Internal medicine

[medguy24]

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I've been looking at job listings for internal medicine doctors in nyc and it seems that all of them said "Monday-Friday 9-5 only one night call and very competitive pay" the average salary in nyc for internal medicine is 200k
Is it true that they only work 40 hours a week and make 200k?
If it's true then why do people say there under paid? I mean while other specialities make 300-400k a year they also work 60-70 a week,
Can't a internal medicine work for 60 hours a week and also make 300k?
And lastly if I want to open up my own private practice would it be smarter to go into family medicine- which combines internal medicine and pediatrics into one- rather than just going into internal medicine because then I could see kids as well?

 

[rbnsafsadgf]

Yes, banker hour outpatient primary care exists. with a 200k salary. As you gain experience, there is more to a job than the salary and so fit with a job is also very important. There are often things that fall outside of this 9-5 window (such as finishing notes, followup on results, acute visits, etc.). Also "one night call" can mean a lot of things. Does your phone ring once and you can stay home? Or, are you up all night and having to go to the hospital? Do you work the next day. Also the concept of salary doesn't exist in all cases. They may pay you for your first year and then after that, you earn what you see. AKA fee-for-service.

Why do people talk about being underpaid? Get more experience and you shall see why. And also get $300k in loans at 7% interest and you have a sense of the pressure.

Family med vs. Internal? Yes, you get to see kids with family. Family medicine is more common and is the norm on the West Coast, and in New England. Family medicine also exists in NYC. IF the goal is outpatient primary care you can go either way.

Read up more, shadow docs, and gain more clinical experience.

 

[tiedyeddog]

Dude, those ads are total BS. The jobs in the postings hardly ever are real. They are fishing hooks that job recruiters use to get a physician to call, they say something like "oh, that one is off the market" and then they propose a position 10x ****ter.

Don't use those ads for any kind of career planning. Additionally, yes, you can see kids if you are FM, IM, or even dual FM-IM.

 

[Catalystik]

if I want to open up my own private practice would it be smarter to go into family medicine- which combines internal medicine and pediatrics into one- rather than just going into internal medicine because then I could see kids as well?

If you want to see kids and adults, you might consider doing a 4 year Med-Peds residency instead of a 3 year Family Med residency which doesn't emphasize kids enough and spends time training one in OB.

 

[medguy24]

Yes, banker hour outpatient primary care exists. with a 200k salary. As you gain experience, there is more to a job than the salary and so fit with a job is also very important. There are often things that fall outside of this 9-5 window (such as finishing notes, followup on results, acute visits, etc.). Also "one night call" can mean a lot of things. Does your phone ring once and you can stay home? Or, are you up all night and having to go to the hospital? Do you work the next day. Also the concept of salary doesn't exist in all cases. They may pay you for your first year and then after that, you earn what you see. AKA fee-for-service.

Why do people talk about being underpaid? Get more experience and you shall see why. And also get $300k in loans at 7% interest and you have a sense of the pressure.

Family med vs. Internal? Yes, you get to see kids with family. Family medicine is more common and is the norm on the West Coast, and in New England. Family medicine also exists in NYC. IF the goal is outpatient primary care you can go either way.

Read up more, shadow docs, and gain more clinical experience.

Well I am in a special bs md program (sophie davis) so im going to graduate medical school with no debt. (Thank goodness)

The question I have is whether I can work for like 60 hours for the first few years and make 300k in NYC? Is that possible?

Also if I would like to eventually open up my own office and say work 40-50 hours a week doing a combined im-ped what's the potential salary? Like what's the best you can do?

(Sorry it sounds like all I care about is money. I live in a really expensive area with a high cost of living.. And Theres a few other things Etc)

 

[medguy24]

If you want to see kids and adults, you might consider doing a 4 year Med-Peds residency instead of a 3 year Family Med residency which doesn't emphasize kids enough and spends time training one in OB.

Whats OB? And are those residency much more competitive?

 

[Hospitalized]

Cost of living in NYC is an important thing to consider.

 

[medguy24]

Cost of living in NYC is an important thing to consider.

I live in NYC so I am unfortunately aware of the costs of living :/

 

[caffeinemia]

Cost of living in NYC is an important thing to consider.

What? My closet in Brooklyn is only 1700 a month!

 

[medguy24]

What? My closet in Brooklyn is only 1700 a month!

Lol
but seriously can someone help me out with my question?

 

[Hospitalized]

Lol
but seriously can someone help me out with my question?

About as realistic of a response I can give to this kind of question.

There's virtually no such thing as "this is how much money I will make when I get out of residency so I can live in x and do y." If there is, it's a very, very small portion of medicine. Your salary and lifestyle will be unknown for quite some time. The process is very long and you will eventually find something that caters to your personality. It probably won't be what you had in mind at the beginning. Private practice vs. physician group vs. hospital and everything in-between will be a decision you make in residency.

 

[medguy24]

About as realistic of a response I can give to this kind of question.

There's virtually no such thing as "this is how much money I will make when I get out of residency so I can live in x and do y." If there is, it's a very, very small portion of medicine. Your salary and lifestyle will be unknown for quite some time. The process is very long and you will eventually find something that caters to your personality. It probably won't be what you had in mind at the beginning. Private practice vs. physician group vs. hospital and everything in-between will be a decision you make in residency.

But I need to know if I could make close to 300k in primary care or not. Because if I can't then I need to know so that I specialize. Rather than to go ahead into family medicine.
I'd rather do family medicine but not if all Im going to make is 200... That's why I ask..

 

[miamiheatfan]

But I need to know if I could make close to 300k in primary care or not. Because if I can't then I need to know so that I specialize. Rather than to go ahead into family medicine.
I'd rather do family medicine but not if all Im going to make is 200... That's why I ask..

I'm not an expert but I do not think you would make 300k doing primary care. If you want >300k a year you should specialize in one of the competitive fields.

 

[Hospitalized]

But I need to know if I could make close to 300k in primary care or not. Because if I can't then I need to know so that I specialize. Rather than to go ahead into family medicine.
I'd rather do family medicine but not if all Im going to make is 200... That's why I ask..

What's the difference between 200k and 300k for you? The difference cannot possibly be career defining. I have the sense that medicine is not for you if you are so concerned about the numbers. It's a shame you are in a BS-MD program-- it doesn't seem as if your motives are right for medicine from what you have said thus far. Alas, not all can be told from a message board.

 

[DubVille]

Making 300k in primary care is possible but won't be easy, and likely impossible until you "build" a practice or reputation. Due to cost of everything, doing this in NYC will be harder. Just know even specialists make less in these saturated areas. Some ways to make 300k:
1) Have a great rep and do concierge medicine. This is feasible in wealthy areas but has many drawbacks like needy patients, giving out cellphone to patients, being on call all the time, need for great business sense, etc. Many docs fail when trying to setup this model, but it can be highly profitable if pulled off correctly.
2) High volume (with great payor mix.) You won't be making 300k seeing a large number of Medicaid patients and in some cases Medicare. You need patients with good insurance. If you have 3, 4, 5 PA's who essentially see and document for you then you could see each patient for 3-5 minutes to double check their assessment and plan. I've seen this model done successfully at 75-100 patients a day. However,in a place lilike NYC with saturation some patients may not like to be primarily seen by midlevels and readily switch providers. You would need to review charts, etc which will eat into your time and need to build this type of practice.
3) Do a lot of self pay/elective procedures and/or be shady (Dr. Oz style). Again this would require a reputation and big business risk as many of these practices fail every year, but if pulled off can be highly profitable. Also depends on if you are comfortable making money in this fashion.
4) Work a lot of extra hours doing chart reviews for insurance, lawyers, disability, etc. These can pay pretty well and if you devote one day a week (in addition to the "9-5") to these activities you may be able to bump income to 300k or more.
5) See 40+ patients a day on your own, and sacrifice good documentation working at breakneck speed.
6) Own a practice/facility and skim off the top of of other doctors. This would require excellent business sense and time.

Possible, yes. It won't be easy, especially in oversaturated markers like NYC, LA, SF, etc. Most of these models will require well over 50 hours a week, at least initially. No free lunches I'm afraid. You could always win the lottery. I suppose if you invest very well in real estate, or whatever then you could bump your income. In a place like NYC I'd assume you would need a lot of cash to get in on those things.

 

[tiedyeddog]

Lol
but seriously can someone help me out with my question?

You find out in medical school what specialty you want to do. It's not a purely monetary based choice. Work on getting into medical school first and then worry about making 300k in NYC.

Healthcare is in a dramatic flux right now. We have no idea what the field will look like when you are done with training, which is 7 years or more away.

 

[medguy24]

What's the difference between 200k and 300k for you? The difference cannot possibly be career defining. I have the sense that medicine is not for you if you are so concerned about the numbers. It's a shame you are in a BS-MD program-- it doesn't seem as if your motives are right for medicine from what you have said thus far. Alas, not all can be told from a message board.

Look I'm in a bs md program because o actually want to be a doctor. My dream is to go into primary care and open my own private practice and see my own patients. That's what I would love.
The only problem I have is that I live in an expensive part of nyc and my whole community is here so I can't leave them and therefore I need to make enough money to support my family. The major expensive im going to have is a home. In my area a nice 4 bedroom home can easily go for 1.2m (and that's a decent home nothing fancy) I can't afford to take out a 1.2m mortgage on a 200k salary. My hope is that during the first 3-4 out of my residency I can work 60-70 hours a week and make close to 300k and still live like a resident (of fellow) on a 60-80k salary and save 200k each year. That way I can put a nice 600k down payment of my home and only take out a 600k mortgage and I can then stop working 60-70 hours a week and I can go open up my own office and even if I only make 175-200k I can still live a good life.
However if it won't be possible to work extra hours initially and make a higher salary then I just can't go into primary care and need to know now so I choose a different specialty.
See my dilemma?

 

[medguy24]

New York county avg family medicine salary: $197,000

If the question you're asking is "how can I make more than 100K over the average salary in this area?", the answer is not work 40 hrs/wk.

Like I said before I don't mind working 60-70 hours a week. My question is if by working those extra hours I can find a job that would pay me more (300k)

 

[Catalystik]

Whats OB?

OB=Obstetrics. While many Family Med docs go into it thinking they'd love to deliver their own patients, practically speaking, the malpractice rates in an urban area would be much too high if that component were included in one's practice.

 

[palatopharyngeus]

Is it true that they only work 40 hours a week and make 200k?

meh...40 hours exactly might be kind of hard to do...im sure there's a few more hours of paperwork in addition to those 40...so my guess would be closer to 50 hours. but yeah, 50 hrs/wk total as a PCP making ~200k is not unreasonable at all

If it's true then why do people say there under paid? I mean while other specialities make 300-400k a year they also work 60-70 a week

depends on who you're comparing them to. derm/rad onc/path/rads/optho/GI/ENT/uro/neuro/just about every other speciality you can think other than peds/FM all can work 5o hour weeks if they choose to and make significantly more than 200k a year.

Can't a internal medicine work for 60 hours a week and also make 300k?

yes they can. i know an IM doc who's an absolute workaholic and works 60-80 hrs/wk and makes about 350k.

And lastly if I want to open up my own private practice would it be smarter to go into family medicine- which combines internal medicine and pediatrics into one- rather than just going into internal medicine because then I could see kids as well?

yeah if youre planning on opening up a solo practice and would like to cater to all ages, then FM would be a better choice (imo). I would also look into those IM-peds programs

 

[Catalystik]

And are those residency much more competitive?

Yes, as there are fewer spots. You can look up the data for New York residency spots for Family Med, Internal Med, and Med-Peds here on page 10: http://www.nrmp.org/wp-content/uplo...Match-Results-by-State-and-Specialty-2014.pdf

Average Step I scores are similar to Internal Med, but higher than for Family Med, which you can see from this data: http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

 

[NickNaylor]

You will be able to have a lucrative practice in just about any specialty, though some specialties have a higher ceiling than others. You should focus more on finding something that you're actually interested in and will enjoy doing for 30-40 years rather than something that will get you past some arbitrary salary threshold. Salaries will change, the general line of work will not. You're way too early to be trying to pick a specialty. You haven't even done a single clinical rotation - or even started medical school for that matter.

Just relax. There's plenty of time to work toward a specialty once you get into medical school and have a better idea of what interests you.

 

[mimelim]

Also, this is literally the third time you've started the same thread:

http://forums.studentdoctor.net/threads/internal-medicine.1101997/#post-15758549

http://forums.studentdoctor.net/threads/primary-care.1102041/#post-15757659

Hint OP: You aren't listening. Stop making threads and re-read these threads.

 

[medguy24]

meh...40 hours exactly might be kind of hard to do...im sure there's a few more hours of paperwork in addition to those 40...so my guess would be closer to 50 hours. but yeah, 50 hrs/wk total as a PCP making ~200k is not unreasonable at all


depends on who you're comparing them to. derm/rad onc/path/rads/optho/GI/ENT/uro/neuro/just about every other speciality you can think other than peds/FM all can work 5o hour weeks if they choose to and make significantly more than 200k a year.


yes they can. i know an IM doc who's an absolute workaholic and works 60-80 hrs/wk and makes about 350k.


yeah if youre planning on opening up a solo practice and would like to cater to all ages, then FM would be a better choice (imo). I would also look into those IM-peds programs

Thx!

 

[Mad Jack]

Keep in mind that even specialists in NYC often make well under 300k, depending on the field, due to the competitiveness of the job market. Rural EM can net you 350k+, for instance, while many starting salaries in NYC for EM are 220-260k. NYC is not conducive to making a good living, care of the taxes, competitiveness, and high CoL.

 

[NYCdude]

Aren't Sophie grads locked into doing primary care?

 

[medguy24]

Keep in mind that even specialists in NYC often make well under 300k, depending on the field, due to the competitiveness of the job market. Rural EM can net you 350k+, for instance, while many starting salaries in NYC for EM are 220-260k. NYC is not conducive to making a good living, care of the taxes, competitiveness, and high CoL.

Would commuting and working or opening an office in NJ be any better?

 

[Mad Jack]

Would commuting and working or opening an office in NJ be any better?

It can be.

 

[PlaqueBuster]

What's the difference between 200k and 300k for you? The difference cannot possibly be career defining. I have the sense that medicine is not for you if you are so concerned about the numbers. It's a shame you are in a BS-MD program-- it doesn't seem as if your motives are right for medicine from what you have said thus far. Alas, not all can be told from a message board.

And your motives are? Why is it that when someone brings up anything about salary the entire SDN community thinks they have the wrong motive? BS-MD programs are tough to get into and prespectives change over the span of those 8 years. Your motives change from highschool to college to medical school.

 

[Mad Jack]

And your motives are? Why is it that when someone brings up anything about salary the entire SDN community thinks they have the wrong motive? BS-MD programs are tough to get into and prespectives change over the span of those 8 years. Your motives change from highschool to college to medical school.

We get this way because no amount of money can make you work in a field you hate for 50-60 hours a week plus call the rest of your life.

 

[medguy24]

We get this way because no amount of money can make you work in a field you hate for 50-60 hours a week plus call the rest of your life.

Again I don't hate the field! I love the field! I just need to make a certain salary to live the life I want. We don't tell people who love art to become artists. I just wanted to know if I could go into the field I love the most- family medicine- and make 300k. There's nothing wrong with asking that. I'm human.

 

[PlaqueBuster]

If anyone here was going into medicine without money as one of the factors, I will accuse you of lying because somewhere on your mind you are thinking about that investment of education and what your life will be like later down the line. @Mad Jack I do agree with you that no amount of money is good enough for doing a job you hate, but at the same time you do not need to love your job as long as it is compensating you well.

 

[Mad Jack]

Again I don't hate the field! I love the field! I just need to make a certain salary to live the life I want. We don't tell people who love art to become artists. I just wanted to know if I could go into the field I love the most- family medicine- and make 300k. There's nothing wrong with asking that. I'm human.

This is the third thread you've asked it in, you should have your answer by now. No, you won't make that much money working normal hours in NYC. Yes, it is possible to make that much. Yes, you will be working ungodly hours to make 300k, likely for multiple employers, and probably 6-7 days a week.

 

[medguy24]

If anyone here was going into medicine without money as one of the factors, I will accuse you of lying because somewhere on your mind you are thinking about that investment of education and what your life will be like later down the line. @Mad Jack I do agree with you that no amount of money is good enough for doing a job you hate, but at the same time you do not need to love your job as long as it is compensating you well.

Thank you for being one of the only honest rational human being here.

 

[Mad Jack]

If anyone here was going into medicine without money as one of the factors, I will accuse you of lying because somewhere on your mind you are thinking about that investment of education and what your life will be like later down the line. @Mad Jack I do agree with you that no amount of money is good enough for doing a job you hate, but at the same time you do not need to love your job as long as it is compensating you well.

The thing is, in medicine, your earning floor is roughly 200k if you're smart, and there are numerous fields to choose from, one of which will no doubt suit a given individual very well. The difference between doing something you really enjoy for 200k and something that you absolutely hate for 300k is enormous, hence "don't pick your specialty for the money." Going to work and enjoying what you do versus tolerating what you do can be the difference between practicing until you're 75 or burning out when you're 45, and those short-term gains might cost you enough career longevity to become ultimately negative in their return value.

 

[palatopharyngeus]

This is the third thread you've asked it in, you should have your answer by now. No, you won't make that much money working normal hours in NYC. Yes, it is possible to make that much. Yes, you will be working ungodly hours to make 300k, likely for multiple employers, and probably 6-7 days a week.

that about sums it up

 

[medguy24]

The thing is, in medicine, your earning floor is roughly 200k if you're smart, and there are numerous fields to choose from, one of which will no doubt suit a given individual very well. The difference between doing something you really enjoy for 200k and something that you absolutely hate for 300k is enormous, hence "don't pick your specialty for the money." Going to work and enjoying what you do versus tolerating what you do can be the difference between practicing until you're 75 or burning out when you're 45, and those short-term gains might cost you enough career longevity to become ultimately negative in their return value.

I don't understand you.. Your saying I should I go into family medicine purely since I like it and I shouldn't worry about whether I'll make enough money in the future?

 

[Mad Jack]

I don't understand you.. Your saying I should I go into family medicine purely since I like it and I shouldn't worry about whether I'll make enough money in the future?

I'm saying you shouldn't be picking your specialty before you're even rotating because you have no clue what you like, what you can stand, and what you hate. You may pick something now that looks good on paper and pays well, only to find that you absolutely can't stand it on rotations, and that if you matched you'd burn out before 10 years was up. Worse still, what pays today might not be what pays (or is even employable) tomorrow. Getting a job in radiology that pays even 280k in NYC is damn near impossible, for instance, and it's very difficult to get an anesthesia position that pays over 260k. A lot of people looked at those fields 8 years ago and picked them, hoping to live the life in NYC, only to realize down the road that things had changed- reimbursement was down, the job markets had become tight, and virtually no jobs were available. Don't pick your field based on today's salary, because salaries vary vastly based on how Medicare decides to reimburse. With the switch from fee-for-service to bundled payments, it's possible specialists will take a serious dive in salaries within the next decade.

And "enough money" is completely relative. I'm sure you wouldn't die starving on 200k plus whatever you could make on the side, particularly with zero student loan debt.

 

[medguy24]

I'm saying you shouldn't be picking your specialty before you're even rotating because you have no clue what you like, what you can stand, and what you hate. You may pick something now that looks good on paper and pays well, only to find that you absolutely can't stand it on rotations, and that if you matched you'd burn out before 10 years was up. Worse still, what pays today might not be what pays (or is even employable) tomorrow. Getting a job in radiology that pays even 280k in NYC is damn near impossible, for instance, and it's very difficult to get an anesthesia position that pays over 260k. A lot of people looked at those fields 8 years ago and picked them, hoping to live the life in NYC, only to realize down the road that things had changed- reimbursement was down, the job markets had become tight, and virtually no jobs were available. Don't pick your field based on today's salary, because salaries vary vastly based on how Medicare decides to reimburse. With the switch from fee-for-service to bundled payments, it's possible specialists will take a serious dive in salaries within the next decade.

And "enough money" is completely relative. I'm sure you wouldn't die starving on 200k plus whatever you could make on the side, particularly with zero student loan debt.

I see what you mean. Thx for the help.
But to my defense I spent a good amount of time shadowing a family medicine doctor and I did like it... But again I get your point, thanks for the help.

 

[Mad Jack]

I see what you mean. Thx for the help.
But to my defense I spent a good amount of time shadowing a family medicine doctor and I did like it... But again I get your point, thanks for the help.

I'm not saying don't go into family medicine. I'm not saying to go into family medicine. I'm just saying don't make that decision based on the cash before you've even rotated in other fields.

 

[medguy24]

I'm not saying don't go into family medicine. I'm not saying to go into family medicine. I'm just saying don't make that decision based on the cash before you've even rotated in other fields.

I think your right. I guess I'll wait until after I rotate to decide. Thx Again.

 

[DubVille]

Pick 2:
Location
Hours
Salary

You will almost never find a job that satisfies all 3 in any field. In competitive job markets, you may have to choose one of the 3. Those above me are absolutely correct in saying that job markets can change, and we are likely on the verge of a shift in reimbursement.

 

[Dreamstoo]

Aren't Sophie grads locked into doing primary care?

Nope but they have to pay a fee for not pursuing primary care I believe. Family friend went there and went into a competitive surgical field and had to pay a $70k fine. Altogether, they said it was still a really cheap program. This was when it was a 6 year program still.