Wednesday, September 23, 2009

I think they just want my money

(I have not edited this yet, so hopefully there are not too many spelling and grammar errors.)
It's been a long while since I've posted on this pointless blog . . . . . so . . .here it goes.
I'm approaching finally getting a real medical license after all these years of education, and I just can't believe how much every little fee is now. I have all of my previous debt and now work very long hours for pay averaging less than an experienced person at Taco Bell, along with a wife and kids. And then "they" just throw hundreds of bucks of bills at me like I have wads of money in my sock drawer. So, how much has is cost thus far I've been thinking today . . . . . .

College: Very blessed and I was actually paid for each semester after my grants and scholarships were tallied up -- so that part was sort of a free 5 years of work. Initially I thought the couple grand applying to med school was costly, but I sure didn't realize back then how small of a chunk of the real pie of fee's that would be.

Med school: Well, this cost us over $200, 000, and the interest is literally increasing by the minute, which is a bit disturbing and I have to just try and not think about it or I just get more gray hairs.
Then come some of the tests
USMLE Step I board exam: $505 (1 day computer exam) after 2 years or med school
USMLE Step IIa board exam: $505 (1 day computer exam) a year later with the next test
USMLE Step IIb board exam: $1075 (1 day simulation with humans exam), PLUS you "get" to fly yourself to one of 5 places that actually give this test -- so I had to get myself to California, stay for a hotel, cab, and get back home again, all of course with no additional school loan money to somehow fund any of the over $2K in tests .

Then one graduates from medical school. . . only to realize that they spent about $5-10,000 more applying to and flying around the country interviewing at a dozen places to make sure they had a residency job after the M.D. is attached to the name. (All of which are on new private loans for most folks.)

Then you have a job as a resident, which is the first fulltime job in several years, so it's very nice to have some income that you actually earned, rather than borrowed from a bank, to pay for your beans and rice. Then a few more fees have come my way this past year.
I had to pay $705 to take USMLE Step 3 board exam (the last one), a 2 day test.
So sweet! I've finally finished all my main exams, I can now legally put a sign above a shop and call it a doctor’s office . . . oh wait, I mean . . . I have to pay others more money to let them make sure I really did everything above, which they have already been watching me very closely do.

So here I am now, needing to get state approval to use my stethoscope or treat an individual.
Here is what they now need, from what I have thus far figured out.
$16 to have myself put into some other database that keeps track of me
$48 for a fingerprint card fee
$50 to have my scores shipped from one agency to another of the above tests.
$52 background check fee (about the 10th one thus far, but I'd rather them check everone than not of course)
$205 initial license fee
$295 to pay a company to keep track of which fee's I've paid and to hold the paperwork for the main company
$500 application fee, just to top it off!

Then, if I actually want to be able to give that poor guy with a new kidney stone, or the lady with belly pain, or the kid just hit by some drunk driver some pain meds, I need a DEA number, which is a few hundred more bucks I get to fork out.

But wait -- I'm not even "board certified" in my career path yet, I'm only an M.D. but not a specialist yet in anything. After all of the above, and after finishing an approved residency training program, I then get to pay $385 to first apply to take the test in my Emergency Medicine specialty, which then costs $115 for an "in-training exam" then $895 for a "qualifying exam" then $1,125 for an oral exam. Then I'm sure there are some more to just top things off. All this just to let you actually treat your first patient . . . . who may very well just call the 1800Ididn' line when they get home and file a lawsuit . . . . on the guy who just worked for over a dozen years to try and help you to begin with. Did I really sign up for this???? Why????
Sometimes I wonder.

Yet, I still love my job as an ER resident, and somehow still have a great wife who has stuck by me (in our 10th year now), which I'm very grateful for, and we have 3 incredible kids, who make all the whining above well worth it!!!
Sorry for the ranting, I'm just feeling the burden right now. I know, I know, I'll be sending out the bills to those that have much less than I have ever had soon enough, and I'm just a scum sucking doc that somehow has some alternative motives for the workup I do on my patients that come to the hospital, but really, I'm just a guy like everyone else, trying to be the best I can at what I have been blessed with to be able to do and I really did just go into this to try and help folks out and have a job that I enjoy. In the end, it's our families that matter.


Audra Gines said...

I feel bad for you until I remember you will be making double or triple what we make...actually we are feeling your pane... wish we were rich to help you out!


Rachel Stella said...

James Rowell's professional route was looking better by the second as I read your post. lol. You get to save lives though, he only saves computers :)

Linz said...

From Facebook:
Jason Wilson i feel you james - i just wrote the $757 check for my license as well...but, that's one full day of moonlighting and it's the proportional tax at least is decreasing on us as our incomes and ability to get more $ increases!..
Thu at 5:26am ·

Todd BeckJust remember it's all front-load. You've got that huge payout coming on the back end. Oh, wait, no, maybe you don't. Vote Obama!
Thu at 7:25am ·

Tina Thorley Mattsson I hear you James. Our neighbor has been an attending for 2 years now and still had to pay to take a stupid test a few weeks ago. Of course one would think it would be easy to afford that now that he's done, but when you add up all the debt he's aquired over the last 17 years (4 for undergrad, 4 for medical school, 5 for residency, 2 for fellowship, 2 getting a practice started all with a family along the way) that $1500 become more of a stretch. It's never ending!
Thu at 7:43am · Delete

Chris BartholomaWow james, that's insane. No wonder Doctors charge such insane ammounts. They have to just to pay their student loans.
Thu at 10:09am ·

Samuel McKenzie Young BartlettBag it and become a janitor :)
I really liked Todd's comment!
Thu at 10:40am · Delete

Samuel McKenzie Young BartlettI just read your blog . . . Hmmm, maybe I better start rethinking things. . . (but really, I won't)
Love ya
Thu at 10:52am ·

Audra Munn GinesWe love you, just remember us when you are making obscene amounts of money!! xoxo
Thu at 1:38pm ·

James Rowell said...

Hang in there! It's almost over.