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I want to make money, and i like kids.

Discussion in 'Pediatrics' started by Downstatedoc, Sep 30, 2008.

  1. Downstatedoc

    Downstatedoc New Member
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    I'm sure I will get drilled for this one. but I must ask it.

    I really like kids, would love to do peds...but the $$ really isn't there.
    Is there any subspecialty where I could make ~500k doing work involving kids?
     
  2. BigRedBeta

    BigRedBeta Why am I in a handbasket?
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    I'm not sure about your $500k threshold (there aren't that many adult specialties that make that on a regular basis) bu I suppose any specialty with a pediatric fellowship - Peds Ortho, Peds Radiology, Peds ENT, Peds Anesthesia, Peds Surgery, Peds Urology, etc. - is going to be closer to that amount than any of the fellowships that come out of peds.
     
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  3. CrazyPeds527

    CrazyPeds527 Admitted Scrubs Addict
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    Some private practice fellowship jobs (Interventional Cards, possibly NICU) may start to approach 400k from what i've seen and heard. Of course, not so much in academia (unless you are a well-endowed dept chair).

    Other than that, agree with above, with the exception of Peds rads...some of the radiologists i worked with last year noted that it is a tough sell to do a fellowship in peds rads because it is an extra year that decreases your earning potential (i believe it is due to the types of scans billed for in peds vs adults).
     
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  4. DrThom

    DrThom Thundercat
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    Unfortunately, from what I hear, when you take any subspeciality and add "pediatric" in front of it, it decreases the amount of money you make in comparison to your adult counterparts (rads, surg, ortho...unsure about ENT, there might be a lot of business there with T-tubes).

    So I think the solution is to take a personal inventory. Is it more important to you to make the best living possible in the field of your choice? If so, pursing pediatric training mightst not be the best option but if treating kids is your passion and you are willing to make a little less than your compatriots, then you have your answer.
     
  5. Pontifex Maximus

    Pontifex Maximus Rads-a-palooza
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    I am curious to this as well - not to the OP's 500k stance by any stretch, but where are some reliable sources for some Peds subspecialists salaries?
    I could totally see myself doing Peds critical care, EM, heme/onc, or GI - possibly even hospitalist. However, good data is hard to find these days, and figures vary wildly if there are even ones for those subspecialties.
     
  6. CrazyPeds527

    CrazyPeds527 Admitted Scrubs Addict
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    Check the FAQ...there is a link to peds salaries and subspecialty salaries
     
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  7. Pontifex Maximus

    Pontifex Maximus Rads-a-palooza
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    I've checked those - and they're good for most things, but what about Peds EM? That's probably my top choice right now, and I can't seem to find it anywhere. Also, how about hospitalist salary? I'm just curious how these compare to their adult counterparts (but I don't think you could pay me to do IM).
     
  8. 14022

    14022 Unregistered Abuser
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    I don't think its fair to pay a department chair less just because they are not well-endowed. How do they even determine how well endowed you are during the interview process anyways? :banana: Seems sort of invasive. :bow:
     
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  9. DrThom

    DrThom Thundercat
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    It's funny because its a penis joke! :laugh:
     
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  10. oldbearprofessor

    Staff Member Administrator Physician Rocket Scientist Faculty Verified Expert 10+ Year Member

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    Please look up:

    United States Patent 5183055

    thx k bye

    OBP
     
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  11. stonewall22

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    Good grief...you wouldn't feel like you were making great money at $150k?
     
  12. durty

    durty Lif is too short
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    dude, under $250k is the new middle class
    -durty
     
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  13. 14022

    14022 Unregistered Abuser
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    joe the plumber makes more than us. :confused:
     
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  14. coldflare

    coldflare Peds in Florida : )
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    Well, this is just an anecdote, but one of the Peds Neuroradiologists at my training program turned down a job offer for $700K last year . . . and then this year he accepted a "better" offer. Holy smokes.
     
  15. BORNagainSTDENT

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    wow if I knew what Peds Neuroradiologists was I would be one. 700k sounds worth it to me.
     
  16. Chikoo

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    Hello All,
    Im a MD Pediatrics working in a govt.hospital in a small town in India. I am sure my question may sound silly and stupid to most of you. Still ill go ahead n ask. I wish to enrol in Ped. fellowship programs either in US or Australia. But unfortunately i have no clue as to how to apply. Please, could anybdy advice me on this....
    thanx
     
  17. DrJosephKim

    DrJosephKim Advisor
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    I wouldn't encourage you to pursue Peds if your main goal is to make lots of $. We need providers who are passionate about their work and not motivated by greed.

    However, I know several mid-career and semi-retired pediatricians who have transitioned to non-clinical careers and they have very comfortable incomes. They tell me that weren't motivated by the increased income. Instead, they were more interested in the business challenges associated with the healthcare industry or they just got burned out from clinical medicine.
     
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  18. CarleneM

    CarleneM patent pending
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    Child and adolescent psychiatry is very lucrative if that would interest you. I know many who are predominantly in private practice, accept no insurance and make close to 500K. Academia is much less, of course. There is a major shortage in the field so you essentially write your own ticket. However, you do need to do adult psych first (3 years) before the fellowship and you do have to enjoy working with complicated family and social situations.
     
  19. Staphylococcus Aureus

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    BUMP.

    Any updates on way to work with kids for adult medicine compensation? What are the current salaries like for pediatric subspecialties (NICU, PICU, cards, GI, child neuro)?
     
  20. calvnandhobbs68

    calvnandhobbs68 I KNOW NOTHING
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    It's still the same, best way to do it is to come out of a adult specialty with a peds fellowship (peds ENT, ortho, anesthesia, radiology, ophtho, etc). You simply aren't going to get adult medicine compensation for kids in any specialty coming out of pediatrics (even the critical care specialties, your adult ICU colleagues will be earning to the tune of twice your salary). It has more to do with how pediatrics (which is driven more by Medicaid) is reimbursed vs how adult medicine (which is driven more by Medicare) is reimbursed.
     
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  21. calvnandhobbs68

    calvnandhobbs68 I KNOW NOTHING
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    Starting salaries in NICU and PICU tend to start a bit lower than that while the adult CC salaries tend to be mid to high 300s at least (especially considering you can easily make high 200s-low 300s just being an adult hospitalist vs a peds hospitalist being more like high 100s-low 200s). Salaries also tend to drop very sharply in peds academic centers vs adult academic centers in regards to critical care. There's probably a little less discrepancy in private/community hospitals but the trend right now, especially in NICU, is consolidation of smaller NICUs into larger academic center NICUs or acquisition of NICUs by Pediatrix.

    There were a bunch of hospitals with little <10 bed "NICUs" (level 2-3 nurseries) to keep the higher earning lower acuity ICU beds in at the regional hospitals that are getting consolidated as larger hospital systems acquired regional hospitals. These babies just get transported over to the level 4 NICUs at home base, usually at the big academic center where the attendings are getting paid academic salaries. Others who are actually in NICU and PICU right now would probably know more than I do though.
     
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  22. Stagg737

    Stagg737 Illegal in all 50, Unlynchable Wolf
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    Child psych. Not really peds, but you get to work with kids. and their crazy parents
     
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  23. calvnandhobbs68

    calvnandhobbs68 I KNOW NOTHING
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    That was the trend at least where I did residency. Others who are actually in NICU and PICU right now would have a better idea though.

    I don't know how much is "backbreaking" debt but you're probably going to have a rough time with that in most peds subspecialties.
     
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  24. calvnandhobbs68

    calvnandhobbs68 I KNOW NOTHING
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    But again, this is technically a subspecialty of adult psych and not peds. So it falls into that category of "do an adult residency with the peds fellowship".
     
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  25. Stagg737

    Stagg737 Illegal in all 50, Unlynchable Wolf
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    Ah, missed that part of the thread above. Yea, getting paid after completing peds residency is tough. My peds attending made 400-500k, but he also rounded at a hospital from 5-8, then had clinic from 8-5 or 6, was the pediatrician at 2 child psych hospitals, and saw patients on weekends. So basically he was a workhorse and made his money from multiple revenue streams. Not something most people can sustain for an extended period of time, imo (true of this attending too as he seemed completely miserable).
     
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  26. SurfingDoctor

    SurfingDoctor "Hooray, I'm useful"
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    Yeah, no it’s not. More than 1/2 of the PICU attendings work in academics and that’s not the median salary. Mean maybe if you count higher earners in private practice.... maybe. But I doubt it.

    NICU is a different story because there is a lot more private practice NICU attendings.
     
  27. SurfingDoctor

    SurfingDoctor "Hooray, I'm useful"
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    Those are self reported. I’m telling you reality.
     
  28. SurfingDoctor

    SurfingDoctor "Hooray, I'm useful"
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    Yes it is used. It is also assumed that people lie on it (which they probably do). MGMA data is based on a range. Most places will take into account region metrics and offer at the bottom of the range. Typically they will get it because they know there are a dozen other candidates with the same skill set. Cheapest wins. That’s the way it is in the business world.
     
  29. MEN2C

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    The people in my (NICU) fellowship going into private practice are getting starting offers of around 250k-275k. For partners/senior, the salary seems to end up around $350k-400k. Academics is less, of course (I haven't asked the graduating fellows going into academics, but my guess is starting <$200k).

    People may lie on MGMA but I doubt the peds people would lie more than the adult people. Per MGMA, the adult critical care private practice folks make (mean, of course) about $50-75k more than NICU. Which is significant, of course.

    On the other hand, lifestyle surveys have consistently shown peds specialties to be much higher than most adult specialties.

    Your mileage may vary. I have a lot of debt (along with a family to support) and I don't regret this career choice one bit.
     
  30. Staphylococcus Aureus

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    @MEN2C are there still plenty of non-academic positions, or is the trend towards large academic centers as someone mentioned?
     
  31. mvenus929

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    If you manage money well, you will be able to pay back your debt in peds critical care.

    Now, peds endo, ID, and rheum are screwed. Because they make less than general pediatricians once they complete training, and have had to be on a fellow's salary for 3 years longer than the average general pediatrician. Renal probably falls in that category too, but they can participate in dialysis centers and get more of medicare reimbursement because ESRD is a medicare qualifying diagnosis, so they are probably slightly better off.

    Which is probably a big reason why those four specialties have such poor fill rates in the match and lots of programs are shutting down.
     
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  32. MEN2C

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    There is definitely a huge trend towards consolidation. And MEDNAX is the overwhelming player in private practice. There’s still a lot of Non-MEDNAX PP jobs there but a lot of that will depend on your geography. What the future holds, I do not claim to know. But the trend away from small private practice opportunities is definitely happening all across medicine (not just nicu and Pediatrics - though nicu is probably one of the ones at the forefront) - and I don’t know if that will change unless the laws around health care or the way it is reimbursed changes.
     
  33. NurWollen

    NurWollen Strong with the Force
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    I think purely from a money perspective, NICU is the way to go. But your patient population would be very different than other 'kids.'

    Sent from my SM-G930V using SDN mobile
     
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  34. Staphylococcus Aureus

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    Is it still true that the only fellowships where one comes out ahead financially are NICU, PICU, and cardiology? Anyone know if child neurology is any better off than peds?
     
  35. Oso

    Oso
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    I don't know about peds neuro, but I would add PEM to the list
     
  36. NurWollen

    NurWollen Strong with the Force
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    Peds neuro does alright I imagine. There's a huge demand for it, so that might drive compensation up. Peds gastroenterology, while not nearly as well compensated as adult GI doctors, probably does ok too.

    Sent from my SM-G930V using SDN mobile
     
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  37. FrkyBgStok

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    There are a number of peds specialties that are better off than general peds. The problem is the value. NICU, PICU, cards, and PEM are financially worth it to go to fellowship long term. The ones that make less than general peds are generally ID, rheum, endocrine, behavior/development, sometimes adolescent, genetics, and sometimes nephrology. But pulm, GI, sometimes adolescent and nephrology, heme/onc (depending on the area), and hospitalist make either similar to general peds or more. Sometimes a decent amount more. Just when you factor in the amount lost in fellowship and the long term finances, it makes those specialties less worth it. but if it is something you love, it is an easy choice.
     
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  38. captianplanet

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    For PedsID I am hoping for 90-100k starting after fellowship...... though only looking at large academic places and would be starting as instructor. Would agree with above, easy decision when you like what you do.
     
  39. calvnandhobbs68

    calvnandhobbs68 I KNOW NOTHING
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    The job market for heme onc is not good..there’s more graduating fellows every year than there are jobs, the jobs are almost all in academic centers (so the pay is terrible). I know people coming from a pretty good academic center who have trouble finding jobs.

    To be honest, heme onc is a field lots of people are attracted too because it’s interesting from an academic standpoint and tugs on the heartstrings (who doesn’t want to help kids with cancer?) but there’s just really not that many kids with cancer especially when the cure rates are so good now. The adult field dwarfs the peds field. Those median salaries you’ll find online are quite a bit inflated
     
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  40. MEN2C

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    Peds heme/onc and PEds cards probably have the worst overall job market. Peds cards is sub-specialty dependent (you will likely have to do a fourth - or fifth - year, and doing cath or EP --> many fewer jobs than doing CICU or ACHD).
     
  41. michigangirl

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    There are definitely private practice PICU jobs where you can make >400K- but it should be noted that PICU as a specialty is getting a bit more competitive. Academia-- you're looking at 200K max if lucky.
     
  42. shepardsun

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    The thing about academic PICU (and PICU in general) is that clinical time is significantly less than a lot of other specialties- the group at my residency hospital was full time at 10 weeks of service a year. Now most had to supplement their clinical time with research and grants, but for those with a certain skill set or desire to moonlight you could probably supplement your income by an extra 100-200k or so by moonlighting or doing non-clinical side gigs.
     
  43. SurfingDoctor

    SurfingDoctor "Hooray, I'm useful"
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    10 weeks is a typical clinical schedule for NIH funded researcher who has 75% salary support from grants. That is not most academic PICU faculty.
     
  44. Staphylococcus Aureus

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    Are these clinical jobs in high demand?
     
  45. SurfingDoctor

    SurfingDoctor "Hooray, I'm useful"
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    I don’t know what you mean by in high demand. You mean a lot of applicants? You could go to a website like one of leading private practice management groups (eg. About Pediatrix) and find information on the Internet to see how many employees they have. Additionally you could look through Pediatrix positions listed on PEDSCCM.org . There are private practice gigs available.

    The best paying ones tend to be locums jobs though.
     
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    Last edited: Dec 28, 2018
  46. Psychiatrist wannabe

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    I was looking into peds psych because I was worried about being able to pay back student loans but I still wanted to work with kids. However, I really think I would be happier in pediatrics.

    For those of you with crazy student loan debt, do you make enough in peds to live comfortably middle class?
     
  47. captianplanet

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    Just to give you a ballpark, if you were to make 200k that comes out to roughly 10k a month after taxes. Its still a comfortable life style its just not what our other counterparts make.
     
  48. NurWollen

    NurWollen Strong with the Force
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    It's not at all uncommon to come out of med school these days with 400k or 500k in student loan debt. In fact it's the reality unless you have wealthy parents or had access to a (very) inexpensive state school. I think a lot of people aren't even aware of that. Now even if you get that down to say a 3% interest rate (much lower than the standard federal loan rate) that's 3,000 per month over 20 years. So 7k month?
    I don't care what other people make, if we're content with that as physicians, we've failed ourselves as a profession.

    Sent from my SM-G930V using SDN mobile
     
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  49. SurfingDoctor

    SurfingDoctor "Hooray, I'm useful"
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    Incurring a lot of debt is a symptom of much bigger problem than can be solved by pediatricians need more money...
     
  50. Psychiatrist wannabe

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    Actually, I am fine with $7k/ mo.
     

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