Many in my group have minimal insight into the difference in compensation within our own group based upon productivity, let alone the differences in compensation across the EM landscape or between specialities. Notably, I have a great SDG full of intelligent individuals even if not necessarily business savvy. Not that uncommonly, the difference in compensation within a speciality based upon area/location of practice is more significant than between specialities. I’ve found that many are just not overly compensation driven or focused. That tends to be a priority of those that have a shorter shelf life in EM or a higher degree of burnout. It also tends to be more so an amplified perspective on the internet perhaps as a result of those seeking out further answers. The reality is that it’s very easy to live an upper middle class or lower upper class life as a physician in the US. This is still true as an EP. Most lack of wealth issues in this category are due to spending issues rather than earning challenges.
Truly, the REAL benefit of an EP as a physician is the compensation in relation to time spent working. Yes, the hours are chaotic and terrible. However, you really receive valuable time to spend on your other endeavors and family. Certain surgeon’s income will blow your ROI out of the water when you see their compensation on a public 990 tax form. However, they earn their keep and don’t have the time freedom you do as an EP. They continue to spend a significant higher number of hours working post-training. The highest paid EP in our SDG makes double our lowest paid partner. This is directly related to hours worked, pph, and coding.
An interesting comparison involves the early compounding financial growth that an EP can receive (even despite argument of 3 vs. 4 year residency) versus the higher, delayed annual compensation of some surgical subspecialties (with post-graduate training that can easily last 6-9 years). There is a break even point. However, I’d argue you sacrifice your 30s in those fields taking away from valuable time spent with a young family that can’t be recovered. I also think there is currently a minimal ultimate lifestyle difference between $10M and $20M at retirement. You might need to get to $100M from $10-20M to see a significant change in it really impacting your life. That isn’t accomplishable for the average or above average physician even if financially savvy. I personally struggle with the ultimate financial goal, but also appreciate the opportunities afforded to me as an EP.
