Sunday, August 28, 2011

Physician, Heal Thyself...Financially

For those of you in the Eastern Time Zone being pummeled by Hurricane Irene as I am, here's a little bit of educational leisure reading from the NY Times about the mistakes physicians make in their financial lives.

I noticed over the course of my residency, that many of my colleagues sank themselves in credit card debt.  As the article mentions, ours is a profession of delayed gratification.  Once we finally start making even a little bit of money as residents, it's tempting to go out and indulge a bit after a tough day at work.  Unfortunately, in addition to massive amounts of student loan debt, many also end up with massive credit card debt and little savings.  We basically mortgage our future income.  I think this hit is doubly hard on those who have children during residency.  From what I've seen, many live paycheck to paycheck, relying on credit cards to make up the difference.

It's not hard to see that this is a bad idea, especially in today's economy and litigious environment.

Some ideas: make a budget, read up on financial issues, put some money away in a Roth IRA during residency.  My residency program had a yearly retreat and brought in a financial planner to talk to us about all those practical things that we otherwise don't have time to think about during our training.  If your program has a didactic series, lobby for a session on financial planning.

We should approach the financial aspect of our lives in the same way we approach medicine--careful study and planning for the best possible outcome with the least amount of damage. 

Wednesday, August 17, 2011

More on the (Student) Debt Ceiling

As a follow-up to my earlier post on the effect of the debt deal on student loans, here's a timely article from The Huffington Post on how to deal with the new regulations on Stafford loans for graduate and professional school.  Timely topic for the new first years and those going through the application process.


Welcome Freshmen!

I was walking to the gym yesterday when I spotted some bright-eyed and bushy-tailed young twenty-somethings in shiny, new short white coats.  It's that time of year again--the matriculation of medical students. 

As I bustled by, I couldn't help but feel a bit nostalgic.  I started medical school exactly a decade ago. 

As I watched the new medical students take pictures with their families, I felt a lot of mixed emotions.  On one hand, I am so excited for these newbies.  I can honestly say that they are entering one of the most intriguing jobs a person can have.  As physicians, we have such wonderful opportunities in so many arenas.  We get to meet interesting and incredible people, including our patients and colleagues.  We get to see and do things that most everyone doesn't.  We get to learn, research, teach, travel.  We have great job security.

However, with those great benefits come incredible risks.  When non-medical people ask me about my medical education and residency, I quote Dickens:

"It was the best of times, it was the worst of times."

The best of times for all of the reasons I stated above, but also the worst of times for the many sacrifices we make to do this--personally, mentally, physically, financially.  We get to push ourselves to the limits of our beings in order to do what we do.  I don't need to go into the gory details, we all know them.

Though it sounds cheesy, the emotion that overtook all of the others when I saw those medical students was an incredible sense of pride.  Pride that I made it through, and pride that there are still people who want to do this despite the risks and benefits.

Wednesday, August 3, 2011

The (Student) Debt Ceiling

How many of you are carrying student debt that is the equivalent of a mortgage on a modest new home in the Central Time Zone?  According to recent data, American medical students graduate with an average of $158,000 in student loans.  Check out this item from The New York Times Well blog for more terrifying med student loan stats.

On Sunday, our Congressional leaders arrived at a deal to raise the debt ceiling, but students in professional schools and graduate programs are going to suffer as a result of this.  The deal cut the subsidy on Stafford loans (so all Stafford loans will be unsubsidized and will accumulate interest while you're in school) and the interest rate cuts for people who make timely loan payments when the loans go into repayment.  Check out this story from CNN Money.
 
Though student loans seem like an issue focused on individuals, it is increasingly becoming a major health policy problem  that is finally garnering the press it deserves. For example, the blog post above from NY Times, The Huffington Post, and a recent article in Academic Medicine which chronicles the history of student loans amongst medical professionals.  This article makes for interesting reading--do we really know how much it costs to educate a medical student?  Is it really to the tune of $60,000 per year?

The prohibitive costs and debt associated with medical schools are affecting the practice of medicine throughout the physician workforce pipeline.  High potential debt and the lack of support for medical students affects the applicant pool for medical school, increasingly making medical school a luxury for the more well-off.  This leads to a lack of diversity amongst the applicant pool and medical professionals in general.

Additionally, I think medical student debt is one of the many causes for the primary care physician shortage.  Students choose higher paying, procedural-based specialties because they pay better and allow physicians to pay off massive amounts of debt more comfortably and in a quicker timeline.  In the Well blog post I mentioned earlier, the author talks about how it took her attending 15 years to pay off his debt.  Do I really want to be paying off my own student debt into my 50's, while trying to save or pay for my own kids' educations?

I recently took a health policy class that has opened my eyes to many of these issues.  Ladies, and you brave gents who read this blog, let's all get educated on these issues.  Big changes are coming for American physicians, and we need to have a voice.