Noctors aka "Nurse doctors"

Did you know that there are currently 101 doctorate of nursing programs in the United States accepting patients???? ONE HUNDRED AND ONE! This is nearly as many as the number of allopathic medical schools in the entire United States. Here is the official list according to the American Association of Colleges of Nursing. There is no escaping NP's. They have even managed to make headway as far up and away as the Yukon!
Yes, you too can enter the Texas Woman's University (just make sure you were able to crack a whopping 960 on the GRE to qualify) and a mere 46 credits later (don't worry you will never have to take more than 9 credits a semester) and you too can call yourself DOCTOR. If you fear that 46 credits maybe too much of an academic burden, then you can always apply to the Frontier School of Midwifery and Family Nursing as they only require 33 credits to achieve the doctorate! Or maybe you hate having to sit in class. Well thanks to the the University of Cincinnati you can do your entire doctorate online (plus no GRE needed)!  I had to pull out my old med school transcript to calm myself down since I knew working my butt off for a doctorate certainly required more than the above.  Guess what?  I can safely say that I did not lose my mind- just shy of 160 credits it was.

Oh and it gets better. There are another ONE HUNDRED additional noctor programs in the planning stages. So if you had concerns that your credentials were not competitive enough, you could always wait a couple years since there will be nearly double the spots.

Between greater govt control of healthcare in this country and the explosion of allied professionals, primary care salaries are not going up anytime in the foreseeable future while inflation and compensations in other occupations will only increase. This is chimpanzee economics. To add insult to injury, while your recently graduated med student is working like a racehorse in residency barely able to pay the minimum (assuming he is not in deferment or forebearance) on his quarter of a million dollar student loan balance, your noctor zipped through a one week residency (at the end of the first paragraph in this article) and is humming away making just shy of your future attending salary with a fraction of the loans. Actually, while you were sitting in lecture all day racking up those loans, your future NP was busy at work full time bringing in a nice salary.  I will leave it to one recent NP grad's remarks about her noctor program over on allnurses.com, "University of Cincinnati (UC) is 100% on-line, it allows me to continue to work!" Someone tell me how it is even possible to learn all there is to know in medicine entirely online and while holding a job? Please tell me I am dying to know, as are your future patients whom many of you will be independently treating.

PEDIATRICS- The Most Underpaid Specialty

It is no secret that pediatrics is the most underpaid of all medical specialties. It just goes to show you how much our country really values it's youngest and most vulnerable citizens.  Exactly how bad has it gotten? Check out and see for yourself on this forum where DC housewives congregate and discuss the matter.

 

"I left private practice as an internist because the money was awful and the hours were even worse. I made $110K and worked my butt off; on top of that I have to pay down $150K in student loan debt.
My friends are leaving practice in droves -- esp. OB's because of increasing malpractice premiums."

 "I always assumed that my sister in law who has a nice practice in Baltimore was doing well. Then I found out that she made 89k last year. That is after all the late nights and weekends, her pager is always going off."

"I worked for an insurance company in claims, and at times (sadly) we laughed at the small checks we would send the docs."

"I am a pediatrician. Full-time docs starting out make $90,000. I'm part-time, so I actually make proportionately less."

 "If you thought I had it made...I really HAD IT!!" 

"I do not have any desire to go to the hospital anymore. It cost more to pay the malpractice insurance than what you collect for your services in the hospital"

 "The problem is that you are on a treadmill to keep up with expenses in the face of lower insurance reimbursements -- so the way to make up for it is to see more and more patients."

"There's no prestige left in it, and the salary is not that great. Last year, had I worked full-time, I would have made 1/10 what my non-physician husband made (who spent 9 fewer years in formal education than I did). And I'm a surgeon."

"I doubt it will be too long before I stop going back to work."

"My husband is a dean at one of the medical schools in town and while I don't have an exact figure, I know that a daily concern of his is just how much debt his medical students are graduating with these days. Almost universally 100K+ and often $250K+."

MD Living in Poverty

        I have received several inquiries on a recent posting where I mentioned that I live under the poverty line.  According to the 2009 poverty guidelines, for a single person in my state one needs to make under $10,830 to qualify. I am here to tell you that I do indeed live in "poverty" as my annual expenses throughout my working career since graduating from medical school have been under this amount. How is this possible and even if true, how could I allow myself to suffer like this?
        I do concede that living so frugally is not for everyone. For starters, it is very anti-American to not spend spend spend. I will be perfectly honest with you when I say what you read on this blog you will rarely see elsewhere. Why is that? Well I am not getting paid to sell you something that you really don't need! When you live in a capitalist consumer throw away society where advertisers are working hard to part you from your hard earned dollars, it can be hard to say NO. Wherever we look, we are being constantly bombarded with images of how we should be living the "American dream". It is as if the media and society are programming us on HOW we should live. Everything from the kind of car we drive down to the brand of underwear that gets to caress our ass has now become some sort of status symbol.  Are we that unhappy or insecure that we need to buy "stuff" to fill an empty void?  Rather than looking at others for approval through the silly tokens of importance that we buy or the degrees after our name, we should instead realize that it is by being a good person at heart that inevitably leads to contentment and fulfillment.   So part of the reason why I live this way is out of protest.  The protest of turning into a person I do not want to become.  I do not need "things" to validate myself to others.  I will leave that to my actions, contributions, and the way I treat others.   If you are throwing scalpels across the OR or belittling med students on rounds, I guess buying a lot of stuff is the only way you get to make yourself feel important.
        Everyone has their threshold for what they can tolerate.  As I've mentioned in the above posting, a major impetus for living below my means is to achieve financial independence.  The cornerstone of my plan to get out of a highly toxic career is to break my golden handcuffs (aka student loans).   If one is able to live below their means, one is able to live the life they always wanted.  Think about that for a second.  Ironically, it is almost tantamount to asking yourself if you won the lottery, what would you do for the rest of your life?  It is incredibly liberating to know that you can spend your time doing whatever it is you wish if you are able to live in this manner.   And this is the reason why I am happy as a clam living in poverty.  I do not see it as suffering at all.  Every dollar that I am able to save  is one minute less that I have to suffer in the hospital.  If this isn't motivation than I don't know what is.  I know that one day soon I can walk away from medicine forever and pursue an alternative career that I will greatly enjoy.  As if this wasn't enough of a reason, by continuing to live under my means (spending less than what I make), over the course of time I will SAVE more money than I could ever imagine simply by refraining from buying into the American lifestyle trap.  One day I hope to find myself in a position to upgrade my lifestyle (if I so wish) while many of my fellow Americans will drown further into debt.
So how do I exactly live under the poverty level? I will keep this brief as I don't think the numbers are as important as the reasons which I discussed above. If you take the $10,830 annual amount and divide it up over 12 months, you are left with approximately $900. Here is the rough breakdown of my monthly outflow as a resident:



RENT: $550 -for an old small, but perfectly adequate, studio (found off craigslist) in a good part of the city 3 blocks from the hospital. Needless to say this is not NYC or LA but still a major culturally vibrant city in the top 20 in terms of population. Housing is the number one expense in anyone's budget and this is the one place where anybody can save the most. If you are willing to live small in the right location, you can save big. Europeans already do this, I don't know why we can't???
TRANSPORTATION: $5 -I purposefully chose my apt near the hospital so I didn't have to get a car and pay $9400 a year which is what the average American pays a year to own a car. No monthly car payment, no car insurance, no gas, no paying for a monthly parking spot. Everything I needed was within walking distance of my apt since it was literally in the middle of everything. I could always drop a dollar here and there to take a bus if I needed to hoof over to the opposite side of the city. I never took taxis. Taxis are for lazy people or those who don't know how to use public transportation.
FOOD: $150- spent roughly 35 dollars a week at the local major chain grocery store. Whatever is on sale is what I eat that week. Online coupons help somewhat. I also got about 50 bucks a month to eat on call which also helped. I eat healthy and didn't starve. Would eat out maybe once a month, and usually for lunch. Prefer cooking myself.
UTILITIES: $35- water and cable were free in my studio. Since my place was small, my electric bill was only 15 bucks on average. In summer, I would open the windows and turn on the fan- I only turned on the window AC unit if it went over 90 degrees and only for like 15 minutes since again my apt was small (notice a trend here). Another 20 bucks for gas to cook.
CELL PHONE: $42 with employee discount. My contract is now up and considering going pay as you go to save here.
INTERNET: $30 This is the one NEED in my life. I can't live without it.
GRAND TOTAL:$812 which is well under 900 dollars as you can see.  This left me with an extra 90 dollars a month that I could use as I pleased for MISC EXPENSES.  I would usually bank this into my "vacation fund" so I could put as many miles as I possibly could between me and my residency program during my four weeks of allotted vacation time. Here's an actual pic from a recent domestic excursion to illustrate this point ==> [Yes, I felt more relaxed being a mere earshot from communist Cuba than remaining within a thousand miles from the hospital] 

        Interest earned off my savings helped supplement this expense but I am quite the budget traveler as you could probably guess.  Per year, I averaged one international trip, one domestic trip, and two visits home which was about 200 miles away.   I love to travel and this is where I will be spending more and more money in the future as my debts begin to quickly erode away. 

        On one last note- someone suggested that I must moonlight in order to be able to do this. Absolutely not!  No amount of money was enough to entice me back into the hospital after already being there 60-70 hrs a week.   My coresidents who lived in their 1500 a month one bedroom apts and had expensive car leases had to.  I felt sorry for them while I ate bons bons in my pajamas watching a free movie on hulu.com.  Only if they knew about this blog.

Enjoy the Journey & Don't Be Like Sally!

Music and Life - Alan Watts

"In music, one doesn't make the end of the composition the point of the composition"

Stumbled upon this really great video posted this week over on the millionairemommynextdoor Blog. I think it so nicely encapsulates how one ought to enjoy the journey of life rather than focus on the supposed destination. It has been said that after climbing the tallest of mountains, it can be pretty damn lonely at the top. In medicine, which is ONE hell of a long road, you can easily find yourself wondering if it was all worth it when you come out on the other side. After years of being buried in medical tomes, abused by senior residents and attendings, and deprived of your sleep and time, you may just come out on the other side yelling, "I went through all THAT for THIS!!!"   Don't be like Linus and Sally who wasted their entire Halloween night out in the Pumpkin Patch waiting for the Great Pumpkin.  While everyone else was out having fun trick and treating, they could've been as well.  Here's Sally flipping out after she finally realizes what a crock the pathway to becoming a doctor is-



As you can see, sometimes the endpoint doesn't turn out exactly how one initially envisioned it to be. This is why it is so imperative that one spends their time on this earth pursuing something that they are passionate about and brings them joy rather than zooming from one goalpost to another in a field of misery. Your hours on this planet are a limited resource. Once they are spent, they can never be gotten back. I would personally rather spend those hours "dancing" than wishing them away or just plodding along and trying to just get by all to reach some nebulous end.

Wouldn't You Rather Go To OUTER SPACE?

(photo by skookums on Flickr)

As I was reading through the comments section on a student advocacy site I frequent, I came across the following. Apparently the cost to attend medical school in the United States has risen so "astronomically" that it is now cheaper to go to outer space!   Unbelievable isnt' it? For a cool $200,000, you can secure a spot on Virgin Galactic and go where few have gone before. How can anyone turn down the opportunity to experience several minutes of celestial bliss and zero gravity versus spending year after year getting tortured in our healthcare system? Furthermore, when you are old and gray you will have one awesome story to tell your grandkids rather than explain how you got to disimpact the 90 year old nursing home admit when you were a lowly intern. Need another reason? Victoria Principal has booked a seat and could be your co-astronaut! Anyone interested in putting down a deposit?

Doctors and "Power"

Over on SDN today , someone asked "what specialty will give you the most power?" I would have to say NONE. Some doctors project an image as if they are the coming messiah. Don't be fooled. Trauma attendings can beat their chests all they want and intensivists can gallant through the ICUs but it is all just a charade. Need you ask why? Well, you will be the govt's bitch, HMO's will dictate how you practice medicine, administrators and regulating agencies will ride you, malpractice lawyers will be circling above, patients will freely tell you what they want and will sue you at the drop of a hat, allied professionals will continue to needle their way onto your territory, and Sallie Mae will want a piece of you too. Sounds almighty powerful to me! If you are looking to go on a power trip than don't become a physician. If so you are in for a rather rude awakening. Otherwise you will turn into that surgeon who pitches a fit in the OR like a 2 year old when he doesn't get his way.

What a Thread ==> Should I Quit Medical School?

The Student Doctor Network (SDN) continues to hate on me. Apparently, the cartoon that I featured on my last blog posting was considered to be too "sexual" since "naked women" are not allowed on SDN. I was asked to remove it. I don't even think the Puritans were this prude! And than today, a really great thread that I stumbled upon for the first time that I posted in the Allopathic Forum was pulled down without explanation. So what was my response? To post it here so even more people can read it! Anyways, right below is the involved link.  Apparently, everything is supposed to be peaches and cream in med land. Clearly, it is not.

SHOULD I QUIT MEDICAL SCHOOL?

In case you are short of time because you have to begin a six hour study session, I thought I would give you some of the highlights-

“i feel stupid multiple times a day and i want to punch my resident in the face”

 “I liked the first two years of med school, but then it was downhill from there”

 “Basically finishing my fourth year at Pritzker, UChicago. And am going to quit” 

“i want to quit so badly, but the loans scare me so much.”

 “I have just completed my first year of medical school, and I am quitting”

 “I feel relieved, I’m now free to do whatever else I want, to explore, to spend time with family, friends, and to start building a life instead of burying myself in debt and spending the majority of my 20s in a library.”

 “Med school has turned me into an extremely anxious and depressed person, when I used to be such a smiley optimist”

 “I hate the fact that i’m too afraid to quit right now. My heart is not in it.”

 "I live for weekends off and vacations. I hate that. I feel like I’m wishing my life away.”

 “I’ve got a taste of life out school and I don’t want to ever feel trapped gain. It takes more courage to leave med school than to suck it up.”

Geez Louise!   And we haven't even entered residency yet!  I was simultaneosly amazed yet not surprised at the volume of posts from disgruntled med students. By posting this link I was hoping to convey to others having doubts that they are not alone. I can't tell you how many emails I get from pre-meds all the way up to attendings well into practice asking for advice on how to "get out". Sadly, there is somewhat of a shame in the medical community to openly discuss such thoughts which is nonsense. You know what is shameful? How our healthcare system mercilessly abuses those in it. I can fully relate to many who generously shared their innermost misgivings and concerns in the above link. I never thought it could happen to me as I can always remember wanting to be a doctor going back to elementary school. However, I found that my dissatisfaction with medicine started to emerge third year of med school and only grew from there. Residency is where my feelings REALLY began to sour and I got to see medicine in all its horrid glory. I somehow made it through residency graduating several months ago. As I've recently shared, I am diligently working on my escape plan and hope to be out of medicine forever someday. I have compared this to almost like being in a marriage that has gone horribly wrong that is beyond repair. As each day goes on, it only gets worse and I want a divorce. Especially since I found something else I fell madly in love with (yes, I confess that I had an affair with another career for a year in between switching residencies!) There is only so much physical and mental abuse one can take. Why stay with a zero when you can be with a hero?

You Better Love Your Job. Here's why ==>

(Needless to say this mug is not in my kitchen cupboard)

Of course, work should not be the core of one's life where you love it to the exclusion of everything else. Medicinesux is all about striking a balance between work and personal time. However, work IS an important component of one's life and does provide one a sense of purpose. To deny that fact is outlandish. As a physician, you will easily spend more than half your waking hours on the job. Let's do the math to drive this point home:

There are 168 hours in a week. You "should" spend 33% of that time asleep to maintain sound body and mind (56 hours a week), roughly 36% "on the job" (60 hours a week for avg physician), and 31% "off the job" (52 hours a week). Please keep in mind that when you are pulling ten hour days, you have to factor in such things as waking up at the crack of dawn, showering, shaving, primping, getting dressed, making breakfast, COMMUTING all which can take away 1-2 hrs every day out of your precious 52 hours of "off the job" time. And then you need to factor in time at the end of the day where you get to languish in traffic again or take the train ("meat cart") and also the countless hours you need to recuperate after going to battle for the day. This is yet another 2-3 hrs that you can subtract from "off the job" time. And let's not forget all the extra hours where you need to be constantly reading medically relevant literature to keep yourself up to date on your field and not turn into a medical numb nut. Now revising our numbers, we can STEAL 20 hours out of "off the job" time and ship it right on over to "on the job" time. Doing this new math we have the following:

80 hrs involved with "job related activities" (48%)

32 hrs of "free time" (19%)

56 hrs asleep (33%)

If we just count the time we are awake, then you are roughly spending a whopping 71% of your time (80 out of 112 hours) performing physician related activities!!!

Also, ask yourself if you are able to keep those 32 hours of "free time" unadulterated, where you are able to completely divorce your mind and NOT think for a second about work? Good luck on that one.


So the driving point from this analysis is that you damn better pick a profession that you are going to enjoy and be happy doing. Is any amount of money worth being miserable, discontent, or just biding time 70% of your waking hours for the next 30-40 years??? Or to put in other words, how much a year would you be willing to pay to be happy 70% of your waking hours? Everything in this world has a price. How much is happiness worth to you?

US Govt's Answer to Primary Care Shortage: Increase Residency Slots!

A regular reader, Cryn, whose blog I highly recommend checking out here, tweeted me and pointed out this article from the Wall Street Journal regarding our govt's answer to addressing the Primary Care Shortage.   

How about addressing the core of the problem why primary care is such an unpopular choice among med students? Increasing the number of residency slots is only going to entrap more poor souls into such a thankless overworked specialty. How about doing something about the out of control student loan debt levels and workloads? I recently wrote how an entering med student at Tufts University Med School in 2009 will graduate in 2013 owing $315,000! And that doesn't include the interest! Payed out over 30 years at 7.5% interest and that is 3/4 of a million!!! Throwing a 50K pittance to defray these costs is utterly insulting for the immense importance of such a job. Leaving primary care after my internship and going into another specialty was a decision I don't regret in the least. I don't miss for a NANOsecond the days where I would preround on 15-20 very sick inpatients starting at 6AM, collecting critical lab values and reports, requesting endless consults from irritated fellows...an old lady moaning is rolling down the hallway in a stretcher...who is that????.....going to morning report, rounding again with the attending for another 3-4 hours till noon, getting pimped, not knowing the answer and getting assigned a presentation for the following day, devouring down lunch while attending an "educational noon conference", co-intern is now in clinic so now I get to cover 25 patients! YAY for me! .....back to the floors to follow up on ordered tests and consults, discharging patients, discharge paperwork, medical student ran away- "where did he go? dammit!....does this mean i now have to draw blood from the IVDA whose veins the nurse can't find?", Ms. Clark's husband wants to know why "nothing is being done", finishing 15-20 daily progress notes, admitting new patients, .........Mr. Smith pulled his NG tube out!.....transferring one of my sicker patients who is suddenly crumping to the ICU, Mr. Jones is constipated...oh and by the way that old lady fell in the bathroom and you have to fill out an incident report, being dumped a new patient from Ortho whose problems are now considered more "medical", Mr Smith's IV is out too and he needs his afternoon IV ABX!!!, answering pages every 10-15 minutes from nurses, ortho patient is now having chest pain! IS IT TIME TO GO HOME YET? Not tonight because you are on call!!!! Hey Hippocrates, give me that gun so I can shoot myself before you do.

Want to be the US Govt's Doctor Bitch?

I am sick and tired of hearing about older docs telling premeds how "most doctors pay off their student loans in ten years".   These old timers have no idea how the student loan landscape has changed.   Physicians who graduated in the past had MUCH lower student loan debts. It is like comparing apples to PIGSH!T. This 10 year figure no longer applies when many entering med students for 2010 will be graduating with 250K+ debt loads upon graduation. Also the interest you guys will be paying is mere INSANITY! 7.5% interest (avg of Staffords and Grad Plus) on a 300K debt load on graduation adds 21K a year to your principal. So someone doing a five year surgery residency or a five year IM-fellowship track will see that their debt has ballooned to 400k when they finish!!! Pay that off over 30 years and you are easily paying back a million dollars. Actually $1,006,000 but whose counting. You will be paying $2800 a month for 30 years (basically over your entire professional career). This is like being taxed 30% for 30 years IF you are able to NET 8-10K a month (assuming this number does not tank too much further because of Obamacare)!!!!!! You will be the US govt's doctor bitch for sure.
You'll be tied to the hospital as much as the 45 year old homeless drunk in delirium tremens who you admitted the night before whose now tied to the bed in four point restraints on a one to one watch. As if this weren't enough, you may just find yourself suffering even more!

Why Make $150K when you can make $75K?!

Americans are drowning in debt and our country continues to go down the tubes. Came across these numbers and was quite frankly blown away. Assuming a 7% interest rate, to service 300K of debt costs 21K a year! This requires roughly 30K of gross income to pay just the interest. And if you consider that the avg income in this country is around 40K, that means 75% of one's disposable income is used to pay interest on debt. Unbelievable! Is it no wonder why the banks run this country?
If you apply this to physicians, you can throw in an extra 200-300K to account for super sized student loans which is now becoming the "new normal". Now let's say you are making 150K a year in good old primary care. According to paycheck city, that leaves roughly 95K for a New Yorker (90K if you are in the city), 92K for a Californian, and 102K for someone in Illinois. Deduct out your 40K in interest payments and let's say another 10K for property taxes and you are left with 50K to live on. Digest those numbers for a moment. Do you realize that you are now in the same boat as the person making a mere 75K, HALF of your annual salary, who has no debts and eschews living a life of being in debt to others? How can this be? Let's run some more numbers and see how. After taxes 75K in California is 49K, 51K in NY (48K in NYC), and 53K in IL. Subtract out ZERO interest payments and lower property taxes (by not living in a McMansioin) you are roughly even!!!
By owing money to the banks, you are not only flushing money down the toilet but you are also sacrificing your freedom. The freedom to have more leisure time to do whatever you wish or the ability to work in a job or industry that you would find much more appealing and satisfying. For those in debt, you can easily find yourself in a situation where you are working endless hours a week in a miserable higher paying job just to keep your head above water. So which would you prefer? 60-70 stressful hours a week seeing 35 cranky ass patients a day, filling out reams of paperwork, fighting with HMO's over billing issues or waking up in the morning going to a job you love 35-40 hrs a week with weekends and evenings off for life? Sounds like a no brainer to me.

If there is any good that can be said of having major student loans like so many other med school grads it is that I have vowed to NEVER take out another loan again. NEVER! Fool me once shame on you, fool me twice shame on me. I am a firm believer that the banks in this country are an outright evil parasite draining this country of so much potential greatness. I also believe that CASH is KING. Everything I have purchased since graduating from med school was in cash and will continue to be in cash. This will include even cars and homes. I believe if you can't afford it now, you have no business buying it despite what our culture and mass media tells you. Start off with a condo and move yourself up to a ranch and then ultimately buy that waterfront home as you save up money like mad not paying usurious interest rates. Don't buy a McMansion straight out of the gate with a jumbo loan which is the American way. Need to have that Mercedes to complement your "prestige". Unless you have 50K in the bank you can't afford it. Rather than ogling with jealousy at the nice shiny Beamer or latest model Mercedes whenever I am sitting in my clunker at a traffic light, I instead find myself feeling so much richer than they are. It sure feels good having NO monthly payment rather than paying a mini mortgage payment every month. Americans want to live big...than they are going to pay big....with their time! Time away from family, friends, and most of all to yourself which you can never get back. We've all heard the saying how no one wishes they could've spent another day at the office on their death bed. Sadly for many physicians, we will ironically find ourselves in this very "office" even on our last day.

Stressful Jobs That Pay Badly

This recent article from CNN and some of the ensuing comments make for a good laugh! Here are the candidates:

Social worker: $43,200
Special events coordinator: $35,900
Probation/parole officer: $38,400
News reporter: $32,900
Music ministry director: $40,800
Membership manager: $42,600
Fundraiser: $42,700
Commercial photographer: $43,600
Assisted living director: $46,000
Minister: $45,300
Marriage/family therapist: $44,400
Curator: $46,500
Substance abuse counselor: $32,400
Film/TV producer: $47,600
High school teacher: $43,000



This list lost all credibility in my eyes when I did not see MEDICAL RESIDENT??!?! Film Producer? Are you kidding me! I wonder why I was the first to even mention newly minted doctors in their comments section. Maybe it is because residents are too busy working 80-90 hrs a week or are post call sleeping the day away after being up for the past 30 hrs to take the time to write just a couple words and comment. Even something like "CALL BLOWS" would've sufficed. With salaries hovering in the low 40's, that comes to barely breaking minimum wage when you factor in the 3000+ hours you work a year! All the while your pager is going off at all hours as you try to cover 30-40 very ill pts, dealing with arrogant obnoxious senior attending doctors and ancillary staff, and worrying about not getting your pants sued off or inadvertently killing someone. Let's not forget about the $200K+ in student loans you are going to have to pay off which will trap you in this career forever. I just finished such a residency and even though I am in my early thirties I am so burned out that I am ready to retire. Indeed a career in MEDICINESUX!

Walmart Clinics

Zback on SDN came across this advertisement announcing the opening of another Walmart Clinic If you look very closely at the bottom of the ad, you will see the following:

"Wal-Mart is not responsible for the medical treatment provided in this clinic."

So let me get this straight. Walmart wants to get in on the healthcare business yet not take any of the responsibility that goes along with it? Sorry, but in this highly litiginous society it just doesn't work that way. And surely Walmart realizes that this "disclaimer" means absolutely nothing in a court of law just as a signed informed consent is nearly equally meaningless.

Besides, I couldn't think of a more horrifying job than doing primary care in freaking Walmart. Imagine being one of those PA's or NP's! Here's Big Bertha checking out the meat before waddling over to the weigh station for her cholesterol levels =>

Photo courtesy of www.peopleofwalmart.com

Where do babies come from?

Octomom explains to Youtube's notoriously famous Miss Teen South Carolina 2007, Caitlin Upton, where babies come from in this clip from last night's Jimmy Kimmel Live. Is Nadya Suleman suffering from Postpartum psychosis?

Is Medicine Worth 750K?

Since early September, a popular thread titled, "Is Medicine worth $300K" has been making the rounds over on SDN in the general residency forum. I believe that the heading should've read, "Is Medicine worth $750K?" because that is what one will owe after paying 7.5% interest over 30 years with 300K owed on graduation. Yes, 750K!!!! If you don't believe me than I encourage you to run the numbers yourself here. Keep in mind that this is only the financial toll and does not include any of the other mounting BS medicine increasingly dishes out. You really can't put a price tag on the physical abuse your body will undertake working 70-80 hr weeks, the numerous sleepless nights, 30 hr marathon shifts and the emotional trauma of working under some revolting egotistical maniac attending all the while trying to not make any mistakes or face a multimillion dollar lawsuit. I HIGHLY recommend anyone out there contemplating going to medical school to take just ten minutes and give the above thread a read. It might just save you a pretax million dollar lotto win plus immeasurable happiness.

Disappearing Doctors

"I can't work in a system where I have to see 35 or 40 patients a day and think that I did a good job and don't worry when I get home about the things that I missed because I just didn't have time to think."

"There is no way on what I am making now that you could send someone to college."

"My fee schedule is irrelevant. You have to accept whatever the insurance company pays."

A Career in Mortuary Science

Flickr picture by CasketCoach

Don't dismiss a career in mortuary science. If FORCED to choose a healthcare related field again, this is the one I would give some serious consideration. Why is that you may ask? Well hear me out. Open up a funeral home, and kaching kaching! Don't ever have to worry about getting sued since your client is already dead. No USMLE's. No drawn out residency to suffer through. Minimal paperwork. Charge whatever you wish- mark up prices of coffins and urns to your heart's desire not worrying about Obamacare. Real estate prices are quite depressed nowadays so you could probably get a really good deal on a funeral home. And if they have another cash for clunkers incentive you could get a great bargain on a hearse. Baby boomers who screwed over the next generation will be dropping off in droves in the coming decades. You may even get some morbid satisfaction out of that. Don't laugh.......I am dead serious.

House passes Health Care Reform Bill

Health Care Reform Bill passes House 220-215. Now on to the Senate where things ought to get really interesting. Meanwhile premeds are freaking out (as they should be!).

Heather Graham and Health Care Reform

Track Meet


Heather Graham, have acting offers been so far and between lately that you had to resort to appearing in this?

How Government Programs Drive Up College Tuitions

Watch Peter Schiff clearly explain how the proliferation of student loans through govt backing is one of the main reasons why tuitions are zooming to some eternal zenith in this country. By enslaving the younger generation to years and years of indentured servitude we can now better understand how some highly ranked administrators can make millions as mentioned in yesterday's posting.

23 College Presidents banked over $1 MILLION

From today's NY Times, "23 College Presidents made more than 1 million dollars" including those of the highly esteemed Suffolk University and University of Tulsa:

Also of interesting note, the avg salary of a private college president increased 5.5% in the most recent year over year whereas millions of hard working Americans got pink slips. Good to know that our govt fully funds the higher education cartel in this country by supplying an endless stream of funding via plentiful ever increasing student loans. Sounds eerily similar to that of the shady mortgage loan officer writing a million dollar jumbo loan to the fast food dishwasher so he can move into his McMansion.

Suzanne Somers is at it again!

Suzanne Somers is at it again. Now "Dr. Somers" is releasing yet another book called "Knockout" where "she argues against what she sees as the vast and often pointless use of chemotherapy."

It is egregious that this quackery can be fed to the masses like this. Anyone else who tries to play doctor without a medical license is thrown in jail. But this is worse. While one fake doc might kill one or two people at the most before being found out by the state medical board, her ignorance is capable of killing thousands. I hope one of her reader's vengeful family members sues her ass for millions.



In the following video she explains today to Ann Curry how her book is one of hope!? I see it as one of doom. She further states that she wishes how this book had been around when she was fighting breast cancer. If this was the case she wouldn't be sitting here giving us insight into her remarkable stupidity.

Suzanne Somers is a nauseating heinous hag who will prostitute out her soul to make a dollar even if it means prematurely taking the lives of desperate cancer victims. Utterly disgusting!

Forgive Student Loans

Over the past week, you may have noticed that I have devoted several of my daily posts to highlight the emerging student loan crisis. I was prompted to focus in on this issue after hearing of a contest over on SDN to see who would have the highest debt after graduating from med school. Needless to say I was horrified. After awarding Tufts Medical School the prize for having the highest tuition and fees in the nation, a lot of discussion erupted over this. I was contacted by Ms. C. Cryn Johannsen, the Promotional Writer and Director of Marketing for the Forgive Student Loan Debt Movement (founded by Robert Applebaum whose facebook group now has over 232,000 members and climbing as of this writing). I get many emails from colleagues venting their frustration over the state of healthcare who ask how they can help but often feel powerless. Here is one recent particular message, "For one thing, what can any resident do about tuition costs? We paid our tuitions and moved on. We made the decisions, good or bad, to attend expensive med schools over state schools 5 years ago. What good is posting about tuition costs going to do for us NOW? We made our beds already and now have to live with the consequences." Regarding the student loan issue, I too had similar feelings. However, with the passage of IBR as a part of the College Cost and Reduction Act of 2007 and the introduction of a new president a glimmer of hope appeared. With student loans ballooning out of control more must be done. The massive debt loads are only fueling the fire to the rising cost of healthcare in this country. The president has asked for ideas from the public in how to better control costs in healthcare...Obama are you listening? Your voices are being heard and I strongly believe that change can and will happen. I strongly encourage everyone to show their support of this grassroots movement by chipping in a mere $5 (which is less than your nearly useless AMSA dues but will actually mean something) to buy a bumper sticker. Though I would've preferred my bumper sticker to read, "My other house is my student loans", I eagerly await for mine in the mail. Now at least everyone will understand why a new attending is still driving around in a clunker.

Dermatologist wins $189 Million PowerBall

I am sometimes accused of being too negative. So, I'd thought I'd break tradition and share with you the following story. Dr. William A. Steele, a dermatologist, from Orlando, Florida hit it big. And boy did he hit it big- 189 MILLION Dollars from the recent PowerBall Lotto! Just to think that a mere one week's worth of interest off those winnings would wipe out my six figure student loan debt setting me free to pursue my passion in public service. Dr. Steele states in the article that he would donate some of the winnings to charity. So, if Dr. Steele if you are out there listening.....ah... too dream. Now doesn't that story just make you feel all warm and fuzzy inside?

Sallie Mae Loan Sharks Go after Dead Son's Mom

Watch Sallie Mae hunt down a student loan from this poor mom who just lost her son to myocarditis. This behavior is beyond predatory...it is outright evil. Here is the inside story to this awfully painful situation.

The Hyenas of American Healthcare

The Hyenas of American Healthcare

“Allied” Health Professionals
HMO's
Gov't bureaucrats and eroding reimbursements
Malpractice lawyers and insurers
Student Loan lenders
Institutions of Higher Learning
Walmart minute clinics
Corrupt administrators
Specialty Turf Wars
Medical tourism
USMLE/Licensure/Certification/DEA/Misc. Fees

Why is it so taxing to be a physician nowadays? Having to deal with the hyenas of healthcare...and they are everywhere! Watch this video from start to finish and you will see why practicing as a physician nowadays is so draining and what will be the end result if no stance is taken.

Calling out Penn Dental

Someone gave me the heads up to look into the student budget at Penn Dental. Check out the jaw dropping four year budget here. Penn Dental, you rock! Flavor Flav would be so proud!

Suze Orman and the Student Loan Crisis

Suze Orman and Student Loans

Suze Orman talks about the looming student loan crisis. Congress are you listening? Or are we going to continue to sleep behind the wheel of this sixteen wheeler until it is too late? WAKE UP NOW!

And The AWARD Goes To...

TUFTS University for leading the way with the highest tuition amongst all medical schools in the entire United States. A whopping $51968 per year! Congratulations are in order for being the first institution to cross the 50K barrier!  Surely, others will be taking your lead.  Honorable mention goes to Colorado for raping their out of state students for tuition.

 TUFTS Estimated 2009/2010 student budget

As you can see this does not include everything else from room, board, health insurance, books, transportation, loan fees, etc. After your four years you will be staring at over 300K in debt!!! And with the loans locked at 7% interest, your debt will be climbing to the tune of 21 thousand smackeroos a year. Don't call me an alarmist. The numbers are right there before you in black ink.

Year 1: $73,336

Year 2: $73,625

Year 3: $84,451

Year 4: $82,966

------------------

Grand Total: $ 314378 (God forbid you have undergrad loans to add!)

The current bleak student loan issue is nothing compared to what lies right down the road. With the economy in the toilet, why is it that tuitions keep spiraling upwards when everything else has come crashing down? Just when you think practicing medicine couldn't possibly get any worse. It always....well.......just does. Should be really interesting to see all this unfold-Got popcorn?

You can watch the acceptance speech below-



Way to go Tufts!!! You are so well deserving of this award.

Reigning in Private Student Loans

Today I received an email from projectstudentdebt.org regarding a hearing in Washington on Sept 23 concerning the toxicity of private student loans. A very thorough and interesting testimony by Lauren Asher, President of the Institute for College Access and Success can be read here

The Obama Administration is pushing for the creation of a new Consumer Financial Protection Agency (CFPA), which would protect consumers from risky financial products and services, including private student loans. A strong CFPA could help protect private loan borrowers from deceptive marketing and unfair loan terms and treatment.

The financial industry is lobbying hard against the CFPA, and consumers need to speak up before it's too late. Please tell your members of Congress that we need a CFPA with authority over all private student loans to protect borrowers and ensure private loans are only used as a last resort.

Write to Your Elected Officials Here

Please click the link above and write to your elected officials- it took me less than 45 seconds. Hopefully, this will be the first step towards getting private loans put back on the same wavelength as other consumer debts like credit cards. I wasn't going to take the time to bother but when I read the following excerpt from the above testimony I felt compelled to do something and write-

“Ironically, private loan creditors remain fully eligible for the bankruptcy protection that their borrowers are now denied. Bankruptcy helps failed businesses discharge outstanding debt and make a fresh start regardless of the nature or merits of their product or business model, or the types of debt they carry.

Last year, The Education Resources Institute (TERI) declared bankruptcy with tens of millions of dollars in outstanding debt. TERI guaranteed private student loans for First Marblehead Corporation, which was a major player in the private loan market and a strong advocate for making private loan debt non-dischargeable for borrowers. First Marblehead rode the wave of securitizations that led to the current credit crunch, packaging private student loans from other lenders and selling them as investments. When these loans experienced higher than expected default rates, TERI went bankrupt and First Marblehead’s stock tumbled. Apparently, bankruptcy has enabled TERI to reorganize, and reports of its impending recovery buoyed First Marblehead’s stock last month. Meanwhile, TERI’s website includes this reminder for private loan borrowers:

“The bankruptcy laws provide that, unlike, other commercial debt, a loan guaranteed by TERI can not be discharged or forgiven in a bankruptcy proceeding unless the borrower proves that repayment of the loan will cause him/her undue hardship.”

Nursing Home Crisis

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Nursing Home Crisis

"A Medicare rate adjustment that cuts an estimated $16 billion in nursing home funding over the next 10 years was enacted at week's end by the federal Centers for Medicare and Medicaid Services — on top of state-level cuts or flat-funding that already had the industry reeling."

"And Congress is debating slashing billions more in Medicare funding as part of health care reform."

"In Washington, D.C., health care interests are resisting President Barack Obama's plan to pay for his health care overhaul by slowing Medicaid and Medicare spending. Obama wants to trim $313 billion from the two programs over 10 years."

"A University of Pittsburgh study earlier this year found nearly 1,800 nursing homes nationwide closed from 1999 to 2005, about 2 percent each year."

Pay Me Dammit!!!

With the economy in the toilet and unemployment on the uptick again last month, how on God's green earth are millions of student loan borrowers keeping up with their monthly payments? The answer is they are NOT. Check out the horror stories on this student loan debt forum that I came across-

debtconsolidationcare.com forums

Grab some popcorn and pull up a chair and witness first hand the prologue to our country's next major financial fiasco.

Stressed out Doctors

Among Doctors, An Epidemic of Stress

"But whenever one of us experienced additional stress apart from our work, the house of cards in which we functioned would start to collapse."

"While a lot of attention has been given to the long work hours of residents and medical errors, researchers at the Mayo Clinic in Rochester, Minn., found that distress, and not only fatigue, contributed to errors by doctors-in-training."

"We need to figure out what is the right amount of stress to develop outstanding physicians, but not so much that it decays their humanity.”

“Most of us got into this profession because of passion for medicine, for taking care of people,” Dr. West said. “But somewhere along the way, it gets drummed out."

Why Malpractice is Off Limits

Malpractice Crisis Article

Excerpts from the Wall Street Journal article:

"A few thousand trial lawyers have a lock on Democrats, who refuse to consider any legal reform."

"It doesn't matter much whether the doctor did anything wrong—a lawyer can always come up with a theory of what might have been done differently. What matters most is the extent of the tragedy and that a case holds potential for pulling on a jury's heartstrings."

"Former Sen. John Edwards, for example, made a fortune bringing 16 cases against hospitals for babies born with cerebral palsy. Each of those tragic cases was worth millions in settlement. But according to a 2006 study at the National Institutes of Health, in nine out of 10 cases of cerebral palsy nothing done by a doctor could have caused the condition."

Even Suzanne Somers now thinks she is a DOCTOR

“They took a beautiful man,” and “put poison in his body,” she told columnist Shinan Govani. “Why couldn’t they have built him up nutritionally and gotten rid of the toxins? I hate to be controversial…but I have to speak out.” She made the comments just hours after Swayze’s death.

Oh no Suzanne Somers didn't just say that. Oh yes she did! And maybe if Patrick Swayze just worked out more on her thigh master, he would still be alive too. Stupid wretch!






Suzanne Somers says Chemo Killed Patrick Swayze

My Vanity Plate

I always wanted to get my own vanity plate. What do you guys think?

Fired Hopkins Surgery Resident Sues for $24 Million

It seems like Hopkins is yet again on the cutting edge of medicine these days. According to the article, a former surgical resident, Dr. Oscar Serrano, with a seemingly impeccable record up until his dismissal had gotten the axe from his program after allegedly his superiors erroneously assumed he was behind a complaint that initiated an investigation of their surgery residency program. Furthermore, the article also states that, Dr. Julie Ann Freischlag, chief of surgery claims that this was not the case and that he was terminated because he was MENTALLY ILL! I am quite frankly nauseated to keep hearing about former residents who were just booted out of their program, have been put on probation, are afraid of pending probation, or dropped out altogether because of the hell they have been put through with their programs. In any other job if you get fired you can simply get back up on your feet and just work somewhere else. However, this is not the case with residency. It is like being dropped in the middle of Death Valley in the middle of July and left to fend for yourself without any food or water. Essentially, an MD without residency merely equates to that of a BA degree. In this case, MD stands for "Massive Debt". Furthermore, you have all the years you already invested into medical school and the six figure debt that does not go away. This is why this is such a scary scenario and sadly it happens way more than it should. I hope this resident takes Hopkins to the cleaners and a precedent is set that an environment of bullying and intimidation with the threat of constant dismissal will no longer be tolerated.

Fired Hopkins Surgery Resident Sues for $24 Million

Squeaking By on 300K a Year

Squeaking By on 300K a Year


From this weekends Washington Post, read about the sad pitiful tale of a well to do VP in the financial industry bringing down 150K a year who finds herself "struggling" in the current economy. How can this be?

"Steins takes a breath. Life in this $2.5 million house was built on the premise of two incomes, not the income of a divorced mother of three in a tanked economy. Her property taxes are $35,000 a year, the nanny is $40,000 and the gardener is $500 a month."

When she pays a nanny nearly the same as an intern and lives in one of the most expensive counties in America is it no wonder? Why do I bring up this story? Because I believe it vividly portrays how one can find themselves in a heap of trouble if one insists on living beyond or even at their means. It also clearly shows how not having satisfaction in one's life and quelling that emptiness with buying more things can entrap you. This is how you can find yourself mired in a job you hate with merciless hours robbing you of your valuable time and freedom. It appears that just to maintain this woman's crazy lifestyle is running her 300K a year. So after salary and alimony, she is pulling 50K out of "savings" to stay afloat. This is a clear case of living BEYOND one's means and is simply not sustainable in the long run. This woman can play pretend with all her peers and friends that she is a somebody, however she will never have true freedom. This is a life of confinement and stress that would choke me of my well being not further it. What is even scarier to me is what would happen if she loses her job? It appears that this is something this woman hasn't even considered since it is apparent she doesn't know how to apply the brakes with her reckless financial spending. In medicine, I hear so many stories of physicans making six figure salaries (who are in their 40's and 50's with loans long paid off) crying poverty who can't retire or are stuck and miserable unleashing it on those around them. I sometimes wonder if they are living much like the woman portrayed in the article? I am sorry but I have no pity for such people. My advice for Laura Steins is simple. Sell the house, stop shopping at Saks, ditch the nanny and gardener, put your kids in public school, and learn to Live Below Your Means (LBYM) and start saving for unforeseen life events. Problem Solved. It makes me nauseous that I will be the one stuck flipping the bill to bailout irresponsible people like this. You make your bed and you sleep in it. End of Rant.

Medicine outside of working hours

On SDN, bythesea asks, "Do you value the patient over everything else".   Having strong feelings on this very topic, I decided to also post my response here on my blog-

This is what makes the medicine field so taxing and draining. If the patient is not your priority, you better get out STAT. Otherwise, you can kill someone...literally. Medicine is not a career where you can just flip a switch when you walk out the door and forget about all your patient encounters. Your patients have a tendency to follow you out the door and creep their way into your consciousness at the dinner table, in your dreams, and on your golden weekends. You can find yourself on some beautiful beach 5000 miles away with 2 days left of your hard earned vacation and feel your stomach twist in knots at the thought of being on 24 hr call the Monday you get back. And when you get back into the full swing of things, you will be asking yourself when you come home at night if you made the right decision in treating Mr. Jones ailment? What happens if he gets worse? Should I have ordered test X? If not and Y happens will I be held liable? If it is not your patients then it is reading up on them that will keep you close and dear to medicine. Failure to constantly be reading and keeping up in your field will be detrimental to your medical duties as well and time not spent reading will emerge as guilt. I equate this to how a schizophrenic must feel with the voices that are always in the background singing their haunting chorus, except in our cases it is to read, read, read. And in my specialty at least, you always have to be thinking ahead of how you are going to tackle the next set of patients you will be seeing the next day. As I mentioned before, medicine is not "just" a 60-70 hr a week job. Add in the above and you can tack on another 20 hrs or so. Take all these hours in a year that medicine occupies your body and mind and divide them into your upcoming socialized govt annual gross income and you will really wonder if going through all this is really worth it anymore. Medicine will truly suck your soul. More than you can ever presently imagine.

Plan to Escape Medicine

When I reach "my number", I am so out of medicine. I am completely burnt out after barely surviving through a residency and things are only getting worse. I feel like I am ready to retire and yet I am only in my early 30's! I can't fathom doing this another 30-40 years. In order to escape from the coming Obamacare, I plan to continue to subsist at the poverty line ($10830 US a year- and yes it is doable- I am proof) while living like a pauper in the ghetto as an attending. It is not suffering when you think of the prize of freedom on the other side. You will be amazed at how much you can save over time on even a resident's salary if you are disciplined. I have come to the realization that I would rather be happy and live in some secluded cabin on the Big Island of Hawaii (http://honolulu.craigslist.org/big/reb/1305738266.html) or in the rainforests of Costa Rica than be chained to the hospital and get sh!t rained on just so I can live in some Barbie dreamhouse with a big a$$ mortgage and have my gas guzzling SUV parked in the cobble stoned driveway while trying to keep up with the the Jones's or Dr. Nurse Smith that Coastie (over on SDN )has so vividly depicted. Heck with that! This philosophy of being that I speak of is called "voluntary simplicity", you can google the term and learn more if you want. I concede it is very hard to get out of medicine but I am determined to succeed. I fully realize that you need a well executed plan in place or otherwise you risk committing financial suicide. Just dropping out of residency with no plan is akin to jumping out of a plane without a parachute.

I just wish I would've known all this ten years ago and spared myself a decade of grief. But ten years is enough, I refuse to allow more precious time to slip away. Just as Andy did in the Shawshank Redemption (one of my all time favorite movies which has more meaning to me now than ever before), I will continue to chip away at the walls of my prison until I am free again.

Czech Health Minister Gets Bitch Slapped

And you thought Obama was disrespectful to physicians in our country? Check out what the leader of the Czech Republic thinks of his health minister! This is a country which pays it's docs tiddly winks causing a quarter of all it's medical graduates to practice abroad.

Default: The Movie

Student Loans Default The movie about Student Loans

This is the trailer for the soon to be released movie "Default, the movie about the truth of student loans". Learn More at www.defaultmovie.com or visit www.studentloanjustice.org

Watch Obama Pander to Nurses and Diss Docs

Obama and Health Care

This video has been circulating around the medical blogosphere and decided to post in case you missed it. Change is indeed coming.

Medicinesux on Surgery Call

Medicinesux on Surgery Call as a Medical Student. Please note that I do not advise residents to re enact any portion of this episode or else risk serious repercussions.  Medical students may do so at their own discretion.

Meeting the Program Director

later that day, medicinesux meets the program director of surgery

First Day of Third Year Clinical Rotations

Was trying to kill some time on call the other night and threw together this Xtranormal video.  I hope you get a kick out of it like I did. I definitely would like to shoot some more videos when I can find some more free time and will post them here in the future.  If anyone has any scenarios they would like me to play out you can email me with ideas at medicinesux@gmail.com and I will see what I can come up with.

Video of Nadya Suleman Giving birth

God, I always hated OB.

I Want a Bailout!

Calvin and Hobbes's brilliant take on the US financial crisis.   I am so sick of hearing of YET another bailout!  Greedy corporations and fiscally irresponsible individuals to be let off the hook with MY hard earned tax dollars?   The whole notion nauseates me.   These people made their beds and need to learn to sleep in it.  I say let capitalism do it's thing and let these guys go under.   We need to set a precedent for the future by not condoning such behavior.   Americans need to learn that by living within one's means and respecting our earth's limited resources, one can live a happy and peaceful existence.

CHANGE IS HERE

President Barack Obama 2009 Inauguration and Address

Is College Worth It?

John Stossel Is College Worth It? 20/20 ABC News

Watch last night's segment from 20/20 exposing the scam that higher education has become in America. 

The following is a very insightful scenario described by a recent law school grad commenting on this very situation on one of the more popular law boards.  It just proves how poisonous debt can be to one's financial future and how the magic of compound interest can propel one's wealth over the course of time.

"I think this is a more interesting financial lesson:

If on my 18th birthday, my parents had stuck my college tutition (say $120k) in a trust earning 8%, it would be worth ~ $760k on my 40th birthday.

And if on my 22nd birthday, I had put the cost of law school (say $140k) in a trust earning 8%, it would be worth ~$480K on my 40th birthday.

Bottom line, if I avoided school and real work my entire life (and instead worked ski patrol in the winters and worked in a surf shop during the summers - i.e. an awesome life), I'd have $1.24 million in the bank at age 40.

Instead I went to an expensive college and law school, neither of which were top 10 schools. Now I work at a V50 firm in manhattan and, according to the surveys cited by Okamoto, earn an income in the top 10% for lawyers. After 3 years of practicing, I'm 29 and have about $150K in the bank and save ~50K a year. I have two to three more years of biglaw in me, before I'll have to go in house or switch to a smaller firm that pays a lot less. I won't make a bonus this year and expect bonuses in 2009 to be pretty shitty. Anyway, asuming I can keep making the same salary for the next 11 years doing a job I hate, when I turn 40 I'll have saved a grand total of $1.25 million in the bank (assuming my savings compound at 8%).

So if I'd skipped college and law school completely and spent the first 22 years of my adult life chilling and never saved a dime, I'd only be worth $100K less.

It makes the investment in education pretty hard to justify."

The Great College Hoax

It now appears that with our economy in the midst of a meltdown, the mass media is finally beginning to report on what I have been preaching about in my last posting, "A Lien On Your Life".   Forbes magazine this week put out an excellent article paralleling the "education bubble" to that of the now bursting real estate bubble.   Don't tell me I didn't warn you.   Buyer beware!

"The two disillusioned attorneys were victims of an unfolding education hoax on the middle class that's just as insidious, and nearly as sweeping, as the housing debacle. The ingredients are strikingly similar, too: Misguided easy-money policies that are encouraging the masses to go into debt; a self-serving establishment trading in half-truths that exaggerate the value of its product; plus a Wall Street money machine dabbling in outright fraud as it foists unaffordable debt on the most vulnerable marks."


http://www.forbes.com/leadership/forbes/2009/0202/060.html

A LIEN ON YOUR LIFE

A LIEN ON YOUR LIFE

Primary Care is in for a world of hurt in the very near future. Crushing debtloads with stagnant pay. Still have your head in the sand? It is already happening in the law profession. Something is rotten in Denmark and it is coming our way.

Meanwhile, the lenders and academic institutions are laughing all the way to the bank while they are essentially putting a LIEN ON YOUR LIFE. A lien that can never go away since STUDENT LOANS ARE NOT DISCHARGEABLE. This is truly one of the biggest scams going, if not worse. In any other scam, you only lose what you already have....except in this situation, you lose what you still have yet to make! It's almost as if you would be better off being swindled out of 50K from some fraudulent email sent out of Nigeria than owing 300K to Sallie Mae which you don't even have yet! Don't get me wrong, I am all for paying a reasonable amount back for a quality education. But when you have unreasonable debt loads in an unreasonable healthcare system, paying it back...well...seems rather unreasonable. And what is reasonable? Well, they say you shouldn't buy a house that is more than 2.5-3 times your salary without over leveraging yourself. In the same vein, I believe that your total student debt (including undergrad) should not supercede your anticipated income. In other words, if you plan on doing primary care, your total debt should not go over 125K or so. It should most certainly not be over 200K. But at the rate things are going, this is going to be very problematic to attain with skyrocketing tuitions and higher interest rates.