Daniel Sterns is Out!

[The White Coat Investor]

Daniel Sterns runs the most complete survey of EM salaries in the country. This year's data just came out. Those participating get a free copy of the results. Here are the relevant points:

Employee Total Compensation
10th percentile $200K
50th percentile $263K
90th percentile $375K

Partner Total Compensation
10th percentile $218K
50th percentile $339K
90th percentile $466K

Employee Hours Worked
10th percentile 1350
50th percentile 1768
90th percentile 2250

Partner Hours Worked
10th percentile 1320
50th percentile 1680
90th percentile 2080

Total Compensation per hour Employee/Partner (My math)
10th percentile $148/$165
50th percentile $148/$201
90th percentile $167/$227

I don't recall last year's data specifically, but this seems significantly up and EM is still quite a good income, especially when considered on an hourly basis.

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[old_boy]

I'm not familiar with this survey, but indeed, these numbers look good. My assumption was that Anesthesia paid significantly more, but after looking at this I'm not sure that is the case.

Thank you for sharing. Is there a regional breakdown/summary at all? I imagine Bay Area, LA, and San Diego would be significantly less than rural Texas.

 

[xaelia]

I don't suppose there's an academic breakout on the survey?

 

[sideways]

I don't suppose there's an academic breakout on the survey?

/2

 

[J ROD]

/2

 

[Laryngophed]

x2

Though, looking at the faculty EM salaries here, that seems to fit. It looks like the docs here are bringing in just under $100/hour but I know that their malpractice is covered by the institution. That accounts for a little bit of the decrease in payment and I think that the docs have a contract that requires ~1800 hours/year, which also accounts for some of that.

 

[tegs15]

contract that requires ~1800 hours/year, which also accounts for some of that.

They are only making $180K, seems pretty low to me

 

[Laryngophed]

They are only making $180K, seems pretty low to me

Well, it was a little more than that, ~$195k. I keep hearing that is low, but knowing what the PCPs in the system are making less than that it doesn't seem to shabby, especially knowing the pager doesn't follow you home. I'm curious as to what some would deem acceptable for this area but I haven't had the cajones or opportunity to ask any of the EM physicians (in the University group or at another local, but part of a much larger/well known health care system) what they make and how much they work. Frankly, at this point in my career that $195k with less than 2000 hours/year worked doesn't look too bad. Then again, my loans are still in deferment and I'm not at the end of my rope with regard to living like a student. I'm guessing my attitude is going to change.

Edit - For the record, as someone who has yet to set foot in a medical school as a med student, I recognize I am putting the cart before the horse here.

 

[BurnENickcoles]

Well, it was a little more than that, ~$195k. I keep hearing that is low, but knowing what the PCPs in the system are making less than that it doesn't seem to shabby, especially knowing the pager doesn't follow you home.

Yup - the pager gets to stay at home, but guess what? You will be expected to build a research program and have at least a couple of publications a year to be "allowed" to stay! How do you like your hourly wage now? LOL

Duke, for instance, offers starting salaries of $165,000 (I answered an ad in one of the throwaways last year). Apparently, the Dept of Surgery there wants you to take a pay cut for the "privilege" of being part of the department.

 

[Arcan57]

ActiveDuty, did you get the $/hr for the percentiles by taking the 90th percentile $ / 90th percentile hrs? Because it seems the $167/hr would be low for the 90th percentile on the employee side.

 

[GeneralVeers]

The survey will be considerably simpler in the future:

EM Physician - Government Employee: $120,000

 

[The White Coat Investor]

ActiveDuty, did you get the $/hr for the percentiles by taking the 90th percentile $ / 90th percentile hrs? Because it seems the $167/hr would be low for the 90th percentile on the employee side.

Yes, but the survey also asked about hourly rates, and the 90th percentile was a little different.

Remember this was TOTAL compensation, not necessarily just salary. I can't remember the survey well enough to recall everything that goes into total.

There was an academic breakdown.

They are no longer doing a regional breakdown, like in years past.

 

[Laryngophed]

Yes, but the survey also asked about hourly rates, and the 90th percentile was a little different.

Remember this was TOTAL compensation, not necessarily just salary. I can't remember the survey well enough to recall everything that goes into total.

There was an academic breakdown.

They are no longer doing a regional breakdown, like in years past.

Do you happen to have a link to the survey data or is it something that comes via snail mail/requires a subscription?

 

[surftheiop]

The survey will be considerably simpler in the future:

EM Physician - Government Employee: $120,000

Beats being in academic pediatrics!

 

[southerndoc]

Do you happen to have a link to the survey data or is it something that comes via snail mail/requires a subscription?

It's only available to survey participants and those who purchase it. It's quite expensive if I recall, and they really try very hard to protect the data.

 

[deuist]

Duke, for instance, offers starting salaries of $165,000 (I answered an ad in one of the throwaways last year). Apparently, the Dept of Surgery there wants you to take a pay cut for the "privilege" of being part of the department.

Duke also has a salary cap for all specialties at $500,000. Everything else a doc generates gets picked up by the hospital as a "donation." Not a big deal for EM, but the plastic surgeons are feeling the pain.

 

[xaelia]

There was an academic breakdown.

The only number I'm curious about is the 50th percentile academic, as that's how my starting salary is determined.

 

[WilcoWorld]

Duke also has a salary cap for all specialties at $500,000. Everything else a doc generates gets picked up by the hospital as a "donation." Not a big deal for EM, but the plastic surgeons are feeling the pain.

Oh! The agony of living on a half a million a year.

 

[ronaldo23]

Is it common to become a "partner" in EM practices? I thought most work in EM is done employed with a hospital as a salaried employee, and that partnerships are more common in things like gas or other specialties...

 

[deleted109597]

No. There are hospital employees, and there are groups. Some are large, multi state groups, and some are small, democratic groups. You can make partner in those.

 

[southerndoc]

My group offers partnership from day 1.

 

[GeneralVeers]

My group offers partnership from day 1.

Not sure I'd want to be in a group with "Day 1 Partnership". What do you do if the doctor is incompetent, or slow, or doesn't produce? It often takes a few months to find out if someone is able to practice in the environment.

 

[docB]

Is it common to become a "partner" in EM practices? I thought most work in EM is done employed with a hospital as a salaried employee, and that partnerships are more common in things like gas or other specialties...

There's a FAQ on this here.

Here's the part that really addresses this question.

There are different ways to be employed as an Emergency Physician (EP). The simplest is to be an employee of a hospital. While this is pretty straight forward it’s also rare and is pretty much limited to some academic groups and groups at publicly owned hospitals or hospitals owned by a health plan (and by that I basically mean the Kaiser hospitals in HI, CA and CO). The advantage of this situation is that you are likely to be part of a public or university employee’s benefits organization and can share in the volume advantages of those plans. The downside is that you have less say in decisions about those plans. You money gets paid to you in the form of W2 wages and withholding, SSI (or similar) are taken out as you go. This is like the traditional employee model where every April you sit down and do your taxes. If you owe more than your withholding you write a check to the IRS. If you owe less you get a refund.

Another way to be employed is to be an employee of a group that has a contract with a hospital. This is much more common. In this setting you have more say over things that involve your group as those decisions are made locally. You still get paid W2 wages and have taxes and so on withheld.

A similar situation to the above is to be an employee of a large, corporate group. Groups such as EmCare and EPMG fit this model. In these groups you still get paid W2 wages but you have less say over administrative issues because those issues are negotiated on a regional or national scale.

 

[docB]

Not sure I'd want to be in a group with "Day 1 Partnership". What do you do if the doctor is incompetent, or slow, or doesn't produce? It often takes a few months to find out if someone is able to practice in the environment.

We have "Day 1 partnership" although we don't call it that. In our case it just means that we don't divert money from the new guys to the older guys. If an RVU is worth $X it's the same for everyone in the group. Being a partner in our group doesn't shield you from getting fired if there's a problem so if a guy turns out to be a lemon we can still get rid of him.

 

[southerndoc]

Not sure I'd want to be in a group with "Day 1 Partnership". What do you do if the doctor is incompetent, or slow, or doesn't produce? It often takes a few months to find out if someone is able to practice in the environment.

It means equal voting rights/pay. If the doc isn't up to par, we can still cancel their contract with a 60-day notice. Likewise, the physician can also do the same.

 

[GeneralVeers]

It means equal voting rights/pay. If the doc isn't up to par, we can still cancel their contract with a 60-day notice. Likewise, the physician can also do the same.

That makes more sense. How do you go about canceling a contract? Does the group take a vote?

In my group once you've hit your 1400 hour "buy-in" you're almost impossible to get rid of.

 

[southerndoc]

That makes more sense. How do you go about canceling a contract? Does the group take a vote?

We're a large corporation with a lot of sub-corporations (LLC's). Each LLC is run independently. The members of the LLC can get rid of docs, but the corporation usually moves them to another hospital/health system (another LLC). It's rare, but to my knowledge it has happened once in the past two years, that they just cancel your contract and send you on your own.

 

[Arcan57]

Oh! The agony of living on a half a million a year.

That statement sounds reasonable at face value. But what it's actually saying is that unlike every other facet of productive America, physicians shouldn't have the ability to maximize their income. You're going to have docs that would do what they do currently if they were making $40k/yr. You're going to have at least as many (probably more) docs that are going to look at their lives and realize that if they aren't going to get paid more than X dollars, that spending more time away from family/personal life to make money for someone else doesn't make sense. Which would be fine, except we have an artificial cap on the number of docs that enter the workforce each year. And thus anything that reduces the productivity/doc ratio has to lead to a decrease in the amount of healthcare available. Which again would be fine if the healthcare needs in this country were decreasing, except that they're not.

 

[southerndoc]

What's interesting is 50% of EM physicians said they were considering leaving emergency medicine and the field of medicine within the next 5 years.

 

[The White Coat Investor]

What's interesting is 50% of EM physicians said they were considering leaving emergency medicine and the field of medicine within the next 5 years.

Yea, until they realize they don't have enough money to retire and can't make much money doing anything but emergency medicine. Who hasn't considered leaving after a bad shift?

 

[The White Coat Investor]

I guess I was mistaken, there isn't an academic breakdown for salaries in this year's survey. One interesting facet of this survey that students/residents/new grads should be aware of is that your income is unlikely to go up as you gain more experience. Your salary is pretty flat. Ex: With 4-6 years of experience you average $300K. It doesn't really go up over the next 25 years of experience. EM is very much a field where you're paid for how much you work. You can trade your time for money at a very good rate, but if you want more money, you'll need to exchange more time for it. Likewise, if you're content on living on $150K, you can work essentially part time your entire career.

 

[WilcoWorld]

That statement sounds reasonable at face value. But what it's actually saying is that unlike every other facet of productive America, physicians shouldn't have the ability to maximize their income. You're going to have docs that would do what they do currently if they were making $40k/yr. You're going to have at least as many (probably more) docs that are going to look at their lives and realize that if they aren't going to get paid more than X dollars, that spending more time away from family/personal life to make money for someone else doesn't make sense. Which would be fine, except we have an artificial cap on the number of docs that enter the workforce each year. And thus anything that reduces the productivity/doc ratio has to lead to a decrease in the amount of healthcare available. Which again would be fine if the healthcare needs in this country were decreasing, except that they're not.

Your point is a good, albeit unfortunate, one. However, we're making different points. Yours - that it's human nature to be motivated by personal gain, and mine - that $500k/yr is more than enough money to live a very comfortable life. These two are not mutually exclusive.

 

[GeneralVeers]

Your point is a good, albeit unfortunate, one. However, we're making different points. Yours - that it's human nature to be motivated by personal gain, and mine - that $500k/yr is more than enough money to live a very comfortable life. These two are not mutually exclusive.

Whenever you artificially cap someone's salary, you are going to create disincentives to work. Canada tried this out with salary caps, and when a shortage of specialists got worse they had to repeal the caps.

According to Obama: "At a certain point you have made ENOUGH money"

Scary.

 

[WilcoWorld]

Whenever you artificially cap someone's salary, you are going to create disincentives to work. Canada tried this out with salary caps, and when a shortage of specialists got worse they had to repeal the caps.

According to Obama: "At a certain point you have made ENOUGH money"

Scary.

Please let me clarify - I was never arguing for salary caps, I was simply saying that $500k/yr is a lot (dare I say "enough") of money.

Past a certain point making more money only makes you more money - it doesn't inrease your happieness (or at least not mine). Nevertheless, I support your right to keep earning past that point. If you want to do that, just don't work at Duke.

 

[GeneralVeers]

Please let me clarify - I was never arguing for salary caps, I was simply saying that $500k/yr is a lot (dare I say "enough") of money.

Past a certain point making more money only makes you more money - it doesn't inrease your happieness (or at least not mine). Nevertheless, I support your right to keep earning past that point. If you want to do that, just don't work at Duke.

We can agree there. I have no problem with Duke putting in a "cap" provided that free-market forces are allowed to reign. Theoretically it should hurt their available pool of top talent and benefit their competitors.

 

[Arcan57]

Your point is a good, albeit unfortunate, one. However, we're making different points. Yours - that it's human nature to be motivated by personal gain, and mine - that $500k/yr is more than enough money to live a very comfortable life. These two are not mutually exclusive.

Agreed.

 

[Arcan57]

I guess I was mistaken, there isn't an academic breakdown for salaries in this year's survey. One interesting facet of this survey that students/residents/new grads should be aware of is that your income is unlikely to go up as you gain more experience. Your salary is pretty flat. Ex: With 4-6 years of experience you average $300K. It doesn't really go up over the next 25 years of experience. EM is very much a field where you're paid for how much you work. You can trade your time for money at a very good rate, but if you want more money, you'll need to exchange more time for it. Likewise, if you're content on living on $150K, you can work essentially part time your entire career.

Very true, if you stay in the same region/compensation model. Newly minted attendings going into the community are probably making significantly more then the 15yr vets that trained them.

 

[deleted109597]

Yea, until they realize they don't have enough money to retire and can't make much money doing anything but emergency medicine. Who hasn't considered leaving after a bad shift?

Leaving the country, yes. Leaving EM, no.
I would work for barter in other countries before I work here for less than the nurses.

 

[deuist]

Leaving the country, yes. Leaving EM, no.
I would work for barter in other countries before I work here for less than the nurses.

We residents already make less than nurses. I have a training nurse that I'm working with that makes full salary---which is annoying because I have to show her how to do things like place ECG leads and run an IV.

 

[DrQuinn]

Please let me clarify - I was never arguing for salary caps, I was simply saying that $500k/yr is a lot (dare I say "enough") of money.

Past a certain point making more money only makes you more money - it doesn't inrease your happieness (or at least not mine). Nevertheless, I support your right to keep earning past that point. If you want to do that, just don't work at Duke.

Funny thing was while I was a PGY3, I used to say "I think once you make 200k it does'nt really matter." Then I made 200k, then 210k, then 216k, and now I am significantly more than this (got a new job). I can tell you, there is a pretty big difference from 200k, 250k, 300k, 400k. A world of a difference. Of course we'll see what happens with the new tax strcutre and reimbursement, but I am glad I got a couple years of great pay.
Q