Fuck no, I mean payoff as in interacting with people and helping them. I actually don't give a shit about salary, as long as it gets me through life I'm fine. I'm joining my uncle in a trek to Africa in a few years (provided I make it through med school without dying), so I'm pretty damn hype for that!
Please don't say that when you are interviewing for residency!
Because that is one of the first questions they ask you. If you say "I like to interact with people and help them" then they will say "then why are you becoming a doctor? Why not become a social worker instead?"
My personal reasons to becoming a doctor so people can see where I am coming from:
*Job security/stability. It's very difficult to get laid off or fired as a doctor. There is always demand for doctors and under the Affordable health care there is even more of a demand in the states.
*Transferability. If say my wife is an architect but she can only work in big cities... it is easier for me to relocate and transfer my job than it is for her to do the same for me. In fact I can transfer across countries as well and me being a multinational citizen is a big plus for me.
*Salary that is fair with the level of difficulty of the job. There are many difficult jobs out there that don't pay as well as they should... but you are well compensated for the work you do as a doctor. This is really more of a "doctors are fine, everyone else is just really behind".
*A talentless person can still be a decent doctor and provide for his/her family. What I mean by this is that in certain fields a certain level of innate talent is required to excel in the field otherwise you just can't survive. Sports are one example of this as are fields that require artistic talent. You don't need innate talent to be a doctor, you need average IQ, decent social skills and (most importantly) the capacity to do hard work. Many people can become a doctor if they put in the work.
There are other reasons too but these were the main reasons for me.