The challenge in the US is that the best and brightest increasingly have no interest in entering the medical profession. The debt, crazy years of minimum income, all to let an insurance company admin dictate your every move and while more and more physicians become a labor pool for PE healthcare tracked with metrics fit for warehouse workers (edit: and that’s not OK in a warehouse either). All to earn a decent income but no longer the top of the market. A decent mid-level developer or tech executive makes more than nearly all physicians. No sane top performing talent would dive head first into that mess.
There are exceptions of course but when my brother was considering medical school he visited about 10 different top physicians to seek input and advice and nearly all said if given a Time Machine they wouldn’t do it all over again. That was a real wake up call.
If you go into medicine as a business entrepreneur and build a successful medical business then there’s opportunities for one to still taste some of the glory of the medical profession that once was. Outside that it’s basically a reasonably well paid life of indentured servitude. Yes you’re “helping people” but that only carries you so far which is why so many just burn out and leave.
Massive reform is needed but the powers that be between the AMA and insurance companies seem unlikely to let that change happen unless it’s forced on them by Congress, and that too seems unlikely for now. Something more alike to an apprenticeship model where one grows up from EMT, to nurse, to physician fits the current business model much better than trying to preserve the old world “Officer vs enlisted” model where folks enter the profession directly as officers (physicians).
"decent mid-level developer or tech executive makes more than nearly all physicians"
That's no where near true for a mid level developer or most tech execs or most senior developers. If you exclude faangs a top developer doesn't make as much as a doctor.
You need to consider the economic cost of delayed earnings, which is massive for the physician, and the higher pay later typically doesn’t make up for the massive debt and low pay early on. It’s not just about a point in time salary sizing contest. Earning little to nothing early in one’s career creates a massive net worth void to fill.
Physician lifetime earnings counting for delay, and debt… normal investment, etc: 8.5-10m. Software engineer median is much lower. About 6.5m. Specialist and high end varies greatly. Median doctor is earning 2x a SWE (130k vs 250k).
People on HN vastly overestimate SWE pay as an industry, biased by FAANG as we are :).
Lifetime earnings of 6.5M is more than lifetime earnings of 8.5M if the 6.5M is front-end loaded and the 8.5M is back-end loaded and starts with a 0.5M hole.
It's the difference between compound interest working for you vs compound interest working against you.
I accounted for that when I modeled it. I explicitly added investment start and compounding. A thing to remember: a physician is delayed yes but their higher income lets them much more heavily invest as their income often exceeds life expenses by a lot more than median swe.
> and the higher pay later typically doesn’t make up for the massive debt and low pay early on.
It does, actually.
Physicians have high early career earnings. It’s not like grinding your way up the ladder until you get paid a lot.
Developers only make more if you only look at the very top end. Like a Stanford grad who goes straight to FAANG earning $200K the day after they graduate.
If you need to start accounting for those things you might consider adjusting for the risk of getting laid off as a tech worker .... I'd imagine it's far higher than for a medical professional.
cmiles8 · · focus · HN ↗
There are exceptions of course but when my brother was considering medical school he visited about 10 different top physicians to seek input and advice and nearly all said if given a Time Machine they wouldn’t do it all over again. That was a real wake up call.
If you go into medicine as a business entrepreneur and build a successful medical business then there’s opportunities for one to still taste some of the glory of the medical profession that once was. Outside that it’s basically a reasonably well paid life of indentured servitude. Yes you’re “helping people” but that only carries you so far which is why so many just burn out and leave.
Massive reform is needed but the powers that be between the AMA and insurance companies seem unlikely to let that change happen unless it’s forced on them by Congress, and that too seems unlikely for now. Something more alike to an apprenticeship model where one grows up from EMT, to nurse, to physician fits the current business model much better than trying to preserve the old world “Officer vs enlisted” model where folks enter the profession directly as officers (physicians).
ipaddr · · focus · HN ↗
That's no where near true for a mid level developer or most tech execs or most senior developers. If you exclude faangs a top developer doesn't make as much as a doctor.
cmiles8 · · focus · HN ↗
bitexploder · · focus · HN ↗
People on HN vastly overestimate SWE pay as an industry, biased by FAANG as we are :).
sebmellen · · focus · HN ↗
bryanlarsen · · focus · HN ↗
It's the difference between compound interest working for you vs compound interest working against you.
bitexploder · · focus · HN ↗
robocat · · focus · HN ↗
I still don't know what my own objective function is.
bitexploder · · focus · HN ↗
robocat · · focus · HN ↗
Aurornis · · focus · HN ↗
It does, actually.
Physicians have high early career earnings. It’s not like grinding your way up the ladder until you get paid a lot.
Developers only make more if you only look at the very top end. Like a Stanford grad who goes straight to FAANG earning $200K the day after they graduate.
boelboel · · focus · HN ↗