So I'm aware that the avg starting FP makes like 130k/yr in a group practice, give or take little. But how much does one actually bring home. are these "averages" pre-malpractice/overhead costs? Thanks.
so how much $ do FPs really bring home
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deleted87716
Any time you see income or salary figures, they're usually before taxes, but after expenses.
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Look,
Dont drink the coolaid the specialists are feeding you! FP is alive and viable. Sure, average salary is low, but remember, almost ALL J-1 visas are FP, and about half of FP residents are FMGs. You can write your own ticket. I just signed a junior partner contract for 275K base (350K with bonus), 35K signing bonus and 20K moving expenses, plus they pay off 80K loans. Now mind you I have been in practice 8 years.
Dont drink the coolaid the specialists are feeding you! FP is alive and viable. Sure, average salary is low, but remember, almost ALL J-1 visas are FP, and about half of FP residents are FMGs. You can write your own ticket. I just signed a junior partner contract for 275K base (350K with bonus), 35K signing bonus and 20K moving expenses, plus they pay off 80K loans. Now mind you I have been in practice 8 years.
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So how does their immigration status and their country of graduation affect average FP salaries?
alot of FM docs in the midwest and my home town make around that, $275K, but they have been in practice at the very least 3 years minimum. Some make $350K, even $500K, that work very hard though.
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Those who are on J-1 visa sponsored by their home countries + ECFMG have to work for atleast 2 years as a primary care doc ( FP, IM) in underserved areas if they want to stay in the USA. These "J-1 waiver" jobs are towards the lower side on the pay-scale, so I guess that skews the FP salary survey.
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any info as to the details of your contract? where is the job (rural, urban, location in the country), hours/day, days/week, patients/day? no idea how many details you know ahead of time (since i'm just a soon-to-be resident)... how does this contract compare to your previous contracts? thanks for any details you care to share!
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To be perfectly honest, I don't understand why any doctors complain about income. All doctors earn well. $100k is earning very well. Maybe not relative to other specialties, but it's not a competition. The problem is people's expenses rise to meet their income. So there will always be people that don't feel like they have enough money regardless of how much they make. It's comical that everytime there's a strike in a professional sport the athletes ask for financial assistance. People spend what they make.
I think one of the beauties of medicine is I can choose whatever specialty sparks my interest and know that I will be well compensated. People that don't want to go into family medicine because it doesn't pay enough probably aren't that into it anyway.
I think one of the beauties of medicine is I can choose whatever specialty sparks my interest and know that I will be well compensated. People that don't want to go into family medicine because it doesn't pay enough probably aren't that into it anyway.
Wow. Are you serious? When you calculate the opportunity costs of being in medical school plus residency (no 401k, no investments, time away from family, etc.) and not to mention those of us strapped with enormous student debt, 100k is an insult for working full time as a physician who is responsible for people's lives, usually on call, and at any moment can be sued. After you've gone through medical school, then residency and then fellowship, let us know how you feel about making a whopping 100k per year; which is a not uncommon salary seen by R.N.'s. I value my training and the hard work I've put in and hard-earned skills should valued monetarily as well.
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Wow is right. $100k is already twice what the average household income is in the USA, and you don't feel like you're being valued monetarily? Anyway, it's a moot point because, as pointed out in this very thread, even FM earn better than that.
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F***. PLEASE STOP FEEDING THE TROLL. Can we ignore and continue, this is a hot topic at the water cooler and I'd like to know more about the practicing world!
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Troll = somebody that disagrees with you
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Troll is someone who ruins a perfectly useful thread to be hijacked into some ridiculous soapbox by someone who is in absolutely NO POSITION to comment on the topic to begin with.
When you were looking into FP pre-match, were these same issues around? Did you consider other options because of it?
For instance, my pediatrician always advocated me specializing in one area post grad, then perhaps settling down into a more FP-like career as I get older (as she did-- ER-Peds to Peds). But now that I am seing this stuff first-hand, I question the plausibility of making such a switch. Just curious if this was still possible and your 2 cents.
When you were looking into FP pre-match, were these same issues around? Did you consider other options because of it?
For instance, my pediatrician always advocated me specializing in one area post grad, then perhaps settling down into a more FP-like career as I get older (as she did-- ER-Peds to Peds). But now that I am seing this stuff first-hand, I question the plausibility of making such a switch. Just curious if this was still possible and your 2 cents.
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I love children/pre-meds.
So naive.
So filled with hope.
ummmm? Everybody has the right to post here, what exactly is the significant difference with a medical student?
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About a 250K in loans
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everybody has $250 K in loans, including myself......
naivity = attacking random people and belittling. It's called insecurity
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you are probably on call 24.7 and get zero vacation. That brings your salary down to 120K if you actually had vacation and werent on call so much there is no way that fp docs are making 275. specialist ophtho guys arent even making that
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Shhhhh! Don't tell that to the Blue Dog....
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specialist ortho guys can make $1 million a year. They work very very hard. Lol to zero vacation, that would be a nightmare.
FM schedule varies greatly.
It is usually 4 weeks off per year -- paid vacation, some CME time, and 4.5 days per week, with one weekend on call every 6 weeks or so.
That is pretty cush honestly.
This is the usual FM schedule.. The salary may be less, if there is student loan assistance -- which can range from $100 K to $180 K strictly towards student loan assistance.
Dude yeah I agree to that sarcasm, way too much hating over here at times.
If you are gonna hate, then at the very least post FACTS and not pure speculation.
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deleted87716
It's not going to fall into your lap, but it's certainly possible. Lots of variables to take into account, of course, and it's not anywhere near the national average.
You mean he was serious??? That Ortho guys don't get paid $275...lol j/k..
$130 or $150 K is usually the straight starting salary of FM, coming out of residency... there are tons and tons of variables, and incentives, that will propel you over $200 K. Not easily, as Blue mentioned.
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Well, I can vouche for at least one group of orthopods that each pulled in over 500k. One in particular made significantly more than that... and they took vacations. Of course, they perform 6+ total joints a day and are super specialists if I have ever seen one. Work-o-holics-- stage 4.
So what do you all think of the "after hours- send all patients to the ER" thing that is so frequently brought up here. You all get quite the bad rap in that aspect, any ideas on how to fix the problem? Just curious, because I feel that I get a vary bias view of this both educationally and from SDN.
So what do you all think of the "after hours- send all patients to the ER" thing that is so frequently brought up here. You all get quite the bad rap in that aspect, any ideas on how to fix the problem? Just curious, because I feel that I get a vary bias view of this both educationally and from SDN.
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deleted87716
He said "ophtho." Ophthalmology reimbursements have been hit pretty hard over the years, first with steadily declining payments for cataracts, and last year even MOHS surgery got hammered.* Refractive surgery has helped boost things up again, but competition for this largely cash-based service has started eroding into profits there, too. A faltering economy won't be good for business, either.
Most of the orthopods I know do quite well.
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deleted87716
Sure...be proactive and available. Many ED visits are preventable. For stuff that crops up after-hours, some patients can utilize urgent care rather than the ED for things that can't wait until office hours, and some simple things can be appropriately managed over the phone. True emergencies will still happen, though. There's no way around it. Nobody is ever going to be available 24/7.
sorry, yes Optho guys do very very well..... the more procedures they do obviously the better...
I think that the declining reimbursement for medicare has hit Opthos the hardest most recently.
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For those of you who think 275k is impossible in FP you should look into ontario.
Look in Brampton/Mississauga ontario... making 275k with a busy practice is not a problem.
Look into an article about FP's making 600 + I don't have the link, but I'll post it if I get it.
I have a family member who does accounting work for a large number of FP's and he give me income figures and said 250 is a VERY reasonable expectation in the area and even showed me a lot of peoples files (which he souldn't be doing).
My personal family doc is making 320k.
This obv. won't be the case for every doctor and probbaly won't be the case for most doctors, but its definitely possible.
Look in Brampton/Mississauga ontario... making 275k with a busy practice is not a problem.
Look into an article about FP's making 600 + I don't have the link, but I'll post it if I get it.
I have a family member who does accounting work for a large number of FP's and he give me income figures and said 250 is a VERY reasonable expectation in the area and even showed me a lot of peoples files (which he souldn't be doing).
My personal family doc is making 320k.
This obv. won't be the case for every doctor and probbaly won't be the case for most doctors, but its definitely possible.
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Ok, here's a question that's been bugging me for a while:
Let's say that you own your own solo FP practice. You pay yourself a salary of $X. The Practice makes 5X.
When all these salary figures are quoted for FP's, how do we seperate the income of the Doc from the income of the Practice?
Couldn't an FP doc be claiming they get paid $150k/year while their practice turns a 400k/year profit?
I understand that you can't lie on your taxes, but you can on these surveys...but if your business is set up right, then it's income is seperate from your income anyways, right?
Let's say that you own your own solo FP practice. You pay yourself a salary of $X. The Practice makes 5X.
When all these salary figures are quoted for FP's, how do we seperate the income of the Doc from the income of the Practice?
Couldn't an FP doc be claiming they get paid $150k/year while their practice turns a 400k/year profit?
I understand that you can't lie on your taxes, but you can on these surveys...but if your business is set up right, then it's income is seperate from your income anyways, right?
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deleted87716
Salary surveys are usually based on take-home income, not practice revenue. They probably don't account for non-salary compensation sometimes found in large corporations or health systems, such as paid vacation, stock options, health, disability and malpractice insurance, student loan repayment, or "perks" like a company car, travel allowance, etc.
Perhaps, but depending on how the practice is structured, retained earnings may be subject to heavy taxation. To avoid this, most practices pay out everything they take in, either in salaries or by reinvesting in their infrastructure, and it's frequently advantageous to operate with a net loss for tax purposes.
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"Highly reimbursed" FPs I would place into one of two categories:
1)Docs who see countless patients per day skimming the surface of human disease, or
2)Docs who work their rear-ends off.
Anyhow, for one data point, I'm taking a job with the VA. 18-20 Pt visits per day max (20 min for established Pt, 40 for new). Starting 152k (no more/less), 5 weeks off per year +CME, no night or weekend call.
1)Docs who see countless patients per day skimming the surface of human disease, or
2)Docs who work their rear-ends off.
Anyhow, for one data point, I'm taking a job with the VA. 18-20 Pt visits per day max (20 min for established Pt, 40 for new). Starting 152k (no more/less), 5 weeks off per year +CME, no night or weekend call.
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Recently spoke with a couple of FPs at a state association mixer and found that they're doing quite well.....
Most of them are with group practices where they have their own clinics but the group has an association with a business-type firm who negotiates their loans and processes their billing. Due to the number of docs they're negotiating for, they get a rather large % of reimbursement.....
The figures I heard quoted for those who did clinic and hospital work were around $275K - $300K.....I didn't get the call/nights type of quote but most seemed happy........
Most of them are with group practices where they have their own clinics but the group has an association with a business-type firm who negotiates their loans and processes their billing. Due to the number of docs they're negotiating for, they get a rather large % of reimbursement.....
The figures I heard quoted for those who did clinic and hospital work were around $275K - $300K.....I didn't get the call/nights type of quote but most seemed happy........
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Salary is very regional. My wife is a family physician. When she was looking at jobs a few years ago, salaried positions in the northeast ranged from 80-90k up to $120-130k (these are just starting salaries, no bonus, etc.)
Yes, some try to entice you with benefits, etc. but your salary may be less than $100k if you stay within an academic network in the northeast. If you head to the south, you'll do much better.
Yes, some try to entice you with benefits, etc. but your salary may be less than $100k if you stay within an academic network in the northeast. If you head to the south, you'll do much better.
Academic salaries are typically the lowest I've seen, but the above is only part of the picture. I was offered a two faculty spots just out of residency admittedly both in the South, with starting salaries in the 130-140 range. However, the benefits were great. 20-30k signing bonus; malpractice, health, dental, homeowners, car insurance; matching retirement benefits up to 14K per year, six weeks of vacation, potential production bonus, and free instate tuition for the kids, etc. You would need to pull in close to 200K a year to match the offer. Guys five years out were in the 180's with the same benefits. It wasn't for me, but it's not all gloom and doom either. You can make a decent income in primary care, maybe not rocket surgeon level, but then I don't work like a rocket surgeon either. I've done a ton of job searching in the past two years, and I haven't seen anything less than 120's starting (and that's usually health department work). I have no doubt the above post is true.... it's just not representative of the majority of jobs out there.
Someone in primary care (FP/IM) can easily make in the mid $200K with the caveat that they work like dogs. I've been in a rural midwest town for the past year and the FP and IM guys do well. Many of them moonlight in area ERs augmenting their salaries to mid to high $300K. So most salaries I see thrown around on SDN I take with a grain of salt. If one is willing to work extremely hard, be on call a lot, and not see their family a lot they can up up to $300K as a primary care. ---------------- Listening to: Maroon 5 - This Love via FoxyTunes
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deleted87716
Not necessarily.
You can work hard, or you can work smart. If you want to make the really big bucks, you can do both.
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Once again, salary can be quite different depending on the region of the country. A range of $100-200k is huge!
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Why does region have such an impact on salary? I totally get rural versus urban differences, but there are rural and urban areas all over the country. Seems weird that one of (or the most, let's just say one of the two most) expensive parts of the country to live in has the lowest average salaries.
You just answered your own question. When a place becomes popular to live, there are a surplus of physicians, thus driving down the demand. I don't really think its so much of a rural VS urban thing as it is a perception of how desirable a place is to live. For some damn reason people will always flock to Miami or Boston, yet they will run from Iowa or Kansas. I heard of an orthopod taking a 200K cut in pay to live in Boston.
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You just answered your own question. When a place becomes popular to live, there are a surplus of physicians, thus driving down the demand. I don't really think its so much of a rural VS urban thing as it is a perception of how desirable a place is to live. For some damn reason people will always flock to Miami or Boston, yet they will run from Iowa or Kansas. I heard of an orthopod taking a 200K cut in pay to live in Boston.
Anyone want to place bets on how many nights he lies in bed at night wondering "WTF have I done"??????????
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Based on my experience and personally knowing AND seeing income statements of various physician specialties, don't believe the average salary incomes. Physicians make significantly more. Most physicians underreport their income for various reasons including political ones. Also, some avg income stats are based on reported incomes which includes their income after write-offs and write-offs can be significant as in 50K significant when you account for office equipment, telephone, internet, car lease, trips (CME) etc. It adds up.
In regards to family practice and outpatient Internal Medicine, I've learned a rough rule of thumb is the avg number of patients seen a day. If you see 20 pts a day, that is about 200K. If you see 30, it's 300K...40....400K etc. In my experience that seems to be correct. Of course, you need an awesome billing manager and collections person. It depends where you practice ie California has higher numbers of pts on HMO. It depends on what you do in your office and how many procedures you are comfortable doing.
For example, on the allied health salary survey, I saw the avg income for an interventional cardiologist is 468K, I'm sorry but I don't any busy interventionalist earning less than 700K per year. As you progress in your school and work with more docotors, you will learn the real life numbers are a lot different than average salary surveys. You will also notice the difference in business practices between ones earning more and less. The ones who earn less are usually doctors who don't want to work a lot and they enjoy chatting. This one FP I rotated with saw 11 pts a day and spent an 45 minutes to an hour with each one and worked 4 days a week. He did no procedures or imaging of any type. There is a reason he was making only 130K a year.
In regards to family practice and outpatient Internal Medicine, I've learned a rough rule of thumb is the avg number of patients seen a day. If you see 20 pts a day, that is about 200K. If you see 30, it's 300K...40....400K etc. In my experience that seems to be correct. Of course, you need an awesome billing manager and collections person. It depends where you practice ie California has higher numbers of pts on HMO. It depends on what you do in your office and how many procedures you are comfortable doing.
For example, on the allied health salary survey, I saw the avg income for an interventional cardiologist is 468K, I'm sorry but I don't any busy interventionalist earning less than 700K per year. As you progress in your school and work with more docotors, you will learn the real life numbers are a lot different than average salary surveys. You will also notice the difference in business practices between ones earning more and less. The ones who earn less are usually doctors who don't want to work a lot and they enjoy chatting. This one FP I rotated with saw 11 pts a day and spent an 45 minutes to an hour with each one and worked 4 days a week. He did no procedures or imaging of any type. There is a reason he was making only 130K a year.
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Hello lasvegasDO,
Thank you for your post. I'm a little confused, because the research I have done and the physicians I've spoken to have told me that it's nearly impossible to make such a high salary in FM. Also everyone keeps saying, how regional practice is and how this directly correlates with income, in addition to the "smartness" of one's work ethic. I mean I'm thrilled to hear this info (don't get me wrong), but I just want to make sure this info is accurate. Could you exemplify?
Thank you,
Ariee
Thank you for your post. I'm a little confused, because the research I have done and the physicians I've spoken to have told me that it's nearly impossible to make such a high salary in FM. Also everyone keeps saying, how regional practice is and how this directly correlates with income, in addition to the "smartness" of one's work ethic. I mean I'm thrilled to hear this info (don't get me wrong), but I just want to make sure this info is accurate. Could you exemplify?
Thank you,
Ariee
I think vegas's comments are oversimplified, but as far as numbers go, they may be pretty close. The highest income I've actually seen on paper was the founder of a single speciality group that now has around 20 partners. He has no financial benefit from the other partners other than extremely low overhead. He averages just over forty patients a day and and had an income of over 400K per year. This guy is a machine and definitely an outlier, no doubt in the top 1% in FP (most members of the practice pulled in 275-300). I reviewed income statements from quite a few practices and I would say the average established FP in private practice sees about 25 patients per day and makes around 200K per year. There are quite a few variables though. If you work in a public health setting or academics, you make less. Single speciality groups seem to make a little more than multi specialty groups. Physicians in solo practice seem to have the highest collections and the highest overhead. There's nothing scientific about this stuff, my information comes from interviewing multiple practice opportunities though a couple of years of fellowship and locums work. There is some potential that numbers were inflated to attract new members to the herd. The MGMA, which most hospitals and groups use to set income guarantees and salaries, puts the average established FP salary somewhere between 180 and 190. However "average" doesn't really mean much when incomes are extremely varied. I hope this helps.
These numbers are what I have heard for both FM and IM. If you set yourself up in a good position I can't understand how someone willing to work more than 40hrs a week (50-60) would not make 200 a year. I give the edge to the hospitalists, who work a little harder but less hours, as they can pick up extra shifts. We had an IM guy come give a talk about hospitalist sallary and he said 200 to 300 outside of academia..
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Two important take home messages from vegas' comments:
1. People often lie about their true income.
2. Averages are pointless when one understands the current medical business model.
Medical Economics at one point stratified incomes according by percentiles for varying specialties in their annual report. While many call the MGMA numbers suspect, office managers are more apt to be honest than others when reporting incomes.
Top chart:
http://medicaleconomics.modernmedic...ticleDetail.jsp?id=179086&sk=&date=&pageID=3#
1. People often lie about their true income.
2. Averages are pointless when one understands the current medical business model.
Medical Economics at one point stratified incomes according by percentiles for varying specialties in their annual report. While many call the MGMA numbers suspect, office managers are more apt to be honest than others when reporting incomes.
Top chart:
http://medicaleconomics.modernmedic...ticleDetail.jsp?id=179086&sk=&date=&pageID=3#
http://www.utahsright.com/salaries.php?query=&city=u_of_u&order=&oType=&page=2
See the last line for Prof. of Family & Preventive Medicine. It's definitely not like Interventional Cardiology but pretty decent.
See the last line for Prof. of Family & Preventive Medicine. It's definitely not like Interventional Cardiology but pretty decent.
