Family Med - salaries, sign-ons, loan payoffs, bonuses, etc

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Originally Posted by cabinbuilder

OK, so I just did some random job search in Kansas for a permanent position for family practice on locumtenens.com This is what I came up with. There are about 40 jobs listed. Give you some idea.


Hutchinson, KS – Family Medicine
Multi Specialty Group
FAMILY PRACTICE PHYSICIAN JOB DESCRIPTION

Join physician-owned, 70 physician multi-specialty group in Hutchinson, KS.
• Group recently acquired a smaller group in the area and is in need of additional family medicine physicians to support the increase in volume.
• Group currently has 14 family medicine physicians.
• Mon thru Fri practice with normal office hours.
• See around 25 physicians per day.
• $190K compensation + comprehensive benefit package + $25K signing bonus+ partnership option after 18 months. Nice community with population of 45K, just 45 minutes from Wichita, KS!

PROFESSIONAL DETAILS - FAMILY PRACTICE JOB

Titles DO, MD Location Kansas Specialty Family Practice Job Type Permanent Board Certification Negotiable On Call Negotiable Compensation Permanent($190,000) Telemedicine No Government No

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Originally Posted by slp2doc

Again, I have to ask if what my wife makes is consistent with other non-profits. Sure, she is way beneath the mean for docs in private practice, hospitals, or for-profit clinics; but, what about the FQHCs?

Well, some sites on the internet say $126,000 is average for FQHCs across the country. I can't say for sure how accurate that is, but my gut feeling is to say that that's probably not too far off.

Keep in mind that local FQHC salaries will vary based on reimbursement patterns in the area. Still, I really feel that your wife is probably getting paid quite a bit less than she could working elsewhere in that geographic area.

Hi, I have a few quick questions

1) What are the best websites to look for jobs as a FM doc?
Also, few of the ones I've looked at do not post salary, only say "competitive"

2) What is you take on FM docs working in the ER? I've heard salaries range around 200K-360K. What are the pro's & cons of FM docs working in the ER?

3) I am a first year resident and my program does not give us "classes" per say on what to do after finishing residency.. ie. looking for jobs, opening a practice etc.
so after residency, do recruiters normally find you or do you have to do all the job hunting yourself?

Thanks for the help

I know the $60K salary quoted is after taxes, and it doesn't take into account any loan repayment, but I just wanted to say one thing:

$60K a year / 60 hours a week = $20 per hour

Originally Posted by MT Headed

I know the $60K salary quoted is after taxes, and it doesn't take into account any loan repayment, but I just wanted to say one thing:

$60K a year / 60 hours a week = $20 per hour

Are you saying this is a good or a bad thing? Because a RN with a 2 year degree makes between $22-32/hr.

Originally Posted by MT Headed

I know the $60K salary quoted is after taxes, and it doesn't take into account any loan repayment, but I just wanted to say one thing:

$60K a year / 60 hours a week = $20 per hour

Yes; it appears the high-schooler who mows our lawn makes as much per hour as my wife.

I appreciate everyone allowing me to jump on this thread and do some venting. In defense of my wife's situation, I will again say she loves what she does, and where she does it. The heart she has for her patients, and the care she gets to give them is what has inspired me to pursue medicine; she, and her experience, are the reasons I am going premed this fall.

Yes, she gets paid peanuts. Is her employer taking advantage? Probably. Unfortunately, such is the case often with non-profits--they overwork and underpay their most valuable commodity: employees.

All the data has been good to see, and has functioned as a wake-up call.

Everyone here has been so helpful. Thank you.

1) What are the best websites to look for jobs as a FM doc?locumtenens.com
goldfish.com
comphealth.com
deltalocums.com
martinfletcher.com
MDjobs.com
arthurmarshall.com
onyxmd.com
merritthawkins.com
staffcare.com

That's what I know off the top of my head, many are both locums and permanent job listings as I have done both. My advice is to pick 2 or 3 companies to work with other wise your phone will never stop ringing and you will have too many choices to pick from and you cannot possibly go on all the potential job interviews. My husband and I had a poster where I did a grid that had location, contact, phone number, salary, package, etc as he was the person at home all the time to answer the phone. That way he knew which job was on the line at any given time.
Also, few of the ones I've looked at do not post salary, only say "competitive" : Competitive to me is in the 180K range or higher.

2) What is you take on FM docs working in the ER? There is nothing wrong with it as long as you are confident and qualified. I have worked ER and many of my FP friends have also worked ER. Usually it's in smaller hospitals in the rural setting.

I've heard salaries range around 200K-360K. What are the pro's & cons of FM docs working in the ER? Not sure the nature of this question. Comes down to the training and competance, and confidence of the individual doctor. I'v seen some really bad ER trained docs who kill people and really great FM docs in the ER.

3) I am a first year resident and my program does not give us "classes" per say on what to do after finishing residency.. ie. looking for jobs, opening a practice etc.
so after residency, do recruiters normally find you or do you have to do all the job hunting yourself? Towards the end of the year you should get some type of lecture about job recruitment. One of the residents asked one of our attendings who is very successful come talk about business do's and dont's and partake some of his knowledge on us for future.

Recruiters do not find you. You have to post your CV on a website and then they will call. You will need to find a way to control the barage of folks fighting to place you. See my answer to question number one.


When you go to an interview and you really want the job be sure you obtain a letter of intent at the interview if they hint that they are interested in you and offer you the position. Many time it takes weeks to get the actual contract from their lawyers so that LOI is a binding contract and closes the job. Be sure you have the contract reviewed by a contract lawyer, invest in the $300 to make sure there are no loopholes. Also be sure you have a way to quit or resign without having to pay the malpractice tail coverage - this is a huge thing. Sometimes if you resign you have to pay back the moving, sign-on, etc.You want to be able to walk away clean without owing anyone any money. I learned that the hard way. I had one job where I had to pay back $8000 and was given 60 days to do it. I went on a locum job over a holiday weekend, paid back the money and moved on.

Originally Posted by MT Headed

I know the $60K salary quoted is after taxes, and it doesn't take into account any loan repayment, but I just wanted to say one thing:

$60K a year / 60 hours a week = $20 per hour

You have to compare pre-tax income to pre-tax income. Most people who say, "I make $xx per hour" are talking about pre-tax income, just as people who discuss salary (a fixed wage regardless of hours worked) are usually talking about pre-tax income (e.g., $100K/yr.) This makes sense, because taxes vary depending on the individual, where they live, deductions allowable, etc. Technically, $100K per year (assuming 4 weeks of vacation, so 48 weeks working 60 hours/wk.) works out to closer to $35/hr.

Still, not great for a physician.

FWIW, the docs I know who only earn $100K/yr. are working part-time (around 20 hours per wk).

Keep in mind also that salary does not take into account the value of any additional benefits, such as retirement, disability or malpractice insurance, health insurance, CME, etc. Most employers provide their employees with most or all of these perks. If you're self-employed, most of that will come out after taxes. So, don't be confused by inflated income figures for locums or independent contractor jobs.

Originally Posted by Blue Dog

Keep in mind also that salary does not take into account the value of any additional benefits, such as retirement, disability or malpractice insurance, health insurance, CME, etc. Most employers provide their employees with most or all of these perks. If you're self-employed, most of that will come out after taxes. So, don't be confused by inflated income figures for locums or independent contractor jobs.

I have to agree with this. Working locums is pure cash in hand, they do not take out anything for taxes, there is no retirement, and no health insurance. The only thing provided is malpractice coverage, travel, and housing so you have to be sure to fund your own IRA, buy your own health insurance, etc. Seems like more work and some would rather have the extras included in their job. For me I am too much of a gypsy and would rather not have to be under the thumb of some administrator. I've had too many bad things happen to me I'm just not ready to jump back into a contract job.

thank you for the response to my questions!

as far as the salary question goes, is it fair to say 275K is average for a FM doc working in the ER? or is calculated per hour? ie. $125 per hour

I feel that talking about salaries is very taboo in the medical field.

Originally Posted by docmd1234

thank you for the response to my questions!

as far as the salary question goes, is it fair to say 275K is average for a FM doc working in the ER? or is calculated per hour? ie. $125 per hour

I feel that talking about salaries is very taboo in the medical field.

Hard to say. Really depends on the contract you work out with the employer. Where I did residency, the ER docs go paid by the patient and how well the charting was done. There are so many ways ER docs get paid that it's hard to make a generalization across the board. But if you working ER locums then that would be by the hours. I'm sure there are salary ER docs too.

Originally Posted by SBB2016

I can tell you for certain, that my friend, who is a general hospitalist in Mpls/St. Paul area is making 220 (Salary) PLUS sign-on bonuses and some loan repayment (not sure how much loan repayment)... She works 7-11s and then has 7 off and still gets her ~4wks vacation... I have no fear about going into primary care. My mentor makes ~190-200 (his pay is incentivized) and is in a clinic... He has call like once every 2 weeks...

this is Hospitalist, and not traditional outpatient. Interesting to find out the Traditional Family Practice salaries are, that do not involve the ER, or Hospitalist job.

Originally Posted by cabinbuilder

Yikes, how do you pay the bills with salaries that low? I cannot imagine.

those arent bad for starting salaries.

Originally Posted by EdibleEgg

I worked for the man doing locums my first year out of residency. My hourly rate was 60-90 dollars per hour, depending on location, call, etc. I'm now in my third year of private practice. It's difficult. I put in a ton of hours. I admit my own inpatients, see about 25 patients a day in the office, do lots of procedures, and approximately 6 shifts in the ED a month. I don't want to do this forever, but I've allready paid off all of my student loans and my home with a good bit left over in my retirement account. My pre tax income is over 300K, and I did not pay over half in taxes.

thats a rigorous lifestyle, hope that you dont do it long.

Originally Posted by docmd1234

I feel that talking about salaries is very taboo in the medical field.

It's not just a medical thing. Most people don't go around talking about how much money they make, unless they're jerks.

Agreed, but I've found that many people will discuss it if you ask. Mostly, they are concerned that you may be making more money. It is difficult to compare income though. Things are so different across the scope of family medicine. The first job I really considered was at an academic center, I now make more that twice the starting salary, but work 30 hours more a week with no benefits.

Sleep is for the weak.

Originally Posted by andwhat

those arent bad for starting salaries.

I beg to differ, My first salary out of residency was 180K, have only gone up from there.

[QUOTE=cabinbuilder;12186362]

Originally Posted by SnakeOil

Yeah even all those things added up shouldn't be 40% of your paycheck. Even if you're single, rent, contribute little to a 401k, and have no kids your tax burden should be closer to 30%. If you're married, have kids, own a home, and max out your 401k your effective tax rate should be much closer to 20% or lower on 180k.[/QUOTE]

Man I wish, my tax rate this year comes out to 34.5% and I have a husband, 2 kids, own a home and have a 401K on 180K base. The $$ aren't stretching for me. Will see what my tax return comes out to be and how much I will still have to pay this year

Tax Bracket Married Filing Jointly for 2011
10% Bracket $0 – $17,000
15% Bracket $17,001 – $69,000
25% Bracket $69,001 – $139,350
28% Bracket $139,351 – $212,300
33% Bracket $212,301 – $379,150
35% Bracket Over $379,150

Yay, the tax laws changed in my favor. Only had to fork over another 5K this year instead of the 27K I did last year. So glad.

What about the threat from Nurse Practitioners who will basically be referral mills.... My town is opening a DNP program for Family Nurse Practitioners since their is such a shortage... It makes me not want to go back to my hometown which was my intention all along.. Really disheartening..

I think Physicians should not accept referrals from NP's. They lobbied and got full prescriptive authority, so why not let them take the whole cake and let them try and manage their own patients only referring to other NP's.

Originally Posted by g1p3e4

What about the threat from Nurse Practitioners (blah, blah, blah.)

As you noted, independent NPs are not a threat to physicians. They're a threat to patients.

As for your suggestion that physicians not accept referrals from NP "referral mills," two wrongs don't make a right.

All of this has been beaten to a bloody pulp in numerous prior threads on the subject, so further discussion here is off-topic. This thread is about physician salaries.

Originally Posted by Raptrix

FM (primary care, right?) isn't going to be affected by Obamacare, correct?

The physician income-related elements of the PPACA are generally positive for primary care.

I have a family med salary question. If the PPACA survives and most patients become insured one way or another, how would that affect the salary of family practice clinics that don't accept insurance? I'm thinking specifically of places like Dr. Forrest's Access Healthcare setup. Today they have a mixed clientele of the uninsured plus people who are either too disgusted with their current insurance or don't mind filling out insurance reimbursement forms themselves. But if everybody has one form of insurance or another, do you think the bottom will fall out of this kind of arrangement?

P.S. I see Access Healthcare now has an optional "Access Card" which shifts the model into more of a concierge/contract type clinic, but I was thinking more along the lines of the original "$50, see a doc" vision and 0.33 administrators per provider to reduce unnecessary overhead.

Originally Posted by MT Headed

I have a family med salary question. If the PPACA survives and most patients become insured one way or another, how would that affect the salary of family practice clinics that don't accept insurance?

Theoretically, it might decrease the pool of uninsured patients who would otherwise find a cash-only practice to be their only affordable option. However, many insured patients currently utilize cash-only practices because they have high deductibles, and it's cheaper than using their insurance (which is basically catastrophic coverage only). This wouldn't likely change with insurance reform.

Can someone tell me what an average hourly urgent care job pays and what a "good" urgent care job salary is?

Originally Posted by Seafood

Can someone tell me what an average hourly urgent care job pays and what a "good" urgent care job salary is?

I have only worked urgent care as locums. Depending on the region I get $80-90/hr for regular pay and $125/hr for holiday pay.

Originally Posted by andwhat

this is Hospitalist, and not traditional outpatient. Interesting to find out the Traditional Family Practice salaries are, that do not involve the ER, or Hospitalist job.

The 220k is hospitalist yes, the 190-210 is outpatient clinic. For reference, the outpatient clinician is in an area with a MUCH lower COL, so he's basically making the same. Not to mention he lives 3 blocks from his clinic, so he has very little commuting expenses... Those are both in MN...

Originally Posted by OneLeven

Medpsy82 - you are forgetting interest. And - to take home 120k - you need to make ~200k, possibly more.

Does anyone else have any experience using NHSC for loan repayment after residency? Their websites and the job posting make it sound "readily available", but from what cabinbuilder is saying that does not seem to be the case.

Can anyone else shed some light on this from their experience?

I'm a scholar, not LRP, but I can tell you for FY2012 they are still giving away thousands of loan repayments/year. My impression is that since the LRP went to rolling application, instead of deadline based, it's trickier to get an app in and accepted while they have cash on hand. I also think the legislative shenanigans may have caused some gaps in cashflow periodically.
I did not receive the scholarship the first time I applied. I reapplied the next year, and got it. I can't guarantee persistence pays off, but in my case it did. And I'm not "special" for NHSC -I'm not a minority or impoverished.
I think it helps a lot if you look for jobs in clinics where they have successfully submitted NHSC LRP paperwork in the past, and you follow through on the paperwork like you are fighting Russian bureaucrats. Take names, be a pest, they lose stuff like you wouldn't believe, and won't tell you if one page of a fax is missing.

Regarding salary: Yeah, mid-Atlantic salaries I have heard are consistent w/ above posts. You can make something around 200 as a hospitalist, but starting in outpatient only (call q8ish from home, etc) is 120-140. Rural starting is higher, but more likely a mix of inpatient/outpatient, and you should demand loan repayment and a guaranteed high salary for 5 years, IMHO, based on what attendings have told me. Rural hospitals pay through the nose for locums, and if you get them out of that hole, they should share the spoils with you as long as you are meeting expectations.

chief resident at my program received job 1 hour outside major city, 240,000 to start not including bonus ( don't remember what and how much it was) hospitalist, one week on one week off. Week off doing locums and possibly some ED work looking at 320-350 for year. Other third year resident doing ED small rural med hospital about 1 hour outside major city starting with 300,000. I have no worry about making bank as a primary doc, just can't be too picky and have to realize that I will be commuting at least 30 minutes outside a major city wherever I choose to permanently hang my hat.


-DON'T BE TOO PICKY

Originally Posted by cabinbuilder

NO assumption here. The numbers I gave are my reality. Hard data doesn't mean crap in the real world. Just like all those "evidence based medicine"folks who constantly quote journal articles but have no clue about what it really means to take care of a live patient. You have to be fluid in your decision making. My contracts are my hard data.

"...Just like all those "evidence based medicine"folks who constantly quote journal articles but have no clue about what it really means to take care of a live patient. You have to be fluid in your decision making. ..."

Holy Cow Cabinbuilder! You're awesome. . .and you speak truth!

Originally Posted by jl lin

"...Just like all those "evidence based medicine"folks who constantly quote journal articles but have no clue about what it really means to take care of a live patient. You have to be fluid in your decision making. ..."

Holy Cow Cabinbuilder! You're awesome. . .and you speak truth!

Just trying to keep it real, folks. Don't let the bitches get you down!!! (and I can say that cuz I'm a woman) Don't want to hear it.

"You have to be fluid in your decision making..."


...Truer words were never spoken.

Originally Posted by cabinbuilder

Job offer Alpine
Job offer Glenrose
Locums Colorado City
Locums Livingston
Residency: Corpus Christi

It's funny that I came across this. I haven't read the entire thread, so I don't know where you've actually ended up taking a job, but I'm from Glen Rose, TX. I grew up there, from the ages of 5 to 14. I feel like I should warn you ahead of time: it's a god damn hell hole. Seriously. The town of Glen Rose was founded back in the 1800s when the nearby town of Granbury took all of its "drunks, witches, and devil-worshipers" and kicked them out of town. No, really. You can't make this **** up. Everyone there is a racist, homophobic fundamentalist piece of white trash. In the 9 years I lived there, there was only one black family in the town, and they moved out after three months because of all of the hostility they encountered. Glen Rose is the most backwoods, inbred stain on the map of the US that you could possibly find. Avoid at all costs.

Cabinbuilder does not work in Glen Rose

Jl lin, she is awesome! CB, have you thought about doing a blog?

Originally Posted by SBB2016

Cabinbuilder does not work in Glen Rose

Jl lin, she is awesome! CB, have you thought about doing a blog?

No, I do not work in GlenRose. I don't work in Oregon anymore for that matter since the town I live in is also backwoods and I resigned from my job 3 months in. I am still doing locums and will soon be in the Nevada desert doing 2 weeks on/2 weeks off come May.

No, I have not ever thought about doing a blog. Honestly I wouldn't even know how to do that. I appreciate the fan club and try to keep things real for everyone out there. I'm on this site enough as it is, I don't need to add anymore I don't think. I have been fortunate that my last locums job was very slow (2-5 patients a day) so I had lots of time to "chat". Been on vacation here the last 2 weeks. Working locums in April. My time on line is expected to wane here shortly so the responses will get fewer here soon. I do have a 24 hour reply for any PM's though. Keep plugging everyone.

Originally Posted by cabinbuilder

No, I do not work in GlenRose. I don't work in Oregon anymore for that matter since the town I live in is also backwoods and I resigned from my job 3 months in. I am still doing locums and will soon be in the Nevada desert doing 2 weeks on/2 weeks off come May.

No, I have not ever thought about doing a blog. Honestly I wouldn't even know how to do that. I appreciate the fan club and try to keep things real for everyone out there. I'm on this site enough as it is, I don't need to add anymore I don't think. I have been fortunate that my last locums job was very slow (2-5 patients a day) so I had lots of time to "chat". Been on vacation here the last 2 weeks. Working locums in April. My time on line is expected to wane here shortly so the responses will get fewer here soon. I do have a 24 hour reply for any PM's though. Keep plugging everyone.

^ u da shiznit CB! Good luck in the dessert with the new gig!

I just matched into FM and I am really excited because I picked what I enjoyed the most. I love learning about everything and always keeping myself up to date.

However, many attendings and residents have told me that FM is struggling because of reimbursements (doesn't make sense when the demand is so high). Some quote things such as you'll only get 15-20USD/visit and it doesn't even break often.

This concerns me because I have over 250k in debt (undergrad + med school, no rich parents to foot the bill).

Is there any way FM can make more money (250-300k annually) (legally, ethically, and something probable)???

ie: working 6days/week? doing OB pay a lot more? how about the difference of private group practices vs hospital employment?

PS: Im aware of medicine by cash subscriptions but honestly, how many FM physicians can really get into that? It seems very limited.

PS2: I speak fluent Spanish (first language) and will be in areas filled with Spanish speaking patients, is this helpful for earning more ?


Final note: im not writing this cause I'm in it for money/greed but because I have over a quarter million in debt!

Originally Posted by Ultralisk415

Is there any way FM can make more money (250-300k annually) (legally, ethically, and something probable)???
[/I]

Yes there are many options. You've got a lot of time with just starting residency to feel out how you could get to that goal. Options include but are not limited to:

• Busy rural private practice that does it all (inpt, Ob, lots of procedures...)
• Private practice, outpatient only, that is very well run with a good payor mix
• A busy Hospitalist gig, and you could do urgent care, rural ER, etc inbetween time on the wards

The list goes on but yes that money is totally doable. Speaking spanish definitely makes you more competitive compared to other applicants for certain gig's, but honestly not sure if you can ask for more $$ b/c of it- wouldn't suprise me though.

There's nothing magical about it: work hard in residency, make connections with doctors and practices/hospitals you're interested in working at, and get after it!

Congrats on matching into Family. Doing what you love is the way to go.

~Smiley

Originally Posted by Ultralisk415

Is there any way FM can make more money (250-300k annually) (legally, ethically, and something probable)???

]

Let me just say that the answer is yes. While I'm not going to elaborate I just signed a contract where the base pay is >300K starting plus bonuses.

Rural medicine is where the money is.

Wow Cabinbuilder, you are the woman !!! Congrats on securing such a gig. Good luck with it.

Originally Posted by cabinbuilder

Let me just say that the answer is yes. While I'm not going to elaborate I just signed a contract where the base pay is >300K starting plus bonuses.

Rural medicine is where the money is.

Originally Posted by Paaakwasi

Wow Cabinbuilder, you are the woman !!! Congrats on securing such a gig. Good luck with it.

Thanks, I could use a little love. The haters came out in full force in the pre-osteo forum today. I got so pissed off I just deleted everything I wrote. Get soooo tired of being attacked when my posts are meant to be informative, not absolute.

Originally Posted by cabinbuilder

Get soooo tired of being attacked when my posts are meant to be informative

Probably best to avoid the pre-med forums, in that case.

Believe me, I understand you. The Pre-Med forums in general are annoying, that is why I don't post there anymore aside from the school specific forum. I think your gig is sweet and always do what makes you happy.

Originally Posted by cabinbuilder

Thanks, I could use a little love. The haters came out in full force in the pre-osteo forum today. I got so pissed off I just deleted everything I wrote. Get soooo tired of being attacked when my posts are meant to be informative, not absolute.

CB, you da bomb! No question!!!

I hear the lowest salaries are in big cities in the northeast...120s-150s out of residency. With the cost of living being as high as it can be in places like DC or NYC...Often with tougher ancillary staff, more lawyers. dunno, maybe moonlight? Anyone have experiences in these cities right of training?

Originally Posted by Shinken

If people are having trouble paying bills with a six-figure salary perhaps those people need a more realistic lifestyle.

By the way, everyone realizes that the salary they report is always the take-home salary before taxes, and after all overhead and expenses are paid, right?

When someone offers to hire you for, say, $150k, that means that you will be taking home a salary of $150k at the end of the year. You do not have to pay off malpractice, staff, overhead, etc. off of that salary.

As a family doc, I'm expected to make about $350,000+ in revenue, and after you deduct malpractice, staff salaries, overhead, then I will be taking home a salary in the range of $150,000-190,000 depending on productivity.

Considering that you are not taking home 150K per year, but rather 110, 470 per year, which translates to 9206 per month. I currently pay $2200 a month in loan repayment, so that'll bring it to roughly 7000 a month. Rent is, what, $1500 a month for a decent place? Minus 500 in groceries and 400 in gas? so that'll take you to 5K a month in disposable income? Not bad, but definitely not great. Considering specialists will make double to triple what you make...

Originally Posted by Biscuit799

Considering specialists will make double to triple what you make...

There's no guarantee that they always will.

Do you generally expect to make more if you are also supervising a PA too? Also, does pay tend to increase if are one of two or three doctors in a small town (a valuable commodity)?
This does make family practice look fairly lucrative

Midwest town with a population ~300,000...
The offers I've gotten for o/p FM with no OB or hospital call and with q8-10 office call have been in the 140s. FM with OB and q3-4 OB/office call about 35-45min away starts in the 220s. Urgent Care and ER is typically hourly pay without benefits for 90-110/hr, more if you have ATLS and have the numbers and documentation to support working in a trauma center.

I am curious if that o/p pay is really so low. I've had 3 offers locally in that same range and my colleagues tell me it's an insult, but no one can produce evidence that there are places in town offering more.

Originally Posted by Roguelyn

Midwest town with a population ~300,000...
The offers I've gotten for o/p FM with no OB or hospital call and with q8-10 office call have been in the 140s. FM with OB and q3-4 OB/office call about 35-45min away starts in the 220s. Urgent Care and ER is typically hourly pay without benefits for 90-110/hr, more if you have ATLS and have the numbers and documentation to support working in a trauma center.

I am curious if that o/p pay is really so low. I've had 3 offers locally in that same range and my colleagues tell me it's an insult, but no one can produce evidence that there are places in town offering more.

Dang 140K is a total insult. I wouldn't settle for less than 180K especially if you have lots of student loans. You will never break even or get ahead. Problem is that the area you live in is too large and the bigger the city, the lower the wage.

Originally Posted by cabinbuilder

Let me just say that the answer is yes. While I'm not going to elaborate I just signed a contract where the base pay is >300K starting plus bonuses.

Rural medicine is where the money is.

How rural is rural? We talkin', no Walmart within 100 miles?

As a fellow Northwesterner; Tillamook, La Grande?