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

medicine is a business so anything is possible I suppose. his figures seem extremely high though; my mom is an internist and makes in the mid 100s which I thought was average but I'll let the more learned folks on the matter weigh in.

BestDoctorEver said:

I met a primary physician(IM) last week that told me a primary doc can make 300k+ easily and dont have to work hard...

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Anybody in ANY specialty planning to earn several hundred thousand dollars a year should get comfortable with working hard. Working hard is a requirement.

BestDoctorEver said:

...a primary doc can make 300k+ ...have at least 6 friends that that are primary docs, and all of them are making 250K+. ...have an hospitalist job that pay me 200k. I have my own practice ...and I gross about 150+k a year there. Is that even possible?

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Sure. Just don't mistake working two jobs while managing a practice/business as easy.

As mentioned earlier, running a practice is an opportunity to use business savvy to make a great deal of money. Some would argue that the days of sole private practice physicians are coming to an end (due to group consolidation), but that is merely a result of doctors with no business knowledge trying to practice medicine while running a small business.

If you know how to run a business, then you will make 300-400k per year in the right environment. Unfortunately, the right environment usually pushes you outside of the big cities.

Move to Canada.

I did, and I bill over 400K a year working 6 days a week with hospital work. After overhead, before taxes that's still about 300K.

I know colleagues here who routinely bill 500-600K a year.

Nowadays CAD = USD. Cost of living is a bit more expensive (but who cares if you're paying a buck more for milk or 5 bucks/gal for gas when you make that much), taxes are a bit more but if you incorporate that all goes away (14% tax rate). It's also balanced by lower insurance rates here. I pay 1400 a year for malpractice.

Sounds about right. 200k for a full time hospitalist job going 7-on-7 off. 150k for a full time ambulatory practice going from 8-5p M-F with the cost of a PA covering you in clinic or vice versa while you're trying to finish rounding.

2 full time jobs. Not my idea of a good time. Can be physically & mentally demanding. If it's true that he's not "working hard" at all, I suspect either his employees are pretty pissed or his patients aren't well taken care of. Sounds like a job, but not much of a career.

lowbudget said:

Sounds about right. 200k for a full time hospitalist job going 7-on-7 off. 150k for a full time ambulatory practice going from 8-5p M-F with the cost of a PA covering you in clinic or vice versa while you're trying to finish rounding.

2 full time jobs. Not my idea of a good time. Can be physically & mentally demanding. If it's true that he's not "working hard" at all, I suspect either his employees are pretty pissed or his patients aren't well taken care of. Sounds like a job, but not much of a career.

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not to mention high liability. Having a PA pretty much 'run' the practice while he is at another job? That is not smart at all.

Then again, I know of a few primary care docs that work two jobs, and make mid $300 K (Urgent care, or ER, and private practice). This is ok, it seems to work out quite well for them. Other primary care physicians make high money with endoscopies and colonoscopies, stress tests, and ultrasounds.

moo said:

Move to Canada.

I did, and I bill over 400K a year working 6 days a week with hospital work. After overhead, before taxes that's still about 300K.

I know colleagues here who routinely bill 500-600K a year.

Nowadays CAD = USD. Cost of living is a bit more expensive (but who cares if you're paying a buck more for milk or 5 bucks/gal for gas when you make that much), taxes are a bit more but if you incorporate that all goes away (14% tax rate). It's also balanced by lower insurance rates here. I pay 1400 a year for malpractice.

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Yes, but do you live in the middle of nowhere? I doubt an FP could make that much living in a large city/suburb. It's one thing to work in a small town. Entirely another to work in a smalltown that turns into a freezing cold hell hole come december.

Also, how realistic is it for an FP to land a hospitalist contract for 200k a year?

bravotwozero said:

...I doubt an FP could make that much living in a large city/suburb...

Also, how realistic is it for an FP to land a hospitalist contract for 200k a year?

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As in all things medicine, while many other components may play a part, IMHO the three largest players to large income are:

1. Hard work
2. Location
3. Luck

For example, the urban areas of South Florida will be difficult. Florida in general is a tough market for just about every field and in my experience hospital and/corporate executives/management is not very modern....

If one wants to make the money, you have to make some choices. There is always a trade and you need to set your priorities....

?location,
?employment package/or self employ,
?community & partner qualities

bravotwozero said:

Also, how realistic is it for an FP to land a hospitalist contract for 200k a year?

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Very realistic. You may not be able to do it at a Ivory White Tower Teaching institution in Manhattan, but that kind of a gig with that kind of dough is out there.

bravotwozero said:

Yes, but do you live in the middle of nowhere? I doubt an FP could make that much living in a large city/suburb. It's one thing to work in a small town. Entirely another to work in a smalltown that turns into a freezing cold hell hole come december.

Also, how realistic is it for an FP to land a hospitalist contract for 200k a year?

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Nope, I live in Vancouver. Smack dab in the middle of the city.

You go rural, you can pull 700-800k+ before overhead (which will likely go down as a percentage the more you bill).

moo said:

Nope, I live in Vancouver. Smack dab in the middle of the city.

You go rural, you can pull 700-800k+ before overhead (which will likely go down as a percentage the more you bill).

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Were you recruited by a company, or did you join a practice?

bronx43 said:

Were you recruited by a company, or did you join a practice?

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Joined a practice. I did med school in the US. When I realized I could make way more in Canada, I jumped ship.

All I can say is, don't be afraid of universal health care. You insure the whole population, you have a huge pool of potential patients, and patients who won't not seek out physicians because of having to pay a co-pay. No hassles with ordering lab tests, imaging, etc. because the patient can't afford or don't want to pay the 20 dollar copay for the MRI. No insurance headaches. Malpractice is lower too. I pay 109 bucks a month to be insured with the CMPA.

As for your specialist colleagues, they often don't pull as much as those in the US, but ophthalmologists, for instance can still clear 1 mil easily. Anesthesiologists make 500K without overhead. Pediatricians in private practice generally make 350-450 before overhead, more than the average family doc. I'd say the average family doc bills about 250K (after overhead about 180-190K) working 4-5 days a week, 8 hours a day with no call. But if you work hard you can certainly make the money. Sometimes I bill 2000 bucks a day doing urgent care shifts at a clinic (after overhead, about 1400 a day). Where can you get that as a family doc in the States? It's nice up here. Wouldn't trade it back for life in the US.

As for taxes, I'm incorporated, so I pay a lower tax rate (14%). Not much different from the US.

moo said:

Joined a practice. I did med school in the US. When I realized I could make way more in Canada, I jumped ship.

All I can say is, don't be afraid of universal health care. You insure the whole population, you have a huge pool of potential patients, and patients who won't not seek out physicians because of having to pay a co-pay. No hassles with ordering lab tests, imaging, etc. because the patient can't afford or don't want to pay the 20 dollar copay for the MRI. No insurance headaches. Malpractice is lower too. I pay 109 bucks a month to be insured with the CMPA.

As for your specialist colleagues, they often don't pull as much as those in the US, but ophthalmologists, for instance can still clear 1 mil easily. Anesthesiologists make 500K without overhead. Pediatricians in private practice generally make 350-450 before overhead, more than the average family doc. I'd say the average family doc bills about 250K (after overhead about 180-190K) working 4-5 days a week, 8 hours a day with no call. But if you work hard you can certainly make the money. Sometimes I bill 2000 bucks a day doing urgent care shifts at a clinic (after overhead, about 1400 a day). Where can you get that as a family doc in the States? It's nice up here. Wouldn't trade it back for life in the US.

As for taxes, I'm incorporated, so I pay a lower tax rate (14%). Not much different from the US.

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hey moo, sounds like a great job you got. how difficult was it to move to canada? isn't it difficult if you don't have family to get permanent residence there? also what was the process in getting your medical license there? thanks.

bacteroides said:

hey moo, sounds like a great job you got. how difficult was it to move to canada? isn't it difficult if you don't have family to get permanent residence there? also what was the process in getting your medical license there? thanks.

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Well it helps that I have Canadian citizenship.

If you have US FP board certification, you can get certified (with no extra exams) by the CFPC. You may need to take the LMCCs though, except if you work in Ontario where they recognize the USMLE as equivalent. If you have no family in Canada, you can still immigrate here in the economic/skilled worker category and then get licensed. There are also recruiting agencies in Canada that recruit you to work rural. There are a lot of South African docs working rural in Canada cuz they can't get domestic grads to do it, but generally you make 30% more doing rural practice.

It is a myth that physicians make more in the US. Canadians here value their primary care doctors. Very few NPs, very few midlevels. The Canadian medical establishment protects us well. As a family doc you'll be more respected here than in the US.

Blue Dog said:

Don't get the "no call" part. What do your patients do after hours, just go to the ER?

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I can't speak to the Candian physician specifically.... but, I have seen even in USA that sort of arrangement. After hours goes to ED or affiliated urgent care center.

moo said:

moo said:

...All I can say is, don't be afraid of universal health care. You insure the whole population, you have a huge pool of potential patients, and patients who won't not seek out physicians because of having to pay a co-pay...

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moo said:

Well it helps that I have Canadian citizenship.

...It is a myth that physicians make more in the US. Canadians here value their primary care doctors. ...As a family doc you'll be more respected here than in the US.

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You have commented on quite a few interesting things...

First, the universal system may work ok for primary care. However, as long as Canadians are seeking specialty care accross the boarder, it's hard to say universal health care provides universal healthcare services. I'm also not sure about what you are saying with your double negative statement "won't not"....

Second, yes, it helps you to be Canadian. you are spouting a love affair that really doesn't help the vast majority of US citizens in FM.

Third, you speak to a myth.... never really heard much of a myth about FM making more money or less on either side of the boarder. I have heard some specifics here and there about compensation and such. But, in general, yes, in reference to sub specialists one would likely make less in Canada then in the USA.

Blue Dog said:

In my experience, most commercial insurance carriers in the U.S. require all physicians to provide after-hours coverage, even if it's telephone-only.

That aside, as a patient, I would find it unacceptable that my physician or a designee was unreachable after office hours.

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In Canada, if it cannot wait until the next morning, then it is an emergency that needs to be seen at the ED and not a family medicine issue.

Why would a GP be required after-hours?

24-7 RN-staffed telephone triage and consultation services like Telehealth Ontario are heavily promoted in part for off-hours 'should I go to the ED?' questions.

Blue Dog said:

In my experience, most commercial insurance carriers in the U.S. require all physicians to provide after-hours coverage, even if it's telephone-only.

That aside, as a patient, I would find it unacceptable that my physician or a designee was unreachable after office hours.

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McGillGrad said:

In Canada... Why would a GP be required after-hours?

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Blue Dog said:

I see. Who cares about unnecessary ER visits when it's all "free?"...

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BD, I can not speak to the insurance arrangements. Maybe, it is acceptable because the urgent care center or hospital is "afilliated" with the FM practice and some FM doctors do ED shifts? I don't know.

I agree using the ED for after hours primary care is a waste and ridiculous. I also think we should educate patients to actually have responsibility and do some planning. Physicians are not reimbursed to justify sitting around just in case a patient forgot during regular business hours to make appropriate primary care arrangements. Also, PC is not reimbursed enough to be sitting around all night to prevent patients from having to wait 2-6hrs in the ED for primary care. I think if more PC physicians thought long and hard about the innapropriate night calls and exactly why you may be doing it, some may stop trying to save wasted ED dollars.

In general, US patients continue to expect more and more without paying. We provide private rooms/suites with unlimited local telephone (and long distance sometimes), and basic cable so to be "marketable". Patients do not pay for these things. You go to other countries, patients and families bring their own TV in or pay a TV fee. If you want to call someone after hours to call a script for asthma/DM/hypertension/cholesteol/etc... meds you, FM should be paid a boutique service fee.... after all, you are saving wasteful use of ED and saving the patient 2-6hrs ED waiting time.

chartero said:

24-7 RN-staffed telephone triage and consultation services like Telehealth Ontario are heavily promoted in part for off-hours 'should I go to the ED?' questions.

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That's great, but the biggest problem in our healthcare is the disconnect between payer and service recipient. Patients are not paying for these on-call services. If they pay, they think twice about stupidity. Why do you think hair salons and everyone else charges increasing fees for missed appointments and "late" cancellations?

Blue Dog said:

Actually, if insurance reimbursed primary care physicians for dealing with issues after hours and/or outside of face-to-face office visits, it would save both patients and insurers money...

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Agreed, but they don't. so it's a service you are giving away and potentially promoting poor behavior.

Blue Dog said:

...Right now, it's too easy to just tell people to go to the ER...

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Maybe, but you aren't getting paid and the ED is. If they want to save money and time, you should be getting paid. If you're not getting paid, your not running a business. You're running a charity.

Blue Dog said:

...I've charged no-show fees for years. Anyone who doesn't is an idiot, IMO.

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I believe most do charge such fees. That is the point. If we recognize that such fees are charged and why, we might think twice about free on-call services promoting patient lack of responsibility.

Blue Dog said:

I see. Who cares about unnecessary ER visits when it's all "free?"

Color me unimpressed.

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You seem to have misunderstood what I wrote.

What primary care medicine do you need after hours? Everything non-emergency can wait until the next day. If it an emergency, then you shouldn't be calling your GP anyway. You should be in the ED (i.e. CVA, ACS, trauma...etc).

Blue Dog said:

There are plenty of non-emergent things that are "urgent." Illness doesn't just happen from 9-5 M-F, and sometimes people just need to know what to do.

It's been estimated that upwards of 80% of cases seen in most emergency departments are non-emergent, and should be handled elsewhere. If you are a primary care physician and are inaccessible after hours, you're contributing to the already massive amount of waste that is bankrupting health care systems worldwide.

Clearly, Canada isn't immune from this unfortunate state of affairs. Given the "free" mentality inherent in most socialized systems, they might even be worse off than we are.

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Healthcare isn't free in Canada. We pay for it with out taxes and are proud of it. We consider universal access to healthcare a right.

All citizens have access to primary care physicians and preventative care so we do not flood the Emergency departments with reactionary issues stemming directly from a lack of primary care.

We have overcrowding in ER's, too. But everyone is triaged and assigned priority. It's not perfect but everyone is covered and that's what is important.

Finally, what is so urgent (and not emergent) that it cannot wait overnight?

McGillGrad said:

Finally, what is so urgent (and not emergent) that it cannot wait overnight?

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you kiddin me right?!

Blue Dog said:

Actually, if insurance reimbursed primary care physicians for dealing with issues after hours and/or outside of ...

Technically, we could charge a fee for ...I've considered it...

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Blue Dog said:

...the "free mentality," A.K.A. the "entitlement mentality."...

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I find the entire line of discussion somewhat ironic. On one hand, talking about the entitlement mentality associated with the perception of "free healthcare" and on the otherhand, some sort of shock that someone is not providing actual "free healthcare" through un-reimbursed after hours on-call. It doesn't matter that you may save the healthcare system money by taking call. Anyone taking call and delivering on-call unre-imbursed service obviously will be cheaper then an ED or urgent care center delivery.

Patients expect to call and have their calls responded to for "free" because physicians have allowed them to be entitled to this. That is not the case in numerous countries. It is even less the case in numerous socialized systems. It is very interesting to see how unmotivated a physician is when they are under a socialized system. They often stop taking call and rush out and get employed by on-call businesses to get money for their work.

You provide a service for a fee, that's business. You provide a service for a fee with a smile and compassion, thats good healthcare business. You provide a service for free with or without a smile & compassion, that's charity. Yes.... I know, sometimes freebies may help your business ventures. The question is do the freebies actually cost alot more then you realize or calculate.

Blue Dog said:

No kidding. I didn't say it was. I said the "free mentality," A.K.A. the "entitlement mentality."

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There is no such mentality in Canada. You are projecting the American psyche onto the Canadian people. This is erroneous logic.

Just wait until you're a doctor...or a patient. You'll find out.

It's not always "overnight," by the way. Ever hear of a little thing called the holiday weekend (like we have right now)?

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I was hoping that you could educate me on why FM requires after-hours call. I am not trying to create an argument.

BestDoctorEver said:

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 even possible?

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This is very true or at least possible. I'm an Internal Medicine PA and I work for an Internist who's employed at 2 different facility (as a Hospitalist & at the Prison system). In addition, he own his own practice (where I am employed) where he work 1.5/wk (M, W). I work for him Tuesday (solo coverage) and Wednesday. He's usually gone before 2pm on Wednesday and I will continue to see patient until 6p or 7p (8a-7p). Although, he's always available by phone.

I also work at an urgent care practice owned by a primary care physician. He employed 2 PAs at his primary care clinic. One of his PA had been with him for over seven years. This PA and I runs the Urgent care & he (the MD) would usually provides coverage periodically. Again, he's always available by ph for question.

Finally, I was recently approached by a primary care physician who's in the process of opening an immediate care clinic. He offered me the position, however, I declined the offer.

From what I have observed, this appears to be the direction of most Family/Internal Medicine Physician. At least, here in Upstate NY.

So yes, primary care physician can earn 300+ easily with a good business mindset ("You have to know how to play the game").

princekc said:

This is very true or at least possible. I'm an Internal Medicine PA and I work for an Internist who's employed at 2 different facility (as a Hospitalist & at the Prison system). In addition, he own his own practice (where I am employed) where he work 1.5/wk (M, W). I work for him Tuesday (solo coverage) and Wednesday. He's usually gone before 2pm on Wednesday and I will continue to see patient until 6p or 7p (8a-7p). Although, he's always available by phone.

I also work at an urgent care practice owned by a primary care physician. He employed 2 PAs at his primary care clinic. One of his PA had been with him for over seven years. This PA and I runs the Urgent care & he (the MD) would usually provides coverage periodically. Again, he's always available by ph for question.

Finally, I was recently approached by a primary care physician who's in the process of opening an immediate care clinic. He offered me the position, however, I declined the offer.

From what I have observed, this appears to be the direction of most Family/Internal Medicine Physician. At least, here in Upstate NY.

So yes, primary care physician can earn 300+ easily with a good business mindset ("You have to know how to play the game").

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interesting setup! if the md is in the office only for 1.5 days/wk, how many days is the office actually open? what happens when to a patient when they need to see the md when he's not there? do the pa's write the prescriptions? not doubting or trying to stir anything up...just want to know how the process works. thanks.

Blue Dog said:

I'm not advocating for unreimbursed on-call coverage. Quite the opposite, in fact.

What I'm advocating is for primary care physicians (or their designees) to be available to their patients after-hours AND TO BE PAID FOR IT. Ultimately, this improves care and reduces costs.

Canada is struggling with cost containment, too. Don't think for a moment that a socialized system is exempt from this.

http://www.reuters.com/article/idUSTRE64U3XO20100531

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I agree 100%, everything I have read and seen shows every socialized country/healthcare system is struggling under cost containment issues. I also agree that providing primary care via ER is not a sound financial/business practice. I absolutely believe everyone being held hostage to a pager for after hours/unscheduled calls or having to hire a service to handle after hours/unscheduled calls needs to be compensated.

But, having said all that, I am reading between the lines in this and other threads some sort of ~moral duty mentality that keeps PC physicians (and others) providing uncompensated on-call. As long as physicians can be guilted into service without compensation, they will not be compensated*. On-call carries liability and social/family burden. ~All of our patients have this sense of entitlement that they should be able to reach you or your partner/s at any hour. They often fail to plan. They cancel appointments and then call after hours for call-in scripts, etc.... We sit back and cover these calls at night or have someone cover it for us and do not get compensated.

I find it interesting that this social duty/moral obligation to uncompensated call seems to melt away when physicians are in a socialized system. Suddenly the on-call becomes a compensated service. In many cases one of the few means by which physicians can gain additional revenues.

*Interesting thing I have found is how much the "service", "responsibility", and "owe it to your patient" concept is pushed by hospital CFO/CEOs when the talks of on-call compensation comes up.....

Blue Dog said:

It's not guilt. It's ethical medical practice...if you don't provide any kind of after-hours coverage, you are putting yourself at risk of being sued for abandonment...

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Guilt, moral obligation, ethics, etc.... The question is are you obligated to provide uncompensated care and/or services. I don't think so. The obligation is to inform and educate the patients of where to obtain services after hours and outside of regular business hours.

Thus, a physician can make arrangements with a local urgent care or even an ED to provide such care after hours. Both of those entities would be paid. Then, you inform all your patients that care and services outside of regular business hours will be rendered by the patient going to the local urgent care center or ED. You can even provide them with the information as they join your patient pool. The patients are not abandoned and the service provider is compensated.

You are only ethically obligated to provide uncompensated care if you make that agreement with your patients. If your patients are informed you do not provide this uncompensated service and that they must seek these services from a compensated source, you have met your obligation. It is only abandonment if you fail to clearly outline the terms of your business relationship with your patient and what services they should expect from you as their healthcare provider. If you leaving them expecting 24/7 service and availability... well then that is your choice.

Blue Dog said:

Being obligated to provide services and being compensated for them are two entirely different issues. Just ask any specialist who takes ER call.

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Yep, and upwards of 60% of surveyed are now being compensated for ED call.....
You will remain obligated to provide such services as long as you choose to not refer your patients to qualified alternatives outside of regular business hours.

Pediatricians are being paid as much as $500 per diem for ER call and neurosurgeons are being paid upwards of $2k per diem for ER call. FM..... probably less then $100 if at all. But, they are very ethical in providing services

Blue Dog said:

...I should add that the doctor patient relationship is more than just a "business relationship." I wouldn't want to try to argue your last post in court, Jack.

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If you have a clear clinic practice statement provided to patients at comencement of the business relationship, you can argue it very easily. Inform your patients clearly and document the onset of this relationship. It is not that difficult and it is not abandonment if your patients know "our offices are closed after 5pm. For emergencies and after hour care, please call local ED or you can contact the Johny Pop's urgent care center at..."

bacteroides said:

do the pa's write the prescriptions?

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I will suggest that you do some reading on PA scope of practice. Maybe this link will help. http://www.aapa.org/about-pas

Blue Dog said:

Being obligated to provide services and being compensated for them are two entirely different issues. Just ask any specialist who takes ER call...

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Blue Dog said:

You're not listening.

I honestly don't care about ER call. I'm talking about continuity. Leaving people to fend for themselves after office hours is bad practice. Is that what you do? Just curious.

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I am listening. Your distractionary replies grow tiresome. So, to make it clear I am listening, YOU brought up the issue of specialists taking ER call. Again, I listened to what YOU brought up in reference to ER. Your reference to which I replied.

As to my practice, my patients are informed up front that their scripts will NOT be filled through after hours/weekend/holliday calls. My patients aren't abandoned... they are educated as to what is their responsibility in this doctor patient-relationship.

If my patients require a new script or if the old script requires change or dose adjustment or is causing some adverse reaction, my patient needs to be seen and that is not a phone call issue. It is a come to the ED so my partner or I can examine you. I have no control over ER triage and patient flow. They sign in, are brought back and my partner or I are called by the ED physician.

Blue Dog said:

I used ER call as an example of uncompensated obligatory care because it's frequently a requirement for hospital privileges...

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I understand that... however, the uncompensated portion is becoming less. As I noted, upwards of 60% are reporting now being compensated for providing emergency/ER coverage. The days of everyone just accpting uncompensated ED call as a "duty" are fast evaporating.

MGMA said:

..."Historically, on-call duties have been sporadically compensated by hospitals. However, we're seeing more hospitals compensating physicians and we're seeing hospitals paying more. Hospitals are realizing they must compensate group-practice physicians for on-call duties," said Jeffrey Milburn, MBA, CMPE, consultant, MGMA Health Care Consulting Group...

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MGMA2010 said:

...Some 41 percent of survey respondents report that their physicians do not receive additional compensation for their on-call coverage....
Taylor serves on the MGMA Survey Operations Committee.... Taylor expects this percentage to shrink as young doctors continue to seek a "work-life balance" and older physicians retire. "Call is a burden and certainly has implications on one's family life," he says...

...family practice (without obstetrics) physicians reported much lower daily on-call coverage compensation ($100) than specialists, their levels increased significantly for weekend and holiday coverage – $300 and $588, respectively.

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It will definately be up to the next generation to stand up and say, "show me the money".

http://blog.mgma.com/blog/bid/19706/Benchmarking-physician-on-call-compensation

http://www.allbusiness.com/health-care/health-care-professionals-physicians-surgeons/12278076-1.html

I would say to those looking at contracts and speaking with potential employers, you should keep this in mind. If they tell you they are restricted from paying you more because of "Stark" and must go with MGMA medians.... well, MGMA shows the majority surveyed are getting paid for call. Do the math, those dollars per day can add $100-300K to your annual gross.

Blue Dog said:

I suspect the meager compensation one receives for taking call still doesn't come close to equaling the lost revenue from nonpaying patients.

We all need a better solution.

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Meager is a matter of math and volume. FM seems to be very low on the call pay. I suspect much has to do with choices and negotiations. Pediatricians are getting as much as $500 per diem. If they took 3 calls a week, it could add to $78k/year. Yes, it would be nice to make money without call. However, the work and pay is there if individuals choose it. If you are having to take call, you should push to be compensated at the very least at MGMA medians if not more.

I know from reading many want a "better solution". I have read numerous posts asking about working 4days/wk, little to no call, no OB, etc... and wanting more money.... I think that solution is called the lottery.

Blue Dog said:

Still, not really the point.

The point is to be found in several of my posts above. I apologize, Jack, if you don't "get it," but please remember that this is the family medicine forum, and you are (frankly) out of your element.

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Sure, I get it.... Again, I love the ease of sliding behind that one when we disagree.

It would be nice to see increased compensation while doing the same/current levels of work. Some just do not want additional compensation to be tied to doing additional work. Message heard loud and clear.

My point is that yes, FM and other physicians can earn additional revenues if they choose even under the current reimbursement rates. One can do moonlighting shifts, one can take call and get compensated for it.

The current rates of compensation may not be "fair" depending on perspectives. But, there are ways to earn additional revenues if one chooses to do so. One of the posters in this thread spoke to not taking any call in Canada. We then got into the whole discussion of ethics of not taking call, patient abandonment, etc.... But still, it remains that FM could be compensated for taking call. It is just hard to do so if you fall on the sword of ethics and take call as a duty. It's also hard to do so if FM wants to avoid having call as a significant revenue stream.