Plastics and reconst. compensation vs other fields NOT adding up. What gives?

[Pando355]

While compensation is not my primary intrerest in plastics and reconstruction, it is the one area that I cannot pin down a straight obvious answer and that there seems to be a lot of misinformation? Any other questions I'm answering myself by reading. I am posting this question here on the Student Doctor Network because I am hoping to get some quick informed answers from people here.

There seems to be a major disconnect between the perception (and rumors) about plastic surgery compensation and realities of reported data. I understand that plastics and reconstruction has a greater variability in terms of geographic location as well as practice settings and decision of balance between reconstructive medical cases and elective cosmetics. However, I am constantly getting told that plastics is super competitive because of the earning potential being sky high and incidentally defending my interest in the field as not being ALL ABOUT THE EARNING which is annoying. Truth is, I get why dermatology is competitive if you work 40ish hours a week for 300k-ish yearly salary if your priorities are compensation and lifestyle. But if you're doing the work that it takes not only to match into plastics and reconstruction, then the rough residency (at least very rough by any IM standard), and willing to work 60+ hours a week as an attending, then I see survey after survey showing plastics as only earning on average a little higher than GS, less than vascular, much less than ortho and CT and NS... I don't understand why I'm having to defend that I'm not interested primarily in money just because I'm interested in plastics. Is it just that even medical people have been affected by Nip/Tuck's overblown stereotype of the 1 million plus earning? Is it that the 250-300k figure is far under reported because in addition to salary there are usually huge kickbacks that aren't reported (i.e. only reconstructive is figured in with those figures but plastics as a field tends to have figures more in the range of 500k-1m for private practice?)

Bottom line is that if I look at physician salaries in a table (I'll URL some), and going only based on that and hours worked etc, and I was only interested in money, I would NEVER pick plastics and reconstruction. Am I only getting part of the picture? What in the world is... going on? I would like to submit these as very accessible common (conflicting) points of view, and would really appreciate anyone who can clear up the dynamic of perception and reality regarding plastics median/mean compensation:

1) Easy google search: http://www.profilesdatabase.com/resources/2011-2012-physician-salary-survey 270-380ish starting vs national mean but Rads is way higher, Ortho beats it out by a little or by a lot depending on the subspeciality, derm right up there, but honestly this actually is more lenient to plastics than most salary sites I’ve seen. http://www.medscape.com/features/slideshow/compensation/2012/public slide 2 plastics beat out by a bunch including gastroenterology and even oncology here. This is pretty up to date but widely different numbers (I know absolute values are a crapshoot of how they adjust for multiple factors but I’m trying to just compare WITHIN surveys for comparable methodology). http://www.studentdoc.com/plastic-surgery-salary.html seems pretty inflated compared to most surveys; here though low is 237k mean 412k and high 820k indicating more people in the low categories than a few very high earners probably on the top of the elective pool I’m guessing? Doesn’t it seem like MOST (overwhelmingly) plastic surgeons are not earning near what the very few at the ‘top’ are; but we all have to deal with defending our interest in the non-elective side (if we have such an interest that is)? http://www.mommd.com/component/option,com_core/Itemid,66/dir,0/lang,en/spec_id,56/task,physiciansalarydetail/ again geography can make this vary but look at some of the other specialities.

2) I shadowed a plastic surgeon who was chief at a local hospital’s plastics department (pretty big department). He was adamant that most people were being overly politically correct about motivations of premedical and medical students in selection of career path; he personally directly said dermatology and plastics are the most competitive IM and Surgery specialities by a healthy margain BECAUSE of the compensation. Again, this is a guy who is very successful ‘on the inside’ heading up a department. I didn’t have the temerity to ask about the figures I’d heard and figure out why other fields weren’t as coveted in proportion to how much more they earned (given comparable hours/week and night call). Otolaryngology/ENT has the stereotype of being ‘Every Night Tennis’ and Optho is also a less strenuous call (unless you’re 100% cosmetic, again most plastics people aren’t from what I’m seeing and reading); but they make about the same amount….?

3) “The Ultimate Guide to Choosing a Medical Specialty” really kicks the point home for me: they cite in my version (don’t know if its most updated its not with me) plastics as being about 280k average compensation. CT 400+, Neurosurgery same, ortho beats it no matter the specialization, lots of other specialities beat that figure. Yet, there is a sentence directly in the ‘lifestyle considerations’ portion that says that regardess of subspecialization, plastics and reconstructive surgery tends to be one of the highest compensated medical specialities ALONG WITH CT AND NS. A) It looks like it is WAY BELOW CT and NS according to the book, B) other specialities that surpass the plastic surgery figure aren’t even mentioned (they say CT and NS leaving out Ortho etc etc).

…I could go on but you all get the gist. I feel like I talk to people on the street, or medical people at any level of training/work setting, and they almost all have this perception about plastic surgery compensation compared to other specialties that is NOT supported at all by the numbers, and frankly even regarding those specialties which earn 5 figures less but are pretty close (i.e. within 100k of the mean), many of those you don’t have to work as hard to match in and many of those you don’t have to work as hard the rest of your life through training and also as an attending. So what gives? Under-reported salaries, elective procedures aren’t reported in the compensation numbers and only us students don’t realize it and factor that in, perhaps… plastic surgeons under-report what they make to avoid jealousy? Or honestly going into plastic surgery for the money is a fool’s errand because reality is, eveyone is wrong and the propoganda myth is just so strong that this is a well-kept secret (if so…. Why?) What is going on with the (VERY STRONG and UNIVERSAL it seems) gap of perception vs reported figures? Anyone else get where I’m coming from?

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[LuckyMD2b]

Good question.

* Disclosure -- I'm an orthopedic surgeon

you raise a few good points. The main issue with these surveys is that they are based on physicians voluntarily providing information on their salaries and practice arrangement. so you can argue that there is a lot of bias, with some physicians having incentive to underestimate their reimbursement or choosing not to participate at all. So I would take salary data like that with a grain of salt.

If I were you I'd place more value on what people inside the field are telling you. You shadowed a chief of plastic surgery, at a large department. That person is responsible for hiring plastic surgeons so he likely has very good insight into how much money a plastic surgeon can make for the hospital, and how much they should be compensated for their work.

As a surgeon in a another specialty, based on my limited experience (still in training). Reimbursement in the medical field is very complicated, but in general the amount you get is based on what you do (procedures pay better than office visits) and who is paying you: no insurance/charity care < medicaid < medicare < private insurance in network < private insurance out of network < cash only.

As a plastic surgeon you will be able to help out us orthopods by doing flaps on our uninsured drunk driver who flipped his pickup and has an open tib-fib fracture, the infant on medicaid with a congenital hand problem, the mother with breast cancer with private insurance that needs bilateral breast reconstructions, and do some cosmetic procedures that are out-of-pocket only.

Plastics does some cool stuff, I thought about it as an MSIII but I fit in better in ortho. But you should do what you have a passion for, don't worry too much about reimbursement or what the haters are saying. No matter what you choose someone is going to have something negative to say about it. Focus on becoming the best physician and surgeon you can be, and if you work hard and work smart you'll get the career that you want and deserve. At least that's what I keep telling myself.

 

[igap]

But you should do what you have a passion for, don't worry too much about reimbursement or what the haters are saying. No matter what you choose someone is going to have something negative to say about it. Focus on becoming the best physician and surgeon you can be, and if you work hard and work smart you'll get the career that you want and deserve. At least that's what I keep telling myself.

Definitely worry about the reimbursement. 86% of the class of 2011 graduated with a mean debt of 161,290 dollars. After a 5 year surgical residency, paying up to 7.9% interest, the payback amount will be over $200K. 20% of the class of 2011 borrowed over $250K, and 5% borrowed over $300K. These amounts do not include money borrowed for non-medical school education. I recently met a 4th year medical student with over $400K in educational debt.

It is not only a responsible thing to "worry" about reimbursement, it is essential. You need to understand how your life will be impacted by enormous student debt, and how you will pay it back.

I don't recommend choosing a residency solely based on a salary survey, but from a purely business standpoint you need to understand the financial ramifications of residency choice so that you can make an informed career decision. The days of shlepping your way through residency in any field and then making the "big bucks" are over for most specialties. There are nurses who make more money than pediatricians.

 

[igap]

There seems to be a major disconnect between the perception (and rumors) about plastic surgery compensation and realities of reported data. I understand that plastics and reconstruction has a greater variability in terms of geographic location as well as practice settings and decision of balance between reconstructive medical cases and elective cosmetics.

Or honestly going into plastic surgery for the money is a fool’s errand because reality is, eveyone is wrong and the propoganda myth is just so strong that this is a well-kept secret (if so…. Why?) What is going on with the (VERY STRONG and UNIVERSAL it seems) gap of perception vs reported figures? Anyone else get where I’m coming from?

Pando, I think it is a good thing that you are investigating the financial aspect of a residency choice.

The AAMC academic salary survey is an excellent resource for determining what academic plastic surgeons get paid. This can be purchased from the AAMC, or you can ask a faculty member that you trust if he/she will show you their copy. Most departments/divisions will have one floating around. The data is also online but you need a uid/pw.

ACAPS also has a nice powerpoint about faculty retention that lists the mean starting plastic surgery academic salary as $241,161 (range 175K - 375K). I suspect that this range is a bit lower though...

As for private practice income, it is very hard to gauge. It really depends on payor mix, your abilities as a surgeon, and your willingness to work. It is certainly possible to make over a million dollars in private practice by taking a lot of call, and working extremely hard in the right setting. There are many plastic surgeons out there who make much less, but don't work as hard. The MGMA average is around 400K for a plastic surgeon and I think that this amount is easily achievable by a hard-working, well-trained individual. More than that, you need to work harder than average.

That's about as straight an answer as anyone here will give you.

 

[LuckyMD2b]

Definitely worry about the reimbursement. 86% of the class of 2011 graduated with a mean debt of 161,290 dollars. After a 5 year surgical residency, paying up to 7.9% interest, the payback amount will be over $200K. 20% of the class of 2011 borrowed over $250K, and 5% borrowed over $300K. These amounts do not include money borrowed for non-medical school education. I recently met a 4th year medical student with over $400K in educational debt.

It is not only a responsible thing to "worry" about reimbursement, it is essential. You need to understand how your life will be impacted by enormous student debt, and how you will pay it back.

I don't recommend choosing a residency solely based on a salary survey, but from a purely business standpoint you need to understand the financial ramifications of residency choice so that you can make an informed career decision. The days of shlepping your way through residency in any field and then making the "big bucks" are over for most specialties. There are nurses who make more money than pediatricians.

As someone with >120K educational debt, I don't need a reminder about how expensive becoming a surgeon can be, but thanks anyway.

I don't think "worrying" is the same as being responsible about how I will pay back my loans. It is difficult and my debt does occasionally weigh on me... I went to college and medschool in the early 2000's so my interest rates are very low (much lower than 7.9%) -- much less than credit card rates; and during residency some of my loans were in deferment and others were in forebearance and I couldn't pay the interest rates so they have been accruing, and I definitely wasn't blowing money the way some of my college buddies who went into law or business were. But to me that's common sense, and I didn't "worry" about it on a daily basis. I did choose my specialty with the knowledge that I would have to pay my loans back after completing my training, but I'm assuming most people smart enough to get into medical school do that.

I don't know how many students have 400K of debt, but if you are in that situation and you have a rate of near 8% then you should definitely start worrying.

As someone completing their residency and looking at a few different groups, as an orthopedic surgeon coming right out of fellowship I am looking at the potential of 250k to 350K per year -- gaurantee for 2 years with possiblity of partnership thereafter. I don't know many nurses making that much. Maybe there are nurses making more than plastic surgeons, you'd know better than me.

I'm looking in very desireable areas as well. There are opportunities to make even more than that in smaller communities that really need surgeons to take fracture call from their ER.

From my perspective it's not too bad going from 50K per year to a salary 5 to 7 times as much. I don't know any doctors on food stamps.

Like I said do what you have a passion for, and be smart about your finances and you can do ok in medicine.

 

[igap]

As someone with >120K educational debt, I don't need a reminder about how expensive becoming a surgeon can be, but thanks anyway.

I don't think "worrying" is the same as being responsible about how I will pay back my loans. It is difficult and my debt does occasionally weigh on me... I went to college and medschool in the early 2000's so my interest rates are very low (much lower than 7.9%) -- much less than credit card rates; and during residency some of my loans were in deferment and others were in forebearance and I couldn't pay the interest rates so they have been accruing, and I definitely wasn't blowing money the way some of my college buddies who went into law or business were. But to me that's common sense, and I didn't "worry" about it on a daily basis. I did choose my specialty with the knowledge that I would have to pay my loans back after completing my training, but I'm assuming most people smart enough to get into medical school do that.

I don't know how many students have 400K of debt, but if you are in that situation and you have a rate of near 8% then you should definitely start worrying.

As someone completing their residency and looking at a few different groups, as an orthopedic surgeon coming right out of fellowship I am looking at the potential of 250k to 350K per year -- gaurantee for 2 years with possiblity of partnership thereafter. I don't know many nurses making that much. Maybe there are nurses making more than plastic surgeons, you'd know better than me.

I'm looking in very desireable areas as well. There are opportunities to make even more than that in smaller communities that really need surgeons to take fracture call from their ER.

From my perspective it's not too bad going from 50K per year to a salary 5 to 7 times as much. I don't know any doctors on food stamps.

Like I said do what you have a passion for, and be smart about your finances and you can do ok in medicine.

My post was aimed at those who are still in medical school who are choosing a residency.

I think that you misread my nurse comment... There really are nurses making more than what some pediatricians make. This comment was made to underscore the importance of understanding reimbursement in the era of massive student debt.

I think that advising medical students to not worry about debt, and reimbursement, is doing a disservice to them. They should be worrying.

Best of luck in your career.

 

[Pando355]

My post was aimed at those who are still in medical school who are choosing a residency.

I think that you misread my nurse comment... There really are nurses making more than what some pediatricians make. This comment was made to underscore the importance of understanding reimbursement in the era of massive student debt.

I think that advising medical students to not worry about debt, and reimbursement, is doing a disservice to them. They should be worrying.

Best of luck in your career.

Igap and Luckymd2b, thank you both for starting me off on this question.

Sorry in advance for the length of this and the previous message; you probably don’t need to know where I’m coming from but it is what it is if you need it all.

I guess my angst is not so much over the number (Yet; at my stage!) as over the difference in perception about plastic surgery and other fields.

I think that detailed flapwork is amazing, particularly since I enjoy doing microscopic surgery work. I like muscular grafts. I don’t think it gets a lot better for my personality type than a grueling replantation procedure on a good candidate, as I think that the sheer variety of tissue worked with and percision of restoring form/function is nonperile. I enjoy wound care topics and would enjoy working with lesions/tumors from time to time. I actually am not huge on burn care right now and I’m not so into craniofacial or genitourinary but I don’t know of any surgical field where one can avoid (omitted items included) 75+% of the type of work available and have the type of awesome variety. Also I would be great doing reconstruction after mastectomy which is more common than cosmetic breast surgery nation wide; and if it was required to make ends meet to take a few cases either for priviliges at a hospital or join an otherwise great group or whatever, elective cosmetic surgery is the one type that patients put the type of faith in the surgeon’s skill to rip their face/breasts/body open or OFF by choice (in contrast to, say, neuro where it’s not a hard sell when the options are get the surgery or suffer in pain, progressively lose nerve function, or drop dead). Maybe like you guys say my priorities may have to change when bills pile up, but that is where I’m at.

I don’t mind that laypeople don’t have a perception outside popular culture especially since I was more like them most of my life. What I do REALLY mind is when I have to constantly decide whether or not to reveal my interest in plastic surgery when asked, not because I’m worried I may not be capable of matching or tolerating the work afterwards or because some people associate it with vanity more than reconstruction (that’s easily cleared up), but that I’m only interested in plastic surgery because I’m in a position to consider it and that my motivation is money.

The reason I’m asking (including here on the Student Doctor Network) for clarification is because whether or not the numbers are wrong/misleading, the point is almost every salary figure I’m looking at shows that plastics does NOT make someone super rich on average, and that on average, LOTS of other specialties will make people significantly MORE money. However, whether I talk to someone on the street about my interests or talk to an ortho/NS/rads/derm physician, the first response is ‘ah, they make a lot of money!’ at LEAST half the time. Try it yourself, pose as someone not already involved. It has happened to me far too often for me to worry it won’t be the general consensus response wherever you are in America.

Now, if I looked at salary data and the plastics average was at the top near or above NS and CT and Ortho (etc) on every salary survey, then I’d say OK I get it. You show up to a party with the hot girl 10 years your junior on your arm, and no one will listen to you when you say you’re with her for her intellect. But if you show up with a concert pianist who runs a successful small business on the side, and everyone thinks you’re into her for shallow reasons… That’s confusing! I don’t really even need to have some way to counter it, I just don’t UNDERSTAND where this perception is coming from. My ‘counter’ is pretty standard (I don’t need help with it) – go online and google physician salaries and you’ll see that plastic and reconstructive surgeons actually make considerably LESS than say, money grubbing NS/Orthopods (joking!). And anyway I’m never going to be near the top because my penchant for doing complex reconstruction would ‘hold me back.’ My actual question is, is the DIFFERENCE between plastics and these other fields actually misrepresented in salary survey after salary survey year after year (i.e. in reality plastics people underreport, or some other explaination, and they actually make much more than other specialists on average, which is to say the salary surveys are grossly misleading and the public perception is correct), OR, where does this myth that plastic surgeons have such endless earning potential (honestly even 100% cosmetic it must cap; but anyway I’m talking about the AVERAGE salary since in a group of very competitive and talented people the AVERAGE is what I’m *aspiring* to do) come from?

Thanks!

 

[xf3rn4nd3sx]

Igap and Luckymd2b, thank you both for starting me off on this question.

Sorry in advance for the length of this and the previous message; you probably don’t need to know where I’m coming from but it is what it is if you need it all.

I guess my angst is not so much over the number (Yet; at my stage!) as over the difference in perception about plastic surgery and other fields.

I think that detailed flapwork is amazing, particularly since I enjoy doing microscopic surgery work. I like muscular grafts. I don’t think it gets a lot better for my personality type than a grueling replantation procedure on a good candidate, as I think that the sheer variety of tissue worked with and percision of restoring form/function is nonperile. I enjoy wound care topics and would enjoy working with lesions/tumors from time to time. I actually am not huge on burn care right now and I’m not so into craniofacial or genitourinary but I don’t know of any surgical field where one can avoid (omitted items included) 75+% of the type of work available and have the type of awesome variety. Also I would be great doing reconstruction after mastectomy which is more common than cosmetic breast surgery nation wide; and if it was required to make ends meet to take a few cases either for priviliges at a hospital or join an otherwise great group or whatever, elective cosmetic surgery is the one type that patients put the type of faith in the surgeon’s skill to rip their face/breasts/body open or OFF by choice (in contrast to, say, neuro where it’s not a hard sell when the options are get the surgery or suffer in pain, progressively lose nerve function, or drop dead). Maybe like you guys say my priorities may have to change when bills pile up, but that is where I’m at.

I don’t mind that laypeople don’t have a perception outside popular culture especially since I was more like them most of my life. What I do REALLY mind is when I have to constantly decide whether or not to reveal my interest in plastic surgery when asked, not because I’m worried I may not be capable of matching or tolerating the work afterwards or because some people associate it with vanity more than reconstruction (that’s easily cleared up), but that I’m only interested in plastic surgery because I’m in a position to consider it and that my motivation is money.

The reason I’m asking (including here on the Student Doctor Network) for clarification is because whether or not the numbers are wrong/misleading, the point is almost every salary figure I’m looking at shows that plastics does NOT make someone super rich on average, and that on average, LOTS of other specialties will make people significantly MORE money. However, whether I talk to someone on the street about my interests or talk to an ortho/NS/rads/derm physician, the first response is ‘ah, they make a lot of money!’ at LEAST half the time. Try it yourself, pose as someone not already involved. It has happened to me far too often for me to worry it won’t be the general consensus response wherever you are in America.

Now, if I looked at salary data and the plastics average was at the top near or above NS and CT and Ortho (etc) on every salary survey, then I’d say OK I get it. You show up to a party with the hot girl 10 years your junior on your arm, and no one will listen to you when you say you’re with her for her intellect. But if you show up with a concert pianist who runs a successful small business on the side, and everyone thinks you’re into her for shallow reasons… That’s confusing! I don’t really even need to have some way to counter it, I just don’t UNDERSTAND where this perception is coming from. My ‘counter’ is pretty standard (I don’t need help with it) – go online and google physician salaries and you’ll see that plastic and reconstructive surgeons actually make considerably LESS than say, money grubbing NS/Orthopods (joking!). And anyway I’m never going to be near the top because my penchant for doing complex reconstruction would ‘hold me back.’ My actual question is, is the DIFFERENCE between plastics and these other fields actually misrepresented in salary survey after salary survey year after year (i.e. in reality plastics people underreport, or some other explaination, and they actually make much more than other specialists on average, which is to say the salary surveys are grossly misleading and the public perception is correct), OR, where does this myth that plastic surgeons have such endless earning potential (honestly even 100% cosmetic it must cap; but anyway I’m talking about the AVERAGE salary since in a group of very competitive and talented people the AVERAGE is what I’m *aspiring* to do) come from?

Thanks!

Are you even in med school?

 

[Pando355]

Are you even in med school?

I respect the work you've put in ahead of me if you are a neurosurgery attending, but given the question and the Student Doctor Network forum, I sense a very useless and wasted pun around the corner. Here's hoping to a genuine followup.

I am a new admit.

 

[xf3rn4nd3sx]

I think that detailed flapwork is amazing, particularly since I enjoy doing microscopic surgery work. I like muscular grafts. I don't think it gets a lot better for my personality type than a grueling replantation procedure on a good candidate, as I think that the sheer variety of tissue worked with and percision of restoring form/function is nonperile. I enjoy wound care topics and would enjoy working with lesions/tumors from time to time. I actually am not huge on burn care right now and I'm not so into craniofacial or genitourinary but I don't know of any surgical field where one can avoid (omitted items included) 75+% of the type of work available and have the type of awesome variety. Also I would be great doing reconstruction after mastectomy which is more common than cosmetic breast surgery nation wide; and if it was required to make ends meet to take a few cases either for priviliges at a hospital or join an otherwise great group or whatever, elective cosmetic surgery is the one type that patients put the type of faith in the surgeon's skill to rip their face/breasts/body open or OFF by choice (in contrast to, say, neuro where it's not a hard sell when the options are get the surgery or suffer in pain, progressively lose nerve function, or drop dead). Maybe like you guys say my priorities may have to change when bills pile up, but that is where I'm at.

I respect the work you've put in ahead of me if you are a neurosurgery attending, but given the question and the Student Doctor Network forum, I sense a very useless and wasted pun around the corner. Here's hoping to a genuine followup.

I am a new admit.

I will start with my criticism and then move on to constructive remarks

I asked if you were a med student because you sound like one. You make it sounds like you have a lot of experience in the field and are set upon plastic surgery as a career, but in reality you've only shadowed the chief of your local hospital for a nominal amount of time. "I think that detailed flapwork is amazing, particularly since I enjoy doing microscopic surgery work. I like muscular grafts. I don't think it gets a lot better for my personality type than a grueling replantation procedure on a good candidate, as I think that the sheer variety of tissue worked with and percision of restoring form/function is nonperile." You enjoy doing microsurgery? How much microsurgery have you done? A grueling replantation procedure on a good candidate fits your personality??? Lol what? How do you know you would be great doing reconstruction after mastectomy??? Have you shadowed in any other fields of medicine? I have a hunch why you are set on plastics without rotating through any other fields (hint: your interest in plastic surgery perception and compensation) . Most medical students do not go into the field they planned to when they entered medical school. There is a reason for that.

Now onto constructive remarks. I think you know the reason why plastic surgery has that perception and to be honest, it's fairly common sense. There are few plastic surgeons who make millions a year (Dr. 90210, etc ). These are established purely cosmetic surgeons in cities such as Miami, NYC, Beverly Hills, etc. The vast majority fall near the MGMA average (mid 6 figures). Unfortunately, the public doesn't read MGMA reports. They watch garbage like Dr. 90210. They see an episode where the plastic surgeon is driving his new ferrari and redoing his kitchen for 300 grand and voila... Perception instilled.

Quite honestly...WHO CARES. Why should you care what the perception of plastic surgery is? Every field has stereotypes. Rotate through many fields, think through your choices carefully, and then pick a specialty. Here's an example: When I started medical school 3 of my friends wanted to be plastic surgeons and 2 wanted to be neurosurgeons (hm I wonder why ). Of the 5, 1 went into orthopedic surgery and the rest went into non-surgical fields. Food for thought. Plastic surgery is an awesome field, but don't jump the gun.

 

[igap]

I respect the work you've put in ahead of me if you are a neurosurgery attending, but given the question and the Student Doctor Network forum, I sense a very useless and wasted pun around the corner. Here's hoping to a genuine followup.

I am a new admit.

Pando, I think that you have misrepresented yourself. Based on your previous posts, it is implied that you are further in your training than being a "new admit" to medical school.

I actually answered your question about plastic surgery reimbursement already, so your follow-up post is confusing to me.

Now that I know that you haven't had day one of medical school, I recommend that you start with an open mind, and enjoy what is going to be a lifelong journey. Definitely pay attention to the economics of medicine, but also pay attention to your own quality of life issues. It may be cool to impress your friends and family, or even total strangers, by telling them that you are a plastic surgeon. But guess what? You will be a miserable plastic surgeon unless you choose the field for real reasons other than some deeply-seated need to be perceived as the most successful, wealthiest, surgeon. If you let these immature ideas drive your thought processes, and decision-making, I promise you that you will be unhappy.

Enjoy your summer, and have a lot of fun. As far as medical school, and beyond, well... as one of my favorite basketball cliches goes: "Don't force the ball, let the game come to you".

 

[maxheadroom]

Enjoy your summer, and have a lot of fun. As far as medical school, and beyond, well... as one of my favorite basketball cliches goes: "Don't force the ball, let the game come to you".

I was trained by a Canadian . . . he always told us to "keep your stick on the ice."

 

[KBorglum]

Two of the best annual reports on compensation are the ones from MGMA.com for employment in large groups, and from NSCHBC.org for smaller private practices. I'm an IRS Qualified medical practice appraiser, Licensed & Certified Business Broker of healthcare practices, a Certified Healthcare Business Consultant, faculty to medical association programs, and those two reports above are where I go for info to do compensation evaluations and to support my testimony as an expert witness in litigation legal cases. Finding data on purely cosmetic practices is a LOT tougher. Lots of articles and links about compensation and practice value at my website below too.

I would also recommend any job applicant or practice purchaser to read the book on negotiating named "Getting To Yes". Its very short but very good.

Keith C. Borglum CHBC, CBB
Professional Management & Marketing
Web Page/Credentials/References at http://www.MedicalPracticeAppraisal.com

 

[madtowngrad]

I am a plastic surgeon.

The surveys are correct.

Plastics has the greatest diversity of income of any field.
Academics is like pediatric surgery. It has the cancer specialists that do the resections, burn units, pediatric hospitals and therefore gets the majority of micro, burns, peds, and complex reconstructive that dont exist in private practice.

We are producing a huge oversupply of plastic surgeons, and have for years. It was partially absorbed by the increase in cosmetic work.

Plastic surgeons compete. Agains other board certified plastic surgeons, against non board certified cosmetic surgeons, against ortho for hand, derm for skin cancer, wound care centers for wounds, general surgery for melanoma and now breast.

I have a friend in his 50s, well trained who netted 30k last year after expenses. Too much competition and politics.

Yes, if you become a "name" you may make big dollars. But that is the lucky 2% of plastic surgeons in affluent areas. On the other hand I see most 50 year old plastic surgeons not at academic centers or a large group, or in an affluent cosmetic location, see their practice fade.

Plastic Surgery is the only field where academic makes more than most in private practice. But since those in academics hear about their buddies on Park Avenue making high incomes they think they are underpaid. Academics also gets paid more for the same operation.

So there are two academic surgeons , one in New York, and one in Texas making more than 2 million. There are a few facelift surgeons doing 30k facelifts 4 x a week in New York.

On the other hand I make half what I did when I started 20 years ago, adjusted for inflation much lower, and my expenses climb every year.

I think this is what to expect

practice in rural area range 30k to 600k (if just one more plastic surgeon shows up , your income drops by half or more)
practice in big city, not affluent area, 300k
practice in big city, reconstructive practice, over age 50, 200k
professor at academic center 350k to 1million plus
junior staff at academic center 200k to 500k
private practice, busy cosmetic practice affluent suburb 600k
private practice, Park Avenue, busy 1 million

 

[Alakazam123]

Pando, I think that you have misrepresented yourself. Based on your previous posts, it is implied that you are further in your training than being a "new admit" to medical school.

I actually answered your question about plastic surgery reimbursement already, so your follow-up post is confusing to me.

Now that I know that you haven't had day one of medical school, I recommend that you start with an open mind, and enjoy what is going to be a lifelong journey. Definitely pay attention to the economics of medicine, but also pay attention to your own quality of life issues. It may be cool to impress your friends and family, or even total strangers, by telling them that you are a plastic surgeon. But guess what? You will be a miserable plastic surgeon unless you choose the field for real reasons other than some deeply-seated need to be perceived as the most successful, wealthiest, surgeon. If you let these immature ideas drive your thought processes, and decision-making, I promise you that you will be unhappy.

Enjoy your summer, and have a lot of fun. As far as medical school, and beyond, well... as one of my favorite basketball cliches goes: "Don't force the ball, let the game come to you".

I've also read that the salary you make has much more to do with business savviness/location than it does with specialty outright.