Help me make sense of these outrageous salary figures

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Look at where they're working and the overtime pay. The base salaries aren't outrageous at all for working in a prison, but most of them are working significant overtime and the ones making a ton of "other" pay are probably moonlighting. Also, these are federal jobs so the benefits are going to be ridiculous. If you've never looked at VA benefits you should check those out as they're pretty ridiculous as well (50+ days of paid time off per year + many financial incentives). Keep in mind that jobs at jails are higher (physical) risk than most other practices and your chances of being sued are also much higher (have been told by prison docs that there's lots of bored anti-social patients that do it just for kicks).

Think of it this way: would you work in a federal prison if you didn't get pretty outstanding pay/benefits?
 
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It's prison dude.

You're in there with rapists, murderers, sociopaths, shotcallers for different gangs, etc.

Guess what happens when there' s a riot.

The ONLY thing keeping you safe is ONE C.O.

If he/she don't like you, guess who is at risk of getting stabbed, punched, spit on, pushed, etc. if he/she doesn't make it to the prisoner on time.

I have family that are IN the jail system (on both sides as inmates & on the healthcare side).

It's ugly.

You are STUCK inside the prison. You do NOT go home if it isn't resolved.

You are walking in everyday and are going through metal detectors, getting frisked carefully by the guards, and there are jail doors every 10-15 feet that you need to go through to get anywhere.

Not to mention all of the times you get sued by prisoners and YES... even if you win... they go onto your record so it can be HARD to get certain malpractice insurance at a point in time.

Nobody mentioned documentation either.

It's not an outpatient office.

EVERY FM doc I talked to about prison said they'd rather be in an actual outpatient setting than a metal jungle. They can attain CLOSE to the same numbers these prison docs get with much less risk of being hurt or assaulted.

If you aren't used to this patient population, you will DEFINITELY be overwhelmed.

These figures are also with extensive overtime.

You can clear twice as much in a nonsurgical specialty with less hours.

This type of work will not be for everybody.
 
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The guys making bank are working some serious overtime. That could be you, too...if you want to do it while you're young. You won't want to do it when you're older.
 
You can make that but be prepared to work, like 50 hrs per week for a year. Have some side gigs like plasma/blood donation med director...
 
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Weird thing is when you plug in other specialties in that search FM comes out making more than even most surgical specialties. Unfortunately, nothing but prison medicine is listed but I'm sure outpatient can't be too far off.

The question then is, can one hit these kinds of numbers in the Midwest doing outpatient + nursing home + occassional ED shift? Probably coming in at ~60 hours a week.

I was planning on doing anesthesiology and didn't really care where I went to residency until I got married. Now geography is huge all of a sudden. If I wanna stay in NC, for a DO there's really only a slight chance of getting into Wake. If I did FM, I'd have my pick of the litter with my board scores. Gas comes in at 60 hours a week on average anyway, and if I can do the same hours in FM for the same salary that's a viable alternative at this point. Plus it saves me a year of residency and I have the option of doing a pain fellowship after FM. I know that's unlikely to get coming from FM but it was recently added to the official AAFP list of FM fellowships so maybe more doors will open up in 4 years by the time I'd potentially be applying.
 
zero0 said:
The question then is, can one hit these kinds of numbers in the Midwest doing outpatient + nursing home + occassional ED shift? Probably coming in at ~60 hours a week.
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Yes. Find the right business model and you can make $300k+ in FM working 40 hours a week. spend 15-20 additional hours picking up locums shifts or side gigs and you can add another $100k+ to your income. Not everyone can do it as you have to understand how to manage your time and business properly, but it's certainly possible.

zero0 said:
If I wanna stay in NC, for a DO there's really only a slight chance of getting into Wake.
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One of my friends from med school is a DO gas resident at Wake and I'm sure he'd be willing to answer some questions for you if you've got them. PM me if you're interested.
 
zero0 said:
Weird thing is when you plug in other specialties in that search FM comes out making more than even most surgical specialties. Unfortunately, nothing but prison medicine is listed but I'm sure outpatient can't be too far off.
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This is probably because its "public pay" and thus on this database.
Canada has a similiar program to encourage transparency. Its called "sunshine list".
 
One of the guys in our group makes that kind of money ($600,000+) doing a combination of outpatient, inpatient, nursing home (x2), and hospice. He's also the medical director for the two nursing homes as well as the hospice program. He works way harder than I have any desire to.
 
Blue Dog said:
One of the guys in our group makes that kind of money ($600,000+) doing a combination of outpatient, inpatient, nursing home (x2), and hospice. He's also the medical director for the two nursing homes as well as the hospice program. He works way harder than I have any desire to.
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How man wives/houses does he have?
 
Blue Dog said:
One of the guys in our group makes that kind of money ($600,000+) doing a combination of outpatient, inpatient, nursing home (x2), and hospice. He's also the medical director for the two nursing homes as well as the hospice program. He works way harder than I have any desire to.
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I know someone like that. He has child support and alimony X 2 to pay so he lives paycheck to paycheck. It's both inspiring and depressing.
 
This guy has one wife and family. Maybe his wife has expensive taste or something.
 
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zero0 said:
Weird thing is when you plug in other specialties in that search FM comes out making more than even most surgical specialties. Unfortunately, nothing but prison medicine is listed but I'm sure outpatient can't be too far off.

The question then is, can one hit these kinds of numbers in the Midwest doing outpatient + nursing home + occasional ED shift? Probably coming in at ~60 hours a week.

I was planning on doing anesthesiology and didn't really care where I went to residency until I got married. Now geography is huge all of a sudden. If I wanna stay in NC, for a DO there's really only a slight chance of getting into Wake. If I did FM, I'd have my pick of the litter with my board scores. Gas comes in at 60 hours a week on average anyway, and if I can do the same hours in FM for the same salary that's a viable alternative at this point. Plus it saves me a year of residency and I have the option of doing a pain fellowship after FM. I know that's unlikely to get coming from FM but it was recently added to the official AAFP list of FM fellowships so maybe more doors will open up in 4 years by the time I'd potentially be applying.
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Physicians in primary have the ability to make 300k+ if they are willing to put in the hours... My cousin has been making over 350k+/yr for over 10 yrs working <60 hrs/wk as an IM doc. If you make hour comparison b/t primary care and some of the specialties, the difference in salary is not that much...

For instance, the VA affiliated to my residency program (IM) has IM doc that moonlight in the ED for $185/hr (7a-7p) and >$22o/hr (7P-7a). You can add another 100k to your salary easily working 3-4 shifts/month
 
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Mad Jack said:
'Psychiatrist' search results | Transparent California

Not doing bad on the psych front either
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From what I've seen psych is another possible cash cow where you can stack jobs...

Something like cash only outpatient + some inpatient coverage + billable procedures like ECT and antipsychotic injections = $$$

The only thing keeping most psych docs from that kind of money is they'd just rather not work that much and enjoy their free time instead.
 
zero0 said:
From what I've seen psych is another possible cash cow where you can stack jobs...

Something like cash only outpatient + some inpatient coverage + billable procedures like ECT and antipsychotic injections = $$$

The only thing keeping most psych docs from that kind of money is they'd just rather not work that much and enjoy their free time instead.
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Yeah, in my area it is pretty remote so there is a lot of job stacking due to high need and pay, most psych docs are pulling 500k+
 
I posted it in another thread, but you can easily make that money ($300k-$400k) in the midwest working outpatient. I get emails all the time for teaser salaries in that range from the midwest. In CA I get $200k-$280k numbers, but in NorCal (like real NorCal, like Redding/Shasta area) its closer to $300k+. Those emails also have sign-on bonuses and loan repayment offers on top of those salaries as well.

Everything has its pros and cons. Wait until you're in residency before you jump to conclusions about how much and where you'd be willing to work.
 
nimbus said:
Here ya go. “Nurse”.

Don’t even try “coach”. 😉

'Nurse' search results | Transparent California

Search California public, government employee, workers salaries, pensions and compensation
transparentcalifornia.com transparentcalifornia.com
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similarly Medicare Unmasked: Behind the Numbers

the number of NP's who collected over 1M in medicare reimbursements in 2015 exceeds the number of their physician counterparts in a number of specialties including EM, Allergy/Immuno, and even ENT.
 
Ibn Alnafis MD said:
similarly Medicare Unmasked: Behind the Numbers

the number of NP's who collected over 1M in medicare reimbursements in 2015 exceeds the number of their physician counterparts in a number of specialties including EM, Allergy/Immuno, and even ENT.
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Totally different things here.

Several of these NPs are from rheumatology, and the reimbursements are for buy and bill of biologics. If you get reimbursed two mil, your profit is maybe 200-300k. Furthermore, there are no independent rheumatology practices owned by mid-levels, so someone else is collecting that profit - usually the MD partners. If NP is hospital employed, then the hospital takes it.
 
bronx43 said:
Totally different things here.

Several of these NPs are from rheumatology, and the reimbursements are for buy and bill of biologics. If you get reimbursed two mil, your profit is maybe 200-300k. Furthermore, there are no independent rheumatology practices owned by mid-levels, so someone else is collecting that profit.
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Gotcha. I was salivating over the neurology numbers (my specialty). Perhaps the lion share of these amounts is going to cover the costs of drugs 🙁
 
I cleared 400K this year in urgent care with working extra shifts (4-5 month) and all the RVU bonuses. Wasn't that hard. Remember a lot of those number include health/disability benefits that you never see as money in the bank but still counts.
 
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