How much do plastic surgeons make actually make.

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coconutsareyummy

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I hear all this $350k $500k $650k talk on sites like webmd etc. and then I look on a forum and someone says he knows a plastics guy that makes over 2mil. Please elaborate, what do they actually make.
 
I know one who came from family money and solely does pro-Bono work in third world countries thus his income is 0.00. I also know one who makes 3 mil a year. You can look up average compensation from medscape annual surveys in 2 seconds by googling, don't be an idiot. Love how this gets asked once or twice a year
 
It really depends. If you do mostly pediatric craniofacial stuff, you won't make as much as adult plastics. There are employed models, group practice models, single specialty models, etc. They all vary as to salary, benefits, hours, cases, etc. If what you're looking for is money, you really should choose another career path.
 
It's a top secret, we can't predict how much they can make. Actually the point is not how much do they make, the point is how well a surgeons is.
 
Reimbursement is variable, depending on what you do. Compensation for anesthesiology, ortho, optho, derm, radiology and even dentistry is much higher than for plastic surgery. A lot of community surgeons do free flap breast recon; this can take 8-12 hours (if there are no problems with anastomosis). They get about $1000 for this procedure, but a radiologist could make much more in that same time period (and not have overhead cost). Be sure it is the only thing you want to do. The last thing you want is to do 8 hour flaps and be miserable when you could make more money in a different specialty.

At the university level, once you graduate residency or fellowship, you have to apply to hospitals, and struggle for OR time. For the first few years, the hospital may give you a few hours a day to do cases, but it isn't enough time to do free flaps (which, by the way, are the highest reimbursed plastics procedure). At first you will need to do some trauma cases. You can do hand if you get a hand fellowship and become certified. Any plastics field now almost requires subspecialty training (craniofacial, hand, breast) or otherwise you can't get privileges and coverage. When the market for your particular skill goes down (new ortho guy in town doing all the elective hand, then you're stuck).
 
plasticsur said:
Reimbursement is variable, depending on what you do. Compensation for anesthesiology, ortho, optho, derm, radiology and even dentistry is much higher than for plastic surgery. A lot of community surgeons do free flap breast recon; this can take 8-12 hours (if there are no problems with anastomosis). They get about $1000 for this procedure, but a radiologist could make much more in that same time period (and not have overhead cost). Be sure it is the only thing you want to do. The last thing you want is to do 8 hour flaps and be miserable when you could make more money in a different specialty.
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Really?

I work in a large community with a lot of PP plastic surgeons and none do free flaps. I've never seen it in other community practices. Given the reimbursement, there'd be no way you could run a practice with that time commitment and low rates.
 
Depends on the reimbursement rates worked out with the insurance companies but I'd have to presume putting in tissue expanders for breast recon is much better reimbursement per hour spent in the OR most places in the country.
 
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coconutsareyummy said:
I hear all this $350k $500k $650k talk on sites like webmd etc. and then I look on a forum and someone says he knows a plastics guy that makes over 2mil. Please elaborate, what do they actually make.
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8)read this again until you believe it.
 
There is so some bad information about income for plastic surgeons out there. Salary information is easy to get for those of us in practice or at/near the end of residency or fellowship training as salary surveys do factor in to contract negotiations. One can buy the salary/productivity data from MGMA, and I recommend that everyone entering a contract negotiation have this information. Every contract you negotiate will have some component of productivity clause and for the most part that is how many RVUs that you are expected to generate.

MGMA for example is an organization that provides mean salary information for most specialties. In plastic surgery for a private guy working at an average clip (~5700 RVUs), earning say 70 dollars per RVU, will make about 400k/yr. Most offers for new grads will be in that ballpark. Some a bit lower, some a bit higher depending on need/location/qualifications of the plastic surgeon.

If you are in a strong private group, the rates can be higher. For example, I can guarantee you that no one in private practice is routinely doing free flaps for 1000 dollars. The guys who I know doing free flaps in private practice are either out of network, or have negotiated carve outs from insurers, and get paid much more than that. Getting 10,000 to 20,000 dollars for a free flap is not unheard of.

For academics, the compensation is generally lower as one might expect. MGMA has a separate set of data for academic surgeons. That said, I work in an academic setting that compensates surgeons on a per RVU basis. You basically eat what you kill. Above that, there are other bonuses paid for academic responsibilities (e.g. program director, division chief, etc.). Also we get compensated for taking call in certain situations, and some of us get bonus pay for providing surgical care that is complex, or requires additional training (e.g. - micro, hand, CF).

I am hearing from my friends across the country in academics, that more and more the eat-what-you-kill per RVU compensation is becoming more common in academics. The days of collecting a salary, doing a few cases, going to a lot of meetings, having a lot of time for writing papers and teaching is going away. Hospital administrators want us in the OR doing cases to generate billing. This kind of model can be good from a financial standpoint for guys who want to grind it out in the OR as much as possible, but this model is a poor one for generating academic output. But, this is the way of the future most likely.

In sum, new grads can expect to get first contracts with guarantees of 300K-500K for employed models. For academics it is more like 200K-300K for a first contract. And incentives can skew these numbers higher. After the intro contract it is really what you are bringing to the table in terms of clinical productivity.

***I do not work for MGMA or have any association with the company. I chose this company to discuss because my employer uses this data***
 
Thanks for this enlightening discussion @igap . By chance, are you an inferior gluteal artery perforator? 😛 I've only seen superior gluteal ones, but I guess that could work 😀.
 
The pay scale for plastics is lower then you think. Certainly much lower then Urology, Orthopedics, Surgery, and Neurosurgery in most instances. Unless you do a lot of simple hand cases, there just aren't a lot of areas where you can churn out large #'s of cases, while reconstructive surgery is some of the worst money per time there is in surgery. I think most Plastic Surgeons cluster between $200-400K per year. I do not believe any plastic surgeon earns $2M (as was mentioned in the OP) from doing surgery and seeing patients, that's probably someone with a very busy ancillary service line to hustle that much. The days of $20K OON free flaps is pretty much gone as carriers won't pay that kind of fee anymore.

Plastic surgeons outside the metro areas are having a hard time staying in business unless they're subsidized employees just to keep a service line open at a hospital.
 
droliver - I think that there are a lot of misconceptions about the earning power of plastic surgeons and I find that it is useful to have data. Professional salary surveys are valuable because they give ballpark numbers.

Your contention that plastic surgeons do not do enough cases to generate the earnings of urology/ortho/neuro may be correct in your area, however I do not find that this is necessarily true in my area of the country. I am curious as to where you get that data from.

A plastic surgeon earning 200K is in the bottom 5% of all plastic surgeons in the country from an earnings standpoint. The mean private practive salary per MGMA is over 400K.

The graduates from our program whom go straight into practice are getting offers from multi-specialty groups, and from hospital systems at the MGMA median. One of our chief residents just took a job with a hospital with a base pay of 415k/yr. After the first year, he will go on a production model and get paid 70 dollars per RVU. He could make substantially more than 415k/yr depending on his RVU production.

As for out-of-network billing, that is under attack and the general consensus is that it will go away in the future. Carve outs should survive though as these are simple negotiations with insurers on a group/institutional basis. For example, in my academic institution, we have negotiated carve outs for micro, and some other complex cases. We offer a high level of care, and have the quality metrics to show that we have superior outcomes, and so are able to negotiate these higher rates for things that we do.

I would think that for the old school, general plastics guy in solo practice, the challenges are daunting. Reimbursements are always being pressured, costs do not go down, and there is only so much time in the day to do cases, and there is only so much cost-cutting you can do. Larger single specialty groups have more leverage with insurers, but not nearly what big institutions have. For these practices, it is easier to imagine clearing 200-300K.

Some links to good resources about the past/present/future of physician reimbursement:

http://www.nejmcareercenter.org/careers/

An old MGMA summary table: (One can purchase the new one from the link above. Defintiely worth it if you are a chief resident or negotiating a contract.)

http://forums.studentdoctor.net/threads/2010-mgma-physician-compensation-survey.817247/
 
droliver said:
The pay scale for plastics is lower then you think. Certainly much lower then Urology, Orthopedics, Surgery, and Neurosurgery in most instances. Unless you do a lot of simple hand cases, there just aren't a lot of areas where you can churn out large #'s of cases, while reconstructive surgery is some of the worst money per time there is in surgery. I think most Plastic Surgeons cluster between $200-400K per year. I do not believe any plastic surgeon earns $2M (as was mentioned in the OP) from doing surgery and seeing patients, that's probably someone with a very busy ancillary service line to hustle that much. The days of $20K OON free flaps is pretty much gone as carriers won't pay that kind of fee anymore.

Plastic surgeons outside the metro areas are having a hard time staying in business unless they're subsidized employees just to keep a service line open at a hospital.
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There are about 10 plastic surgeons in Manhattan or in Beverly Hills who make probably 10 million. Otherwise, plastic surgery is way way overrated. Demanding patients, surgery residency, lack of diversity and pay similar to hospitalist in most markets. Just met a classmate from med school who is a plastic surgeon. He had expected to become a top notch Hollywood surgeon, but things turned out to be very different. The only good thing is that he can brag about being a "plastic surgeon" when he dates hot chicks in SoCal.
 
shark2000 said:
There are about 10 plastic surgeons in Manhattan or in Beverly Hills who make probably 10 million.
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Name ONE & explain how you get to that # practicing medicine. You can't do it.

I personally know some of the heaviest hitters in our field, and the only ones earning several million per year make most of it outside patient care.
 
Head Plastic Surgery Prof at UNLV earns around $1,300,000 a year
 
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WastedTime said:
Head Plastic Surgery Prof at UNLV earns around $1,300,000 a year
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To hit that # he is almost certainly heavily subsidized by the University in several ways (call pay, paid by billed RVU rather then on collections, , multiple rooms running simultaneously, etc...). To net $1.3m doing an academic practice you would have to usually generate charges of close to $3m (Assuming 60%+ overhead including taxes from the school and department of surgery). That is almost impossible to physically do that much surgery for what reconstruction pays and the length of the more complex cases. You just can't do it based on what you collect anymore.

Likewise, on a predominately cosmetic practice, you still have large overheads and your net per major surgical procedure may run between $1500-3500 for the more common procedures (breast augmentation or abdominoplasty) The more complex body and facial cases may net you more per case, but your throughout is limited. As I mentioned it's very hard to get > $1m net doing plastic surgery anymore, and those people are certainly outliers. For some perspective, a TRAM flap used to reimburse close to $10,000 in 1985. I would get paid <<$3000 for the same case 30 years later.
 
droliver said:
To hit that # he is almost certainly heavily subsidized by the University in several ways (call pay, paid by billed RVU rather then on collections, , multiple rooms running simultaneously, etc...). To net $1.3m doing an academic practice you would have to usually generate charges of close to $3m (Assuming 60%+ overhead including taxes from the school and department of surgery). That is almost impossible to physically do that much surgery for what reconstruction pays and the length of the more complex cases. You just can't do it based on what you collect anymore.

Likewise, on a predominately cosmetic practice, you still have large overheads and your net per major surgical procedure may run between $1500-3500 for the more common procedures (breast augmentation or abdominoplasty) The more complex body and facial cases may net you more per case, but your throughout is limited. As I mentioned it's very hard to get > $1m net doing plastic surgery anymore, and those people are certainly outliers. For some perspective, a TRAM flap used to reimburse close to $10,000 in 1985. I would get paid <<$3000 for the same case 30 years later.
Click to expand...

http://www.transparentnevada.com/salaries/2014/university-nevada-reno/william-zamboni/
 
droliver said:
To hit that # he is almost certainly heavily subsidized by the University in several ways (call pay, paid by billed RVU rather then on collections, , multiple rooms running simultaneously, etc...). To net $1.3m doing an academic practice you would have to usually generate charges of close to $3m (Assuming 60%+ overhead including taxes from the school and department of surgery). That is almost impossible to physically do that much surgery for what reconstruction pays and the length of the more complex cases. You just can't do it based on what you collect anymore.

Likewise, on a predominately cosmetic practice, you still have large overheads and your net per major surgical procedure may run between $1500-3500 for the more common procedures (breast augmentation or abdominoplasty) The more complex body and facial cases may net you more per case, but your throughout is limited. As I mentioned it's very hard to get > $1m net doing plastic surgery anymore, and those people are certainly outliers. For some perspective, a TRAM flap used to reimburse close to $10,000 in 1985. I would get paid <<$3000 for the same case 30 years later.
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That's cuz you do TRAMs. We all know DIEPs are sexier 😉. (I only tease.)
 
MOHS_01 said:
I hate to tell you this, but that map is **** - they give incomes for many areas without practitioners.
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Certainly higher than starting salaries, but pretty close for mid-career practitioners.

Perhaps inflated as it might include things like non-salary reimbursement --a problem with self-reported data.
 
Moravian said:
It really depends. If you do mostly pediatric craniofacial stuff, you won't make as much as adult plastics. There are employed models, group practice models, single specialty models, etc. They all vary as to salary, benefits, hours, cases, etc. If what you're looking for is money, you really should choose another career path.
Click to expand...

are HMOs, hospitals, or whatever employing plastic surgeons in significant amount? If so, what type of cases predominate in this employment model? I am curious bc I have only heard of opportunities in PP and academics for plastic surgery.


Winged Scapula said:
Really?


I work in a large community with a lot of PP plastic surgeons and none do free flaps. I've never seen it in other community practices. Given the reimbursement, there'd be no way you could run a practice with that time commitment and low rates.
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a plastics attending at my school went even further than this and said PP guys avoid recon cases and largely stick to cosmetic cases bc they are more lucrative. Do you agree PP plastics is vastly just cosmetic cases?
 
giraffesuptop said:
are HMOs, hospitals, or whatever employing plastic surgeons in significant amount? If so, what type of cases predominate in this employment model? I am curious bc I have only heard of opportunities in PP and academics for plastic surgery.




a plastics attending at my school went even further than this and said PP guys avoid recon cases and largely stick to cosmetic cases bc they are more lucrative. Do you agree PP plastics is vastly just cosmetic cases?
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In my community, yes. YMMV.

However, I have several plastic surgeons who are willing to do recon cases and some that even enjoy them. But for the amount of work involved, including the postoperative care, the reimbursement is very low. Couple that with the high expectations (they all eventually become cosmetic patients), it's easy to see why many decide it's not worth it to do reconstruction.
 
We have some Kaiser docs locally that do free flaps (we trained them). There is another community surgeon that also does micro but he does it at the University. He's able to afford it because he gets a huge carve-out from the insurance company. A carve out is a negotiated rate, usually at or close to billed charges, that an insurance company will pay to a certain practitioner for a certain procedure. Other hospital employment models can vary. You might work on a salary plus a productivity bonus, you might be only on productivity after the first year or two, you might get extra money to take call, etc. The cases are generally mixed in these systems. Some employment models are also single specialty and multi specialty which may or may not have revenue sharing or other bonus structures built into the plan.
 
Moravian said:
We have some Kaiser docs locally that do free flaps (we trained them). There is another community surgeon that also does micro but he does it at the University. He's able to afford it because he gets a huge carve-out from the insurance company. A carve out is a negotiated rate, usually at or close to billed charges, that an insurance company will pay to a certain practitioner for a certain procedure. Other hospital employment models can vary. You might work on a salary plus a productivity bonus, you might be only on productivity after the first year or two, you might get extra money to take call, etc. The cases are generally mixed in these systems. Some employment models are also single specialty and multi specialty which may or may not have revenue sharing or other bonus structures built into the plan.
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That screams DIEEEEEPPPP to me.
 
Wrong.
Some responses sound like residents hoping they get what they would like.
Sorry to burst the bubble.

During the recession I knew people that took home just 30k.
Slow years I make 250k.
Most private practice plastic surgeons make 300-350k.
Too many plastic surgeons. Too many non plastic surgeons doing non surgical.
Reconstructive pays poorly and we are dumped on by most specialties. Cosmetic in the non rich areas is not a gold mine, not people lined up, and a lot if competition. And the fewer rich people leave town

Big city big name 600k to 2 million or more .that is the top 10% but luck and circumstance are needed.

Full professors 600k
Only one of 2 specialties that academics makes more than average private practice.

Anesthesia pays better for half the hours and stress.
 
As someone on the job market now, I am seeing numbers between $225-300 for straight out of fellowship + production bonuses. (some with signing bonus)
 
Well, its been some time since the OP was well posted, this question is directed to the people who answered at an earlier timeframe, How is it like now? Has the market improved? Has the median income increased?. Thank you!
 
mpa123 said:
Yup. Definitely not the windfall you expect after training for 6-8+ yrs. Sucks.
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Is this in major metros? Had heard of a few recent grads getting offers in the $400-600k range, but those seemed to be in much less desirable areas.
 
Slack3r said:
Is this in major metros? Had heard of a few recent grads getting offers in the $400-600k range, but those seemed to be in much less desirable areas.
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Yes, mostly major cities (east coast). The published number from KP was also along those lines (I think it was $345k+ bonus), but they are in desirable/competitive west coast cities. I would be curious as to how undesirable a location it would have to be to get paid $600k. Never heard that number for a new grad. Though that listing for Fargo, ND has been up for a while!
 
5 million plus is possible tbh.
David samadi earns more han 7 mill as a celeb urologist.
 
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250-350K is very reasonable for just being out of training. If you're trying to get into a market that's saturated (highly desirable) you might actually make less. Conversely, in a place like North Dakota, you might make more starting out. The bottom line is that it takes time, hard work and dedication to your patients to build a practice. There are also a lot of variables such as the type of practice you have (ratio of cash/insured), your insurance contracts (i.e., carve-outs) and payer mix (PPO/HMO/Medicare/Medicaid). One of the better pieces of advice I received in training was not to worry about the money. Worry about your patients. The money will follow.
 
Gandalf_Greybeard said:
5 million plus is possible tbh.
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No, it is not possible to earn $5M doing Plastic Surgery. There aren't enough hours in the day and the revenue per case is too low. to earn $5M in salary you'd need to generate $10-12M in revenues. that is impossible to do with procedures. People with multimillion dollar earnings get most of it through ancillary services rather then actually doing surgery.

Guys like Zamboni at UNLV (who has since died I believe) who earned a large salary (> $1M) mentioned upthread used to run multiple rooms at a teaching hospital in a way that's now largely considered billing fraud.
 
droliver said:
No, it is not possible to earn $5M doing Plastic Surgery. There aren't enough hours in the day and the revenue per case is too low. to earn $5M in salary you'd need to generate $10-12M in revenues. that is impossible to do with procedures. People with multimillion dollar earnings get most of it through ancillary services rather then actually doing surgery.

Guys like Zamboni at UNLV (who has since died I believe) who earned a large salary (> $1M) mentioned upthread used to run multiple rooms at a teaching hospital in a way that's now largely considered billing fraud.
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Dr Samin sharma who is an interventional cards guy does the same thing...multiple procedures at the same time..he makes 3.5 mill.
Dr samadi is a pioneer in robotic urology surgeries and hence probably the big bucks
https://www.google.co.in/url?sa=t&s...ggfMAE&usg=AFQjCNEWMNOiS4ljciAVmmMp_n0CKWyPCA
 
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Interesting conversation. I was recently talking with some plastic surgery residents and I got the sense that there was a rather large disparity for plastic surgeons. It seemed that business savvy surgeons who can do a high volume of cosmetic/elective cases can make pretty absurd money, although well earned. However these jobs are likely hard to come by and take entrepreneurial skills and business acumen to be successful. I could imagine the frustration of completing a brutal plastics residency and then being salaried at only 300-400k.

Do a lot of people fall into the trap of thinking they'll be making 500K+ in cosmetics only to find out that they're not part of the lucky few?
 
Dermpire said:
Interesting conversation. I was recently talking with some plastic surgery residents and I got the sense that there was a rather large disparity for plastic surgeons. It seemed that business savvy surgeons who can do a high volume of cosmetic/elective cases can make pretty absurd money, although well earned. However these jobs are likely hard to come by and take entrepreneurial skills and business acumen to be successful. I could imagine the frustration of completing a brutal plastics residency and then being salaried at only 300-400k.

Do a lot of people fall into the trap of thinking they'll be making 500K+ in cosmetics only to find out that they're not part of the lucky few?
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This is the same for all fields. It's always the entrepreneurial doctors that make the big bucks. As a rheumatologist, I can tell you that the average rheumatologist makes $200-300k, but I personally know several guys that pull $1.5-2 mil a year by having a ton of ancillary services in a high volume practice.

Most med students don't realize this, but it's not about the field that determines your income potential. It's about your business acumen after you complete training.
 
Gandalf_Greybeard said:
Dr Samin sharma who is an interventional cards guy does the same thing...multiple procedures at the same time..he makes 3.5 mill.
Dr samadi is a pioneer in robotic urology surgeries and hence probably the big bucks
Click to expand...

Those guys aren't doing plastic surgery though. There is no surgery we do with the same revenues at high volumes like some of the other specialities (GU, ENT, Ortho) with the exception of some of the hand guys. Our cases take too long to get those volumes. We can't do 10-20 cases in a day. A bread and butter case for example, like a breast reduction, takes close to 2.5-3 hours (or more sometimes) and may only pay $1500-1800. Two of those back to back is a long 7-8 hours with turnover and such by the time you're done. Even the cosmetic stuff doesn't command extroidinary per hr rates, and that business line has overhead normally 60%+.

That kind of math is why most busy plastic surgeons top out somewhere between $275-500k take home pay, and why the idea that there's lots of $1m incomes from just surgery not to be true.
 
You also have to be a great surgeon. You can get referred cases and be an average surgeon in many other fields and stay busy. If you suck at surgery and try to succeed as a cosmetic surgeon, you will be stuck spending loads on marketing and the ceiling you are able to charge for cosmetic cases will be lower. Your surgical skill is broadcast on the body of every patient you touch. And you can't be an a**hole either. If you are having a bad day and are a bit rude to a colectomy patient.... who cares. If you snap at your high needs cosmetic patient, and they post 500 negative reviews about you all over the internet..... You're gonna feel some pain.

That's why there are a few outliers making millions in cosmetic surgery, while the rest are making regular surgeon physician salaries but probably not working quite as hard as their general surgeon colleagues.
 
The MGMA data does not seem to be too far off.

Recent grads from our program have gone into hospital-employed practice. Starting salary has been between $400-600k, all of which had a production bonus based on wRVUs.

That being said, almost all of these contracts will have a clause regarding Anti-Stark laws do that your additional income combined with salary does not exceed 95% of MGMA data (depending on the area somewhere between $750-950k).

All of these practices are wRVU based and have minimal concern for cosmetic. They all anticipate a mostly reconstructive practice and convert cosmetic procedures to wRVU production. Obviously, these are more financially beneficial to the hospital or hospital group, as it is 100% and Out of pocket. Regardless, these are not private practice individuals or practices where all of the procedures are all cash.

The instances of plastic surgeons making millions (as stated by Dr. Oliver) is confined mostly to those who have ancillary income. The former chair at UNLV did indeed make over $1M while he worked there before he passed away. This is exceptionally rare and certainly not the case with most academic plastic surgeons.

There are few instances where a private practitioner can have a 100% cosmetic practice and make the kind of money described. The vast majority of plastic surgeons these days are going to work in hospital-employed groups, multi-specialty private groups, or in academia. Of course, there are multi-practitioner single-specialty groups. There is one, for instance, in Minnesota that I know of that is very successful. But they also offer the full array of plastic and reconstructive procedures and are not a 100% cosmetic group.

To answer the OP's question:
There is wide variability. It, as one of the original responses says, depends greatly on the where and the how.
For new grads in an area of need, I would expect to look for a hospital contract with a base salary between $300-400k with a work production bonus. Expect less starting out at an academic institution and slightly more in a multi-specialty practice.
The more crowded an area, the less you will make, almost completely irrespective the type of surgery you do.

I would not plan to make millions each year unless you invent something, have a very specialized niche, or become the absolute best in your field. After all, at the end of the day, if you charge it and someone pays it....
 
Million.jpg
 
Anyone with most recent MGMA for 50 percentile plastic surgeon salary in Boston/northeast area?
 
There's a plastic surgeon overseas in Australia that charges 30 thousand per breast surgery, and he does over 900 per year. Insane. Must be taking home at least 20 mill (14 mill USD) after expenses?
 
coconutsareyummy said:
I hear all this $350k $500k $650k talk on sites like webmd etc. and then I look on a forum and someone says he knows a plastics guy that makes over 2mil. Please elaborate, what do they actually make.
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Academic center plastic surgeon here. The last few years I've been taking home ~1M per year. My comp is essentially 100% clinical. Been in practice for over 10 years and am what you'd consider "mid-career". I do a mix of cosmetic and reconstructive microsurgery.

I worked very hard early on in my career doing a lot of stuff, but eventually carved out a niche practice. I work less than I used to, but my is spent wisely. I'm probably pretty typical of most mid-career surgeons who have a significant cosmetic component to their practices.
 
igap said:
Academic center plastic surgeon here. The last few years I've been taking home ~1M per year. My comp is essentially 100% clinical. Been in practice for over 10 years and am what you'd consider "mid-career". I do a mix of cosmetic and reconstructive microsurgery.

I worked very hard early on in my career doing a lot of stuff, but eventually carved out a niche practice. I work less than I used to, but my is spent wisely. I'm probably pretty typical of most mid-career surgeons who have a significant cosmetic component to their practices.
Click to expand...

What advice do you have for the rest of us starting out in practice to getting to that mark? 1M is higher than even most private practices.
 
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