How much do doctor's actually make?

[TryingToBeHouse]

Hello all,
First of all, I'd like to say that I'm sorry if this is a repetitive topic, however I would like some other people's opinions as well as their opinions on my experiences.
Secondly, I don't really need anyone to tell me that I shouldn't become a doctor for money, I've heard it a thousand times, and do not intend on studying medicine solely for financial purposes. However, money is important in ones life and income is a very real and necessary topic to discuss.

Online statistics say that the average SALARY for physicians is at the least, 150k up to about 190k. This means that any ordinary physician, MD/DO will be making at least 130k reasonably. My problem is that these statistics are about SALARIES, not income. What happens if a physician owns their own practice? A surgeon? The area they practice in? Multiple practices?

I'm also well aware that there are celebrities among the community for surgeries and whatnot who make over 2m/y. I don't really care or want to count these in my calculations.

I personally know multiple physicians, one being a cardiologist, one an ordinary family doctor, and one a gastroenterologist. The first two own multiple practices, neither are famous, and one makes 1m+ and the other makes 500k+ respectively. The gastro has one practice, works 3 days a week and makes 500k+. Mind you, the doctors I'm talking about and myself included, live in Silicon Valley where 1500 sq ft. 3-4bed 2baths are over $1m. Now, in these inflated areas, how do the statistics hold up?

I also know surgeons who are on salaries working for large groups who were offered 500-600k right out of residency, who didn't go to any "amazing" ivy league med school. This is nearly double what averages say. (And these were fresh post-residents)

Now, with these personal experiences (Noting none of these doctors are famous or came from notable Medical schools) I find it hard to believe that the "average" statistics online are correct. It can't ONLY be the area in which they practice, as the statistics for California / Bay area are only 20% more than the national average, but these specific examples are 60-90% more than average. Thus, I can only think that the statistics are either counting salary only (not privately owned practices), or the practice-owners (clearly have no incentive) aren't reporting everything they make.

Thus I believe that doctors make WAY more than what's stated online, or at least have a relatively easy potential to.

A second topic I don't understand is why people are saying doctor's salaries are going down. I'm no master economist but Less doctors + more people = more demand for doctors = higher pay for doctors. 200k in debt and missing the majority, if not all, of your 20s is a large sacrifice that is only increasing in monetary debt and forcing less and less people to be willing to take the route. Nonetheless the amount of sick people is not going down, in fact it's going up as the pop. increases. Why on earth would doctor's pay be going down? The family doctor I was talking about earlier actually flies to a different state (where there's a shortage of doctors in a specific area) every weekday, and comes back to California on the weekends to his family because he actually makes 2-3x what he would make in California!

Also, please refrain from telling me that if you want the most money, become so-and-so. While I agree that a couple of other routes may yield more money over the course of one's life, many of them will not. The fact of the matter is, even with the online stats which I think are low, doctor's have a high, sustainable, guaranteed income which is not at all difficult to become a multi-millionaire with proper investment. And that 200k average debt is nothing compared to the income advantage a doctor has when he starts working. Assuming the average career age is 65, the doctor will out-earn most other jobs by that time despite a large debt and many years of no income due to schooling and residency. To the most common example of the Engineer, engineers don't typically own their own business. This is a huge financial advantage that a doctor with their own practice has in terms of write-offs and other miscellaneous deductions and breaks. And movement up the corporate ladder in the engineer's fortune 500 computer company isn't necessarily guaranteed throughout the course of their career, whereas a pretty much concrete minimum of 130K is guaranteed for life to any physician, who is also not affected dramatically by changes in the economy. (Such as losing their job). Additionally, I know of multiple 4 year degree engineers who have been making 50-60k for years, however, I've yet to hear of a doctor making under 130.

Edit: I noticed the typo in the title after posting, don't think I can change it though.

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[DBC03]

I'm interested in hearing replies. And, yes, there are multiple four year degree engineers (with professional licensing) who make only $60k or even less, depending on market conditions. While money should certainly not be the reason to go into medicine, it's very important to consider it when you are willingly taking on that much debt. My guess is that salaries will be changing dramatically over the next few years, but it is good to get a feel for it now.

 

[YouEverHadOurSausages?]

I don't know enough to answer your questions, but I can mention that the declining salaries portion is more about decreased reimbursement from insurance companies and the government (I think) rather than lower physician demand.

 

[Mad Jack]

Medscape: Medscape Access

Enjoy. MGMA data is also pretty good, but it's got a paywall.

As to doctors earning less, PCPs earned around 130-150k out of the gate in 2006. A new PCP today can earn 200-230k easily. Specialists, however, have seen stagnant or declining reimbursement in the last decade, and are often barely at or even below inflation. Essentially the bottom has come up but the top hasn't risen all that much, which probably grinds the gears of specialists that are having to work harder to make the same amount of money.

 

[new_dood_don't_be_rude]

I've see where PCPs make about 200k in average and specialists 300k. Not sure where you get 130k from.

 

[DrfluffyMD]

Ok, i'll bite. Physicians owning practices are not the norm and new grads now usually don't have that option.

 

[Mh0311]

What about with the physician shortage the AAMC says will happen in the 2020s, won't hospitals/clinics offer better salaries, benefits, etc to recruit physicians?

 

[DrfluffyMD]

What about with the physician shortage the AAMC says will happen in the 2020s, won't hospitals/clinics offer better salaries, benefits, etc to recruit physicians?

The physician shortage, in my opinion, is a lie. There is a maldistribution of physician, not shortage.

I grew up in California but now I may have to practice away from home because of saturation of nearly ALL physician jobs in socal outside of primary care.

You may say, oh, woe is me, etc.This doesn't change the fact that I am the only one in my friends group who have a hard time returning (I am the only physician).

Huge amount of money doesn't matter if you are away from friends and family.

 

[cactusman]

130k would be pretty normal for neurology and IM subspecialties if you're in academia I think (at least if you have your own lab and do a lot of research), but is otherwise on the low end.

I only skimmed but I don't think I saw it mentioned that more desirable areas (like the Bay Area) actually tend to pay less. I believe Nebraska has highest physician salary (although it might be somewhere else in the mountain/Midwest or south, and NH is pretty high).

 

[DrDwayneJohnson]

130k would be pretty normal for neurology and IM subspecialties if you're in academia I think (at least if you have your own lab and do a lot of research), but is otherwise on the low end.

I only skimmed but I don't think I saw it mentioned that more desirable areas (like the Bay Area) actually tend to pay less. I believe Nebraska has highest physician salary (although it might be somewhere else in the mountain/Midwest or south, and NH is pretty high).

I believe it's North Dakota now but don't quote me. Either way, the highest paid region is the north central aka where almost nobody wants to go/currently is


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[md-2020]

In my admittedly limited experiences thus far meeting with new attendings/upperclass graduates and physician mentors though, MGMA & Medscape data are woefully skewed low as OP mentions.

Would be interested in hearing docs opinions on this at some point too, my best guess thus far has been that there's a far more significant proportion of physicians contributing to their data sets who are working part-time or locum tenens, than I'd thought.

Medscape's significant year-to-year variability in some specialties also makes me question the reliability of their sample population/methods & size.

But to answer your maths question: your income really depends on 1. specialty 2. whether or not you care about where you practice (Alaska anyone?) 3. academic vs. pp and 4. blind luck to some extent.

 

[Spaghetti Shark]

The Atlantic published an article on this exact subject. I'll just post the article here.
What Doctors Make

 

[USCguy]

In my experience, the following things play a major role in your income vs peer group

1. Market forces at play in your local area(if you are the only one of your kind willing to go to X town, you can demand a higher price from an employer.

2. Speciality, and if you do any procedures

3. How hard you are willing to work

4. Proper documentation and coding, which is overlooked but probably one of the biggest drivers of your income

5. Controlling your debts and spending: while this is an aside and doesn't affect gross income, it can make 200,000 feel like 400,000 (or 400,000 feel like 90,000). Watching the bank account go up at a logarithmic type rate as debts are paid off is beautiful

You can get rich as a PCP or live paycheck to paycheck as a subspecialist.

If you show up and work hard in medicine, in most places you will make at least 200-300k as a full time clinician outside academia. Obviously there are exceptions to everything.

 

[BigRedBeta]

What's your question exactly?

@USCguy has the big points right although didn't expand on what those mean.

1) location always matters. Market saturation drives salaries down. If you are willing to move for a job, you have a much better chance at maximizing your income. But you have to find a place with the right balance - not too large that it automatically attracts people, not too small where there's simply no market. Staying away from nearby academic centers is also probably wise as they're constantly turning out new residency grads who are prone to stay in the area. But not every specialty can survive every place. I'm a PICU attending and there simply aren't PICU's in small towns that might offer the best earning potential for a general internal medicine physician or general surgeon.

2) how hard your willing to work also always matters - you always hear stories about the outlier general pediatrician who is making 80k outside San Francisco, but they never mention that person doesn't do newborn nursery, only works 3 days of clinic per week and takes no night or weekend mommy call. The fact of the matter is that they made a choice about how hard they were willing to work (and where) and get the salary/income commensurate with that amount of work in that area. If they were to take call or see newborns in the nursery or work a regular number of clinic hours, they would get paid more. If they were to do it in a different location, they would get paid more.

I had two internal medicine mentors when I was a med student. One triple booked every appointment slot at 12 minute intervals from 1000am to 530pm, every day even though he never got back from seeing his patients in the hospital until 1030. He would routinely work in sick visits into his schedule too. He and his PA ran their butts off all day to see his patient load and he usually didn't finish charts until 730p. The man was a machine. The other only single booked 20 minute appointment times, did not see his own patients in the hospital, and always left the office by 445p with all his charts done. A request to work in someone for a sick visit sent his office into a tailspin every time. Two doctors, graduated from the same residency class, with offices 5 miles apart in the same city (so essentially same payor mix)...guess which one had vacation homes in Breckinridge and Charleston, and which one complained that declining reimbursement was going to be the death of medicine?

3) Debt sucks. For my field, I make good money comparatively. But I have to be smart about large purchases month to month because I can quickly outspend my means. That's the part that doesn't always make sense until you've lived it when you hear about pulling down X number of dollars per year. Now, that said, in the context of my monthly bills, my wife and are maxing out our 401k's, we are able to make solid contributions to our child's college fund, and continue to make other small investments every month. We're able to pay our future selves first and still do well, a luxury not everyone has. But I still have what most people would consider the equivalent of an extra mortgage payment every month in student loan debt. Life would be easier if that money stayed in my pocket.

 

[Gauss44]

Salaries will vary with specialty and area of the country among other things. There are websites that will tell you. Not sure if it's against the rules to post those websites. If you look hard enough, you will find them.

 

[Gilakend]

Medscape: Medscape Access

Enjoy. MGMA data is also pretty good, but it's got a paywall.

As to doctors earning less, PCPs earned around 130-150k out of the gate in 2006. A new PCP today can earn 200-230k easily. Specialists, however, have seen stagnant or declining reimbursement in the last decade, and are often barely at or even below inflation. Essentially the bottom has come up but the top hasn't risen all that much, which probably grinds the gears of specialists that are having to work harder to make the same amount of money.

According to that 1/3 of doctors think they should make 26%-50% more. Imagine if all those people saying doctors are way overpaid heard that. Thanks for the link.

 

[bannie22]

11 dollar an hour. if i am abused more i make less. on weeks i am abused less maybe it goes to 13 dollar an hour tops.

 

[TypeADissection]

After reading the article published in the Atlantic, I'd say those numbers look about right give or take a few grand on either side. We all have loans and we'll all get them paid off. We're going to make money and do well for ourselves and our families. As you go through the residency process, you'll begin to see how important the practice situation you're walking into is more than the upfront dollars. Especially our generation of physicians, most of us will not be staying at our first practice post for the rest of our lives and probably because the dollars we're making doesn't make up for the practice situation we're in either because of call, lack of administrative support, locoregional politics, etc.

 

[TryingToBeHouse]

I've see where PCPs make about 200k in average and specialists 300k. Not sure where you get 130k from.

I was simply stating the very least I've ever seen, I'm well aware and agree most make near or above 200k.

And to everyone else who commented, thanks for the comments. I unfortunately wasn't able to get on my computer to watch the thread after i posted it, and totally forgot.

 

[Soccer171983]

this question is tough to answer and involves a lot of generalizations. I know people who work urgent care 40 hours per week making 200k with basically very cush lifestyles. I know spine surgeons who work 60+ hours a week and pull 1million. The situation also depends on private practice vs employeed positions which within the same field can cause huge variations. For example I know of a bunch of IM starting jobs 250k very regimented and predictable regarding calls, bonus structure, and benefits. I also know people who have gone solo who have way more to worry about such as getting people to cover them when they want off, paying own insurance and billing etc who could put in 80 hour weeks but make 500-600k easy. This question is too vague to accurately answer. If you want to ask what "an average pulm critical care 1st year attending in las vegas makes with certain stipulations" might be an easier question to answer about a doctor somewhere in the us because you are specifying the field, years of experience, location and modifying factors.

 

[Dox4lyfe]

So basically docs can make as little as 80k (or less) or as much as $1M+ depending on experience, location, hours worked, patients seen, speciality, hospital employed vs private practice, etc.