Do we really make more salary than a primary care doc? Or is this just a myth?

[cool_vkb]

Someone said to me that Internists and FP's make in $220K-250K if they work fulltime. Hospitalists make even more. Thats pretty high for a non-procedural field comparable to our humble $120K average (lets just say we are taking average of 65k----200K range). I mean we pods have so many procedures and modalities to bill yet we cant gross over $120K-150K. :-(

heck even Pharmacists are being offered salary ranges in 100-120K in areas of shortage. Nurse anesthetists even make $120K-150k sometimes. Note : Iam referring pharms and nurse anesthetists because they dont do a residnecy or spend 7yrs like us. Its not a profession comparision. Its the number of years spent comparision.

Why are our reimbursements so low. I know medicine is like any other business and it depends on supply & demand. but still Pods consider themselves Foot & Ankle specialists and we make less than an average primary care doc. thats really disturbing.

Iam sure we have to be realistic and cant demand salary just because we graduated from a 36months program. and honestly my own observation in past few days is comparable to PADPM and Tracheadoc . I want to open my own practice or probably buy a running practice. so i always keep an eye on coding/fee schedules,etc. i saw the medicaid /blucross medical fee schedule for illinois and wisconsin. Not one phucking pod surgery is more than 1200-1500 dollars worth. everything is listed in 100-600 range.

if i were to struggle for 3yrs and that too after struggling and spending sleepless nights in school studying surgery and learning with passion all the kewl surgical techniques, screw insertion methods, plates, tenotomies,etc etc etc only to find out that the awesome procedure i just mastered after all this hardwork pays me only $160 or $300 . what motivation do i really have?

if i were to just make $100k-$120K. i might just do a 1yr or maximum 2yr residency and become an ordinary pod cutting toenails and writing orthotics.

I really pray and hope our seniors Krabmas and Jonwill and others are right and things have really changed. I trust them and my heart says they are right. This is indeed a big crisis. we should recognize this. its a matter of our life. During my shadowing i never found a pod struggling. so i enetered podiatry with my experiences and i personally feel we make good money. but all these recent posts our salary issues are really giving me sleepless nights. I dont want to let all my hardwork go in drain :-(

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[cool_vkb]

Wisconsin fee schedule

http://74.125.95.132/search?q=cache...ee+schedule+podiatry&cd=1&hl=en&ct=clnk&gl=us

 

[G0dFather]

god bless dis is great info

 

[Gryhu]

Couple points I'd like to talk about:

1) 220k-250k for FP and IM in a hospital? Sure, maybe thats doable. But as you said thats working full time (REALLY FULL TIME) and, most likely, being on call forever. I'd rather take my "humble" $120k and still have time to spend with my family and have a decent life.

2) Pods can't GROSS more than $150k? Sure maybe you can't gross that much in your first 2 or 3 years of practice but hopefully by year 4 and on you'll be doing much better. Dude, the pod I shadowed is grossing more than that and he's only in been practice on his own for about 6 years.

3) Wisconsin! Who wants to live in Wisconsin?


...but what do I know? I'm just a lowly prepod.

 

[215512]

I really pray and hope our seniors Krabmas and Jonwill and others are right and things have really changed. I trust them and my heart says they are right. This is indeed a big crisis. we should recognize this. its a matter of our life. During my shadowing i never found a pod struggling. so i enetered podiatry with my experiences and i personally feel we make good money. but all these recent posts our salary issues are really giving me sleepless nights. I dont want to let all my hardwork go in drain :-(

praying will do you no good as religion is merely an opiate for the downtrodden masses, anyways I think that if your heart says something is right-then it is-because there are more nerve endings in your gut and heart than in your brain, yeah I know some of you are saying "hey thetachi, i checked up on that and you are wrong" well thats because you arent thinking with your gut and listening to your heart!! Buck up everyone and things will be dandy.

sorry i couldn't resist...no emoticon needed

 

[cool_vkb]

Couple points I'd like to talk about:

1) 220k-250k for FP and IM in a hospital? Sure, maybe thats doable. But as you said thats working full time (REALLY FULL TIME) and, most likely, being on call forever. I'd rather take my "humble" $120k and still have time to spend with my family and have a decent life.

2) Pods can't GROSS more than $150k? Sure maybe you can't gross that much in your first 2 or 3 years of practice but hopefully by year 4 and on you'll be doing much better. Dude, the pod I shadowed is grossing more than that and he's only in been practice on his own for about 6 years.

3) Wisconsin! Who wants to live in Wisconsin?


...but what do I know? I'm just a lowly prepod.

.

what school you going to? we will have this discussion once you finish your first semester of school. believe me then it will really make sense.

 

[cool_vkb]

praying will do you no good as religion is merely an opiate for the downtrodden masses, anyways I think

Wow! Religion-downtrodden masses. do you even think before you type? As a god loving person i find your remarks very offensive and lame. Please refrain from preaching your bull**** ideology on SDN. its a podiatry forum and talk about podiatry instead of preaching people your personal opinions on non-podiatry related matters.

 

[hyperpodia]

Someone said to me that Internists and FP's make in $220K-250K if they work fulltime. Hospitalists make even more. Thats pretty high for a non-procedural field comparable to our humble $120K average (lets just say we are taking average of 65k----200K range). I mean we pods have so many procedures and modalities to bill yet we cant gross over $120K-150K. :-(

:-(

I am sure you have shadowed, several Pods. Pods are making more money today than back in the days. However, you have to know proper billing, cause the same procedure in pod can be several diff things. Now this is where exprience matters to make sure your are billing at the "right level"

 

[cool_vkb]

I am sure you have shadowed, several Pods. Pods are making more money today than back in the days. However, you have to know proper billing, cause the same procedure in pod can be several diff things. Now this is where exprience matters to make sure your are billing at the "right level"

yeah i agree with you on this issue. but iam disturbed because of our surgical reimbursements. they are so low. sometimes non-surgical or minor stuff end up being more profitable than doing a complex surgery. And this shudnt be the case. we are gonna spend 3yrs in a surgical residnecy program. i want to get a good reimbursement for my surgical services.

 

[Darklord]

Cool_Vkb

Salaries don't really make sense to me either... and it is giving me a headache.

I mean 0-6 year pharmacy program - 100-120k (but little private practice potential) Note that some pharmacy schools require an undergraduate degree, plus you can do up to 2 years of residency. So it really can be 10 years long! But residency doesn't really give you more pay in return in pharmacy.... You just get to do more interesting stuff.

11 year podiatric surgery - the online online salaries are about 100,00-180,000 (large private practice potential)

4 Years PA + Prerequisites: 80-120k. (Hospitalist PA WOOT, collaborative practice potential).

Salaries are not everything, but we cannot deny that they play a huge role.

Unfortunately, the PA has the largest scope of practice and salary for the profession's education. Check the PA forums, hospitalist PAs are functioning with huge autonomy.

ARRGH

 

[PADPM]

What you want and what you get are two different animals! For example, the last time I performed a subtalar arthrodesis, I received a WHOPPING $348 from the insurance company for the surgery and 90 day global fee (surgical follow up).

I saw the patient's cousin in my office and performed bilateral P&A's (permanent nail avulsions) on one border of each hallux. I billed $300 per toe, and ended up receiving a total of $450 for about 10 minutes worth of work, with one post op visit.

YOU do the math. $450 for 10 minutes worth of nail surgery in the office vs. $348 for a subtalar arthodesis in the hospital OR and 90 days of post op follow up at no charge.

If you never performed a day of hosptial surgery, and performed "palliative" care, treated plantar fasciitis, performed nail surgery, dispensed orthoses, etc., you can make a VERY comfortable living.

Surgery is not for the $$$, it's for patients that require the procedures and it's for our ego. The only time surgery pays, is when you do a lot of cases and have ancillary help for paper work, etc., to expedite the process.

 

[cool_vkb]

Cool_Vkb


4 Years PA + Prerequisites: 80-120k. (Hospitalist PA WOOT, collaborative practice potential).

ARRGH

My friend PA is not even 4yrs. Its just a 2yr degree.

 

[cool_vkb]

What you want and what you get are two different animals! For example, the last time I performed a subtalar arthrodesis, I received a WHOPPING $348 from the insurance company for the surgery and 90 day global fee (surgical follow up).

I saw the patient's cousin in my office and performed bilateral P&A's (permanent nail avulsions) on one border of each hallux. I billed $300 per toe, and ended up receiving a total of $450 for about 10 minutes worth of work, with one post op visit.

YOU do the math. $450 for 10 minutes worth of nail surgery in the office vs. $348 for a subtalar arthodesis in the hospital OR and 90 days of post op follow up at no charge.

If you never performed a day of hosptial surgery, and performed "palliative" care, treated plantar fasciitis, performed nail surgery, dispensed orthoses, etc., you can make a VERY comfortable living.

Surgery is not for the $$$, it's for patients that require the procedures and it's for our ego. The only time surgery pays, is when you do a lot of cases and have ancillary help for paper work, etc., to expedite the process.

Sir, is there something we can do about this situation. I mean why are our reimbursements so low? there must be some reasoning.

 

[Darklord]

My bad. The degree is two years, plus two years of pre-reqs for a total of four years.

There job makes me jealous. I guess, I really like internal medicine (I can't believe I just said that.)

 

[Gryhu]

.

what school you going to? we will have this discussion once you finish your first semester of school. believe me then it will really make sense.

I'll be applying in Sept. I'll let you know

 

[Darklord]

Why are surgical insurance reimbursements low..... this is what we would like to know.

 

[PADPM]

Surgical reimbursements all depend on the particular insurance carrier, and it varies from carrier to carrier. Once in a while you can hit gold and get a good carrier to actually pay well.

First, don't feel as if we (DPM's) are being discriminated against. In most if not all states, we are paid the same exact amount for surgical procedure XYZ as any other doctor that performs that procedure. There are NOT different pay scales for different degrees.

Insurance companies determine reimbursements based on a system based on values (RBRVS) resource based relative value scale, which takes into consideration the the skill involved, time, overhead, malpractice, etc., etc. Since surgery is not performed in your office, there is no overhead involved, etc. There is some crazy formula involved and some actuary with white socks and black socks, along with the insurance companies, the AMA, and the rest of the crew developed this system.

So, this is how reimbursements are ultimately determined. And when you look through the code book, many make absolutely NO sense at all.

One SIMPLE example. If you have a diabetic patient in the office, and bill for cutting 10 mycotic nails, you receive LESS money than if that diabetic patient had ONE mycotic toenail and 9 "normal" nails.

To bill for 10 mycotic nails you would bill the code 11721 (debridement of mycotic nails greater than 5)

To bill for 1 mycotic toenail you would bill the code 11720 (debridement of mycotic nails less than 5)

You are also allowed to bill along with the 11720, the code 11719, (routine palliative care) for the trimming of the remaining nails. (You can't bill the 11719 with the 11721 if a patient only has 6 mycotic nails. Anything over 5 can only be billed as 11721).

Therefore, if you bill the 11720 and the 11719, which is COMPLETEY "kosher" and is how this is supposed to be billed to Medicare for a diabetic patient that qualifies, and has one mycotic nail and 9 "normal" nails, you would receive greater payment than a diabetic patient that has 10 mycotic nails (11721).

And naturally, it is more work to debride 10 mycotic nails than 1!!!

This was just one simple everyday non surgical example of the lunacy.

 

[G0dFather]

I see what occurs here ... isn't there a review board or a feedback system in place to make corrections to the insurance system in general?

 

[NatCh]

I've seen FP's make up to $280K (yes, I've seen the financials with my own eyes).

Contrary to what you may have been led to believe, FP can be a procedural field if they wish. Off the top of my head here are several procedures they can do:

Sigmoidoscopy
Colposcopy
IUD insertion/removal
Paps
Skin biopsies
Endometrial biopsy
Vasectomy
Injections
Nail avulsion
Nail matricetomy
Plantar wart excision
Immunizations
Hemorrhoidectomy

Some "country docs" might still do:
OB/GYN
Appendectomy
Cholecystectomy

They can also assist in General Surgery

They can bill Level 4 Office Visits ($300-$400 I think. I'm not certain since I've never been able to bill it)

From what I've seen first-hand they are highly capable and deserve a lot more credit than many Pod students give them credit for. "Would you want your patient being treated by an FP???" Yes. Absolutely. When your foot surgery patient gets sick post-op, I bet you will be on the phone asking the FP for help with medical management.

They also work too hard. Harder than we but less than a general surgeon or OB/GYN.

Cool VKB, I know you are voicing concerns over our reimbursement rather than complaining about theirs. I didn't read your post as anti-PCP (or anti- any other profession you listed), but somebody might.

As you guys have read and heard before, a lot of DPM's eventually do the less complicated procedures by choice, to make the money without long O.R. times, protracted recoveries, and 90-day global periods. Maybe it' due to financial reasons or maybe it's because we're just too old and tired, but even if you only do half a dozen classic "bread-and-butter" pod procedures you can make a lot of money. I believe PADPM said the same thing above.

I think it all comes back to this: our work is varied and interesting, is emotionally satisfying, and pays the bills very well. Plus, we can have a great quality of life compared to many other medical professions.*

*Except for dentists. They have all the money, the best cars, the hottest spouses, and the best schedule.

Hermie grew up, hooked up with Suzie:

 

[PADPM]

NatCh is 100% correct. Family docs/GPs can perform many procedures in their offices that we often forget about as he has mentioned. And please don't forget that in addition to the procedures mentioned, they also perform ECG's in the office on patients all day long, which also pays well.

Additionally, many of these docs see a LOT of patients daily, because some patients are coming in for quick "renewal"/maintenance visits for blood pressure checks, etc., and are in and out of the office in literally minutes.

So in addition to the procedures, it's also high volume that increases their numbers.

 

[215512]

Wow! Religion-downtrodden masses. do you even think before you type? As a god loving person i find your remarks very offensive and lame. Please refrain from preaching your bull**** ideology on SDN. its a podiatry forum and talk about podiatry instead of preaching people your personal opinions on non-podiatry related matters.

and I dont care that you find my remarks offensive, it was a comment on another persons comment about their religion...theres nothing wrong with loving god good for you i think religion is great if used for the right reasons and gives hope for those that require it, you telling me that my remarks are offensive is you putting your ideology on me and telling me that I am wrong just like you told me the same-anyways carry on with the regular discussion as you are right sdn is no place for religion beliefs, comments, preachings, or opinions.

 

[215512]

and I dont care that you find my remarks offensive, it was a comment on another persons comment about their religion...theres nothing wrong with loving god good for you i think religion is great if used for the right reasons and gives hope for those that require it, you telling me that my remarks are offensive is you putting your ideology on me and telling me that I am wrong just like you told me the same-anyways carry on with the regular discussion as you are right sdn is no place for religion beliefs, comments, preachings, or opinions.

and by the way my initial comment about religion was sarcasm, guess you didn't catch that and you blew up so sorry to cause you such grief! hope you have a great day.

 

[Darklord]

True FP training is very versatile. I once read about a FP doc that just did some hernia procedure all day (I forgot what it was called). Something to think about if I get into medical school.

Then again PA training is like FP.

Did you know PAs even have Cardiothoracic Surgery residency? http://www.appap.org/prog_specialty.html One year long, you get bored, you can easily switch over. Then again you don't need to go back to school to practice hospitalist or outpatient medicine.

The more I research about different health professions, the more I get blown away.

We are fortunate to work in such a great field.

Cheers and best of luck to all in your future decisions!

 

[NatCh]

1) 220k-250k for FP and IM in a hospital? Sure, maybe thats doable. But as you said thats working full time (REALLY FULL TIME) and, most likely, being on call forever. I'd rather take my "humble" $120k and still have time to spend with my family and have a decent life.

Me too. Being on-call BLOWS. A joke we have here is "I'm on-call this weekend -- oh wait...it's Podiatry."

2) Pods can't GROSS more than $150k? Sure maybe you can't gross that much in your first 2 or 3 years of practice but hopefully by year 4 and on you'll be doing much better. Dude, the pod I shadowed is grossing more than that and he's only in been practice on his own for about 6 years.

If "gross" means "money collected before expenses, before taxes" then I think you'd have to try hard to only gross $150K. Part-timers and newbies excepted.

3) Wisconsin! Who wants to live in Wisconsin?

Apparently FIB's (something-Illinois-somethings) do. At least that's what my Wisconsinite in laws tell me.

 

[NatCh]

Then again PA training is like FP.

Except for it's half the schooling and none of the Residency. Two years versus seven years. FP's are more highly-trained, make no mistake.

 

[Podmeister]

In CA, more FPs are getting into laser hair removal and facial rejuvenation. All cash of course.

 

[cool_vkb]

and I dont care that you find my remarks offensive, it was a comment on another persons comment about their religion...theres nothing wrong with loving god good for you i think religion is great if used for the right reasons and gives hope for those that require it, you telling me that my remarks are offensive is you putting your ideology on me and telling me that I am wrong just like you told me the same-anyways carry on with the regular discussion as you are right sdn is no place for religion beliefs, comments, preachings, or opinions.

Oh thank you kind sir.

 

[cool_vkb]

and by the way my initial comment about religion was sarcasm, guess you didn't catch that and you blew up so sorry to cause you such grief! hope you have a great day.

Sarcasm my *****. we are discussing a podiatry related topic. I dont even understand whe the phuck do you even contribute to a post in which you have nothing positive or constructive related to the topic being discussed. Please limit your posts to podiatry related issues. we have already lost 100s of threads thanks to people who divert the thread by posting useless comments.

 

[NatCh]

There job makes me jealous. I guess, I really like internal medicine (I can't believe I just said that.)

LOL, how did I have you pegged as an Internist-type?

Edit: I didn't mean in a bad way. I meant intense and driven, maybe anal. I didn't mean anal in a bad way either; I just couldn't think of the proper term for it.

 

[iceman69]

Natch,

For some reason I truly do not believe that the picture you paint for FP's is this rosy. You must be in a real a small town if the FP's there are scoping the pooper out. These days just about every hospital will require a GI fellowship or general surgery residency to get privileges to run the bowel. A friend of mine is a GI doc and he's in a small town (<50K) and FP's there do not run the bowel so I don't know where you are getting this info from. These days FP's will not be performing Lap Chole's, Appy's or any other invasive procedure beyond a vasectomy in some cases. FP's grossing over 200K per anum are like podiatrists netting over 500K/y rare. There is a reason why people with high board scores do not do FP or IM typically...money...hours...

 

[215512]

Sarcasm my *****. we are discussing a podiatry related topic. I dont even understand whe the phuck do you even contribute to a post in which you have nothing positive or constructive related to the topic being discussed. Please limit your posts to podiatry related issues. we have already lost 100s of threads thanks to people who divert the thread by posting useless comments.

you writing that comment in response to mine was, in and of itself, neither positive nor constructive-btw-and also nice disguise of the F-word. Ugh there is no need for this uselessness everyone please disregard cool-vkb's and mine squabble haha

 

[Gryhu]

Apparently FIB's (something-Illinois-somethings) do. At least that's what my Wisconsinite in laws tell me.

Haha. I had to look up what FIB stood for.

 

[NatCh]

Natch,

For some reason I truly do not believe that the picture you paint for FP's is this rosy. You must be in a real a small town if the FP's there are scoping the pooper out. These days just about every hospital will require a GI fellowship or general surgery residency to get privileges to run the bowel. A friend of mine is a GI doc and he's in a small town (<50K) and FP's there do not run the bowel so I don't know where you are getting this info from. These days FP's will not be performing Lap Chole's, Appy's or any other invasive procedure beyond a vasectomy in some cases. FP's grossing over 200K per anum are like podiatrists netting over 500K/y rare. There is a reason why people with high board scores do not do FP or IM typically...money...hours...

Well, not that I feel I need to convince you, but this info is based on the info I've gained being married to my wife, who is an FP in a huge multispecialty group. If FP's grossing >$200K is rare, then they're all in my wife's practice. She grossed $500K last year.



Punk.


Edit: Who said it was rosy? I said they work too hard. I wouldn't want that job.

More edit: Alright, I just asked my wife about it. She said there a re a couple of FP's in her group who do the flexible sigmoidoscopies but most send them to GI for colonoscopies since that procedure has better diagnostic value. However, last year they added an FP to the staff who moved in from Burns, OR (pop. 3000), which is halfway between here and Boise (i.e., middle of nowhere). He still does colonoscopies at the surgery center and was doing appendectomies until he moved here.

You darned kids...

 

[iceman69]

I am a bit of a punk from time to time, however, I simply had to voice some reality when it comes to being granted institutional privilleges for procedures. You learn about these things when you grow up surrounded by medicine...It seems you're wife has found a very lucrative place to practice. I'm from a big city and I will tell you what my FP told me about big city medicine. "If you want to make money you will want to be a sub-specialist in a procedural field, i.e. ENT, Urology, Ortho, NeuroSx, GI, IR, etc." He told me that most multispecialty practices the only guys making over 200K pre-tax are partners or proceduarlists who are high volume.

 

[NatCh]

I am a bit of a punk from time to time, however, I simply had to voice some reality when it comes to being granted institutional privilleges for procedures. You learn about these things when you grow up surrounded by medicine...It seems you're wife has found a very lucrative place to practice. I'm from a big city and I will tell you what my FP told me about big city medicine. "If you want to make money you will want to be a sub-specialist in a procedural field, i.e. ENT, Urology, Ortho, NeuroSx, GI, IR, etc." He told me that most multispecialty practices the only guys making over 200K pre-tax are partners or proceduarlists who are high volume.

Just to make sure you understand, I'm calling you names only in jest. No harm intended.

The FP with whom you spoke was correct in saying that the procedural subspecialists do make a lot of money. Every one of those specialties that you listed above to make an awful lot of money, much higher than what Podiatry or FP makes. I have a brother-in-law who is an orthopedic surgeon and another brother in law who is an ophthalmologist and both make well above the average income that you see printed in surveys.

As I explained in an above post, FPs can do a lot of procedures and also have high-volume. The FPs who are partners at my wife's group do well because they work very hard and do a lot of procedures. The FPs who are employees make considerably less money. Same goes with podiatry; if you are on the payroll you will make less than if you are an owner. Otherwise, there would be no incentive to Partner.

 

[Darklord]

Just make sure you like the field before you go into it, money isn't everything (though it plays a part).

Heck, there are veterinarians out there who gross more than Pods or FPs also.

NatCh, no offence taken (I actually took at as a complement).

Yes, from my experience FPs can perform various procedures.

and I'm getting sick of waiting for admissions results.... that's why I'm checking the forum daily and researching other careers (for backup plans).

Arrggh.

 

[NatCh]

Just make sure you like the field before you go into it, money isn't everything (though it plays a part).

Yep.

Regardless of which medical field you go into, you will still probably be in the top 10% income of all Americans, in a relatively stable profession that is fairly insulated from economic crises.

 

[Black Surgeon]

FP's grossing over 200K per anum are like podiatrists netting over 500K/y rare. There is a reason why people with high board scores do not do FP or IM typically...money...hours...

You are wrong in assuming that MSs with high boards do not go into FM and IM, not everyone wants to get into a ROAD program and the only alternative to those is surgery or a surgical subspecialty which mandate sacrificing family time for work. Lifestyle is listed as one of the major factors students take into consideration when deciding on a specialty. Don't get me wrong, FM and IM specialties still keep physicians pretty busy but in comparison to different surgical specialties, they aren't as torturous.

Really? you think an FP grossing over 200K is rare? You would be hard pressed to find an FP netting below 180K. An FP netting 200K or an FP w/OB netting 250K is the norm and not the exception.

I am a bit of a punk from time to time, however, I simply had to voice some reality when it comes to being granted institutional privilleges for procedures. You learn about these things when you grow up surrounded by medicine...It seems you're wife has found a very lucrative place to practice. I'm from a big city and I will tell you what my FP told me about big city medicine. "If you want to make money you will want to be a sub-specialist in a procedural field, i.e. ENT, Urology, Ortho, NeuroSx, GI, IR, etc." He told me that most multispecialty practices the only guys making over 200K pre-tax are partners or proceduarlists who are high volume.

Like Natch stated, these guys are bringng home salaries way over 200k. In fact, most of these guys easily start at 350K which is still at the low end for Ortho, NeuroSx and IR. However, the exception arises for academic physicians. Those in academia take a pay cut for zebras, the love of teaching and the prestige of being world renowned.

 

[dtrack22]

Speaking of specialties, this goes back to a post PAPDM made awhile ago...my roommate had to go visit the same orthopedic group as I did for a knee injury of his own (darn athletes). I saw the bill yesterday (thank God our school's athletic insurance picks up the tab) and there was a facilities code on the bill. It was just north of $2000 for that one code. All he had done was an x-ray (in-office) and a consult immediately afterwards...it's all digital so the film pops right up on the computer in the exam room, pretty cool actually. I wish I could remember the ref # but I can't. Anyways, not only is ownership important but it sounds like owning your own equipment (if you have the patient volume) can be a very worthwhile investment as well.


Edit: I found out that the group of ortho's who own the building have an imaging center in there as well with MRI and CT capabilities. The MRI was done on site as well as the x-ray and the MRI was the reason for the big charge on the bill. Still doesn't change the point that owning your own facilities/equipment (or owning the space and leasing it out so that you can bill the usage code) is a good idea.

 

[uberconfuzzled]

Natch,
FP's grossing over 200K per anum are like podiatrists netting over 500K/y rare.

I think that really all depends on location, location, location. I live in a town where there is LITERALLY an MD practice on every block--i kid you not. If you chose to be to FP or IM here, you probably would not net more than 110K. And if you're a new doc, even less. But that's only one town out of many, many, many other towns. It may very well be possible for FP's/IM to make more than 200K, as others have already attested to. LOCATION!!

 

[iceman69]

I think that really all depends on location, location, location. I live in a town where there is LITERALLY an MD practice on every block--i kid you not. If you chose to be to FP or IM here, you probably would not net more than 110K. And if you're a new doc, even less. But that's only one town out of many, many, many other towns. It may very well be possible for FP's/IM to make more than 200K, as others have already attested to. LOCATION!!

You hit the nail on the head.

 

[NatCh]

I think that really all depends on location, location, location. I live in a town where there is LITERALLY an MD practice on every block--i kid you not. If you chose to be to FP or IM here, you probably would not net more than 110K. And if you're a new doc, even less. But that's only one town out of many, many, many other towns. It may very well be possible for FP's/IM to make more than 200K, as others have already attested to. LOCATION!!

Location is of high importance, absolutely, but unless you see the financial reports of those doctors in your town you really can't know if they're netting $110,000 per year or not. That $110,000 figure that you stated was just a guess, was it not? Or was it based on any actual financial evaluation?

You can't evaluate the financial well-being of a practice by simply looking at the ratio of population to providers, or by simply looking at the total number of patients that come through the doors. You have to look at money in versus money out.

 

[Darklord]

I highly doubt the 110,000. I live in a town where there are Dentists on every block , and it's not like any of their practices are shutting down. Damn, my dentist just bought a 1,000,000 house (I know, my dad is into real estate), which means he has to NET at LEAST $300,000 (basic house affordability calculation, you must make 1/3 of the price of your house a year). He also just leased brand new office space, and damn his clinic looks like hip: you go to an I-Mac to sign in lol, and there is new age furniture.

If the market is saturated, people move out if they can't find jobs. In some fields (pharmacy, for example) salaries are the same everywhere because insurance companies are national and so are Walmart and Walgreens. Location plays a significant role, but it is not everything. Who in the world would go to school for 11 years and WILLINGLY STAY in an area where they make 100,000.

Then again this totally defys concept of a mid-level practitioner making money for the practice, because the mid-level makes as much as the doctor with 1/4 of the schooling. Thus, it is terribly wrong. I say FPs make at least 200,000-250,000, and I am in agreement Black Surgeon.

 

[Podmeister]

Well, not that I feel I need to convince you, but this info is based on the info I've gained being married to my wife, who is an FP in a huge multispecialty group. If FP's grossing >$200K is rare, then they're all in my wife's practice. She grossed $500K last year.

No wonder why you're working only 3 days a week.

Sweet deal and congrats.

 

[uberconfuzzled]

Location is of high importance, absolutely, but unless you see the financial reports of those doctors in your town you really can't know if they're netting $110,000 per year or not. That $110,000 figure that you stated was just a guess, was it not? Or was it based on any actual financial evaluation?

You can't evaluate the financial well-being of a practice by simply looking at the ratio of population to providers, or by simply looking at the total number of patients that come through the doors. You have to look at money in versus money out.

I completely understand. I got that figure from a close cousin of mine who works on one of those blocks. She is in IM and it was her who suggested that i not go into FP or IM, especially if I wanted to end up practicing around there. Her husband, an FP, is also having a hard time in term of pay cuts. I don't know the details and I tried my best not to generalize, but I failed . SOrry!

 

[NatCh]

No wonder why you're working only 3 days a week.

Sweet deal and congrats.

Har! Gravy train.

 

[215512]

I highly doubt the 110,000. I live in a town where there are Dentists on every block , and it's not like any of their practices are shutting down. Damn, my dentist just bought a 1,000,000 house (I know, my dad is into real estate), which means he has to NET at LEAST $300,000

1/3 is "AT LEAST" 333,333.33 just to be clear

Also I have to say that you can make much less than this to buy MORE than a million dollar house I think you meant a million dollar LOAN as you have to pay 20% down for homes I believe as a GENERAL rule. But I mean say you save up 350 grand then you can get much more than a million dollar house maybe 1.2ish even if you NET like 220ish

 

[PADPM]

Guys,

This conversation has SO many factors involved that it's almost "moot". Because it really depends on where you practice, how you practice, etc.

For example, in some geographic areas you can bill for certain procedures and make $$$ and in some areas you can't, therefore your income is automatically limited. In some areas there are large amounts of capitation which means at the end of the day, no matter how many "procedures" you perform, your bill out at the end of the day is the same, since it's "built in" to the contract. In some areas malpractice can be triple it is in other areas. Therefore, these factors all add up to your bottom line.

Our group has offices in Pennsylvania/Philadelphia region and New Jersey. Malpractice premiums in the Philly region are 2.5 higher than NJ. In the Philly region, a majority of the insurance carriers are "capitated", therefore we rarely get paid for surgery, x-rays or any procedure, whereas in NJ we basically get paid relatively well for everything we do. In the Philadelphia region, most insurance company contracts will not allow our office to dispense DME equipment, "diabetic therapeutic shoes", orthoses, etc., but we must send that out to "approved" suppliers. In our NJ offices we can provide ALL those services, therefore get reimbursed for those services.

As a result, naturally we see a much larger income per patient/per doctor in NJ. So the potential for each doctor's income is much greater in NJ. Each doctor can earn a greater income by seeing fewer patients due to the reimbursements, lower overhead, lower malpractice, etc.

So, these factors all play a significant role in your bottom line. It's not as simple as how good you are, how much you smile, how great a residency you completed, how fancy your office is or whether or not you're the only game in town. It's also based on the factors above, because those factors will also impact your income, so do your homework and choose your location wisely.....it DOES make a difference.

 

[cool_vkb]

Guys,

This conversation has SO many factors involved that it's almost "moot". Because it really depends on where you practice, how you practice, etc.

For example, in some geographic areas you can bill for certain procedures and make $$$ and in some areas you can't, therefore your income is automatically limited. In some areas there are large amounts of capitation which means at the end of the day, no matter how many "procedures" you perform, your bill out at the end of the day is the same, since it's "built in" to the contract. In some areas malpractice can be triple it is in other areas. Therefore, these factors all add up to your bottom line.

Our group has offices in Pennsylvania/Philadelphia region and New Jersey. Malpractice premiums in the Philly region are 2.5 higher than NJ. In the Philly region, a majority of the insurance carriers are "capitated", therefore we rarely get paid for surgery, x-rays or any procedure, whereas in NJ we basically get paid relatively well for everything we do. In the Philadelphia region, most insurance company contracts will not allow our office to dispense DME equipment, "diabetic therapeutic shoes", orthoses, etc., but we must send that out to "approved" suppliers. In our NJ offices we can provide ALL those services, therefore get reimbursed for those services.

As a result, naturally we see a much larger income per patient/per doctor in NJ. So the potential for each doctor's income is much greater in NJ. Each doctor can earn a greater income by seeing fewer patients due to the reimbursements, lower overhead, lower malpractice, etc.

So, these factors all play a significant role in your bottom line. It's not as simple as how good you are, how much you smile, how great a residency you completed, how fancy your office is or whether or not you're the only game in town. It's also based on the factors above, because those factors will also impact your income, so do your homework and choose your location wisely.....it DOES make a difference.

Iam wondering if PA has high malpractice and low rates then why do DPMs stay in PA? Cant they move to better locations.

ofcourse those who have family is one thing, but if they knw that nearby state pays well. why not move there?

 

[Darklord]

So in simple terms:

how much money you make in private practice depends on a variety of factors including: overhead expenses (salaries for workers, office space-real estate, overall price related to the area). mal-practice, insurance companies in the particular area, state laws, other pods, ect.

Most of these factors can be variable from area to area, thus geography and location are important.

One question: what about hospital podiatrists? like you are salaried and work for the hospital, like the VA? Do private, regional hospitals hire? If so what determines the salary or contract? Is it similar to the above factors?

Just trying to figure out how practicing medicine works in general...

Please correct me if I am wrong in any way.