Do primary care docs in rural areas really make $300K-400K? Is this the norm or the exception?

[VA Hopeful Dr]

The person was talking total revenue, aka billings. So yes there would some billing that much.

Your wording was poorly chosen and imprecise.

There are definitely some surgeons who have made 8 figures in 1 year. It's possible if you're a top end plastics, a top of the line workhorse spine surgeon or optho.
So we actually do have doctors who make a lot. We also have a lot of doctors who make low 7 figures, even in family medicine.

When we talk about what people "make", that doesn't mean what they bill that means their income. Its why the person you quoted specifically said:

No physician generates $15 million or anywhere close in revenue.

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[Snoopy2006]

There are definitely some surgeons who have made 8 figures in 1 year. It's possible if you're a top end plastics, a top of the line workhorse spine surgeon or optho.
So we actually do have doctors who make a lot. We also have a lot of doctors who make low 7 figures, even in family medicine.

Talk about missing the point of the post.

Fine. There are some godly spine surgeons who might generate 15 million in a year, they probably exist somewhere, because you say they do. I should have said "few" instead of "no" physicians. It doesn't really change the point of the post or the point I was making about the way capitalism works. When you find a physician generating revenue on the scale of a LeBron James or Justin Bieber, then you can demand equal pay to celebrities.

 

[MedicineZ0Z]

Talk about missing the point of the post.

Fine. There are some godly spine surgeons who might generate 15 million in a year, they probably exist somewhere, because you say they do. I should have said "few" instead of "no" physicians. It doesn't really change the point of the post or the point I was making about the way capitalism works. When you find a physician generating revenue on the scale of a LeBron James or Justin Bieber, then you can demand equal pay to celebrities.

Im saying that the top celebrities make a ton as do the top end doctors.

People's income usually is proportional to their level of talent, in some way. Hard work is always a #2 to that, and if we aren't all about political correctness then we can admit it.

 

[siliso]

Yes, you can be the king of Garbutt or wherever as a pcp. On the other hand, there’s not so much to buy with your bucks except a really big house in the middle of nowhere, and I guess early retirement. Which is why they’re always recruiting and few people want to go unless they’ve got family there.

 

[siliso]

Who’s the top doctor is a philosophical question. If you make a mil doing spine procedures or knee scopes that aren’t statistically better than PT and ibuprofen, or cash cosmetic procedures for people with dysmorphia, are you a top doctor? By revenue, yes. Are you more talented or intrinsically valuable than an oncologist curing some poor folks at the safety net hospital or a rural PCP keeping multiple counties healthier? You be the judge.

 

[Angus Avagadro]

Yes, you can be the king of Garbutt or wherever as a pcp. On the other hand, there’s not so much to buy with your bucks except a really big house in the middle of nowhere, and I guess early retirement. Which is why they’re always recruiting and few people want to go unless they’ve got family there.

Small towns aren't as isolated as they used to be, especially with Prime memberships. Nothing wrong with a big house and some property. Works for a lot of people. I understand living in an area without major sports, theater is a disadvantage. We live in a area with all that and rarely take advantage of them. I think I'd rather be more rural with some property than in say San Diego where I probably couldn't afford to buy a house.

 

[siliso]

Being a flyover PCP, though not rural, I’m with you. I like low cost of living and having a big family (my own + extended) around. But having that family in a midsized city makes me unwilling to relocate more remote for more money, personal choice. Plus that I like being a semi-academic clinical professor. I’m glad there are people happy and willing to make the trade so my outlying feeder areas are well served.

 

[nimbus]

My billings are pure fantasy. My actual collections (revenue) are actually a small proportion of my billings.

 

[Bacchus]

Have you ever had a blue-collar job at all?

As an attending I’ve had many and know where you’re coming from but agree with DR.
(In ref to that one post only)

 

[VA Hopeful Dr]

As an attending I’ve had many and know where you’re coming from but agree with DR.
(In ref to that one post only)

You honestly think physicians work for "slave wages"?

 

[Bacchus]

You honestly think physicians work for "slave wages"?

That may be a little strong worded but you have to admit we deal with a lot of stuff outside MDM. I think one of the biggest problems is salary comparison when we have this discussion. Comparisons within Medicine, sure. Outside medicine, unfair. This week a lot of extraneous BS I have no control over. I also had a bad Friday so that’s probably on my mind if I am making excuses. We are well paid but the BS sometimes is excessive.

 

[Splenda88]

You honestly think physicians work for "slave wages"?

Some peds doc make 120k/yr... If you have a 300k student loan to pay back, 120k is "slave wages."

 

[RNthenDoc]

We are well paid but the BS sometimes is excessive.

I 100% agree with this!
Hopefully things will change and lifestyles will improve to cut down on administrative crap.

Being “well paid”=/= slave wages, though.

You could say that you feel the hassle isn’t worth the money... that would be a reasonable statement!

I’ve never seen a doctor quit to be a janitor, though.

 

[VA Hopeful Dr]

Some peds doc make 120k/yr... If you have a 300k student loan to pay back, 120k is "slave wages."

No. Not even a little bit.

Pediatricians making that little do so by choice (so the slave part is out the window right there), usually either academics or saturated area.

If you can either move or take a different job it is by definition not slave anything.

 

[AMEHigh]

No. Not even a little bit.

Pediatricians making that little do so by choice (so the slave part is out the window right there), usually either academics or saturated area.

If you can either move or take a different job it is by definition not slave anything.

Ugh yes exactly.

Why must people use the term slave wages and then try to justify it. Wtf.

 

[Snoopy2006]

1) Living in rural nowhere and being miserable vs. HCOL aren't necessarily either-or. You can use a LCOL to pay off debt and supercharge your retirement savings, and then move to a more desirable area in 3-6 years. It's hard and against human nature to take a paycut, but made easier by moving from the cornfields to Chicago. One of the advantages to docs being employeed now instead of owners is mobility,

2) While I agree the BS we have to deal with in medicine is incredibly frustrating, we can't pretend non-doctors don't have to deal with their own BS/bureaucracy/stressors with far less pay. Often times the doctors who complain the most have this idealized version of what their non-medicine alternative life would look like in their head, that doesn't match up with most Americans' reality,

 

[Angus Avagadro]

I 100% agree with this!
Hopefully things will change and lifestyles will improve to cut down on administrative crap.

Being “well paid”=/= slave wages, though.

You could say that you feel the hassle isn’t worth the money... that would be a reasonable statement!

I’ve never seen a doctor quit to be a janitor, though.

I've seen a busy orthopedist quit and buy a tree nursery. Over regulations, lawsuits, and hospital bureaucratic nonsense. He'd had enough

 

[RNthenDoc]

I've seen a busy orthopedist quit and buy a tree nursery. Over regulations, lawsuits, and hospital bureaucratic nonsense. He'd had enough

Point taken! I’d still posit that becoming a small business owner isn’t some awful fate, though.

 

[battie]

I take issue with how you and many others compare the revenue of physicians to the average household income in the US. Doctors compose the outskirts of the maximum revenue possibility of the academic circle. Contrast this with the outskirt of the entertainment/finance/entreprenaural/music/pornography circle to avoid measurement bias. Calculate the money difference ratio and you'll realize that we're talking about slave wages for the doctor. I can't believe this. Doctors are outrageously underpaid for what they do and have done.

Some peds doc make 120k/yr... If you have a 300k student loan to pay back, 120k is "slave wages."

Please come see us over in the vet med forum to discuss these slave wages human doctors make. Even our specialists that do full internships and residencies aren't making close to the averages in the corresponding human specialty. And we have the corresponding debt. Any veterinarian would gladly make what human doctors make. Hence people being stunned by the use of the words "slave wages"; yall are making much more than slave wages.

 

[Splenda88]

Please come see us over in the vet med forum to discuss these slave wages human doctors make. Even our specialists that do full internships and residencies aren't making close to the averages in the corresponding human specialty. And we have the corresponding debt. Any veterinarian would gladly make what human doctors make. Hence people being stunned by the use of the words "slave wages"; yall are making much more than slave wages.

Not sure why people go to vet school to be honest. Vet school school is financial suicide unless daddy or mommy is footing the bill for you.

I guess it must be a 'calling'...

 

[Chibucks15]

Not sure why people go to vet school to be honest. Vet school school is financial suicide unless daddy or mommy is footing the bill for you.

I guess it must be a 'calling'...

Vet school to go into a city is definitely not ideal, but those rural people have a pretty solid deal. My good friend is one and the clinic pays for his new truck they gave him, mileage, gas, and has loan repayment, on top of his decent salary. Hes like 40 minutes outside of a medium city in the midwest. If he went further out into the boonies he would've had an even better deal.

 

[battie]

Vet school to go into a city is definitely not ideal, but those rural people have a pretty solid deal. My good friend is one and the clinic pays for his new truck they gave him, mileage, gas, and has loan repayment, on top of his decent salary. Hes like 40 minutes outside of a medium city in the midwest. If he went further out into the boonies he would've had an even better deal.

That's grossly inaccurate for the average rural vet. The state of Missouri currently is in a veterinary crisis of lacking in rural veterinarians, mainly due to the fact that the average salary in rural areas is not enough to pay off student loans and live. Missouri is currently the poster child, but many rural areas suffer the same.

Some vets can make it. If they are the 1/5 who graduate without debt, or if they were an in state student with in state tuition, it's definitely doable. Also people who work with more expensive animals (where people can afford a 5k dystocia or colic surgery for their mare or cow) or work with large corporations (Tysons poultry vets do well) drive up salary numbers. Also vets who graduated prior to 2005 are in a decent spot, too.

But vets graduating post-2005, were out of state students, or working with the average Farmer Joe, they are seldom the rural vet making 100k. Farmer Joe can't afford a 5k dystocia surgery on a cow/calf pair valued at 2k. He's going to cut his losses.

Good for your friend, really! I would love to live in rural northwest NE. But the salary of vets up there is 50k. My debt will be 282k. It's just not feasible.

Veterinarians in short supply, leaving Missouri clinics, farms scrambling for care

 

[Chibucks15]

That's grossly inaccurate for the average rural vet. The state of Missouri currently is in a veterinary crisis of lacking in rural veterinarians, mainly due to the fact that the average salary in rural areas is not enough to pay off student loans and live. Missouri is currently the poster child, but many rural areas suffer the same.

Some vets can make it. If they are the 1/5 who graduate without debt, or if they were an in state student with in state tuition, it's definitely doable. Also people who work with more expensive animals (where people can afford a 5k dystocia or colic surgery for their mare or cow) or work with large corporations (Tysons poultry vets do well) drive up salary numbers. Also vets who graduated prior to 2005 are in a decent spot, too.

But vets graduating post-2005, were out of state students, or working with the average Farmer Joe, they are seldom the rural vet making 100k. Farmer Joe can't afford a 5k dystocia surgery on a cow/calf pair valued at 2k. He's going to cut his losses.

Good for your friend, really! I would love to live in rural northwest NE. But the salary of vets up there is 50k. My debt will be 282k. It's just not feasible.

Veterinarians in short supply, leaving Missouri clinics, farms scrambling for care

I don't keep up with vet trends sorry. Just was relaying the personal experience. I have enough on my plate on the medicine side

 

[battie]

I don't keep up with vet trends sorry. Just was relaying the personal experience. I have enough on my plate on the medicine side

You're good! My original intent was just to point out that making 6 figure salaries can in no logical way be considered "slave wages", even in medicine. I'm all for what you guys make. My PCP has been a life saver over the years, literally and figuratively. So has my cardiologist, orthopedic surgeon, and the ER docs I've seen. They could make a million dollars, I don't care.

But some perspective was sorely needed. Any veterinarian would look at 120k/year as a blessing. More than that is icing on the cake, even for our specialists.

 

[KeikoTanaka]

I'm getting irritated. Dude, people like you ignoring the money talk is precisely why physicians won't do anything for the declining reimbursements and soon the US doctor salaries will equalize the horrendous 60k/year salaries in Europe. We have families to feed, colleges to fund, retirement to contribute to, debts to pay after all these slave years. If I read your comment between the lines these things mean nothing to you. Are you a European socialist or something?

Regarding the hospitalist question. I think that any US doctor should make at least the lower end of the average salary calculated from the same quantity of physicians in the US as there are in the fields outside of academia, in the same area of the circle i described earlier. That roughly comes down to 15 million USD per year. If this is an eye-opener for you, then you probably never realized how overpaid those folks that irriate me to the teeth actually make. Best part is when they claim they go bankrupt. Stupid lucky idiots they are.

Also, you can't just look at the physician salary and be like ohh, that's great. No, it isn't. You have to be considerate of the effort put into whatever that lead to that money. 250k a year in passive income? That's outstanding! 250k a year as an actively working physician? Dude, that stinks. I'll be lucky to have money for noodles after my monthly pays for my 500k+ med school debt, retirement contributions and other essential expenses.

Somebody just got hit hard this first month of first year of med school.

 

[nimbus]

You're good! My original intent was just to point out that making 6 figure salaries can in no logical way be considered "slave wages", even in medicine. I'm all for what you guys make. My PCP has been a life saver over the years, literally and figuratively. So has my cardiologist, orthopedic surgeon, and the ER docs I've seen. They could make a million dollars, I don't care.

But some perspective was sorely needed. Any veterinarian would look at 120k/year as a blessing. More than that is icing on the cake, even for our specialists.

I can tell you that equine vets in Southern California do quite well. Much higher than 120k/yr. Lots of folks here love our elderly horses.

 

[battie]

I can tell you that equine vets in Southern California do quite well. Much higher than 120k/yr. Lots of folks here love our elderly horses.

Depending on where you are, the industry is good. Suburban/urban vets do the best out of anyone. There's a ton of race horses and breeding stock in California (not to mention the cost of living), so that's awesome. The average equine vet is still making 64k per year, factoring in the vet that takes care of Barbaro's stock and the vet taking care of Farmer Joe's stock. Only 4% of grads go directly into equine at this point cause to do surgery or anything high end, you need an internship and residency to get hired.

 

[SLC]

Exception. If you want to work 24/7 then you might make that much.

I work 36hrs per week, and make almost $300k

 

[Thesimplelifeofamyloid]

I work 36hrs per week, and make almost $300k

I'm guess you have a wealthy spouse, no? Does that include their income?

 

[SLC]

I'm guess you have a wealthy spouse, no? Does that include their income?

Wife is a stay at home mom. That’s just me.

 

[Chibucks15]

I'm guess you have a wealthy spouse, no? Does that include their income?

What a weird assumption

 

[Thesimplelifeofamyloid]

Wife is a stay at home mom. That’s just me.

Are you involved in some sort of business or stocks? No way you can make that much in family

 

[VA Hopeful Dr]

Are you involved in some sort of business or stocks? No way you can make that much in family

Its actually not that hard to hit 300k in family medicine.

 

[AMEHigh]

Are you involved in some sort of business or stocks? No way you can make that much in family

Now you must just be trolling!

 

[SLC]

Are you involved in some sort of business or stocks? No way you can make that much in family

It’s not a difficult number to hit at all these days.

But no, no investment income, no outside business.

 

[Cranjis McBasketball]

Are you involved in some sort of business or stocks? No way you can make that much in family

I mean... Ive shadowed him.. and seen this all first hand. Some of my free time now consists of randomly checkin zillow to scope out homes in his city haha

 

[Splenda88]

I mean... Ive shadowed him.. and seen this all first hand. Some of my free time now consists of randomly checkin zillow to scope out homes in his city haha

Have you seen his tax return?

 

[Cranjis McBasketball]

Have you seen his tax return?

Yeah, it was crazy

 

[Giovanotto]

I mean... Ive shadowed him.. and seen this all first hand. Some of my free time now consists of randomly checkin zillow to scope out homes in his city haha

I don't think his city is for everyone, lol. If I'm not mistaken, it's not exactly a diverse place.

 

[KeikoTanaka]

I don't think his city is for everyone, lol. If I'm not mistaken, it's not exactly a diverse place.

What city/Region of the country are we talking?

 

[SLC]

What city/Region of the country are we talking?

Rural mountain west

 

[SLC]

I don't think his city is for everyone, lol. If I'm not mistaken, it's not exactly a diverse place.

Diverse? Well it’s not NYC diverse, but there are plenty of racial groups, different religions (or lack thereof). But most people here are white and middle-lower SES.

But they’re the nicest, most welcoming, least judgmental people anyone could hope to meet when it comes right down to it. Even though they don’t often receive the same consideration from people complaining about a “lack of diversity”.

 

[BlueBleck]

But they’re the nicest, most welcoming, least judgmental people anyone could hope to meet when it comes right down to it. Even though they don’t often receive the same consideration from people complaining about a “lack of diversity”.

Bit of a tangent in this compensation thread, but I've always been interested in rural practice, but i am obviously not white. Do you have any noticeably non-white colleagues? And if you're aware, how's their family? Biggest issue I have is getting my spouse to agree to go rural. 2nd biggest issue would be my kids possibly being bullied/ostracized.

 

[SLC]

Bit of a tangent in this compensation thread, but I've always been interested in rural practice, but i am obviously not white. Do you have any noticeably non-white colleagues? And if you're aware, how's their family? Biggest issue I have is getting my spouse to agree to go rural. 2nd biggest issue would be my kids possibly being bullied/ostracized.

We have one doctor of I believe Hispanic descent, she’s very popular. And one of my MA’s has adopted kids who are AA. My daughter goes to school with them and best I can tell they’re some of the most popular kids in the school.

It’s all about how you interact with the community. Be open and friendly, and generally you’ll get the same treatment in return.

 

[Giovanotto]

Diverse? Well it’s not NYC diverse, but there are plenty of racial groups, different religions (or lack thereof). But most people here are white and middle-lower SES.

But they’re the nicest, most welcoming, least judgmental people anyone could hope to meet when it comes right down to it. Even though they don’t often receive the same consideration from people complaining about a “lack of diversity”.

I could do without the personal attack. I both agree with the sentence that precedes the bolded, and yet much prefer living among diversity.

 

[SLC]

I could do without the personal attack. I both agree with the sentence that precedes the bolded, and yet much prefer living among diversity.

Personal attack? I didn’t attack you at all, like not even a little. In fact I didn’t attack anyone.

 

[VA Hopeful Dr]

I could do without the personal attack. I both agree with the sentence that precedes the bolded, and yet much prefer living among diversity.

That's not a personal attack

 

[AMEHigh]

Diverse? Well it’s not NYC diverse, but there are plenty of racial groups, different religions (or lack thereof). But most people here are white and middle-lower SES.

But they’re the nicest, most welcoming, least judgmental people anyone could hope to meet when it comes right down to it. Even though they don’t often receive the same consideration from people complaining about a “lack of diversity”.

What are the other major racial groups in the area out of curiousity?

I remember when I was younger driving through Wyoming and my family stopped for dinner. This Black man was so happy to see us but was so disappointed that we were just driving through haha.

I grew up in several different cities which led to often being the only Black person in school/activities. I definitely don’t want to go through that again or my hypothetical kids go through that. But rural practice could definitely have its benefits for the short term!

 

[SLC]

What are the other major racial groups in the area out of curiousity?

I remember when I was younger driving through Wyoming and my family stopped for dinner. This Black man was so happy to see us but was so disappointed that we were just driving through haha.

I grew up in several different cities which led to often being the only Black person in school/activities. I definitely don’t want to go through that again or my hypothetical kids go through that. But rural practice could definitely have its benefits for the short term!

We have some African American families, tons of Central American immigrants, and the college brings in multiple ethnicities in the form of foreign students. Plus, the college brings with it a lot of religious diversity, political diversity, etc.

Like I said, most people are still while and low to middle class socioeconomically; but man these people are nice, and inclusive of anyone from what I’ve seen.

 

[AMEHigh]

We have one doctor of I believe Hispanic descent, she’s very popular. And one of my MA’s has adopted kids who are AA. My daughter goes to school with them and best I can tell they’re some of the most popular kids in the school.

It’s all about how you interact with the community. Be open and friendly, and generally you’ll get the same treatment in return.

Or get called the N word simply for existing. I’m sure you meant no harm in your statement, but I can’t help but call things out that are incorrect when I see them. People who experience racism aren’t the ones whose behavior needs to change. I’m a very nice and open person, but that doesn’t stop the racism and harassment I’ve experienced (from both the general public and from patients). Trust me, when someone calls me the N word or a patient says “get your black hands off me, N” I certainly am not combative and am nice. Those people literally give me nightmares and I don’t mess around with that.