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Glad I'm not a physician. Good read if you are interested in becoming a physician. Not to make it political, but with Obamacare and reduced reimbursements, the income of physicians will likely decrease with increase in work load.


Physicians spend about 40,000 hours training and over $300,000 on their education, yet the amount of money they earn per hour is only a few dollars more than a high school teacher. Physicians spend over a decade of potential earning, saving and investing time training and taking on more debt, debt that isnít tax deductible. When they finish training and finally have an income Ė they are taxed heavily and must repay their debt with what remains. The cost of tuition, the length of training and the U.S. tax code places physicians into a deceptive financial situation.

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The biggest negative impact on physician's net worth is not Obamacare or really any other form of managed care.

It's their own consistently, incredibly poor investment judgement.

Yep. You don't do it for the money.

misterspaghetti said:   Yep. You don't do it for the money.

That's fantasy thinking. We all (minus hipsters supported by parents) all do something for joy and money. At some point, money enters the equation.

Not saying most of what you said isnt valid, but currently most physicians take advantage of the PSLF program. Pay the minimum on their loans for 10 years, and since theyre working for a non profit, the balance is forgiven.

Also, this is worst case... 100k for ugrad, 250k for med school, unable to at least maintain the balance while in a residency, 80 hr weeks 50 weeks a year? lol someone is trying to make a point. All of my medical friends have done all 4 of those things better than this article suggests.

Finally, the loan interest deduction phases out at like 60k if single, not 115k (i know this because I couldnt take it this year)

Also, the teacher pension part is lol, gl getting a pension 40 years from now.

OMG, really???? I work with physicians EVERY DAY. I don't shed any tears for them or their financial health and well-being. If they don't have a lot to show for their work, they either do a lot of charity work/involved in docs without borders type stuff (rare as hen's teeth) or they're too arrogant and egotistical to admit they need to hire a financial manager. Puhleez.

ingenue007 said:   Link

Glad I'm not a physician. Good read if you are interested in becoming a physician. Not to make it political, but with Obamacare and reduced reimbursements, the income of physicians will likely decrease with increase in work load.


Physicians spend about 40,000 hours training and over $300,000 on their education, yet the amount of money they earn per hour is only a few dollars more than a high school teacher. Physicians spend over a decade of potential earning, saving and investing time training and taking on more debt, debt that isnít tax deductible. When they finish training and finally have an income Ė they are taxed heavily and must repay their debt with what remains. The cost of tuition, the length of training and the U.S. tax code places physicians into a deceptive financial situation.
Not really. Population and demand for healthcare continue to increase faster than the pace of the growth in trained doctors due to their monopolistic hold of the industry which means they will still drive BMWs and live in McMansions.

I've said it before - across the globe what makes a health care sytem good or bad is not it's fairness, but it's efficiency. Effiecient social systems are good, inefficient social systems are bad. Efficient private systems are good, inefficient private systems are bad. WE can villify one group to engage another or reduce incentives in one group to incentivise the other, we can change from one form to another once every four years, you're just pushing your vegetables around the plate! Until you make the system more efficient, you have accomplished nothing.

BEEFjerKAY said:   The biggest negative impact on physician's net worth is not Obamacare or really any other form of managed care.

It's their own consistently, incredibly poor investment judgement.

Some of the best investment advice I've ever gotten - When doctors buy -- sell.

BEEFjerKAY said:   The biggest negative impact on physician's net worth is not Obamacare or really any other form of managed care.

It's their own consistently, incredibly poor investment judgement.


Care to explain?

ChumChurum said:   Care to explain?

They spend a lot of time focusing on their pre-med and med school studies ... which tends to crowd out getting broader life experiences.

By the time they do get their license -- or worse yet, their specialization -- they tend to confuse their brilliance in one narrow field with the ability to be brilliant in all things. Not true.

Looking down upon business people in general as mere "suits", doctors tend to underestimate the complexity of investments. They also are susceptible to flattery.

Varies by generation, of course.

ingenue007 said:   misterspaghetti said:   Yep. You don't do it for the money.

That's fantasy thinking. We all (minus hipsters supported by parents) all do something for joy and money. At some point, money enters the equation.


Wait. Then what is this thread about?

maxfleischer said:   OMG, really???? I work with physicians EVERY DAY. I don't shed any tears for them or their financial health and well-being. If they don't have a lot to show for their work, they either do a lot of charity work/involved in docs without borders type stuff (rare as hen's teeth) or they're too arrogant and egotistical to admit they need to hire a financial manager. Puhleez.

The second part is wrong. Ill be working a few extra years bc of the professional advice i trusted. I think many doctors are like myself and mistakenly believe that those in the financial industry act like other doctors except that their specialty is in finances. They dont recognize that most are just sales people.

Most physicians would be best served by a boglish investment style and staying away from the permanent insurance sales person. Id bet its close to 100% of physicians whom have been approached with whole life as an investment from a "professional".

It is also unknown if and how much obamacare will affect physicians financially at this time. It doesnt sound like its gonna be in our favor but the truth is that its an unknown at this point.

jkimcpa said:   ingenue007 said:   Link

Glad I'm not a physician. Good read if you are interested in becoming a physician. Not to make it political, but with Obamacare and reduced reimbursements, the income of physicians will likely decrease with increase in work load.


Physicians spend about 40,000 hours training and over $300,000 on their education, yet the amount of money they earn per hour is only a few dollars more than a high school teacher. Physicians spend over a decade of potential earning, saving and investing time training and taking on more debt, debt that isnít tax deductible. When they finish training and finally have an income Ė they are taxed heavily and must repay their debt with what remains. The cost of tuition, the length of training and the U.S. tax code places physicians into a deceptive financial situation.
Not really. Population and demand for healthcare continue to increase faster than the pace of the growth in trained doctors due to their monopolistic hold of the industry which means they will still drive BMWs and live in McMansions.


jkim, you make this point every time and every time someone explains that docs don't control the supply of practicing physicians - Medicare does (through its funding of residency programs). Do you even care that what you're saying is wrong?

ingenue007 said:   Link
yet the amount of money they earn per hour is only a few dollars more than a high school teacher.


WTH are you (or the author) smoking?

Firstly - high school teachers who have been around for a bit get paid pretty well. It is highly dependent on district, but can easily get into six figures. They also have amazing insurance and other benefits - like most union jobs.

That being said - many teachers are underpaid, but many teachers are also inept. This country needs a better way to identify efficient teachers and reward them - and not tenure in with these benefits those that care less about their job.

While a doctor certainly goes through more schooling (probably 3x as much) as most H.S. teachers, they also get paid 3x as much. Please review one such survey:

http://www.profilesdatabase.com/resources/2011-2012-physician-sa...

That's an average starting salary of over $220K and a 6 year practicing average of well over $300K.

Most doctors who put in this amount of time and energy deserve this type of salary. It is a grueling education and generally extremely long hours until they are established enough with a practice that they can be more flexible.
I liken this almost 10-15 year investment in school and work like someone putting in the energy to a start up - except they are investing in their own skills instead.

But, to say that they make a living that is only marginally better than a H.S. teacher? cry me a river...

Well, I'll toss this out here:

I'm a primary care physician in the midwest.

If you're worried, please don't shed any tears for me. I feel pretty comfortable with my salary. Also, I have more job security than almost anyone I know.

Would I tell someone going to med school to go into primary care? Probably not... specialty is a much better investment. But I'm happy and love my job.

So wipe away those tears, fellow fatwalleters... Weep not for those in the top 5%!!

dhodson said:   maxfleischer said:   OMG, really???? I work with physicians EVERY DAY. I don't shed any tears for them or their financial health and well-being. If they don't have a lot to show for their work, they either do a lot of charity work/involved in docs without borders type stuff (rare as hen's teeth) or they're too arrogant and egotistical to admit they need to hire a financial manager. Puhleez.

The second part is wrong. Ill be working a few extra years bc of the professional advice i trusted. I think many doctors are like myself and mistakenly believe that those in the financial industry act like other doctors except that their specialty is in finances. They dont recognize that most are just sales people.

Most physicians would be best served by a boglish investment style and staying away from the permanent insurance sales person. Id bet its close to 100% of physicians whom have been approached with whole life as an investment from a "professional".


I never mentioned insurance. I spent a LOT of time selecting my cardiologist; perhaps you should have spent a little more time investigating your financial manager.

BenH said:   
Firstly - high school teachers who have been around for a bit get paid pretty well. It is highly dependent on district, but can easily get into six figures. They also have amazing insurance and other benefits - like most union jobs.

That being said - many teacher's are underpaid, but many teachers are also inept. This country needs a better way to identify efficient teachers and reward them - and not tenure in with these benefits those that care less about their job.


Definitely HIGHLY dependent on district. If my SO school district in Texas, a teacher with 20 years experience makes under $60k.

maxfleischer said:   dhodson said:   maxfleischer said:   OMG, really???? I work with physicians EVERY DAY. I don't shed any tears for them or their financial health and well-being. If they don't have a lot to show for their work, they either do a lot of charity work/involved in docs without borders type stuff (rare as hen's teeth) or they're too arrogant and egotistical to admit they need to hire a financial manager. Puhleez.

The second part is wrong. Ill be working a few extra years bc of the professional advice i trusted. I think many doctors are like myself and mistakenly believe that those in the financial industry act like other doctors except that their specialty is in finances. They dont recognize that most are just sales people.

Most physicians would be best served by a boglish investment style and staying away from the permanent insurance sales person. Id bet its close to 100% of physicians whom have been approached with whole life as an investment from a "professional".


I never mentioned insurance. I spent a LOT of time selecting my cardiologist; perhaps you should have spent a little more time investigating your financial manager.


insurance is one of the most common investments doctors lose money on. I did the typical things one might do but there just isn't a good system to find the right advisor. For investments once you know enough to pick the right advisor, you typically don't need one. Low cost index investing is the best strategy for most docs. Additionally I don't know any docs who pick stocks directly or just think they know best. I'm sure some exist. Most of their bad investments were some expert's idea.

misterspaghetti said:   jkimcpa said:   ingenue007 said:   Link

Glad I'm not a physician. Good read if you are interested in becoming a physician. Not to make it political, but with Obamacare and reduced reimbursements, the income of physicians will likely decrease with increase in work load.


Physicians spend about 40,000 hours training and over $300,000 on their education, yet the amount of money they earn per hour is only a few dollars more than a high school teacher. Physicians spend over a decade of potential earning, saving and investing time training and taking on more debt, debt that isnít tax deductible. When they finish training and finally have an income Ė they are taxed heavily and must repay their debt with what remains. The cost of tuition, the length of training and the U.S. tax code places physicians into a deceptive financial situation.
Not really. Population and demand for healthcare continue to increase faster than the pace of the growth in trained doctors due to their monopolistic hold of the industry which means they will still drive BMWs and live in McMansions.


jkim, you make this point every time and every time someone explains that docs don't control the supply of practicing physicians - Medicare does (through its funding of residency programs). Do you even care that what you're saying is wrong?
If doctors wanted to talk a 50% haircut and double the number of physicians, or lobby the gov't to increase the funding for residencies, I'm sure their genius brains could figure out a way to double residencies and/or find another way to accommodate such a goal. The problem is 1) you people don't even try as it props up your lifestyle and 2) lobby to fight any kind of innovation or efficiency that would reduce the cost of medicine (aka reduce your artificially high salaries).

You can repeat the same propaganda all you want; fortunately the laws of economics are free to be learned by those who seek the knowledge as it's not hoarded by some medieval guild.

jkimcpa said:   misterspaghetti said:   jkimcpa said:   ingenue007 said:   Link

Glad I'm not a physician. Good read if you are interested in becoming a physician. Not to make it political, but with Obamacare and reduced reimbursements, the income of physicians will likely decrease with increase in work load.


Physicians spend about 40,000 hours training and over $300,000 on their education, yet the amount of money they earn per hour is only a few dollars more than a high school teacher. Physicians spend over a decade of potential earning, saving and investing time training and taking on more debt, debt that isnít tax deductible. When they finish training and finally have an income Ė they are taxed heavily and must repay their debt with what remains. The cost of tuition, the length of training and the U.S. tax code places physicians into a deceptive financial situation.
Not really. Population and demand for healthcare continue to increase faster than the pace of the growth in trained doctors due to their monopolistic hold of the industry which means they will still drive BMWs and live in McMansions.


jkim, you make this point every time and every time someone explains that docs don't control the supply of practicing physicians - Medicare does (through its funding of residency programs). Do you even care that what you're saying is wrong?
If doctors wanted to talk a 50% haircut and double the number of physicians, or lobby the gov't to increase the funding for residencies, I'm sure their genius brains could figure out a way to double residencies and/or find another way to accommodate such a goal. The problem is 1) you people don't even try as it props up your lifestyle and 2) lobby to fight any kind of innovation or efficiency that would reduce the cost of medicine (aka reduce your artificially high salaries).

You can repeat the same propaganda all you want; fortunately the laws of economics are free to be learned by those who seek the knowledge as it's not hoarded by some medieval guild.


First off: I'm not a doc, so save the childish finger pointing.

Secondly, physicians have tried for more than a decade to push congress to increase residency funding. Obamacare was their first major success in that arena. I don't buy your "if they wanted to do it, they could figure out a way" attitude. That's like me saying that if you really wanted to be a billionaire, you could figure out a way. It isn't that simple.

sigh can any doctors out there give me advice? i'm a third year med student. school itself is not a pleasant experience. i got a 232 on step 1, but 3rd year grades are not going well... just passing. i was thinking of going into peds, but person above said he wouldn't recommend primary care in retrospect? i feel like i may like peds because 1.) helping cute kids who are sick without illnesses they control 2.) being able to be an advocate for kids who often may not have one

misterspaghetti said:   
Secondly, physicians have tried for more than a decade to push congress to increase residency funding. Obamacare was their first major success in that arena. I don't buy your "if they wanted to do it, they could figure out a way" attitude. That's like me saying that if you really wanted to be a billionaire, you could figure out a way. It isn't that simple.


Ha, they tried to get government funding for free labor? What about allowing a new medical school to open? What about allowing doctors to immigrate? Those are the things that matter and are within the control of the AMA.

The article starts off with insane assumptions. $100k debt and 40 hours a week for a bachelors degree? Its quite possible to get into a good medical school with 1/3 of that debt (or less) and for "working" 15-20 hours a week on classes.

One thing that I've noticed recently is that while a lot of people think MD's make big money, for the time/effort put in I think physician assistants have it best. PA jobs require a masters level degree and from the ones I know the programs are not that competitive in terms of admission. I am good friends with one PA in particular who went to a below average state school for almost no debt and a below average private school for his PA masters degree for $30k. For a total debt of $35k, he got a job offer even though he admits he had mediocre academic performance and his first year was being paid $85k plus a bonus in a town where the median income is $30k. I talked to him a few months ago and hes now making $100k+ (~2 years later) and works 30 hours a week. He is out the door at noon on Fridays to go golf.

Quite a good deal...

misterspaghetti said:   Yep. You don't do it for the money.We do it for H&B.

None of our family docs earn less than $200k and some of our specialists make $750k. Plus benefits. I wouldn't break out the violins quite yet. That said I'm making hay while the sun shines... And I don't know what the landscape will look like in twenty years.

I have not had a chance to read the whole thread.
However, it is ironic that I am driving home now after spending the night dealing with emergencies and emergent procedures.
Going home to lay down for 2 hrs before I have to go in again.
The 1230 am phone call awoke my family as usual; my two year old isn't used to it yet.
(And I'm in a fairly benign specialty!)

So, yeah, medicine kind of sucks. It still reimburses reasonably well, but it's something you really, really need to want to do or it's not for you.

linkin06 said:   sigh can any doctors out there give me advice? i'm a third year med student. school itself is not a pleasant experience. i got a 232 on step 1, but 3rd year grades are not going well... just passing. i was thinking of going into peds, but person above said he wouldn't recommend primary care in retrospect? i feel like i may like peds because 1.) helping cute kids who are sick without illnesses they control 2.) being able to be an advocate for kids who often may not have one
OT but just wondering - how can you see sick kids all day without catching their illness too? Are dr superhuman a d immune to all these sick kids , or do they miss half the year working because the dr themselves are ill?

I'd rather work on people with injuries than contagious disease. Then again , I'd rather just work with a book, pen and computer and not deal with anyone in person

ingenue007 said:   misterspaghetti said:   Yep. You don't do it for the money.

That's fantasy thinking. We all (minus hipsters supported by parents) all do something for joy and money. At some point, money enters the equation.


Do something you enjoy doing, sure.
But I'd be careful about doing something "for the money". Money is a means to an end. Decide first what you want that end to be, then how to get there, then let the money flow.

Case in point: Did you know that baggage porters at major airports can make more than $100,000 a year? Salary is minimum but the tips are very good. If you're in it for the money, you should go and be a baggage porter. But for most of us, that would be a rather unfulfilling life.

I suspect physicians, even poor ones, get a lot more satisfaction out of their jobs (and lives) than most others.

My daughter is currently working towards a BS. She is currently a licensed medical Esthetician- her final plans are to become a dermatologist. She has never swayed from her desire to do this.... and yes it is because she thinks she will be rich but she is also a "by the book" person and would not deal in fads or other things that do not really work. I will keep encouraging her because what are the options? Corporate job slaving for people with less intellegence getting promoted faster and higher than you? Retail with it's crazy hours and rude customers? Research or accounting with it's tedious boring redundant paperwork? I've learned a long time ago some basics:
Most people have the money to do what they want OR the time to do what they want but few have both
Work hard now so you can play later OR play now and you'll have to work hard forever
Work is work and even if you love what you do, it is work - not a fun party-fest

linkin06 said:   sigh can any doctors out there give me advice? i'm a third year med student. school itself is not a pleasant experience. i got a 232 on step 1, but 3rd year grades are not going well... just passing. i was thinking of going into peds, but person above said he wouldn't recommend primary care in retrospect? i feel like i may like peds because 1.) helping cute kids who are sick without illnesses they control 2.) being able to be an advocate for kids who often may not have one

This may be the worst place to look for this kind of advice. Try studentdoctor.net

JohnGalt69 said:   misterspaghetti said:   
Secondly, physicians have tried for more than a decade to push congress to increase residency funding. Obamacare was their first major success in that arena. I don't buy your "if they wanted to do it, they could figure out a way" attitude. That's like me saying that if you really wanted to be a billionaire, you could figure out a way. It isn't that simple.


Ha, they tried to get government funding for free labor? What about allowing a new medical school to open? What about allowing doctors to immigrate? Those are the things that matter and are within the control of the AMA.


1. Residents are paid.

2. Increasing the number of medical schools or class size of existing medical schools will do ABSOLUTELY NOTHING toward increasing the number of practicing physicians without a commensurate increase in the number of residency spots. That is the bottle-neck. Think about it logically: if we have 100 medical school graduates and only 50 residency spots, why do you think increasing the number of medical school graduates would help?

3. They could potentially allow more docs to immigrate (they do allow many to do so now), but there is currently a requirement for US clinical experience prior to licensure. Keep in mind that docs try to come to the US from all over the world and from every kind of medical system imaginable. Without knowledge of how to function in this system, it's bad for both them and the patient. It's hard enough for a doc to go from practicing in one state to another - imagine going from a socialized system to this one.

Medical school has set rigorous standards for admission and licensure in the U.S. in attempt to keep quality up. Doing this on the one hand and then opening the flood gates to anyone who has trained in any kind of system with the other doesn't make a lot of sense.

SUCKISSTAPLES said:   linkin06 said:   sigh can any doctors out there give me advice? i'm a third year med student. school itself is not a pleasant experience. i got a 232 on step 1, but 3rd year grades are not going well... just passing. i was thinking of going into peds, but person above said he wouldn't recommend primary care in retrospect? i feel like i may like peds because 1.) helping cute kids who are sick without illnesses they control 2.) being able to be an advocate for kids who often may not have one
OT but just wondering - how can you see sick kids all day without catching their illness too? Are dr superhuman a d immune to all these sick kids , or do they miss half the year working because the dr themselves are ill?

I'd rather work on people with injuries than contagious disease. Then again , I'd rather just work with a book, pen and computer and not deal with anyone in person


There are several reasons. Precautions such as handwashing are very important, but by the time that a disease becomes symptomatic, it is often no longer contagious. And in the end, it's typically the same bugs over and over again. So you may come down with it the first time, but then you're immune for the next 25 that you see with the same issue. Keeping visits short also helps.

Sounds like you'd like pathology or radiology.

steve1jr said:   BenH said:   
Firstly - high school teachers who have been around for a bit get paid pretty well. It is highly dependent on district, but can easily get into six figures. They also have amazing insurance and other benefits - like most union jobs.

That being said - many teacher's are underpaid, but many teachers are also inept. This country needs a better way to identify efficient teachers and reward them - and not tenure in with these benefits those that care less about their job.


Definitely HIGHLY dependent on district. If my SO school district in Texas, a teacher with 20 years experience makes under $60k.

In California, some teacher's contract is for 181 days of work per year. School day started after 8:30 and finished before 3PM. Although teaching is a noble profession it is a good deal for some if they receive an early pension after 25 years as in the past. No guarantees for present or future teachers.
This holds true for physicians, since the government is substituting PA' s with 22 months of training as physician equivalents. Most new physicians are now employed by corporations who will take care of them (sic).

Hey bud. Here is my advice as I am a physician. DON'T GO INTO PEDIATRICS!!!! They make like 80k per year, and you have to deal with psycotic parents who are worried about little Johnie's behavioral problems preventing him from going to harvard in the future. If you really like pediattrics, I would recommend doing anesthesia and then doing a fellowship in pediatric anesthesia. I work days now, no weekends or overnights at a pediatric hospital and make about 350k. If you want to work weekends and overnight call you can make 500k/year pretty easily. It is fun and the kids are fun.

232 is a great step 1 score. Don't worry about the passes in the 3rd year clerkships. It is all subjective anyway, if you are a hot female you will get better grades. Just make sure to not piss anyone off.

bigtimesaver3652 said:   Hey bud. Here is my advice as I am a physician. DON'T GO INTO PEDIATRICS!!!! They make like 80k per year, and you have to deal with psycotic parents who are worried about little Johnie's behavioral problems preventing him from going to harvard in the future. If you really like pediattrics, I would recommend doing anesthesia and then doing a fellowship in pediatric anesthesia. I work days now, no weekends or overnights at a pediatric hospital and make about 350k. If you want to work weekends and overnight call you can make 500k/year pretty easily. It is fun and the kids are fun.

232 is a great step 1 score. Don't worry about the passes in the 3rd year clerkships. It is all subjective anyway, if you are a hot female you will get better grades. Just make sure to not piss anyone off.


Anesthesia. Interesting. You don't see many TV doctor shows about anesthesiologists - there's not the excitement of an ER doctor or a surgeon. Dare I say that for most people this speciality might be a bit boring? Important, yes, and vitally so for those going under. I imagine it takes a very specific personality type to do well as an anesthesiologist. What attracted you to the field?

BEEFjerKAY said:   

They spend a lot of time focusing on their pre-med and med school studies ... which tends to crowd out getting broader life experiences.

By the time they do get their license -- or worse yet, their specialization -- they tend to confuse their brilliance in one narrow field with the ability to be brilliant in all things. Not true.

Looking down upon business people in general as mere "suits", doctors tend to underestimate the complexity of investments. They also are susceptible to flattery.

Varies by generation, of course.


Another example: my cardiologist friend decided he wanted to manage his own investment. He has the whole set-up in his office and carried a pager which alerted him to market changes. Between seeing patients he would rush back to his office to check on the latest trends. While seeing patients he literally jumped whenever the pager beeped. He gave up a year later. He said he actually lost money and probably his mind trying to do it. Now he lets a professional financial guy manages his investment. One day he admitted he could do a heart catherization blind folded but that brilliance does not translate into knowing how to invest.

while im sure there are some peds making 80k in academic medicine, the average is likely double that.
http://www.medscape.com/features/slideshow/compensation/2012/pub...
these surveys have tons of holes in them from a research standpoint so i dont want to pretend its great evidence

still do your best to pick what you think you will like to do. it isnt an easy decision. you get very limited time in each field and some fields you dont rotatte in at all. no matter what field you pick, you can make a reasonable living. some certainly make a lot more than others but i wouldnt pick based soley on that criteria. If i liked two professions equally as well then id probably let money sway me but i wouldnt use money as the first defining criteria.

unfortunately everything counts. usmle, grades, letters, research, rotations. just do your best and dont rule anything out bc of a few average rotations. the more competitive the specialty the more little details matter. if you feel a few roations are keeping you back then try to boost another area like research. get to know someone in the dept of the field you want to pursue. The smaller the field, the more letters of recommendation from dept heads can make a difference.

Skipping 111 Messages...
arent the last bagels always a day old and a little hard. i try and pawn them off on my kids.



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