$250,000 Family Practice Doctor Salary

[slcdoc]

This is a poll for those who ARE NOT PLANNING ON GOING INTO family practice or internal medicine.

Would it change your mind if your starting salary was $250,000 (making you rich, according to a certain politician)?

I have talked to way too many people that say that money doesn't matter to them, and then I ask them what they are going into and they say something from the infamous ROAD specialties. I am venturing to say money has more to do with people's decisions than they want to admit to.

Just for the record, money is not the primary force driving my specialty choice, but I would be lying to say that it had no part at all.

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[Blesbok]

Hell no. Have you ever spent a day in a family practice office? I would rather work in a cubicle.

Some people may like it, but I would rather find another career then spend my life in family practice.

 

[PeepshowJohnny]

I'd rather do a ROAD specialty for family practice money than be a family practice doctor for ROAD money.

 

[slcdoc]

I'd rather do a ROAD specialty for family practice money than be a family practice doctor for ROAD money.

I would bet big money that if the ROAD salaries and Family Practice Salaries were switched, the ROAD specialties would not be nearly as competitive, and the Fam. Practice residencies would be very competitive.

 

[MrBurns10]

I'd rather do a ROAD specialty for family practice money than be a family practice doctor for ROAD money.

+1

If it was between doing FM/IM or finding another career, I'd go into real estate...even in this economy. And there isn't anything at all wrong with FM or IM as specialties, they're just not for me. Just like you couldn't pay me enough to go into surgery.

 

[NonTradMed]

People make career choices on a number of factors. Salary, enjoyment of field, lifestyle all contribute. It's foolish to make such an important decision on one thing. If FM/IM makes a lot of money, some people who were on the fence about the field may be pushed into doing it. For others, you can't pay them enough money.

 

[deleted77919]

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[supernareg]

i agree with the few friends above... people DO make their residency decisions based on money... it plays a BIG factor... not the biggest factor, but it does play a big factor.

 

[edmadison]

It isn't just money, it's also administrative hassles. PCPs get inundated by insurance companies for justification of their treatment plans. Patient's want all sorts of forms completed: disability, medical clearance, physicals. It's ugly.

Ed

 

[sgglaze]

Every year the most competitive specialties are those with some combination of high pay/good hours.

Salary and hours are the 2 most important factors governing residency applications. If the money or hours of the PCP improved significantly, applications would shoot way up. The numbers don't lie.

Edit: The contrast between the poll and the posts is worth noting. The poll seems to indicate money would be a significant attracting factor, while the posts would lead one to believe it's not the main reason.

 

[DF38]

I didn't vote, because I couldn't say I would definitely do FM/IM for 250k, but I'd certainly give it a whole lot more consideration than I am giving it right now (none).

 

[RisingSun]

I'd rather do a ROAD specialty for family practice money than be a family practice doctor for ROAD money.

I wholeheartedly agree. Family med is stretched too thin - there is too much to know to actually do a good, through job in the little bit of time available. For me, too much watchful waiting, lifestyle counseling, and band-aids for chronic medical problems due to patient lifestyle issues.

 

[indo]

Hell no. Have you ever spent a day in a family practice office? I would rather work in a cubicle.

Some people may like it, but I would rather find another career then spend my life in family practice.

yeah, I'm gonna go ahead and raise your diuretic and insulin doses, mmmkay?

 

[LadyWolverine]

I wholeheartedly agree. Family med is stretched too thin - there is too much to know to actually do a good, through job in the little bit of time available. For me, too much watchful waiting, lifestyle counseling, and band-aids for chronic medical problems due to patient lifestyle issues.

BS. This isn't unique to family med. It is true of most other specialties, including more competitive specialties and sub-specialties like cardiology, GI, and plastic surgery. My family medicine rotation blew my mind - while there was certainly a lot of "lifestyle counseling," there was a lot of "real medicine" going on, too.

And the hours were really nice. Not gonna lie.

 

[cfdavid]

The bottom line is that the financial situation in the US will dictate a closing of the spread b/t speciaties and primary care. This will be driven by economic necessities and NO political party will be able to mitigate this change. The money is just not there.


Get ready to practice medicine in the US in a very different way. I can't speculate on the changes, but they WILL be based on economics. Gone are the days where we stent coronary arteries 45% more than the next most prolific stenter (Norway), and getting worse results to boot. Those days are GONE. You can disagree, but consider how the global economic structure is changing in a very, very fundamental level.

Personally, for the first time in a long time, IMHO, primary care may very well close the gap in terms of opportunity cost of extra years in training etc. in the subspecialties, which in a poorer economy will be discouraged economically, not from a clinical perspective, but rather a beaucracratic point of view.

We shall see. Remember this. Do not take these statements lightly.

 

[Blesbok]

The bottom line is that the financial situation in the US will dictate a closing of the spread b/t speciaties and primary care. This will be driven by economic necessities and NO political party will be able to mitigate this change. The money is just not there.


Get ready to practice medicine in the US in a very different way. I can't speculate on the changes, but they WILL be based on economics. Gone are the days where we stent coronary arteries 45% more than the next most prolific stenter (Norway), and getting worse results to boot. Those days are GONE. You can disagree, but consider how the global economic structure is changing in a very, very fundamental level.

Personally, for the first time in a long time, IMHO, primary care may very well close the gap in terms of opportunity cost of extra years in training etc. in the subspecialties, which in a poorer economy will be discouraged economically, not from a clinical perspective, but rather a beaucracratic point of view.

We shall see. Remember this. Do not take these statements lightly.

oh ok.

 

[cfdavid]

oh ok.

You can burry your head in the sand. But, if you have ever followed economics, and want to chat, then call ME out in a separate thread, and we'll debate. But, I will bring you to task personally.

First, post what exactly you disagree with. I can't make too much sense of "oh, o.k.", other than you disagree, in which case that's grounds for a debate. So, gather your facts and let's chat. In a SEPARATE thread if your interested.
However, in order to shape the debate, we should define our disagreements. So, copy my previous post from above, and we can start from there.

cf

 

[lilnoelle]

I really like primary care and honestly can't think of doing anything else. Obviously I want to live a comfortable lifestyle and be reimbursed for my work, and I'd prefer not to have $400K in debt hanging over my head.... but I am pretty certain that I'll do primary care no matter what.

 

[Ashers]

I was bored/annoyed out of my mind on FP and IM. If I had to choose one of those, I'd quit medicine and go into paleontology or marine biology (marine bio only if I get to work with Shamu or other whales/dolphins).

 

[njbmd]

This is a poll for those who ARE NOT PLANNING ON GOING INTO family practice or internal medicine.

Would it change your mind if your starting salary was $250,000 (making you rich, according to a certain politician)?

I have talked to way too many people that say that money doesn't matter to them, and then I ask them what they are going into and they say something from the infamous ROAD specialties. I am venturing to say money has more to do with people's decisions than they want to admit to.

Just for the record, money is not the primary force driving my specialty choice, but I would be lying to say that it had no part at all.

It's kind of a useless poll because you can open a very savvy Family Medicine Practice, be willing to work plenty of hours and earn over $250K if you are in the right locale (designer practice) or primary care to a very wealthy clientèle.

If you love Family Medicine, it doesn't matter if you earn $50K, because you enjoy what you do and can't wait to get to work. If you hate spine surgery, it doesn't matter if you earn $1,000K, you are going to be a miserable person and a miserable physician/surgeon.

Any medical specialty can provide a good income if you are willing to do some hard work and put in some long hours. There are plenty of people who didn't have any options other than IM/FM, Psych or Peds (the specialties that have lower average incomes) but make a very nice living and actually learned to enjoy what they do.

I am a surgeon and I work very, very hard. I LOVE what I do and my income reflects that love. I leave my house earlier than most humans and I get home later than most humans but still, I find every minute that I practice medicine, a joy. I would practice surgery if I was going to make $50K and I can afford to make $50K because I have minimal school loans (less than $30K) and by virtue of my long hours, I don't need tons of expensive toys because I don't have that much time to play with them. Surgery is my profession and not my hobby.

If you enter medicine/surgery strictly for money, you are always going to be disappointed in some form. That first dissappointment comes when you open that USMLE Step I score report and find that your options are going to be limited.

 

[alan06]

It really doesn't really matter to me because my goal is primary care. Regardless what you do, you still need to do something that you enjoy.

 

[sirus_virus]

With the democrats poised to take control, expect some activity in healthcare policy. I am pretty sure their version of healthcare reform tilts wildly in favor of primary care and against specialist care. So if you are in the business of choosing specialty by pay, you might be a bit surprised how this whole thing plays out. Beware!

 

[RisingSun]

With the democrats poised to take control, expect some activity in healthcare policy. I am pretty sure their version of healthcare reform tilts wildly in favor of primary care and against specialist care. So if you are in the business of choosing specialty by pay, you might be a bit surprised how this whole thing plays out. Beware!

What exactly have the democrats said that suggest a shift from specialized to primary care?

I always find it amusing and ironic how med students swear that the democrats will cut their salaries while at the same time complaining that reimbursement has gone down dramatically over the past decade. Who exactly do people think have been in power for the last 8 years (and since '94 for the senate)?

Honestly I don't think that people would be breaking down doors to get into family med even if it was one of the better reimbursed specialties. I know that I sure wouldn't. But the interest in the field is not representative of its importance in maintaining the public health - along with IM, the two fields are probably the most important and vital of all fields of medicine in terms of preventing disease and keeping the public healthy.

 

[Law2Doc]

People make career choices on a number of factors. Salary, enjoyment of field, lifestyle all contribute. It's foolish to make such an important decision on one thing. If FM/IM makes a lot of money, some people who were on the fence about the field may be pushed into doing it. For others, you can't pay them enough money.

Agreed -- these single variable decisions are expected in pre-allo where folks don't really know about many other variables yet (and it's understandable when written up in garbage news like USA Today), and are very far removed from specialty decisions, but it's kind of sad when they crop up in allo. Pay is important, but really not the most important variable. Doing what you want to do for the next 40 years is more important. Lifestyle considerations generally become more important as you approach the age that most folks are married and starting families. Administrative issues, geography, career advancement potential, research potential all weigh in.

I'd say anyone who jumps to a specialty just because it pays well either (1) already liked the career for multiple other reasons but was only holding back due to salary, or alternatively (2) didn't find anything they liked, and so they are just going to let $ govern. If you are in the former group, then I think you should probably do what you'd like to do notwithstanding the salary. You can make it work, and it's more important to be happy. If you are in the latter group, then you really ought to take a research year or do something that will buy you more time to figure out where you want to be. You don't pick what you are going to be doing for the next 4+ decades based on salary. If you hate it, the bump in your bank account won't be much consolation -- you will be miserable and feel like your life is wasted. This isn't a prison sentence to be served out, it is your career. Unlike the poor schmuck who is forced to pump gas or stock shelves for his weekly bread, you actually have a ton of advantages and a lot of choices. So figure out what you want to do and get onto a track to do that. Take it from a career changer -- you aren't relegated to a path that is only satisfying in one aspect (and the not most important aspect at that). You find a career that actually gives you some enjoyment. Because you have choices. You are among the best and brightest and most educated on the planet. Don't squander it.

 

[Law2Doc]

I always find it amusing and ironic how med students swear that the democrats will cut their salaries while at the same time complaining that reimbursement has gone down dramatically over the past decade. Who exactly do people think have been in power for the last 8 years (and since '94 for the senate)?

Both parties are deep enough in bed with the insurance companies that you can expect this trend to continue. The real questions are going to surround universal healthcare.

 

[RisingSun]

Both parties are deep enough in bed with the insurance companies that you can expect this trend to continue. The real questions are going to surround universal healthcare.

I agree, there is nothing about either plan that suggests otherwise. I think that it is misleading to suggest that in terms of physician payments one party is better than the other.

 

[meister]

Why can't we just have subsidized medical education and universal healthcare and then we can all stop bitching simultaneously about student loan debt AND insurance companies?!

A man can dream can't he?

 

[Law2Doc]

Why can't we just have subsidized medical education and universal healthcare and then we can all stop bitching simultaneously about student loan debt AND insurance companies?!

A man can dream can't he?

It is a dream. Most likely we will have some form of universal coverage in which the insurance companies play a big role, and so bitching with the insurance companies is here to stay as part of the profession for good -- they are too entrenched and have a lot more lobby dollars at work than doctors. As for subsidized tuition, this will never happen. The public still feels that doctors earn too much and are part of the problem, so no politician in his right mind would suggest a tuition break for this predominantly upper class segment of society, no matter how oppressive the loans. So yeah, it will never ever happen and folks who keep suggesting this simply aren't in step with the political realities. Until it becomes impossible to fill med school classes, nothing like this will get past the political issues and public perceptions. And currently less than 50% of applicants get into med school so filling classes, even at absurd tuition and interest rates, is not an issue. And doctors continue to look bad to the public as article after article suggests they are forsaking the public and not going into primary care -- docs are being painted as the bad guys even in current news. Expect tuition to continue upward as it continues to be a seller's market.

 

[Blesbok]

It is a dream. Most likely we will have some form of universal coverage in which the insurance companies play a big role, and so bitching with the insurance companies is here to stay as part of the profession for good -- they are too entrenched and have a lot more lobby dollars at work than doctors. As for subsidized tuition, this will never happen. The public still feels that doctors earn too much and are part of the problem, so no politician in his right mind would suggest a tuition break for this predominantly upper class segment of society, no matter how oppressive the loans. So yeah, it will never ever happen and folks who keep suggesting this simply aren't in step with the political realities. Until it becomes impossible to fill med school classes, nothing like this will get past the political issues and public perceptions. And currently less than 50% of applicants get into med school so filling classes, even at absurd tuition and interest rates, is not an issue. And doctors continue to look bad to the public as article after article suggests they are forsaking the public and not going into primary care -- docs are being painted as the bad guys even in current news. Expect tuition to continue upward as it continues to be a seller's market.

It is too bad that joe blow from the general public is too stupid to realize the reason for the decrease in primary care doctors and the reason it takes them 3 months to find a doctor that is accepting new medicare patients.

 

[sirus_virus]

Both parties are deep enough in bed with the insurance companies that you can expect this trend to continue. The real questions are going to surround universal healthcare.

When it becomes politically feasible to pursue Universal healthcare, politicians will make a 360 turn and force it down the country's throat. I don't think you guys understand that we are on the brink of this. The only thing holding them back is how to convince people to pay more taxes, and they might just decide to go with a cheap poorly funded version of universal healthcare, then turn arround and force physicians and hospitals to accept it. This will happen in the very near future IMO, there is really no way arround it. Healthcare is the next american system waiting to collapse, and if you have learned anything from the credit crisis, you should know that once the public gets desperate and nervous, politicians will start swinging wildly, and within one day they could pass a bill way beyond your present imagination.

Another thing you guys are forgetting is that politicians are now buying into the Obama technique of fund raising without special interests, and if the special interest hold on washington gives, Universal healthcare will surface almost simultaneously.

 

[Law2Doc]

... if the special interest hold on washington gives, ...

That's a big "if" that isn't likely to happen. Money makes the world go round, especially in Washington. The insurance companies have it to throw around (even after the financial services crisis), and the medical profession doesn't. Special interests have been a part of politics for centuries, and won't suddenly disappear because Obama has a better idea. This past administration has been absurdly blatent about pandering to special interests (basically handing Halliburton, Cheney's cronies, huge profits from the Iraq war), so it's reasonable to expect the next administration to be a bit more subtle. But make no mistake, politicians get elected due to campaign finance, and those that hope to be reelected maintain close friendships with those that got them there. Campaign finance reform has been a big ticket item for decades and guess what -- lobbying is a bigger industry today than ever.

 

[mcconvillejr]

yeah, I'm gonna go ahead and raise your diuretic and insulin doses, mmmkay?

you are NOT authorized to hot link images off the webserver for the image you used. please remove, or the URL to the image will be renamed to break your link.

 

[soonereng]

This past administration has been absurdly blatent about pandering to special interests (basically handing Halliburton, Cheney's cronies, huge profits from the Iraq war)...

[Threadjack]Get your facts straight L2D. I worked for Halliburton for 7 yrs (and I don't really like them as a company so it's not company loyalty here), but they were awarded those contracts under CLINTON.[/Threadjack]

 

[psy]

My PCP when i was young makes about 400K+ per year. After overhead etc... he takes home about 200-300K per year. Is this all from his practice? Maybe. He has alot of mecaid/medicare patients. He also does many minor surgery procedure as well so it is hard to tell. In addition, it turns out he's rather business savvy or maybe his wife is, but he owned all the properties near his practice and lease them out to businesses. So making 250K as a primary care is not impossible, but you would have to be pretty business savvy.

 

[pancakesyrup]

It is a dream. Most likely we will have some form of universal coverage in which the insurance companies play a big role, and so bitching with the insurance companies is here to stay as part of the profession for good -- they are too entrenched and have a lot more lobby dollars at work than doctors. As for subsidized tuition, this will never happen. The public still feels that doctors earn too much and are part of the problem, so no politician in his right mind would suggest a tuition break for this predominantly upper class segment of society, no matter how oppressive the loans. So yeah, it will never ever happen and folks who keep suggesting this simply aren't in step with the political realities. Until it becomes impossible to fill med school classes, nothing like this will get past the political issues and public perceptions. And currently less than 50% of applicants get into med school so filling classes, even at absurd tuition and interest rates, is not an issue. And doctors continue to look bad to the public as article after article suggests they are forsaking the public and not going into primary care -- docs are being painted as the bad guys even in current news. Expect tuition to continue upward as it continues to be a seller's market.

It sounds like you are implying that medical school debt will be 400K, and PCPs will make 120K (much less after taxes) working 80 hour weeks, and nobody will help.

Am I exaggerating?

 

[TexasPhysician]

Most of the FP docs I know leaving residency are getting offers at $200,000 and up. My best friend's father is an FP making $300,000/year in DFW.
It is NOT unheard of.

 

[deleted36260]

Why can't we just have subsidized medical education and universal healthcare and then we can all stop bitching simultaneously about student loan debt AND insurance companies?!

A man can dream can't he?

Nothing like losing pay and autonomy to make me even happier to be a doctor!



As for the OP:
I am interested in FP/IM, but its the pay that scares me from it. I won't pick a specialty for the money, but I'll sure as hell stay away from one for it. Boutique Derm for 350k a year? I can't think of a more boring existence than creams on acne for the rest of my days, even if the lifestyle is amazing.

 

[deleted36260]

Most of the FP docs I know leaving residency are getting offers at $200,000 and up. My best friend's father is an FP making $300,000/year in DFW.
It is NOT unheard of.

Perhaps I will be moving to DFW. I'm in a large Texas city and I see listings for FP docs at 140-150k. Smaller areas around me are only paying 120k. That's not chump change in the grand scheme I guess, but its almost HALF of what almost any other specialty is making.

 

[meister]

[Threadjack]Get your facts straight L2D. I worked for Halliburton for 7 yrs (and I don't really like them as a company so it's not company loyalty here), but they were awarded those contracts under CLINTON.[/Threadjack]

"Those contracts" for the Iraq war? How is a company awarded no-bid contracts for a war that is 2+ years away?