Surgeontodd94

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Jan 7, 2016
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Please don't banish me to hell for wanting to talk about salary/competition.
Physiatrist seem to be on the lower side of the spectrum for feeling like they're not compensated properly. Why is this?
PMR docs seem to make an average of 280K which is slightly more than primary care docs. Yet they feel more compensated. Is there a reason for this? Or is this bias because of the type of people going into this field.
 

j4pac

Prior Flight Surgeon PM&R attending guy
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I think a part of it is another statistic within the same article.

When asked “would you choose the same specialty again?” PM&R physicians responded yes at a very high rate.

But when asked “would you choose medicine again?” PM&R physicians said “no” higher than any other specialty.

I think that there are lots of PM&R that regret going into medicine and therefore should get paid more to do something they are unhappy doing. There are other factors such as a unique patient population (highly impaired vs chronic pain) that can be challenging and stressful.
 
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Ogliodendrocyte

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I kinda imagine there's a lot work that's done that's not directly compensated that eats up a lot of our day like insurance authorizations and paperwork, more so than most of other specialties. Just a guess though
 
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RangerBob

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Please don't banish me to hell for wanting to talk about salary/competition.
Physiatrist seem to be on the lower side of the spectrum for feeling like they're not compensated properly. Why is this?
PMR docs seem to make an average of 280K which is slightly more than primary care docs. Yet they feel more compensated. Is there a reason for this? Or is this bias because of the type of people going into this field.
Can you clarify your question? From my read, it sounds like you’re saying that the study you read said PM&R physicians DO feel appropriately compensated, but the posts above suggest they thought you meant the opposite. Being in the “lower side of the spectrum for feeling like they’re not compensated properly” seems like you’re saying a low percentage of us say we don’t get paid enough. It’s also not clear to me if “they” means PM&R or FM when you’re comparing the two fields.
 

j4pac

Prior Flight Surgeon PM&R attending guy
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Can you clarify your question? From my read, it sounds like you’re saying that the study you read said PM&R physicians DO feel appropriately compensated, but the posts above suggest they thought you meant the opposite. Being in the “lower side of the spectrum for feeling like they’re not compensated properly” seems like you’re saying a low percentage of us say we don’t get paid enough. It’s also not clear to me if “they” means PM&R or FM when you’re comparing the two fields.
It is confusing now reading. I assumed the OP was referring to the medscape article that showed PM&R least satisfied with compensation.

Medscape physician compensation
 

RangerBob

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It is confusing now reading. I assumed the OP was referring to the medscape article that showed PM&R least satisfied with compensation.

Medscape physician compensation
That makes sense.

Looking at the survey, 50% of physiatrists feel fairly compensated, as well as 53% of FM. About half of specialties are around 49-54%, which to me is all the same. The data really isn't all that useful, in my opinion. No med student bases their specialty choice on how many physicians in a field feel fairly compensated.

Keep in mind most people in general don't feel fairly compensated--a quick google search (very unscientific...) throws out 36-48% of Americans feel fairly compensated.

I think a large part is also likely that older physicians were used to being paid more when they were in independent practice, and now many are employees, or spending more for EMRs, and ultimately getting paid less.

Physicians probably feel more compensated than the general population because we are. $237k (generalists) to $341k (specialists) is a TON of money. Physicians that feel they aren't getting paid enough are people that will complain regardless of what they make, and/or are basing their feelings on what other doctors are getting paid. I think it's rather ridiculous ortho surgeons get paid so much more than FM. It's even more ridiculous that NFL players make more than ortho, and that teachers make about 1/4 the salary of a PCP. But we just can't read too much into the salary stuff--we know what the salaries are going into our fields, so when people complain that their salary that is more than 3-4x the median American household, it makes us seem rather out of touch. Yes, we work had, and we sacrifice a lot, but so do lots of other Americans. They have high debt loads as well (and often don't have wealthier parents like many physicians). We have BS paperwork (it's really not that bad in PM&R...), but so does everyone else. Cops spend all day writing reports on their computers as well.

Some people just have a habit of complaining. Look at me-I'm complaining about people complaining.

PM&R has some odd statistics lately now that it's been included in a few studies. Apparently we're the happiest residents, but the most burnt out as attendings (which seems weird to me-I've really never met an unhappy physiatrist..). And as J4Pac mentions, we would choose PM&R again, but not medicine. These are all somewhat at odds with each other.

We're a hard field to analyze. The older generation of PM&R comes with the stuff older specialists all come with (being disappointed with EMRs, the transition to being hospital employees, etc.), but also out field used to be mostly made up of people who failed to match ortho, and FMGs who were practicing other specialties (especially ortho) in their home country. And it was inpatient-dominated. Now we're outpatient-dominated (at least that's the preference for most med students/residents going into PM&R), hardly any IMG/FMGs match into PM&R, we're rarely a "backup" specialty anymore, and we have among the highest rate of seats filled in the match (higher than many surgical specialties, despite our near lowest mean USMLE scores). And to top things off, we're such a small specialty that is often overlooked, it's probably fairly easy for data to skew one way or the other.

I for one, don't ever recall filling out a Medscape survey. I mean, who really fills those out? I'm not telling some big data company what my salary is.
 
Aug 31, 2018
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That makes sense.

Looking at the survey, 50% of physiatrists feel fairly compensated, as well as 53% of FM. About half of specialties are around 49-54%, which to me is all the same. The data really isn't all that useful, in my opinion. No med student bases their specialty choice on how many physicians in a field feel fairly compensated.

Keep in mind most people in general don't feel fairly compensated--a quick google search (very unscientific...) throws out 36-48% of Americans feel fairly compensated.

I think a large part is also likely that older physicians were used to being paid more when they were in independent practice, and now many are employees, or spending more for EMRs, and ultimately getting paid less.

Physicians probably feel more compensated than the general population because we are. $237k (generalists) to $341k (specialists) is a TON of money. Physicians that feel they aren't getting paid enough are people that will complain regardless of what they make, and/or are basing their feelings on what other doctors are getting paid. I think it's rather ridiculous ortho surgeons get paid so much more than FM. It's even more ridiculous that NFL players make more than ortho, and that teachers make about 1/4 the salary of a PCP. But we just can't read too much into the salary stuff--we know what the salaries are going into our fields, so when people complain that their salary that is more than 3-4x the median American household, it makes us seem rather out of touch. Yes, we work had, and we sacrifice a lot, but so do lots of other Americans. They have high debt loads as well (and often don't have wealthier parents like many physicians). We have BS paperwork (it's really not that bad in PM&R...), but so does everyone else. Cops spend all day writing reports on their computers as well.

Some people just have a habit of complaining. Look at me-I'm complaining about people complaining.

PM&R has some odd statistics lately now that it's been included in a few studies. Apparently we're the happiest residents, but the most burnt out as attendings (which seems weird to me-I've really never met an unhappy physiatrist..). And as J4Pac mentions, we would choose PM&R again, but not medicine. These are all somewhat at odds with each other.

We're a hard field to analyze. The older generation of PM&R comes with the stuff older specialists all come with (being disappointed with EMRs, the transition to being hospital employees, etc.), but also out field used to be mostly made up of people who failed to match ortho, and FMGs who were practicing other specialties (especially ortho) in their home country. And it was inpatient-dominated. Now we're outpatient-dominated (at least that's the preference for most med students/residents going into PM&R), hardly any IMG/FMGs match into PM&R, we're rarely a "backup" specialty anymore, and we have among the highest rate of seats filled in the match (higher than many surgical specialties, despite our near lowest mean USMLE scores). And to top things off, we're such a small specialty that is often overlooked, it's probably fairly easy for data to skew one way or the other.

I for one, don't ever recall filling out a Medscape survey. I mean, who really fills those out? I'm not telling some big data company what my salary is.
This post makes some very good points. US physicians are overpaid when you look at the average household income. Should be capped at 2x median house hold income.
 
Jul 30, 2018
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This post makes some very good points. US physicians are overpaid when you look at the average household income. Should be capped at 2x median house hold income.
Oh boy. Jerking it to salary caps on this forum I see not the first and certainly will not be the last. 2x LOL. What the average household lives on or thinks is adequate is about as irrelevant as it gets. Nobody gets to this point as says “oh gee whiz where’s the average Joe/Jane in all this”.

To the ones just starting out Make as far in excess of the average American as you can.

Provide for yourself and pad that savings acct.
 

RangerBob

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This post makes some very good points. US physicians are overpaid when you look at the average household income. Should be capped at 2x median house hold income.
I don’t see the need for a salary cap. I was just suggesting every American feels underpaid, and we come across as insensitive and out of touch with others when we complain about a salary of ~$300k as not fair.

I feel quite happy with my income. I’d certainly be happier with more (who wouldn’t?), but I do feel fairly compensated.
 

bear2020

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May 30, 2018
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Another important thing to keep in mind is that it is expensive to be a physician. Medical school is one of the largest investments you will have in your life and most will not be able to realistically pay them off until you start working as an attending 15 years down the road. This, combined with $2000 for boards and $800 for conferences and MOC etc... can breed this kind of attitude. Lets not forget, just because you make $300k, doesn't mean you take home $300k. I don't think the general public knows or cares enough to look into this. Most medical students and residents are not really aware until they actually start working.
 

Gauss

Damnit Jim!
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compensation may be your priority for your 1st 10 years or so but eventually time becomes more important than money for the next 20ish years so will your career allow you to cut back and make the income you need? PM&R tends to have more flexibility than other fields; other fields that allow for more flexibility and cutting back: EM, anesthesia, hospitalist
 

PMR2008

PM&R
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100% agree with you Gauss. Those are words of wisdom.
It has been 10 years since graduating medical school. The first few years after completing training I was more focused on money. Eventually I was able to make an income that allowed me to live my chosen lifestyle. If I worked the same number of hours as I did right out of training I would make more money. Now I am cutting back and using my time wisely.
I am spending a lot more time with family, traveling and taking care of my health
 
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aafisahar

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Oct 22, 2015
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This post makes some very good points. US physicians are overpaid when you look at the average household income. Should be capped at 2x median house hold income.
Disagree, OECD compensation for physicians is 4-6x median wage, the US is not terribly skewed because our median income is higher.
 

lejeunesage

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Jan 7, 2010
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Please don't banish me to hell for wanting to talk about salary/competition.
Physiatrist seem to be on the lower side of the spectrum for feeling like they're not compensated properly. Why is this?
PMR docs seem to make an average of 280K which is slightly more than primary care docs. Yet they feel more compensated. Is there a reason for this? Or is this bias because of the type of people going into this field.
A huge part of it is about expectations.
When I was a resident, my dream salary was $240K. When I was doing my financial planning, this is the number I would put in a calculator. I figured that I would lose about a quarter to a third of it in taxes, depending on where I lived, and that I would take home anywhere from $160-180K per year. In other words, I expected my take home pay to be anywhere from 13-15K per month. And remember, that was my dream salary. My expectation was that I'd find a job that would pay me around $220K.

But thankfully for me, in my first job, I started out as an independent contractor in inpatient rehab. By the time I had been working a year, my take home pay after taxes was around $18-20K per month!

Happiness = reality - expectations.

When your expectations are low, it's really easy to be super happy with what you get. Most people don't go into PM&R expecting to make bank, unless their plan is to do a pain fellowship. I was never going to do pain. So, I set my expectations pretty low from the get go. Today, I'm extremely satisfied with how much I earn between my collections and directorship stipend. And my hours aren't bad at all. I started at 0930 today and got done at 1530. And that was on a day when I had to do a team conference on 15 patients. Personally, I don't think it gets much better than this.
 
Jul 30, 2018
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Disagree, OECD compensation for physicians is 4-6x median wage, the US is not terribly skewed because our median income is higher.
I always hated when those statistics were posted because it’s bascially someone with an anti doctor agenda. People get all angry about those greedy doctors but then when you start actually looking at it on a country by country basis they’re all in the top 1-5% wage earners usually within their own country.

There are ofcourse exceptions but I think even in those countries like Russia or China. There is a non transparent aspect to it namely “tips” or gifts that patients give. I certainly don’t endorse the practice.
 

Eilat87

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All I gotta say is.. software engineering baby! They invest so little years compared to us and make more in some cases when they've reached senior management positions in big companies.
 
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Piebaldi

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All I gotta say is.. software engineering baby! They invest so little years compared to us and make more in some cases when they've reached senior management positions in big companies.

Some software engineers make good money at some of the bigger companies, sure but that's probably the top 10-15% of them. The rest don't typically even hit the $200k mark even by the time they retire. But like with anything, the sky is the ceiling depending on what you make out of things -sadly I am making more money with a small beauty/cosmetic type dealio, in the 400K plus range than I did with PM&R even when I was making good money in PM&R. I might not even make what I make with my cosmetics clinic even when I finish pain fellowship. But again it's always a mix - do some of what you like and something that makes you money. There's no amount of money in the world for doing something you hate.
 
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