ER Doc Salary

Started by jngo2
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I wanted to get some feedback on the salaries of ER docs. I was told that the salaries vary from place to place but in CA, salaries are usually 200K and up. A third year resident and an associate clinical professor in ER told me that certain cities in Texas, the starting salaries are 300K. I was curious as to what anyone else has heard.
 
1) It isn't called ER. The people are EPs (Emergency Physicians), and the field is EM (Emergency Medicine), practiced in the ED (Department).
2) It varies geographically, and then academic vs community.
3) There is a forum for Emergency
4) Those numbers aren't far off.
 
You should pick up the latest copy of Iserson's Guide to Getting a Residency-- it has the salaries of most specialties. The short answer is that yes, attending in Emergency Medicine do often make in excess of 200K and can be started at much higher salaries(i.e. 300K) if they have a special niche.
 
DrMom said:
Many EPs start out around $300K in the midwest.
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Oh please, please let this salary trend continue.

Baby needs new shoes.


P. Bear, MD
Emergency Medicine Resident
Read My Friggin' Blog....if You're not Chicken, That Is
 
Oh wow...$300k in the midwest?! Hey, I live there!

Are those $300k places really small towns? That's a lot of money for doing 36 hours/week (it *is* for 36 work week, right? 😀).
 
Midwest is an armpit (personally, if you like it, hey, you like it. Whoop de do)

You can make 3 bills on the beach too.
 
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vtucci said:
You should pick up the latest copy of Iserson's Guide to Getting a Residency-- it has the salaries of most specialties. The short answer is that yes, attending in Emergency Medicine do often make in excess of 200K and can be started at much higher salaries(i.e. 300K) if they have a special niche.
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What kind of niche would that be?
 
I'd caution to avoid expectations low or high. I don't really see being a physician as having a "starting salary" that can be measured. Most new board-certified docs in all specialties will be hired by a group that offers them a base with incentives. If you are in an area (regardless of coast or midwest) that has a need where the people have insurance, then you can negotiate a big money contract as long as the clientele can afford health insurance (again, projecting this many years into the future may be ambitious) and the malpractice rates are pleasing.

With high demand and high compensation, however, there will be necessarily a higher workload. Your group is ultimately billing per patient seen, so they don't make money until you bust your hump. In my neck of the woods, EM docs are group-based and not hospital-based.
 
anon-y-mouse said:
What kind of niche would that be?
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I have been told by several people in the field-- it is most helpful if you have an interest and knack for administration. There are many fellowship programs and if a hospital is looking to establish a niche (i.e., ultrasound, critcal care, forensics etc), a higher salary could be an enticement to someone with the necessary credentials.

However, starting salary is not the reason to choose a job. Location, benefits, cost of living need to be factored in. 300K in NYC is nothing if compared to 250K in the midwest. For those of you obsessed with the bottom line, Remember, there are regional differences in taxes as well as malpractice.
 
vtucci said:
...there are regional differences in taxes as well as malpractice.
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Very good point about malpractice. It is typically regulated by state law. Where I live, lots of docs have fled because our state government does not adequately protect docs from outlandish awards.
 
Wizard of Oz said:
Very good point about malpractice. It is typically regulated by state law. Where I live, lots of docs have fled because our state government does not adequately protect docs from outlandish awards.
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Florida's malpractice laws are pretty bad for many specialties. I won't even advertise some of the rates that I have heard from mentors.
 
300k/ year in the midwest is like 1.5 million/year in Manhattan. You could buy a lotta ugly girls a lotta Miller High Life!
 
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IbnSina said:
Midwest is an armpit (personally, if you like it, hey, you like it. Whoop de do)

You can make 3 bills on the beach too.
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Oh man. The Midwest and the rural South so totally rock if you have a family, like having a big house and a lot of land. I realize that by living in Shreveport, Louisiana you may sacrifice some access to culture and the ability to order Punjabi food at 3AM but private schools are reasonable, they have Target, Wal Mart, and Home Depot, I'm not that into high culture anyways, and we even have passable Sushi and a few Starbucks.

200,000 a year puts you in the middle-class in San-San (San Francisco to San Diego). In Shreveport you are definitely in the top income bracket and can buy a house bigger than you can probably stand for what a little piece-of-**** bungalow would fetch in Monterrey. (Hey, I watch HGTV) You can live five minutes from the downtown and own enough acres to have horses or dogs or whatever you want.

There is practically no traffic, people are very friendly, and everything is just less stressful. Plus we have lots of sick people and a shortage of doctors which, all other things being equal, gives you better earning potential in a lower cost of living area which means a higher material standard of living.
 
indo said:
300k/ year in the midwest is like 1.5 million/year in Manhattan. You could buy a lotta ugly girls a lotta Miller High Life!
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For you young, single guys, there are pretty girls everywhere. The prettiest girl I ever saw was from Vermont and I married her.
 
TheProwler said:
whoa, that's like $150/hr. hmmmmmm. 😛
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that's the going rate where i grew up, in the midwest. to give you a picture of the group: 12 bed ED in 50k town, census of about 23k pts/yr, fairly average acuity for a community practice. usually coveraged by a doc with a mid-level; they do schedule physician double coverage during peak volume times. i don't think any of the docs are EM boarded. I know they all trained in primary care but that most of them have been doing EM work for the majority of their careers. Sorta the old-school pathway to EM.
 
Panda Bear said:
Oh man. The Midwest and the rural South so totally rock if you have a family, like having a big house and a lot of land. I realize that by living in Shreveport, Louisiana you may sacrifice some access to culture and the ability to order Punjabi food at 3AM but private schools are reasonable, they have Target, Wal Mart, and Home Depot, I'm not that into high culture anyways, and we even have passable Sushi and a few Starbucks.
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I didn't say which beach. I don't dig the left coast, too expensive. Florida-Virginia is good enough for me, Florida needs MLR now, Georgia and SC already have it, NC and VA I don't know about.

But yes, you can get a ridiculous house in most places in the south for what it costs to have a maid in Boston.

Wyoming is actually really nice if you want to own a lot of land, they are one of the few places that hundreds of acres are freely available. You just have to like shoveling snow. I don't.
 
stargirl50 said:
there may be SOME ER docs who make $300k in the midwest. but i'd bet that it's not the average or the majority.
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It's getting there in a hurry. It is nowhere close to the most you can make. The field is growing in salary because of board certification now more than ever.
 
IbnSina said:
It's getting there in a hurry. It is nowhere close to the most you can make. The field is growing in salary because of board certification now more than ever.
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i don't think you're going to see an explosion in EP salary. it's already basically the highest paid 3 year specialty.
 
No explosion, but it is going to grow a lot from where it used to be, from the standpoint of what they pay BC/BE EM docs versus FM/IM/Whatever to work in the ED.
 
you'd have to pay me at least $800,000/year to live in the midwest. and daily foot massages would have to be included in the package.

the midwest is ugly and cold. that's why they pay so much there...
 
Panda Bear said:
Oh man. The Midwest and the rural South so totally rock if you have a family, like having a big house and a lot of land. I realize that by living in Shreveport, Louisiana you may sacrifice some access to culture and the ability to order Punjabi food at 3AM but private schools are reasonable, they have Target, Wal Mart, and Home Depot, I'm not that into high culture anyways, and we even have passable Sushi and a few Starbucks.
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Shhhhhhhh......He's lying. You all really don't want to live here, trust me. Just go to the Northeast or the West Coast. There's nothing but a bunch of rednecks in the South. Move along, nothing to see here.

In all seriousness, the phrase I usually use to describe the South is "Great place to live, but I wouldn't want to visit." You can take all the crazy money that you save and travel wherever you want, if you want culture, etc. Salaries are nowhere near proportional to cost of living in the Northeast and West Coast, meaning the real standard of living (defined by purchasing power) is significantly less in those places.
 
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Dr. McDreamy said:
you'd have to pay me at least $800,000/year to live in the midwest. and daily foot massages would have to be included in the package.

the midwest is ugly and cold. that's why they pay so much there...
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Chicago is a wonderful place, you should go visit!!
 
jota_jota said:
In all seriousness, the phrase I usually use to describe the South is "Great place to live, but I wouldn't want to visit." You can take all the crazy money that you save and travel wherever you want, if you want culture, etc. Salaries are nowhere near proportional to cost of living in the Northeast and West Coast, meaning the real standard of living (defined by purchasing power) is significantly less in those places.
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That's what I tell myself to convince myself to stay another four years in the midwest. 😀 I hope to someday live somewhere cheap but be within a few hour's driving distance of a 'fun' place. It is probably more economical to live in a cheap, boring, uncultured city and to save up that money to travel to the fun, cultural hotspots. Honestly, all my friends who lived near Disneyworld did not go there every week, most went there during breaks and such, I can do the same minus the premium cost of living near a tourist city.
 
The salaries in this thread are a lot closer to reality than what I've often seen. I spent a lot of time working on physician salary stats for a major health system before I decided to leave the dark side of administration and become a physician.

Where I live, an EM physician with three or more years in practice (which is the "usual benchmark" for someone who is not just starting out) will earn in the neighborhood of $225K - $250K - that's "all found" after malpractice and all other expenses paid. I've never heard of $300K to start, but for a busy group who is working short - I suppose it's not impossible. You'll have to have a lot of production to keep that salary, though, and you could probably forget any loan assistance with that much cash up-front.

But I'm assuming that *is* cash up-front. I'd look at a reliable salary survey like the Medical Group Management Association (which is big bucks to get the right to see) - they make sure apples and apples are being compared. If someone said they were paid $300K, that would seem a little high to me in cash salary - however, if they meant $300K which included fringes and defered compensation (retirement), I'd say it was right in the neighborhood.

Interestingly, though, for many years physician salaries have been highest in the South - perhaps lots of people don't want to live here! You'd think that salaries would be higher in high-cost areas like California, but it's just the opposite - in places that are considered more desirable places to live, salaries tend to be a little bit lower - more competition, I suppose. I haven't made a final decision on where I want to practice, but I do have to consider that I can make the highest average salary here in a place with one of the lowest costs of living in the US - if I move to a place where the cost of living is twice what it is here, my salary is likely to be slightly lower.
 
here( west coast) the docs I work with make 145-180 dollars/hr with malpractice only or around 120/hr with a full benefits package.
 
ACEP News delivered today shows median incomes of EPs in group practice per region.
West:$246,455 (CA,AZ,AL,UT,NM,CO,NV,WA,OR,ID,MT,WY)
Midwest:$250,563 (ND,SD,NE,MN,WI,IA,IL,IN,OH,MI)
Northeast;$218,788 (ME,VT,NH,NY,PA,NJ,MA,WV,MD,DE,RI,VA?, NC??!)
South:$286,277 (TX,OK,KS,MO,AR,LA,MS,AL,GA,SC,TN,KY,FL)

So, that means that people starting at $300K (as I've heard many residents state) are either likely getting sign-on bonuses, or they haven't affected the median yet. Either way, I still like it where it is warm, and there is very little snow.
 
an1206vitalsigns.jpg
 
I guess competition makes a huge difference in compensation. In places where there is presumably a glut of doctors (west coast and northeast), they get paid the least, and in the South, where traditionally, there has been a lack of doctors, you see the highest salary. Still, everywhere you live, it's a pretty nice salary to have.
 
KNightInBlue said:
Ortho spine and interventional rads are top!
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I have to say that any survey has to be taken with a grain of salt. Private practice has a HUGE range. (ie. gastroenterologists that make 150K to some that make >600K) Anyways, I really can't imagine EM going up more. I mean, most EM docs don't have their own practice (or group practice) and instead are paid via salary. This is a huge minus. I just dont get how their salaries can be 300k and they only work ~36 hours/week (12 hour shifts)!! Is there malpractice paid for too?? Maybe I should do EM then!!! Lol. 😉
 
Panda Bear said:
For you young, single guys, there are pretty girls everywhere. The prettiest girl I ever saw was from Vermont and I married her.
Click to expand...
is she blonde? height/weight? did you specifically come to vermont for a girl? i live 40miles from vermont border.
 
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OHMAN0125 said:
I have to say that any survey has to be taken with a grain of salt. Private practice has a HUGE range. (ie. gastroenterologists that make 150K to some that make >600K)
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Yes, but that is mainly based on how much work they do, patents, procedures, etc.
Anyways, I really can't imagine EM going up more. I mean, most EM docs don't have their own practice (or group practice) and instead are paid via salary.
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You mean wages. They are paid by the hour
This is a huge minus.
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Why, I enjoy the fact that if due to some fluke in scheduling, or some massive traffic accident occurs, the extra hours I put in I get paid for by the hour
I just dont get how their salaries can be 300k and they only work ~36 hours/week (12 hour shifts)!! Is there malpractice paid for too?? Maybe I should do EM then!!! Lol. 😉
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Their salaries just are. They usually work 7 out of 14 days, sometimes more, sometimes less. That averages out to 42 hours per week. Malpractice is paid some places, others it isn't. You have to look at the contract. Now you know why it is competitive.
 
IbnSina said:
Midwest is an armpit (personally, if you like it, hey, you like it. Whoop de do)

You can make 3 bills on the beach too.
Click to expand...
FYI, here's what $2 million buys you in the Midwest (yes, I'm serious - I cut the grass at this place)
2d7g6sl.jpg


here's what $2 million buys you in SoCal
IMG_2165.sized.jpg


here's what $2 million buys you in Manhattan
Port_o_let.jpg



just something to keep in mind 😉
 
People keep missing the point. The US isn't SoCal, NYC, and the Midwest only. There are lots of other places that the property is just as cheap as Iowa.
 
IbnSina said:
People keep missing the point. The US isn't SoCal, NYC, and the Midwest only. There are lots of other places that the property is just as cheap as Iowa.
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there are also cooler places to live between the coasts than Iowa cornfields and Missouri trailer parks.
 
damn if you own such a big house and are single you can live like Hugh Heffner.
 
Let's leave these folks to the slums in the cities of the East Coast, the smog, and the trailer parks in Florida.

I would take Charleston, SC over a lot of places..but other than that..I'm good...

I'd be interested in the which places these folks that are hatin' on the midwest have actually visited.
 
I could see how someone who didn't grow up in the midwest might find it a bit boring. Fields of corn and beans (if you're in the rural midwest) aren't all that exciting unless its what your used to. I love the rural midwest though. Oh, so many memories. That said, its really nice to go see mountains occasionally, and the west coast is beautiful as well. I'm satisfied doing those things on vacations though, and will stick with the midwest (preferably by family) most likely the rest of my life. Moving to a more temperate or more grandios location would mean my children wouldn't get to spend time with their grandparents, aunts, uncles, and cousins.
 
Unless your tastes are so refined that they are silly, what is the functional difference between living in Indianapolis or San Francisco? You can get pretty much anything you could want to satisfy your materialism in either place.

Seriously, even if you are artsy every big Midwestern city has its pretentious arts community which is no different than any other. And you can be a metrosexual with facility in any city of 500,000 or larger.

Not to mention other big Midwest cities like St. Louis, Omaha, Kansas City or Chicago.

Sincerely,

P. Bear, MD
Emergency Medicine Resident and Real Man
The Midwest
 
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