2020 FM Physicians - what do you earn?
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I thought that it was still doing okay...last time when I checked sleep med jobs the starting salary was ca 330k...definitely more than the one of a FM doctor...on the other hand is more location dependent.
Semi-rural mountain West. I'm make $230k working 35 hours/week all outpatient and hospital newborns. I'm 10 years out from residency now. That's at my main job. Moonlighting consists of hospice medical director, rural ER, suburban hospitalist. At my peak a few years ago I had 3 straight years of about $520k. Cut out one of the rural ERs that sucked my will to live and have been around $420k the last 2 years. I'll probably cut the other ER out in the next year or 2 now that my kids are getting older and will settle in about $320k working 40ish hours/week.
Here's a thread with my thoughts on the matter that all look to be still accurate from my perspective.
Here's a thread with my thoughts on the matter that all look to be still accurate from my perspective.
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Rural probably, issue has become reimbursement in the form of sleep studies and device titration fees (i.e. follow ups for cpap related issues) are going down. More insurance companies are wanting home tests which are significant cheaper at the cost of maybe less accuracy. Not my specialty, but this is based on industry claims..
I see...then which fellowship is worth it in money terms in the FM field? Or is it better off without it?
I'm just starting out. I live in a very large city.
Outpatient medicine job - $170,000 (has a lot of flexibility, multiple admin sessions/week)
Telemedicine job - $50/patient consult, can usually do 3 consults in an hour. Just started, but was told there's a doctor who has 300 patients on his panel, so that's $50 x 300 monthly
Telemedicine job - $80/hour, can set own hours. Even if don't see any patients still get the $80.
Abortion care - $600 to $900 a day
I have no desire to do urgent care, but from colleagues they've said it's $125/hour
It's all personal preference.
FM is so wide that you can have so many jobs as evidenced by this post.
But if you really have a desire to do more sports med or women's health or geriatrics and you want that extra focused training, then do a fellowship. They're mostly only 1 year, so yes of course you do lose money that 1 year of training, but if overall it makes you a happier person because on top of general FM you can also be an "expert" in something within FM, then go for it.
The outpatient gig salary seems low. How many days/hours?
6 patient sessions a week.
1 session is either 3 hours or 3.5 hours.
Sorry not comfortable giving more specific info.
The beauty of FM, you can make your career/practice what you want.
2 people I know that do sports med are also pcp's.
1 person I know strictly does sports med.
MSK - OMM and joint injections - it is a busy practice. Out of network facility.
Chart review is usually 6-8 hours a month.
Depends how you set up your practice. If you’re with an Ortho group or purely Sports/MSK you’re saying go see your PCP. I do both and see Sports/MSK patients from my panel but also take consults from other PCPs around and do US guided procedures and concussion management in athletes and some adults. It’s all in how you want it, which is the beauty of FM.
i live in a big city
200k/yr fqhc
36 hrs clinic outpatient only
1-2 patients /hour [average 10 pts -12 pts a day]
10+ yrs out , i took a paycut but have loads of time to devote to family/hobbies
200k/yr fqhc
36 hrs clinic outpatient only
1-2 patients /hour [average 10 pts -12 pts a day]
10+ yrs out , i took a paycut but have loads of time to devote to family/hobbies
That is true happiness
Is this typical? I always thought 200k in FM by default means 20-25 pts a day.
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FQHCs pay market average salary. Not all of them have only 10-12 patients per day. You are treating an underserved population so there is usually a fair number of non-English speaking patients (anywhere from 10% to 60%) plus the patients are usually sicker than your standard population, so they require more time. But I have seen FQHC jobs where they want you to see 25 patients average which imho would cause most physicians to burn out pretty quick. It’s actually really rewarding to work with that population, especially at 10-12 per day (the patients really actually need your help). You should be able to get 230k-250k seeing 20-25 in private practice but it’s people demanding antibiotics for viral URIs and asking you what the latest research says about how much vitamin D you should take daily.
NO in a private group its more like 20-25
in my previous fqhc job paid a little more like 250 but always saw like 30pts a day
i was like F that so i picked a quiet one its in a s$%#@ part of the city but not really unsafe
for 3 x 12 hour shifts a week , 200k is not a bad deal
i supervise 2 x NP as well
yes took me shifting through 3 x fqhcs to find this low volume job and so for last almost 2 yrs its ok
they wanted to dump more NPs but i successfully resisted that
you are right though fqhcs prey on young and eager doctors and EXPLOIT them , i was too for first 2 yrs after residency
i know its pretty low for what most of my FP friends and colleagues make but everyone has their preferences not saying one is better than the other
im very cheap i live on very little , dont have a mortgage , low rent my average monthly expenses are like 2000/month and i eat out a lot [unfortunately ] but nothing fancy
im weird though have a multitude of hobbies and i spend a lot of time with my son hes only 5 and INCREDIBLY curious
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deleted87716
At that volume, you should be earning >$300K.
This needs to be emphasized.
Let's split the difference at 22 patients/day. 5 days/week. 46 weeks/year (that's 6 weeks off including holidays per year).
That's 5060 patient encounters.
I probably average around 1.5 wRVUs/patient encounter (very possibly a shade more, God bless AWVs and patients who bring up 18 issues during their yearly physicals). That's 7590 wRVUs/year. Average wRVU value for FM is around $40 each. So that's 303k/year even before any bonuses.
With those numbers I'd expect you PP folks to do better, but the math is harder since each insurance pays slightly differently and you have to include ancillary revenue as well.
Yeah unfortunately not the same thing, so not the same benefits. Working at an FQHC doesn’t mean you’re a federal employee unfortunately. Working for the IHS you are a federal employee (to my understanding). So for example you can have a medical license from any state and work in NM for the IHS since it’s federal.
no , main benefit is FTCA malpractice coverage
no pension unless the organization you work for has one
there are about 10-50% no shows depending on community , how long you have been there and other "providers" in your group
It is possible but do not base everything on this as wide fluctuations can happen
another doc can leave and they might not hire another one for yrs [you get all their patients and your numbers go upto 22 WITH noshows ]
scheduling policies change all the time and you as a doc usually HAVE zero input
tips to negotitate with FQHC
1- You hold all the cards and make sure they know it few docs want to work in fqhc you are a rare commodity , "carry a big stick and speak softly" as Teddy said.Get as much in writing in your contract things that are important to you.If you have no loan or visa requirements you really have nothing to fear
2-I live in a big city because of this , we have dozens of FQHCs and several large groups of them, if my present group gives me more trouble then its worth it then I will jump ship again so be prepared for that.Keep your options open, FQHCs might pretend they care about docs switching jobs but they all know it happens all the time.
3-They all claim to have such high standards of care and try to emulate private groups , they don't and they cannot for the most part.If some patients are well taken care of its because the individial "provider" was conscientious and knowledgeable. If there is a certain style of practice they like just be assertive and let them know right up front at the interview inc the clinic manager and nurse manager do not expect them to take the initiative, they are typically very resistant to change and staff has poor motivation to be creative [ ofcourse there are exceptions]
4- { From personal experience} ALWAY give resistance if they try to put too many NPs with you and I got it in my contract, or push you to see more patients.Just take your time with patients one time [yrs ago] patients waited 2 hrs to see me and starting leaving , clinic manager was livid my repsonse was simple "don't double book " it stopped within days.
low standards and thick skin will get you a long way, its not for everyone TWICE [ in 10 yrs] I have seen docs just quit without even the required 90 day notice [ don't do that but happens]
For me there are 2 major and dare I say only advnatages over traditional practice 1-FTCA malpractice 2- Guaranteed pay and No push [ and no incentive] to see more patients and low volume
if you are a go-getter [ and not a slacker in scrubs like me] its not for you,
I am not a slacker, but lifestyle (time off) is my main concern and money is not. My second concern is that I don’t want to get stuck seeing a ridiculous number of patients per day and stay late writing a ridiculous number of notes.
I got into medicine to help people. The culture of medicine seems to be work long hours and maximize those RVUs. Screw that. I’d rather be paid less and have a life outside medicine.
For someone like me, is an FQHC the way to go? Or should I look for a private practice that doesn’t care about volume?
I got into medicine to help people. The culture of medicine seems to be work long hours and maximize those RVUs. Screw that. I’d rather be paid less and have a life outside medicine.
For someone like me, is an FQHC the way to go? Or should I look for a private practice that doesn’t care about volume?
There's no one model that lets you do that. Some hospital jobs will let you, some won't. Some FQHCs will, some won't.
Right
You have to weigh pros and cons after they offer a contract talk to other docs there too
My priorities i.e low volume, guaranteed pay and good malpractice that's why atleast for me fqhc model has worked
I wasn't trying to offend you but I'm truly a " slacker in scrubs" medicine is not my passion but my profession and I fulfill my responsibilities to the highest standard I can but I refuse to take on more work than I can handle just to please my colleagues or administration.Passion is something you do regardless of pay and [ sometimes] without any regard to your personal safety.
Fqhc may work for you But bear in mind it comes at a price and quite a few drawbacks and if going there from private practice it can be quite a shock
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Yeah like others said, it really just depends. There are a lot of jobs out there so you really can find a wide variety of things. Working part-time, telemedicine, urgent care a couple shifts a week, employer based medicine, etc. Are you interested in teaching? If so academics is also another way to go if you’re not looking to see as many patients. Obviously being in academics isn’t "easy" but you have more admin and teaching time, so less direct patient care in general.
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How do you get into that?
I was actually interested in that as well. There’s also been a thread on SDN about an ex FM doctor who got into the pharmacy industry...and they’re making something like 600k
I like that. I've yet to meet someone with this mentality who wasn't a decent person and physician.
DennisReynolds
Full Member
Looks like those making a killing are putting in work and putting in time. Which makes sense. There are plenty of side hustles you can do to clear more than 300-350K with a little bit of time left over to live a normal life.
Hey. Hey, hey hey! Didn't you jump ship to IM? Phony! He's a phony!
DennisReynolds
Full Member
lmao I can't celebrate with my FM bros and sistas????
my understanding is that not everyone gets that successful , you need a certain personality type to pull it off
ATleast in bread and butter FM there is that mundane consistency of getting a national average salary
And that’s true but for the ones who want to surpass a certain threshold they need to look for other ways to boost their income.
Luck and good timing. A CRO was opening up in my area willing to train physicians.
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deleted1025203
How does this chart review at home work?
I am a collaborating physician for nurse practitioners. I review their charts from home and I am available to them when they need help.
11 years out of residency. 4 years into a permanent job in Urgent care. 220K base salary. Working extra shifts and RVU bonuses I grossed $465K 2019 taxes. Due to COVID cuts currently at base pay only with no extra shifts in sight.
3 years out of residency, employed by a rural access hospital doing just primary care, earn about 130k working 3 days a week. I could make more but I've got two young kids.
How many hours a week are you putting in to hit that number?
A lot!!!! The last 4 months of the year I was working 24 days a month. Of course it was flu season and I was seeing 50+ people a day. My RVU minimum is 296 and month and I was hitting over 800 RVU's each month which put me in the 60K bonus range for the quarter.
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This is like making ~ 25k/month post taxes. What it feels like making so much money? I just can't wrap my head around having a paycheck of 10k+ every two weeks.
I’d guess tired and burnt out...that sounds like a tough schedule! But I might have to do something similar if there are opportunities to do so in order to pay off my loan early
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deleted87716
Not at all trying to rain on @cabinbuilder ’s parade, but based on her previous posts, I’m pretty sure she is working as an independent contractor at most of these locums gigs, and she’ll have to pay health insurance, retirement, malpractice, etc. out of that amount.
NO, Blue Dog. I gave up locums 4 years ago and this is from my permanent job that does include insurance, 401K, etc.
Well, I did it because I had goals of paying off vehicles and a built a rental house with cash this year, etc.
