Pediatricians really that sub-optimally compensated?

[monkeyMD]

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I would like to go into peds but everyone that I talk to keep mentioning the fact that even peds subspecialty is poorly compensated for. I would like to be making 200K+ as a physician, especially with all the debt I have been accruing as a student. And especially after additional years of fellowship. The only thing that is turning me away from pediatrics is the pay. Any input about this?

 

[colbgw02]

I like your thread title.

 

[PL198]

why are you inferring it's sub optimal just because they make X amount

 

[RySerr21]

It depends on where you live in the U.S and which specialty you are doing. If you are willing to live anywhere, you'll find a job that pays 200K or greater as a hospitalist. It may not be your first year out, but you'll get paid that much. I would expect though to make mid 100K as a general pediatrician. If you do a fellowship, there is potential to make a lot more. Some of the cardiologists at my institutioon are making >450K. I just looked up one of the hospitalists salary (government salaries are public) and he makes around 160...i looked up another persons and they were making 215K....so really it all depends. Bottom is that pediatricians do get paid less than their internal medicine counterparts, but they do well for themselves.

 

[Cytarabine]

It depends on where you live in the U.S and which specialty you are doing. If you are willing to live anywhere, you'll find a job that pays 200K or greater as a hospitalist. It may not be your first year out, but you'll get paid that much. I would expect though to make mid 100K as a general pediatrician. If you do a fellowship, there is potential to make a lot more. Some of the cardiologists at my institutioon are making >450K. I just looked up one of the hospitalists salary (government salaries are public) and he makes around 160...i looked up another persons and they were making 215K....so really it all depends. Bottom is that pediatricians do get paid less than their internal medicine counterparts, but they do well for themselves.

450k for a nonsurgical peds subspecialty? :O

 

[LaughingMan]

Average salary data is easily available via a Google search.

Look at the data - If the pay is not good enough for you, then I don't know what other input we can give you, aside from unicorns and wishes.

I wouldn't assume that you'll be in the 99th percentile for salary

Might I ask why you think Peds salary are low? Have Pediatric Physicians failed to organize properly leading to the lower salary?

Also, based on your experience, do you feel wages will increase in the future?

 

[RySerr21]

450k for a nonsurgical peds subspecialty? :O

...yes...i was literally looking at the salary. As I said, the salaries are public. I just looked up another physicain in the same field with a salary > 550K. This is obviously not the norm, but the point is that there are plenty of opportunitie sto make money in pediatrics.

 

[Cytarabine]

...yes...i was literally looking at the salary. As I said, the salaries are public. I just looked up another physicain in the same field with a salary > 550K. This is obviously not the norm, but the point is that there are plenty of opportunitie sto make money in pediatrics.

Wasn't saying you were lying, just considerably higher than I'd heard for any non-surgical peds

 

[DrBowtie]

Might I ask why you think Peds salary are low? Have Pediatric Physicians failed to organize properly leading to the lower salary?

Also, based on your experience, do you feel wages will increase in the future?

High percentage of Medicaid patients, not many procedures.

 

[PL198]

Might I ask why you think Peds salary are low? Have Pediatric Physicians failed to organize properly leading to the lower salary?

Also, based on your experience, do you feel wages will increase in the future?

lol wut

 

[NurWollen]

Average salary data is easily available via a Google search.

Look at the data - If the pay is not good enough for you, then I don't know what other input we can give you, aside from unicorns and wishes.

I wouldn't assume that you'll be in the 99th percentile for salary

Is it really that easy though? Every time I google physician salaries I get numbers that are all over the place. It's easy to find pediatrician job listings for pediatricians quoting salaries of $250,000+, but I don't think recruiters are to be trusted.

 

[JP2740]

I remember working with a pedes GI guy, and he was all like "I don't know why any pediatrician refers patients to me. There are a ton of pedes GI issues and they should probably be able to manage and put me out of a job." I was just like"..., can I go to lunch?"

 

[Nasrudin]

It's a shame what general pediatricians make. It's a difficult residency. Crappy work flow demands to justify a crap salary too. I like interacting with child patients. But that specialty left my mind for good as I grasped how much debt I was in after 1 year of medical school. Don't think about those poor bastards much either now except for a thread like this.

It's a crime that a specialist NP makes more. I couldn't take that.

 

[LaughingMan]

High percentage of Medicaid patients, not many procedures.

I see--a trend I don't see changing in the future.

lol wut

Organized Labor, especially in skilled fields in demand, is a force to be reckoned with.

 

[PL198]

right, yet the fact that you assume a groups pay is due to failure to organize is laughable at best.

 

[MatCauthon]

Peds ER doctors can make over 200k. I don't think peds should make much more than other primary care docs though.

 

[Roxas]

What about a peds hospitalist? A quick Google search shows mean salaries as low as 110k up to 230k (most were mid-100k). I get that the number will vary by # of shifts and # of patients, but that just seems so much lower than adult hospitalists

 

[DermViser]

Might I ask why you think Peds salary are low? Have Pediatric Physicians failed to organize properly leading to the lower salary?

Also, based on your experience, do you feel wages will increase in the future?

Not to get politically oriented, but it's bc their specialty group is filled with liberals/socialist types and it diffuses thru. It's the one thing that annoyed the heck out of me on Peds. Exhibit A: see OldBearProfessor and his annoying views on healthcare.

That being said -- those who work in Peds and its subspecialties have one of the HIGHEST levels of satisfaction. This is mainly bc they work with children -- fully understandable IMHO. Peds hospitals are so beautiful.

http://www.washingtontimes.com/news/2013/may/6/sebelius-urges-pediatricians-promote-obamacare/ (it's the Washington Times, but whatever)

 

[DermViser]

What about a peds hospitalist? A quick Google search shows mean salaries as low as 110k up to 230k (most were mid-100k). I get that the number will vary by # of shifts and # of patients, but that just seems so much lower than adult hospitalists

Peds patients also have very few comorbid conditions interacting. The complexity is less.

Peds ER doctors can make over 200k. I don't think peds should make much more than other primary care docs though.

And why not?

 

[DermViser]

It's a shame what general pediatricians make. It's a difficult residency. Crappy work flow demands to justify a crap salary too. I like interacting with child patients. But that specialty left my mind for good as I grasped how much debt I was in after 1 year of medical school. Don't think about those poor bastards much either now except for a thread like this.

It's a crime that a specialist NP makes more. I couldn't take that.

Have you thought about doing Child and Adolescent Psychiatry? I would think that would be gratifying. I agree with you on Pediatricians and specialist NPs. That's ridiculous and unfortunately Pediatrics has embraced the PCMH and working with NPs. Ick.

 

[PL198]

I understand the background behind derms post because I know he wants to do peds derm

 

[NurWollen]

Have you thought about doing Child and Adolescent Psychiatry? I would think that would be gratifying. I agree with you on Pediatricians and specialist NPs. That's ridiculous and unfortunately Pediatrics has embraced the PCMH and working with NPs. Ick.

In what way has pediatrics embraced working with NPs? Does the AAP have a pro-NP position or something?

 

[DermViser]

I understand the background behind derms post because I know he wants to do peds derm

And it's supported by surveys as well: http://news.legalexaminer.com/pedia...d-with-chosen-profession.aspx?googleid=270344

But compare your children's hospital to an adult hospital. The difference is vast.

 

[DermViser]

In what way has pediatrics embraced working with NPs? Does the AAP have a pro-NP position or something?

They support the PCMH -- the Primary Care Medical Home, which integrates NPs in the system and is a team based approach to care. Then you get bull**** like this: http://www.nursingworld.org/MainMen...nd-Resolutions/Issue-Briefs/APRNs-as-PCPs.pdf

ANA’s Advocacy for NPs, CNMs, and all APRNs
The American Nurses Association (ANA) supports the removal of barriers and
discriminatory practices that interfere with full participation by advanced practice
registered nurses (APRNs) in the health care delivery system. This includes the
ability of NPs and CNMs to lead a medical home.

 

[lorddisick]

A family member of mine is a pediatrician (FMG) and makes upwards of $250,000 a year...granted, she co-owns her own private practice in lucrative Texas, but it's definitely possible to make more than $200,000 as a pediatrician. PM me if you have any specific questions!

 

[ZuluHotel]

why are you inferring it's sub optimal just because they make X amount

well what is "optimal compensation" ? It would really be optimal for me to have the hospital's ATM pin code and unlimited vacation. So I guess we all have "suboptimal compensation" to look forward to.

 

[IlDestriero]

Go into Peds anesthesia.

 

[Ismet]

And it's supported by surveys as well: http://news.legalexaminer.com/pedia...d-with-chosen-profession.aspx?googleid=270344

But compare your children's hospital to an adult hospital. The difference is vast.

😍😍CHP😍😍
http://www.healthimaging.com/topics/diagnostic-imaging/imaging-adventure-creates-happy-endings-kids

 

[Serous Demilune]

Peds ER doctors can make over 200k. I don't think peds should make much more than other primary care docs though.

Not a good idea. It's a 6 year road to wind up with half the responsibility and two-thirds the salary of someone who did 3 years of EM residency.

 

[tima]

It's a shame what general pediatricians make. It's a difficult residency. Crappy work flow demands to justify a crap salary too. I like interacting with child patients. But that specialty left my mind for good as I grasped how much debt I was in after 1 year of medical school. Don't think about those poor bastards much either now except for a thread like this.

It's a crime that a specialist NP makes more. I couldn't take that.

Continue to live as a resident for a few years as an attending and work a few extra shifts every month for loan repayment purposes.

 

[tima]

Not a good idea. It's a 6 year road to wind up with half the responsibility and two-thirds the salary of someone who did 3 years of EM residency.

Some people do fellowships because they like that particular field. Happiness over making bank.

 

[Nasrudin]

Continue to live as a resident for a few years as an attending and work a few extra shifts every month for loan repayment purposes.

I plan to. It's just I'll be making more money in a field that suits me better. If your response was to the crowd then fine. But you should do that anyway. What you shouldn't be doing is making less than a nurse with an online degree. But hey, that's just me. But as a counterpoint...once you get your bills paid, there's not a whole lot of satisfaction to be gained for more money.

DV, I am taking a side glance at child psych, but the climate is much different than well checks and outpatient derm visits. It's some messed up situations that I'm not sure I want to be in the middle of. If I'd finished med school in my 20's I might have given peds a longer look. But I doubt it. Liking kids and being pressured to see 30 of the little no job havin, zero bills payin, public money draining (vaccines aren't all cheap) bastards is a different thing. I worked in a hustling pediatric clinic before med school and liked the interactions, but also some of the feigned but enforced saccharine sweetness of the work culture was irritating.

 

[PL198]

Some people do fellowships because they like that particular field. Happiness over making bank.

right but at some point it's cost prohibitive to where all the happiness in the world still makes it a dumb decision

 

[NurWollen]

So let's say I want to do general outpatient and/or inpatient peds, what kind of practice settings/locations/strategies lead to higher pay? If some are making $250,000 with the exact same education as someone making 150,000, what are they doing differently?

 

[Serous Demilune]

So let's say I want to do general outpatient and/or inpatient peds, what kind of practice settings/locations/strategies lead to higher pay? If some are making $250,000 with the exact same education as someone making 150,000, what are they doing differently?

Medicaid fraud.

 

[IlDestriero]

But as a counterpoint...once you get your bills paid, there's not a whole lot of satisfaction to be gained for more money.

I can't tell you how much I disagree with this. I get tremendous satisfaction from saving a great deal of money annually and look forward to an early and satisfying retirement. I was just reviewing the years financials this weekend.

 

[NurWollen]

Medicaid fraud.

Well, duh. I don't know why I didn't think of that. 🙄

 

[calvnandhobbs68]

So let's say I want to do general outpatient and/or inpatient peds, what kind of practice settings/locations/strategies lead to higher pay? If some are making $250,000 with the exact same education as someone making 150,000, what are they doing differently?

1) Those people have likely been in practice for at least a few years
2) The majority of those people will have some partnership/part ownership in a private practice or some kind of additional seniority hospital system compensation if part of a hospital group
3) Like everything else in medicine, it pays to not be in academics and to work in undesirable areas. Working for a big name hospital in new york as a hospitalist is going to net you less than working in north dakota.

Unlike general hospitalist medicine, 250k is pretty high for general peds, inpatient or outpatient. Again, as many have said here, I wouldn't go into it thinking you're going to be making what the partners in private practice are making (which is true for any specialty).

 

[IlDestriero]

So let's say I want to do general outpatient and/or inpatient peds, what kind of practice settings/locations/strategies lead to higher pay? If some are making $250,000 with the exact same education as someone making 150,000, what are they doing differently?

Your payer mix will determine your income potential. A higher percentage of insured patients is more cash coming in the door.
I work at a hospital with a great payer mix and everyone is very well compensated. A couple of jobs I looked at worked harder for much less. The majority of the patients there were Medicaid. That's great if that's the population that you want to serve, but you're likely to take a big hit.

 

[Nasrudin]

I can't tell you how much I disagree with this. I get tremendous satisfaction from saving a great deal of money annually and look forward to an early and satisfying retirement. I was just reviewing the years financials this weekend.

Sorry sir. I f'd up. And had some feelings in solidarity with the proletariat. It won't happen again.

 

[DermViser]

I can't tell you how much I disagree with this. I get tremendous satisfaction from saving a great deal of money annually and look forward to an early and satisfying retirement. I was just reviewing the years financials this weekend.

You also work in academia where your schedule is much better than private practice anesthesia, correct?

 

[PL198]

I can't tell you how much I disagree with this. I get tremendous satisfaction from saving a great deal of money annually and look forward to an early and satisfying retirement. I was just reviewing the years financials this weekend.

my thoughts exactly. having more money never hurts you(alright besides tax brackets) and having a safety blanket doesn't hurt.

 

[IlDestriero]

Correct.
Not all academic jobs are created equal. It pays to look around. Some are structured more like PP with productivity bonuses, etc.
There are academic jobs that pay better than the MGMA average, but if you want to exceed the MGMA 90th percentile, you need to bust your hump in PP, or be the chief, for anesthesia. There's no secret formula, if you work more and have a good payer mix, you (should) make more than at a place where 3 days a week is full time and 90% of the patients are Medicaid.

 

[DermViser]

Correct.
Not all academic jobs are created equal. It pays to look around. Some are structured more like PP with productivity bonuses, etc.
There are academic jobs that pay better than the MGMA average, but if you want to exceed the MGMA 90th percentile, you need to bust your hump in PP, or be the chief, for anesthesia. There's no secret formula, if you work more and have a good payer mix, you (should) make more than at a place where 3 days a week is full time and 90% of the patients are Medicaid.

How in God's name do hospitals stay in the black in terms of budget with greater than 90% of their patients being Medicaid?

 

[PL198]

How in God's name do hospitals stay in the black in terms of budget with greater than 90% of their patients being Medicaid?

by pumping them in and out I'd think. gotta have big revenue numbers

 

[DermViser]

by pumping them in and out I'd think. gotta have big revenue numbers

But Medicaid pays even lower than Medicare. Financially for the hospital they are not worth it -- hence the patient dumping.

 

[PL198]

But Medicaid pays even lower than Medicare. Financially for the hospital they are not worth it -- hence the patient dumping.

yeah I'm kinda curious to. I'm going to be with a doc for 4 hours that owns a predominately medicaid based practice, not sure if that's inappropriate to ask about in terms of how that affects bottom line

 

[DermViser]

yeah I'm kinda curious to. I'm going to be with a doc for 4 hours that owns a predominately medicaid based practice, not sure if that's inappropriate to ask about in terms of how that affects bottom line

Probably not until AFTER he turns in your evaluation and you're not going to ask him for a LOR. If he's in PP, he'll likely be flying thru patients like crazy (or crazier than it already is).

 

[jl lin]

Peds patients also have very few comorbid conditions interacting. The complexity is less.


And why not?

Have to disagree on the less comorbidity and less complexity. Of course I am assuming that you are looking at the average, generalist pediatrician in primary care. Otherwise, work at children hospitals or even agencies that deal with kids in private duty home care. Trust me, there are plenty of medically complex kids w/ a good amount of comorbid issues. They are tricky, and some generalist pediatricians are good with managing these kids and some just aren't. I have had kids both in and out of the hospital that see multiple specialists and have a lot of stuff going on, and they have less reserve to deal with these issues. Going back and forth with their insurance case mgers or appeals committees is a thrill b/c they often fail to see the complexity of the kids' condition/disease processes.

The bigger issue is Medicaid.

 

[jl lin]

I plan to. It's just I'll be making more money in a field that suits me better. If your response was to the crowd then fine. But you should do that anyway. What you shouldn't be doing is making less than a nurse with an online degree. But hey, that's just me. But as a counterpoint...once you get your bills paid, there's not a whole lot of satisfaction to be gained for more money.

DV, I am taking a side glance at child psych, but the climate is much different than well checks and outpatient derm visits. It's some messed up situations that I'm not sure I want to be in the middle of. If I'd finished med school in my 20's I might have given peds a longer look. But I doubt it. Liking kids and being pressured to see 30 of the little no job havin, zero bills payin, public money draining (vaccines aren't all cheap) bastards is a different thing. I worked in a hustling pediatric clinic before med school and liked the interactions, but also some of the feigned but enforced saccharine sweetness of the work culture was irritating.

ITA about pediatricians needing to make more than NPs, but I don't know of any reputable NLN programs allowing students, which are already RNs, to become educated completely online and then to be allowed to sit for the PNP boards. At least I haven't seen this in my area--and I can't see how this would be approved. Being allowed to take all courses online and doing any labs or clinicals online wouldn't work.

But again, don't get me wrong. There is no way on Earth that NPs should make anything close to a board certified physician. I continue to stand firm on that--and frankly, I have always been firm on that. To be sure, it was very rare that my children saw a PNP, even when I am sure that there are times, for a simple well visit, it would have been fine. But I felt like I didn't pick the practice b/c of the NP/s but b/c of the pediatrician/s--and b/c I had a bit of a hard time having those children, so. . ..