How much do family doctors actually earn? Right after residency?

[Aspiringphysician]

I'm getting all sorts of numbers from all sorts of websites. Some say fam docs earn 200k. Some say fam docs earn 100k. But what are the actual numbers? For example, someone on the west coast in a city, how much would they earn as a family doctor straight out of residency?

---

Members don't see this ad.

 

[brats800]

Lots of topics about this if you do a forum search. Bigger cities will pay less than smaller towns. I'd put your range between $120k - 250k and, in general, you'll be somewhere towards the middle. I realize that is vague and not super helpful. Check out
Blog Post on Compensation
Cejka Salary Surveys

 

[VA Hopeful Dr]

West coast cities, assuming you mean something like San Diego, SF, LA are going to be some of your worst paying jobs for the simple reason that lots of people want to work there and are willing to take a salary hit to do it. Conversely, the non-coast parts of the country and even the coastal South tend to pay better for the same reason - not as many people want to be there.

If you're in a location you really like, I wouldn't go for less than 150k for outpatient only, 200k for inpatient and outpatient. If you're in a less than ideal location, no less than 180k outpatient, closer to 250k both.

 

[Aspiringphysician]

West coast cities, assuming you mean something like San Diego, SF, LA are going to be some of your worst paying jobs for the simple reason that lots of people want to work there and are willing to take a salary hit to do it. Conversely, the non-coast parts of the country and even the coastal South tend to pay better for the same reason - not as many people want to be there.

If you're in a location you really like, I wouldn't go for less than 150k for outpatient only, 200k for inpatient and outpatient. If you're in a less than ideal location, no less than 180k outpatient, closer to 250k both.

I am thinking more about states like Oregon and Washington. Specifically washington, because I really like it that they have no income taxes.

How many hours a week does a family doc need to work to earn 250k? 250k seems more like "specialty zone" to me...

 

[cabinbuilder]

Depends on location and how much you want to work. Remember that I do locums so my numbers a little different. I made 250+ last year when I worked 8-9 months. This year I only worked six months and made 130K. I expect to hit 300K this year since I am not taking as much time off. Just depends on your location, your contract, how much you work, etc.

 

[deleted87716]

If anyone offers you $250K to start, be afraid. Be very afraid.

 

[cabinbuilder]

If anyone offers you $250K to start, be afraid. Be very afraid.

This is very very very true. There will be a catch somewhere and you will be a corporate slave with less rights than the janitor.

 

[plica]

At my program there were several R3's that just signed for $280K/yr in the ED. Others have signed $230K/yr (w/ $30-60K bonuses) for FM w/ OB (working 4.5 days/wk and call 1:5). These are rural - semi rural locations. The money is out there, and you don't have to sell your soul to get it (you just won't be in a big city)

 

[KnuxNole]

If anyone offers you $250K to start, be afraid. Be very afraid.

I'm a few years away from thinking about this stuff, but what is a safe starting offer...in an non urban area?

 

[deleted87716]

I'm a few years away from thinking about this stuff, but what is a safe starting offer...in an non urban area?

For usual hours and duties, something in the $150-200 range would be more typical. The higher end of the scale would almost certainly include hospital.

 

[deleted87716]

At my program there were several R3's that just signed for $280K/yr in the ED. Others have signed $230K/yr (w/ $30-60K bonuses) for FM w/ OB (working 4.5 days/wk and call 1:5). These are rural - semi rural locations. The money is out there, and you don't have to sell your soul to get it (you just won't be in a big city)

ED work should pay more, as should OB.

 

[VA Hopeful Dr]

For usual hours and duties, something in the $150-200 range would be more typical. The higher end of the scale would almost certainly include hospital.

Agreed, plus maybe in the upper end of that depending on how rural you are.

 

[styphon]

Depends on if you do hospital, OB, or strict outpatient.

Depends on what part of the US you live in (east,midwest, coast, Alaska).

Depends on what type of area you live in (Urban,surburban, ural).

I only know New England salaries, as I have never tried to leave this area. I have looked at rural (where I am now), suburban (yech), and Urban areas.

The suburban area where your patients are other doctors, lawyers, businessmen paid the most - followed by Rural - then lastly Community Centers/Urban poor clinics.

 

[JustPlainBill]

Agree with above -- a colleague who remained in the city with no hospital work got a flat $160K with no bonus but standard benefits - medical/dental/3weeks vacation -- 8-5, no call, 15 minute visits and turn 'em out....

Another colleague negotiated 180K/year, $18K stipend while still in residency ($2K/month for 9 months), benefits, complete office setup, staff, no OB, help with qualifying for state loan repayment up to $160K over 4 years, $2k of CME expenses with 1 week of CME time off, 3 weeks of vacation...but, this also includes 1 in 4 call, plus 1 in 4 days taking unassigned patients in the hospital and you have to follow patients into the ICU, the hospital controls when you can/can't moonlight, non-compete in the county for 12 months and 4 year stipend payback (you work there 4 years, you owe nothing for the stipend) -- contract renewable on a yearly basis with 2 months notice -- renews in every January. Bonus eligibility after hittting the 25th percentile in RVUs with only a specified number of RVUs over that qualifying for a total possible of $28K in bonus'....but you have to see 17 patients per day to be eligible.....which is very nice and his hospital patients count towards that value also.....But this is in a small (emphasize small) hospital...the ER is more like a closet.... so all totaled, counting the loan repayment (which is spread out over 4 years) it turns out to be 205, 215, 225, 235 for the first 4 years then drops to 180 (loan repayment stops after 4 years)....but by then a renegotiation will probably be in order for him....\\

Contracts in the burbs are more like $150-160 with $5K signing bonus and more of an income guarantee for the first year....

 

[cabinbuilder]

Agree with above -- a colleague who remained in the city with no hospital work got a flat $160K with no bonus but standard benefits - medical/dental/3weeks vacation -- 8-5, no call, 15 minute visits and turn 'em out....

Another colleague negotiated 180K/year, $18K stipend while still in residency ($2K/month for 9 months), benefits, complete office setup, staff, no OB, help with qualifying for state loan repayment up to $160K over 4 years, $2k of CME expenses with 1 week of CME time off, 3 weeks of vacation...but, this also includes 1 in 4 call, plus 1 in 4 days taking unassigned patients in the hospital and you have to follow patients into the ICU, the hospital controls when you can/can't moonlight, non-compete in the county for 12 months and 4 year stipend payback (you work there 4 years, you owe nothing for the stipend) -- contract renewable on a yearly basis with 2 months notice -- renews in every January. Bonus eligibility after hittting the 25th percentile in RVUs with only a specified number of RVUs over that qualifying for a total possible of $28K in bonus'....but you have to see 17 patients per day to be eligible.....which is very nice and his hospital patients count towards that value also.....But this is in a small (emphasize small) hospital...the ER is more like a closet.... so all totaled, counting the loan repayment (which is spread out over 4 years) it turns out to be 205, 215, 225, 235 for the first 4 years then drops to 180 (loan repayment stops after 4 years)....but by then a renegotiation will probably be in order for him....\\

Contracts in the burbs are more like $150-160 with $5K signing bonus and more of an income guarantee for the first year....

Oh, hell NO.........

 

[Silent Cool]

Agree with above -- a colleague who remained in the city with no hospital work got a flat $160K with no bonus but standard benefits - medical/dental/3weeks vacation -- 8-5, no call, 15 minute visits and turn 'em out....

Another colleague negotiated 180K/year, $18K stipend while still in residency ($2K/month for 9 months), benefits, complete office setup, staff, no OB, help with qualifying for state loan repayment up to $160K over 4 years, $2k of CME expenses with 1 week of CME time off, 3 weeks of vacation...but, this also includes 1 in 4 call, plus 1 in 4 days taking unassigned patients in the hospital and you have to follow patients into the ICU, the hospital controls when you can/can't moonlight, non-compete in the county for 12 months and 4 year stipend payback (you work there 4 years, you owe nothing for the stipend) -- contract renewable on a yearly basis with 2 months notice -- renews in every January. Bonus eligibility after hittting the 25th percentile in RVUs with only a specified number of RVUs over that qualifying for a total possible of $28K in bonus'....but you have to see 17 patients per day to be eligible.....which is very nice and his hospital patients count towards that value also.....But this is in a small (emphasize small) hospital...the ER is more like a closet.... so all totaled, counting the loan repayment (which is spread out over 4 years) it turns out to be 205, 215, 225, 235 for the first 4 years then drops to 180 (loan repayment stops after 4 years)....but by then a renegotiation will probably be in order for him....\\

Contracts in the burbs are more like $150-160 with $5K signing bonus and more of an income guarantee for the first year....

All this for 500K of debt, huh? Where do I sign up?

 

[Dharma]

All this for 500K of debt, huh? Where do I sign up?

Loans won't be that bad for me, but yeah man. I have an interest in FM, but every time I come on SDN FM forums, I close my screen wondering if that's the best option. That said, I need to go study...

 

[drcrispmd]

It depends on:
1. Location (city vs rural)
2. type of practice: outpatient only, outpatient and inpatient, previous with OB
3. type of clinic: FQHC (federally qualified health clinic) vs private vs hospital owned
4. how many days a week you want to work
5. How you are paid. some places will give you a higher guarantee the first 2 years then after that you get paid based on what you bill. Other places will give you a base salary plus rvu bonus
6. how well your lawyer negotiates (always have a lawyer review your contract!)

 

[MJB]

Offers out of residency in Kansas City area are routinely 180-200 for outpatient only with no hospital call.

 

[MJB]

And several are making upper 2 to low 3's after getting established.

 

[FiveRivers]

And several are making upper 2 to low 3's after getting established.

That's a great point, MJB. I feel that students can get so entrenched in the starting salary post residency, that the realistic potential often gets over looked.

 

[deleted480308]

At my program there were several R3's that just signed for $280K/yr in the ED.)

That's fm r3 signing full time ED gigs at $280?


Sent from my iPad using Tapatalk

 

[cabinbuilder]

That's fm r3 signing full time ED gigs at $280?


Sent from my iPad using Tapatalk

Yes, well ER pays more than FM so that would be expected.

 

[didymus]

Go concierge. That's a big thing these days. There is a concierge practice in my hometown that offered a job to a family member of mine. 350 patient base total (approx. 7-10 patient visits per day), $200,000 per year. When you consider the average PCP has a patient base of 2,500+ (25 patients per day), this is a sweet gig.

*Edit* The practice is also located in a metro area. If the doc was so inclined, he or she could bump up that patient load to average PCP levels and bring home Nip/Tuck dollars.

 

[Silent Cool]

Go concierge. That's a big thing these days. There is a concierge practice in my hometown that offered a job to a family member of mine. 350 patient base total (approx. 7-10 patient visits per day), $200,000 per year. When you consider the average PCP has a patient base of 2,500+ (25 patients per day), this is a sweet gig.

*Edit* The practice is also located in a metro area. If the doc was so inclined, he or she could bump up that patient load to average PCP levels and bring home Nip/Tuck dollars.

Wouldn't that defeat the purpose of why people pay more for concierge medicine, which is to have more time with a physician?

 

[didymus]

Wouldn't that defeat the purpose of why people pay more for concierge medicine, which is to have more time with a physician?

Of course it would. Doesn't mean one can't still do it if they want the lime green lambo. None of the docs at the practice do it, but it is still a feasibility.

 

[Sophocles]

I was looking at the job offers at Merrit Hawkins and some of the jobs stated that their salaries ranged from 350-400 and one was 500-700k. Can anyone comment on this?

 

[deleted480308]

I was looking at the job offers at Merrit Hawkins and some of the jobs stated that their salaries ranged from 350-400 and one was 500-700k. Can anyone comment on this?

(i looked up the post) 4day work week...700k? I know I'm a pre-med, but I also run a business, and I call bullcrap

 

[Sophocles]

You and I aren't that far apart in training but I agree with you, as well. It's obviously not that important for us but I'm still curious; hopefully a resident or attending could lend some insight

 

[VA Hopeful Dr]

Of course it would. Doesn't mean one can't still do it if they want the lime green lambo. None of the docs at the practice do it, but it is still a feasibility.

In theory its possible. In reality, no one is going to pay an extra couple thousand dollars a year for the standard 15 minute appointment not same day.

 

[VA Hopeful Dr]

I was looking at the job offers at Merrit Hawkins and some of the jobs stated that their salaries ranged from 350-400 and one was 500-700k. Can anyone comment on this?

Those are usually salary potentials, not what they will actually pay you. Usually for jobs that say that its either somewhere that no one wants to live or they work you like a rented mule to earn that money.

 

[didymus]

In theory its possible. In reality, no one is going to pay an extra couple thousand dollars a year for the standard 15 minute appointment not same day.

Well it only costs the patient $50 per month for unlimited access if they are 18-65; over 65 is $100 per month (same access), and peds are $10 per month. The setup is pretty great since it works like a gym or club membership. The patients aren't really paying so much more--if any more--for the concierge services.

Also, if a doctor wanted to pursue much higher income, he or she wouldn't have to even ramp up to 2,500+ patients. Notice how the docs are collecting $200,000 on such a small number of patients currently. Adjusting the patient load even by another 300 will increase income considerably.

 

[VA Hopeful Dr]

Well it only costs the patient $50 per month for unlimited access if they are 18-65; over 65 is $100 per month (same access), and peds are $10 per month. The setup is pretty great since it works like a gym or club membership. The patients aren't really paying so much more--if any more--for the concierge services.

Also, if a doctor wanted to pursue much higher income, he or she wouldn't have to even ramp up to 2,500+ patients. Notice how the docs are collecting $200,000 on such a small number of patients currently. Adjusting the patient load even by another 300 will increase income considerably.

OK this is just semantics, but that's not really concierge practice as its generally thought of. That's more like Direct Primary Care (Paging Josh). Even still, those folks aren't going to be happy with the normal way of scheduling if you have the "full" patient panel at 2000+. You could go from 300-500 easily enough, but going from 300-3000 just won't fly.

 

[cabinbuilder]

(i looked up the post) 4day work week...700k? I know I'm a pre-med, but I also run a business, and I call bullcrap

You are smart to question this. I have worked with Merritt Hawkins on the job hunt before. Most of what they say is untrue and the jobs they are selling a miserable existence. Just don't do it.

 

[Sophocles]

You are smart to question this. I have worked with Merritt Hawkins on the job hunt before. Most of what they say is untrue and the jobs they are selling a miserable existence. Just don't do it.

What's the most they've offered for a permanent non-traveling job, regardless of ob, in/outpatient, etc? And what kinds of hours or stipulations were on it?

 

[cabinbuilder]

What's the most they've offered for a permanent non-traveling job, regardless of ob, in/outpatient, etc? And what kinds of hours or stipulations were on it?

220K base with 400K earning potential. They don't have control over hours/stipulations. My two jobs I interviewed through them never panned out due to problems with politics at the site.

Just remember that their job is solely recruitment for the site. It's up to you as the candidate to see through all the wine and dine and get to the nitty gritty as to hours, call, ER coverage, hospital work, etc. The recruiter can't dictate that. The politics of the job site does.

 

[yesdee]

There is a concierge practice in my hometown that offered a job to a family member of mine. 350 patient base total (approx. 7-10 patient visits per day), $200,000 per year.

Humm.. this doesn't seem feasible. 350 patient base paying $50 pm will be $210,000 per year. Deduct other expenses like staff, lease, utilities, other overheads. No one will pay $200K out of $210K gross.

 

[didymus]

Humm.. this doesn't seem feasible. 350 patient base paying $50 pm will be $210,000 per year. Deduct other expenses like staff, lease, utilities, other overheads. No one will pay $200K out of $210K gross.

You aren't factoring in those patients who pay $100 per month. They also offer Rx at discounted price points, and get a small portion of that. It is a small practice, and all the docs pay into the facilities and such. They also developed their own EMR, have extremely low overhead since they don't need a staff of people billing to insurance (because they don't accept insurance), they room their own patients, so no nursing or MA staff. It is not only quite feasible, but actually already happening.

I think the docs are averaging collections of around $21,000 per month each. That gives them $252,000 on the year at the 350 patient load, before expenses.

 

[SnakeOil]

Well it only costs the patient $50 per month for unlimited access if they are 18-65; over 65 is $100 per month (same access), and peds are $10 per month. The setup is pretty great since it works like a gym or club membership. The patients aren't really paying so much more--if any more--for the concierge services.

Also, if a doctor wanted to pursue much higher income, he or she wouldn't have to even ramp up to 2,500+ patients. Notice how the docs are collecting $200,000 on such a small number of patients currently. Adjusting the patient load even by another 300 will increase income considerably.

There's no way you could run a concierge practice only charging $50/month for unlimited access

You aren't factoring in those patients who pay $100 per month. They also offer Rx at discounted price points, and get a small portion of that. It is a small practice, and all the docs pay into the facilities and such. They also developed their own EMR, have extremely low overhead since they don't need a staff of people billing to insurance (because they don't accept insurance), they room their own patients, so no nursing or MA staff. It is not only quite feasible, but actually already happening.

I think the docs are averaging collections of around $21,000 per month each. That gives them $252,000 on the year at the 350 patient load, before expenses.

$250k/year before expenses is hardly worth the time/risk/effort of having your own business. Even if their overhead was extremely low (50% is average, 30% is low, 20% is insanely low) you'd still be looking at a salary of just over (maybe less) than $200k/year before taxes with NO benefits. Most of my colleges were signing $200k+ contracts that included full benefits right out of residency.

 

[SnakeOil]

Plus they didn't have to give their cell phone # to all their patients.

 

[didymus]

There's no way you could run a concierge practice only charging $50/month for unlimited access


$250k/year before expenses is hardly worth the time/risk/effort of having your own business. Even if their overhead was extremely low (50% is average, 30% is low, 20% is insanely low) you'd still be looking at a salary of just over (maybe less) than $200k/year before taxes with NO benefits. Most of my colleges were signing $200k+ contracts that included full benefits right out of residency.

Right. You have no idea what you're talking about. Check out Atlas.md to learn a few things. Also, I didn't realize total autonomy, no burdensome insurance paperwork, seeing 7-10 (max) patients per day, and having ownership of a practice/being your own boss, was "hardly worth it" for $200,000 AFTER expenses (facilities, benefits, etc.)

I guess some people just love the piles of paperwork, 30 patients per day, hospital rounds, and non-medical administrators setting the pace and protocols for them. To each his own, I guess.

 

[didymus]

Plus they didn't have to give their cell phone # to all their patients.

Because your call burden is so light since patients don't have your direct line

 

[cabinbuilder]

You aren't factoring in those patients who pay $100 per month. They also offer Rx at discounted price points, and get a small portion of that. It is a small practice, and all the docs pay into the facilities and such. They also developed their own EMR, have extremely low overhead since they don't need a staff of people billing to insurance (because they don't accept insurance), they room their own patients, so no nursing or MA staff. It is not only quite feasible, but actually already happening.

I think the docs are averaging collections of around $21,000 per month each. That gives them $252,000 on the year at the 350 patient load, before expenses.

No thanks. I'm happy getting paid by the hour and having no ties to anyone, no overhead, and if I hate it I can leave.

 

[didymus]

No thanks. I'm happy getting paid by the hour and having no ties to anyone, no overhead, and if I hate it I can leave.

I never suggested it was for everybody, and I think your aversion to establishing roots is an exception, @cabinbuilder--so for those who have no problem with being a part of a community, constant cash flow, low overhead, no insurance coding, a limited and very manageable patient volume, and being their own bosses, they should consider concierge.

 

[cabinbuilder]

I never suggested it was for everybody, and I think your aversion to establishing roots is an exception, @cabinbuilder--so for those who have no problem with being apart of a community, constant cash flow, low overhead, no insurance coding, a limited and very manageable patient volume, and being their own bosses, they should consider concierge.

Perhaps. I am my own boss, btw. Not looking for an argument either way. Just adding into the commentary. My aversion is giving up my freedom and having "the system" telling me how much time off I can have and when.

 

[didymus]

Perhaps. I am my own boss, btw. Not looking for an argument either way. Just adding into the commentary. My aversion is giving up my freedom and having "the system" telling me how much time off I can have and when.

No argument from me, just a simple response to what you shared.

When one owns his or her own practice, especially in a concierge model, there is no system that you refer to. It's just you and your colleagues (as few or as many as you want). Plus the freedom one gains from not having to run a patient mill to make a living is remarkable. Just something to consider. There is nothing wrong with the gypsy spirit; it's just not something we all value.

 

[cabinbuilder]

I probably would feel differently if I was a lot younger and felt like I had the time to have an office and patient base. For me it's more important to work on my own bucket list than have an office. That's the beauty of medicine, we all have a niche that makes us happy and fulfilled.

 

[didymus]

I probably would feel differently if I was a lot younger and felt like I had the time to have an office and patient base. For me it's more important to work on my own bucket list than have an office. That's the beauty of medicine, we all have a niche that makes us happy and fulfilled.

Well said.

 

[Sophocles]

Well said.

Very interesting to see two sides.

A question for everyone: where is the political bs more prevalent, in academic centers or community hospitals?

 

[Dharma]

You aren't factoring in those patients who pay $100 per month. They also offer Rx at discounted price points, and get a small portion of that. It is a small practice, and all the docs pay into the facilities and such. They also developed their own EMR, have extremely low overhead since they don't need a staff of people billing to insurance (because they don't accept insurance), they room their own patients, so no nursing or MA staff. It is not only quite feasible, but actually already happening.

I think the docs are averaging collections of around $21,000 per month each. That gives them $252,000 on the year at the 350 patient load, before expenses.

Are there any resources where I can learn about the DPC set up? I'd like to learn the ins-and-outs if possible. Thanks Epi.