Go into medicine if you really want to get rich

I know money can’t buy you love, but wouldn’t it be nice to have enough money to buy whatever else you want?

I’m here to help you!

The most likely way to become rich is to try to get into a line of work that’s hard to get into, particularly if the people in that profession are the ones setting the rules for entry.

For example, if you want to become rich, tech may be a less likely way than you suppose. In 2019, about 2.4% of software developers made it to the top 1% of earners. As economist Jonathan Rothwell points out in his book, “A Republic of Equals,” as of 2015 there were nearly eight times as many software developers in this country as there were dentists, but nearly as many dentists in the top 1% as there were software developers.

The odds are also against you if you go into the STEM professions. Just about 2.2% of electrical engineers made it to the top 1%, just about 3.3% of chemical engineers did and about 0.8% of industrial engineers did. The arts aren’t so hot either. Even just among people who manage to make a living as an actor, a director or a producer, just about 2.1% made it to the tippy top.

What’s wrong with all these professions? That’s simple: These are highly competitive, innovative and productive industries where global competition drives down earnings. You want to go into a profession protected by strong professional organizations and state legislators who will shield you from global competition and productivity growth.

So what profession is most likely to get you rich? Medicine! You get to save lives and make bank all at once! One third of doctors overall, including about 58.6% of surgeons, are in the top 1% of earners. There are more doctors and surgeons in the top 1% than any other job category. According to Rothwell’s book, in Spain, Sweden and Iceland, doctors earn twice as much as the average worker, but in the United States physicians and surgeons earn nearly five times as much.

Why is that? First, there’s our screwed-up health care system in which nearly 18% of gross domestic product flows into medicine and disproportionately toward a relatively small number of doctors. Second, there are huge barriers of entry into that profession — including, of course, the strenuous education that’s required. The number of medical school students is limited. In 2018-2019, only 41% of applicants who applied to medical school actually got into one. Plus, a 1997 federal law capped the number of residency slots that Medicare funds would support.

It typically takes a minimum of 11 years of difficult training to become a doctor, costing hundreds of thousands of dollars. Once you’re a doctor, you are protected by state laws from competition from lower-cost workers. Rothwell cites research suggesting that nurse practitioners and dental hygienists can perform many duties now done by doctors and dentists, at lower cost.

You could go into law. Census data for 2019 shows that about 14.5% of lawyers are in the top 1% of earners. And for some of the same reasons: high barriers to entry, limits on competition from less costly alternatives and limits on innovation. For example, in most states it’s illegal for a nonlawyer to own a law firm. If some MBA has an innovative idea for how to streamline practices, she is not allowed to start a firm and use that idea.

If that doesn’t float your boat, try getting a job in venture capital, hedge funds or private equity. Don’t go into consumer banking. Companies with low-fee options, like those introduced by Vanguard, can’t pay the big bucks. The real money is in managing those higher-end investment vehicles to which only rich people and institutions have had easy access. For reasons that seem to mystify everyone, pension fund managers are willing to pay ridiculously high fees to people in those professions, so there are tons of money to be made. About 5% of financial managers are in the top 1% of earners.

Once you’ve made some money, there’s one more way to get richer. Buy a home in a neighborhood with a lot of zoning restrictions. For example, 84% of the land in Charlotte, North Carolina, and 94% of the land in San Jose, California, is zoned for detached single-family homes. These restrictions keep the supply of housing low and jack up the value of homes for people wealthy enough to already own one.

My main message is that if you want to get rich, don’t invent a new and useful product, start a company and try to sell it. Put the effort into entering a clubby line of work in which legislators and professional associations are working to make you rich. It’s easier!