EP Expenses

Discussion in 'Emergency Medicine' started by docB, Jun 11, 2007.

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  1. docB

    docB Chronically painful Moderator Emeritus Lifetime Donor 10+ Year Member

    As I was giving yet more money to the government today (I renewed my DEA) I thought it might be valuable to give everyone an idea of what sort of expenses you’ll face every year as an EP. Here goes:

    •License $600 every 2 years. (I have 2 so double that)
    •DEA ~$550 every 3 years.
    •State pharmacy license $50/yr. Many states don’t have these. If your’s doesn’t you get a pass.
    •ATLS $300 every 4 years. That’s the refresher. If you go over your 6 month grace period it’s a whole weekend and $600 for the whole course.
    •ACLS varies but I have partners who have paid $200 to do an online version and avoid the class.
    •PALS varies, see above.
    •ACEP $550 / year.
    •Hospital privileging $50 - $500 per hospital per year. Many groups pay this. Some don’t.
    •CME varies. It’s easy to get free CME but some states require specific things like ethics and bioterrorism. You often get stuck paying for these. $25- $200 per class.
    •LLSA $100/yr for the test.
    •LLSA $80-$300/yr for the study materials. Most people I know (including me) do one that costs $225.
    •ConCert exam $1625 every 10 years.

    --I know that ACEP is not mandatory but I think everyone should belong to at least one of the professional orginizations.

    --I know that ACEP and AAEM have policies about BC EPs not needing the merit badges but many EPs are in my situation where a group or hospital as said “We don’t care. Do it.”
     
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  3. EMFreakz

    EMFreakz New Member 10+ Year Member

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    What LLSA review thing do you use? Do you do one that you take the exam together?
     
  4. spyderdoc

    spyderdoc Moderator Emeritus Lifetime Donor 10+ Year Member

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    My ACEP was $790....I think this is the max since they increase it each year for the first few years you are out of residency....

    AAEM is in the mid $400s.

    My group requires us to be with Santa Clara Medical Assoc, and they require CMA membership, about $1000 for both.

    I belong to AMA, about $450/yr, but it pays for itself with the discounts it gives for the disability and life insurance that I have with them (saves me more than the cost of the dues).

    As a DO in CA, I have to do an AOA conference once during each 3 year cycle to get my AOA cat IA credits, about $600 per 3 year cycle (plus travel/lodging costs).

    I pay my own malpractice, about $1500/quarterly (goes up to about $3500ish over a 5 year span).

    My hospital does not require ACLS/PALS for the ER docs, but I do them for the AOA cat I CME, $175 for each every 2 years via online course.

    $400 every 2 years for Critical Decisions (60 CMEs/yr).

    Plus the usual license, LLSA, DEA fees, a many more that I can't think of off the top of my head.

    It ain't cheap to be a doc, that's for sure. Everyone seems to want a piece of the pie...
     
  5. EctopicFetus

    EctopicFetus Keeping it funky enough 10+ Year Member

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    Quick question.. Doesnt your group pay for this? I would assume they do. Lastly 3500 / qtr for insurance seems cheap!
     
  6. DrQuinn

    DrQuinn My name is Neo Moderator Emeritus 10+ Year Member

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    I do have all the same fees, but my group pays for them.

    One could say that those fees could come out of my salary, since it comes out of the group....

    but regardless, I get a check after I submit my payments.

    Q
     
  7. spyderdoc

    spyderdoc Moderator Emeritus Lifetime Donor 10+ Year Member

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    I think that no matter where you work, you are really paying for your own malpractice and other expenses. Like Quinn said, you are paying for it with less of a salary, and it comes out of your group's expenses. I work in a FFS group, and I get paid 100% of my collections minus a few expenses, such as group overhead fees, billing company fees, and malpractice. There is no middle man siphoning off the top.

    Med mal is relatively cheap in CA thanks to malpractice reform (MICRA). I don't really "write the check" each quarter, but it is taken out of my paycheck since the group has a policy, which is also nice since we get a little bit of a group discount.
     
  8. docB

    docB Chronically painful Moderator Emeritus Lifetime Donor 10+ Year Member

    Every group is different. Some groups pay all of this stuff (and as was astutely pointed out by others, it's your money so if your group is paying it you're paying it), some let the docs do it. To your bottom line it probably doesn't make much difference.
     
  9. docB

    docB Chronically painful Moderator Emeritus Lifetime Donor 10+ Year Member

    Sorry for the necrobump but I just renewed my DEA for $731. That's up from $550 back in '07 (which is what I was curious enough about to search up this old thread). Now $731 isn't that bad for a 3 year cert especially compared to medical licenses. Both of my licenses are $800 every 2 years. I also have to pay for a pharm card. So I do feel like I'm paying my "fair share."
     
  10. dotcb

    dotcb --------- 10+ Year Member

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    Even so, you pay these off in less than 1 shift of work, so what's the big deal?
     
  11. Pons Asinorum

    Pons Asinorum Moderator Emeritus 7+ Year Member

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    Thanks for bumping this actually, I've been curious about how the financial headaches shake out for EP's for a bit. One quick question, probably more specific to the license fees, but are those fees, and their periodicity, a state-by-state variable? Or will some states have 10 year renewals for licenses, etc? Thanks for the input.
     
  12. gutonc

    gutonc No Meat, No Treat SDN Administrator 10+ Year Member

    I don't know of any state that will license you that long. And if they did, you can bet it would cost ~$3-5K to do so. Most states that I'm familiar with (an admittedly small sample of 20% of them) license for 2 years at a time.
     
  13. alphaholic06

    alphaholic06 Doctor, Who? Me? 10+ Year Member

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    How much of this is tax deductible?
     
  14. alphaholic06

    alphaholic06 Doctor, Who? Me? 10+ Year Member

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    How many people are able to use the AAEM expert resuscitation card in lieu of ACLS, PALS and ATLS?
     
  15. Pons Asinorum

    Pons Asinorum Moderator Emeritus 7+ Year Member

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    Perfect, thanks gut.
     
  16. docB

    docB Chronically painful Moderator Emeritus Lifetime Donor 10+ Year Member

    Sure. One shift for these expenses. One shift for the board certification stuff plus the time spent. 2 or 3 shifts a month for malpractice. It all adds up. Throw in EMTALA mandated care to get really depressing.

    The big deal is this: students and residents should know about this stuff before they budget wrong and the idea that people in our income bracket don't pay our fair share does not take into account a lot of expenses.

    It depends on how your finances are set up. If you are W2 it's hard to deduct it. If you are incorporated all of it should be deductible.
     
  17. docB

    docB Chronically painful Moderator Emeritus Lifetime Donor 10+ Year Member

    I've never heard of this. Do tell.
     
  18. dotcb

    dotcb --------- 10+ Year Member

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    But virtually every field has an analogous set of expenses - the price of doing business.



     
  19. Birdstrike

    Birdstrike 5+ Year Member

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    By this logic, it's okay for your car dealership to charge you twice what they charge everyone else, and rip you off because "you can afford it." It's the same tired old "doctors are greedy and rich" mentality.

    The logic works perfectly until it's the guy that earn less than you, saying you should get soaked because you make more than him.

    :yawn:
     
  20. Dr.McNinja

    Dr.McNinja Nobel War Prize Winner SDN Moderator 10+ Year Member

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    You don't need an AAEM card. You just need to get on whatever committee (usually something like medical executive committee) and make it where only non-BC EPs have to get the merit badges.
    ACS doesn't recommend ATLS but once for EPs. There isn't any legitimate reason for us to have to take the same classes nurses do, when the flowchart goes to "consult expert" and you're the expert. It's ridiculous.
    It's all tax deductible for IC, but all that means is that you only pay 70% of it or so instead of 100%. I don't consider that a "win".
     
  21. Tiger26

    Tiger26 Senior Member 10+ Year Member

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    Agree with McNinja.

    At the end of the ACLS algorithm is "seek expert consultation"--we are the expert consultation

    Edit: (didn't read McNinja's post fully until afterward when he talked about expert consultation)
     
  22. la gringa

    la gringa Senior Member 10+ Year Member

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    do ya'll really pay for LLSA study materials??? i haven't paid a dime above the cost of the exams. the articles are free... the tests are easy peasy.

    as far as ACLS/PALS - my main hospital system doesn't require them for EP's, but is an EM strong area (top notch EM residency in the hospital system). i am looking to moonlight so i have kept them up for that purpose only - don't want to get stuck having to actually do the courses. i do the online stuff, takes an hour each max, and about $200 each.

    FWIW, my group has a rather generous "business account", which covers all of the above. i know it's the same "money", but it feels better not having to actually pay the $$ myself out of my own account, and do tax deductions etc.
     
  23. alphaholic06

    alphaholic06 Doctor, Who? Me? 10+ Year Member

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