What exactly makes your salary rise as a physician?

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Other than more patients, are there any other reasons why a physician who has been practicing 12 years would make more than one who has only been practicing for 3? Granted that they are in the same specialty, city and so on.
 
ejay286 said:
Other than more patients, are there any other reasons why a physician who has been practicing 12 years would make more than one who has only been practicing for 3? Granted that they are in the same specialty, city and so on.
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It doesn't matter because as long as I can make $60,000 a year as a physician I will be happy. Most people live pretty well on less than that and I can't imagine needing any more to be happy. In fact, just asking about salary shows that you are going into medicine for the wrong reasons and you may need to reconsider your career goals. As long as the underserved have no access to medical care, I would be embarrassed to ask them to spend their cigarette money on medicine while I wallow in the luxury that $60,000 per year will buy.
 
So bitter! :laugh:
 
Panda Bear said:
It doesn't matter because as long as I can make $60,000 a year as a physician I will be happy. Most people live pretty well on less than that and I can't imagine needing any more to be happy. In fact, just asking about salary shows that you are going into medicine for the wrong reasons and you may need to reconsider your career goals. As long as the underserved have no access to medical care, I would be embarrassed to ask them to spend their cigarette money on medicine while I wallow in the luxury that $60,000 per year will buy.
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r o f l
 
ejay286 said:
LOL, but I did find this interesting article although its a couple of years old.

http://www.aafp.org/fpm/20050700/16what.html#box_a

One part that surprised me was that it said to be a higher earning FM physician one needs to see more Medicare patients. Thought that was kinda counterintuitive.
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Medicare pays by the procedure. So if a physician has a Medicare patient and wishes to earn more money all they have to do is tell the patient that a CT scan, MIR, .... will be necessary to confirm a diagnosis. The nice part of this is the MIR or CT machines are a fixed cost so once it is paid for the doctor can make bank by recommending all his Medicare patients to use it. Where as other people on private insurance plan my not have some procedures covered or do not wish to pay their portion of an expensive test, so they opt out.

Does anyone know anything more about this? I really don't know too much about Medicare, but this is what I have heard.
 
Panda Bear said:
It doesn't matter because as long as I can make $60,000 a year as a physician I will be happy. Most people live pretty well on less than that and I can't imagine needing any more to be happy. In fact, just asking about salary shows that you are going into medicine for the wrong reasons and you may need to reconsider your career goals. As long as the underserved have no access to medical care, I would be embarrassed to ask them to spend their cigarette money on medicine while I wallow in the luxury that $60,000 per year will buy.
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You need have some compassion and use some of your inflated salary to give out a free carton of cigarettes to every patient, there is no reason they should be using their beer money on cigarettes while you are rolling in $60k/yr. 😡
 
redrumi said:
You need have some compassion and use some of your inflated salary to give out a free carton of cigarettes to every patient, there is no reason they should be using their beer money on cigarettes while you are rolling in $60k/yr. 😡
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I actually LOL'ed. Doesn't happen very often. Well done, sir/madam.
 
mdmdt said:
I actually LOL'ed. Doesn't happen very often. Well done, sir/madam.
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Why? Panda's post was funny. Redrumi's was like telling the same joke again, 3 posts later. Lame.
 
*thinks of witty comment in order to impress others with my clever use of the English language*

Sorry. This is me avoiding MCAT studying. Laterz!
 
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fire2 said:
Why? Panda's post was funny. Redrumi's was like telling the same joke again, 3 posts later. Lame.
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I guess my sarcasmeter didn't go off for Panda's post 😛 I thought he/she were serious. There are people who feel that way after all...
 
mdmdt said:
I guess my sarcasmeter didn't go off for Panda's post 😛 I thought he/she were serious. There are people who feel that way after all...
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Nah Panda has actually debated the alternate view point ad nauseum on these boards before and has a bit of a reputation for it. It looks like he's done trying 😛
 
Doing more of the highly reimbursed stuff will make your salary go up.

Learning how to get insurance to pay (they reject an inordinate number of claims).
 
ejay286 said:
Other than more patients, are there any other reasons why a physician who has been practicing 12 years would make more than one who has only been practicing for 3? Granted that they are in the same specialty, city and so on.
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It's the same with any profession -- it's called leverage. You make more money if you have people working under you. So you join a partnership as an employee, and at some day down the road you get invited to buy into the partnership and then you and the partners split the pot (based on partnership interests). Then when you have enough business to hire some new employees, you hire them at a lower starting salary with the promise that someday they too will be allowed to buy in as partners. But until that day, they are generating more money then their salary, and this difference is split by the partners. And so on. By a decade from now, the partnership has multiple employees, all generating more money than they earn, that the higher ups split. So yeah, the longer you are in private practice the more money you will make, because you are getting money out of those lower down the pyramid.

As for solo practitioners, the only way you can make more money is to see more patients, and do more procedures.
 
dienekes88 said:
Doing more of the highly reimbursed stuff will make your salary go up.

Learning how to get insurance to pay (they reject an inordinate number of claims).
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Nah. This is already optimized by pretty much everybody who is in business over a week, so you really can't improve upon it.
 
prescribing expensive medicine unnecessarily and getting kickbacks from pharmaceuticals is common in many countries, I'm not sure about the US though.
 
Panda Bear said:
It doesn't matter because as long as I can make $60,000 a year as a physician I will be happy. Most people live pretty well on less than that and I can't imagine needing any more to be happy. In fact, just asking about salary shows that you are going into medicine for the wrong reasons and you may need to reconsider your career goals. As long as the underserved have no access to medical care, I would be embarrassed to ask them to spend their cigarette money on medicine while I wallow in the luxury that $60,000 per year will buy.
Click to expand...

This was welcome after an entire day of studying anatomy.
 
Law2Doc said:
It's the same with any profession -- it's called leverage. You make more money if you have people working under you. So you join a partnership as an employee, and at some day down the road you get invited to buy into the partnership and then you and the partners split the pot (based on partnership interests). Then when you have enough business to hire some new employees, you hire them at a lower starting salary with the promise that someday they too will be allowed to buy in as partners. But until that day, they are generating more money then their salary, and this difference is split by the partners. And so on. By a decade from now, the partnership has multiple employees, all generating more money than they earn, that the higher ups split. So yeah, the longer you are in private practice the more money you will make, because you are getting money out of those lower down the pyramid.

As for solo practitioners, the only way you can make more money is to see more patients, and do more procedures.
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Is this how the nurses and secretaries are paid in a private practice as well? If so, do you make more by having less of them?
 
Panda Bear said:
It doesn't matter because as long as I can make $60,000 a year as a physician I will be happy.
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See, I knew you should have gone into general pediatrics where we make $60,000 year after 10 years and use most of it to buy medicines for our patients.🙄

Seriously, I would point out that a physician in academic medicine, although taking a vow of poverty (well, I'm semi-serious😛) will usually get a raise each year and a raise when increasing in academic status/tenure. They can also get a raise based on grants received and as their career advances. Many will have the opportunity to do consulting and give talks, etc that are paid. These opportunities tend to fall disproportionately to folks who've been around longer.
 
For some specialties your sales skills will make a difference in your salaries.
 
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ejay286 said:
Is this how the nurses and secretaries are paid in a private practice as well? If so, do you make more by having less of them?
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Um no. When you have nurses giving all the vaccines, administering the eye/hearing tests, weighing the patients and getting them ready in the room, they free you up to see other patients. So the patient may be in the office for a half hour, but you only have to spend 10 minutes with them. It still gets billed as an office visit. So the nurses make you money by allowing you to see more patients. Secretaries are part of the general and administrative cost of being in business, just like the power bill and rent. No, they don't really generate any money, but to some extent they too free you up to see more patients. It's a fixed cost you have to pay, or you cannot really run a business of any significant size without a staff.
 
I've read some things about MDs prescribing tests that are administered through entities that the MDs own and subsequently profit from, the article discussed making this illegal or somehow stopping the practice as it appeared improper.

One area that's probably mostly common knowledge relates to the insurance companies that a physician's office accepts - I've heard that medicare/medicaid (depending on the office cost structure) generates tiny or even negative net revenue for a practice, considering the total office overhead costs. I've read that most physicians must limit the % of medicare/medicaid patients that they see in order to make enough to pay their staff & have $$ left over to take a salary; if a physician was able to market to patients covered by "preferred" insurance firms, they could increase their salary.

Also as l2d said working in a larger practice is an option - a relative had this setup where they worked in a mid-sized MD office initially on salary, with the option to become a partner after a certain number of years and presumably earn a higher average income.

As a sole practitioner, one could partner with other sole practitioners, possibly sharing office space or an admin or an RN in order to spread those costs a bit wider, can't imagine a sole practitioner would need their own admin + RN fulltime.
 
Or working for an HMO, you get yearly raises. Not to mention bonuses periodically, often based on seniority. Plus, one like Kaiser lets the more senior physicians (3+ years) become shareholders, and they get a cut of the profits every year as well.
 
Panda Bear said:
It doesn't matter because as long as I can make $60,000 a year as a physician I will be happy. Most people live pretty well on less than that and I can't imagine needing any more to be happy. In fact, just asking about salary shows that you are going into medicine for the wrong reasons and you may need to reconsider your career goals. As long as the underserved have no access to medical care, I would be embarrassed to ask them to spend their cigarette money on medicine while I wallow in the luxury that $60,000 per year will buy.
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OH YAWN! YOU JUST GO TO WORK EVERYDAY TO MAKE THE "ULTIMATE SACRIFICE". You GRACIOUS servant of humanity! Quite frankly, your post made me ****ing sick. Why don't you step off your two foot stool you midget. :meanie:
 
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UFGatorMed said:
OH YAWN! YOU JUST GO TO WORK EVERYDAY TO MAKE THE "ULTIMATE SACRIFICE". You GRACIOUS servant of humanity! Quite frankly, your post made me ****ing sick. Why don't you step off your two foot stool you midget. :meanie:
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Haha. But seriously, in this day and age is $60,000 sufficient to raise 2.5 kids, a dog, a house/mortgage and still have enough to enjoy yourself every now and then? I'm serious people: I still live with the parental unit and don't know the value of money.
 
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nontrdgsbuiucmd said:
As a sole practitioner, one could partner with other sole practitioners, possibly sharing office space or an admin or an RN in order to spread those costs a bit wider, can't imagine a sole practitioner would need their own admin + RN fulltime.
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This can be done, but as I mentioned above, the point of a nurse is to do 90% of the run of the mill office visit, getting the vitals, administering eye/hearing tests, giving shots, etc. so the doc can just poke his head in at the end and do a quick physical and send the patient on their way. So you might often be better off if the nurses outnumber the doctors. You also have to be careful how you run these companies, because when you "partner" with other sole practitioners, if you don't watch your step then under the law you have a partnership and can be financially liable for any of those other doctors mistakes. So if you are going to be in a partnership, do it right and structure it with the appropriate business entity. If you think you are solo, but are "partnering" you are living a very precarious existence. Too many people get in big trouble by not understanding the law and what constitutes a partnership for legal purposes. Very dangerous waters here.
 
If I have to goto college for 8 years and 2+ of additional training... By God: SHOW ME THE MONEY! :hardy:
 
ONYX4000GT said:
If I have to goto college for 8 years and 2+ of additional training... By God: SHOW ME THE MONEY! :hardy:
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I can show it to you, but it's not going to be where you are. 😀

And what's this 2+ years of additional training garbage -- the minimum residency for most fields these days is 3+. Most of us will do 4+.
 
Law2Doc said:
I can show it to you, but it's not going to be where you are. 😀

And what's this 2+ years of additional training garbage -- the minimum residency for most fields these days is 3+. Most of us will do 4+.
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If I have to goto college for 8 years and 4+ of additional training... By God: SHOW ME THE MONEY! :hardy:
 
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Virgil said:
Haha. But seriously, in this day and age is $60,000 sufficient to raise 2.5 kids, a dog, a house/mortgage and still have enough to enjoy yourself every now and then? I'm serious people: I still live with the parental unit and don't know the value of money.
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Yes you would be comfortable with 60k a year if you didnt have the 200k+ loans over your head and the 4 years less of working.
 
Can't you just use an elevator?









:corny: (yes, yes, corny joke, I know.)
 
Virgil said:
Haha. But seriously, in this day and age is $60,000 sufficient to raise 2.5 kids, a dog, a house/mortgage and still have enough to enjoy yourself every now and then? I'm serious people: I still live with the parental unit and don't know the value of money.
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No.
 
There is still money to be made in medicine. Get into the right specialty and operate your practice like a smart businessman. Simple as that.
 
nontrdgsbuiucmd said:
I've read some things about MDs prescribing tests that are administered through entities that the MDs own and subsequently profit from, the article discussed making this illegal or somehow stopping the practice as it appeared improper.
Click to expand...

I shadowed a GI and I think he somehow alluded to doing this. He was telling me how when he sees the patient, if he does the a colonoscopy or something he charges them for that under his "surgery company" which is independent of his private practice company but is all in the same office. So the patient gets charged twice as much as they normally would. I probably got some of the specifics wrong but thats basically what he said I think.

Law2Doc said:
So if you are going to be in a partnership, do it right and structure it with the appropriate business entity.
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Is this what the P.A. suffix is for?

8mile said:
There is still money to be made in medicine. Get into the right specialty and operate your practice like a smart businessman. Simple as that.
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This OB-GYN makes 12 million a year.
http://www.drmatlock.com/aboutdrmatlock.htm
 
How do you make your salary go up?! EASY! Just stand in front of a hot nurse. That makes your salary go from 6 to 12 really quick.
 
8mile said:
There is still money to be made in medicine. Get into the right specialty and operate your practice like a smart businessman. Simple as that.
Click to expand...

Sounds simple, but VERY hard to do.
 
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ejay286 said:
I shadowed a GI and I think he somehow alluded to doing this. He was telling me how when he sees the patient, if he does the a colonoscopy or something he charges them for that under his "surgery company" which is independent of his private practice company but is all in the same office. So the patient gets charged twice as much as they normally would. I probably got some of the specifics wrong but thats basically what he said I think.


Is this what the P.A. suffix is for?



This OB-GYN makes 12 million a year.
http://www.drmatlock.com/aboutdrmatlock.htm
Click to expand...


Where does it show that this OB/GYN makes 12 million a year? Do you really mean that the private pratice is worth 12 million a year? If so, then you need to take into account expenses. I have a feeling he does a lot of work for people who can pay for this services in cash. I doubt insurance covers a lot of the procedures this clinic does.
 
ejay286 said:
Other than more patients, are there any other reasons why a physician who has been practicing 12 years would make more than one who has only been practicing for 3? Granted that they are in the same specialty, city and so on.
Click to expand...

Easy. You start a group practice, hire other physicians and reap the benefits. If you want to make 7 figures, you need to be managing other doctors in your own practice.
 
ejay286 said:
I shadowed a GI and I think he somehow alluded to doing this. He was telling me how when he sees the patient, if he does the a colonoscopy or something he charges them for that under his "surgery company" which is independent of his private practice company but is all in the same office. So the patient gets charged twice as much as they normally would. I probably got some of the specifics wrong but thats basically what he said I think.
Click to expand...


This sounds like pod lab arrangement, which has become a threat to pathology during past 5 years. Basically, it allows the clinicians to bill Medicare for services rendered by pathologists. Needless to say, pathologists hate it and are actively lobbying against it.

There are many, many more schemes like that in medicine, which are only borderline legal at the best. Medicine is business just like any other, with its own share of crooks.
 
footballrules said:
[/B]

Where does it show that this OB/GYN makes 12 million a year? Do you really mean that the private pratice is worth 12 million a year? If so, then you need to take into account expenses. I have a feeling he does a lot of work for people who can pay for this services in cash. I doubt insurance covers a lot of the procedures this clinic does.
Click to expand...

http://mdsalaries.blogspot.com/2007/03/this-gynecologist-makes-12-million.html

This article is where I read it.
 
Panda Bear said:
It doesn't matter because as long as I can make $60,000 a year as a physician I will be happy. Most people live pretty well on less than that and I can't imagine needing any more to be happy. In fact, just asking about salary shows that you are going into medicine for the wrong reasons and you may need to reconsider your career goals. As long as the underserved have no access to medical care, I would be embarrassed to ask them to spend their cigarette money on medicine while I wallow in the luxury that $60,000 per year will buy.
Click to expand...


Why 60k/year and not $10,400 (US poverty line for a single adult)?
 
Panda Bear said:
It doesn't matter because as long as I can make $60,000 a year as a physician I will be happy. Most people live pretty well on less than that and I can't imagine needing any more to be happy. In fact, just asking about salary shows that you are going into medicine for the wrong reasons and you may need to reconsider your career goals. As long as the underserved have no access to medical care, I would be embarrassed to ask them to spend their cigarette money on medicine while I wallow in the luxury that $60,000 per year will buy.
Click to expand...

First, this is an honest question... You TRULY believe that if you care about money/being adequately compensated for your time spent serving society you should reconsider medicine? Do you believe a career should be based solely on idealistic considerations, and not practical ones, such as proper compensation for service (again, an honest question)?

Second, based on your first sentence, though it isn't phrased as a question ("Will I make 60,000 dollars a year?"), are you reconsidering going into medicine, or believe that you are going into it for the wrong reasons?

I'm honestly not trying to start any trouble, I'm trying to understand what you're trying to say.


As a side note, I was talking to someone about the idea of adequate compensation, specifically with respect to professional athletes, and someone mentioned to me that although I don't believe professional athletes deserve the money the get, not only is someone willing to pay for them to do it, it's based on a different standard of living. While you may be happy with 60,000 dollars a year and little else, others may not be. However much I am bitter than professional athletes make as much as they do, I can't fault them for basing their standard of living on their expectations of rightful or believed compensation.
 
ejay286 said:
http://mdsalaries.blogspot.com/2007/03/this-gynecologist-makes-12-million.html

This article is where I read it.
Click to expand...

He's not making it as an OBGYN, he's making it as an elective cosmetic surgeon. And he's only able to make this kind of bling because he has a cash only business (possible in cosmetic surgery) and he has been featured on national TV. Even so, I think this is probably his net revenues (before expenses, medmal exposure etc) and not his salary. But regardless, this isn't gonna be you.
 
betheltim said:
First, this is an honest question... You TRULY believe that if you care about money/being adequately compensated for your time spent serving society you should reconsider medicine? Do you believe a career should be based solely on idealistic considerations, and not practical ones, such as proper compensation for service (again, an honest question)?

Second, based on your first sentence, though it isn't phrased as a question ("Will I make 60,000 dollars a year?"), are you reconsidering going into medicine, or believe that you are going into it for the wrong reasons?

I'm honestly not trying to start any trouble, I'm trying to understand what you're trying to say.


As a side note, I was talking to someone about the idea of adequate compensation, specifically with respect to professional athletes, and someone mentioned to me that although I don't believe professional athletes deserve the money the get, not only is someone willing to pay for them to do it, it's based on a different standard of living. While you may be happy with 60,000 dollars a year and little else, others may not be. However much I am bitter than professional athletes make as much as they do, I can't fault them for basing their standard of living on their expectations of rightful or believed compensation.
Click to expand...

Dude, he's being sarcastic. Panda has been fighting a good fight against the kneejerk responses of pre-allos who say doctors are overpaid and that they would go into it even if the salaries were only $60k. (Sadly, there are quite a few such posters among us).
 
betheltim said:
First, this is an honest question... You TRULY believe that if you care about money/being adequately compensated for your time spent serving society you should reconsider medicine? Do you believe a career should be based solely on idealistic considerations, and not practical ones, such as proper compensation for service (again, an honest question)?

Second, based on your first sentence, though it isn't phrased as a question ("Will I make 60,000 dollars a year?"), are you reconsidering going into medicine, or believe that you are going into it for the wrong reasons?

I'm honestly not trying to start any trouble, I'm trying to understand what you're trying to say.


As a side note, I was talking to someone about the idea of adequate compensation, specifically with respect to professional athletes, and someone mentioned to me that although I don't believe professional athletes deserve the money the get, not only is someone willing to pay for them to do it, it's based on a different standard of living. While you may be happy with 60,000 dollars a year and little else, others may not be. However much I am bitter than professional athletes make as much as they do, I can't fault them for basing their standard of living on their expectations of rightful or believed compensation.
Click to expand...

... :laugh:
 
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