how much to expect from differant specialties??

[sirdude]

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How much will you make doing different specialties... I was really wondering about the average family doctor in a good practice, also an endocrinologist and a radiation oncologist?

 

[deleted87716]

Here ya' go: http://www.allied-physicians.com/salary_surveys/physician-salaries.htm

FYI, the search engine on SDN works pretty well. 😉

 

[Law2Doc]

How much will you make doing different specialties... I was really wondering about the average family doctor in a good practice, also an endocrinologist and a radiation oncologist?

Attached are the average salaries reported in JAMA a few years back. http://www.medfriends.org/specialty_hours_worked.htm . There are also a variety of search firms whose salary survey results have been posted on SDN periodically (such as the one the poster above linked to), some of which are of questionable accuracy, IMHO. But bear in mind that nothing stays the same, and many specialties have seen salaries recede over the past decade. FPs in particular have made the news (NY Times, etc) by losing about 10% over the last decade, while the profession at large lost about 7%, while other organized professions increased about 7% over the same time frame. And medicine is a field in transition, with increased insurance company strangleholds and gradually decreasing reimbursement amounts. So it is a bit difficult to try and determine what the salary will be by the time you get there. Also bear in mind that some specialties take longer to get to than others, so a slightly higher salary years later might not actually be better in "today" dollars. The specialties you listed are quite different in terms of the kinds of tasks, job, level of competitiveness etc.
Best to pick what you like to do, rather than base your decision on the paycheck (this is a hard lesson to get but a lot of nontrad career changers can tell you first hand that a great salary doesn't make it a great job).

 

[mikedc813]

How much will you make doing different specialties... I was really wondering about the average family doctor in a good practice, also an endocrinologist and a radiation oncologist?

Radiation oncology is an awesome field that not many people are familiar with. You can have a great lifestyle and make very very good money. It's extremely competitive, however, to match into that field. Without even looking at a list of incomes I can tell you a radiation oncologist will make much more on average than an endocrinologist!

 

[Critical Mass]

How much will you make doing different specialties... I was really wondering about the average family doctor in a good practice, also an endocrinologist and a radiation oncologist?

Rad onc is competative because there aren't many training programs for it.

How does rad onc wind up in the same thought process at family med?

 

[SupergreenMnM]

Maybe he is a physicist with a nursing degree

 

[Fiac]

I can tell you that the family doctor I'm doing my clinical experience with is making 250K/year working less than 40 hours a week (which is half of what he was making 5 years ago working more hours). Important caveat: this doctor and his associates are very business savvy. They have made special arrangements with the hospital and personnel (forgot the specifics...too complicated) to allow him to do this. Average run of the mill family docs will make about half his salary working the same hours. Salary is also highly dependent on the population you serve; more insured patients = higher salary.

Endocrinology is one of the more underpaid specialties in Internal Medicine. A lot of what they do and/or prescribe is not covered by insurance and therefore limits you to the number of patients you have to draw your income from. If you are thinking about doing internal med and then a fellowship, the highest paid and therefore most competitive fellowships are cardiology & GI.

 

[vök]

It's sad how common this question has become

 

[AmoryBlaine]

It's sad how common this question has become

Get a few tens of thousands of dollars in student loans and you might sing a similar tune.

 

[jbrice1639]

www.salary.com

lets you look at salaries for different types of docs and gives averages based on zip codes.

 

[QuantumMechanic]

It's sad how common this question has become

right, people shouldn't be concerned at all with their future incomes.🙄

 

[Captain Fantastic]

Get a few tens of thousands of dollars in student loans and you might sing a similar tune.

+1

Yesterday at IM Grand Rounds the Assistant Residency Director presented on the future of primary care. She showed data on the level of debt versus the specialty pursued. Those with more $150K in debt were less likely to pursue FP, General IM, or Peds and it was extremely rare to find anyone with more than $200K in debt planning on going into primary care.

 

[Tiger26]

+1

Yesterday at IM Grand Rounds the Assistant Residency Director presented on the future of primary care. She showed data on the level of debt versus the specialty pursued. Those with more $150K in debt were less likely to pursue FP, General IM, or Peds and it was extremely rare to find anyone with more than $200K in debt planning on going into primary care.

word. If for some reason you become disabled and can't pay your loans, there's not going to be a line of 'save the world' types bailing you out from bankruptcy. Medicine's a business like anything else, and they should be teaching business courses along w/anatomy and pharm so we can compete. Believe me, I've seen it first hand. My grandpa was an orthodontist making 250k easily in the 80's and when HMO's starting moving in, he lost everything because he didn't know the money side of medicine well enough.

 

[Gametime]

Hi Fiac,

It would be nice if you could go into the specifics, at least whatever you remember of it, of that family doc you're working with. The business side of medicine is oftentimes overlooked and an example like this simply shows how business-skills and a entrepenur mentality can double or triple your income

Does he have his own practice ?
What kinda arrangment does he have with the hospital ?
Partnership or running solo ?

Thanks

 

[Critical Mass]

Get a few tens of thousands of dollars in student loans and you might sing a similar tune.

<----------Over 100K here and counting

I think that what makes the thread unpopular around here is that the question reads "How much to expect?" Expect... as in 10 years from now when we are just finishing our training or have a little bit of experience as practicing docs. You can't equate "expect" with today's salary. Not only are reimbursements dropping, but the number of uninsured and underinsured will continue to rise as premiums increase.

It's fair to say that a surgeon will probably always be compensated significantly more than a general practitioner, but there are plenty of specialties that wax and wane in the face of medicare adjustments and turf wars.

I'd rather just work on excelling on board exams for now. I'd personally be happy with resident pay if I didn't have all of the debt that comes with medical education, but there will be a time and a place to negotiate a contract. That time is not now.

I guess I also can't ascertain what the statistics mean anyway since a lot of it depends on how much you are willing to work. I have a friend who finished an IM residency almost a year ago. The first practice he joined already dropped his contract in which he was a hospitalist getting paid about $150K. The new group that picked up the contract in the same hospital upped him to $220K but jacked his call way up so that he is on the clock for about 70 hours a week instead of 55. It just depends on what you're willing to sacrifice in your personal life. Medicine is a fee-for-service business.

L2D has dropped some mad wisdom on this topic before. Here is one example:

http://forums.studentdoctor.net/showthread.php?t=365676

 

[Law2Doc]

Average run of the mill family docs will make about half his salary working the same hours.

No, the average run of the mill family doc will make half his salary working significantly more hours.

Averages (obviously) exist because a lot of people do both above and below that mark. But it does no good to look to someone very successful and assume that will be you. Or tell yourself that can be you if you are "business savy". I suspect there are business savy folks who don't do so well -- there certainly were in my prior career. Numerous circumstances exist beyond the very superficial "this guy is business savy", that can make or break people. So you really need to use average as the guide, not someone who has beaten the curve. Also it should be noted that it has become progressively harder to earn higher income or work lesser hours in certain fields (particularly FP), so an opportunity seized a few years back might not be the same kind of deal one could realistically expect to land today.

 

[deleted87716]

No, the average run of the mill family doc will make half his salary working significantly more hours.

Not quite. The average annual income in family medicine is around $160K, and the average hours worked/week is around 50 (source: http://www.aafp.org/online/en/home/aboutus/specialty/facts/14.html ).

However, nobody said you had to settle for being average, and working smarter usually pays off better than working harder. 😉

 

[Law2Doc]

Not quite. The average annual income in family medicine is around $160K, and the average hours worked/week is around 50 (source: http://www.aafp.org/online/en/home/aboutus/specialty/facts/14.html ).

However, nobody said you had to settle for being average, and working smarter usually pays off better than working harder. 😉

Well 50 is, in fact, significantly more than "the less than 40" the prior poster indicated. But if we go by my JAMA data cited above, the average FP earns $132k and works 52.5 hours/wk, so I stand by my statement. That data is a couple of years old, but recent publications (referenced this past year in the NYTimes) have indicated that FP salaries dropped about 10% over a recent decade, so the average today's salary numbers are likely not significantly higher than that (more likely lower).

As for your last statement, if there were a secret to "working smarter" everybody would do it. Yet as many people will end up below average than above -- I doubt they thought they were "working dumber". So while I suppose I agree that you never have to "settle" for being average, most people won't end up above average, no matter how hard they try. Such is the nature of an average.

And a lot of it has to do with timing -- folks who graduated a few years back may have gotten breaks (especially in terms of salary, ease in setting up a practice, lack of reimbursement hurdles, etc) that folks getting into the profession a few years from now likely won't get. So it's not really so useful to use an above average mark as your frame of reference, because it's sort of like trying to be above average height while standing in quicksand. If you can peg to today's average, you should probably be thrilled.

 

[SupergreenMnM]

Not quite. The average annual income in family medicine is around $160K, and the average hours worked/week is around 50 (source: http://www.aafp.org/online/en/home/aboutus/specialty/facts/14.html ).

However, nobody said you had to settle for being average, and working smarter usually pays off better than working harder. 😉

Actually, if you look at table 15 from the same source as your link the mean pay before taxes and other expenses is 143k, with median 135k. Cut this by 30% (in some cases more like 50%) to get take home.

 

[SupergreenMnM]

Well 50 is, in fact, significantly more than "the less than 40" the prior poster indicated. But if we go by my JAMA data cited above, the average FP earns $132k and works 52.5 hours/wk, so I stand by my statement. That data is a couple of years old, but recent publications (referenced this past year in the NYTimes) have indicated that FP salaries dropped about 10% over a recent decade, so the average today's salary numbers are likely not significantly higher than that (more likely lower).

As for your last statement, if there were a secret to "working smarter" everybody would do it. Yet as many people will end up below average than above -- I doubt they thought they were "working dumber". So while I suppose I agree that you never have to "settle" for being average, most people won't end up above average, no matter how hard they try. Such is the nature of an average.

And a lot of it has to do with timing -- folks who graduated a few years back may have gotten breaks (especially in terms of salary, ease in setting up a practice, lack of reimbursement hurdles, etc) that folks getting into the profession a few years from now likely won't get. So it's not really so useful to use an above average mark as your frame of reference, because it's sort of like trying to be above average height while standing in quicksand. If you can peg to today's average, you should probably be thrilled.

You're right, in fact MOST of us will be below the average, if you notice the median income vs mean.

 

[deleted87716]

Actually, if you look at table 15 from the same source as your link the mean pay before taxes and other expenses is 143k, with median 135k. Cut this by 30% (in some cases more like 50%) to get take home.

Other reliable sources (the MGMA, for example) report average after-tax* income in the $160K range for family medicine (2006 data). Most everyone I work with makes considerably more than that. As with all things, your mileage may vary.

If you can peg to today's average, you should probably be thrilled.

I imagine most people would prefer to be on the right side of the bell curve, but to each his/her own.

*Oops, I meant "pre-tax." I was thinking "after expenses."

 

[Law2Doc]

Other reliable sources (the MGMA, for example) report average after-tax income in the $160K range for family medicine (2006 data). Most everyone I work with makes considerably more than that. As with all things, your mileage may vary.

The FP's I've worked with in my prior career didn't come close to that ballpark, (which is why I think the JAMA numbers are closer to correct) so you might be in a better than average region. Either way it's a comfortable salary (if it stays put), but not particularly high given the number of years and amount of debt it takes to get there. But if it's what you want to do, it's not a prohibitive sum.

 

[Law2Doc]

I imagine most people would prefer to be on the right side of the bell curve, but to each his/her own.

It's not a question of preference -- it's a question of reality. EVERYONE shoots for the right side of the curve, but at least half miss. Even more if you are shooting for the right side of today's curve tomorrow.

 

[Fiac]

The specifics of the FP I've done my clinics with are the following. I will emphasize though that this is a unique situation, and you'll see why.

1. He's in the middle of rural Texas where there is only one hospital and one major clinic (which he and his group owns).
2. He and his group "sold" their employees to the hospital that is right across from the parking lot of their clinic. The result is that his group is no longer responsible for their staff's payroll, insurance, etc. even though they work in the clinic for them. In exchange, the hospital gets overhead from the clinic's profits.
3. As part of the agreement, the doctors are exclusively associated with the hospital, which is OK because (a) there is only one hospital in town and (b) all the doctors at the clinic were already on the hospital's board of directors to begin with.

I forgot the arcane details and mechanics that he told me about, but that's the gist of it. So, to really make money as an FP, you have to find a way not to pay business expenses and have a monopoly on all health care in the area which usually implies working in the middle of nowhere. As it has been said before, this RARELY ever happens.

 

[deleted87716]

It's not a question of preference -- it's a question of reality. EVERYONE shoots for the right side of the curve, but at least half miss. Even more if you are shooting for the right side of today's curve tomorrow.

The key is to shoot for the right side of tomorrow's curve today. 😉

So, to really make money as an FP, you have to find a way not to pay business expenses and have a monopoly on all health care in the area which usually implies working in the middle of nowhere. As it has been said before, this RARELY ever happens.

Family medicine isn't a big-money field, and likely never will be. However, there are plenty of opportunities to earn a good (read: above average) living without selling out or being the only game in town. Most people who go into FM don't do it for the money. That's not necessarily a bad thing.

 

[Law2Doc]

... shoot for the right side of tomorrow's curve today. 😉

That would make a good bumper sticker.👍

 

[Captain Fantastic]

That data is a couple of years old, but recent publications (referenced this past year in the NYTimes) have indicated that FP salaries dropped about 10% over a recent decade, so the average today's salary numbers are likely not significantly higher than that (more likely lower).

The number I saw yesterday in Grand Rounds was for General Internists and they have seen a 7.5% drop in income, adjusted for inflation, since 1995.

We also saw data from a recruiting firm here in the mid-west (I can't remember which one, sorry). The practices/groups they represented were offering anywhere from $130K to 250K, with the average being $162K for general internists (2006).

 

[Law2Doc]

The number I saw yesterday in Grand Rounds was for General Internists and they have seen a 7.5% drop in income, adjusted for inflation, since 1995.

We also saw data from a recruiting firm here in the mid-west (I can't remember which one, sorry). The practices/groups they represented were offering anywhere from $130K to 250K, with the average being $162K for general internists (2006).

The NYTimes article this past year indicated a 7% drop across all physicians and closer to 10% for primary care. The article I am linking (which links to the Times article among others) indicates a primary care average salary of $146,405. I suspect that FP is not at the top of the pack for "primary care", so am assuming it that its average is below this figure (and closer to the JAMA figure). http://www.medicalnewstoday.com/medicalnews.php?newsid=45794

 

[Haemulon]

Other reliable sources (the MGMA, for example) report average after-tax income in the $160K range for family medicine (2006 data). Most everyone I work with makes considerably more than that. As with all things, your mileage may vary.

I imagine most people would prefer to be on the right side of the bell curve, but to each his/her own.

160k after taxes would be over 230k gross. There is no way that Fam. Practice docs average income is over 230k. Not even close. Are you including in the value of benefits and other perks or something? Something seems really off here.

 

[deleted87716]

160k after taxes would be over 230k gross. There is no way that Fam. Practice docs average income is over 230k. Not even close. Are you including in the value of benefits and other perks or something? Something seems really off here.

That was a typo, sorry. I meant to say "pre-tax income".

 

[Haemulon]

That was a typo, sorry. I meant to say "pre-tax income".

Ha. Yeh, I thought that might be the case. Still though, I am surprised by the 160k gross (pleasantly). Most of the numbers I have seen place it in the 140's (with starting salaries more along the lines of 115-125k). I guess this doesn't factor in profit sharing and incentives and so forth, such as may be the case in a group practice. Anyway, I am still hopefull that there may be a way to make it with primary care type practice, we certainly are in need of more such docs.