Family Med Salaries and the Future of the Specialty

[user3]

Your idea of EM is a little skewed. In EM you can work as little or as much as you want with the average being around 30-35 hours a week. EM salary is also location dependent. Big city equals less and BFE making well over 400s in some areas. With those hours, pay, no call, no clinic, high flexibility sounds good to me. I may be biased since that's what I'm going into though.

but according to birdstrike, 1 hour in ED = 1.5 hours in other specialties.

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[W19]

I don't think EM salary will stay that high in the next few years... 350k+/year for 30-36 hours/wk is unsustainable... People in EM should enjoy the gravy while it last...

 

[Mad Jack]

Why would anyone wanna go into EM should the salary drop to say 300k? At that point I dont think the long hours, detriment to your health, family, etc would be worth it to very many people (some wouldn't mind ofc and would still enter the field). I can't see that salary decreasing much; but then again, what do i know.

Well, the average hours being just shy of 1,700 per year is one draw lol. 300k is hardly a floor for EM salaries- maybe 250 and it starts to get less desirable.

 

[Mad Jack]

but according to birdstrike, 1 hour in ED = 1.5 hours in other specialties.

There is and there isn't truth to that. It really depends on how your schedule is structured. 3 12s in a row will murder you, but if they're broken up, they are much more survivable. And it really depends on the acuity of the ED- small town EDs can be very low volume, while inner city EDs can be too much volume for all but the most efficient providers to handle.

 

[Giovanotto]

Emergency medicine and family practice medicine are intrinsically related. As the shortage of PCPs continues, the number of EM physicians will only keep increasing. It makes sense, given that urgent care centers are on the rise and more and more people are going to them for primary care needs. However, if the number of mid-level providers (willing to do primary care) and PCPs does begin to rise and meet demand, EM will decline. I'm considering both specialties and will look at the current health care climate when time comes to decide.

 

[Mad Jack]

Emergency medicine and family practice medicine are intrinsically related. As the shortage of PCPs continues, the number of EM physicians will only keep increasing. It makes sense, given that urgent care centers are on the rise and more and more people are going to them for primary care needs. However, if the number of mid-level providers (willing to do primary care) and PCPs does begin to rise and meet demand, EM will decline. I'm considering both specialties and will look at the current health care climate when time comes to decide.

I doubt EM will see a great decline outside of urgent care. EM physicians function largely as liability sponges for hospitals. If they forego physicians for NPs and PAs, which largely operate on protocols in EDs, they will be putting their own ***es on the line when lawsuits happen. In EM, that is all the damn time.

The big thing people forget about midlevel creep is that there's still a function of physicians from a hospital's perspective in that they are autonomous enough to have the blame shoved on them, and their pockets are deep enough that lawyers will often settle for them as sole targets. Having a less experienced and qualified provider opens up a huge legal can of worms, and a few lawsuits can totally put a hospital underwater financially so that really isn't something they're willing to risk.

 

[Relentlessrook18]

Medicare pays ~$70 for a routine visit. Assuming your overhead is 50%, your take home would be ~$35 per patient. At this pace, you can see 20 pts a day, work 5 days a week, take 4 weeks off per year, and generate ~170k/year of income.

Thank you so much!

 

[asdf123g]

I'll take my 300k, and be off 18days a month. Lol. It's all relative. I'm looking at a gig paying almost 450k(50k of that is for loan repayment). Personally I'm working 20years and then doing solely Locums a few times a year or working two days a week in a rural ed if possible. This is all dependent on salaries not crashing of course.

5 weeks in a month X 2 weekend days = 10 days off for other specialties. I dont think its worth the damage to one's health. A college student can take those hours but when you hit your 40's, i think one would begin to sing a different tune. The malpractice has also gotta be through the roof!

 

[Makati2008]

5 weeks in a month X 2 weekend days = 10 days off for other specialties. I dont think its worth the damage to one's health. A college student can take those hours but when you hit your 40's, i think one would begin to sing a different tune. The malpractice has also gotta be through the roof!

To each his own. My malpractice will be covered by the group/hospital I work for so that's one area of no concern. Heck I can work 8days a month in rural Texas and still do well. Also you are making the assumption that there is no call for other specialities to get your 10days off. But again, it's not for everybody and I think audition rotations/sloes/ The Match does an acceptable job of weeding folks out.

 

[FutureDO2016]

Ibn Alnafis MD said: ↑
Medicare pays ~$70 for a routine visit. Assuming your overhead is 50%, your take home would be ~$35 per patient. At this pace, you can see 20 pts a day, work 5 days a week, take 4 weeks off per year, and generate ~170k/year of income.

Is this true now? I thought Medicare is cutting reimbursements yearly?

So I can work Monday-Friday 9 am to 7 pm seeing 4 patients for 10 hours a day so 40 patients a day and make close to 300K as a family med doc in a big city or suburb with 4-6 weeks of vacation a year?

 

[AMEHigh]

Ibn Alnafis MD said: ↑
Medicare pays ~$70 for a routine visit. Assuming your overhead is 50%, your take home would be ~$35 per patient. At this pace, you can see 20 pts a day, work 5 days a week, take 4 weeks off per year, and generate ~170k/year of income.

Is this true now? I thought Medicare is cutting reimbursements yearly?

So I can work Monday-Friday 9 am to 7 pm seeing 4 patients for 10 hours a day so 40 patients a day and make close to 300K as a family med doc in a big city or suburb with 4-6 weeks of vacation a year?

I don't know if 300k is accurate, but I do think it's possible to make above average family medicine money if you are business savvy and open your own practice or take over a retiring physicians practice. I know a few family med docs out there that are older that I think make decent money. However, obviously it's not very easy to start out as an attending fresh out of residency, open your own practice and voila make that kind of money. If you put the time/money/stress/effort in and do your own billing in your office I think it's possible to be rather profitable. I don't think most physicians who open their own practice in the beginning can take any kind of extended vacation the first several years especially. I also know several family med docs that spend some time doing nursing home care, which makes an ok amount of cash on the side. But as you probably know, the days of opening your own practice are kind of falling by the wayside, which means most physicians will be making whatever salary their employer decides to pay them.

 

[FutureDO2016]

I don't know if 300k is accurate, but I do think it's possible to make above average family medicine money if you are business savvy and open your own practice or take over a retiring physicians practice. I know a few family med docs out there that are older that I think make decent money. However, obviously it's not very easy to start out as an attending fresh out of residency, open your own practice and voila make that kind of money. If you put the time/money/stress/effort in and do your own billing in your office I think it's possible to be rather profitable. I don't think most physicians who open their own practice in the beginning can take any kind of extended vacation the first several years especially. I also know several family med docs that spend some time doing nursing home care, which makes an ok amount of cash on the side. But as you probably know, the days of opening your own practice are kind of falling by the wayside, which means most physicians will be making whatever salary their employer decides to pay them.

Yeah most private practices are being bought out by companies or affiliated hospitals and they salary the doctor with around $170-250K type salaries based on location, schedule, and experience.

 

[Giovanotto]

Yeah most private practices are being bought out by companies or affiliated hospitals and they salary the doctor with around $170-250K type salaries based on location, schedule, and experience.

Could it have to do with increasing student debt and real estate? I can't imagine taking out a 200k loan on top of student loans to open a practice.

 

[Rekt]

Could it have to do with increasing student debt and real estate? I can't imagine taking out a 200k loan on top of student loans to open a practice.

No. It has to do with seasoned physicians getting lured by seven-figure bonuses to sell their groups/practices. They can retire and not give any **** about future physicians. The company/affiliate works out a deal with the hospital where they split the money that would have been going to physicians who did profit-sharing in private groups. The physicians who don't quit or were unable try to find some other private group get stuck on a salary at a huge reduction in pay.

 

[Postictal Raiden]

Ibn Alnafis MD said: ↑
Medicare pays ~$70 for a routine visit. Assuming your overhead is 50%, your take home would be ~$35 per patient. At this pace, you can see 20 pts a day, work 5 days a week, take 4 weeks off per year, and generate ~170k/year of income.

Is this true now? I thought Medicare is cutting reimbursements yearly?

So I can work Monday-Friday 9 am to 7 pm seeing 4 patients for 10 hours a day so 40 patients a day and make close to 300K as a family med doc in a big city or suburb with 4-6 weeks of vacation a year?

http://www.aasmnet.org/resources/pdf/evaluationmanagement.pdf

 

[BorntobeDO?]

http://www.aasmnet.org/resources/pdf/evaluationmanagement.pdf

Decreased RVU by 4-7%? That sucks big time. Many of the bonuses I hear about are RVU based not payment based. I thought FP was relatively safe from cuts, and I guess payment wise its relatively similar. But if you are in the normal psuedopartner/employee model your bonus just took a hit. That sucks.

 

[asdf123g]

No. It has to do with seasoned physicians getting lured by seven-figure bonuses to sell their groups/practices. They can retire and not give any **** about future physicians. The company/affiliate works out a deal with the hospital where they split the money that would have been going to physicians who did profit-sharing in private groups. The physicians who don't quit or were unable try to find some other private group get stuck on a salary at a huge reduction in pay.

Lets be honest, who wouldn't take up that offer in the tail end of their career.
That aside, the corporatizing (sp?) of medicine isn't good at all..I did not know of this issue until now

 

[Postictal Raiden]

Decreased RVU by 4-7%? That sucks big time. Many of the bonuses I hear about are RVU based not payment based. I thought FP was relatively safe from cuts, and I guess payment wise its relatively similar. But if you are in the normal psuedopartner/employee model your bonus just took a hit. That sucks.

Yeah, but remember that things are more complicated than that. For example, the conversion factor was $31 in 1991 (equivalent to $54 in today's money), but the conversion factor right now is $35. This means, only based on the conversion factor, reimbursements have been reduced by nearly half. However, physicians today, with exceptions of few specialties, didn't suffer that much of a pay cut. FP's are still making over 200k and they didn't make that much higher back in the "golden era". This compels me to believe that there's more to the story than we know.

 

[group_theory]

Ibn Alnafis MD said: ↑
Medicare pays ~$70 for a routine visit. Assuming your overhead is 50%, your take home would be ~$35 per patient. At this pace, you can see 20 pts a day, work 5 days a week, take 4 weeks off per year, and generate ~170k/year of income.

Is this true now? I thought Medicare is cutting reimbursements yearly?

So I can work Monday-Friday 9 am to 7 pm seeing 4 patients for 10 hours a day so 40 patients a day and make close to 300K as a family med doc in a big city or suburb with 4-6 weeks of vacation a year?

Don't forget all the office phone calls that you have to review and return. Don't forget all the forms you have to fill out on your patients behalf (prior authorizations, FMLA, disability, sports camp physical, work physical, school physical, etc). Don't forget the insurance appeals/denials for tests/imaging that you want done, which may involve peer-to-peer review. You also have to fight rejection claims from insurance companies who do not want to pay you. You also have to have time to review labs and imaging results that you ordered on your patients. And that's just the medical aspect.

Are you using an EMR (which cost hundreds of thousands of dollars)? If not, the government will penalized you with decreasing reimbursement. Are you attesting to meaningful use requirements? Are you up to date since there are new requirements every year? If not, the government will penalized you by decreasing reimbursement. Are you involved in quality assurance/PQRS? If not, the government will penalized you by decreasing reimbursement. Are you, your staff, as well as the business/EMR HIPAA compliant? Are you prepare for random audits (whether for meaningful use, or Medicare RAC, or insurance audits)? What about random IRS audits since you are a small business owner with a lot of potential business deductions?

Do you have an office nurse or medical assistant? How about a good office manager (who can help with the above - don't want to skimp on salary or you can lose a good office manager)? Do you offer health care? Retirement? Remember, they are W2 employees while you are a private business owner ... so you have to pay the employer portion of their social security and medicare taxes. Don't forget the usual business insurances for the building, non-medically related business liability, etc.

Are your diabetics well controlled? Are your asthmatics well controlled? Are your patients getting all age appropriate cancer screening? What percentage of your patients still smoke? The future trend is to punish (or "reward") PCPs who have "good results" and punish doctors whose patients still smoke, eat fried food, and go into COPD exacerbation/DKA/CHF every other weekend ... by decreasing reimbursement

Oh, and while you deal with the above, don't forget to do some Maintenance of Certification stuff to maintain your board certification. And in most states, you also have to do some CMEs as well.



*one reason why I'm glad I'm not in primary care. I joined an established group that had everything already up and running, but starting out on your own, there are a lot to consider ... the above are just a small sample

 

[asdf123g]

@group_theory Well...now i know what i probably wont be getting into...

 

[67552931811]

Lets be honest, who wouldn't take up that offer in the tail end of their career.
That aside, the corporatizing (sp?) of medicine isn't good at all..I did not know of this issue until now

I wouldn't. Selling out the profession and thousands of colleagues isn't in the cards for me. Personally, I think those people should be moved into a proper 6 x 8 foot apartment.

 

[BorntobeDO?]

Yeah, but remember that things are more complicated than that. For example, the conversion factor was $31 in 1991 (equivalent to $54 in today's money), but the conversion factor right now is $35. This means, only based on the conversion factor, reimbursements have been reduced by nearly half. However, physicians today, with exceptions of few specialties, didn't suffer that much of a pay cut. FP's are still making over 200k and they didn't make that much higher back in the "golden era". This compels me to believe that there's more to the story than we know.

Aren't you supporting the argument that they are losing income by inflation with that statement? 200k now is worth about half what it was 20 years ago.

 

[Postictal Raiden]

Aren't you supporting the argument that they are losing income by inflation with that statement? 200k now is worth about half what it was 20 years ago.

According to surveys, FPs made in the low 100s back in the 1990s, which is equivalent to low 200's in today's dollar value.

http://www.turner-white.com/pdf/hp_jan00_phycomp1998.pdf

 

[kenjixshadow]

Don't forget all the office phone calls that you have to review and return. Don't forget all the forms you have to fill out on your patients behalf (prior authorizations, FMLA, disability, sports camp physical, work physical, school physical, etc). Don't forget the insurance appeals/denials for tests/imaging that you want done, which may involve peer-to-peer review. You also have to fight rejection claims from insurance companies who do not want to pay you. You also have to have time to review labs and imaging results that you ordered on your patients. And that's just the medical aspect.

Are you using an EMR (which cost hundreds of thousands of dollars)? If not, the government will penalized you with decreasing reimbursement. Are you attesting to meaningful use requirements? Are you up to date since there are new requirements every year? If not, the government will penalized you by decreasing reimbursement. Are you involved in quality assurance/PQRS? If not, the government will penalized you by decreasing reimbursement. Are you, your staff, as well as the business/EMR HIPAA compliant? Are you prepare for random audits (whether for meaningful use, or Medicare RAC, or insurance audits)? What about random IRS audits since you are a small business owner with a lot of potential business deductions?

Do you have an office nurse or medical assistant? How about a good office manager (who can help with the above - don't want to skimp on salary or you can lose a good office manager)? Do you offer health care? Retirement? Remember, they are W2 employees while you are a private business owner ... so you have to pay the employer portion of their social security and medicare taxes. Don't forget the usual business insurances for the building, non-medically related business liability, etc.

Are your diabetics well controlled? Are your asthmatics well controlled? Are your patients getting all age appropriate cancer screening? What percentage of your patients still smoke? The future trend is to punish (or "reward") PCPs who have "good results" and punish doctors whose patients still smoke, eat fried food, and go into COPD exacerbation/DKA/CHF every other weekend ... by decreasing reimbursement

Oh, and while you deal with the above, don't forget to do some Maintenance of Certification stuff to maintain your board certification. And in most states, you also have to do some CMEs as well.

*one reason why I'm glad I'm not in primary care. I joined an established group that had everything already up and running, but starting out on your own, there are a lot to consider ... the above are just a small sample

QFT.

 

[BorntobeDO?]

According to surveys, FPs made in the low 100s back in the 1990s, which is equivalent to low 200's in today's dollar value.

http://www.turner-white.com/pdf/hp_jan00_phycomp1998.pdf

I see. I thought you were suggesting that FP made 200k 'still,' as in just like they did before. But you were actually talking adjusted for inflation, in which FP do a little worse but not much.

 

[yanks26dmb]

Can a FM doc easily find extra work in an urgent care, etc to supplement income?

In other words, can a FM doc who is committed to working 50-60 hours a week, relatively easily pull in 300k a year?

 

[kenjixshadow]

Can a FM doc easily find extra work in an urgent care, etc to supplement income?

In other words, can a FM doc who is committed to working 50-60 hours a week, relatively easily pull in 300k a year?

Location, location, and location. Did I mention location? You will not pull 300k in SoCal, NoCal, Boston, NYC, etc. I've read somewhere on SDN that some FM attendings were able to pull 300k, but they worked their ass off.

 

[FutureDO2016]

Location, location, and location. Did I mention location? You will not pull 300k in SoCal, NoCal, Boston, NYC, etc. I've read somewhere on SDN that some FM attendings were able to pull 300k, but they worked their ass off.

But you can make 300K easily as a IM hospitalist in any major city? Can FM docs work as hospitalists full time in Chicago?

 

[hallowmann]

But you can make 300K easily as a IM hospitalist in any major city? Can FM docs work as hospitalists full time in Chicago?

Define easily. In the experience of multiple IM hospitalists I know in major cities, they are making ~$180-$240k at most. They're working 7 on, 7 off, so I suppose they could double it if they were machines, but the services in major cities tend to be much more intense and physically demanding. Most say they need 3-4 days to recover.

 

[Pisiform]

But you can make 300K easily as a IM hospitalist in any major city? Can FM docs work as hospitalists full time in Chicago?

Yes my sis is one. Not making 300 though, close to 200 14 on and 14 off and she is usually home by 1pm lol

 

[67552931811]

Define easily. In the experience of multiple IM hospitalists I know in major cities, they are making ~$180-$240k at most. They're working 7 on, 7 off, so I suppose they could double it if they were machines, but the services in major cities tend to be much more intense and physically demanding. Most say they need 3-4 days to recover.

You could do one overnight shift a week on your week off and that would REALLY drive your income up.

 

[hallowmann]

You could do one overnight shift a week on your week off and that would REALLY drive your income up.

I could see that, but that's true in most medical fields. Most specialists I know can add $80-$100k/yr if they work an extra day/ON a week. Not many with families really want to do that though. Its more doable in a smaller community hospital in the suburb of a city where your 7 days on are 8-5 or shorter.

 

[67552931811]

I could see that, but that's true in most medical fields. Most specialists I know can add $80-$100k/yr if they work an extra day/ON a week. Not many with families really want to do that though. Its more doable in a smaller community hospital in the suburb of a city where your 7 days on are 8-5 or shorter.

Yeah, that's fair. Personally, I think I would be bored out of my skull having 7 straight days off. So, the aforementioned idea is appealing to me. But, what you said makes sense for sure.

 

[user3]

Yes my sis is one. Not making 300 though, close to 200 14 on and 14 off and she is usually home by 1pm lol

wow. honestly, <200k for pretty much any full time physician gig seems like weak compensation imo.

 

[Pisiform]

wow. honestly, <200k for pretty much any full time physician gig seems like weak compensation imo.

She is only 2 yr out post residency. Seems Alright to me. She is off half the month

 

[FutureDO2016]

She is only 2 yr out post residency. Seems Alright to me. She is off half the month

So she only works 6 months a year? What does she do with all that time off?? I mean you can only travel and spend and relax so much? Aren't most docs workaholics?

So if someone works like 9-10 months a year and takes 2-3 months off, they will make 250K-300K? And I'm talking about a family med trained hospitalist.

 

[67552931811]

So she only works 6 months a year? What does she do with all that time off?? I mean you can only travel and spend and relax so much? Aren't most docs workaholics?

So if someone works like 9-10 months a year and takes 2-3 months off, they will make 250K-300K? And I'm talking about a family med trained hospitalist.

That's pretty unsustainable as a hospitalist

 

[kenjixshadow]

So she only works 6 months a year? What does she do with all that time off?? I mean you can only travel and spend and relax so much? Aren't most docs workaholics?

So if someone works like 9-10 months a year and takes 2-3 months off, they will make 250K-300K? And I'm talking about a family med trained hospitalist.

Dude, if you think that you'll work as a hospitalist, why don't you want to be IM trained? There was an IM attending cleared 45k in a month by working 25 shifts and if you were anything like him, you would be pulling 450k pretax after 10 months, but note that he isn't a new graduate -- his rate was $150/hr, you're not getting that from fresh out of residency. Plus, nobody works that much b/c burnout is real you know.

 

[NurWollen]

Dude, if you think that you'll work as a hospitalist, why don't you want to be IM trained? There was an IM attending cleared 45k in a month by working 25 shifts and if you were anything like him, you would be pulling 450k pretax after 10 months, but note that he isn't a new graduate -- his rate was $150/hr, you're not getting that from fresh out of residency. Plus, nobody works that much b/c burnout is real you know.

There are certainly places that only hire IM-trained physicians as hospitalists, but there are a lot of places (even in large cities) that do hire FM-trained hospitalists. Among the places that do take FM, I don't think the pay is any different from IM

 

[Pisiform]

So she only works 6 months a year? What does she do with all that time off?? I mean you can only travel and spend and relax so much? Aren't most docs workaholics?

So if someone works like 9-10 months a year and takes 2-3 months off, they will make 250K-300K? And I'm talking about a family med trained hospitalist.

She does urgent care on few days she is off

 

[GUH]

So she only works 6 months a year? What does she do with all that time off?? I mean you can only travel and spend and relax so much? Aren't most docs workaholics?

I'm pretty sure I could find a way to take off six months and spend 200 grand per year. It just takes dedication.

So if someone works like 9-10 months a year and takes 2-3 months off, they will make 250K-300K? And I'm talking about a family med trained hospitalist.

Slightly off-topic but I know FM-trained docs pulling almost 280 grand/year working outpatient-only with a week of call Q~10wks in the state prison system.
When you consider that their malpractice is covered by the state and their pension plan, you're looking at an equivalent salary of over 300k. The patient population can be difficult to work with, though.

 

[Makati2008]

I'm pretty sure I could find a way to take off six months and spend 200 grand per year. It just takes dedication.
Slightly off-topic but I know FM-trained docs pulling almost 280 grand/year working outpatient-only with a week of call Q~10wks in the state prison system.
When you consider that their malpractice is covered by the state and their pension plan, you're looking at an equivalent salary of over 300k. The patient population can be difficult to work with, though.

How do lawsuits work in that system? Does the state take the liability or the individual physician?

 

[W19]

I'm pretty sure I could find a way to take off six months and spend 200 grand per year. It just takes dedication.
Slightly off-topic but I know FM-trained docs pulling almost 280 grand/year working outpatient-only with a week of call Q~10wks in the state prison system.
When you consider that their malpractice is covered by the state and their pension plan, you're looking at an equivalent salary of over 300k. The patient population can be difficult to work with, though.

I can't talk about prisons, but I worked in a jail as a RN and I can tell you that these people are no different than the general population in term of how they interact with healthcare professionals. The physicians who were there love their jobs... M-F 8-5pm and no calls because PA/NP take the calls.

 

[GUH]

I can't talk about prisons, but I worked in a jail as a RN and I can tell you that these people are no different than the general population in term of how they interact with healthcare professionals. The physicians who were there love their jobs... M-F 8-5pm and no calls because PA/NP take the calls.

The jail population is a closer reflection of the public (or maybe a county hospital population) than the prison population is. Some of the prison docs are happier than others but none of them complain about the hours, pay, or patient load. I recommend doing a rotation at a prison as an elective if you're interested and if your school and the site allow it. It's been one of my favorites so far.

How do lawsuits work in that system? Does the state take the liability or the individual physician?

The state covers malpractice issues in most cases. Malpractice claims are common in that setting.

 

[Pisiform]

Lol reminds me of the chick who set scofield free in prison break ... I know totally random

 

[Makati2008]

The jail population is a closer reflection of the public (or maybe a county hospital population) than the prison population is. Some of the prison docs are happier than others but none of them complain about the hours, pay, or patient load. I recommend doing a rotation at a prison as an elective if you're interested and if your school and the site allow it. It's been one of my favorites so far.

The state covers malpractice issues in most cases. Malpractice claims are common in that setting.

Sorry I should be clearer. When a physician is sued is it listed the prisoner vs the state OR prisoner vs physician. Makes a big difference.

 

[Mad Jack]

So she only works 6 months a year? What does she do with all that time off?? I mean you can only travel and spend and relax so much? Aren't most docs workaholics?

So if someone works like 9-10 months a year and takes 2-3 months off, they will make 250K-300K? And I'm talking about a family med trained hospitalist.

Sounds like you need more hobbies and interests. I could do plenty with that time. Hell, international vacation for two weeks every other month, and use the rest of the time off to chill.

 

[FutureDO2016]

Sounds like you need more hobbies and interests. I could do plenty with that time. Hell, international vacation for two weeks every other month, and use the rest of the time off to chill.

I don't think you can travel that much when you have a family and kids that go to school and a spouse that may not have 2 weeks a month off but a more typical 9-5 weekday job. Of course you can relax and spend money though haha no problem.

 

[Mad Jack]

I don't think you can travel that much when you have a family and kids that go to school and a spouse that may not have 2 weeks a month off but a more typical 9-5 weekday job. Of course you can relax and spend money though haha no problem.

All of those are problems I won't have, so I'm good.

 

[Seth Joo]

My point was CRNA schools are flooding the market with CRNAs and that put some pressure on wages... 10 years ago, anesthesiologists could write their own ticket in term of wages... They were getting 350k+/years right out of residency with 8-10 weeks vacation. These things are not happening anymore.

Specialist incomes are going to change across the board. Things for primary care physicians might improve because of the Affordable Care Act. I do not think wages though will go up that much.