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Can doctors be super rich?


Doctors play a vital role in society by caring for people’s health. Their skills and knowledge enable them to diagnose and treat injuries and illnesses, improving quality of life and sometimes even saving lives. While doctors enter the profession to help others, their services come at a high cost. This leads many to wonder – can doctors become super rich from their work?

What does it mean to be “super rich”?

There is no definitive threshold for being considered “super rich,” but it generally refers to individuals with a net worth in the hundreds of millions or billions of dollars. For doctors specifically, an annual income over $1 million could potentially put them in the “super rich” category depending on their overall assets and investments. However, most doctors have incomes well below the seven-figure mark.

According to Medscape’s Physician Compensation Report 2019, the average annual salary for doctors in the United States is around $313,000. Specialists tend to earn more than primary care physicians. For example, orthopedic surgeons average around $482,000 per year while pediatricians average around $232,000. While doctors are certainly well-compensated for their skills and experience, the majority are not earning incomes in the super rich range.

What factors influence a doctor’s earning potential?

A doctor’s specialty is one of the biggest factors affecting their salary and potential to accumulate wealth. As mentioned, specialists earn significantly higher pay than primary care doctors. Within specialties, there are also large pay differences. For example, spinal neurosurgeons average $720,000 annually while pediatric infectious disease doctors average $199,000.

Doctors working in metro areas and prestigious facilities also tend to earn higher incomes than those in rural areas. Those who see a high volume of patients can increase their billing and pay. A doctor’s geographic location, business costs, and even reputation can affect how much they are able to make.

Demographics like gender and race also influence earnings, with male doctors out-earning females by significant margins in most specialties. Hourly rates, bonuses, and procedures billed contribute to these pay disparities.

How do doctors build wealth?

A high income is often necessary but not solely sufficient for building immense wealth. Doctors may employ a combination of strategies to accelerate their assets:

– Investing – Doctors can invest their income into real estate, mutual funds, startups, and other appreciating assets. Compounding returns allow their money to grow.

– Saving – Avoiding lavish expenditures and lifestyle inflation by living modestly and saving income.

– Developing multiple income streams – Doctors can earn additional income from speaking engagements, books/DVDs, consulting, and selling medical products or services.

– Owning real estate – Once financially stable, doctors may expand into owning real estate for rental income and appreciation.

– Equity participation – Some doctors negotiate deals to acquire partial facility ownership or obtain shares in new ventures. This provides them equity in a larger enterprise.

– Reducing taxes – Doctors may use tax reduction strategies to minimize how much of their income gets paid in taxes.

With the right strategies and discipline, a high-earning doctor certainly has potential to become super rich over an entire career. Very few, however, will achieve this just from salaries alone.

Are there billionaire doctors?

Though uncommon, there are doctors who have amassed immense billion-dollar fortunes:

Thomas Frist Jr. – Co-founder of Hospital Corporation of America (HCA). His investment enabled rapid expansion of the for-profit hospital chain. His current net worth is estimated at $12.1 billion.

Patrick Soon-Shiong – South African-American surgeon and biotech entrepreneur. He sold two pharmaceutical companies for billions and now owns the Los Angeles Times. His net worth is approximately $7 billion.

Phillip Frost – Dermatologist, pharmaceutical company executive, and investor. He led IVAX Corporation and Teva Pharmaceutical Industries, amassing a $4.9 billion net worth.

Sandra Brintnell – Canadian heiress of Brintnell Pharmacies, which was acquired by McKesson Corp. Her inherited fortune is estimated at $4.4 billion.

While representing the high end of physician wealth, these doctors turned executives demonstrate the enormous potential earnings from the business side of medicine.

The challenges of becoming super rich as a doctor

Despite their comfortable incomes, the vast majority of doctors will not attain ultra-high net worth status from clinical practice alone. Some key challenges include:

High costs of education – The many years of schooling and residency required leave new doctors with over $200,000 in student loan debt on average. High debt burdens early in their career delay wealth accumulation.

Delayed earning potential – Doctors don’t begin independent clinical practice until their 30s in most cases. The delayed initiation of peak earning years restricts assets relative to other high paying fields.

High business costs – Doctors in private practice have very high overhead expenses for staff, equipment, rent, insurance, and supplies. This restricts the income available for personal wealth growth.

Risk of lawsuits – While malpractice insurance provides coverage, frequent lawsuits can still restrict wealth growth and drive up the costs of practicing medicine.

Lack of business training – Medical schools provide no training in personal finance, investing, or running a profitable enterprise. This can inhibit a doctor’s business acumen.

For the above reasons, the super rich threshold seems to be realistically attainable for only a very small subset of elite doctors.

The typical wealth status of doctors

While super riches are rare, doctors as a whole are still among the wealthiest professionals in America. Their incomes alone position them in the top few percentage points of wealth nationally.

According to research from the Federal Reserve on consumer finances in 2019:

– The median net worth of all U.S. families was $121,700. Doctors far exceed this level.

– For families headed by someone with a professional degree, the median net worth was $405,100. This would include many physicians.

– The median net worth just among those in health professions and science occupations was $200,000.

So while doctors may not be private jet and mega-yacht rich, their incomes, job security, and high societal status do facilitate building significant wealth well beyond average over a career. With careful planning and investing, retired physicians often have millions in assets to enable a comfortable lifestyle in their later years.

Wealth distribution among physicians

There is considerable variation in wealth among doctors depending on their circumstances and strategies. According to Medscape’s Physician Wealth and Debt Report 2021:

– 29% of doctors have a net worth under $1 million
– 30% have between $1 million and $3 million
– 24% have between $3 million and $5 million
– 17% are worth over $5 million

Net Worth Percentage of Doctors
Under $1 million 29%
$1-3 million 30%
$3-5 million 24%
Over $5 million 17%

This breakdown shows a skew towards the high end, with over 40% of doctors becoming millionaires at some point in their careers. However, the majority remain well below the super rich threshold.

Specialties most likely to yield high wealth

While no clinical career guarantees immense wealth, doctors in certain fields tend to earn higher incomes and have greater wealth building potential. According to Medscape’s physician wealth report, the specialties with the highest median net worth are:

– Radiologists – $714,000
– Cardiologists – $594,000
– Dermatologists – $526,000
– Gastroenterologists – $469,000
– Urologists – $409,000
– Anesthesiologists – $408,000
– Orthodontists – $402,000

These specialists earn more on average due to higher pay rates and ability to perform a high volume of procedures or scans. Many also receive bonuses and compensation beyond salary.

Focusing on a lucrative specialty and pursuing additional income streams can optimize a doctor’s chances of building significant wealth over their career.

Geographic regions with the highest physician compensation

Another factor enabling wealth accumulation is location of practice. Some U.S. regions feature much higher average pay for doctors. According to Doximity’s 2020 physician compensation report, the metropolitan areas with the highest average salaries are:

1. Charlotte, NC – $421,000
2. Milwaukee, WI – $412,000
3. New Orleans, LA – $408,000
4. Dallas, TX – $407,000
5. Pittsburgh, PA – $406,000

In general, compensation is highest in the South and Midwest compared to the West Coast and Northeast. Rural areas tend to pay less than major metro regions. Locating in a well-paying geographic area gives doctors more income to potentially invest and build wealth over time.

Wealth comparisons to other high earning professions

It can also be useful to compare physician wealth and income relative to other prestigious, high paying careers:

Lawyers – The median net worth of lawyers is $230,000. Typical lawyers earn less than typical doctors, which impacts wealth building capacity.

Corporate executives – Average CEO net worth is $5 – $10 million. Top executives have much higher earning potential than doctors which facilitates wealth accumulation.

Engineers – Median net worth for engineers is $290,000. Engineering salaries are good but not at the level of doctor pay in most cases.

Academics – University professors have an average net worth of $210,000. Academic pay is modest compared to clinical medical incomes.

So physician net worth and income does tend to exceed that of most other professionals (except highest tier business executives). Doctors’ earning potential is likely exceeded only by elite investors, lawyers, and corporate leaders.

Impact of debt on physician wealth

Student loan and educational debt poses one of the biggest hurdles to doctors accumulating wealth. Based on current medical education costs and debt levels:

– 75% of doctors take out loans for medical school.

– The average medical school debt is $201,490 upon graduation.

– Average repayment timeframe is 10-25 years depending on the monthly payment amount.

– Lifetime lost earnings from compounded interest paid is $65,000 – $100,000.

This high debt burden handicaps doctors right from the start of their career. It can take years for their income to exceed their educational debt costs before they have earnings available to invest and build wealth. Minimizing debt or rapidly paying it down accelerates doctors’ wealth potential.

Impact of taxes on physician wealth

Taxes also play a major role in determining doctors’ net income available for wealth building. Points on physician taxes include:

– Federal income taxes reduce doctor take-home pay by 24% (for 33% marginal tax bracket)

– State income taxes further reduce net pay by up to 13.3% depending on location

– Payroll taxes like Medicare/Social Security reduce net pay by 7.65%

– Maintenance of licensure costs and insurance premiums also reduce net income

In total, doctors can pay well over 50% of their gross clinical income in taxes and practice expenses. Reducing tax burdens through retirement account contributions, deductions, estate strategies, and other means helps doctors accumulate and preserve more wealth long-term.

Wealth building and financial advice for physicians

For physicians seeking to optimize their wealth and finances throughout their career, some key tips include:

– Aggressively paying down student loans and credit card balances

– Contributing maximum amounts to retirement accounts like 401(k)s and IRAs

– Investing through low-cost index funds and ETFs; avoiding high fee products

– Engaging in high income specialty fields like radiology and anesthesiology

– Relocating to regions with the highest doctor compensation

– Purchasing appropriate disability and liability insurance

– Establishing trusts and estates to minimize gift/inheritance tax

– Delaying Social Security until age 70 to maximize payouts

– Owning some real estate; benefiting from appreciation

– Starting side businesses to develop additional revenue streams

– Working with financial advisors on taxes, investing, and wealth growth strategies

With proper planning, most doctors can retire with over $1 million in assets. While short of super rich status, this level of wealth represents the top 5-10% of Americans. Doctors’ earning ability clearly facilitates building significant wealth over a career relative to other professions.

Conclusion

Very few physicians will join the billionaire ranks occupied by those like Thomas Frist Jr. and Patrick Soon-Shiong. However, doctors uniformly enjoy high status and above average incomes that can facilitate building wealth well beyond most Americans given the right habits and strategies. $1 million to $5 million is an attainable net worth range over the length of a clinical career.

While indebtedness, taxes, business costs, and delayed earnings make it unlikely for the vast majority of doctors to become “super rich”, they are almost guaranteed to join the ranks of the financially comfortable upper middle class over their working lifetimes. Careful investing, developing side income streams, controlling costs, and taking advantage of all available wealth accelerating strategies can help doctors make the most out of their earning potential. While doctors may not buy superyachts from their salaries alone, they can retire extremely comfortably relative to most Americans.