Primary physicians(IM, FM) making 350K+ salary...

[BestDoctorEver]

I met a primary physician(IM) last week that told me a primary doc can make 300k+ easily and dont have to work hard. In fact, he told me that he has been making in the high 300s and low 400's in the past four year. I asked him how can he be making that much when the average salary primary care physicians is 170k+. His answer was (I am quoting): "I dont where people got these numbers from. I have at least 6 friends that that are primary docs, and all of them are making 250K+. You have to know how to play the game". He proceeded on saying: I have an hospitalist job that pay me 200k. I have my own practice that I staff with a Physician Assistant and spend about 20 hours a week there, and I gross about 150+k a year there. Is that possible?

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[JeetKuneDo]

Where does he live? Is this place rural?

 

[Sinfest]

A primary care doc (IM) I shadowed makes over half a million a year, but he's definitely not in the majority.

 

[painmd87]

Averages are averages. There are many above the average and many below the average. I'm sure there are PCPs making $80,000 a year as well as those making $500,000 a year. It's all in how much you put into it, your clientele, your locality, etc. I'm sure there are very hard working PCPs who put in 100 hours a week to take home the big $$.

A lot of internists around here are moving to the 'retainer' model where they charge you $1,500 a year in addition to billing your insurance company. The upside is that instead of having 20,000 patients, they accept 5,000 for the entire practice, which makes it more likely that you'll get to see the doctor, they do home visits, longer office visits, etc. If you have enough patients willing to pay a certain retainer each year, I'm sure you can get well above average compensation.



At a local hospital, there are two GYN surgeons (there are more than two, but for the example, imagine there are two). One comes in at 5 a.m. and leaves at 11 p.m. He is the highest paid person in the hospital, exceeding the CEO, at $754,984 in 2009. There is another GYN surgeon who works 8 a.m. to 6 p.m. and pulls in $345,000. Billable hours, people!

 

[DbDan]

I met a primary physician(IM) last week that told me a primary doc can make 300k+ easily and dont have to work hard. In fact, he told me that he has been making in the high 300s and low 400's in the past four year. I asked him how can he be making that much when the average salary primary care physicians is 170k+. His answer was (I am quoting): "I dont where people got these numbers from. I have at least 6 friends that that are primary docs, and all of them are making 250K+. You have to know how to play the game". He proceeded on saying: I have an hospitalist job that pay me 200k. I have my own practice that I staff with a Physician Assistant and spend about 20 hours a week there, and I gross about 150+k a year there. Is that possible?

As a hospitalist he's taking on 40hrs/wk+ and he's doing 20 a week at his own practice. I'm sure his practice is also successful... He works hard and he makes money to show it.

 

[BestDoctorEver]

Where does he live? Is this place rural?

Not rural...It's in south FL.

 

[wolverinepwns]

you can make as much as you want, depending on how much you're willing to work, how many partners you take on (which dicated how much you'll be oncall), how many patients you accept, ....

 

[IamaBanana]

Billable hours, people!

He works hard and he makes money to show it.

This is why medicine is such a great field to be in. You work as hard as you want and your compensation is directly proportionate.

 

[willen101383]

I worked with a large FM group for a year after college prior to graduate school. There were I think 6 partner physicians...a few associate physicians, and a TON of midlevels.

The partners maybe 10 years ago threw down some cash and purchased the large "medical arts building" they are in. They rent the building out to like 5 other practices. They are each making 500+ a piece.

This is in upstate NY...large city not rural.

The practice is a fing assembly line but still they are making a killllingggg

 

[JaggerPlate]

Stuffing a few practices with PAs and flying in to review charts every once and a while = gold IMO.

 

[ccc2009]

To understand all the options available for IM/FP, such as hospitalist, and to use the healthcare system efficiently is just an MD/DO enough these days? Is an MBA worth the time and money and extra year of med school tuiton (40k) and is it necessary to be able to set up such practices? The obvious benefit would be decreasing the learning curve, a few years or problems perhaps, for starting a practice without a business background. Or would an MMM or MHA suffice? Or are any of these extra degrees even necessary.

 

[JaggerPlate]

To understand all the options available for IM/FP, such as hospitalist, and to use the healthcare system efficiently is just an MD/DO enough these days? Is an MBA worth the time and money and extra year of med school tuiton (40k) and is it necessary to be able to set up such practices? The obvious benefit would be decreasing the learning curve, a few years or problems perhaps, for starting a practice without a business background. Or would an MMM or MHA suffice? Or are any of these extra degrees even necessary.

No. You don't need to get a MHA/MBA/MMM to set up an efficient practice. Lesson 1: keep costs/debt low while you're a student (by not paying the 40k or whatever to get these degrees).

 

[DbDan]

No. You don't need to get a MHA/MBA/MMM to set up an efficient practice. Lesson 1: keep costs/debt low while you're a student (by not paying the 40k or whatever to get these degrees).

Truth. I would definitely not want to add an additional 40k+ on top of my med school loans just for someone to teach me how to supposedly run a successful business.

BTW, how was the drive to K-ville?

 

[DOwnage]

As nice as this sounds, I don't think this is something that anyone should bank on going into primary care medicine. Sure, you can pull off something like this NOW, but we really don't know what the future of health care holds. I've spoken with many physicians that express their doubts about the future of private practice medicine, even questioning its existence with the new health care bill signed by Obama.

With reimbursements trending down because government and insurance payers know they can give us the shaft the easiest (compared to say the pharma lobby), it becomes harder to see enough patients to pay for all the cost of running the business. What if your clientele is mostly the elderly on Medicare? You cannot simply pass the cost down to the patient as you could in a normal business if the government decides to cut your reimbursement. Medicare doesn't let you bill for anything over what Medicare says they will reimburse you. Therefore, if you are losing money doing a certain procedure on medicare, you aren't allowed to charge the patient what it takes to just break even on that 1 procedure.

With the government's intrusion on making it harder to run private practices, they are basically funneling all of us doctors (or future doctors I suppose) into becoming hospital employees on a flat salary. This goes along the lines of the corporatist model that promotes positive legislation for big corporations (hospitals) and screws the smaller competitors into massive regulation and eventual going out of business.

I'm not saying this is the future and it is carved in stone, I'm simply saying that this is one possible future we're looking at. Of course, the market can spring up in the form of a 2-tier system that provides people with money choices other than the oligopoly of hospitals available to them, but legislation can be a b-tch sometimes and potentially deny that from happening.

 

[CopToEM]

FWIW, I was told by one of the founding physicians in a local practice that none of their primary care doctors make under $300,000/year. Very rural.

 

[JWP07]

A primary care physician I shadowed told me he started off making about 140,000. Today, He makes around 250,000-300,000. He's been practicing for 16 years in Los Angeles.

 

[Skippygonenuts]

Numbers mean nothing more than "it is possible". As previous posters said, the average internist makes 170k but if u look at mdsalary.com and almost any salary site it'll tell u that numbers can be 30 or 40k higher or lower. Just take these things with a grain of salt.

Now my question...say ur a surgeon (ent, ortho, plastics, general, whatever) and ur hospital employed. Obviously u get paid by the hour. But don't u also bill the patient separately for whatever procedure u may have performer? So in essence your not just getting ur hospital salary. And while ur working at the hospital, they're just scouting more patients for u to perform procedures on and then drag them into ur office for several post-ops and essentially their ur patient for life.

Am I that inaccurate?

 

[DOwnage]

Numbers mean nothing more than "it is possible". As previous posters said, the average internist makes 170k but if u look at mdsalary.com and almost any salary site it'll tell u that numbers can be 30 or 40k higher or lower. Just take these things with a grain of salt.

Salary statistics can also be inaccurate. People surveyed may not be full time, which can lower the average. We don't know how well the sample was constructed either. Hell, people can even lie. Why would you tell the world in a survey how much you really made, since the resulting information will ultimately fuel public jealousy and a cry for reimbursement decreases. Only the foolish proud flaunt their wealth.

Now my question...say ur a surgeon (ent, ortho, plastics, general, whatever) and ur hospital employed. Obviously u get paid by the hour. But don't u also bill the patient separately for whatever procedure u may have performer? So in essence your not just getting ur hospital salary. And while ur working at the hospital, they're just scouting more patients for u to perform procedures on and then drag them into ur office for several post-ops and essentially their ur patient for life.

Am I that inaccurate?

I know a surgeon personally who is in a private practice group, and from what I gather, most if not all of the other surgeons I've ever come across operate the same way. They collect insurance information at the office visit and bill the patient accordingly. When the patient goes to the hospital for an operation, the hospital bills them as well. From what I gather, the hospital doesn't transfer any money to the surgeon directly and the surgeon is not a hospital employee; they only provide the place for the operation. This is why if you have an operation done by a surgeon in a hospital, it's super expensive, while having it done in a privately owned surgical center, it's competitively priced. Hospitals eat up costs of deadbeats so they have to charge their actual paying customers MORE to make up for it. This is why surgeries bills' are in the tens of thousands of dollars, but surgeons only make a few thousand from reimbursement - the hospital is a large item in the bill. When someone tells you about them damn rich doctors, tell them about them damn rich hospital executives instead.

 

[Skippygonenuts]

I know a surgeon personally who is in a private practice group, and from what I gather, most if not all of the other surgeons I've ever come across operate the same way. They collect insurance information at the office visit and bill the patient accordingly. When the patient goes to the hospital for an operation, the hospital bills them as well. From what I gather, the hospital doesn't transfer any money to the surgeon directly and the surgeon is not a hospital employee; they only provide the place for the operation. This is why if you have an operation done by a surgeon in a hospital, it's super expensive, while having it done in a privately owned surgical center, it's competitively priced. Hospitals eat up costs of deadbeats so they have to charge their actual paying customers MORE to make up for it. This is why surgeries bills' are in the tens of thousands of dollars, but surgeons only make a few thousand from reimbursement - the hospital is a large item in the bill. When someone tells you about them damn rich doctors, tell them about them damn rich hospital executives instead.

I see what your saying. But what about of the surgeon actually is hospital employed? Can he bill each patients insurance company for every procedure or does he just get his yearly salary?

 

[DOwnage]

I see what your saying. But what about of the surgeon actually is hospital employed? Can he bill each patients insurance company for every procedure or does he just get his yearly salary?

I can't really speak for this situation with great confidence, but I've heard of some interventionalists who are hospital employed (different hospital in the area). I haven't ever spoken with them about this but from what I heard, they accept a flat salary and the hospital appears to handle the billing. I'm kind of guessing that you can't have the best of both worlds, where you charge patients for services while collecting a safe salary at the hospital. There has to be some kind of trade off there.