Medscape Comp Report 2018

[DubbiDoctor]

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Medscape: Medscape Access

Plastics has stolen the top earning spot from orthopedics, Psych went way up, EM is now at 350k per year (74%, the most of any, feel fairly compensated), physical medicine is finally included, and gen surg fell sharply. Discuss.

 

[Dr. Bruce Banner]

always have to take these surveys with a grain of salt. The responding rate was pretty low overall, such as plastic surgery having only 1% of respondents, which means the data can be VERY skewed. Reasons for responding can also vary. For example, studies have shown that you're more likely to respond if you have more negative things to say, or on the other end want to brag about how much your specialty makes, etc. I'm not saying these sorts of data and survey can't be helpful, but definitely need to be careful interpreting them.

 

[Rekt]

As if there weren't enough reasons to avoid general surgery already

 

[DubbiDoctor]

As if there weren't enough reasons to avoid general surgery already

Why is the comp relatively low? I would figure that you can bill a lot for surgery, and it's not as if surgeons have to compete with midlevels - driving down primary care pay - as midlevels cannot operate independently.

 

[Dr. Bruce Banner]

Why is the comp relatively low? I would figure that you can bill a lot for surgery, and it's not as if surgeons have to compete with midlevels - driving down primary care pay - as midlevels cannot operate independently.

it's not about the existence of midlevel or not (eg. anesthesiologists still get paid ALOT despite CRNA, EM physicians get paid alot despite PAs), it's more about the trend towards wanting less invasive methods and spending less money on procedures. One of the gyn onc physicians I was with couple of weeks ago was telling me that all the surgeons here basically had about the same salary since late 1990s. Now salary stagnancy is not nationwide, but pretty much everyone agrees the rate of pay is NOT keeping up with the overall inflation and economy. He also told me that now there is a huge push towards spending less money on invasive procedures and surgeries to save money, and spend more money on minimally invasive or non-invasive means of treatment. On the bright side, surgery will NEVER die because there will always be a need. But with the advent of regenerative medicine, there might be a shift of which specialties might benefit more from reimbursements in the future. But don't let money stop you from doing what you love!

 

[PatchAdams25]

Interesting that Gas makes more on average than Optho, Urology and ENT?? Guessing the ceiling is much higher in those 3 specialties compared to gas

 

[W19]

IM docs should be making more than that.

 

[libertyyne]

There is regional variation in salary,compensation differences in terms of benefits, partnership stake, rvu productivity, etc. These are very , very rough estimates. I would probably look at mgma data if you wanted a better dataset. A good example is in my neck of the woods they were offering cc jobs at 425 + a sign up bonus.

 

[CherryRedDracul]

5th place, bitches.

 

[libertyyne]

5th place, bitches.

probably Sixth considering Neurosurgery is not on the list.

 

[CherryRedDracul]

probably Sixth considering Neurosurgery is not on the list.

Now that you mention in, probably 7th since Pill Miller is not on the list either.

 

[libertyyne]

Now that you mention in, probably 7th since Pill Miller is not on the list either.

Also missing IR and CT surg, I wonder if they are lumping in Interventional Cards with straight cards.

 

[DubbiDoctor]

GI boy we the best music

only if you're scoping in private practice.

 

[SpartanWolverine]

IM docs should be making more than that.

Considering IM starts at 165-185k in my area 230 is something most people here would be pretty happy with. Think that Ann Arbor is the second lowest paying area in the country behind Raleigh/Durham, however.

Edit: source

 

[Redpancreas]

only if you're scoping in private practice.

Um no...it’s an average. PP scopers would make quite a bit more than that. Just my opinion, but I think GI is the best field overall given the range of pathology, compensation, and ability to work with you hands.

 

[DubbiDoctor]

Considering IM starts at 165-185k in my area 230 is something most people here would be pretty happy with. Think that Ann Arbor is the second lowest paying area in the country behind Raleigh/Durham, however.

Edit: source

You seem to be referring to out-patient internists. I think they're lumping in hospitalists in the IM total, raising it a bit above family medicine. In 2017, according to medscape, the average IM hospitalist made 252k, compared to 211k for non-hosptialists. The average FM hospitalist made 236k, compared to 207k for non-hospitalists.

 

[libertyyne]

Considering IM starts at 165-185k in my area 230 is something most people here would be pretty happy with. Think that Ann Arbor is the second lowest paying area in the country behind Raleigh/Durham, however.

2 hours west and you are in the 300's or close to for inpatient hospitalists.

 

[theonlytycrane]

EM is doing work! But everyone was bashing EM on my other thread...

 

[AnatomyGrey12]

Also missing IR and CT surg, I wonder if they are lumping in Interventional Cards with straight cards.

They should probably separate IC cards from non-invasive. All the IC people in the department here make complete bank. I think according to the MGMA data it’s one of the highest compensated fields at the moment. Up there with spine surgery and orthopedists that do elective join replacement.

 

[DubbiDoctor]

EM is doing work! But everyone was bashing EM on my other thread...

EM is excellent. They're working 36 hours a week (least in medicine for among the highest hourly pay), making 100k more than hospitalists who work 7on/7off (averages to 42 hours a week). They also see a diverse range of pathology, perform an interesting and exciting mix of procedures and medicine, and are able to treat trauma, particularity if they work at a level 1 or 2 trauma hospital. All that and no on call. It's a wonder it's not more competitive than it is.

 

[PhillyMed777]

5th place, bitches.

probably Sixth considering Neurosurgery is not on the list.

It's not only how much you make but how long you work for that and what the work consists of.

 

[libertyyne]

EM is excellent. They're working 36 hours a week (least in medicine for among the highest hourly pay), making 100k more than hospitalists who work 7on/7off (averages to 42 hours a week). They also see a diverse range of pathology, perform an interesting and exciting mix of procedures and medicine, and are able to treat trauma, particularity if they work at a level 1 or 2 trauma hospital. All that and no on call. It's a wonder it's not more competitive than it is.

BURN OUT.
Retail public
Drug seeking
Spotting zebras
You are always on in EM too, churning through patients. IM will afford some respite during the 12 hour shifts.

It is not all hearts and unicorns in EM. Plus if you look at MGMA data EM is 25-50K more compared to hospitalist IM. Not a huge difference considering liability for zebra's, and dealing with the public without a filter.

 

[SpartanWolverine]

You seem to be referring to out-patient internists. I think they're lumping in hospitalists in the IM total, raising it a bit above family medicine. In 2017, according to medscape, the average IM hospitalist made 252k, compared to 211k for non-hosptialists. The average FM hospitalist made 236k, compared to 207k for non-hospitalists.

Nope, the two main hospitals pay their hospitalists 165-185k to start (with a typical 1 week on, 1 week off schedule), as reported by grads looking for jobs this year. Assume this is salary and not a 'total compensation' figure. Because of this a lot of our IM grads leave for Ohio or places at least a few hours away where 250+ can be reasonably found.

 

[DrfluffyMD]

Also missing IR and CT surg, I wonder if they are lumping in Interventional Cards with straight cards.

IR make the same or less compared to diagnostic rad.

 

[libertyyne]

IR make the same or less compared to diagnostic rad.

Thats interesting. I was under the impression IR made significantly more. MGMA has them at 100K more for the first two experience categories.

 

[DrfluffyMD]

Thats interesting. I was under the impression IR made significantly more. MGMA has them at 100K more for the first two experience categories.

IRs are loss leaders in many practices because vascular surgery have taken the more lucrative ones. Some IR in private practice are competing and taking those back but that is not the norm.

 

[AnatomyGrey12]

Thats interesting. I was under the impression IR made significantly more. MGMA has them at 100K more for the first two experience categories.

I wonder if PP makes a lot more. I too was under the impression IR made more than diagnostic due to a high volume of procedures.

 

[libertyyne]

IRs are loss leaders in many practices because vascular surgery have taken the more lucrative ones. Some IR in private practice are competing and taking those back but that is not the norm.

Has someone told the matching seniors about this? Because they may have seriously missed the memo. I did have an disgruntled IR doc tell me to go into ENT.

 

[DrfluffyMD]

Has someone told the matching seniors about this? Because they may have seriously missed the memo. I did have an disgruntled IR doc tell me to go into ENT.

The thing is though, having IR training gives you OPTIONS ranging from a full surgical lifestyle practiced by Dr.Arslan at Rush to one week on two week off locum IR gigs to telerad from Hawaii.

The premium of IR is the options it offers. I chose IR because I had a hard time deciding what I want with my life. A lot of IR docs do a few years of hardcore work then transition into lighter work while maintaining salary. Surgeons don’t have this option.

 

[Anti-PD1]

These things never have neurosurgery.

Then again the variation is so nuts (i.e. fresh attending at Harvard [350k] vs locum tenens in Long Island [1.8mil]) what does it matter.

 

[zero0]

Psych looks better every year, think I found myself a plan B

 

[W19]

Psych should be plan A for anyone who does not have derm stats, which about 95% of US med students...😛

 

[Kgizzle]

Um no...it’s an average. PP scopers would make quite a bit more than that. Just my opinion, but I think GI is the best field overall given the range of pathology, compensation, and ability to work with you hands.

Lol @ pee pee scopers

 

[Redpancreas]

Lol @ pee pee scopers

Lol is that urology?

 

[Kgizzle]

Lol is that urology?

Naw private practice scopers but that's how I read it so it made me chuckle

 

[Dr. Bruce Banner]

pm&r is the next derm 😛

 

[RTD]

This is nice data but I dont feel safe interpreting it since I have no idea how many people from each speciality responded and how each part of the country is representated.

For example, average for hospitalist is 230 but I know no one who is making anywhere close to that low of a number( not to mention people in these forums). Either the standard deviation is ridiculous or something is fishy.

 

[W19]

Why don't they train FM docs to scope? It would be a good source of income for PCP.

 

[NeurologyHopeful2018]

This is nice data but I dont feel safe interpreting it since I have no idea how many people from each speciality responded and how each part of the country is representated.

For example, average for hospitalist is 230 but I know no one who is making anywhere close to that low of a number( not to mention people in these forums). Either the standard deviation is ridiculous or something is fishy.

Starting offer for academic IM at my institution is 160K...

 

[gshocke]

Interesting that Gas makes more on average than Optho, Urology and ENT?? Guessing the ceiling is much higher in those 3 specialties compared to gas

Psych should be plan A for anyone who does not have derm stats, which about 95% of US med students...😛

Gas should be plan A. Top earner and not competitive at all. I think 2017 match, Gas had one of the highest IMG match rates which says a lot. Good lifestyle. Very flexible. Very much a mommy track specialty and starting at a min 300

 

[W19]

Gas should be plan A. Top earner and not competitive at all. I think 2017 match, Gas had one of the highest IMG match rates which says a lot. Good lifestyle. Very flexible. Very much a mommy track specialty and starting at a min 300

But you will have to deal with surgeons...

 

[LoGo]

pm&r is the next derm 😛

haha no it's not. Here's a post from 2001, and nothing has changed in that 17 year time.

if you match into derm spot people will say, wow, he/she's smart and had solid board scores, that's impressive... i'm pretty sure people don't say that about matching in PMNR. the field is gaining recognition among med students and even doctors. i think it will become more competitive in time. it's not the nature of some med students to do something that isn't impressive to others.

PMR is an old specialty - since the 40s. It's not as though it's magically on people's radar now. It's a good specialty, with good lifestyle and good pay - but the job description is also not really what most med students want to do and it will never have the same flexibility that derm has.

So...

 

[DubbiDoctor]

haha no it's not. Here's a post from 2001, and nothing has changed in that 17 year time.



PMR is an old specialty - since the 40s. It's not as though it's magically on people's radar now. It's a good specialty, with good lifestyle and good pay - but the job description is also not really what most med students want to do and it will never have the same flexibility that derm has.

So...

"So you're a physical therapist?"

 

[JamesPotterMS-3]

Can someone please explain to me why/how the anesthesiologist makes more than the general surgeon?

 

[libertyyne]

Can someone please explain to me why/how the anesthesiologist makes more than the general surgeon?

Overseeing CRNA's.
Can oversee many more surgeries.
Supply and demand?

There is no logic to reimbursement in terms of societal good or effort, contrary to what people would have you believe.

 

[Postictal Raiden]

Can someone please explain to me why/how the anesthesiologist makes more than the general surgeon?

Because they don’t.

These surveys are BS. Most of the ones that participate are academicians/salaried/underpaid. PP physicians don’t like to report their true income (for obvious reasons).

244k for neurology. That makes me laugh. I have worked with neurologists long enough to know that this can’t be further from the truth. Same goes for GS.

 

[DubbiDoctor]

Because they don’t.

These surveys are BS. Most of the ones that participate are academicians/salaried/underpaid. PP physicians don’t like to report their true income (for obvious reasons).

244k for neurology. That makes me laugh. I have worked with neurologists long enough to know that this can’t be further from the truth. Same goes for GS.

Why should we trust your anecdotes over what large surveys consistently report year after year?

 

[Postictal Raiden]

Why should we trust your anecdotes over what large surveys consistently report year after year?

No one is telling you to trust my anecdotes.

I’m entitled to share my opinion and challenge the data.

 

[libertyyne]

No one is telling you to trust my anecdotes.

I’m entitled to share my opinion and challenge the data.

MGMA data that is used by organizations for salary estimates indicates that Anasthesia does make 30k+ more than gen surg and that 240 is within 30K of the neurologist average. this data i have is older, but follows the same trends.

 

[mymembernames]

Doesn't EM actually make more than Gas since EM works so few hours in comparison?