paying $3000/mo on student loans, then you&#8217;ve chosen a pretty aggressive payoff plan.  But you&#8217;re still the top 1% right now, whether you feel like it or not.</p>
<p>If you feel like you have it bad, how do you think those who don&#8217;t have free room and board and have to support a family on less than 1/3 of what you make feel.</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2006/06/why-physician-salaries-matter.html/comment-page-1#comment-64623</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Sun, 02 Jul 2006 15:37:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2006/06/why-physician-salaries-matter.html#comment-64623</guid>
		<description>The only school I got into was a private out of state school. I did not have a choice. And as a primary care doctor? I am salaried at $120,000. That is the avergae for where I live, and I live here to take care of my elderly widowed mother. My student loan payments are $3000 a month. You need to stop generalizing. Some of us docs came from poor families and are in a bad way financially, yes by choice, because we love the profession and helping people. Call me in 30 years when I write my last student loan check...then I will feel like the top 1%.</description>
		<content:encoded><![CDATA[<p>The only school I got into was a private out of state school. I did not have a choice. And as a primary care doctor? I am salaried at $120,000. That is the avergae for where I live, and I live here to take care of my elderly widowed mother. My student loan payments are $3000 a month. You need to stop generalizing. Some of us docs came from poor families and are in a bad way financially, yes by choice, because we love the profession and helping people. Call me in 30 years when I write my last student loan check&#8230;then I will feel like the top 1%.</p>
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