future salary for fp

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wertyjoe

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I have been considering family practice ever since being accepted to medical school, however I am concerned about the low salary compared to other specialties. I know I shouldn't choose a specialty based on money but when CRNA's are being offered similiar wages (gasworks.com) I get a little upset. :mad:

If there is such a great demand for family practice why hasn't the pay gone up? I know reimbursements are low but something has to give pretty soon.

Please, no flaming

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Well in places where there is a great demand (rural areas) the pay can be good if you're willing to put in the hours. Also you have to look at the climate of the location, do the fps in that region do alot of procedures or do the specialists usually handle it. Thats not to say that you can't do well in a urban environment with specialists left and right. You'll just have to find a niche to work in.

Primary care especially, fp is more business like than most other fields. You're not going to be able to just walk in and work like an ER dock or orthopod and get paid well no matter the climate (bit of an exageration).
 
The demand for general internists and FP is speculated to skyrocket within the next decade - so as far as demand goes, maybe it needs to reach a breaking point before salaries increase. As far as wages - it totally depends. I worked in a rural area where docs typically did a shifts in the ER q 10 (and covered hospital patients when they were in there - so no home call except for OB), some OB and 4 days of clinic a week, rounding on their on inpatients. A physician new to the practice (been there 2 years) who didn't do much ER told me she made 230k a year - she said it was bull---- that FPs can't make it salary-wise. I know others in the practice (16 FPs) were making way more than her. The catch? This rural hospital and clinic were independent - not owned or operated by any of the large HMOs in the state. So that may play a big role - the HMOs tend to pay less to primary care providers than specialists (while those greedy CEOs eat up their million dollar bonuses - they can all go to hell as far as I'm concerned). I agree with what the other poster said as well - more procedures and more care mean higher salaries (sorry for the paraphrasing) for whoever does it - the specialist or the FP. However, that means areas of the country that are more desirable to live in would likely have more specialists wanting to practice there, and thus lower salaries for FPs.

There's a million ways to look at the situation, but either way - do what makes you happy - the demand is there, and salaries should eventually go up - and salaries, without sounding greedy, are important when you have 150k in loans. I never thought I'd say that, but here I am with that much in loans and now I care what I will be making! :D
 
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Do you think it's more likely that instead of increasing FP salaries to help fill positions there will instead be more autonomy given to PAs/NPs?
 
I remember seeing somewhere cited on SDN that FPs were among the top in $$ earned to hrs worked ratio...I mean it all comes down to how much you think ~140,000 a yr really is, right?
 
nebrfan said:
Do you think it's more likely that instead of increasing FP salaries to help fill positions there will instead be more autonomy given to PAs/NPs?

Honestly, I personally think it will HAVE to be both. I've seen awesome PAs and NPs - but general practice is difficult (despite its reputation) - family practice has a daunting number of diagnoses, conditions, illnesses that the physician has to be aware of. When you compare how much training PAs and NPs have compared to the years of training involved in a M.D. and the FP residency (or any residency for that matter), it's difficult to imagine PAs and NPs serving as the sole providers (or as the majority of sole providers) of primary care. The position where I have seen NPs and PAs function the most autonomously is actually as PART of a specialist's practice - like the ortho PA or the plastic surgery NP - they are trained to perform a specific function in the clinic or hospital (wound checks) but have some background in medicine to recognize if something is nor the way it should be. I've seen the other end, with PAs and NPs in family practice clinics who just don't have the experience or training to provide the full-spectrum of care that a family physician can (hypertension and diabetic checks are one thing - but delivering a baby or doing some procedures (colonoscopy) or caring for patients with complicated illnesses). However, I think PAs and NPs are important to FP - but do need to be closely supervised. I'll never forget working with a physician in the ER, and a patient with a list of meds a page long (you know the patients I'm talking about) and multiple medical and social issues came in - and her primary was a PA (a well respected one in the community) - and the ER physician said "Geez, I really wish Dr. X (the supervising physician of the PA) wouldn't farm these kinds of patients out to his PAs." But everyone is happy when the PAs take care of the urgent care stuff in clinic - colds, etc. I guess - where to draw the line?? :confused:

One other thing - whenever a health care company or HMO is selecting one kind of provider over the other because it helps them make more money, whether it's requiring a certain number of referrals to specialists to make more money or adding NPs and PAs so that they can pay them less and save money rather than hiring physicians, who really wins??? Not the patient....the corporation. Something to think about.

I would like to add, please don't flame me - this message was NOT meant to be a slam to PAs and NPs. Everyone has a role in the health care system, it's just figuring out what that role is so a patient can receive the best care possible (at the least cost).
 
I have been considering FM recently as well. I did quite a bit of research during my first year and most in Ortho Surgery, expecting to go into that field. However, I have recently realized that spending time with my wife is much more important than working 70 hours a week. If you have another income coming in I think $140K a year won't be to bad. We live economically and are planning to retire at 45. Assuming our home in paid off and we have no debt, which other than school loans is none. It depends on the lifestyle you want. We anticipate traveling 2-3 months out of the year after we retire and enjoying the rest of our lives doing what we want.
 
FPs may not make as much as some specialists but 120-140k is more than almost everyone else in the US makes. If someone is really interested in FP they shouldn't let financial concerns stop them.

CambieMD
 
CambieMD said:
FPs may not make as much as some specialists but 120-140k is more than almost everyone else in the US makes. If someone is really interested in FP they shouldn't let financial concerns stop them.

CambieMD


To further that point, the 140K/yr is working mostly office hours whereas you have to remember a specialist often works many more hours/week.
 
Hey, no worries, your tone comes across as anything BUT flaming.
One of my biggest frustrations as a FP PA is feeling saddled with people who consider me their "doctor" (believe me, they know I'm a PA) and refuse to see anyone else despite having problem lists a mile long and polypharmacy. A few of these choice patients are chronically mentally ill and perceive that other MDs haven't been kind to them. They may be right. But then you pile on diabetes, hypertension, hyperlipidemia, obesity, obstructive sleep apnea, heavy smoking and all the other risk factors that go along with schizophrenia & severe bipolar disorder and you have a recipe for disaster! One of my favorite ladies, a 55 y/o bipolar woman with a history of multiple psychiatric admissions, had a noticeable tremor that was getting worse and worse. She was on lithium, Cymbalta, Cogentin, Levoxyl and (Neurontin? I think). All came to a head last week when she came in severely distraught that for the first time in her life she had "B.O.". I could NOT convince her that she smelled fine to me. I'm thinking, what the hell, is she having olfactory hallucinations? She was increasingly tremulous and I thought for sure she was going to decomp that day. Of course her psychiatrist was unavailable (ick, small town with inadequate coverage). In desperation I got some labs and guess what? Her TSH was 0.02. ****. She was overreplaced. I cut her levoxyl in half and she feels soooo much better. Guess she stopped smelling B.O. when I told her she didn't smell bad to me.
This is the thing: FP is hard. Really, really hard. You get to know a little about a lot. I frequently (daily) feel like I don't know enough, and I know so very much more than I did when I finished PA school and started working 5 years ago. But I still don't feel like I know enough, and some days the only saving grace is knowing I have any number of docs just down the hall who are willing to step in and help me if I ask. What scares me is the PAs & NPs who DON'T ask for help or who don't have the benefit of working in a group where it's easy to grab someone to look at that funky rash or listen to that weird (new!) murmur in the acutely dyspneic woman (anybody seen a case of HOCM? hypertrophic obstructive cardiomyopathy...weird).
So I may be nuts, but I'm going back to medical school. And you can bet I'm NOT going into FP.
Good luck to you all though,
Lisa PA-C

shemozart said:
Honestly, I personally think it will HAVE to be both. I've seen awesome PAs and NPs - but general practice is difficult (despite its reputation) - family practice has a daunting number of diagnoses, conditions, illnesses that the physician has to be aware of. When you compare how much training PAs and NPs have compared to the years of training involved in a M.D. and the FP residency (or any residency for that matter), it's difficult to imagine PAs and NPs serving as the sole providers (or as the majority of sole providers) of primary care. The position where I have seen NPs and PAs function the most autonomously is actually as PART of a specialist's practice - like the ortho PA or the plastic surgery NP - they are trained to perform a specific function in the clinic or hospital (wound checks) but have some background in medicine to recognize if something is nor the way it should be. I've seen the other end, with PAs and NPs in family practice clinics who just don't have the experience or training to provide the full-spectrum of care that a family physician can (hypertension and diabetic checks are one thing - but delivering a baby or doing some procedures (colonoscopy) or caring for patients with complicated illnesses). However, I think PAs and NPs are important to FP - but do need to be closely supervised. I'll never forget working with a physician in the ER, and a patient with a list of meds a page long (you know the patients I'm talking about) and multiple medical and social issues came in - and her primary was a PA (a well respected one in the community) - and the ER physician said "Geez, I really wish Dr. X (the supervising physician of the PA) wouldn't farm these kinds of patients out to his PAs." But everyone is happy when the PAs take care of the urgent care stuff in clinic - colds, etc. I guess - where to draw the line?? :confused:

One other thing - whenever a health care company or HMO is selecting one kind of provider over the other because it helps them make more money, whether it's requiring a certain number of referrals to specialists to make more money or adding NPs and PAs so that they can pay them less and save money rather than hiring physicians, who really wins??? Not the patient....the corporation. Something to think about.

I would like to add, please don't flame me - this message was NOT meant to be a slam to PAs and NPs. Everyone has a role in the health care system, it's just figuring out what that role is so a patient can receive the best care possible (at the least cost).
 
my fp doc charged the insurance company 75 just for a check up, and a bunch of other things that came to $247. i saw him all of maybe 15 minutes total and totaled from about three 5 minute look overs. is that normal? wow. and then i had a physical that $137. if docs are making that kind of money just from the mediocre insurance companies what is everyone complaining about? is that amount higher than normal or something?? i know that does not account for overhead and all, and i have a real good understanding of all of that, but i was guessing at maybe 70 average visit TOTAL cost. this is way more... :confused:
 
espbeliever said:
my fp doc charged the insurance company 75 just for a check up, and a bunch of other things that came to $247. i saw him all of maybe 15 minutes total and totaled from about three 5 minute look overs. is that normal? wow. and then i had a physical that $137. if docs are making that kind of money just from the mediocre insurance companies what is everyone complaining about? is that amount higher than normal or something?? i know that does not account for overhead and all, and i have a real good understanding of all of that, but i was guessing at maybe 70 average visit TOTAL cost. this is way more... :confused:

physicians can charge whatever the market will bear. insurance will pay so much, and then the patient will have to make up the difference.

generally most physicans treat patients with varying insurance/resources and your bill likely subsidizes the no-pay indigent care the physician is providing to others. also, medicaid patients reimburse way less... it's all about payor mix, and what type of insurances physicians choose to accept.
 
http://finaid.org/calculators/

according to this, i will have to make 215k/year to be able to afford to pay my loanss (couldbe as high as 160k)! I am kind of interested in FP (pre-MS1 w/ little exposure), but can't help but take this into consideration. My FP said he loved his work, but was struggling with his loans and wished he would have done something like podiatry or pharmacy.
 
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If pay is a consideration, I would definitely investigate other specialties. Dealing with insurance companies, medicare, and medicaid is a nightmare and time consuming.
 
fun8stuff said:
http://finaid.org/calculators/

according to this, i will have to make 215k/year to be able to afford to pay my loanss (couldbe as high as 160k)! I am kind of interested in FP (pre-MS1 w/ little exposure), but can't help but take this into consideration. My FP said he loved his work, but was struggling with his loans and wished he would have done something like podiatry or pharmacy.

how many yrs did you assume? i think you need to adjust your numbers.

at any rate, there are a number of programs around the country that will help pay off loans for fp's. if you are worried about it, look for them.
 
fun8stuff said:
http://finaid.org/calculators/

according to this, i will have to make 215k/year to be able to afford to pay my loanss (couldbe as high as 160k)! I am kind of interested in FP (pre-MS1 w/ little exposure), but can't help but take this into consideration. My FP said he loved his work, but was struggling with his loans and wished he would have done something like podiatry or pharmacy.

Someone who is making $120k per year can easily afford payments on a loan for $160k. How would people buy houses if this weren't true.

Just spend a few years with a used car, living in a cheap apartment and pay off your loans.
 
skypilot said:
Someone who is making $120k per year can easily afford payments on a loan for $160k. How would people buy houses if this weren't true.

Just spend a few years with a used car, living in a cheap apartment and pay off your loans.

i assumed 10 years at 8% (kind of high interest rate). if you were to do 20 years, then u end up paying 300k overall- and you wouldnt be done paying off loans until near retirement. i thought it was affordable for someone making 120k, which was why i was surprised when i saw the results off this site.
 
fun8stuff said:
i assumed 10 years at 8% (kind of high interest rate). if you were to do 20 years, then u end up paying 300k overall- and you wouldnt be done paying off loans until near retirement. i thought it was affordable for someone making 120k, which was why i was surprised when i saw the results off this site.

Yeah but in 20 years at $120k per year with small salary increases per year you will have made about $3 million bucks. Paying off loans of $160k doesn't sound so bad then does it? :) ;) Plus are you planning to retire at 55? :)
 
It seems that FP and general internists are doing many things that specialist use to or still do. Diagnositic machines have become so easy to use that FP and internists can do many diagnostic tests that may have been reserved for specialisits in the past. I know two husband and wife general internists and they are doing many low risk procedures that many specialists do. They just bought a hearing test machine, which ENT's often use to test hearing. They also just bought a nerve testing machine, which many neurologist use (sorry I don't know the name of the machines or the procedures), they also perform eco testing, and do many treadmill tests.
 
I know two husband and wife general internists and they are doing many low risk procedures that many specialists do. They just bought a hearing test machine, which ENT's often use to test hearing. They also just bought a nerve testing machine, which many neurologist use (sorry I don't know the name of the machines or the procedures), they also perform eco testing, and do many treadmill tests.

this was VERY inspiring! thank you so much for sharing! :)
 
y is that so inspiring? telling of how someone is making a lot of money doing something??

:(
 
I think its inspiring bc FP and General Internists can really perform and see a very broad spectrum of illnesses and patients. Not just see them and then send them off to a specialist, they can actually treat many of the diseases that specialist will often treat. They can perform many derm, ENT, optho, neuro, and cardio procedures (not all).
 
espbeliever said:
y is that so inspiring? telling of how someone is making a lot of money doing something??

:(

lol...are you kidding me?! OF COURSE NOT!

oooh...someone's testy!! :rolleyes:

anyway, back to the answer your question: no - it is inspiring because i now know that it is possible to do such a variety of procedures/diagnostic tests when one is not 'neurologist', 'dermatologist', or 'cardiologist. i have no plans to be rich or make a lot of money - that's why i'm going into primary care, remember? i just want to make a living doing something i love, which happens to include procedures.


i found this quote in another thread...i'll put it right here so that you can get even more ticked off... :laugh:

Money can be made in FP. I know several FP that earn in excess of 500K per year. And these physicians are not living in Timbuktu or performing procedures that specialists perform. They live in large cities but they see a large volume of patients. They will hire 2 or 3 PA's and see 180-200 patients per day. Granted, these physicians are earning every penny because they are often working 10-12 hours per day. It takes a lot of stamina to personally see around 60-80 patients every single day. They can't take much vacation either. And don't believe the myth that city dwelling FP don't perform procedures. Many FP in large cities perform stress tests, colonoscopy and skin tests as examples. Many patients don't mind going to an FP for these procedures because it usually means they don't have to wait 3 months to see a specialist.

now what - are you going to accuse me of actually wanting to see 50 patients a day?! puh-lease! :thumbdown:
 
I think its inspiring bc FP and General Internists can really perform and see a very broad spectrum of illnesses and patients. Not just see them and then send them off to a specialist, they can actually treat many of the diseases that specialist will often treat. They can perform many derm, ENT, optho, neuro, and cardio procedures (not all).
 
skypilot said:
Someone who is making $120k per year can easily afford payments on a loan for $160k. How would people buy houses if this weren't true.

Just spend a few years with a used car, living in a cheap apartment and pay off your loans.

this is what i was thinking. If you are able to make it (barely i know) on residency pay of maybe 40k just live like that or slightly above that levelfor about 2 or 3 yrs and even on a 120k salary you should have all or the bulk of the loan reapaid. Then live it up! ;)
 
smkoepke said:
this is what i was thinking. If you are able to make it (barely i know) on residency pay of maybe 40k just live like that or slightly above that levelfor about 2 or 3 yrs and even on a 120k salary you should have all or the bulk of the loan reapaid. Then live it up! ;)
I work with an er doc who did just that. lived like a resident for 2 yrs after graduation, drove a beater, paid off all his medschool and undergrad in 2 years......paid off his house the next 2 years....now he works 10 shifts a month and takes off 3 months a yr to go surfing.......
 
espbeliever said:
my fp doc charged the insurance company 75 just for a check up, and a bunch of other things that came to $247. i saw him all of maybe 15 minutes total and totaled from about three 5 minute look overs. is that normal? wow. and then i had a physical that $137. if docs are making that kind of money just from the mediocre insurance companies what is everyone complaining about? is that amount higher than normal or something?? i know that does not account for overhead and all, and i have a real good understanding of all of that, but i was guessing at maybe 70 average visit TOTAL cost. this is way more... :confused:

What you are forgetting is that those $ amounts are how much the doctor CHARGED not how much he was PAID by the insurance company.
 
actually im not forgetting that.

the bill actually listed the amount the insurance company ALREADY paid, and now im being billed for the remainder.




:)
 
ramonaquimby said:
lol...are you kidding me?! OF COURSE NOT!

oooh...someone's testy!! :rolleyes:

anyway, back to the answer your question: no - it is inspiring because i now know that it is possible to do such a variety of procedures/diagnostic tests when one is not 'neurologist', 'dermatologist', or 'cardiologist. i have no plans to be rich or make a lot of money - that's why i'm going into primary care, remember? i just want to make a living doing something i love, which happens to include procedures.


i found this quote in another thread...i'll put it right here so that you can get even more ticked off... :laugh:



now what - are you going to accuse me of actually wanting to see 50 patients a day?! puh-lease! :thumbdown:


comon dont be mean.

i was reading stuff into it probably. im sorry.

the way i saw it was, someone was inspired or whatever acting as if FP were a horrible way to go and no one does well in it. so to see some ppl do well is inspiring. thas why i thought it was a sucky thing.

i personally want to do fp, i see a HUGE potential there, so i guess i dont understand why that minor post would be "inspiring" in a different manner than what i had first thought. obviously i was wrong.

have a great day! ;)
 
smkoepke said:
this is what i was thinking. If you are able to make it (barely i know) on residency pay of maybe 40k just live like that or slightly above that levelfor about 2 or 3 yrs and even on a 120k salary you should have all or the bulk of the loan reapaid. Then live it up! ;)

That's a mistake a lot of people make. Our loans are usually at such a low interest rate that by paying them off early you are losing capital that you could be using to invest and make money with. If it's worth it to you not to have a loan payment to worry about, then yea, go ahead and pay it early. But realize that comes with price.

I consolidated a few months ago, my interest rate is 2.8% and the pay period is 30 years. You can bet that I will use all the time too. If I could I would stretch it out so long I would die before it was paid off. It's true that interest rates may go up for some of you guys in the future, but as long as you are smart with your money, you still won't want to pay the loans off early.

All the FPs I talk to in private practice make plenty of money, but I think you have to be smart and remember that your practice is also a business.
 
Regarding the student loans...

I agree that it's the BEST kind of debt to have. Whether it's 20,000 or 200,000, you should spend a longer time paying them off, and when you're a junior attending (or a moonlighting PGY-3/fellow), you should be diversifying your investments so you get yourself started (a 401k, Roth IRA either for you, a spouse, future kids, etc).
 
How do you feel these minute clinics are going to affect FP? I know there is a thread on it but no one really discussed it's potential future ramifications on FP. It sounds scary to me. Wal-Mart and malls pretty much destroyed the optometry industry; do you think it will have the same affect on FP and IM outpatient clinics?
 
no way. fp scope is BROAD. while optometry is very narrow. you can make fp what you want it to be.
 
bigeyedfish said:
That's a mistake a lot of people make. Our loans are usually at such a low interest rate that by paying them off early you are losing capital that you could be using to invest and make money with. If it's worth it to you not to have a loan payment to worry about, then yea, go ahead and pay it early. But realize that comes with price.

All the FPs I talk to in private practice make plenty of money, but I think you have to be smart and remember that your practice is also a business.

It all depends on what you are going to do with the money. If you are going to live cheaply for a few years and instead of paying off the student loans, you are socking the equivalent amount into a retirement fund or other investments that is great. Once your investment balance is equal to your loan balance you will have made it.

But if you are spending the money on a BMW and fancy vacation home financially you won't get ahead of the game for 20 years. For some people it is easier just to pay off debt. They get a guaranteed return on their money and they get the satisfaction of seeing the loan balance drop to zero.
 
I have a friend that was recently offered $200K with $25K of loan repayment per year to work in rural community of 9,000. I think the smaller the community, the higher the salary. A 4,000 square foot house sells for under $500,000 in the area.
 
skypilot said:
It all depends on what you are going to do with the money. If you are going to live cheaply for a few years and instead of paying off the student loans, you are socking the equivalent amount into a retirement fund or other investments that is great. Once your investment balance is equal to your loan balance you will have made it.

But if you are spending the money on a BMW and fancy vacation home financially you won't get ahead of the game for 20 years. For some people it is easier just to pay off debt. They get a guaranteed return on their money and they get the satisfaction of seeing the loan balance drop to zero.


Paying the loan off early garantees you nothing but a missed oppurtunity to invest that money. You don't have to live like a pauper. Investing is all about getting in the game as early as possible. You could be making money off the extra amount you're paying on the loan balance. It has nothing to do with the investment balance equaling the loan balance. It has to do with the rate. Any reasonable investment is going to have a higher rate of return than 2.8% over a period of 30 years. As a bare minumum, you could put whatever excess you would want to pay into an annuity, which, with a respectable investment firm, will have a garanteed minumum return of 5.0%. But, the same money in the stock market will give an even higher rate of return over 30 years.

I won't be living cheaply during repayment. My payment on about 130000 is a little over 450 a month. I don't think six grand a year is going to put a damper on my summer vacation plans, or have a huge effect on the car I drive. Spending your money excessively on expensive cars and houses won't get you ahead of the game regardless of whether you pay the loan balance off or not.

I agree that for a lot of people, having the loan balance at zero will give them a lot of satisfaction, and it may be easier for whatever reason, but with interest rates like they are right now, and for the foreseeable future, they are throwing money away. If those people want to pay off the loan early to save a few hundred bucks a month so they can afford the 911 turbo instead of the 911, well, more power to them.

I love our loans. :) At these rates, if they'd let me borrow a million bucks I'd do it in a second.
 
NDMD said:
I have a friend that was recently offered $200K with $25K of loan repayment per year to work in rural community of 9,000. I think the smaller the community, the higher the salary. A 4,000 square foot house sells for under $500,000 in the area.


are you kidding me? ive had this discussion before on here, and i guess in kansas city, a city of like over several hundred thousand, you can EASILY get a house over 4000 sqft for UNDER 300k and by a lake in a special community and the works!! the housing market in the usa is heavily inflated right now and it worries me. i think that is the last thing hold this economy up and when it bursts it will be like the the 1930s.......
 
I ve heard of FP making over 500k a year. But they are usually in rural to semi-rural areas.
 
espbeliever said:
my fp doc charged the insurance company 75 just for a check up, and a bunch of other things that came to $247. i saw him all of maybe 15 minutes total and totaled from about three 5 minute look overs. is that normal? wow. and then i had a physical that $137. if docs are making that kind of money just from the mediocre insurance companies what is everyone complaining about? is that amount higher than normal or something?? i know that does not account for overhead and all, and i have a real good understanding of all of that, but i was guessing at maybe 70 average visit TOTAL cost. this is way more... :confused:
That's pretty normal. Remember, the doc doesn't keep much of that. There's rent, payroll, insurance, supplies, etc....
 
bigeyedfish said:
Paying the loan off early garantees you nothing but a missed oppurtunity to invest that money. You don't have to live like a pauper. Investing is all about getting in the game as early as possible. You could be making money off the extra amount you're paying on the loan balance. It has nothing to do with the investment balance equaling the loan balance. It has to do with the rate. Any reasonable investment is going to have a higher rate of return than 2.8% over a period of 30 years. As a bare minumum, you could put whatever excess you would want to pay into an annuity, which, with a respectable investment firm, will have a garanteed minumum return of 5.0%. But, the same money in the stock market will give an even higher rate of return over 30 years.

Just stay away from Enron, internet stocks, and the like. :) I stick by what I said although I see your point. It is possible to have a negative return in the stock market or the real estate market. I have seen it plenty of times. :) Doesn't seem possible but it is! :)
 
Lee A Burnett said:
That's pretty normal. Remember, the doc doesn't keep much of that. There's rent, payroll, insurance, supplies, etc....


Lee, yea i know, im guessing maybe 60-70% overhead?? actually this place was an hmo building i think. i dunno, its weird...

i am actually planning on going to work in a rural area and operate my own practice. i have already gotten funding from the state and a scholarship at my school combine to basically give me a full ride and then some. the state funding was contingent upon working primary care in a rural area which i already wanted to do. i think i would like to make around 200k in such an area. i guess im not sure how feasable that is at this point but i do think it is possible. i am also in a program to get my mba (or at least soon will be). i dont know... at any rate i will have no loans and if i can live comphy ill be happy, very happy actually. who knows.
 
espbeliever said:
Lee, yea i know, im guessing maybe 60-70% overhead?? actually this place was an hmo building i think. i dunno, its weird...

i am actually planning on going to work in a rural area and operate my own practice. i have already gotten funding from the state and a scholarship at my school combine to basically give me a full ride and then some. the state funding was contingent upon working primary care in a rural area which i already wanted to do. i think i would like to make around 200k in such an area. i guess im not sure how feasable that is at this point but i do think it is possible. i am also in a program to get my mba (or at least soon will be). i dont know... at any rate i will have no loans and if i can live comphy ill be happy, very happy actually. who knows.

Why an mba if ur gonna work in rural areas in primary care?
 
bigeyedfish said:
Paying the loan off early garantees you nothing but a missed oppurtunity to invest that money. You don't have to live like a pauper. Investing is all about getting in the game as early as possible. You could be making money off the extra amount you're paying on the loan balance. It has nothing to do with the investment balance equaling the loan balance.

When the investment balance is greater than the loan balance you will finally have a positive net worth. That is a good thing to have. :)
 
NRAI2001 said:
Why an mba if ur gonna work in rural areas in primary care?
i thought it would allow me to more effectively run my private practice. do you think otherwise? further, the mba can be completely in this dual program in which i complete both the DO and MBA in 4 yrs. so, giving up my summer doesnt seem that bad.
 
espbeliever said:
i thought it would allow me to more effectively run my private practice. do you think otherwise? further, the mba can be completely in this dual program in which i complete both the DO and MBA in 4 yrs. so, giving up my summer doesnt seem that bad.

O cool, good deal.

Maybe i m mistaken, but i thought the main people who were doing md/mba and do/mba programs were people who wanted to become the head of a dept. hospital managers, handle the financial and administrative parts of medicine?
 
NRAI2001 said:
O cool, good deal.

Maybe i m mistaken, but i thought the main people who were doing md/mba and do/mba programs were people who wanted to become the head of a dept. hospital managers, handle the financial and administrative parts of medicine?

ive heard that somewhat, but i thought it was mostly for ppl who got MPH's. i dunno... ive talked to a number of private prac docs who all say that an MBA would be very helpful in a private practice setting...
 
wertyjoe said:
I have been considering family practice ever since being accepted to medical school, however I am concerned about the low salary compared to other specialties. I know I shouldn't choose a specialty based on money but when CRNA's are being offered similiar wages (gasworks.com) I get a little upset. :mad:

If there is such a great demand for family practice why hasn't the pay gone up? I know reimbursements are low but something has to give pretty soon.

Please, no flaming


My attending told me that she was offered 4x the salary she now makes (major city) to work in an underserved area . You figure she rakes in, at the minimum, 80 grand in the big city. You do the math.
 
Back34 said:
My attending told me that she was offered 4x the salary she now makes (major city) to work in an underserved area . You figure she rakes in, at the minimum, 80 grand in the big city. You do the math.

Most of the family practice physicians i know work in private practice. The thing that i ve noticed is that their scope is very large. They perform many specialized procedures also, which tend to pay better. Especially as technology is improving, its becoming easier to perform more specialized procedures.
 
I just crack up when I hear people panicking about FM salaries. As a PA I was billing over half a million dollars a year for my boss seeing an average of 30 patients a day, 4.5 days per week. We collected about 390-410K per year on that, and even if you take half of that out for overhead, you are left with over 200K. And if you have a partner, or a rural hospital subsidizing your lease, you can easily shave 15-20% of that overhead off and put it back in your pocket. Then you could even taper down to approximately 20-25 patients per day and still do very well. And hire yourself one very competent and experienced PA, pay them well, treat them well, and supervise them correctly, and you will add 30% to your salary. My boss made over 300K per year net and he only worked 2.5 days per week. Granted, I paid a lot of his salary, but such is life.

On an average day, I would do 2 full physicals, and see lots of benign stuff that took only seconds. Plus, I was one of these guys that took care of things that came up instead of referring it out to be done in 2 months. For instance, I routinely did punch biopsies of lesions and did moderately complex derm stuff like cysts, lipomas, shaves, excisions, and then some toenails, thrombosed hemorrhoids, ripped earlobe repairs, lots of lacerations, etc...

Thos procedures are quick and pay well if you are fast and good at them. And patients love the fact that they did not have to wait 2 months to see some derm doc. Of course if they want to wait, they can.

If you want to be some FM doc with a poor bedside manner, see 15-20 patients a day, come in at 9 and leave at 4:30, and have no weekends or call, then you probably will have a hard time making average at 120K. But trust me, if you came into FM with the right attitude and are here because you love it, your patients will pick up on that and appreciate you. Word will spread and soon you will be booked for days to come. Then the world is your oyster. A good competent FM doc with good organizational skills and a quick set of feet can comfortably see 30 patients per day and make well above average into the 200K+ range. And to me, that is more than God makes!
 
I always wondered, why do people become PA's when it seems like they re just doing everything the physician does, and probably more of the dirty work that he doesn't want to handle? I m sure there are some reasons? Don't mean to flame, just wondering?
 
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