Becker: Only 14% of Young MD/DO's are Own Boss; Physiatrists Most Burned Out...

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14% of physicians under 40 years old are in private practice: 17 insights

Alan Condon - Thursday, September 30th, 2021 Print | Email
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Early-career physicians continue to favor employed opportunities over private practice as declining reimbursements, steep medical school debt and the cost of malpractice insurance premiums remain key factors driving career choices, according to the "Medscape Young Physician Compensation Report 2021."

Almost 2,500 "young physicians" — defined by Medscape as under 40 years old — participated in the survey, published Sept. 24. Data were collected from Oct. 6, 2020, through Feb. 11, 2021.

Here are 17 insights on early-career physician compensation, practice situation, gender pay gap and more:

1. Fourteen percent of physicians under 40 are self-employed, compared to 29 percent of physicians between 40 and 69 years old.

2. On average, specialists in the survey reported earning an annual salary of $304,000, compared to $200,000 for primary care physicians. For physicians overall, specialists earn $344,000 and primary care physicians earn $243,000.

3. On average, male physicians under 35 years old earn $281,000 and women of the same age range earn $197,000.

4. Among physicians under 40 years old, 46 percent are women, compared to 35 percent among physicians between 40 and 69 years old.

5. The largest income disparity between male and female physicians occurs at 35 to 54 years old, where men earn $346,000 on average compared to $248,000 for women.

6. Early-career physician compensation based on practice situation:

Office-based single-specialty group practice: $295,000
Hospital: $282,000
Office-based multispecialty group practice: $272,000
Academic (nonhospital), research, military, government: $268,000
Healthcare organization: $266,000
Outpatient clinic: $200,000

7. Among survey respondents, emergency medicine (69 percent), psychiatry (68 percent) and radiology (68 percent) specialists were among those most satisfied with their pay.

8. Respondents specializing in gastroenterology (44 percent), orthopedics (47 percent) and otolaryngology (48 percent) ranked the lowest in terms of compensation satisfaction.

9. Twenty-one percent of physicians under 40 deferred or refinanced mortgages or student loans in 2020.

10. Percentage of certain ethnicities and races represented in physicians under 40:

White: 55 percent
Asian: 26 percent
Black: 7 percent
Other: 6 percent
Mixed: 3 percent
Prefer not to answer: 8 percent
11. Four percent of physicians under 40 years old reported spending more than 65 hours a week with patients, while 19 percent reported spending less than 30 hours a week.

12. Ten percent of respondents said that they spend less than five hours a week on administrative work, compared to 36 percent who reported spending more than 20 hours a week.

13. Relationships with patients (26 percent), helping others (26 percent) and finding answers/diagnoses (20 percent) were among the most rewarding parts of early-career physicians' jobs.

14. Dealing with difficult patients (20 percent) and working with many rules and regulations (20 percent) were among the biggest challenges for physicians under 40 years old. Seven percent of respondents cited EHRs as a challenge.

15. If given the choice, 76 percent of respondents said they would choose medicine again.

16. Those in critical care (88 percent), ophthalmology (88 percent) and gastroenterology (87 percent) were most likely to pursue medicine again. Just 56 percent of physical medicine and rehabilitation physicians said that they would pursue medicine again.

17. One-hundred percent of gastroenterologists said that they would choose their specialty again, compared to 73 percent of internal medicine and family medicine specialists.

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Just 56 percent of physical medicine and rehabilitation physicians said that they would pursue medicine again.
Those doing inpatient probably brought that avg down. Ugh
 
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“You know it's hard out here for a pimp
When he tryin to get this money for the rent
For the Cadillacs and gas money spent”

Starting a private practice is a bit scary. Totally different hustle than Med school and residency.

Resources are scattered an unfortunately, it’s dog eat dog so can’t reliably ask folks in your area for guidance.
 
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I am amazed 88% of critical care physicians polled last fall to winter had the same career satisfaction as ophthalmologists. All the ones I know are pissed off and burnt out. That must have been free pizza season.
 
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“You know it's hard out here for a pimp
When he tryin to get this money for the rent
For the Cadillacs and gas money spent”

Starting a private practice is a bit scary. Totally different hustle than Med school and residency.

Resources are scattered an unfortunately, it’s dog eat dog so can’t reliably ask folks in your area for guidance.

 
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I can't imagine why someone wouldn't want to be their own boss or own their own practice/have %age in one. I'd rather make less money but having my own autonomy/business than getting paid more but being an employee. Aside from the priceless freedom of not answering to anyone, I'm happier, far more confident in myself and 1099 perks are great. Also, as a Doctor, being an employee is terrible especially if you work for a hospital or private equity. You take all the liability and risk, they collect all the money and your blood, sweat, and tears. Without you, the business doesn't operate, but you're treated like a dog while they stroll in pissed why you're not doing enough procedures to help pay off their Ferrari.
 
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Do u really believe private practice docs make less on the long haul?
 
New grad here working in a HOPD as an employee. I’m making a very, very fair base salary and the job has been the most easygoing and low pressure experience I could have imaged. Great benefits. Perfect place to start out and have time to make careful decisions. Patients love all the time and attention. Couldn’t be happier.
 
New grad here working in a HOPD as an employee. I’m making a very, very fair base salary and the job has been the most easygoing and low pressure experience I could have imaged. Great benefits. Perfect place to start out and have time to make careful decisions. Patients love all the time and attention. Couldn’t be happier.

...they will never love you back...
 
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the fantasy, and the reality for some, is that "employees" dont have to worry about anything but punching in and out, and practicing medicine, which is what everyone wanted when going to medical school. They dont want to manage a practice. They dont want to run a business. They never wanted to be their own boss. They never wanted to be responsible for a bunch of staff and their families.

Neither did i. But i quickly found out i had to when my previous boss/job didnt work out. I realized how much they were making off of my labor. I love it now. Im the master of my own domain. I love controlling my own life. I like being responsible for my staff and their families. I loved seeing the smile on their kids faces when they opened up PS5's last Christmas(even though i paid double). It is worth it.
 
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...they will never love you back...

if you are looking for love from hospital administrators then you might want to re-think your romance decisions.
 
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For those of you in private practice, what would you say your monthly collection percentage is relative to billing?
 
For those of you in private practice, what would you say your monthly collection percentage is relative to billing?
What do you mean?

Do you mean the amount you bill to the amount you actually collect? If so, it's kind of meaningless since what you bill is somewhat arbitrary and you can bill any amount you wish.

Or, do you mean the percentage of claims that get billed to those which are paid and not denied? If so, this number should eventually be very close to 100%.
 
I guess to each their own but this and this

I can't imagine why someone wouldn't want to be their own boss or own their own practice/have %age in one. I'd rather make less money but having my own autonomy/business than getting paid more but being an employee. Aside from the priceless freedom of not answering to anyone, I'm happier, far more confident in myself and 1099 perks are great. Also, as a Doctor, being an employee is terrible especially if you work for a hospital or private equity. You take all the liability and risk, they collect all the money and your blood, sweat, and tears. Without you, the business doesn't operate, but you're treated like a dog while they stroll in pissed why you're not doing enough procedures to help pay off their Ferrari.

the fantasy, and the reality for some, is that "employees" dont have to worry about anything but punching in and out, and practicing medicine, which is what everyone wanted when going to medical school. They dont want to manage a practice. They dont want to run a business. They never wanted to be their own boss. They never wanted to be responsible for a bunch of staff and their families.

Neither did i. But i quickly found out i had to when my previous boss/job didnt work out. I realized how much they were making off of my labor. I love it now. Im the master of my own domain. I love controlling my own life. I like being responsible for my staff and their families. I loved seeing the smile on their kids faces when they opened up PS5's last Christmas(even though i paid double). It is worth it.
 
But patients love us in PMR! 😂

 
...they will never love you back...
I’m not expecting anything like love from them. Just saying I don’t see why this is considered to be such a bad deal, especially for someone just starting out. I’m on a short term contract and can of course leave anytime this stops being a nice low pressure job. In private practice I would be making less in take home pay, have less vacation time, fewer benefits, and would be rushed and seeing way more patients per day.
 
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I’m not expecting anything like love from them. Just saying I don’t see why this is considered to be such a bad deal, especially for someone just starting out. I’m on a short term contract and can of course leave anytime this stops being a nice low pressure job. In private practice I would be making less in take home pay, have less vacation time, fewer benefits, and would be rushed and seeing way more patients per day.

Not everyone is cut out for private practice. It's a 5 AM to 9 PM job.
 
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I’m not expecting anything like love from them. Just saying I don’t see why this is considered to be such a bad deal, especially for someone just starting out. I’m on a short term contract and can of course leave anytime this stops being a nice low pressure job. In private practice I would be making less in take home pay, have less vacation time, fewer benefits, and would be rushed and seeing way more patients per day.
In private practice (assuming ownership), the ratio of pay relative to effort increases over time. Early on you will work more and make less than at a hospital job, but you are putting in the groundwork to enjoy that later success.

It's analogous to renting vs buying a house. With renting, you pay a fixed amount per month, usually not much, they take care of all maintenance. When you buy, you have closing costs, repairs, mortgage interest, but over time, you equity and value goes up, plus you have something to sell.
 
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I’m not expecting anything like love from them. Just saying I don’t see why this is considered to be such a bad deal, especially for someone just starting out. I’m on a short term contract and can of course leave anytime this stops being a nice low pressure job. In private practice I would be making less in take home pay, have less vacation time, fewer benefits, and would be rushed and seeing way more patients per day.
Are you on a guaranteed base for the entirety of the contract? If so, how long is the contract? Some HOPD gigs guarantee a base for 1-2 years and then put you on production.
 
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If you are private and have shares in an asc that cranks, you can do very well. It’s also geographic. I know people in different parts the country that are making a killing off of asc distribution. One guy is in Georgia and the other group is in bucks county PA. Each shareholder of the group in PA takes home 20k in distribution per month...
 
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Are you on a guaranteed base for the entirety of the contract? If so, how long is the contract? Some HOPD gigs guarantee a base for 1-2 years and then put you on production.
Contract renews yearly but is only for one year at a time. Guaranteed base first 2 years.
 
In private practice (assuming ownership), the ratio of pay relative to effort increases over time. Early on you will work more and make less than at a hospital job, but you are putting in the groundwork to enjoy that later success.

It's analogous to renting vs buying a house. With renting, you pay a fixed amount per month, usually not much, they take care of all maintenance. When you buy, you have closing costs, repairs, mortgage interest, but over time, you equity and value goes up, plus you have something to sell.
Yeah I get that, but I’m tired of delayed gratification at this point and am more than happy doing this for a couple years with a great base salary while I start actually living my life for once. Lots of the private practice jobs weren’t offering partnership either, or offered a pretty tenuous partnership track. No one wants to risk offering partnership to someone right out of training I guess.
 
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Contract renews yearly but is only for one year at a time. Guaranteed base first 2 years.

What happens after the first 2 years? In my set up nothing changes. In many places you’re converted to production only.
 
Nyc, Miami, LA, SF, SD(not Dakota) seattle, austin, Honolulu, denver, etc…

Are there many of these new grad jobs at 600k working 32 hours a week with no call and 8 weeks vacation in these locations?

Please don’t tell me about the burbs. City limits office only please.

I’m honestly curious. The salaries have more than doubled in 10 or so years if true.
 
Nyc, Miami, LA, SF, SD(not Dakota) seattle, austin, Honolulu, denver, etc…

Are there many of these new grad jobs at 600k working 32 hours a week with no call and 8 weeks vacation in these locations?

Please don’t tell me about the burbs. City limits office only please.

I’m honestly curious. The salaries have more than doubled in 10 or so years if true.
lol

On the off chance you're serious. No.
 
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