[ljohnson_509]

In my opinion, radiology can never feel like not working for me because of the immense responsibility we carry and the potential consequences of an error.

That being said, I dont think I could handle just giving it up one day. I think part time is the answer those of us who can find it and afford it.

[Unknown Member]

Its interesting reading all of the different viewpoints above.

Upon reflection, it seems no one really thinks the same way. Everyone has their own particular view of how much they would like to work and how much money they would like to make. This is okay.

I think my way of thinking about this issue is that one may pursue whatever practice or lifestyle one wishes to, with the caveat that one should pay close attention to how the choice affects their health, stress level and relationships. If one is making a lot of money but one has a sick feeling in their stomach coming into work, or has gained a bunch of weight since they took the job, or if their spouse seems to be upset with them a lot, then its worthwhile examining ones choice and making changes as necessary.

I dont think there is a right/one size fits all ideal. There is that which works for you, and its OK to experiment until you find it.

[mariana.gonzalez_122]

Yeah hedo Rick was a thing 10 years ago but tosh.o rekindled. I think he is probably rebirths dad. It is kinda nsfw but so funny and hits the nail on the head. I mean only a few posts later he is asking a guy how much ya bench basically.

The way I see it going part time or choosing pure lifestyle is about as nonconformist a bunch of rads can handle entertaining. This whole anti marriage screed may be 100 percent accurate and the key to true hedo happiness but it’s just a bridge to far for the audience. Go gyrate on a wet floor with that song and dance somewhere else man. Ruins interesting threads

[Unknown Member]

Location premium
private practice premium
small group premium
Access to high volume of work

All of these are linked together
Grabbing these premiums is not free money.

I have generated significant alpha chasing these premiums- 8 figure net worth.
There is a finite window in one’s career when this can be done.

[Unknown Member]

Quote from drad123

Location premium
private practice premium
small group premium
Access to high volume of work

All of these are linked together
Grabbing these premiums is not free money.

I have generated significant alpha chasing these premiums- 8 figure net worth.
There is a finite window in one’s career where this can be done.

 
Good for you. I am in similar boat. But looking backwards, I had to slow it down once I hit 2 mil. You can afford a good high middle class life if you have 200-250K salary and 2 mil of savings. My 2 cents. 

[ranweiss]

Quote from Hospital-Rad

Quote from drad123

Location premium
private practice premium
small group premium
Access to high volume of work

All of these are linked together
Grabbing these premiums is not free money.

I have generated significant alpha chasing these premiums- 8 figure net worth.
There is a finite window in one’s career where this can be done.

Good for you. I am in similar boat. But looking backwards, I had to slow it down once I hit 2 mil. You can afford a good high middle class life if you have 200-250K salary and 2 mil of savings. My 2 cents. 

When words like 2 mil and 8 figure are thrown around, are you including your retirement accounts? Or simply other investments. 
 
I saw a post the other day where the doc said if you simply put 50k / year into a index fund for 20 years or something, you’d have 3-5 million in savings aside from your retirement account. Would be easily doable as a radiologist by early 50’s, even if living a ‘upper middle class’ lifestyle in all other ways.
 
Maybe it’s easier said than done, but as I mentioned earlier, even if making 5-600k but treating income like you’re making 300k ( PRE TAX, i.e, living like more of a a high earning hospitalist than a radiologist ), which is still a very comfortable lifestyle in most of the US, and excluding any spouse income…seems like 50k+ per year savings should be very doable..

[Unknown Member]

Quote from ar123

Quote from Hospital-Rad

Quote from drad123

Location premium
private practice premium
small group premium
Access to high volume of work

All of these are linked together
Grabbing these premiums is not free money.

I have generated significant alpha chasing these premiums- 8 figure net worth.
There is a finite window in one’s career where this can be done.

Good for you. I am in similar boat. But looking backwards, I had to slow it down once I hit 2 mil. You can afford a good high middle class life if you have 200-250K salary and 2 mil of savings. My 2 cents. 

When words like 2 mil and 8 figure are thrown around, are you including your retirement accounts? Or simply other investments. 

I saw a post the other day where the doc said if you simply put 50k / year into a index fund for 20 years or something, you’d have 3-5 million in savings aside from your retirement account. Would be easily doable as a radiologist by early 50’s, even if living a ‘upper middle class’ lifestyle in all other ways.

Maybe it’s easier said than done, but as I mentioned earlier, even if making 5-600k but treating income like you’re making 300k ( PRE TAX, i.e, living like more of a a high earning hospitalist than a radiologist ), which is still a very comfortable lifestyle in most of the US, and excluding any spouse income…seems like 50k+ per year savings should be very doable..

Equity is generally better outside a retirement account.

[jeevonbenning_648]

2 mil number I agree is when you can start feeling nice. But that number is meaningless by itself.

It’s all about how much cash flow your NW generates. I know folks with a $1-2M net worth in index fund generating a 2% dividend they have to pay taxes on = not even close enough to live off.

Then there are those with a $1-2M net worth with ~$200K in cash flow (leveraged real estate, businesses, partnerships, royalties, etc.) = whole nother ballgame.

You can’t eat your NW. It’s all about how much cash does your portfolio generate that you don’t work for.

That’s why 4% rule (if you’re just investing in index funds) IMO is a fool’s errand most of the time. It affords you options only when you are much older.

[Unknown Member]

Quote from Re3iRtH

2 mil number I agree is when you can start feeling nice. But that number is meaningless by itself.

It’s all about how much cash flow your NW generates. I know folks with a $1-2M net worth in index fund generating a 2% dividend they have to pay taxes on = not even close enough to live off.

Then there are those with a $1-2M net worth with ~$200K in cash flow (leveraged real estate, businesses, partnerships, royalties, etc.) = whole nother ballgame.

You can’t eat your NW. It’s all about how much cash does your portfolio generate that you don’t work for.

That’s why 4% rule (if you’re just investing in index funds) IMO is a fool’s errand most of the time. It affords you options only when you are much older.

 
Let’s say you hit 2 mil at the age of 40. Put it in stock market and forget about it. It is your fortress of solitude. You can expect it to become 8 mil once you become 60 and if you play it right (take it out slowly with low tax), it is equal to 6-7 mil. More than enough for the rest of your life. 
 
Now get an easy job that pays 250K. Something like a VA job and spend your salary to its last penny and don’t even bother thinking about saving. on 250K  salary, you pay much less percentage of tax (compared to 400-500K) and it is enough to have a high middle class life. You are all set. 

And all of this is true if your spouse doesn’t work and you don’t have any other belongings (no family wealth, no other investments, etc)
 
 

[jeevonbenning_648]

I’m with you there, but a VA job is not as favorable as you might think. This is for one main reason – you get like 23 days of vacation. And you work all the training holidays. So you’re looking at M-F 0730 – 0430 but not a lot of vacation days. Some 3 day weekends but no bonus 4 day weekends that active duty rads get about monthly.

When I’m 40, I’d want more time for projects. 23 days just ain’t cutting it. I want something like work 6 months, 6 months off. You’re going to want large blocks of time for reflection, trying a new workout routine, language immersion, intensive reading, business plans, vacations, etc.

VA/contractor is good for the bored 45-50yo rad with a military pension who doesn’t know what else he wants to do in life.

[Unknown Member]

Quote from Re3iRtH

I’m with you there, but a VA job is not as favorable as you might think. This is for one main reason – you get like 23 days of vacation. And you work all the training holidays. So you’re looking at M-F 0730 – 0430 but not a lot of vacation days. Some 3 day weekends but no bonus 4 day weekends that active duty rads get about monthly.

When I’m 40, I’d want more time for projects. 23 days just ain’t cutting it. I want something like work 6 months, 6 months off. You’re going to want large blocks of time for reflection, trying a new workout routine, language immersion, intensive reading, business plans, vacations, etc.

VA/contractor is good for the bored 45-50yo rad with a military pension who doesn’t know what else he wants to do in life.

 
OK. Let’s forget about VA. But you can find a job with good schedule for 250K. 

[jeevonbenning_648]

Most definitely.

[Unknown Member]

Quote from Hospital-Rad

Quote from drad123

Location premium
private practice premium
small group premium
Access to high volume of work

All of these are linked together
Grabbing these premiums is not free money.

I have generated significant alpha chasing these premiums- 8 figure net worth.
There is a finite window in one’s career where this can be done.

Good for you. I am in similar boat. But looking backwards, I had to slow it down once I hit 2 mil. You can afford a good high middle class life if you have 200-250K salary and 2 mil of savings. My 2 cents. 

My body is already forcing me to slow down. I just don’t have as much energy and motivation anymore.
2019 was a stellar year for my investment return and radiology income. I may be on the downhill stretch now. 
 
Next 10 years in the market won’t be anything like the last 10 years.

[jeevonbenning_648]

Try laying off the Jack Daniels before you post next time LOL

[Unknown Member]

ar123,

That would take a pretty juicy rate of return.

Here you go:

[link=https://www.bankrate.com/calculators/retirement/roi-calculator.aspx]https://www.bankrate.com/…nt/roi-calculator.aspx[/link]

Even with a 7% ROI, youre at maybe 2 million after 20 years. But, 2 million in 20 years is not 2 million today. With a conservative 2.9% inflation rate, that 2 million in the future is worth a little over 1 million in todays bucks.

Youre going to want to save/invest north of $100,000 annually to hit that goal, particularly when one accounts for the stock market not being in a perpetual bull market, inflation likely to increase and the likelihood that they eventually raise taxes on investment income.

[Unknown Member]

Quote from radgrinder

ar123,

That would take a pretty juicy rate of return.

Here you go:

[link=https://www.bankrate.com/calculators/retirement/roi-calculator.aspx]https://www.bankrate.com/…nt/roi-calculator.aspx[/link]

Even with a 7% ROI, youre at maybe 2 million after 20 years. But, 2 million in 20 years is not 2 million today. With a conservative 2.9% inflation rate, that 2 million in the future is worth a little over 1 million in todays bucks.

Youre going to want to save/invest north of $100,000 annually to hit that goal, particularly when one accounts for the stock market not being in a perpetual bull market, inflation likely to increase and the likelihood that they eventually raise taxes on investment income.

 
No. I was saying if you have 2 mil at the age of 40. With the return of 7%, it doubles every 10 years and it becomes 8 mil at the age of 60.
 
[b]And FYI, the 7% number is inflation adjusted. I agree that 7% may not happen in the future but it may also happen. [/b]

 

[Unknown Member]

Quote from radgrinder

ar123,

That would take a pretty juicy rate of return.

Here you go:

[link=https://www.bankrate.com/calculators/retirement/roi-calculator.aspx]https://www.bankrate.com/…nt/roi-calculator.aspx[/link]

Even with a 7% ROI, youre at maybe 2 million after 20 years. But, 2 million in 20 years is not 2 million today. With a conservative 2.9% inflation rate, that 2 million in the future is worth a little over 1 million in todays bucks.

Youre going to want to save/invest north of $100,000 annually to hit that goal, particularly when one accounts for the stock market not being in a perpetual bull market, inflation likely to increase and the likelihood that they eventually raise taxes on investment income.

A weighted portfolio of 63% large-cap stocks and 37% municipal bonds, but with no rebalancing or income withdrawals, would yield the following results:
30 years 4.52% real real return
20 years 3.78% real real return
15 years 4.08% real real return
 
[link=http://news.morningstar.com/pdfs/thornburg_realreturn.pdf]http://news.morningstar.com/pdfs/thornburg_realreturn.pdf[/link]

[Unknown Member]

Quote from Re3iRtH

I’m with you there, but a VA job is not as favorable as you might think. This is for one main reason – you get like 23 days of vacation. And you work all the training holidays. So you’re looking at M-F 0730 – 0430 but not a lot of vacation days. Some 3 day weekends but no bonus 4 day weekends that active duty rads get about monthly.

When I’m 40, I’d want more time for projects. 23 days just ain’t cutting it. I want something like work 6 months, 6 months off. You’re going to want large blocks of time for reflection, trying a new workout routine, language immersion, intensive reading, business plans, vacations, etc.

VA/contractor is good for the bored 45-50yo rad with a military pension who doesn’t know what else he wants to do in life.

 
This is what I’m talking about, but there are very few of us who consider actualizing it, so we are generally pariahs on boards like this for suggesting there might be a better way.

[jeevonbenning_648]

You’ll get there. I can tell you have the right attitude. There is no nobility in “grinding it out” if you’re unhappy, overworked, or just have other goals in life. As I have read on this board countless of times, the reasons that many of the 50s 60s 70s radiologists are still working is 1. bad decisions (lifestyle too rich) 2. 2nd or 3rd marriage 3. scared too retire / no idea what they will do with themselves (the 3rd one is much less common)
 
Then you will hear “best advice is marry the right person” like this has a 100% success rate LOL
Its kinda like when you are playing Ninja Turtles or Super Mario Bros. on Nintendo and you’re buddy next to you says “Don’t die!” great advice indeed
 
If you:
a) can’t imagine doing ANYTHING else with your life M – F at 8 AM besides radiology (when people are honest with themselves this is pretty uncommon)
b) maintain perfect health, and
c) can complete all projects and leisurely activities you’d like to do
then continuing to work after 40 makes sense.
 
How likely that someone can fulfill all the above criteria?
 

Quote from Castlevania

Quote from Re3iRtH

I’m with you there, but a VA job is not as favorable as you might think. This is for one main reason – you get like 23 days of vacation. And you work all the training holidays. So you’re looking at M-F 0730 – 0430 but not a lot of vacation days. Some 3 day weekends but no bonus 4 day weekends that active duty rads get about monthly.

When I’m 40, I’d want more time for projects. 23 days just ain’t cutting it. I want something like work 6 months, 6 months off. You’re going to want large blocks of time for reflection, trying a new workout routine, language immersion, intensive reading, business plans, vacations, etc.

VA/contractor is good for the bored 45-50yo rad with a military pension who doesn’t know what else he wants to do in life.

This is what I’m talking about, but there are very few of us who consider actualizing it, so we are generally pariahs on boards like this for suggesting there might be a better way.

[katiemckee84_223]

Quote from Re3iRtH

You’ll get there. I can tell you have the right attitude. There is no nobility in “grinding it out” if you’re unhappy, overworked, or just have other goals in life. As I have read on this board countless of times, the reasons that many of the 50s 60s 70s radiologists are still working is 1. bad decisions (lifestyle too rich) 2. 2nd or 3rd marriage 3. scared too retire / no idea what they will do with themselves (the 3rd one is much less common)

Then you will hear “best advice is marry the right person” like this has a 100% success rate LOL
Its kinda like when you are playing Ninja Turtles or Super Mario Bros. on Nintendo and you’re buddy next to you says “Don’t die!” great advice indeed

If you:
a) can’t imagine doing ANYTHING else with your life M – F at 8 AM besides radiology (when people are honest with themselves this is pretty uncommon)
b) maintain perfect health, and
c) can complete all projects and leisurely activities you’d like to do
then continuing to work after 40 makes sense.

How likely that someone can fulfill all the above criteria?

Quote from Castlevania

Quote from Re3iRtH

I’m with you there, but a VA job is not as favorable as you might think. This is for one main reason – you get like 23 days of vacation. And you work all the training holidays. So you’re looking at M-F 0730 – 0430 but not a lot of vacation days. Some 3 day weekends but no bonus 4 day weekends that active duty rads get about monthly.

When I’m 40, I’d want more time for projects. 23 days just ain’t cutting it. I want something like work 6 months, 6 months off. You’re going to want large blocks of time for reflection, trying a new workout routine, language immersion, intensive reading, business plans, vacations, etc.

VA/contractor is good for the bored 45-50yo rad with a military pension who doesn’t know what else he wants to do in life.

This is what I’m talking about, but there are very few of us who consider actualizing it, so we are generally pariahs on boards like this for suggesting there might be a better way.

Post of the year
 
cheers

[asevvala_18]

What is your networth after doing all this for 20 years?
 
 

Quote from Hospital-Rad

Recently a current fellow asked me about my recommendations about jobs.
This is my recommendations:

As a person who has worked in real private practice for my entire career of 20 years and have made a $hitload of money, my recommendation to younger guys is to go for a “lifestyle” job.

Beyond a certain point, money is way overrated. “Time” is very underrated. Get a lifestyle job, make an average doctor’s salary of 200-250K, live a middle class lifestyle (which is very good in US) and not “doctor’s lifestyle” and enjoy your time.

My experience:
– Networth: The first 2 mil was very exciting. After that it was just a number. Never made me happy.
– House: Another overrated piece of crap that you can buy.
– Cars: A Camry can do the job well. Anyway, you can lease a BMW for 2-3 years and enjoy it.
– Luxurious Vacation: Overrated. Do one just to experience it. Then travel like most middle class Americans

TIME: Very very precious and very underrated. In my first private practice job I had 12 weeks of vacation but Q3 weekend call
It was terrible. I had to pick my vacation 5-6 months in advance. There was zero Flexobility. I missed a lot of social events. Go to a practice that let you take “random days off with short notice”. Also go for a practice that has “least number of weekend calls”. Weekend work is Terrible and becomes exhausting and annoying very soon.

I personally regret my choice. It was not worth it. Hope the younger guys choose a different path.

Good luck.

[Melenas]

yes, what is your NW after 20 years.
 

Quote from merad

What is your networth after doing all this for 20 years?

Quote from Hospital-Rad

Recently a current fellow asked me about my recommendations about jobs.
This is my recommendations:

As a person who has worked in real private practice for my entire career of 20 years and have made a $hitload of money, my recommendation to younger guys is to go for a “lifestyle” job.

Beyond a certain point, money is way overrated. “Time” is very underrated. Get a lifestyle job, make an average doctor’s salary of 200-250K, live a middle class lifestyle (which is very good in US) and not “doctor’s lifestyle” and enjoy your time.

My experience:
– Networth: The first 2 mil was very exciting. After that it was just a number. Never made me happy.
– House: Another overrated piece of crap that you can buy.
– Cars: A Camry can do the job well. Anyway, you can lease a BMW for 2-3 years and enjoy it.
– Luxurious Vacation: Overrated. Do one just to experience it. Then travel like most middle class Americans

TIME: Very very precious and very underrated. In my first private practice job I had 12 weeks of vacation but Q3 weekend call
It was terrible. I had to pick my vacation 5-6 months in advance. There was zero Flexobility. I missed a lot of social events. Go to a practice that let you take “random days off with short notice”. Also go for a practice that has “least number of weekend calls”. Weekend work is Terrible and becomes exhausting and annoying very soon.

I personally regret my choice. It was not worth it. Hope the younger guys choose a different path.

Good luck.

[Unknown Member]

Who cares?

[Melenas]

Since hes giving advice, we do.
 
Easy to say dont worry about money if you have lots of it. 
 

Quote from rayZor

Who cares?

[Dr_Cocciolillo]

Meh. Disagree with post.
250k is simply not enough to live in many places in the us. My neighborhood you cant do squat with that. An updated , modern open concept 4 bed house with a tiny yard costs a mil with property taxes of 20k.

Daycare is 17k per child. Babysitters 16-20/hr so about 30k a year.

2 mil is also not that great a number. At 2 mil , one can turn a current job into more lifestyle but as single household with 250k, its going to take you till 60 to get v to 2 mil.

The rest , Id agree with but it all depends on how hard you are working to generate PP income you speak off.

[Unknown Member]

Heh.  Then you’ll have 2 million dollars, but you’ll be 60 with at least a couple chronic medical conditions.  Unless of course you’re already dead.
 
It’s a process.  Happens with teenagers too.  Young generation growing up thinks the older generation are greedy jerks who don’t know anything, then time goes on and then one day the younger generation is staring at the even younger generation calling them greedy jerks who don’t understand anything.
 
 

[Unknown Member]

Quote from peehdee

Since hes giving advice, we do.

Easy to say dont worry about money if you have lots of it. 

Quote from rayZor

Who cares?

If I remember correctly he is in the upper 7 figures. I interpret that to be between 5 and 10 mil.

[dorisbueno]

From a young resident thinking about area of specialization. What is the least stressful subspecialization on day-to-day basis?

[mpezeshkirad_710]

Quote from vln

From a young resident thinking about area of specialization. What is the least stressful subspecialization on day-to-day basis?

Mammo.  They are treated like royalty, have the best job security and clout, and people don’t die quickly from breast problems.
 
All the other diagnostic rads are commodities.  IR has job security but people can die.

[ruszja]

Quote from Takayasu

Quote from vln

From a young resident thinking about area of specialization. What is the least stressful subspecialization on day-to-day basis?

Mammo.  They are treated like royalty, have the best job security and clout, and people don’t die quickly from breast problems.

All the other diagnostic rads are commodities.  IR has job security but people can die.

Mammo is also the only specialty that will be decimated by AI. 10 years from now, 95% of screener mamms and MRIs will be AI read. 1 in 20 still need a rads to look at because the system can’t come up with a conclusive interpretation.

I can’t wait for that to happen.

[Unknown Member]

Quote from fw

Quote from Takayasu

Quote from vln

From a young resident thinking about area of specialization. What is the least stressful subspecialization on day-to-day basis?

Mammo.  They are treated like royalty, have the best job security and clout, and people don’t die quickly from breast problems.

All the other diagnostic rads are commodities.  IR has job security but people can die.

Mammo is also the only specialty that will be decimated by AI. 10 years from now, 95% of screener mamms and MRIs will be AI read. 1 in 20 still need a rads to look at because the system can’t come up with a conclusive interpretation.

I can’t wait for that to happen.

I have to say, in reading more about AI, and the proliferation of NP/PA’s; I just see a dismal future for mammo.
Of all the specialities in radiology, it seems to me a NP/PA with a 2 year fellowship will have more training than a radiologist with a 1 year fellowship. I don’t see how medical school or the rest of radiology training helps with dedicated mammographers. They are not radiologists, they are mammographers.
Additionally, AI seems ideal for deconstructing mammograms.
The two together, will, should, obliterate the specialty. 
And although I see mostly bad outcomes from the proliferation of NP/PA/extenders, this is one area where I don’t.
So yeah, today mammography seems like “royalty;” but 10 years come faster than you think. So better to cover your bets, and diversify your portfolio; go all in on mammography with trepidation. 
Besides, what a mind numbing awful way to spend a career.
 

[julie.young_645]

Looking at things from the end of my career…
 
DON’T focus on money. Or things that money can buy. Just don’t. He who dies with the most toys is still dead. 
 
DON’T focus on your friend, or your colleague, or the plastic surgeon, or the guy with Goldman Sachs, who is making more than you, who wears the gold Rolex, who has a boat and a plane and a place in Monaco. You might achieve that in your chosen profession, or you might not. Your life isn’t over if you have to settle for an Apple Watch. But if you are constantly chasing the next shiny object, you will never be satisfied. With anything. 
 
Focus on your LIFE. On your spouse and on your children. If you miss some life event, even something like your kid’s baseball game because you are [i]always[/i] working, you will NOT GET THOSE PRECIOUS MOMENTS BACK. And you cannot BUY them back with any amount of money.
 
No one ever said on their death-bed, “I regret not spending more time at work.” Well, almost no one. 
 
Pick the specialty/subspecialty that you LOVE. Something you can be passionate about. Mine was/is Nuclear Medicine. I love it and it shows. The technologists and the referring docs see that. It is equally apparent to all if you are doing something you don’t love. 
 
Focus on being a good physician. Focus on your patients. The money will come. And if it isn’t enough, re-evaluate your [i]spending[/i] and ratchet it down to a level that lets you save for the future. 
 

[ljohnson_509]

Well said Dr. Dalai. Should be a sticky on this forum. Your a success and worked during the golden era of radiology. Todays young radiologists have to deal with a very different radiology and all the threats on the horizon.

[Dr_Cocciolillo]

i think everything Dalai and Flounce say is absolutely true. 
It’s just not fail proof to put into practice.
I’d add the following– you don’t have to be there for every single activity when your kids are young — that is…if they have soccer 2x a week and baseball or tennis or whatever and it’s not a “game” , it’s ok to miss the occasional one.   But as they get older and the competition gets more relevant (teens), then one should try to make all events.  It’s impossible to make every single event , every single time if the kids have something 3-4x a week.  
 
but in general, err strongly on making as many events as you can.  
 
back to that podcast i sent the link to…
 
 Why Nobody Feels Rich

[ruszja]

Quote from wisdom

.
.
back to that podcast i sent the link to…

Why Nobody Feels Rich

 
I know I am rich, there is just no two ways about it. Anyone whose social life includes humans from the world of ‘normal people’ knows the absurdity of claims that you ‘cant raise a family on 250k’.
 
In my social circles, I have individuals in their 50s who are C-level executives, bankers and specialty surgeons on one hand and another group who are retired on public safety pensions. The difference in annual income between those groups is probably in the range of 10x.  All own boats or planes, just different in scope. The difference in happiness between the two groups is also 10x, except the inverse of the income relationship. The guy who is retired goes out at 8 in the morning on his 23ft boat to catch some fish, the banker is on the phone with his mechanic in Florida to approve another $20k repair bill just to keep the thing from sinking at the dock.

[julie.young_645]

I am reminded of the Biblical story starring King Solomon. To paraphrase…
 
King Solomon made a pronouncement to all of Jerusalem: “I will give my kingdom to anyone who is content with his lot!” A little guy in the back yelled out, “I’m content! I’m content! Give me your kingdom!” To which Solomon replied, “If you were truly content, you wouldn’t want it.” 
 
Don’t make money and things your end-all to end-all. 

[nicolasvg.1003]

Nobody is content when grinding through the stack hour upon hour.  Sure, plenty do it for the income but they are certainly not happy.  I went part-time for a few years just to try it out (was a unique circumstance that allowed it) and I was very happy.  My own observations is that when volume is lower I am a lot happier and more pleasant a person.  This is not cause I don’t like to work or don’t enjoy radiology – but rather that there is a certain volume where what we do as Rads is satisfying and enjoyable and above that it becomes miserable.  How much money I make seems to have much less impact on my contentment than the volume of work I am doing.  Completely stopping Rads would also I believe leave me less than happy and being a physician is part of my identity and life.  Hopefully, I will be able to find something part-time when I decide to slow down for good.  I think part-time is a sweet spot for Rads. 
 
 

[Dr_Cocciolillo]

right.  i am sure all the posters on here had lifetime earnings of 250k and now are saying how ridiculous it is to not be able to make it on 250k
 
we aren’t discussing “surviving here”   we are discussing how to accumulate wealth. on 250k, i don’t think i can save more than 70k a year.  but maybe many others can.  without state income tax and in a low cost area of living, that’s another 30-50k in savings potentially.  
 
to each his own i suppose.  

[ljohnson_509]

Your out of touch wisdom. Dont think I can save more then 70k on 250k? Surviving? You should step out of your bubble a bit.

[Dr_Cocciolillo]

maybe i am.  as are many, many people on this forum
I am happy with my work load though for now and hopefully, things remain the same for a long, long time.  

[satyanar]

[link=https://www.ted.com/talks/dan_gilbert_the_surprising_science_of_happiness]https://www.ted.com/talks…g_science_of_happiness[/link]

[scandoc]

I live in an area where real estate appreciation created significant difference in intergenerational wealth between different generations of radiologists despite similar earning.

Personally, I feel a quiet sense of dignity when joking to my partnerS that I can never afford to live in the parts where they live in or my choice for driving a camry or my desire to have a home that is average or below average price in an average part of the city.

I have cheap hobbies like firearms and computer gaming. It turns out that a little money in firearms can make you feel like a king. Not having hobbies like planes or boats help a lot.

[afazio.uk_887]

“Building wealth” as a Radiologist is never going to be that impactful.  We are high income professionals which means we are never going to be able amass the kind of wealth those in the finance / business world can.  Their wealth is tied to stock values which can create tremendous wealth over time with no upper ceiling.  The strength of our profession is not the ability to amass a fortune, but rather that it is a stable, meaningful, largely recession resistant job which pays well and that one can do for decades.  Sure, over the longterm you will likely build yourself a nice little nest egg on the side but it will still be peanuts compared to the true wealthy of society so don’t spend your time and mental energy trying to play in their sandbox.  
 
 

[Unknown Member]

Radiology (and medicine in general) have a lower ceiling and a higher floor than business/tech/law.  Most people in those other sectors make less than us, but a few make a lot more.

[william.wang_997]

Agree. A couple of years ago, I was sitting next to a tech entrepreneur from Silicon valley who was about 10 years younger than me. He said if people are not in the game for making a couple of billion; they should just relax, work reasonably and enjoy their life. Completely different sandbox.

[ruszja]

Quote from RADD2010

Agree. A couple of years ago, I was sitting next to a tech entrepreneur from Silicon valley who was about 10 years younger than me. He said if people are not in the game for making a couple of billion; they should just relax, work reasonably and enjoy their life. Completely different sandbox.

 
The part people underestimate about medicine is the steady paycheck throughout a long career. I have met former ‘tech enterpreneurs’ behind the counter of a coffee shop and a friend of mine who was COO of a name brand manufacturer is now driving the patient shuttle for a university hospital ’cause it gets me health insurance’.
 

[Dr_Cocciolillo]

Yep, the grass is always greener 🙂

@Boomer, great points about games and so forth. I think at a young age it builds rapport with your child.

[timhaaga]

Quote from Waduh Dong

“Building wealth” as a Radiologist is never going to be that impactful.  We are high income professionals which means we are never going to be able amass the kind of wealth those in the finance / business world can.  Their wealth is tied to stock values which can create tremendous wealth over time with no upper ceiling.  The strength of our profession is not the ability to amass a fortune, but rather that it is a stable, meaningful, largely recession resistant job which pays well and that one can do for decades.  Sure, over the longterm you will likely build yourself a nice little nest egg on the side but it will still be peanuts compared to the true wealthy of society so don’t spend your time and mental energy trying to play in their sandbox.  

Above and 2BRads make good points.
 
As a higher end earning doctor, such as a radiologist, you still cannot compete with a high end business executive on an income nor time level.
 
The income and hours worked relationship is reversed between high end executives (Hospital CEO/CFO/COO, service/product line executive for example) and Radiologists.
 
The further you move up in the business executive stratosphere, in general, the less time you spend working, and the more money you make.  
 
Few executives put in the hours of a private practice radiologist.  Virtually no executives putting the nights and weekends that our profession puts in.
 
Therefore, as I always say, find a job where you are more like an executive. Put in the least amount of input for the greatest amount of output.  That’s what an executive at Rad Partners would do! 🙂 

[Unknown Member]

Quote from noondoo

Quote from Waduh Dong

“Building wealth” as a Radiologist is never going to be that impactful.  We are high income professionals which means we are never going to be able amass the kind of wealth those in the finance / business world can.  Their wealth is tied to stock values which can create tremendous wealth over time with no upper ceiling.  The strength of our profession is not the ability to amass a fortune, but rather that it is a stable, meaningful, largely recession resistant job which pays well and that one can do for decades.  Sure, over the longterm you will likely build yourself a nice little nest egg on the side but it will still be peanuts compared to the true wealthy of society so don’t spend your time and mental energy trying to play in their sandbox.  

Above and 2BRads make good points.

As a higher end earning doctor, such as a radiologist, you still cannot compete with a high end business executive on an income nor time level.

The income and hours worked relationship is reversed between high end executives (Hospital CEO/CFO/COO, service/product line executive for example) and Radiologists.

The further you move up in the business executive stratosphere, in general, the less time you spend working, and the more money you make.  

Few executives put in the hours of a private practice radiologist.  Virtually no executives putting the nights and weekends that our profession puts in.

Therefore, as I always say, find a job where you are more like an executive. Put in the least amount of input for the greatest amount of output.  That’s what an executive at Rad Partners would do! 🙂 

You are out to lunch.
I have some very rich businessperson friends; and they are always working. Workaholics.
Junior investment bankers put in more hours than interns.
There is no free lunch.
We have it pretty sweet; $300-400 hour. If someone slapped that cash on your desk every hour, maybe you would get perspective.
Our homes won’t be in the WSJ mansion section, but we are 99% compared with everyone else.
And most of us are not savy enough to make it big in business; that’s why we are nerdy radiologists.
Many of us seem to overestimate our abilities; a classic cognitive bias. 

[timhaaga]

There are countless research studies and summary article on the general subject. Data is more helpful than anecdotal evidence.   For example:
 
“The research team of Lee Biggerstaff and Andy Puckett at Tennessee and David C. Cicero at Alabama said the results of golf time versus performance were telling.
 
We find that the highest levels of leisure are indeed associated with lower firm operating performance, [link=http://harbert.auburn.edu/binaries/documents/finance/2014/fall/Fore.pdf]the trio wrote[/link].
CEOs in the top quartile of the survey played a minimum of 22 rounds a year, while the top decile (or most frequent of 10 groups) played at least 37 rounds a year.
 
In companies where the CEOs played more than 22 rounds of golf a year the return on assets was about 1.1 percentage points lower than firms where the top executives played less frequently. Thats significant because the average ROA for the sample was about 5.3 percent, so the performance was equal to about 20 percent lower.
 
Some CEOs in the database play in excess of 100 rounds in a year! the study said. While some golf rounds may clearly serve a valid business purpose, it is unlikely that the amount of golf played by the most frequent golfers is necessary for a CEO to support her firm.
 
Engaging in that much golf proved hazardous for employment health: The study found that for every 1 percent the CEOs increased their golf time, they were 0.83 percent more likely to get fired.
 
Those golfers in the top decile spent the equivalent of 5.5 weeks on the course and not in the office. Then there was one CEO who played a staggering 146 rounds.
 
Such behaviors, the study concluded, are consistent with a strong leisure component and appear inconsistent with value-maximizing behavior.  ”
 
[link=https://www.cnbc.com/2015/05/18/proof-ceos-hurt-companies-by-golfing-too-much.html]https://www.cnbc.com/2015…-golfing-too-much.html[/link]

[ljohnson_509]

At least as a radiologist, your guaranteed to be financially independent at least at a basic level by 50. Assuming you avoided divorce, McMansions, and other rich lifestyle traps.

[timhaaga]

Quote from CoronaRad

Nobody is content when grinding through the stack hour upon hour.  Sure, plenty do it for the income but they are certainly not happy.  I went part-time for a few years just to try it out (was a unique circumstance that allowed it) and I was very happy.  My own observations is that when volume is lower I am a lot happier and more pleasant a person.  This is not cause I don’t like to work or don’t enjoy radiology – but rather that there is a certain volume where what we do as Rads is satisfying and enjoyable and above that it becomes miserable.  How much money I make seems to have much less impact on my contentment than the volume of work I am doing.  Completely stopping Rads would also I believe leave me less than happy and being a physician is part of my identity and life.  Hopefully, I will be able to find something part-time when I decide to slow down for good.  I think part-time is a sweet spot for Rads. 

 
Very well put. Once one reads above their critical mass of their happy daily workload, it becomes cumbersome, annoying and can bread resentment which spills over into other aspects of a persons life. 

[Unknown Member]

Quote from wisdom

i think everything Dalai and Flounce say is absolutely true. 
It’s just not fail proof to put into practice.
I’d add the following– you don’t have to be there for every single activity when your kids are young — that is…if they have soccer 2x a week and baseball or tennis or whatever and it’s not a “game” , it’s ok to miss the occasional one.   But as they get older and the competition gets more relevant (teens), then one should try to make all events.  It’s impossible to make every single event , every single time if the kids have something 3-4x a week.  

but in general, err strongly on making as many events as you can.  

back to that podcast i sent the link to…

Why Nobody Feels Rich

Being always available and part of your kid’s lives is very important, of course. 
 
But this obsession with attending every event makes me uncomfortable. The event/game/play is about them, not us. Kid’s need to be independent; to participate in events for themselves. It’s not about us, or our judgement; which is where it goes many times.
 
I remember riding my bike to little league games, by myself. Never thought anything of it. Played high level sports in high school and college, and my parents only made it to some games. I was playing for me. It would have been weird, in fact suffocating, if they came to every game. They came to some, just enough. They had lives too. I don’t get it. 

[julie.young_645]

Quote from Drrad123

Well said Dr. Dalai. Should be a sticky on this forum. Your a success and worked during the golden era of radiology. Todays young radiologists have to deal with a very different radiology and all the threats on the horizon.

 
Thank you, Drrad. 
 
Yes, things are not what they were 30 years ago. Physicians have sold out to MBA’s, and medicine as a whole is impacted and impaired. My advice? TAKE MEDICINE BACK. It won’t be easy. 

[Melenas]

Boomer I agree.
 
People put too much guilt/emphasis on kids and what they need. My son is not going to get spoiled. And Im not working long hours so that he can become a snotty kid with a trust fund. He wont starve, hell have a decent car, hell get most of his college paid for. But spoiling them, and making them the most important part of life/the family is not for me. 
 
I remember a celebrity saying that, we (husband and wife) were the most important people in their relationship.  After all, you married that person to spend the rest of your life – not your kids. The kids will grow up and leave the nest. And guess whos gonna be in the house when the kids leave? The spouse. Thats why your spouse should be the most important person, not your kids. 
 
 
 

Quote from boomer

Quote from fw

Quote from Takayasu

Quote from vln

From a young resident thinking about area of specialization. What is the least stressful subspecialization on day-to-day basis?

Mammo.  They are treated like royalty, have the best job security and clout, and people don’t die quickly from breast problems.

All the other diagnostic rads are commodities.  IR has job security but people can die.

Mammo is also the only specialty that will be decimated by AI. 10 years from now, 95% of screener mamms and MRIs will be AI read. 1 in 20 still need a rads to look at because the system can’t come up with a conclusive interpretation.

I can’t wait for that to happen.

I have to say, in reading more about AI, and the proliferation of NP/PA’s; I just see a dismal future for mammo.
Of all the specialities in radiology, it seems to me a NP/PA with a 2 year fellowship will have more training than a radiologist with a 1 year fellowship. I don’t see how medical school or the rest of radiology training helps with dedicated mammographers. They are not radiologists, they are mammographers.
Additionally, AI seems ideal for deconstructing mammograms.
The two together, will, should, obliterate the specialty. 
And although I see mostly bad outcomes from the proliferation of NP/PA/extenders, this is one area where I don’t.
So yeah, today mammography seems like “royalty;” but 10 years come faster than you think. So better to cover your bets, and diversify your portfolio; go all in on mammography with trepidation. 
Besides, what a mind numbing awful way to spend a career.

[julie.young_645]

Quote from peehdee

Boomer I agree.

People put too much guilt/emphasis on kids and what they need. My son is not going to get spoiled. And Im not working long hours so that he can become a snotty kid with a trust fund. He wont starve, hell have a decent car, hell get most of his college paid for. But spoiling them, and making them the most important part of life/the family is not for me. 

I remember a celebrity saying that, we (husband and wife) were the most important people in their relationship.  After all, you married that person to spend the rest of your life – not your kids. The kids will grow up and leave the nest. And guess whos gonna be in the house when the kids leave? The spouse. Thats why your spouse should be the most important person, not your kids. 

 
There is a balance. No, you don’t want to spoil the little parasites. But they need to know that they are loved, and not just some accoutrement you produced because the Millennial Guide said you had to do so. 
 
A friend lost his father while he was a freshman in college. His dad was a very famous physician, who spent his life being a famous physician. On his death-bed, dad expressed regret for not spending more time with his children. My friend, as he put it, spent “several years in a bottle” after his dad passed. 
 
To yank on your heartstrings even more…
 
[link=https://www.youtube.com/watch?v=EUNZMiYo_4s]https://www.youtube.com/watch?v=EUNZMiYo_4s[/link]
 
Raise your kids any way you see fit, guys. Work as hard as you wish. Make as much money as you think you just have to have. And rationalize it any way you have to to look yourself in the mirror. But you will most likely regret trading time with your kids for yet another coupla hundred K. 

[Unknown Member]

Quote from DoctorDalai

Quote from peehdee

Boomer I agree.

People put too much guilt/emphasis on kids and what they need. My son is not going to get spoiled. And Im not working long hours so that he can become a snotty kid with a trust fund. He wont starve, hell have a decent car, hell get most of his college paid for. But spoiling them, and making them the most important part of life/the family is not for me. 

I remember a celebrity saying that, we (husband and wife) were the most important people in their relationship.  After all, you married that person to spend the rest of your life – not your kids. The kids will grow up and leave the nest. And guess whos gonna be in the house when the kids leave? The spouse. Thats why your spouse should be the most important person, not your kids. 

There is a balance. No, you don’t want to spoil the little parasites. But they need to know that they are loved, and not just some accoutrement you produced because the Millennial Guide said you had to do so. 

A friend lost his father while he was a freshman in college. His dad was a very famous physician, who spent his life being a famous physician. On his death-bed, dad expressed regret for not spending more time with his children. My friend, as he put it, spent “several years in a bottle” after his dad passed. 

To yank on your heartstrings even more…

[link=https://www.youtube.com/watch?v=EUNZMiYo_4s]https://www.youtube.com/watch?v=EUNZMiYo_4s[/link]

Raise your kids any way you see fit, guys. Work as hard as you wish. Make as much money as you think you just have to have. And rationalize it any way you have to to look yourself in the mirror. But you will most likely regret trading time with your kids for yet another coupla hundred K. 

No doubt. And every kid is different.
But a lot of “activities” are about the parents, not the kids.
Children are resilient. They need love and security. They can figure out a lot on their own. That takes thought and discipline on the parents side; which is work.
Kids from big families get it, doing things on your own is required, and understood; not personal.
Attending little league games does not make one a good parent; I didn’t care, that’s for sure.
 

[julie.young_645]

Don’t focus on the baseball game thing. It’s simply one example. 

[JohnnyFever]

Yeah I don’t get the little league thing. Would always choose spending 2 hours of quality 1:1 time with my kids over watching them play a game with their friends. One parent will always be present, but rarely both

[afazio.uk_887]

Working ur @ss off in modern day medicine is simply not worth it. Sure, maybe in the days of DeBakey and such those guys were legit god like figures but today medicine is becoming just a private equity business. Do your best for your patients that count of you and F the rest of it. Squirrel away a little cash monthly and focus on the big picture like enjoying your family and working on your own personal improvement and well-being.

[Melenas]

what happened to helping people and being a humanitarian? you know the ‘reason for applying to medical school?’? there was no mention of private equity, or making lots of money or retire early. 

[Unknown Member]

Quote from peehdee

what happened to helping people and being a humanitarian? you know the ‘reason for applying to medical school?’? there was no mention of private equity, or making lots of money or retire early. 

So true, pull out your med school essay and read it.
Since mine was typed on paper with a Smith Corona, I don’t have it. But as I recall, it was pretty idealistic; in a good way.

[btomba_77]

Quote from boomer

So true, pull out your med school essay and read it.
Since mine was typed on paper with a Smith Corona, I don’t have it. But as I recall, it was pretty idealistic; in a good way.

I explained to a resident the other day that back when I was applying for residencies you have to send a letter to each program requesting an application form.    
 
Each program had a separate form with different questions, different essays etc. 
 
And you had to pay $30-40 for the privilege of submitting the application.
 
 
They were flabbergasted.  
 
____
 
I have no recollection of what I wrote for my medical school application statement.   It was probably a lot more “love of science” than “I want to be a healer”
 

[ruszja]

Quote from dergon

I explained to a resident the other day that back when I was applying for residencies you have to send a letter to each program requesting an application form.    

Each program had a separate form with different questions, different essays etc. 

And you had to pay $30-40 for the privilege of submitting the application.

They were flabbergasted.  

 
 
People also didn’t apply to every residency program in the country. Now that ‘its just money’ and you just add programs via mouse-click, most programs get flooded with applications from people who on initial review will never show up.

[Unknown Member]

Do they still have medical school and residency application system where you go and select a ton of schools, and they charge you $50 a school for the privilege of emailing them your application, followed by the school emailing you back asking you to fill out THEIR application and charging you another $100 for the privilege of having them read your essay?

Money machine go brrrrttt

[Unknown Member]

Yes, they have that system. The fee goes up based on the number of programs to which you apply. Plus you pay to register for the match. Now we also have the privilege of paying FCVS to do essentially nothing. There may have been more legwork in dergons day, but they havent given a break on fees.

[ruszja]

Quote from radgrinder

Do they still have medical school and residency application system where you go and select a ton of schools, and they charge you $50 a school for the privilege of emailing them your application, followed by the school emailing you back asking you to fill out THEIR application and charging you another $100 for the privilege of having them read your essay?

Money machine go brrrrttt

 
They don’t actually read your essay. The robot looks at your MCAT score, your GPA and whether you clicked ‘yes’ for some of these silly clubs like AOA and if the robot decides that you are ‘competitive’, your application makes into the stack of 500 that gets reviewed by a human.

[Melenas]

I realize this is a select group of rads who choose to write on AM. Thus not a true sample of all the radiologists out there. 
 
But, I wonder if other areas of medicine have the same thoughts – make lots of money quick and get the heck out of there. Or do they tend to be more focus on the art and healing of medicine. Go down with the sinking ship. Being sunk by less pay, more hours, paper work, more regulations, NPs/PAs, AI.
 
 
 

Quote from boomer

 

Quote from peehdee

what happened to helping people and being a humanitarian? you know the ‘reason for applying to medical school?’? there was no mention of private equity, or making lots of money or retire early. 

So true, pull out your med school essay and read it.
Since mine was typed on paper with a Smith Corona, I don’t have it. But as I recall, it was pretty idealistic; in a good way.

[btomba_77]

Quote from vln

From a young resident thinking about area of specialization. What is the least stressful subspecialization on day-to-day basis?

Mamms (only if you *really* like it to start with … otherwise it’s digging  ditch all day for 30 years)
 
I’d put in a nice vote for MSK as relatively low stress. 

[Unknown Member]

Im a +1 for Hospital-Rad’s post above.

For those who say that $250K/yr is not enough to live in some neighborhoods – clearly true – my response is that earning $600K/yr is also not enough for some neighborhoods – such as one 2 miles from me.

The answer is to not live those neighborhoods. If there are no neighborhoods where one can live in with the income of the radiologist job of your choosing, be it VA or PP, then do what everyone else does : find another city where you can live comfortably with whatever income you make.

Plenty of Americans live happy lives making much less than $250K a year.

[Dr_Cocciolillo]

as with all things, not everything is black and white.   The advice given is true if you are debating between a 4 bed 3000 sq ft home or a macmansion of 7 beds, 6000  sq feet and pool and 1 acre of land. 
 
The example i gave is a very real one and it’s not on the east coast or west coast.  In many of those places, you have to spend 1.5 mil to get what costs 1 mil here.  
 
Moving – not always practical for reasons that have been described ad nauseum.  
 
By the way, most of my friends who have awesome houses really like their awesome houses — be it pool, big yard where they can have barbecues, friends, kids over. 
 
I am in full agreement to live at “upper middle income ” levels but to pick a job that has 50% of earning potential because you can take vacation “on the fly” and don’t have to put in for vacation 6 months in advance is foolish.   
Every job that i have had, we picked vacation 3-9 months in advance.  
Need to absolutely maximize earning potential in 30s, 40s but not at the expense of complete exhaustion. 
 
Lastly, retrospective analysis when you have achieved FIRE is always going to be flawed, particularly made it “big”    

The biggest challenge to taking that complete lifestyle job in one’s 30s is the unknown future with respect to earning potential. Forces from so many corners threaten our EP as we know it and hopefully, it ends up all noise but for someone with a 20-25 yr career span, it’s hard to not go for “it” right now
 
That being said….TIME IS UNDERAPPRECIATED.   Do the things you want to do now when you have time and resources.  If you don’t have a young family, even more important, as having kids in the age range of 0-5 really limits what you can do if you want to be a good/great parent. 
 
If you are in your late 30s/early 40s, realize your stamina and athletic ability will begin to decline rapidly over the next decade so do what you want to do NOW and most certainly, take an extra 2 weeks of time off to do those things or figure out how to not work 10 hr days in a grind.  
 

[Unknown Member]

Lots of wisdom in wisdom’s post.

I agree that it’s unusual that you will find an efficiently run pp group where you’re able to randomly take a day off in a week and where the schedule isn’t planned out 3, 6 or 12 months at a time. Some groups have baked in an off day post call which is nice but harder to pull off in smaller groups.

[melissa.mason_511]

I just bought an airplane. Childhood dream. YOLO.

[Unknown Member]

Quote from wisdom

as with all things, not everything is black and white.   The advice given is true if you are debating between a 4 bed 3000 sq ft home or a macmansion of 7 beds, 6000  sq feet and pool and 1 acre of land. 

The example i gave is a very real one and it’s not on the east coast or west coast.  In many of those places, you have to spend 1.5 mil to get what costs 1 mil here.  

Moving – not always practical for reasons that have been described ad nauseum.  

By the way, most of my friends who have awesome houses really like their awesome houses — be it pool, big yard where they can have barbecues, friends, kids over. 

I am in full agreement to live at “upper middle income ” levels but to pick a job that has 50% of earning potential because you can take vacation “on the fly” and don’t have to put in for vacation 6 months in advance is foolish.   
Every job that i have had, we picked vacation 3-9 months in advance.  
Need to absolutely maximize earning potential in 30s, 40s but not at the expense of complete exhaustion. 

Lastly, retrospective analysis when you have achieved FIRE is always going to be flawed, particularly made it “big”    

The biggest challenge to taking that complete lifestyle job in one’s 30s is the unknown future with respect to earning potential. Forces from so many corners threaten our EP as we know it and hopefully, it ends up all noise but for someone with a 20-25 yr career span, it’s hard to not go for “it” right now

That being said….TIME IS UNDERAPPRECIATED.   Do the things you want to do now when you have time and resources.  If you don’t have a young family, even more important, as having kids in the age range of 0-5 really limits what you can do if you want to be a good/great parent. 

If you are in your late 30s/early 40s, realize your stamina and athletic ability will begin to decline rapidly over the next decade so do what you want to do NOW and most certainly, take an extra 2 weeks of time off to do those things or figure out how to not work 10 hr days in a grind.  

 
Excellent post!
 
The current and most common view of the threat matrix for radiology consists of private equity, artificial intelligence and mid-levels taking on additional space from radiologists, and declining reimbursements.
 
Its about money and the security of future income.  Many people are afraid they wont make as much money as they thought and will feel that all their time spent learning the field, becoming a doctor and so on will have been wasted; this whole effort was a total ripoff.
 
So one seeks assurance from elders in the field…private practice rads, the ACR, academic professors and so on that the field is actually really secure and the threats listed above wont change anything.  And then people get frustrated when that impossible level of assurance is not met, and lash out at the elders as fools and incompetents and grifters.
 
 

[Melenas]

So if the fear is potential short comings of the future. Shouldnt that be addressed by working hard say the first 10 years and slowing down? It seems like no one wants to slow down. After the 1st million, you aim for the 2nd million than its 3 million then the 5 million mark. 
 
Is it just greed? 
 
And on a side note, we are very fortunate to be able to think/dream of becoming multimillionaires. There are close to 10 million households who have NW over 1 millions so it isnt like becoming a millionaire is a huge hurdle. But to have NW over 5 million or even 10 million; now thats a special place. And radiologist can certainly achieve that. 
 
Millions of workers work into their late 60s just to get close to a million dollar NW. Why in the world if you have the chance to get to 10 million would you stop working? I think this question is why people keep slaving away. They have a unique opportunity to achieve a NW only a few can even dream about. 
 
 
 
 

Quote from radgrinder

Quote from wisdom

as with all things, not everything is black and white.   The advice given is true if you are debating between a 4 bed 3000 sq ft home or a macmansion of 7 beds, 6000  sq feet and pool and 1 acre of land. 

The example i gave is a very real one and it’s not on the east coast or west coast.  In many of those places, you have to spend 1.5 mil to get what costs 1 mil here.  

Moving – not always practical for reasons that have been described ad nauseum.  

By the way, most of my friends who have awesome houses really like their awesome houses — be it pool, big yard where they can have barbecues, friends, kids over. 

I am in full agreement to live at “upper middle income ” levels but to pick a job that has 50% of earning potential because you can take vacation “on the fly” and don’t have to put in for vacation 6 months in advance is foolish.   
Every job that i have had, we picked vacation 3-9 months in advance.  
Need to absolutely maximize earning potential in 30s, 40s but not at the expense of complete exhaustion. 

Lastly, retrospective analysis when you have achieved FIRE is always going to be flawed, particularly made it “big”    

The biggest challenge to taking that complete lifestyle job in one’s 30s is the unknown future with respect to earning potential. Forces from so many corners threaten our EP as we know it and hopefully, it ends up all noise but for someone with a 20-25 yr career span, it’s hard to not go for “it” right now

That being said….TIME IS UNDERAPPRECIATED.   Do the things you want to do now when you have time and resources.  If you don’t have a young family, even more important, as having kids in the age range of 0-5 really limits what you can do if you want to be a good/great parent. 

If you are in your late 30s/early 40s, realize your stamina and athletic ability will begin to decline rapidly over the next decade so do what you want to do NOW and most certainly, take an extra 2 weeks of time off to do those things or figure out how to not work 10 hr days in a grind.  

Excellent post!

The current and most common view of the threat matrix for radiology consists of private equity, artificial intelligence and mid-levels taking on additional space from radiologists, and declining reimbursements.

Its about money and the security of future income.  Many people are afraid they wont make as much money as they thought and will feel that all their time spent learning the field, becoming a doctor and so on will have been wasted; this whole effort was a total ripoff.

So one seeks assurance from elders in the field…private practice rads, the ACR, academic professors and so on that the field is actually really secure and the threats listed above wont change anything.  And then people get frustrated when that impossible level of assurance is not met, and lash out at the elders as fools and incompetents and grifters.

[Unknown Member]

Just a reflection. If someone needs reassurance that their future income as a radiologist will remain strong before they can take a breath and relax… then there will be no relaxing.
 
There are no guarantees that you will either earn the same money or be around to spend it. There is just today. Heraclitus said that man can not step in the same river twice. We are in constant flux and should you still be above ground in 10 years to enjoy early retirement, you will not be the same person you are today, nor will your parents or your children. 
 
Practically speaking, this makes for an argument to live small such that the income needed to sustain it is lessened and your freedom increased and your FI closer. 
 
Mindfulness is lost when your planning for a raining day costs you today. 
 
 
 
 
 

[Dr_Cocciolillo]

I think that’s it’s  hard to predict what the future will look like income wise more than 5 years out.   That causes a lot of anxiety for the younger rads out there coupled with (to a much lesser extent) 
 
Being surrounded by people with more than us (those of us early/mid career)  Most of my partners have houses 3x nicer than mine…many others have vacation homes or many other toys.  And their net worth is still about 3x-5x mine.  it’s hard to catch up to someone who has been in the market 15 years longer than you, even if you are relatively frugal and the other person is an overspender.  Not to mention that most of my partners made 30% more the decade before this one.    When discussing car choices, boat choices, kids college choices, one can’t help but think “i’d like to have a little bit of this as well” 
 
Flounce makes a great point to spend more time with other lower paid professionals so that these contrasts aren’t as stark and one can appreciate it more.  Volunteering would also satisfy this recalibration.   GREAT ADVICE.  s
 
there is a good podcast on this topic of “greed” i came across recently
 
[link=https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzA4/episode/MjI1N2MxYTktYTA3OS00ZmVjLWIzYmItYWRkMmJiNjU3ZjM0?hl=en&ved=2ahUKEwjKwZb5r4jsAhXZZs0KHd4VBRAQieUEegQIDhAI&ep=6]https://podcasts.google.c…QieUEegQIDhAI&ep=6[/link]
 
In summary,:
   Try to maximize your 30s for income, especially before kids.  Once your kids are 2 and up, prioritize them even more.  Try to have a job where you are not gone for more than 9-10 hrs door to door and where you are not mentally crushed 75% of the time when you get home.  If you luck out with a good job market and salary in your early 30s, you can begin to gradually take the foot off the gas 7-10 years in.  The first million is the hardest.   Need to allow for compounding to work.  
In late 30s/early 40s, begin to sell shifts, make  it to 80-90% of your kids’ activities , or if you are single, realize this is your last opportunity perhaps to do certain things and maximize whatever your experience buckets may need.   
 

[btomba_77]

Quote from peehdee

So if the fear is potential short comings of the future. Shouldnt that be addressed by working hard say the first 10 years and slowing down? It seems like no one wants to slow down. After the 1st million, you aim for the 2nd million than its 3 million then the 5 million mark. 

Is it just greed? 

No. It’s not just greed.
 
Here’s the problem with the “I’m just going to work really, really hard for these first xxxx number of years and then slow down” theory.
 
During the course of those xxxx number of years the work [b]becomes your life[/b].  You fail to develop hobbies and outside interests. You lose closeness in your relationships with spouse, family, and friend.  You don’t time to volunteer and build social networks outside of work.
 
So once those xxxx number of years have gone by ….. Poof… all you have is the work.
So you keep working… because that’s what you do.
 
Before someone sets out on this career path they should consider the wise words of Admiral Ackbar:
 
It’s a Trap!
 
 

[ljohnson_509]

250k is 95% household income.

[link=https://dqydj.com/household-income-percentile-calculator/]https://dqydj.com/househo…percentile-calculator/[/link]

Give me a break. There are some incredibly out of touch people posting here. If you cant live comfortably on 250k then you are living above your means.

[leann2001nl]

70k for 25 yr at 8% return is over 5M . Plenty of wealth accumulation

8M at 30 yr

[julie.young_645]

8%?

[leann2001nl]

Quote from noondoo

Quote from Waduh Dong

“Building wealth” as a Radiologist is never going to be that impactful.  We are high income professionals which means we are never going to be able amass the kind of wealth those in the finance / business world can.  Their wealth is tied to stock values which can create tremendous wealth over time with no upper ceiling.  The strength of our profession is not the ability to amass a fortune, but rather that it is a stable, meaningful, largely recession resistant job which pays well and that one can do for decades.  Sure, over the longterm you will likely build yourself a nice little nest egg on the side but it will still be peanuts compared to the true wealthy of society so don’t spend your time and mental energy trying to play in their sandbox.  

Above and 2BRads make good points.

As a higher end earning doctor, such as a radiologist, you still cannot compete with a high end business executive on an income nor time level.

The income and hours worked relationship is reversed between high end executives (Hospital CEO/CFO/COO, service/product line executive for example) and Radiologists.

The further you move up in the business executive stratosphere, in general, the less time you spend working, and the more money you make.  

Few executives put in the hours of a private practice radiologist.  Virtually no executives putting the nights and weekends that our profession puts in.

Therefore, as I always say, find a job where you are more like an executive. Put in the least amount of input for the greatest amount of output.  That’s what an executive at Rad Partners would do! 🙂 

 
This is so wrong. Do you think these people became executives because they sat on their butts?
 
Rads is a pretty easy job TBH. It’s mentally taxing but you’re literally sitting on your butt all day reading studies off a computer, maybe a few phone calls, some protocolling etc. 
 
A big wig exec like you guys are talking about works way way harder than average rad and has also grinded way harder to get to where they are. They didn’t just have to memorize a bunch of random factoids and regurgitate them. 
 
Everyone always thinks the grass is much greener. 

[mcampbell_392]

Quote from IR27

Quote from noondoo

Quote from Waduh Dong

“Building wealth” as a Radiologist is never going to be that impactful.  We are high income professionals which means we are never going to be able amass the kind of wealth those in the finance / business world can.  Their wealth is tied to stock values which can create tremendous wealth over time with no upper ceiling.  The strength of our profession is not the ability to amass a fortune, but rather that it is a stable, meaningful, largely recession resistant job which pays well and that one can do for decades.  Sure, over the longterm you will likely build yourself a nice little nest egg on the side but it will still be peanuts compared to the true wealthy of society so don’t spend your time and mental energy trying to play in their sandbox.  

Above and 2BRads make good points.

As a higher end earning doctor, such as a radiologist, you still cannot compete with a high end business executive on an income nor time level.

The income and hours worked relationship is reversed between high end executives (Hospital CEO/CFO/COO, service/product line executive for example) and Radiologists.

The further you move up in the business executive stratosphere, in general, the less time you spend working, and the more money you make.  

Few executives put in the hours of a private practice radiologist.  Virtually no executives putting the nights and weekends that our profession puts in.

Therefore, as I always say, find a job where you are more like an executive. Put in the least amount of input for the greatest amount of output.  That’s what an executive at Rad Partners would do! 🙂 

This is so wrong. Do you think these people became executives because they sat on their butts?

Rads is a pretty easy job TBH. It’s mentally taxing but you’re literally sitting on your butt all day reading studies off a computer, maybe a few phone calls, some protocolling etc. 

A big wig exec like you guys are talking about works way way harder than average rad and has also grinded way harder to get to where they are. They didn’t just have to memorize a bunch of random factoids and regurgitate them. 

Everyone always thinks the grass is much greener. 

Reading this thread, I finally understand why private groups are so quick to sell out to private equity…….

[leann2001nl]

Why is it one or the other ? Why cant people acknowledge its a good job with good pay, the opportunity to directly help others , all with some intellectual stuff to keep it interesting ?

Who wants to be Debakey ? Who wants to be a peace corp worker ? Ill settle for the in between

[ruszja]

Quote from IR27

Why is it one or the other ? Why cant people acknowledge its a good job with good pay, the opportunity to directly help others , all with some intellectual stuff to keep it interesting ?

Who wants to be Debakey ? Who wants to be a peace corp worker ? Ill settle for the in between

 
Debakey ? The poor guy had to work until he was almost 90.

[julie.young_645]

DeBakey INSISTED on working into his 90’s. The rest of the staff had to watch him like a hawk to be sure he didn’t cause harm. He usually didn’t. He also had a MUCH younger wife, and young children VERY late in life. 

[jennycullmann]

Quote from DoctorDalai

DeBakey INSISTED on working into his 90’s. The rest of the staff had to watch him like a hawk to be sure he didn’t cause harm. He usually didn’t. He also had a MUCH younger wife, and young children VERY late in life. 

 
Be careful, even talking about someone with a younger wife or girlfriend on here might get you black listed as some sort of “p-phile”. Being honest about biology is not modern (leftist) society’s goal for the lemmings. Control and disruption of the family is, oh yeah, and depopulation, that’s why feminism came to the rescue for western women, with abortions to boot.

[jennycullmann]

By the way, how hard is it really to get a part time gig? I think it is hard in that most won’t allow you unless you were already a partner right? It’s that “we want you to slave with us and take call all the time too” stuff, correct?

[Unknown Member]

Possibly IR27. What if we just did a bunch of prelim zoom interviews and only made the really serious candidates physically come out?

I mean why are they really there? Yes, yes, heres a tour of the radiology department. We have many dark rooms and several chairs. Here is an MRI scanner. It makes loud noises, just like all the other scanners youve seen.

[Melenas]

Thats been my experience. Must take call.
 

Quote from Casino Royale

By the way, how hard is it really to get a part time gig? I think it is hard in that most won’t allow you unless you were already a partner right? It’s that “we want you to slave with us and take call all the time too” stuff, correct?

[Dr_Cocciolillo]

You can get a part time job. But the hourly rate with discount lack of call weekends etc.

[clickpenguin_460]

I always thought the residency match system would be fixed if they just limited it to 5-8 choices total.  Then people would only apply to places they actually wanted to go/thought they had a chance to get into.  The nonsense of paying 12-15000 dollars to apply and interview at 15-20 places for residency needs to stop.

[Unknown Member]

Agreed. Its one more way to financially screw over people who are already 6 figures in debt.

Maybe do tranches of interviews. Everyone put your top 5, do a month of interviews, match. It doesnt work out, do another 5. And so on.

[leann2001nl]

Just going to get worse . Seems like consistently people are going on more and more interviews. Makes whole system inefficient

Hard to cap it at with so much at stake but its going to get to point where average person goes on 20 interviews