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Medscape Physician Compensation Report 2017
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Time to move to Canada?
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I interpreted that as Canadian physicians who were practicing in America. Are those physicians practicing in Canada?
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Why would Canadian physicians practicing in America earn more?
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They get paid in Canadian dollars so they get more.
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If you actually look at EM vs Gas on the web you will find EM's hourly rate at $250-$300 vs Gas at around $180-$200. I believe those numbers are accurate and reflect the wages paid by AMCs and hospitals.
So, while 10 years ago GAS paid 20-30% more per hour vs EM things have now switched around with EM paying more money in many situations.
This survey shows what I already know about wages for GAS: real wages for new grads are stagnant at best with only the elite practices (those fortunate enough to be owners) getting the wage increases of 5-6%.
The final fact which the survey does not take fully into account is lifestyle: Anesthesiology is not a lifestyle choice if you want to earn $200 per hour or more. For "lifestyle" that wage is likely around $150-$175 per hour.
ENT, Ortho, Optho, Derm and even General Surgery (non trauma) offer better lifestyle options than most GAS jobs.
So, while 10 years ago GAS paid 20-30% more per hour vs EM things have now switched around with EM paying more money in many situations.
This survey shows what I already know about wages for GAS: real wages for new grads are stagnant at best with only the elite practices (those fortunate enough to be owners) getting the wage increases of 5-6%.
The final fact which the survey does not take fully into account is lifestyle: Anesthesiology is not a lifestyle choice if you want to earn $200 per hour or more. For "lifestyle" that wage is likely around $150-$175 per hour.
ENT, Ortho, Optho, Derm and even General Surgery (non trauma) offer better lifestyle options than most GAS jobs.
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The report said something about the Canadian trained cohort that they polled being younger and more likely to work longer hours. And I also thought it meant physicians who were trained in other countries but practicing in America because I didn't think that physicians in India were bringing in 270k USD a year..or Mexican physicians making 260 USD/ year in Mexico. That seems really high for those economies to me but I could be mistaken.
Yes. People focus on "salary". Per hour (since EM docs generally work shifts). EM docs are doing much better per hour than anesthesia docs per hour.
I focus on "work load" and "hours worked"
AMCs have found the sweetspot in terms of recruiting docs and it's around $350-400k w2 (not factoring in work hours). But that's the magic number.
I focus on work hours and work pace. I switched over to the VA a month and a half a hour. While my pay is low. For the hours I work and the pace of the work. I feel like I am fairly compensated.
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I heard VA got a raise recently that bumped them over 300
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EM is also only 3 years of training and there isn't this expectation to do a fellowship.
I also frequently get recruiter emails for hospitalist jobs in non-NYC/SF/Chicago locations for around $300-350k salary in a 7on/7 off model. The employed, non-procedural physician salaries are becoming more equal across the board.
Med students really do need to consider lifestyle. Anesthesia is one of the few specialties where you will likely be doing in-house 24 hour shifts well beyond residency.
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Sorry, but you couldn't pay me $1000 an hour to work in an ER. Your time off work may be great but during it has to be one of the worst lifestyles in medicine. Did you guys enjoy your ER rotations?
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Agree physician only anesthesia is a lot easier than ER. If your running around supervising 4 rooms in a busy OR, that might be similar to an ER job. Our ER docs work hard when they're there. They're not chillaxing in the chair.
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More than likely it is a factor of their specialty distribution and practice location. Maybe Canadians are willing to work in cold places.
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Sorry that is hilarious....I didn't realize people are fighting to get into any AMC. I would never call 350-400k the sweet spot....double it and then we will talk. 350-400 to supervise 4 or more CRNAs no way.
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The problem is a lack of knowledge and transparency. No resident has any clue what he or she is worth and the only data is from these lame surveys...which are probably published by AMCs anyway. Then once you start working for the AMC (or shady private practice), the billing process is kept hidden from you and all you can do is make guesses and assumptions. You know you are being taken advantage of, but don't have the necessary information to prove it. This is how corporations have always worked and will always work. You are worth whatever they are willing to pay you.
actually what you are worth is the sweet spot where they are willing to pay it and you are willing to work for it. Unfortunately you gotta find someone to pay you that values you as much as you value yourself.
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And if they drop that salary below your "willing" threshold, do you just not work? That's easy for someone who has been practicing for 10-15 years, has no debt, and a sizable nest egg. That's not so easy for a new grad with no savings or assets and 200k+ in debt. A new grad has neither the knowledge to know if a job is a bad deal, nor the means to walk away from a bad deal. That "willing to work for" part of that equation is pretty low for new grads and is part of the reason we will continue to see stagnant anesthesiology pay.
People aren't fighting for the AMCs jobs. Trust me they rather avoid them. But not many choices in many parts of the country. Go up and down the north east. Mainly AMCs these days. Look at the salary. You don't have much pickings. And the few true private remaining groups aren't paying much more. In fact, many are paying even less for "partnership" track in the high 200s. I guess the pot of gold for those partnership tracks may or may not exist after 2-3 year to make in the 500s. My sister's group in the northeast (very fair all MD group) recently increased their partnership track from 2 to 3 years. Starting base in in the upper 200s with full all MD call plus OB which is pretty busy. But group is under constant regnotiation with the hospital. She doesn't know if group can maintain contract and they have had same contract with hospital for 20 plus years with same anesthesia group.
Go down south. Check out Charlotte/Atlanta/Miami/Tampa. Slim pickings. Maybe you can go to Arkansas to make dough, some rural parts of Tennessee. But even Nashville is saturated.
So unless you wanna work in the midwest/upper midwest, maybe some parts of Ohio/Kentucky/Minnesota etc to make real cash. Out in California is completely saturated. My brother is out in LA. Brutal market and he's blended unit but payer mix is getting worst and the private insurers don't pay as well either. You can still make some real income in some parts of Texas but Dallas and Houston are pretty much saturated unless you have a niche market like my best friend from college and med school in Texas who's pulling a lot of $$$. But he mixes pain procedures along with doing lots of lucrative spine cases for anesthesia.
Could someone fill me in on what AMC is? Google searching yields Australian Medical Council and I'm about 90% sure that's not it. Thanks!
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Nope, you got it right. Those god damn Aussies are ruining anesthesia one group at a time here in the US.
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Many Med students choose EM over Gas. I see it year after year that for some reason they "prefer" EM and it remains a popular choice. As for me personally, I detest the ER but that wasn't my point of the post.
EM pays better than GAS.
I'm assuming if where you work drops your salary below what you are willing to work for, you look for a new job. That was everybody else in the world does when they feel they aren't being paid enough.
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People keep saying EM pays better than gas, but I just don't see it. Sure, every once in a while you can get a crazy hourly rate, or you can go to TX or the middle of nowhere and make bank, but most EM docs aren't making 350-400 working for management groups - they're making 200-250.
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200-250 an hour is still more than most employed anesthesiologists are making. Overall compensation may be higher in anesthesia, but workload is also more.
Yes. People need to evaluate the overall work they are doing.
Too much focus on salary. Salary means nothing without taking into content acuity of work, work hours than adjusting even more than calls and weekends.
That's why the AANA propaganda MDs make $340k. Lowly crna makes $160k "salary". To the public that a lot of salary difference.
But considering most Crna's work 37 hours a week. Most MDs work 52 hours a week. Than adjusting for late nights and calls and weekends. That big salary difference isn't as larger as most people think.
That's why many "independent crna" easily make 300-400k in group practice
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I don't know why everyone keeps saying ER docs work like crazy. Ive done em rotation and it wasn't bad at all and I'm at a busy ER. Sure you work nonstop but it's only 12 Hrs. And it was 21 shifts in the month w bunch of random nights and days in there. A lot of patients are there for stupid things and only few are true emergencies. There's a lot of paperwork but not much difficult stuff. Their pay is ridiculously high if you ask me
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Saunter over to the EM forum for their thoughts on their version of AMCs (Anesthesia Management Companies, for the poster above), it seems to be much worse and cutthroat - see the recent Summa Health debacle in Ohio at the start of the year.
EM is a very different field, in my opinion. Unlike most others the peak demand by patients isn't a first start or clinic between 7 and 9 AM, its early afternoon into late evenings 3-7 PM. Sure they work less shifts, but a lot of them are overnight and evenings. Their shifts can also be quite draining as other posters have alluded to.
I chose something I'd enjoy doing for 30+ years of practice, EM burnout rates are so high and the forced primary-car/psychiatry aspect would weigh on me personally. Maybe a higher hourly wage, but not near attractive enough to stomach the inherent issues in an emergency room.
Final thought - think you don't get a lot of respect as an anesthesiologist, chat with your neighbor in EM. Literally all specialties groan when they get a consult from the emergency room, including our own!
EM is a very different field, in my opinion. Unlike most others the peak demand by patients isn't a first start or clinic between 7 and 9 AM, its early afternoon into late evenings 3-7 PM. Sure they work less shifts, but a lot of them are overnight and evenings. Their shifts can also be quite draining as other posters have alluded to.
I chose something I'd enjoy doing for 30+ years of practice, EM burnout rates are so high and the forced primary-car/psychiatry aspect would weigh on me personally. Maybe a higher hourly wage, but not near attractive enough to stomach the inherent issues in an emergency room.
Final thought - think you don't get a lot of respect as an anesthesiologist, chat with your neighbor in EM. Literally all specialties groan when they get a consult from the emergency room, including our own!
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You can do ER and work in a small comm hospital. Trust me you can find a sweet gig. The ER drs at my hosp have it good. :0 They don't even do lines/intubate etc-complete joke. I bet there are a bunch of ER jobs like that...
many small community hospital ERs are not staffed by board certified ER docs. They are staffed by FP or IM docs.
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So here is the way I see it.
I work in the OR and hear surgeons dealing with ER physicians- sometimes it's a good interaction a lot of the times it's an annoyed reaction.
ED's job is to acutely treat and discharge or find someone in the hospital to take over care and admit them to their service so they can free up an ED bed- rinse and repeat.
I just don't want that job.
At least in the OR I can do some good medicine, read some SDN, do my MOCA minute BS chillax a bit and participate in some really cool cases.
ED would drive me up the wall. Especially a busy ED. I do like the pace of managing one patient (albeit sometimes very sick patient) at a time.
I have partner that makes a little over 200k and takes no call. He also takes over 25 weeks off a year. It's a good flexible gig and I can't wait to get there.
I work in the OR and hear surgeons dealing with ER physicians- sometimes it's a good interaction a lot of the times it's an annoyed reaction.
ED's job is to acutely treat and discharge or find someone in the hospital to take over care and admit them to their service so they can free up an ED bed- rinse and repeat.
I just don't want that job.
At least in the OR I can do some good medicine, read some SDN, do my MOCA minute BS chillax a bit and participate in some really cool cases.
ED would drive me up the wall. Especially a busy ED. I do like the pace of managing one patient (albeit sometimes very sick patient) at a time.
I have partner that makes a little over 200k and takes no call. He also takes over 25 weeks off a year. It's a good flexible gig and I can't wait to get there.
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As said above, it's striking how much the gap has closed, if you believe these numbers. There was a time not long ago when FM/IM made much less than 40% of an orthopedist. This has been predicted for some time and was the basis for a lot of advice to ignore compensation that I got while a med student, so maybe they were onto something.
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There is no amount of money in the world that could get me to be a primary team or do primary care, deal with ER bull****, take consults, take routine pages from nurses, round on patients, write notes, get on the hamster wheel in a clinic, or have to talk to someone more than I want to. I guess that eliminated everything, except... 😉
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Pathology
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No but if you can ignore that during the 4 years of residency, then it is a sweet deal...no patients, no overnight call (always sleep in your own bed every night of residency), no rounding, no patients, no SOAP notes, and the list will go on.
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Pretty much every field has gone way up though - the average has gone from 206k in 2011 to 294k in 2017, which is close to a 50 percent increase in 6 years. Can anyone here explain why so many doctors claim that salaries are going down when they seem to be going up?
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Okay. I'll keep it simple for you. The subspecialty fields offer the chance for a hard working Physician to earn DOUBLE what the Medscape survey lists as "the average annual salary." Those fields where a young Physician can enter into true private practice arrangement/fee for service/eat what you kill/partner in a group are much different than those where the vast majority of employment opportunities are "employee models."
Employee model= Average Medscape Salary plus maybe 25% (if you are lucky or fellowship trained)
Private practice Model in a subspecialty= 2 X average Medscape Salary (potentially)
Both EM and Gas are now mostly "employee models" with EM about $250 per hour vs Gas at $200 per hour.
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Thank you. I did not know about this at all.
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so if thats the case why do people complain about Gas job out look? seems like theyd be in decent demand ? serious question. I see so much doom and gloom on these forms and the gas residents i know say " im not worried about that "
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Several Reasons, but mathematically, the simplest two reasons would be, increases in anesthesia salary have not kept up with inflation, and second the salaries have not included hours worked (which anecdotally, has inched ever so slightly up), these two combined nets you less per hour than prior years.
Yup. Gotta take the whole workload picture in order to fully comprehend income.
Like i worked briefly at a surgery center last year for 5.5 months. The pay was in the high 300s for rh year. Monday through Friday. Not bad on paper right?
Yet my friend worked at same exact surgery center for essentially same exact pay (high 300s).
But he was working 25-30 hours roughly seeing maybe 15-25 patients daily (mixture of peds ent/eyes/ortho and some endo getting down at 1pm most days and a few off days paid as well
But I was seeing 50-60 patients daily. Heavy GI. Double as many eyes. Same peds/Ortho. Only md covering 3 crnas. Working 55-58 hours often times to 6pm (12 hour days). I'm the only md seeing that many preops.
So on paper compensation is exact same at this surgery center. But I'm doing 2-3x the work and almost double the hours.
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So how'd he get the sweet low hours ? Fellowship trained or seniority
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No. Surgery center was private locally owned.
Than sold out to national company owned by hedge fund in 2012. Than new corporate surgery kicked out anesthesia peeps and did illegal company model. And than jacked up the number of cases.
And they hired got two new surgeons literally when I started there to increase the case volume even more.
