Willamette

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Does anyone have solid info about what realistic starting salaries are like in the Pacific NW? A little background: I have some time to before I need to decide, but am currently torn between EM and FM. My wife and I are very family oriented, and as such will settle in the PNW (where our family is...of course :) ). My concern is, since I am a bit of a late bloomer in the medical field (I'll be 35 after residency...not real old, but not 27 either), that I won't make enough money as a Family Doc in Oregon or Washington. We'll have our school loans to pay (my wife is finishing up with PA school and our combined school debt will be a staggering $350,000), a young nuclear family (we're going to try to start having kids during my residency), aging parents that we may have to help support, and finally lifestyle and retirement considerations. I don't want to make this decision based soley upon the pertinent economics, but I feel that low salaries in family medicine may force my hand. Thoughts anyone?

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dr.smurf

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i think the big thing to consider is what you will be happy doing. the other thing is that em is very competative these days so if you dont think you would relocate just for residency then maybe em isnt as appealing as fp since right now its pretty wide open.

there isnt a staggering difference in salary between the two. the last i checked it was maybe 30k more a yr. go to salary.com for salaries in the pacific nw.

lifestyle is an issue for you as well..esp if you are going to start a family. in my fp program they are very into time off for your family...hince family practice. if you dont mind working 12 hour shift work then em might be the route for you.

hope this helps!
good luck
 

Willamette

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I would certainly love to go with my heart on this one, once I decide what that means of course, but it's my understanding that PNW salaries for family docs are not very appealing. My dad sent me an OPB special on healthcare in rural Oregon, and one thing they kept saying was that the work was hard (yet satisfying...why do I feel like the Lion King?) but the pay was lousy. The thing is, I could very easily decide that I like EM best and then the salary question becomes moot. However, I am not willing to even consider Family Medicine if it means working for $100-110K, no matter how much I might like it. As for 12-hour shifts, I was a sailor in the USN and know that they would suit me just fine. Shift work would therefore be an appealing but not a "decision-making" peice of this complex puzzle.

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erichaj

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You have answered your own question. 110 to 120 are the starting salary for fp nationwide. The average salary is aroung 140 to 150. This information is available on the aafp website.
www.aafp.com

Your wife will most likely make around 50k per year as a PA.

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emedpa

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a liitle more info on pnw salaries from a local....
starting salary for fpmd in the portland /vancouver area is 90-120 k for a new grad. a pa here makes only slightgly less at 55-75k to start in primary care and more for specialties with > 100k possible in em/ortho/surgery.
em docs in the area make 175-300k/yr. one local er pays docs $145/hr.
the other thing you could do is get boarded in fp and work some urgent care in addition to your regular fp practice. docs around here who do that make about 170 k/yr.
also you may want to consider loan repayment options. 90 k a year isn't bad if they also pay off a year of school loans for each year you work. check out the national health service corps for info on these types of positions.
 

Willamette

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Thanks for your input guys. I went into med school fairly certain that I wanted to go back home (I'm from an underserved area) and be a family doc. It really bites that, even at this stage of the game, money still makes such a big difference. I'm sure that I'll end up picking something that I like (heavily leaning toward EM at the moment), but it would be really great to just pick what I like DOING the best, and let money take care of itself. Again, thanks to those who took the time to answer.

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tcpro

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As a fellow Pacific Northwest guy, I grew up in Portland, OR (my parents still live there), and have been in Seattle (at UW) for 8 years now (undergrad on to medical school).

One thing you also have to take into account w/ the slightly lower salaries, is in Oregon there's a terrible income tax. I'm sure you're well aware of this (esp for the higher tax brackets). I remember once, just to prove to me (being the naive high school kid), my father showed me one of his paychecks and indeed almost 50% of it was taxed out (he is in the highest tax bracket--not a doctor though).

Washington may be a better bet, because we have no income tax up here. BUT.. there has been a push lately by the state to institute an income tax, but I don't see it passing anytime soon.

People have enjoyed living in Vancouver, WA (working there) and then buying their stuff in Portland (5 minutes away).
 

Willamette

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tcpro said:
As a fellow Pacific Northwest guy, I grew up in Portland, OR (my parents still live there), and have been in Seattle (at UW) for 8 years now (undergrad on to medical school).

One thing you also have to take into account w/ the slightly lower salaries, is in Oregon there's a terrible income tax. I'm sure you're well aware of this (esp for the higher tax brackets). I remember once, just to prove to me (being the naive high school kid), my father showed me one of his paychecks and indeed almost 50% of it was taxed out (he is in the highest tax bracket--not a doctor though).

Washington may be a better bet, because we have no income tax up here. BUT.. there has been a push lately by the state to institute an income tax, but I don't see it passing anytime soon.

People have enjoyed living in Vancouver, WA (working there) and then buying their stuff in Portland (5 minutes away).

Great info and well worth considering! Thanks!

Willamette
 

r90t

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Take the residency that you want to do and don't let salary be the deciding factor. You will be working that job too many hours/week to be dissatified with your choice. Also, if you are going to an underserved area, the local hospital may absorb your loans if you contract to that area for a set number of years. I have seen this done in the outskirts of Arizona.

Urgent cares pay an unboarded physician 50/hour. Do the math on that to see if working the extra time/salary is worth being away from the family.

Look at the lifestyle you want. A married couple that I worked with were EM and FP. He did 3-4 12 hr shifts/week. She worked 4-5 days/week, 40-50 hrs/wk. Long lunches with the kids, kids play room in her office and flexibility to reschedule a day of work if something (family emergency) came up.
 
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