Can you make 300K in FM? My friend says it is "easy" but every online article says FM doesn't pay.

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futurestudent2021

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I honestly like FM but I wouldn't pursue it if it paid less than 200K because I would have exorbitant student loans.

Is 300K a realistic figure for someone who wants to work for it?

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What are the odds of negotiating some type of student loan reimbursement when signing for your first job? I've heard residency programs offering 100K for four years of service after. Do you know of any other programs that pay more than that?
 
Work 2 Hospitalist jobs. 500k right there.

Do full time urgent care, 250k, do suboxone, another 75-100k.

Plenty of clinic job advertisements I’ve seen where they say “every provider making over 300k”.

300k isn’t a difficult number to hit if you are willing to work for it.
 
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300k is very doable. My employed practice has 5 full time FPs, all of us make over 300k. 4 of us are likely to hit 400k this year. But, we do work pretty hard for it. We all take most of our 30 days/year time off and 1 half day per week off but are seeing upper 20s of patients/day.

Our employer offers loan repayment and/or decent signing bonuses. Non-profit so PSLF is also an option.
 
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There's nothing easy about the work required to hit the $300k threshold in family medicine. It is certainly do-able, but make no mistake, you will be busy.
 
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300k is very doable. My employed practice has 5 full time FPs, all of us make over 300k. 4 of us are likely to hit 400k this year. But, we do work pretty hard for it. We all take most of our 30 days/year time off and 1 half day per week off but are seeing upper 20s of patients/day.

Our employer offers loan repayment and/or decent signing bonuses. Non-profit so PSLF is also an option.
If more students were made aware of this then I think more would actually want to pursue FM because that's actually what a lot of people want to do but they look elsewhere because they are constantly told that pursuing FM makes no financial sense.

If I get my info online, apparently FM makes $5/hour. If I ask real docs, apparently nobody makes less than $220K and most everybody is above that and sometimes well above that.
 
If more students were made aware of this then I think more would actually want to pursue FM because that's actually what a lot of people want to do but they look elsewhere because they are constantly told that pursuing FM makes no financial sense.

If I get my info online, apparently FM makes $5/hour. If I ask real docs, apparently nobody makes less than $220K and most everybody is above that and sometimes well above that.
My base salary is officially 195k-ish which is what the paid me the first year I was here. But if I out earn that by being productive (which takes around 15 patients/day) and/or meeting quality measures, they pay me the difference at the end of every quarter.
 
My base salary is officially 195k-ish which is what the paid me the first year I was here. But if I out earn that by being productive (which takes around 15 patients/day) and/or meeting quality measures, they pay me the difference at the end of every quarter.
This is my setup as well. Similar base salary, but bonuses for productivity, and for quality metrics.

I have been exceeding my base salary productivity benchmark by 100 wRVU/month or more for the past 12-14 months. I have a team of care coordinators who’s job is to get my patients on board with all the stuff my quality metrics are based on. So they practically earn my quality bonuses for me.

I don’t feel like I work too hard. I’m generally done charting and on my way home between 5 and 6 pm, and I take a 2hr lunch break every day. I do an occasional weekend of light hospitalist call, but that’ll change soon too. I feel like the work I put in is minimal compared to the income I get.
 
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This is my setup as well. Similar base salary, but bonuses for productivity, and for quality metrics.

I have been exceeding my base salary productivity benchmark by 100 wRVU/month or more for the past 12-14 months. I have a team of care coordinators who’s job is to get my patients on board with all the stuff my quality metrics are based on. So they practically earn my quality bonuses for me.

I don’t feel like I work too hard. I’m generally done charting and on my way home between 5 and 6 pm, and I take a 2hr lunch break every day. I do an occasional weekend of light hospitalist call, but that’ll change soon too. I feel like the work I put in is minimal compared to the income I get.
If you were to push yourself to work harder than you do, would you make significantly more money than you already do?

Also, do you feel that an FM doc needs to have business knowledge to run an efficient practice? Where do you learn how to understand the business side of medicine? I doubt they teach that in medical school.
 
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If you were to push yourself to work harder than you do, would you make significantly more money than you already do?

Also, do you feel that an FM doc needs to have business knowledge to run an efficient practice? Where do you learn how to understand the business side of medicine? I doubt they teach that in medical school.
I could work five days/week and make more, but I value my free time too much. Nobody ever says on their death bed, "I wish I'd spent more time at the office."

Aside from the day to day stuff we all have to deal with, the business of medicine is so complex that it would be very difficult for the average doctor to acquire the necessary skillset. IMO, you're better off associating yourself with people who know how to do that part, so you can focus on the medicine.
 
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I could work five days/week and make more, but I value my free time too much. Nobody ever says on their death bed, "I wish I'd spent more time at the office."

Aside from the day to day stuff we all have to deal with, the business of medicine is so complex that it would be very difficult for the average doctor to acquire the necessary skillset. IMO, you're better off associating yourself with people who know how to do that part, so you can focus on the medicine.
Are you saying that a very good office manager will handle the business aspect adequately so that you can focus on the patient and not have to worry about all of the business-related issues that decide whether you get paid or not?
 
If you were to push yourself to work harder than you do, would you make significantly more money than you already do?

Also, do you feel that an FM doc needs to have business knowledge to run an efficient practice? Where do you learn how to understand the business side of medicine? I doubt they teach that in medical school.
Just a resident, but for somebody going into employed practice I think it's not so much business knowledge as knowledge about how reimbursement works and how to maximize that. Knowing how to document in a way that gets you a level 4 visit when it's deserved instead of a level 3, which these days really doesn't take more than an extra sentence or two in your note in most cases. Double billing when you manage an acute concern or chronic illness at a wellness visit. Knowing you can bill for things like a PHQ9 or an MCHAT or vision/hearing screenings at certain visits. Properly billing for procedures (and maximizing your office-based procedure knowledge during residency so you have an opportunity to bill for these). A good FM residency should be teaching you those things. Having a good relationship with an office coder/biller who knows what they're doing can help you with those things as well - they should be sending you emails to say hey, if you document X then we can make this a higher level visit, for instance.

You really only need the business knowledge like dealing with payroll, HR, hiring/firing, purchasing supplies/equipment, etc. if you want to own a practice, otherwise the health system will take care of most of that stuff for you.
 
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Are you saying that a very good office manager will handle the business aspect adequately so that you can focus on the patient and not have to worry about all of the business-related issues that decide whether you get paid or not?
Depends on your practice setup. If you're small/solo, a good, experienced OM could probably handle it.
 
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Just a resident, but for somebody going into employed practice I think it's not so much business knowledge as knowledge about how reimbursement works and how to maximize that. Knowing how to document in a way that gets you a level 4 visit when it's deserved instead of a level 3, which these days really doesn't take more than an extra sentence or two in your note in most cases. Double billing when you manage an acute concern or chronic illness at a wellness visit. Knowing you can bill for things like a PHQ9 or an MCHAT or vision/hearing screenings at certain visits. Properly billing for procedures (and maximizing your office-based procedure knowledge during residency so you have an opportunity to bill for these). A good FM residency should be teaching you those things. Having a good relationship with an office coder/biller who knows what they're doing can help you with those things as well - they should be sending you emails to say hey, if you document X then we can make this a higher level visit, for instance.

You really only need the business knowledge like dealing with payroll, HR, hiring/firing, purchasing supplies/equipment, etc. if you want to own a practice, otherwise the health system will take care of most of that stuff for you.
At what point does billing become fraud though?

A few years ago I went to an IM clinic for an ingrown hair and they asked me if I wanted to get an EKG while I was there. I just said "sure what the hell" but something tells me that I didn't need that EKG.

I'm too nice of a guy, I couldn't do that with a good conscience. Does that mean I am not going to be making 300K in FM?
 
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At what point does billing become fraud though?

A few years ago I went to an IM clinic for an ingrown hair and they asked me if I wanted to get an EKG while I was there. I just said "sure what the hell" but something tells me that I didn't need that EKG.

I'm too nice of a guy, I couldn't do that with a good conscience. Does that mean I am not going to be making 300K in FM?
No, that’s not how to do it.
 
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I could work five days/week and make more, but I value my free time too much. Nobody ever says on their death bed, "I wish I'd spent more time at the office."

Aside from the day to day stuff we all have to deal with, the business of medicine is so complex that it would be very difficult for the average doctor to acquire the necessary skillset. IMO, you're better off associating yourself with people who know how to do that part, so you can focus on the medicine.
How many days/week do you work?
 
As others have pointed out, being board certified in family medicine gives you the opportunity to do a ton of different job options. So really there is no 1 size fits all for family medicine.

With that being said, the area I went to residency in the NE (not same city I work in now), private practice jobs right out of residency started around 190k-220k as a base. So that just gives you an idea. You can make a lot more in private practice in the south and Midwest.

I do not work in private practice. I work in public health in somewhat of a "specific" area of family medicine and I make 180k/year. But I only work 4 days per week and I only see patients 3 days per week and have 1 day of admin. I also have 2 other per diem jobs where I pick up shifts as needed and that nets me at least another 30k/year.

Plus I do a little kind of what I’d consulting work and the project I’m working on right now pays $250 an hour.

I definitely think med school and even sometimes residency does not give one a good idea of all the possibilities in FM. I’m glad I kind of stumbled my way to where I am now and am happy with my "work-life" balance and my compensation.
 
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As others have pointed out, being board certified in family medicine gives you the opportunity to do a ton of different job options. So really there is no 1 size fits all for family medicine.

With that being said, the area I went to residency in the NE (not same city I work in now), private practice jobs right out of residency started around 190k-220k as a base. So that just gives you an idea. You can make a lot more in private practice in the south and Midwest.

I do not work in private practice. I work in public health in somewhat of a "specific" area of family medicine and I make 180k/year. But I only work 4 days per week and I only see patients 3 days per week and have 1 day of admin. I also have 2 other per diem jobs where I pick up shifts as needed and that nets me at least another 30k/year.

Plus I do a little kind of what I’d consulting work and the project I’m working on right now pays $250 an hour.

I definitely think med school and even sometimes residency does not give one a good idea of all the possibilities in FM. I’m glad I kind of stumbled my way to where I am now and am happy with my "work-life" balance and my compensation.
Considering what you make right now would you say that 300K is not unreasonable for other doctors in other areas of FM?
 
At what point does billing become fraud though?

A few years ago I went to an IM clinic for an ingrown hair and they asked me if I wanted to get an EKG while I was there. I just said "sure what the hell" but something tells me that I didn't need that EKG.

I'm too nice of a guy, I couldn't do that with a good conscience. Does that mean I am not going to be making 300K in FM?
The things I described are not fraud, it's just making sure you get paid for the work you actually did. If you reviewed notes and imaging from a recent ER visit or specialist appt, say so. If you are working around things like housing insecurity or financial challenges that impact your treatment plan, say so. If you are addressing multiple problems or considering a medication change, say so. If you/your nurse performed, reviewed, and interpreted the results of an MCHAT or vision test or PHQ9 as an appropriate part of a well child visit or a follow up for depression after a change in therapy, say so. These are all things that get you extra "points" to bill a higher level or add another billing code, and rightfully so because you did that work and it was necessary to take good care of that patient.

I am not at all suggesting family docs should be doing things they don't need to to make more money, billing for things they didn't do, or fluffing up notes to make it sound like they did more than they did. I'm saying you should be aware of what you can bill for and know how to document in a way that insurance companies know what you did in order to maximize your billing while also practicing good medicine and taking good care of your patients.
 
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I honestly like FM but I wouldn't pursue it if it paid less than 200K because I would have exorbitant student loans.

Is 300K a realistic figure for someone who wants to work for it?
possible but must work hard. i made close to 700 last year working in rural ERs and likely 750 this year. i have 1 ft and 3 pt jobs = 2 fte. this doesnt include investments (stocks, dividends...)
 
possible but must work hard. i made close to 700 last year working in rural ERs and likely 750 this year. i have 1 ft and 3 pt jobs = 2 fte. this doesnt include investments (stocks, dividends...)

How many hours would you say you were working per week overall the whole year?
 
Considering what you make right now would you say that 300K is not unreasonable for other doctors in other areas of FM?
There are people in this thread that say they make 300k plus, so yes of course. That certainly isn’t the norm in my city for private practice purely though but as I pointed out above there are all sorts of jobs in FM that can get you different salaries.

Obviously people should understand financial implications of whatever specialty they chose but there’s so much more to it than just money in my opinion. I personally love the flexibility of family medicine, that really fits my lifestyle. I have acquaintances that did specialized fellowships and then there were literally 4-5 jobs in the country open to them and they had to move, no thanks. I also personally wouldn’t want to be tied to a speciality that you have to rely on/work in a hospital exclusively (surgery, ER, anesthesia, etc).
 
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There are people in this thread that say they make 300k plus, so yes of course. That certainly isn’t the norm in my city for private practice purely though but as I pointed out above there are all sorts of jobs in FM that can get you different salaries.

Obviously people should understand financial implications of whatever specialty they chose but there’s so much more to it than just money in my opinion. I personally love the flexibility of family medicine, that really fits my lifestyle. I have acquaintances that did specialized fellowships and then there were literally 4-5 jobs in the country open to them and they had to move, no thanks. I also personally wouldn’t want to be tied to a speciality that you have to rely on/work in a hospital exclusively (surgery, ER, anesthesia, etc).
This can't be overstated. Sure, very very few of us will ever pull in ortho/neurosurgery/cardiology/GI money. But there is a lot to be said for basically infinite jobs. I live in SC. I can put a pin in literally any part of the state and find a job within 20 minutes drive. This is true of pretty much any state with the likely exception of the really big midwestern states. The lifestyle is also just fantastic. I work 8-5 with a 90 minute lunch break 4 days per week and 8-12 on Wednesday. No nights, no weekends, no holidays. As @Blue Dog always says, we are the ultimate lifestyle specialty.

And if money is a big deal, you can always work more. We have an FP group in town that does weekend call for inpatient rehab. It works out to one weekend/month per physician, that 1 weekend gets them last I heard $2500.

Do another weekend of urgent care moonlighting, should be 3k/month or so.

Or do like a previous poster and just cobble together a bunch of jobs that works out to 2 FTEs and really rake it in.
 
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There are people in this thread that say they make 300k plus, so yes of course. That certainly isn’t the norm in my city for private practice purely though but as I pointed out above there are all sorts of jobs in FM that can get you different salaries.

Obviously people should understand financial implications of whatever specialty they chose but there’s so much more to it than just money in my opinion. I personally love the flexibility of family medicine, that really fits my lifestyle. I have acquaintances that did specialized fellowships and then there were literally 4-5 jobs in the country open to them and they had to move, no thanks. I also personally wouldn’t want to be tied to a speciality that you have to rely on/work in a hospital exclusively (surgery, ER, anesthesia, etc).
That is true. You make good points.

Honestly, I haven't met an unhappy FM doc.
 
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I honestly like FM but I wouldn't pursue it if it paid less than 200K because I would have exorbitant student loans.

Is 300K a realistic figure for someone who wants to work for it?
Comes down to how many people are you willing to see in a day? RVU value is everything.
 
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This is my setup as well. Similar base salary, but bonuses for productivity, and for quality metrics.

I have been exceeding my base salary productivity benchmark by 100 wRVU/month or more for the past 12-14 months. I have a team of care coordinators who’s job is to get my patients on board with all the stuff my quality metrics are based on. So they practically earn my quality bonuses for me.

I don’t feel like I work too hard. I’m generally done charting and on my way home between 5 and 6 pm, and I take a 2hr lunch break every day. I do an occasional weekend of light hospitalist call, but that’ll change soon too. I feel like the work I put in is minimal compared to the income I get.

whats your monthly wRVU goal?
 
I aim to be in the high 600’s. My “hurdle” to clear $195k which is my base is upper 300’s, and out here, that is a piece of cake.
300K is a lot of money no matter what your perspective. Do any FM docs envy those who clear much more than that or would you take the 300K and lower stress levels and say that is a better deal overall?

The more I research FM, the more it sounds like the best gig in medicine. Am I wrong?
 
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300K is a lot of money no matter what your perspective. Do any FM docs envy those who clear much more than that or would you take the 300K and lower stress levels and say that is a better deal overall?

The more I research FM, the more it sounds like the best gig in medicine. Am I wrong?
Yes, >$300K/yr. puts you in the top 5% of wage earners in the US. Is more better...? That's up to you to decide.

IMO, there's more to life than work.*

*Caveat: Strictly applies to legal ****. If you wanna go rogue, I'm out.
 
Yes, >$300K/yr. puts you in the top 5% of wage earners in the US. Is more better...? That's up to you to decide.

IMO, there's more to life than work.*

*Caveat: Strictly applies to legal ****. If you wanna go rogue, I'm out.
I'm too nice of a guy. That's why I started this thread! I wanted to make sure that 300K was easily attainable without having to go rogue.

Another thing about FM is that I realized I don't want to work with people who are too sick or deal with death too much. I realized that I don't want to take that home with me.
 
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If you are not making 400k+/yr as a physician (except for peds), it's because you are lazy. Lol

For the record, I won't be making that much because I value my time off.
 
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Yes, >$300K/yr. puts you in the top 5% of wage earners in the US. Is more better...? That's up to you to decide.

IMO, there's more to life than work.*

*Caveat: Strictly applies to legal ****. If you wanna go rogue, I'm out.
More like top 3% I believe.
 
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Physicians are one of the most notorious groups for trying to count each others' money, and living way above their means. Never try to count other peoples' money!

The income is good at all levels, the problem arises when the primary care doc with $250k in student loans wants to send all 3 kids to private school, drive an $80k Benz and live in a $600k house like his/her radiologist colleague.... and wonders why the credit card bills get higher each month. Surely it means we're not getting paid like we should, right?

The trap is to want to live the "doctor life" the moment you graduate from residency with the first big income "guarantee" you have ever known. You come to find out how far it doesn't go when you have the student loan sharks circling for their pound of flesh every month.
 
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There are a lot of variables, but it's possible.
Oh I meant attending physicians who clearly make six figures but feel that they don't get paid enough.

My understanding on this issue is that doctors made lots of money in the 70's and 80's and then something happened with HMO's and now those same doctors don't make the same money and they are not happy so they tell others that their is no money in medicine anymore.
 
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Physicians are one of the most notorious groups for trying to count each others' money, and living way above their means. Never try to count other peoples' money!

The income is good at all levels, the problem arises when the primary care doc with $250k in student loans wants to send all 3 kids to private school, drive an $80k Benz and live in a $600k house like his/her radiologist colleague.... and wonders why the credit card bills get higher each month. Surely it means we're not getting paid like we should, right?

The trap is to want to live the "doctor life" the moment you graduate from residency with the first big income "guarantee" you have ever known. You come to find out how far it doesn't go when you have the student loan sharks circling for their pound of flesh every month.
Have less than 3 kids, live in a area with good public schools. Problem solved.
 
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In residency, I made the equivalent of $9.25 per hour
Residency is only three years and you have plenty more years to make real money.

Are those three years of residency really as tough as you make them out to be? I heard that you can even defer student loans in residency because it is still an educational training program.
 
You can, but the interest accrues in the meantime and it's no joke on a 6 figure principal.

All the dying cancer patients in the hospital have family docs too. I'm a current resident so take care of a mix of my own clinic panel plus random people in the hospital...I get even more sad when someone from my primary care panel gets seriously ill compared to a hospitalized patient with the same illness because I know my own patients and and their families so well. As a family doc you're also often one of the first people to catch life-threatening/life-changing diagnoses. It may not be as direct as coding someone in the ICU but it's still very, very difficult in a different way. Just food for thought.
What about the PSLF? My understanding is that it benefits lower-paying specialties more than it does the higher paying ones.

Regarding the very sick, I feel that it is a different feeling to "hand off" a patient to another doctor as opposed to dealing with a patient who dies under your care. I feel that FM is more preventative care than it is sick care. Is that about right?
 
I'm too nice of a guy. That's why I started this thread! I wanted to make sure that 300K was easily attainable without having to go rogue.

Another thing about FM is that I realized I don't want to work with people who are too sick or deal with death too much. I realized that I don't want to take that home with me.
I’ve been an attending for 3 years now. I see extremely sick and complicated patients that I get attached to. I’m also in rural medicine. One of my patients died a few days ago who was around my age and who I’ve been around in social settings as well. I’ve barely been able to sleep and I’m meeting with their mom Saturday am to give us all some closure. I enjoy my work and I make plenty of money and will be a partner soon with I’m sure it’s own set of headaches. I do work with midlevels and would greatly prefer more mds but it’s hard to find ones who want to live here. Our practice has midlevels who come to the mds with anything they need help with. They also want our practice to have more mds and are respectful of the differences in our degrees.
 
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This is a question I'm curious about in primary care. I'm currently a PGY2 FM resident and absolutely getting killed with the amount of work I'm having to do outside of work-hours. Every lab, imaging, specialist note, paperwork forms, med refills, etc., triages through our EMR systems gets routed to me to address it ideally within 24hrs. Not to mention finishing my progress notes which are impossible to complete when I'm seeing patients back-toback. It takes up a significant amount of time when I just wanna go home after a long day and relax and not take my work home with me.

I understand residency is different than being an attending, but how do you guys manage this in your practice?
I envy hospitalists because they don't have to take their work home with them.
 
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