Geriatrician Salary

[lsu1000]

This was suppose to be the up and coming field that would pay more and be in high demand, but I don't see that it has happened(besides the demand).

Anyone know the average for a geriatrician now?

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[iatrosB]

This was suppose to be the up and coming field that would pay more and be in high demand, but I don't see that it has happened(besides the demand).

Anyone know the average for a geriatrician now?

I can't say as to how much the salary is, but I can tell you why the income didn't sky-rocket like demand would dictate. Reimbursement...geriatrics is going to be mainly Medicare Most physicians try to avoid this senario.

 

[deleted87716]

Most of the people I know who call themselves "geriatricians" do some nursing home medicine in addition to their ambulatory practices. This is usually outside of office hours, and it doesn't necessarily take a huge amount of time if you're organized about it. You can also serve as medical director of a nursing facility, which can add to your income. You won't be fabulously wealthy, but there's no reason you have to do any worse than anyone else in primary care.

 

[futuredo32]

Do geriatricians who just work in an outpatient setting only without working in nursing homes generally make as much as family practice or IM doctors? I've been kinda considering geriatrics, but I worry about being able to pay back my enormous student loans.

 

[deleted87716]

Do geriatricians who just work in an outpatient setting only without working in nursing homes generally make as much as family practice or IM doctors? I've been kinda considering geriatrics, but I worry about being able to pay back my enormous student loans.

I've never seen any kind of income breakdown for geriatrics specifically. Geriatrics is basically internal medicine, anyway. Your income relative to the rest of the pack will have more to do with the specifics of your particular practice than to the specialty itself.

 

[McDoctor]

Do geriatricians who just work in an outpatient setting only without working in nursing homes generally make as much as family practice or IM doctors? I've been kinda considering geriatrics, but I worry about being able to pay back my enormous student loans.

Reimbursement for E and M codes would be the same. I don't think you would get many referrals for "geriatric consults" from PCP's either, so I don't think you'd make much more than an FP or internist. Working in nursing homes could work for you financially, however, since there's no overhead.

I think that as a geriatric specialist, you would find nursing homes frustrating. You may have a better idea of how to maximize the rehab potential of your geriatric patients in PT and OT, but you will still be hamstrung by what services medicare will pay for and how often medicare will (or won't) pay for them. You may have a superior understanding of the pharmacokinetics of medication in the elderly, but you will still get routine rubberstamped hatemail from the pharmacy and therapeutics committee suggesting you attempt a "therapeutic wean" for your patients on psychotropics, as if you didn't know any better.

The whole system pretty much discourages independent thought or individualization of medical care.

 

[deleted87716]

You may have a superior understanding of the pharmacokinetics of medication in the elderly, but you will still get routine rubberstamped hatemail from the pharmacy and therapeutics committee suggesting you attempt a "therapeutic wean" for your patients on psychotropics, as if you didn't know any better.

I have a special file for that stuff...

 

[Hygieia]

I'm also interested in the field of geriatrics, but would definitely not go into it for the money. I attended a geriatrics conference a few years ago and found out from a new geriatrics fellow grad that she was taking a pay cut after doing 2 years of geriatrics fellowship training at a top 5 program (she was offered $170K immediately after completing IM residency training vs $140K after geriatrics fellowship training).

For the salaries of various medical specialties, click on the following link (I hope this works!):
http://www.cejkasearch.com/compensation/amga_physician_compensation_survey.htm

 

[Bellary]

Hi. I am interested in doing Geriatrics as well. However, I am confused as to which is the best path to take. What is the difference, if any, in going via Internal Medicine vs. Family Medicine? Does one route have advantage over another?
Could you explain for me please?
Thanks in advance.

 

[iatrosB]

Hi. I am interested in doing Geriatrics as well. However, I am confused as to which is the best path to take. What is the difference, if any, in going via Internal Medicine vs. Family Medicine? Does one route have advantage over another?
Could you explain for me please?
Thanks in advance.

This is just an opinion, take it with a grain of salt. If you want to do ONLY geriatrics, do IM. If you want to keep your options open (see peds and a younger, healthier population), do FM. In my opinion, IM will train you better for geriatrics (you won't be wasting time in peds/ob and will focus generally on a sicker, older patient base). The trade off is you lose flexiblity in who you can see and what you can do.

If you are positive that you want to do geriatrics and only that, do IM.

 

[deleted87716]

If you are positive that you want to do geriatrics and only that, do IM.

I'm not so sure about that. If you look at many definitions of "geriatrics," you'll find that it advocates a clinical approach that is much more aligned with the teachings of family medicine than internal medicine. For example:

Geriatricians are expert in dealing with multiple medical problems and chronic illness. Geriatricians focus on optimizing quality of life and functional ability for their patients rather than seeking definitive cures.

Geriatricians use a holistic approach to address the physical, psychological and social problems surrounding the patient and family. A geriatrician works closely with other health care professionals and organizations, including other physicians, therapists, home care agencies, pain clinics and support groups, to meet the specific needs of each patient. A geriatrician considers the patient and family as key members of the health care team, and expects them to contribute to all decisions that need to be made.

Source: http://geridoc.net/geriatrician.html

You tell me, does that sound more like an FP or an internist?

 

[iatrosB]

I'm not so sure about that. If you look at many definitions of "geriatrics," you'll find that it advocates a clinical approach that is much more aligned with the teachings of family medicine than internal medicine. For example:


Source: http://geridoc.net/geriatrician.html

You tell me, does that sound more like an FP or an internist?

Well, since Dr. Stall is an internal medicine trained physician (the source of the posted link) with a geriatrics fellowship, it appears it could go either way.

 

[deleted87716]

Well, since Dr. Stall is an internal medicine trained physician (the source of the posted link) with a geriatrics fellowship, it appears it could go either way.

Of course. That's why I chose the link. My point was that we shouldn't assume that IM training necessarily prepares you better to be a geriatrician. It's right up the FP's alley.

 

[iatrosB]

Of course. That's why I chose the link. My point was that we shouldn't assume that IM training necessarily prepares you better to be a geriatrician. It's right up the FP's alley.

I still stand that the OB/peds would be time wasted for someone who wants to work with elderly only. That was my point, not that FM wouldn't prepare you, just that it would have more training that wouldn't be appropriate (it would make you more versitile as I said earlier, but that wouldn't matter to someone who never wanted to see peds or pregos).

 

[Bellary]

Thanks all for the feedback. Truth is, I am not quite sure if I want to zero in on geriatrics or have a wider base with the option of weighing practice more on that age group if I wished. Decisions, decisions! I still have time left to make up my mind. After all I am fast approaching final year. And I have internship to be exposed to the various groups.
My only other concern would be the time it takes. I am a little longer in the tooth than the average med student and my fear is that IM would take forever compared to FM. Am I misguided in that opinion?

 

[iatrosB]

My only other concern would be the time it takes. I am a little longer in the tooth than the average med student and my fear is that IM would take forever compared to FM. Am I misguided in that opinion?

FM = 3 years residency and 1 year fellowship if desired.

IM = 3 year residency and 1 year fellowship is desired.

Same amount of time either way. Good luck

 

[MacGyver]

You guys got it all wrong. Geriatrics has the potential to be one of the BEST primary care fields ifyou do it right.

The key is to be a medical director at as many nursing homes as you can. One guy I know is med director at 12 nursing homes and pulls down 250k per year.

 

[ajce9]

How does one go about becoming the medical director for a nursing home?

 

[McDoctor]

You guys got it all wrong. Geriatrics has the potential to be one of the BEST primary care fields ifyou do it right.

The key is to be a medical director at as many nursing homes as you can. One guy I know is med director at 12 nursing homes and pulls down 250k per year.

Of course it can be. Exclusively doing nursing home work virtually eliminates any overhead involved with running an office.

My point is that exclusive nursing home work is apt to drive many doctors insane. For better or for worse, nursing homes exist for profit. They seek to employ a minimum number of staff to care for a maximum number of people allowable by law. The "holistic" approach alluded to above sounds nice, but won't be attained in this environment, as it tends to require extra staffing and ancillary services and ultimately more financial cost to the facility.

The homes want someone as medical director who above all else is going to adhere to protocol and maintain the status quo. Basically, the equivalent of a hospitalist, but without the reward of getter people measurably better than when they came into the institution.

Personally, I need a little more variety in my day.