Advertisement - Members don't see this ad
Can you get similar jobs as IM outpatient primary care?
2020 FM Physicians - what do you earn?
Started by Medical8
Get help with your application
Use all the free resources available to you from SDN: articles, guides, expert advising, forums discussions, and school research.
From what I’ve seen looking for jobs, yes. Especially in cities where the its less important that you can see kids and OB
So that’s 3 days in the clinic with one admin day?
Advertisement - Members don't see this ad
Is this representative of community health center work? 30 min appointments seems like a pipe dream in a lot of areas.
That's strange. I think it should be 45 minutes for new patient and 30 for follow ups...
Where I'm at follow-ups are typically 15 min and 30 min for news. 45 min I think only happens if its a new medicare annual wellness.
Honestly, I think 30 min is a sweet spot, but I rarely am seeing a pt with 1 acute problem that isn't there for a young annual.
It's 30 minutes for everyone where I am... But I still fall behind sometimes, especially when you are presenting to attendings that want to know every details.
30 min is pretty generous. At Kaiser, physicians only get like 20 minutes per patient
Does that include MAWs? 20 min on average sounds right as far as I've heard, 10-12/halfday, but it feels short, especially if documentation is meant to be included.
No wonder I don't see myself doing outpatient...
20 minutes is not enough unless you are only addressing one issue during these visits.
Yeah documentation is included in that time. There's also an expectation that the FM physicians will tend to their inbox messages and phone calls which takes up a lot of uncompensated time. Your employment hinges on you hitting patient satisfaction score thresholds. The compensation is great at ~250k/yr but the work and hours (when accounting for all the uncompensated work) is a great recipe for burnout.
Nah, just takes time to get efficient. All of my visits are 15 minutes. The single issue acute visits are easily under 10 minutes which balances out with new patients or complicated established patients.
Yes.
The previous place I was at was 20 min for everything.
This job I started during COVID and I was told they went from 20 to 30 min appts in order to not make the waiting room crowded. I’d be fine with 20 min appts but 30 min is certainly nice since patients are often late.
Edited to add: we also do things like prenatal care and those first visits often take awhile especially if doing an ultrasound. We also do procedures so those definitely typically take more than 15 min once the pt is roomed. So everything is 30 min to keep it simple, especially during COVID.
Last edited:
Urgent care I'm 2-3 minutes in the room. But I'm not charting during that time.
Advertisement - Members don't see this ad
throwawaysteve19897
Full Member
Here are some FM outpatient situations:
1. 20 min visits.
Unlimited physicals, short staffed medical assistant or secretary, homeless, underinsured, uninsured patient panel.
Double booked several times a day
About 40% of patients are new
Average clinician lasts 1.5 years at this clinic
2. One year ramp up. You see 1 pt an hour for the first 3-4 months. After 1.5 years you see 17 patients in 8 clinical hours.
Lot of support. Very organized.
3. 20 min visits, have to work in ICU during covid. Your inbox takes 3-4 hours more than most jobs due to burdensome paperwork.
Number 2 is ideal and not *too* far outside the average IMHO. Situation 1 and 3 are challenging
Last edited:
Arizona pays about $52/RVU. You can make 256k if you reach 50th percentile which is 4886 RVUs
What kind of patient load is necessary to produce this number of wRVUs?
4886 is ~23 wRVUs per day assuming 4.5 days/week and 47 work weeks a year.
im hitting 600/month seeing between 17-20 per day.
Bare minimum you should be getting 1.3 wRVUs per patient encounter which gives you 17.5 patients/day to hit that yearly total based on the numbers you gave.
Realistically, most of us are hitting more like 1.5 wRVUs per patient which is 15 patients/day.
@ $52/RVU, that’s 400k+. Healthy.
I'm not at $52/RVU. Base is $40 here.
Where do you find how much each state pays per RVU?
Has nothing to do with states in general but the employer. Rural > suburban > urban.
Oh gotcha. Is it HRSA or something who determines rural vs suburban vs urban?
Thats interesting to learn!
D
deleted87716
CMS assigns RVS to CPT codes geographically, but that doesn't necessarily translate into how employed physicians ultimately get paid. That's up to their employer.
www.cms.gov
Physician Fee Schedule Look-Up Tool | CMS
To start your search, go to the Medicare Physician Fee Schedule Look-up Tool .To read more about the MPFS search tool, go to the MLN® booklet, How to Use The Searchable Medicare Physician Fee Schedule Booklet (PDF) .
The $/RVU I quoted is from my specific employer in suburban area
Many different market forces at play but the biggest one is supply and demand. Employers have to pay more to attract docs out to rural areas, whereas major metro employers probably have multiple emails per week asking for jobs.
Advertisement - Members don't see this ad
Yuck.
That's how I feel about clinic haha.
360k base salary (drop from last year)
Breakdown as follows:
25% inpatient (mix of adults and peds, work with residents) (set salary, updated yearly to reflect how many actual shifts I complete)
20% educational time (med students) (set salary, based on ACGME data)
7% precepting residents in clinic (based on ACGME clinical salaries for academic centers and dependent on academic rank)
48% my own panel (entirely wRVU based, I try to schedule 14 per half day and this works out to around 7 half days a week)
I do add in extra clinics from time to time to meet demand of patients. Panel average around 1400-1600
Additional stipend for panel size to help with messaging, refills, etc. This is helpful to keep me from completely losing my mind.
Breakdown as follows:
25% inpatient (mix of adults and peds, work with residents) (set salary, updated yearly to reflect how many actual shifts I complete)
20% educational time (med students) (set salary, based on ACGME data)
7% precepting residents in clinic (based on ACGME clinical salaries for academic centers and dependent on academic rank)
48% my own panel (entirely wRVU based, I try to schedule 14 per half day and this works out to around 7 half days a week)
I do add in extra clinics from time to time to meet demand of patients. Panel average around 1400-1600
Additional stipend for panel size to help with messaging, refills, etc. This is helpful to keep me from completely losing my mind.
Between 250k and 300k including salary, loan repayment (40k tax free a year, but runs out after 5 years total), and yearly bonus for outpatient 30 minute appointments with 20% admin time at the VA in the mountain west.
Downsides are the paperwork and decreased autonomy working in a big system with a lot of policies, but I think well worth it for the time with patients and a good salary and benefits. Good specialty support, lots of physicians I can talk to, nice for early career. Low risk as well. The amount I make has only gone up like usual with covid-19, and overall a very stable salary. Disability, health, and life insurance all wrapped up in benefits. Low cost retirement plan (TSP) with pension in top. Statutory immunity from personal liability from malpractice lawsuits. I dream about doing something else, but it's hard to beat really.
Downsides are the paperwork and decreased autonomy working in a big system with a lot of policies, but I think well worth it for the time with patients and a good salary and benefits. Good specialty support, lots of physicians I can talk to, nice for early career. Low risk as well. The amount I make has only gone up like usual with covid-19, and overall a very stable salary. Disability, health, and life insurance all wrapped up in benefits. Low cost retirement plan (TSP) with pension in top. Statutory immunity from personal liability from malpractice lawsuits. I dream about doing something else, but it's hard to beat really.
Why do you say that?
Kidding... I am ok with you guys killing it because people in medicine think FM docs make minimum wage.
D
deleted1079620
Shhh...let’s keep it that way, at least until after I’m in the workforce, 😂
What size are these bonuses? What do you end up with altogether?
Varies with census (obviously), You can easily add another 40K a year that way.
$470k in 2020. I'm an independent contractor now working from home. I gave up the daily clinic grind in 2019 and haven't regretted it.
Are you doing telemedicine full time? Any other side gigs? I didn't think telemedicine could be this lucrative
I'm not hired full time by any one telemedicine company, but yes I work on 3 telemedicine platforms as an independent contractor. That makes up the bulk of my work.
@hsmooth if you don't mind me asking, how many hours are you working per week? and do you get paid for no-shows?
Advertisement - Members don't see this ad
I work probably about 40 hours a week, around my own schedule. No, I only get paid for completed consults. If a patient doesn't pick up my phone call, they get placed back into the queue or their appointment cancelled.
D
deleted941485
How do you gain access to these platforms and they don't employ you?
You can be hired as an independent contractor (1099, rather than W2) without benefits of typical 'employment'. So no health insurance, no 401k matching, no disability / life insurance. Many companies will at least provide malpractice though.
How many patients do you see on average?
For phone / video consults, I can generally do around 8 per hour.
The workflow for doing telemedicine for a 3rd party company is different than doing telemedicine visits for your own clinic patients and submitting a CPT code, and charges to insurance though. All I need to do is a SOAP note and sign off
