Family Med Salaries and the Future of the Specialty

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Medicare pays ~$70 for a routine visit. Assuming your overhead is 50%, your take home would be ~$35 per patient. At this pace, you can see 20 pts a day, work 5 days a week, take 4 weeks off per year, and generate ~170k/year of income.

8 hour day that would be 24 minutes/patient which is extremely high. I get the sense that many FM docs spend like 6 minutes/patient in busy practices.

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8 hour day that would be 24 minutes/patient which is extremely high. I get the sense that many FM docs spend like 6 minutes/patient in busy practices.

You're not taking into account charting, following up, and calling patients/other providers (or delegating others to do so). You don't get paid anything for any of that time (its considered part of your visit) and you're spending at least as much or more time on that than you are with the patient (usually). So really, I'd say its more like 12 min/patient on average, which still isn't bad. Most patients only require 6 min or so of meeting/examining, but in the day you'll get a couple that require 10, 15, 20 or even 40 min, so the average would probably be around 10-15 min for most docs. Most FM docs I know have to see 25-30/day for it to be worth it, and they have no trouble filling their census, its just busy. Specialists might only see half of that and still make the same or more depending on what they're doing.
 
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You're not taking into account charting, following up, and calling patients/other providers (or delegating others to do so). You don't get paid anything for any of that time (its considered part of your visit) and you're spending at least as much or more time on that than you are with the patient (usually). So really, I'd say its more like 12 min/patient on average, which still isn't bad. Most patients only require 6 min or so of meeting/examining, but in the day you'll get a couple that require 10, 15, 20 or even 40 min, so the average would probably be around 10-15 min for most docs. Most FM docs I know have to see 25-30/day for it to be worth it, and they have no trouble filling their census, its just busy. Specialists might only see half of that and still make the same or more depending on what they're doing.
sounds like being a teacher. going home and grading HW,tests, et cetera so your day doesnt end when the students leave
 
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Does anyone know the median salary for family docs working in Tennessee? Starting salary? Just wondering how much I'll be able to negotiate in a few years. Always have been excited about family medicine! Thanks!
 
The public does not know how inept a lot of these people are so you shouldn't let you guard off. I think we make mistake by saying: Oh well! they will never be able to replace us. Also, by flooding the market with NP/PA, they are affecting FM/peds/psych and even IM salary to some extent. Look at what has happened to anesthesia.

This. Look at the legislation they have passed and the legislation that they're trying to pass. Hospital administrators are on board as well. Anywhere they can replace a physician with someone thats cheaper, and get away with it, they will.. It's very sad but it's ECO 101. I know someone will bring up that article where NPs and physicians have nearly identical outcomes in most family care interactions, but how about for the stuff they weren't trained in? How about when they start missing diseases and misdiagnose long term ailments that are really difficult to catch? You cannot compare the wealth of information and the training a physician has received vs. an NP. Sometimes cutting the budget isn't worth the publics health and well being.
 
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I don't think EM salary will stay that high in the next few years... 350k+/year for 30-36 hours/wk is unsustainable... People in EM should enjoy the gravy while it last...

I think this gravy will be around for a while.. it is much more difficult to use an NP or PA to replace a physician in the ER. Misdiagnosing in an emergency environment = a massive liability that hospitals just won't take on. You will notice that in big city hospital emergency departments, the NPs and PAs are limited to the green zones or whatever your hospital calls very clear cut non-emergency situations.
 
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This. Look at the legislation they have passed and the legislation that they're trying to pass. Hospital administrators are on board as well. Anywhere they can replace a physician with someone thats cheaper, and get away with it, they will.. It's very sad but it's ECO 101. I know someone will bring up that article where NPs and physicians have nearly identical outcomes in most family care interactions, but how about for the stuff they weren't trained in? How about when they start missing diseases and misdiagnose long term ailments that are really difficult to catch? You cannot compare the wealth of information and the training a physician has received vs. an NP. Sometimes cutting the budget isn't worth the publics health and well being.

The problem is the public perception that most FM docs don't care enough to catch these "really difficult" ailments anyway. Not defending them but honestly, based on some of my personal interactions, it's hard to argue sometimes.
 
The problem is the public perception that most FM docs don't care enough to catch these "really difficult" ailments anyway. Not defending them but honestly, based on some of my personal interactions, it's hard to argue sometimes.

If they're saving money there, you think they'll stop at FM? They'll start going after everyone and anyone, specialist or not. They're starting to replace anesthesiologists with nurses and more legislation is trying to push through to spread this practice. Pharmacists are pushing to prescribe, they fought hard for the flu shot now the battle is going everywhere else. Once you remove the autonomy and responsibility that a medical degree carries, you destroy the value of the degree for everyone. The argument will go along the lines of 'what do you need doctors for if NPs, Pharmacists and PAs can do most of the same thing?' and 'well we can save X amount of dollars on the budget and keep the ACA afloat if we let the Y profession prescribe and treat with more autonomy.' This is not a good trend my friend..
 
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If they're saving money there, you think they'll stop at FM? They'll start going after everyone and anyone, specialist or not. They're starting to replace anesthesiologists with nurses and more legislation is trying to push through to spread this practice. Pharmacists are pushing to prescribe, they fought hard for the flu shot now the battle is going everywhere else. Once you remove the autonomy and responsibility that a medical degree carries, you destroy the value of the degree for everyone. The argument will go along the lines of 'what do you need doctors for if NPs, Pharmacists and PAs can do most of the same thing?' and 'well we can save X amount of dollars on the budget and keep the ACA afloat if we let the Y profession prescribe and treat with more autonomy.' This is not a good trend my friend..

I agree 100%, I was just adding to your points.

From our perspective though, even if all of this legislation is passed and they hustle our average salary down to 100k, we can always go somewhere else to practice. Plenty of countries starved for US trained physicians.
 
I agree 100%, I was just adding to your points.

From our perspective though, even if all of this legislation is passed and they hustle our average salary down to 100k, we can always go somewhere else to practice. Plenty of countries starved for US trained physicians.

This is a very valid point!
 
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