so how much $ do FPs really bring home

[thethom]

Interesting, the rest of the family medicine department is spread out between $150k and $200k with the highest at $375k....now thats in ACADEMICS. So everyone should keep in mind that income will be MORE in private practice...

..so stop whining...

Also interesting to note is the Professor of Pediatric Cardiothoracic surgery at $1.1 million a year, the coaches at $965k, and the professor of Pathology at $700k! Nice!

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[SOLOFPCC]

For the medical students who are trying to compare reimbursement between different specialists - it all depends on what you bill - for office visits, the visits are paid the SAME no matter what your specialty - it depends on whether they are consults, or existing patient visits, or new patient visits - if you do procedures, the procedures pay the same regardless of specialty. As a primary care physician, most of your charges will be office visits and hospital visits, and it depends how productive you are, how much money you make. If you can only see 2 patients an hour, you will make less. If you see 6 patients per hour, you will generally make more. If your patients are more complicated, you can charge more for your visits; if they are simple, they will pay less. Whether you are a brain surgeon or a family doctor, Medicare pays the exact same for a 15-minute office visit. So, when you ask how much money you will make, there's never a guarantee unless you work for the VA or work on salary. But for us independent docs, it all depends how hard you work. You can see the salalries in the MGMA surveys which are pretty accurate. All I can say about FP is it's so flexible; in some rural areas you can work as an ER doc and you can get your MBA after completing FM residency and do management; you can go into health care IT and do some health law as well. You can do hospice medicine, sleep medicine, geriatrics, and adolescent medicine. You can work in private practice, hospitalist practice, or government practice, or academics, or sports medicine or a nursing home. You can even go to the dark side and work for the insurance companies as a medical director. FP is the most flexible primary care specialty in my opinion because of its breadth of training. I highly endorse FP and don't regret my decision but as med students, try not to think about salary at this point; you will be disappointed. If you wanted to earn more money, then you should have been a CEO or a trial lawyer or a dentist Please don't close yourself off to a specialty solely because you are told by your attendings that FP's only earn 100,000 per year - if you are a non-productive doctor, or work in a poor area and only see Medicaid patients, or work part time, you will earn under 100,000 but if you work hard, you may even earn twice that amount. We can always moonlight. In the end, if you work 20 hours per week you will earn less than if you work 80 hours per week.

 

[SOLOFPCC]

I will also say that if you want to pay off your school loans, live like you are still earning a $40,000 resident salary when you graduate residency; drive a cheap car, clip coupons and don't go out and spend tons of money. If you are earning $140,000 salary as an FP, then you can probably pay off your school loans within a few years! How about that thought? You can get a headstart on your loan repayments.

 

[flumazenil]

This should end discussions hopefully.

http://www.aafp.org/online/en/home/aboutus/specialty/facts/15.html

 

[psychforme]

For the medical students who are trying to compare reimbursement between different specialists - it all depends on what you bill - for office visits, the visits are paid the SAME no matter what your specialty - it depends on whether they are consults, or existing patient visits, or new patient visits - if you do procedures, the procedures pay the same regardless of specialty. As a primary care physician, most of your charges will be office visits and hospital visits, and it depends how productive you are, how much money you make. If you can only see 2 patients an hour, you will make less. If you see 6 patients per hour, you will generally make more. If your patients are more complicated, you can charge more for your visits; if they are simple, they will pay less. Whether you are a brain surgeon or a family doctor, Medicare pays the exact same for a 15-minute office visit. So, when you ask how much money you will make, there's never a guarantee unless you work for the VA or work on salary. But for us independent docs, it all depends how hard you work. You can see the salalries in the MGMA surveys which are pretty accurate. All I can say about FP is it's so flexible; in some rural areas you can work as an ER doc and you can get your MBA after completing FM residency and do management; you can go into health care IT and do some health law as well. You can do hospice medicine, sleep medicine, geriatrics, and adolescent medicine. You can work in private practice, hospitalist practice, or government practice, or academics, or sports medicine or a nursing home. You can even go to the dark side and work for the insurance companies as a medical director. FP is the most flexible primary care specialty in my opinion because of its breadth of training. I highly endorse FP and don't regret my decision but as med students, try not to think about salary at this point; you will be disappointed. If you wanted to earn more money, then you should have been a CEO or a trial lawyer or a dentist Please don't close yourself off to a specialty solely because you are told by your attendings that FP's only earn 100,000 per year - if you are a non-productive doctor, or work in a poor area and only see Medicaid patients, or work part time, you will earn under 100,000 but if you work hard, you may even earn twice that amount. We can always moonlight. In the end, if you work 20 hours per week you will earn less than if you work 80 hours per week.

What!? That would mean if I would only see skin patients I would earn like a dermatologist!?

 

[deleted87716]

What!? That would mean if I would only see skin patients I would earn like a dermatologist!?

Maybe. But, consider...

1) Many patients seen by the dermatologist are consults, which pay more. Can you get people to refer to you? The most successful dermatologists have busy, high-volume practices.
2) Many dermatologists schedule patients in five-minute slots, allowing them to see up to 12 patients/hour. Is this how you want to work?
3) Most dermatologists do a lot of skin procedures, many examine their own specimens microscopically, and they can bill for it all. How good are you at dermatopathology?
4) Many dermatologists perform a number of cosmetic (read: CASH) procedures, such as Botox, microdermabrasion, facial peels, etc. Some sell cosmetic-type products in their offices. Are you into that stuff?

In short, if you can practice like a dermatologist, you can earn like a dermatologist. I suspect this is easier said than done, however, and probably for a good reason.

 

[asmallchild]

What!? That would mean if I would only see skin patients I would earn like a dermatologist!?

Gee, for someone who hates dermatology so much, you sure seem awful excited at the prospect of taking on derm patients

 

[psychforme]

Gee, for someone who hates dermatology so much, you sure seem awful excited at the prospect of taking on derm patients

Since you bring it up... I find the conditions interesting and they seem to be enjoyable to treat since they are easy (second-hand knowledge from a dermatology resident I know). I do not see the point in it being a specialty (except the point where a select elite makes a ****load of money with minimal effort or talent). It's the only specialty where fourth year medical students function at the level of attendings. I even had a roommate in undergrad who removed his own naevi with a knife heated on the stove. I doubt we'll find very many cases of undergrad cardiothoracic surgeons.


Bluedog, thank you for a very constructive answer.

 

[MOHS_01]

Since you bring it up... I find the conditions interesting and they seem to be enjoyable to treat since they are easy (second-hand knowledge from a dermatology resident I know). I do not see the point in it being a specialty (except the point where a select elite makes a ****load of money with minimal effort or talent). It's the only specialty where fourth year medical students function at the level of attendings. I even had a roommate in undergrad who removed his own naevi with a knife heated on the stove. I doubt we'll find very many cases of undergrad cardiothoracic surgeons.


Bluedog, thank you for a very constructive answer.

Read Blue's post again. Pay close attention to the last line. Your conclusion on the matter is erroneous because the prism through which you reach that conclusion is tainted by ignorance on the subject. Portions of dermatology are exceptionally easy; these are handled every day in offices of all specialties all across America. Other portions are not so easy -- hence the large number of referrals. Technically, the vast majority do not constitute "consultations" and should not be billed as such. The vast majority constitute a "transfer of care" for a given problem; these are new patient visits when applying strict terminology. Billing for a consultation, regardless of return letter generation or physician referral, is, more often than not, an abusive billing practice. They generally are not asking "what should I do for this", but "hey, can you help with this?" -- two completely different questions from a coding standpoint.

 

[asmallchild]

Read Blue's post again. Pay close attention to the last line. Your conclusion on the matter is erroneous because the prism through which you reach that conclusion is tainted with ignorance on the subject. Portions of dermatology are exceptionally easy; these are handled every day in offices of all specialties all across America. Other portions are not so easy -- hence the large number of referrals. Technically, the vast majority do not constitute "consultations" and should not be billed as such. The vast majority constitute a "transfer of care" for a given problem; these are new patient visits when applying strict terminology. Billing for a consultation, regardless of return letter generation or physician referral, is, more often than not, an abusive billing practice. They generally are not asking "what should I do for this", but "hey, can you help with this?" -- two completely different questions from a coding standpoint.

Excellent post, although likely lost on such a close-minded pre-clinical student who seems to already have it "all figured out".

 

[deleted87716]

Read Blue's post again. Pay close attention to the last line.

Exactly. Realistically, you probably aren't going to be able to practice like a dermatologist unless you are a dermatologist.

 

[nissangtr]

realistically, expect to make between 175-225k working reasonable hours as a fp. when i say reasonable....it means 45-60 hours. there are extreme cases out there..........remeber, that's in either a group or in private practice........

there's this ***** who makes over 300-k in brooklyn who works literally 7 days a week.......has a clinic and works as an attending at a hospital nearby as well.........the guy has no life literally, but he makes 'OVER 300-K THIS YEAR' in his own words........go figure...........the guy left his wife and kid in the car waiting for 5 hours while he came to the hospital to round with the students/residents............then he forgets about his wife/kid.......and then goes back to check on them at 2am.............complete *****.......

 

[psychforme]

Exactly. Realistically, you probably aren't going to be able to practice like a dermatologist unless you are a dermatologist.

If I start a huge FP practice and make everyone is the practice refer derm cases to me I could work as a dermatologist!

 

[asmallchild]

If I start a huge FP practice and make everyone is the practice refer derm cases to me I could work as a dermatologist!

Hammer this point home on your residency interviews.

 

[deleted87716]

If I start a huge FP practice and make everyone is the practice refer derm cases to me I could work as a dermatologist!

Good luck with that.

 

[andwhat]

Read Blue's post again. Pay close attention to the last line. Your conclusion on the matter is erroneous because the prism through which you reach that conclusion is tainted by ignorance on the subject. Portions of dermatology are exceptionally easy; these are handled every day in offices of all specialties all across America. Other portions are not so easy -- hence the large number of referrals. Technically, the vast majority do not constitute "consultations" and should not be billed as such. The vast majority constitute a "transfer of care" for a given problem; these are new patient visits when applying strict terminology. Billing for a consultation, regardless of return letter generation or physician referral, is, more often than not, an abusive billing practice. They generally are not asking "what should I do for this", but "hey, can you help with this?" -- two completely different questions from a coding standpoint.

in our Urgent Care clinic, our N.P.s handled most of the derm cases. They are just too easy. It does not require a residency in my opinion, as you can master almost anything and everything commonly encountered in Derm practice in a matter of maybe one week, or maximum two.

 

[asmallchild]

in our Urgent Care clinic, our N.P.s handled most of the derm cases. They are just too easy. It does not require a residency in my opinion, as you can master almost anything and everything commonly encountered in Derm practice in a matter of maybe one week, or maximum two.

 

[deleted87716]

you can master almost anything and everything commonly encountered in Derm practice in a matter of maybe one week, or maximum two.

Dude, seriously...

It's better to remain silent and be thought a fool than to open one's mouth and remove all doubt.

 

[andwhat]

Dude, seriously...

It is the truth, like it or not.... similar argument can be made about FM at times -- cough, cold, sore throat, pneumonia, hospital followup, back pain, shoulder pain, etc.
My entire rotation in Derm, was thinking "That is the same thing that we are taught to do, and I see that case every other day"
Other than very complicated Dermatopathology, Derm is not a difficult subject.
Looks like some people have problems with that. Oh no!
tempers tempers wow!
I will be one to admit wholeheartedly, FM doesn't take 3 years to learn.
Man... hate is rampant here at times.... have no idea why.
The simple statement "Derm is not hard" incites anger, hostility -- interesting theory.

 

[deleted87716]

I will be one to admit wholeheartedly, FM doesn't take 3 years to learn.

Wow.

Just...wow.

 

[asmallchild]

Wow.

Just...wow.

My thoughts exactly.

 

[andwhat]

Wow.

Just...wow.

yup. If I do not plan on doing ob gyn, then this should be undertaken on an elective basis. Surgery should be spent learning about consults, and not scrubbing in Surgeries and taking Surgery call nights and days for that matter. This would include gynecology. Most fm docs nowadays practice only general medicine without ob. FM residency could be consolidated into two, to two and a half years.
I am sure that there is a significant amount taught during derm residency that is not applied in clinical practice. It is a very very academic and lucrative field, that does offer an excellent lifestyle. However, is everything taught during residency applied in the real world? Highly doubtful.
woww just wow, cummon everyone join in the chorus !! I am not stating anything, that hasn't been said, or thought one billion times. I loved my residency, but it could have been restructured.
I would hope that a Dermatologist knows extraordinarily more than me about Dermatologic conditions. My point being, is that Dermatologists do not know a whole lot more than FM docs or internists, about skin conditions commonly encountered in everyday practice.
Hate on me all you want, like Bruce Bowen Asmallchild, who loves to aggravate situations.

quote from small child

Uhh, the whole point of MOHS surgery is to avoid performing a wide excisional biopsy.

Way to spout off on something you evidently know little-to-nothing about



EDIT: It would help if you knew how to quote as well..... [/I]

get a life goodness?? Stop hating on everyone on the planet.....

 

[asmallchild]

Hate on me all you want, like Bruce Bowen Asmallchild, who loves to aggravate situations.

get a life goodness?? Stop hating on everyone on the planet.....

I'm done with you. Look in the mirror lately?

 

[andwhat]

I'm done with you. Look in the mirror lately?

 

[MOHS_01]

The worst, and most dangerous doctors, are the narcissistic who have no insight into that which they do not know.......

 

[DOCTORSAIB]

I'm done with you. Look in the mirror lately?

The worst, and most dangerous doctors, are the narcissistic who have no insight into that which they do not know.......

Guys, you're far too intelligent to get dragged into this again. I went through it a few weeks ago with him. I finally gave up.

No worries, he'll learn his lesson from the guy in the pin-stripped suit in Court Room C one day.

 

[cabinbuilder]

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.

Ok guys, I just signed a contract. I just graduated family practice residency and I am DO. I chose a rural site because I hate the city and it has lots of incentives.

I have $260,000 student loan debt

My base salary is $170,000 guaranteed or 40% gross whichever greater. The pay goes up 3K for every year I stay.

I have no overhead, I am employed by the hospital so they pay all licensing fees, the nurse, the biller, to coder, and own the charts.

I get 8 weeks paid vacation plus one week for conferences.

My call is one weekday each week, every fourth weekend.

It qualifies for federal and state student loan repayment so I will be free of student loans in 4 years if I stay.

I have no set contract and can leave at anytime with 3 months notice.

Had a medical contract lawyer look it over, my total contract is 6 pages, he said it was the best one he has ever seen. Not bad for just starting FP. Like I said though, I went way rural which isn't for everyone.

Hope that clears up any questions.

 

[thethom]

Hot-dammm...!

 

[andwhat]

Ok guys, I just signed a contract. I just graduated family practice residency and I am DO. I chose a rural site because I hate the city and it has lots of incentives.

I have $260,000 student loan debt

My base salary is $170,000 guaranteed or 40% gross whichever greater. The pay goes up 3K for every year I stay.

I have no overhead, I am employed by the hospital so they pay all licensing fees, the nurse, the biller, to coder, and own the charts.

I get 8 weeks paid vacation plus one week for conferences.

My call is one weekday each week, every fourth weekend.

It qualifies for federal and state student loan repayment so I will be free of student loans in 4 years if I stay.

I have no set contract and can leave at anytime with 3 months notice.

Had a legal lawyer look it over, my total contract is 6 pages, he said it was the best one he has ever seen. Not bad for just starting FP. Like I said though, I went way rural which isn't for everyone.

Hope that clears up any questions.

rural should pay a bit better actually. Don't get me wrong though that is very good. Does you're pay incorporate RVUs and bonuses? Or are they separate?

 

[cabinbuilder]

I'm not on an RVU system at this job. I looked at other jobs similar that did the RVU things and I didn't like it so I didn't do it. It's straight billing. I wanted a flat salary since I knew I wasn't going to be there forever and wanted an out without hassle about partner, buying into anything. I wanted the freedom to come and go as I pleased, when I wanted.

Sorry, forgot the sign on bonus and relocation reimbursement that is in addition to the base.

I didn't put this out there to get negativity because most of my fellow residents who stayed in the city are tied up with non-compete clauses and subsidized pay at the $120,000 range so I feel very good about my package. Just trying to give a real answer to the real questions.

Plus, look at the fact that I am just graduating and going from 42,000 as a resident to $170? There just isn't any comparison.

 

[andwhat]

I'm not on an RVU system at this job. I looked at other jobs similar that did the RVU things and I didn't like it so I didn't do it. It's straight billing. I wanted a flat salary since I knew I wasn't going to be there forever and wanted an out without hassle about partner, buying into anything. I wanted the freedom to come and go as I pleased, when I wanted.

Sorry, forgot the sign on bonus and relocation reimbursement that is also included.

I didn't put this out there to get negativity because most of my fellow residents who stayed in the city are tied up with non-compete clauses and subsidized pay at the $120,000 range so I feel very good about my package. Just trying to give a real answer to the real questions.

Plus, look at the fact that I am just graduating and going from 42,000 as a resident to $170? There just isn't any comparison.

\

non compete clause seen it steer clear of it. Great choice, sounds like you researched you're position well, and didn't jump into it.

 

[deleted87716]

non compete clause seen it steer clear of it.

Non-competes are pretty standard for most desirable positions, and aren't typically all that onerous. To remain enforceable, they can't restrict you for more than a few miles from your current practice for more than a couple of years. They're for the protection of the group that you're becoming a part of, remember, so look at it that way. If a group doesn't feel that it's interests are worth protecting, I'd frankly be more concerned about that.

 

[andwhat]

Non-competes are pretty standard for most desirable positions, and aren't typically all that onerous. To remain enforceable, they can't restrict you for more than a few miles from your current practice for more than a couple of years. They're for the protection of the group that you're becoming a part of, remember, so look at it that way. If a group doesn't feel that it's interests are worth protecting, I'd frankly be more concerned about that.

true, I have seen very very interesting lawsuits, published in the newspaper, against a Cardiologist.
One Cardiologist left the local group, and tried to establish a practice on his own, less than one mile away.
The company did anything and everything, to prove that this guy was out of line, and stealing patients.
The court obviously didn't care what the company thought, and the patients were very generous of the Cardiologist's time and efforts, in staying in the community.
How much clout does a 'non-compete' clause actually have? I wouldn't sweat it honestly.

 

[Octagonecology]

Had a legal lawyer look it over,

is there any other kind? lol.

 

[deleted87716]

How much clout does a 'non-compete' clause actually have? I wouldn't sweat it honestly.

No? Look up the word "injunction." Then, look up "money damages."

Then, ask yourself...

...do you feel lucky?

Well, do ya, punk?

[YOUTUBE]7l2y8HDU7-U[/YOUTUBE]

 

[cabinbuilder]

is there any other kind? lol.

Sorry, still a tired resident. Medical contract lawyer. I fixed the original post.

 

[Octagonecology]

Sorry, still a tired resident. Medical contract lawyer. I fixed the original post.

Man that is an awesome deal. You did well, congrats. So there is hope for us that want to do FP.

170K w/ no overhead at all? 8 weeks plus CME? Man you got over like a fat rat.

Are there any downsides to your contract? Do you think it will be rough being an employee of the hospital? I just wonder if there will ever come a time where you will be sitting across the desk from a 25 y/o intern hospital administrator and asked to "explain yourself" due to some frivolous complaint or something.

 

[cabinbuilder]

Man that is an awesome deal. You did well, congrats. So there is hope for us that want to do FP.

170K w/ no overhead at all? 8 weeks plus CME? Man you got over like a fat rat.

Are there any downsides to your contract? Do you think it will be rough being an employee of the hospital? I just wonder if there will ever come a time where you will be sitting across the desk from a 25 y/o intern hospital administrator and asked to "explain yourself" due to some frivolous complaint or something.

I don't see many downsides, have to pay for my own health insurance but if I get treated at the hospital there's no charge. I don't see any problems with the admin, she is the one who hired me and I really like her. She did all my paperwork for licensing/credentialing, all I had to do was sign my name. The thing is they have a hard time recruiting doctors because it is so far out. It takes a special person to live out in the wilds and it's not a bother for me. I am 2 hours away from the nearest major city so you have to go that far for groceries, furnature, clothes, etc. I grew up that way so that was not an issue for us. I like being an employee because I don't plan on living there forever, just until my loans are paid and then moving on. So I wanted the freedom of being able to leave without ties. It wasn't important to me to buy into a practice or be partner. I grew up in a really small town (500pop.) and people who live out there accept the risks and tend not to have frivolous complaints. They are generally happy to have any health care at all and do their best to keep doctors. It's a great deal for me and my family. Yes, there is hope for all of us FP docs, you just have to be willing to go where the money is. And remember that it's not forever but living in the wilds you get to do everything. My job is clinic, inpatient (12 bed hospital), nursing home (20 patient home), and ER (no ER physician). I will be the 4th FP in town and we all share the responsibility. My residency was extremely ER heavy so I like that part of it. I don't do OB and am not expected to. That's not part of my contract. I can do it in an emergency but not per usual. There is another FP who does the OB. I would rather suture, cast, ER, etc. I also do great OMT so they are selling me as the manipulation specialist which is great.

 

[lowbudget]

I grew up in a really small town (500pop.) and people who live out there accept the risks and tend not to have frivolous compaints. They are generally happy to have any health care at all and do their best to keep doctors.

During a time, on a thread, where all people can do is talk about the money they make, they should be making, that they won't make, that others are making, I think you'll that this will be the biggest payoff you'll receive.