Hi, I like to know what a FP/IM docs make right after residency; if he works for a hospital. Thanks. I hate to spend 8 years to make a loudsy $120K per year.
average salary for FP/IM doc post residency
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8 years? College, med school, and residency together are 11 years, med school and residency = 7 years, residency = 3 years, just wondering where 8 years comes from..?
If you want to make lots and lots of money, do business, or do CT or Ortho, or radiology, or anesthesia..the question is, how much do you want to work non-8-5 hours? (The ROAD specialty reimbursements may be taking a turn for the worse however...)
Now that I've gotten that out of my system, Working as a hospitalist is >200k starting where I am in the Southeast. Most outpatient practices start graduating residents ~170k here. You will make less as a hospitalist or even in outpatient practice the closer you are to a big city (saturated with physicians)
If you want to make lots and lots of money, do business, or do CT or Ortho, or radiology, or anesthesia..the question is, how much do you want to work non-8-5 hours? (The ROAD specialty reimbursements may be taking a turn for the worse however...)
Now that I've gotten that out of my system, Working as a hospitalist is >200k starting where I am in the Southeast. Most outpatient practices start graduating residents ~170k here. You will make less as a hospitalist or even in outpatient practice the closer you are to a big city (saturated with physicians)
I say 8 years because I have my B.S. 4 years med. school + 3 years FP/IM residency. If FP/IM grad makes >170K then what is the fuss about FP/IM docs making crappy salary?
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I am not so sure.... I appreciate FP/PCP work hard. But, I am wondering what folks think is "fair" compensation for putting off numerous earning years etc... to achieve subspecialty training and then work hard too. What I am talking about is:
Pedes = 3 years
FP = 3yrs
IM = 3 or 4yrs
GSurgery = 5+ years
colorectal = 6+ years
Breast/MIS surgery = 6+
Vascular = 6+
CT = 7+ (often 8-9)
I appreciate FP/PCP is working hard but just don't get the push for equality in reimbursement/pay without equality in training length/requirements. If it continues forward, some folks are going to start demanding hazard/risk pay. IM no longer requires central line placement training as part of residency. Surgeons are left exposed to sharp bones, sharp instruments, and much blood... in addition to the standard airborne exposures of the PCP/FP fields....
JAD
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deleted87716
Nobody has said that all doctors should receive equal compensation.
The current disparity, however, is difficult to justify no matter how brainwashed you are.
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I know you present a side that suggests how important this matter is to you. I think personal snaps of "brainwashed" are petty. My points are based on general observation of what has occurred and of what is going on.... I am really not sure what the president has actually done to convince PCPs he walks on water or should be trusted....other then promise increased money to PCP.
This isn't brainwashing. This is an observation. Currently, because of business requirements, PCPs can not spend as much time with each patient to provide the best care they believe is possible. The demands/requests of PCPs I have heard and/or seen is to have increased revenue to see fewer patients for longer periods.
A PCP that earns 180-220/yr is just as "rich" as the businessman that earns that much. Most of my friends graduating FP are starting around 180+/yr. To date, in order to support these social programs, rich were originally defined as earning over 1 million/yr, then 500k/year, then 250k/yr and more recently 200k/yr. At that rate, PCP/FPs will soon be classified as rich... If "we" convince society that 200k/yr equals being rich, I ask why it is hard to envision cutting reimbursements to the "rich" PCPs???
It is quite easy to be tunnel visioned on these matters. But when all is said and done, we are talking increased money to a group of physicians. We are further talking about increased monies to bring said group to a level being defined by the administration as... "rich". The nobility of the cause will get lost if to pass the cause we start defining in a "disparaging" or at least "justifying" manner... as "rich". Because, the definition one uses to get their increase in income will be the same definition used on you after you get your raise. We will have little ground to stand on if you make even 180/yr because that makes you very close or almost "rich".
We can argue that it is for patients' healthcare if we like. My points in all this are that there really needs to be honesty. The arguments and claims to date have not been honest. Do I think a good PCP that works hard should receive increased salary? Yes. But, just by the recent downward adjustments of definitions, PCPs get closer to being rich everyday without a single dime of increased income.
JAD
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agreed totally. Most fps in my area (400,000 population) make between 170-220. It is hard work, but very nice lifestyle overall. Liability is low.
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Which by the current administration's standards makes most FPs (in your area) fall into "rich" (or at least almost) members of society. By extension, some would argue complaining about that income and wanting more makes you greedy.
To date, none of my friends graduating FP have received "serious" offers under 160/yr first year guarantee. Most receive offers of 180+/yr with student loan assistance/repayment, and "fully loaded" packages.
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deleted87716
Incorrect. The average businessman doesn't carry $200,000+ in educational debt, doesn't have to defer earning a real income or starting to save for retirement for an additional 7+ years after college, and doesn't have to buy malpractice insurance.
As for being "rich," fewer than 2% of households in the U.S. had incomes in excess of $250,000 in 2006. Consequently, the general public thinks we're all "rich." What most people don't realize is that the factors I mentioned above keep most doctors in the middle class.
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I wanted to further respond to the OP. I think it is important to ask these questions and investigate this no matter what career you are looking at... lawyer/engineer/physician. I think it would be worth your while to speak with a family or friend's accountant.
You see, your question allows a "it depends" answer...
Are you speaking an after tax $120K?
What amount of work are you engaged in to get $120k after tax?
I encourage you to do a google search of "jobs" for differing specialties. You will find a wide variety of offerings for differing levels of work. You should then consider what the dollar amount offered represents in after tax dollars/take home.... Suppose your after tax is a "loudsy(sic)" $120k. Are you a Monday to Friday limited call, most weekends off, most major hollidays off practice???
JAD
These are all great questions. To clarify my question : 120k gross, 40 hours a week; 8-5pm, no on call, work in hospital-not private clinic.
better yet, some Urgent Care/E.D. centers that hire FM docs locally, pay about $225 K for 12 12 hour shifts per month. Working more than those minimum hours comes even better hourly pay. Almost one third higher on an hourly basis. This amounts to about $325-$375 K yearly, if you do 18 shifts per month (which I would not recommend because that is alot). Even this schedule would leave you almost two weeks off per month.
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What you describe sounds like it might be a fairly nice gig.... are speaking before overhead/malpractice, etc??? 120k/yr for 40hr wks, 8-5pm is not easily made in many fields....
Medicine is hard work. We put a large upfront investment to have the opportunity to work hard jobs with good rewards. Some may work just a 40/wk, no call gig and make 120K/yr others work under different potentially more lucrative arrangements. The GSurgeons I know that earn 350k/yr work hard for it. It includes a good deal of on-call, numerous weekends, plenty of hollidays, and very long days in general. They often cover several hospitals. I wouldn't want the hours or on-call of the Cardiac or vascular surgeons or the up and down the strip hospital coverage.
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You left off anesthesiology. It makes perfect sense that they would get paid twice as much as an FP for one extra year of residency?
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I am not claiming to know or dictate the correct number.... I am asking, as so many look at the numbers and declare it obviously incorrect/unfair, "what is the number?".
It goes beyond the extra year of training. The years of training and/or debt and/or putting off years of earning are in fact used by all specialties as to why they deserve greater salaries. As pointed out in this thread by others, depending on practice structure and "accepted" workloads, FP/FM can have income similar if not equal to GSurgery.... I guess, if we are to discuss or consider what is "fair" we should consider some pertinent points.
1. what should be the differential for years of education and or delay in earning?
2. what should be the differential for workload.... i.e. if a physician works only 4 or 5 days per week, around 40hrs/wk, what should that income look like compared to someone that works on average 6 days per week and 60-80hrs/wk?
3. What about on-call differential? If a physician works Mon-Fri, 40 hrs/w, and no on-call; should there be a difference for the physician that takes on-call Q1, 2, 3 that requires actually getting called and/or coming to the hospital or providing patient care in the middle of the night?
4. What about weekends & hollidays? Similar to number "3" above.
5. What about malpractice and other costs? I welcome correction and or explanation from those with more information.... But, my take on reimbursements is that a percentage of each reimbursement "includes" cost of malpractice....
6. How many cases should a surgeon do to earn say, 350k as compared to a FP/FM to earn say 180/220/300k?
Again, I don't know the correct answers to these questions. I do think nebulous/vague reference to specialties with greater "income" as unfar is not appropriate or very helpful. IMHO, specifics are more in order. What would it cost "you" to assume these levels of work? Keep in mind the (opposing) "stereotypes" as some noted on the other thread..... neurosurgeon = no life, GSurgeon = no weekends, lots of call, FP/FM = good lifestyle but no money..... etc... Each physician in each specialty has made a decision. In general, each considers the upfront "invesment" with certain expectations based on the points above.... But, in the end, it is an individual choice with associated consequences.
JAD
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My guess is that a PA could gross about 80-90K/yr with only only 2.3 yrs of schooling. So 120 gross as a FP doc dosen't seem to appealing.
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deleted6669
actually lots of specialty pa's make > 120k for their 7-8+ yrs of school(undergrad, medic/rn/rt, pa school.
125k/yr for an em/ortho/surgical/derm pa is not uncommon.
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By your arguments FPs should be making more. (1) They only have one fewer year of residency training than anesthesiologists, who make 300k plus compared to 200k or less. I doubt one extra year of training is worth a 100k or more increase in salary every year for the rest of somebody's life. (2) Most FPs clock in more than 40 hours and 4 days per week. Generally speaking, hourly differentials are largely overrated, unless you're talking about dermatologists. (3) Many FPs still hospitalize patients and accept call. They get called quite regularly when one of their 2,500 or so regular patients pops up at the ER, since the first question the ER doc asks is, "Who is your family doc?" (4) Lots of FPs have to work clinic or accept call for partners every once in a while on a weekend or holiday as part of their group responsibilities. (5) I'm all for malpractice rates going down for anybody. (6) How many patients does an FP have to see in an hour for 50 bucks a time from Medicare or some similar nonsense to make 200k versus a surgeon treating one patient for a couple hours for several thousand dollars?
All this stuff goes both ways. A surgeon can very easily say their work is more important, more time consuming, and more risky. These views are largely artificial. FPs don't just pass out cough syrup all day. Their work is important, time consuming, and risky as well.
Some incomes in medicine are artificially high (radiologists), while others are artificially low (general med), perpetuated by myths about whose work is more important, time consuming, and risky.
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For which there is no justification compared to an FP doc or pediatrician starting in the low 6 digits. Stupid system that rewards treating sickness rather than health.
I came to this conclusion for those who are money driven.
If you are over 30 and are financing your education via 100% student loans then PA may be the better option since the opportunity cost is much greater to becoming a doc.
If you are over 30 and are financing your education via 100% student loans then PA may be the better option since the opportunity cost is much greater to becoming a doc.
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I would assume there are more considerations in the minds of those choosing to become a PA versus an MD rather than the money driven ones, or at least there should be. There are some very real long range problems with our system if we favor a reduction of healthcare educational standards (ie, minimal preparation to get by versus maximal preparation to be best prepared).
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I'm not making any arguments... I am posing some questions. I think these questions are reasonable when some will make generalizations about what is "fair" or "appropriate" compensation for one discipline or another. I think these questions are more relevant then simply eye-balling a 350K income and saying it isn't right or fair compared to someone else's income number. You are comparing apples to oranges regardless the field until you start getting down to specifics.
Again, that's fine... but the question then remains. what is the differential to consider relative to the length of one's education. I have often heard... even in the FP forum the claim that "x" number of years for only "y" dollars is not appropriate/fair...
I am NOT speaking to FPs alone in the general question about comparing 40hr etc... I leave you to check some of the links posted by BD in reference to details of the average FP practice. The 40hr example actually comes from someone in this thread that posed that as their plan of practice. Hourly differentials may or may not be overated. But, the questions remain as far as what factors should be used to calculate appropriate differentials in income... as opposed to simply eye-balling a number and declaring it "too much" or "unfair". IMHO you need to consider exactly what was done and what is being done to achieve that income level.
You tell me? That is the point of these questions. Should you consider the additional years of education investment? Your point/question is deceptive and misleading. It is apples and oranges. You can not compare reimbursement for a PCP office visit (?20 minutes) to a single operative procedure because...
Should you also consider the post-operative time? The surgeon gets reimbursed a lump sum. There is no additional monies for the care post-op, through the night, daily rounding, etc... You are comparing a single office visit (20 minutes?)to only 2 or more hours of the larger amount of care provided over 10-90 days!!! The surgeon gets no more reimbursement even if there is an increase in care requirements during the "global period"... These are questions that I think need an honest answer. It could be just as easily asked why should a PCP receive $50-100 for 20-40 minutes while the surgeon only receives ~$1500 for over 10 or more hours of dedicated care for a single patient? It's apples and oranges.OutsidePublication said:
Absolutely agree.
Thus, I have posed these questions. If it is artificial then what should the criteria be??? Again, I don't know the answers. But, If some one is certain about what isn't a fair amount.... I ask them to state what is (a fair amount) and how they arrive at that conclusion.
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deleted6669
and procedures>prevention.
all the specialties that pay well for both docs and pa's are procedure intensive.
when I was a medic the most I ever made was 35k.
when I went to pa school a good starting salary for a pa was 40k.
I didn't go into this for the money.
It's really not your fault that you are making great money as a PA. If the system works on your side, just roll with it brother.
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deleted6669
I intend to....and if for whatever reason the u.s. healthcare system of the future requires me to take a 33% pay cut I will still keep doing what I am doing right now(and still would be making good money).
As a PA, aren't your salary tied to what your SP makes? In this case, if you work in a private office, a 33% cut would affect you much more right?
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deleted6669
I work in emergency medicine. I have an hourly salary and a production bonus. the docs make exactly 2x our hourly and keep a bigger chunk of the bonus pie than we do as a "partnership bonus".
pa salary range in our group is 110k-200k depending on number and type of shifts worked(some shifts are busier so more production bonus/hr).. doc range is probably 220-400k.
my salary is not tied to a specific doc as it might be if I worked in an outpt setting. I have a supervising physician of record but in reality every doc in the group functions as an "alternate supervisor" as the doc working a shift with me signs my charts at the end of the shift(and gets 50% of my bonus for doing so...)
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I am curious about your bonus.... Are you speaking of the production revenue generated/produced under the supervision of the physician that assumes a certain liability by being the supervisor? I am NOT being sarcastic, I am just asking out of true curiousty of the arrangement. It reads as if you are paying some sort of "protection" fee by having 50% of your ("my") bonus going to someone other then you...
When you wrote of a "pie", I initially envisioned that you were employed by a group. Everyone in the group generated revenue. The revenue belongs to the group and was distributed/divided according to whatever formula/structure was established. The reference to 50% of your ("my") bonus being taken by a physician sort of altered that perception.... Are your revenues being taken or were they not really yours?
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deleted6669
let me rephrase: 50% of the production/profits I generate goes to the physicians. if I work solo(as I do most of the time now) I keep 75%.
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deleted87716
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I'm not sure if there is any response for that....."One million dollars." 😉
maybe pose a question of clarification, "before tax or after?"
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deleted87716
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I hope that guy gets OMF coverage...."Taxes...? We don' need no steenking taxes!"
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can i bump this thread?
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No rule against that I know of...🙄
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