Comments on: The primary care signing bonus http://www.kevinmd.com/blog/2008/01/primary-care-signing-bonus.html Tue, 14 Feb 2012 17:18:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2008/01/primary-care-signing-bonus.html#comment-82914 Anonymous Mon, 21 Jan 2008 01:01:00 +0000 http://clients.emmense.com/kevinmd/2008/01/the-primary-care-signing-bonus.html#comment-82914 Anon 11:17p,<br/><br/>I feel your pain. I did primary care for 5 years and then went back to do hem/onc. Now in fellowship taking home $1200/two weeks. <br/><br/>I sympathize with you more than you know, probably more than your wife or family as I walked in your shoes and saw the future the way you see it. Now some tough words--you have two choices, 1) Find another way to make money for your family 2) Spend less money so that you can save for retirement and college<br/><br/>1) You are probably smarter than everyone you went to high school with and most in your college class. You have just lost the vision you had then. Expand your horizons. Can you start a second job at night? Can you hire a few transcriptionists to work from home and start a dictation business? Can you program? Start a web based database for doctors and sell it on a shoestring to everyone you know. You have to adapt. This is the galapagos my friend and you are a small beaked finch. You must change. You are smart enough and strong enough to do it now, even with a mortgage, car payment, two kids and a wife who wants to spend like a "doctor's wife".<br/><br/>2) Convince your partners, wife, kids, parents that you have to sell you house and cars. Stop dictating your notes and type. Fire the one office person you don't really need. Cut your own grass. Change your own oil. Buy a book on home repair so you can switch out the faucet when you need to. You need to start saving 20-30% of your income if you want your retirement and kid's education to turn out ok. You need to take the gloves off.<br/><br/>Doctors are horrible with money. If you don't believe me, don't pay some financial provider to review your situation, call your accountant, pay him $200 to talk to you for 30 minutes about your expenses and show him everything. It will be embarassing, but if you choose option 2), you have to make some drastic changes. <br/><br/>Hang in there. You are one of the good guys.<br/>b Anon 11:17p,

I feel your pain. I did primary care for 5 years and then went back to do hem/onc. Now in fellowship taking home $1200/two weeks.

I sympathize with you more than you know, probably more than your wife or family as I walked in your shoes and saw the future the way you see it. Now some tough words–you have two choices, 1) Find another way to make money for your family 2) Spend less money so that you can save for retirement and college

1) You are probably smarter than everyone you went to high school with and most in your college class. You have just lost the vision you had then. Expand your horizons. Can you start a second job at night? Can you hire a few transcriptionists to work from home and start a dictation business? Can you program? Start a web based database for doctors and sell it on a shoestring to everyone you know. You have to adapt. This is the galapagos my friend and you are a small beaked finch. You must change. You are smart enough and strong enough to do it now, even with a mortgage, car payment, two kids and a wife who wants to spend like a “doctor’s wife”.

2) Convince your partners, wife, kids, parents that you have to sell you house and cars. Stop dictating your notes and type. Fire the one office person you don’t really need. Cut your own grass. Change your own oil. Buy a book on home repair so you can switch out the faucet when you need to. You need to start saving 20-30% of your income if you want your retirement and kid’s education to turn out ok. You need to take the gloves off.

Doctors are horrible with money. If you don’t believe me, don’t pay some financial provider to review your situation, call your accountant, pay him $200 to talk to you for 30 minutes about your expenses and show him everything. It will be embarassing, but if you choose option 2), you have to make some drastic changes.

Hang in there. You are one of the good guys.
b

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/01/primary-care-signing-bonus.html#comment-82766 Anonymous Wed, 16 Jan 2008 04:17:00 +0000 http://clients.emmense.com/kevinmd/2008/01/the-primary-care-signing-bonus.html#comment-82766 Yes! What about those of us in our 40's, out of residency for 10 years, working on the front lines, who will be paying off loans in excess of $180K until we're 70, while grossing $120K/year? There's no retirement account. There's no college fund. Just work, and work, and fear. <br/><br/>And diminishing empathy. Yes! What about those of us in our 40′s, out of residency for 10 years, working on the front lines, who will be paying off loans in excess of $180K until we’re 70, while grossing $120K/year? There’s no retirement account. There’s no college fund. Just work, and work, and fear.

And diminishing empathy.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/01/primary-care-signing-bonus.html#comment-82764 Anonymous Tue, 15 Jan 2008 22:59:00 +0000 http://clients.emmense.com/kevinmd/2008/01/the-primary-care-signing-bonus.html#comment-82764 I do not think these ideas are bad but how about some help for those of us already in these situations? I am 13 years out of medical school and would not mind a little debt relief or a raise in paltry medicaid reimbursement (New York pays around 30 dollars per visit). Come on Elliot, how about some relief for those of us already on the front lines?<br/><br/>Signed: an overworked, under-appreciated, under-compensated family practitioner in upstate New York I do not think these ideas are bad but how about some help for those of us already in these situations? I am 13 years out of medical school and would not mind a little debt relief or a raise in paltry medicaid reimbursement (New York pays around 30 dollars per visit). Come on Elliot, how about some relief for those of us already on the front lines?

Signed: an overworked, under-appreciated, under-compensated family practitioner in upstate New York

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/01/primary-care-signing-bonus.html#comment-82749 Anonymous Tue, 15 Jan 2008 16:20:00 +0000 http://clients.emmense.com/kevinmd/2008/01/the-primary-care-signing-bonus.html#comment-82749 Much like the med-mal insurance premium relief in Oregon. It too a couple years for the Legislature to realize its power, but they now tie the premium subsidy to Medicare and Medicaid acceptance proportional to your county's Medicare/Medicaid population. And, of course, without tort reform, you still face the risk of a bankrupting lawsuit. Much like the med-mal insurance premium relief in Oregon. It too a couple years for the Legislature to realize its power, but they now tie the premium subsidy to Medicare and Medicaid acceptance proportional to your county’s Medicare/Medicaid population. And, of course, without tort reform, you still face the risk of a bankrupting lawsuit.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/01/primary-care-signing-bonus.html#comment-82748 Anonymous Tue, 15 Jan 2008 15:12:00 +0000 http://clients.emmense.com/kevinmd/2008/01/the-primary-care-signing-bonus.html#comment-82748 Student loan forgiveness is usually given via the local hospital and tied to accepting Medicaid and Medicare. This ties the new physician to those messes for years to come and limits the ability of small groups to recruit new physicians or drop Medicaid or Medicare. Student loan forgiveness is usually given via the local hospital and tied to accepting Medicaid and Medicare. This ties the new physician to those messes for years to come and limits the ability of small groups to recruit new physicians or drop Medicaid or Medicare.

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