500k?

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VA Hopeful Dr said:
Fewer and fewer EDs are wanting family doctors that aren't already working in EDs. I'm only 3 years out of residency, but even if I wanted to (outside of either the boonies or fast-track) very few EDs would hire me.
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VA I think it's both for some FMs. But moonlighting is just trading time for pay. To make significant income you have to leverage time and people. That means owning the urgent care.
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VA Hopeful Dr said:
Fewer and fewer EDs are wanting family doctors that aren't already working in EDs. I'm only 3 years out of residency, but even if I wanted to (outside of either the boonies or fast-track) very few EDs would hire me.
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What's wrong with commuting to the boonies for a 24 hour shift with low acuity at $200/hour every now and then? Seems worth it to me.


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styphon said:
I find this quote funny, it implies you can "take it easy" and make >$200k.
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It all depends on how you work, and who you work for. I've made >$200K for years working four 8-hour days/week seeing 20-25 patients/day. I wouldn't call that "taking it easy," but I'm definitely not burning myself out.
 
Blue Dog said:
It all depends on how you work, and who you work for. I've made >$200K for years working four 8-hour days/week seeing 20-25 patients/day. I wouldn't call that "taking it easy," but I'm definitely not burning myself out.
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After 3, 12-hour shifts per week seeing 60 patients per day in Urgent Care I would absolutely call that "taking it easy" :p
 
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BlackDynamite said:
What's wrong with commuting to the boonies for a 24 hour shift with low acuity at $200/hour every now and then? Seems worth it to me.


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That becomes much less appealing once you're out, have a family, and are used to banker's hours
 
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VA Hopeful Dr said:
After 3, 12-hour shifts per week seeing 60 patients per day in Urgent Care I would absolutely call that "taking it easy" :p
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It's a pretty typical schedule in my group. Most of us take one day off/week, and very few work on weekends. Those who want to work more certainly can, but most of us would rather "work to live, not live to work" as the saying goes.
 
Blue Dog said:
It's a pretty typical schedule in my group. Most of us take one day off/week, and very few work on weekends. Those who want to work more certainly can, but most of us would rather "work to live, not live to work" as the saying goes.
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And if I lived in your area I'd have already applied for a job. The PP groups around here are more in the volume + ancillary services = money mindset which I just don't care for.
 
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surrender903 said:
how much money are you spending to get to the boonies? is the money you are spending to to the shift you are making money at worth it?
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For me? It would be a 20 minute drive from the suburbs where my clinic would be.


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VA Hopeful Dr said:
That becomes much less appealing once you're out, have a family, and are used to banker's hours
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I was thinking I would just cut back on clinic, maybe three to four days a week and then do a 24 hour shift (mostly sleeping for 8-12 hours of it).

Maybe there's something I'm missing here though.


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BlackDynamite said:
I was thinking I would just cut back on clinic, maybe three to four days a week and then do a 24 hour shift (mostly sleeping for 8-12 hours of it).

Maybe there's something I'm missing here though.


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Why not just work an extra day at the practice - 4 days instead of 3 or 5 days instead of four? Heck, even an extra half day over the course of a month will work out to about the same as one 24-hour ED shift a month and it won't screw up your sleep schedule, home life, or anything like that.
 
Well I was thinking 5 days of clinic for 230k or 3 days of clinic and 1 x 24 hour shift for 387.. Hopefully sleeping through most of the night and not wrecking my schedule.


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styphon said:
I find this quote funny, it implies you can "take it easy" and make >$200k.

I work 6 days a week, about 60 hours a week, and I make much, much less than 500k. Even if I chose to work 80 hrs a week, I still would make about $400k. Not only that, but working as I do now, I make more than at least 75% of my FM colleagues in the local geographical area.
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I take it you don't own your own practice and hire NPs/PAs
 
I honestly think it would not be difficult for most family physicians with a full panel to pull at least 250,000/year and even up to 300,000 a year. This is especially true in a productivity-based model.

For example, assuming a rvu rate of around 41 dollars, an individual would have to pull about 4630 rvus a year to make 190,000 dollars/yr , which equals about 385/month. If you can bill correctly, you could FAR EXCEED this in one month.

Per my own personal example, I see on average about 20-27 patients a day. I bill mostly Level 4 established patients (60%) and Level 3 with a mix of procedures, and then a Level 1 visit for a INR check or controlled substance visit. This is about 1.3 rvus on average per patient visit. I was able to pull in about 583 work rvus on average per the first three months of this year. My partners (just two other physicians) averaged 666 RVUS as they have more established panels and have far more patients to see. I expect they will get to far above 300,000 dollars for 2016 in terms of overall compensation (not including benefits such as CME, 4o1K, etc). We all work as employees for a big hospital system. Sure, we work hard but we need to in order to provide access for patients. We are glad to overbook our schedules if it means preventing a patient from going to the ED or urgent care. We do not work nights or holidays. We work one Saturday sick clinic from 8-12 about once every two months that is very easy and simple.

You will not go hungry in primary care if you work hard and learn how to bill properly. Quality of life is awesome. There are days where the job sucks, but I am far happier doing this than anything else. Granted our situation is a little more rare as we have had a large number of primary care physicians either retire, pass away or move over the past six months. However, this is not atypical for a lot of places in this country. Primary care is in demand.
 
raginasian1 said:
I honestly think it would not be difficult for most family physicians with a full panel to pull at least 250,000/year and even up to 300,000 a year. This is especially true in a productivity-based model.

For example, assuming a rvu rate of around 41 dollars, an individual would have to pull about 4630 rvus a year to make 190,000 dollars/yr , which equals about 385/month. If you can bill correctly, you could FAR EXCEED this in one month.

Per my own personal example, I see on average about 20-27 patients a day. I bill mostly Level 4 established patients (60%) and Level 3 with a mix of procedures, and then a Level 1 visit for a INR check or controlled substance visit. This is about 1.3 rvus on average per patient visit. I was able to pull in about 583 work rvus on average per the first three months of this year. My partners (just two other physicians) averaged 666 RVUS as they have more established panels and have far more patients to see. I expect they will get to far above 300,000 dollars for 2016 in terms of overall compensation (not including benefits such as CME, 4o1K, etc). We all work as employees for a big hospital system. Sure, we work hard but we need to in order to provide access for patients. We are glad to overbook our schedules if it means preventing a patient from going to the ED or urgent care. We do not work nights or holidays. We work one Saturday sick clinic from 8-12 about once every two months that is very easy and simple.

You will not go hungry in primary care if you work hard and learn how to bill properly. Quality of life is awesome. There are days where the job sucks, but I am far happier doing this than anything else. Granted our situation is a little more rare as we have had a large number of primary care physicians either retire, pass away or move over the past six months. However, this is not atypical for a lot of places in this country. Primary care is in demand.
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This is very comforting
 
If I wanted to do something extra to make more money, I could take some shifts at our group's after-hours clinic and/or do nursing home. I just don't want to.
 
Ericslv said:
raginasian,

Are you currently doing that? Have you ever done that?
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I just graduated residency last year, so I have nothing to compare to. I was convinced I would not even generate enough revenue to meet my salary when I signed my contract. I was surprised that I was able to exceed my first month salary in productivity and I was not even seeing even 20 patients a day.

I am currently generating that much and could potentially exceed this. Granted, I work in a fairly rural area that is about 45 minutes outside of a reasonably large metropolitan area. Not the greatest place to live, but it is my hometown.

Our payor mix is also not ideal. We see about 50% Medicare, 10% Medicaid (about 90 percent over age 18), 3% self pay, and the rest is commercial.
 
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Merely said:
I take it you don't own your own practice and hire NPs/PAs
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I work with a PA for an IHS/tribal facility, but I do not own my own practice, so I do not profit from them.

raginasian1 said:
I honestly think it would not be difficult for most family physicians with a full panel to pull at least 250,000/year and even up to 300,000 a year. This is especially true in a productivity-based model.
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Lots of hospital own clinics offer around 200k for salaried positions (not RVU based) for a Mon-Friday job, it is easily with an extra shift at a nursing home, ER, urgent care to boost that to 250-300.
 
Lostin_space said:
If you have an accountant that charges 500$/hr, then you are a really poor business person. No accountant that I know charges that for one. If you can't find an accountant that charges much less (and 99.9% of accountants don't charge per the hour btw), then you are doing something terribly wrong. Our accountant does miracles and he charges by the job not the hour.
Second there are TONS of lawyers these days, so if you have one of the few that charges that, then simple - get a new lawyer. Tons and tons of lawyers charge by the job, and not the hour. You simply need to become a better business person. Sorry.
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You get what you pay for. You know nothing of my business acumen, thank you very much.
 
Merely said:
Some of you are commenting about making 200k/yr which is obviously attainable. I think what a lot of us are interested in is knowing if we can hit the 500k, 750k, 1m+ mark. I know there are certainly GI docs running scope factories def hitting that so I was wondering if that is possible in FM as well. Keep in mind, money is not worth anything if you are unhappy with your life and job. If you are going to be working that hard, you better love what you do. I'm just talking about the person who loves FM and would also love running a successful practice to hit that 1m+ mark. Is that possible or is the ceiling around 500k?
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Did you go into medicine to run a scope factory though? I mean, you could just go to a state with medical marijuana and do prescriptions, work 4 days a week and make 300k if money's all you're after.
 
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NontradCA said:
Did you go into medicine to run a scope factory though? I mean, you could just go to a state with medical marijuana and do prescriptions, work 4 days a week and make 300k if money's all you're after.
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I'd rather run a scope factory making 700k than be an employed wage slave at a corporate medical center with administrators telling me how many patients to see, how to see them, and having more power over me when they know nothing about medicine/treating patients.
 
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Merely said:
I'd rather run a scope factory making 700k than be an employed wage slave at a corporate medical center with administrators telling me how many patients to see, how to see them, and having more power over me when they know nothing about medicine/treating patients.
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Thats all of medicine. In fact I'd argue family medicine has the most pushback to this since they're the ones having initial point of care.

My point is you're gonna be extremely disappointed if your expectations are 700k no matter what field you choose.
 
NontradCA said:
Thats all of medicine. In fact I'd argue family medicine has the most pushback to this since they're the ones having initial point of care.

My point is you're gonna be extremely disappointed if your expectations are 700k no matter what field you choose.
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Spine surgeon:p
 
NontradCA said:
Thats all of medicine. In fact I'd argue family medicine has the most pushback to this since they're the ones having initial point of care.

My point is you're gonna be extremely disappointed if your expectations are 700k no matter what field you choose.
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Yeah you're right but there a certainly people doing it. I agree though, thats not a good mindset to have.
 
Blue Dog said:
It all depends on how you work, and who you work for. I've made >$200K for years working four 8-hour days/week seeing 20-25 patients/day. I wouldn't call that "taking it easy," but I'm definitely not burning myself out.
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Are you hiring? I know someone that may be interested and wouldn't mind living in that neck of the woods --- hint, hint....;-> JK -- It's about the same down here....
 
Merely said:
I'd rather run a scope factory making 700k than be an employed wage slave at a corporate medical center with administrators telling me how many patients to see, how to see them, and having more power over me when they know nothing about medicine/treating patients.
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And you will be able to retire much sooner. And after doing anything for a few years it will become monotonous.
 
BlackDynamite said:
If Family physicians aren't happy with their income, why don't they just moonlight in the ED? Are most family physicians not comfortable with that type of work due to lack of preparation during residency or do you guys just hate the lifestyle shift work etc


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I supplement my income doing bachelorette parties as "Dr. Love" complete with KISS intro.......a couple of grand for about 2-4 hours of work ....;-)
 
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Ericslv said:
And you will be able to retire much sooner. And after doing anything for a few years it will become monotonous.
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I got into medicine because I wanted to retire as soon as possible. That's just me though.


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