Potential of family medicine

[MadScientist95]

Hello everyone! I’m an upcoming OMS I here and am really interested in family medicine. I like the diversity as well as the family-friendly work hours. However I am wondering what is the salary potential behind this career? I’ve looked up the average income but can PCP easily make more/less? What if you are willing to practice in underserved areas? What can PCP do to increase their income? Thanks!

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[hang50]

from what i have read, there are plenty of ways to boost income as a fm doctor. few examples i have seen: opening a private practice in a rural area, moonlighting in the ER (in rural areas—i have read in more urban areas that it is harder for fm docs to get moonlight gigs in ER)

 

[Goro]

Hello everyone! I’m an upcoming OMS I here and am really interested in family medicine. I like the diversity as well as the family-friendly work hours. However I am wondering what is the salary potential behind this career? I’ve looked up the average income but can PCP easily make more/less? What if you are willing to practice in underserved areas? What can PCP do to increase their income? Thanks!

Where's the wise @SLC when you need him???!!!

 

[mc29012]

Where's the wise @SLC when you need him???!!!

Livin that Country life, Easily my favorite user on here!

To answer the question. If you look up ER jobs in really rural/remote areas, many will accept FM docs and many have pretty flexible schedules. They usually pay a ton too.

This is like my dream scenario when I'm an attending.

 

[sixersfan]

If you look up ER jobs in really rural/remote areas, many will accept FM docs and many have pretty flexible schedules.

Learn something new everyday! That is pretty damn cool

 

[SLC]

So this is a great question and there are a lot of answers, which is awesome.

Some easy ways to increase income:

1. Medical directorships: Nursing homes, Hospice, etc. They all need a doc to place orders and call the shots. Usually not terribly demanding (can run a busy clinic and still do this) and the pay can be great.

2. OMM: (not a popular option on SDN) I don’t do this, but you’d be surprised how many people love OMM and are willing to pay cash for it. And if it keeps them off Narcs, then I’m all for it.

3. Moonlighting: I do hospitalist work on the side, I love it. I only do weekends and can choose when to work and when not to. My gig is paid hourly, and it’s usually a few grand extra per month. Enough to pay my mortgage, or buy a nice car etc if I needed it to, mainly I just throw it toward student debt. I have partners who work in ED, L&D, urgent care etc.

4. Cosmetics: there are courses in cosmetic medicine, Botox etc. Pay is good, but I can’t bring myself to do it.

5. Telemedicine: I’m seriously considering getting in on this. It’s super simple stuff, anyone that’s the least bit sick you triage to a face to face appt with a provider, otherwise you write scripts for basic stuff and get paid fairly well considering you can do it from your own home if you want.

That’s a pretty good list; but there are way more options out there too. FM is extremely broad, meaning opportunity for side earnings is as well.

 

[MadScientist95]

So this is a great question and there are a lot of answers, which is awesome.

Some easy ways to increase income:

1. Medical directorships: Nursing homes, Hospice, etc. They all need a doc to place orders and call the shots. Usually not terribly demanding (can run a busy clinic and still do this) and the pay can be great.

2. OMM: (not a popular option on SDN) I don’t do this, but you’d be surprised how many people love OMM and are willing to pay cash for it. And if it keeps them off Narcs, then I’m all for it.

3. Moonlighting: I do hospitalist work on the side, I love it. I only do weekends and can choose when to work and when not to. My gig is paid hourly, and it’s usually a few grand extra per month. Enough to pay my mortgage, or buy a nice car etc if I needed it to, mainly I just throw it toward student debt. I have partners who work in ED, L&D, urgent care etc.

4. Cosmetics: there are courses in cosmetic medicine, Botox etc. Pay is good, but I can’t bring myself to do it.

5. Telemedicine: I’m seriously considering getting in on this. It’s super simple stuff, anyone that’s the least bit sick you triage to a face to face appt with a provider, otherwise you write scripts for basic stuff and get paid fairly well considering you can do it from your own home if you want.

That’s a pretty good list; but there are way more options out there too. FM is extremely broad, meaning opportunity for side earnings is as well.
[/QUOTE

So this is a great question and there are a lot of answers, which is awesome.

Some easy ways to increase income:

1. Medical directorships: Nursing homes, Hospice, etc. They all need a doc to place orders and call the shots. Usually not terribly demanding (can run a busy clinic and still do this) and the pay can be great.

2. OMM: (not a popular option on SDN) I don’t do this, but you’d be surprised how many people love OMM and are willing to pay cash for it. And if it keeps them off Narcs, then I’m all for it.

3. Moonlighting: I do hospitalist work on the side, I love it. I only do weekends and can choose when to work and when not to. My gig is paid hourly, and it’s usually a few grand extra per month. Enough to pay my mortgage, or buy a nice car etc if I needed it to, mainly I just throw it toward student debt. I have partners who work in ED, L&D, urgent care etc.

4. Cosmetics: there are courses in cosmetic medicine, Botox etc. Pay is good, but I can’t bring myself to do it.

5. Telemedicine: I’m seriously considering getting in on this. It’s super simple stuff, anyone that’s the least bit sick you triage to a face to face appt with a provider, otherwise you write scripts for basic stuff and get paid fairly well considering you can do it from your own home if you want.

That’s a pretty good list; but there are way more options out there too. FM is extremely broad, meaning opportunity for side earnings is as well.

Thanks so much! This is really informative. The broadness of this field is one of the major factors that draw me. Just a ball park estimate, how much could a family physician boost their yearly income by taking advantage of opportunities such as the ones you have listed? I know the average is around 220K a year. For example, could a PCP easily break 300K doing things like this?

 

[SLC]

Question about earning potential

It’s not incredibly difficult to surpass 300k in FM at all. I’m already there as a new attending doing only the hospitalist moonlighting.

 

[MadScientist95]

It’s not incredibly difficult to surpass 300k in FM at all. I’m already there as a new attending doing only the hospitalist moonlighting.

That’s awesome! How many total hours a week on average do you work since you moonlight? Do you work every day of the week?

 

[SLC]

If you want some inspiration on what’s possible with FM; look into the career of John Cullen MD, current AAFP president.

He works out of Valdez, Alaska. He literally does everything.

He came and spoke to the Med students at the Medical School where I was a resident (upper tier school, few students going into FM) then following year they had a record breaking FM match at that school. Dude’s a freak of nature and yet so humble and relatable.

 

[SLC]

That’s awesome! How many total hours a week on average do you work since you moonlight? Do you work every day of the week?

I work about 30hrs total, sometimes more, sometimes less, depending on moonlighting. If the hospital is full, I’m pulling more hours, if it’s empty I get paid to sit at home and be “available”

My clinic is 8:15-4:45 4 days a week, 2hr lunch break.

Moonlighting is weekends only, 48hrs total on call per weekend, but it’s call from home. I go in to round in the mornings, I go in for clinical status changes, and I go in for new admits. Most weekends I’m doing 8-10 hospital hours. I do 2 weekends per month on average.

 

[madiso30]

So this is a great question and there are a lot of answers, which is awesome.

Some easy ways to increase income:

1. Medical directorships: Nursing homes, Hospice, etc. They all need a doc to place orders and call the shots. Usually not terribly demanding (can run a busy clinic and still do this) and the pay can be great.

2. OMM: (not a popular option on SDN) I don’t do this, but you’d be surprised how many people love OMM and are willing to pay cash for it. And if it keeps them off Narcs, then I’m all for it.

3. Moonlighting: I do hospitalist work on the side, I love it. I only do weekends and can choose when to work and when not to. My gig is paid hourly, and it’s usually a few grand extra per month. Enough to pay my mortgage, or buy a nice car etc if I needed it to, mainly I just throw it toward student debt. I have partners who work in ED, L&D, urgent care etc.

4. Cosmetics: there are courses in cosmetic medicine, Botox etc. Pay is good, but I can’t bring myself to do it.

5. Telemedicine: I’m seriously considering getting in on this. It’s super simple stuff, anyone that’s the least bit sick you triage to a face to face appt with a provider, otherwise you write scripts for basic stuff and get paid fairly well considering you can do it from your own home if you want.

That’s a pretty good list; but there are way more options out there too. FM is extremely broad, meaning opportunity for side earnings is as well.

I know something like sports medicine can increase earning potential too. Could you do hospitalist work if you're doing sports medicine as well? Or would that be spreading yourself time to thin between running a normal FM clinic, sports clinic/procedures, and hospitalist shifts?

 

[DOthebestyoucan]

I'm not sure if you have heard of the podcast "the white coat investor". I've listened to his stuff and I really enjoy the knowledge he shares. He also has a book out which broadly goes over the finances of medicine. Maybe you will be able to find more financially minded docs there, not to say that @SLC isn't killing it already.

 

[SLC]

I know something like sports medicine can increase earning potential too. Could you do hospitalist work if you're doing sports medicine as well? Or would that be spreading yourself time to thin between running a normal FM clinic, sports clinic/procedures, and hospitalist shifts?

Nope, ideally you do your regular office hours (sports, regular primary care, or a mix of both), then find a side gig to do outside of regular office hours.

 

[madiso30]

Nope, ideally you do your regular office hours (sports, regular primary care, or a mix of both), then find a side gig to do outside of regular office hours.

Sorry to hijack this thread....but say you did decide to mix sports and FM clinic along with the occasional hospitialist shift, what would that lifestyle look like? I'm not adverse to working a lot, I'm just curious. I mainly ask just because this sounds like I could cover my bases with what I'm interested in at this point. I got interested in medicine from both PM&R/PCSM for MSK stuff and EM around the same time for high acuity patients. As I get through school those interests are obviously subject to change so I'm not sweating it at this point. But is it too much of a dream to itch that high accuity side with hospitialist work and MSK with PCSM?

 

[SLC]

Sorry to hijack this thread....but say you did decide to mix sports and FM clinic along with the occasional hospitialist shift, what would that lifestyle look like? I'm not adverse to working a lot, I'm just curious. I mainly ask just because this sounds like I could cover my bases with what I'm interested in at this point. I got interested in medicine from both PM&R/PCSM for MSK stuff and EM around the same time for high acuity patients. As I get through school those interests are obviously subject to change so I'm not sweating it at this point. But is it too much of a dream to itch that high accuity side with hospitialist work and MSK with PCSM?

Your schedule can look any way you want. Most likely it would look something like mine which means 4 days a week of full day clinic (6-7 hours of patient encounters). Then hospital coverage on the weekends.

You could mix your clinic up between PCSM and regular FM.

30-40hrs per week on average.

Or it could be different; depending on your preferences. You'll almost certainly have the opportunity to dictate much of your schedule and craft it to your liking.

 

[PA_dud3]

Your schedule can look any way you want. Most likely it would look something like mine which means 4 days a week of full day clinic (6-7 hours of patient encounters). Then hospital coverage on the weekends.

You could mix your clinic up between PCSM and regular FM.

30-40hrs per week on average.

Or it could be different; depending on your preferences. You'll almost certainly have the opportunity to dictate much of your schedule and craft it to your liking.

Did many of your colleagues pursue IM or IM sub specialization? Sorry to get off of the FM topic a bit, just curious.

 

[madiso30]

Your schedule can look any way you want. Most likely it would look something like mine which means 4 days a week of full day clinic (6-7 hours of patient encounters). Then hospital coverage on the weekends.

You could mix your clinic up between PCSM and regular FM.

30-40hrs per week on average.

Or it could be different; depending on your preferences. You'll almost certainly have the opportunity to dictate much of your schedule and craft it to your liking.

And you continue to make me wonder why theres so much hate from Premeds and med students towards FM. Thanks for the replies.

 

[SLC]

Did many of your colleagues pursue IM or IM sub specialization? Sorry to get off of the FM topic a bit, just curious.

My colleagues? Med school classmates? A few of them did. More did FM than IM though.

 

[PA_dud3]

My colleagues? Med school classmates? A few of them did. More did FM than IM though.

Could I ask what sort of conditions you see in rural FM on a daily basis? Sort of the common issues patients see? Rural practice is something I hope to pursue in my future due to my upbringing. Off the top of my head I imagine you would see a good bit of everything due to the nature of the beast, but Im not sure. Do you think you will use OMM in your practice (if you haven't already?)

 

[Calizboosted76]

I am glad I found this thread. I keep telling all of my buddies that FM is last on my list but I was obviously being ignorant. I am definitely more open to it seeing the possibilities.

 

[PA_dud3]

I am glad I found this thread. I keep telling all of my buddies that FM is last on my list but I was obviously being ignorant. I am definitely more open to it seeing the possibilities.

It seems like a very good mix of income and lifestyle. Not my first choice but definitely my second or third.

 

[Calizboosted76]

It seems like a very good mix of income and lifestyle. Not my first choice but definitely my second or third.

I totally agree. My wants at the moment are
1. Surgery (The surgical subspecialties are also organized into a hierarchy of wants.)
2. Everything else LOL

 

[PA_dud3]

I totally agree. My wants at the moment are
1. Surgery (The surgical subspecialties are also organized into a hierarchy of wants.)
2. Everything else LOL

Mine are:
1) Rural Nephrology
2) Rural Internist/Hospitalist
3)Rural Family Medicine/Other

 

[SLC]

Could I ask what sort of conditions you see in rural FM on a daily basis? Sort of the common issues patients see? Rural practice is something I hope to pursue in my future due to my upbringing. Off the top of my head I imagine you would see a good bit of everything due to the nature of the beast, but Im not sure. Do you think you will use OMM in your practice (if you haven't already?)

Tomorrow’s schedule (July is slow season here, it’s a college town, most everyone is back home for the summer):

Medicare Annual Wellness Visit

Patient returning for follow up after being treated for cholecystitis/choledocholithiasis (which I diagnosed).

Well Child Checks

Diabetes follow up

Bipolar Depression/dementia follow up

Well Woman Exam

IUD placement

Flank Pain.


There will inevitably be 10-15 walk-ins too. I’ve had a lot of interesting walk-ins, from URI’s to Digit Amputations, Open Skull Fractures, MI’s, Testicle lump that ended up being Seminoma, and the bread and butter lacerations and MSK stuff that happens in a community full of ATV riders. I’ve even diagnosed pheochromocytoma in a kid that initially came in with severe headache and elevated BP.

It runs the gammut.

 

[SLC]

So my walking yesterday brought the total number of patients seen to 22. Among the complaints/dx’s:

1. Skin rash: Erythema Multiforme
2. Sciatica
3. Viral Syndrome in elderly pt. with Bronchiectasis.
4. Gout
5. Conjunctivitis.
6. R/O Scaphoid Fracture
7. ACS (got stabilized and then sent lights and sirens to the ED). Then helicoptered to the city.
8. Skin moles
9: Ear piercing that had somehow been “enveloped” by the earlobe. Surgical removal.
10: a few more well child visits and Sports Clearance physicals.

Decently eventful day.

 

[sixersfan]

So my walking yesterday brought the total number of patients seen to 22. Among the complaints/dx’s:

1. Skin rash: Erythema Multiforme
2. Sciatica
3. Viral Syndrome in elderly pt. with Bronchiectasis.
4. Gout
5. Conjunctivitis.
6. R/O Scaphoid Fracture
7. ACS (got stabilized and then sent lights and sirens to the ED). Then helicoptered to the city.
8. Skin moles
9: Ear piercing that had somehow been “enveloped” by the earlobe. Surgical removal.
10: a few more well child visits and Sports Clearance physicals.

Decently eventful day.

Thank you for you sharing this stuff! FM seems far more interesting than I thought in the past. Also, do you see an overwhelming amount of diabetics on a daily basis? When I shadowed in a IM clinic, there seemed to be about 5-10 diabetics a day (sometimes less), seemed like a lot.

 

[SLC]

Thank you for you sharing this stuff! FM seems far more interesting than I thought in the past. Also, do you see an overwhelming amount of diabetics on a daily basis? When I shadowed in a IM clinic, there seemed to be about 5-10 diabetics a day (sometimes less), seemed like a lot.

Not an overwhelming amount. there are plenty of diabetics in my panel; but I don’t feel like I’m seeing more than one or two a day on average.

 

[SLC]

I figured I’d add an update to this thread. I know it’s old but folks may want to know what’s been going on with my career and compensation.

My company has been fairly active in updating our salaries in the past couple of years. My current annual base salary is $280k, with potential for RVU production bonus and bonuses for quality metrics above that. Planning $300k to $310k this coming year. I have 32 clinic hours per week, and am expected to see a minimum of 16pts per day average.

I’ve moved locations to a more suburban clinic (was in the rurals back in 2019) so I don’t see quite as much of a variety since there are specialists and and ER close by; but I still am rarely bored.

I work urgent care in the off season (I mountain bike when the weather is conducive, work for extra scratch when it isn’t). My urgent care side hustle is 100% self driven. I get a list of open shifts at a local urgent care center and I sign up for the ones I want. If I don’t want to work, I don’t have to sign up at all, but if I want to work a lot I can. I get paid $160 per hour for that, and some months I’ll even work 24-30 extra hours (usually in 6-12hr chunks) there which amounts to $3800 to $4800 per month (pre-tax) on months I want it.

 

[Cranjis McBasketball]

I figured I’d add an update to this thread. I know it’s old but folks may want to know what’s been going on with my career and compensation.

My company has been fairly active in updating our salaries in the past couple of years. My current annual base salary is $280k, with potential for RVU production bonus and bonuses for quality metrics above that. Planning $300k to $310k this coming year. I have 32 clinic hours per week, and am expected to see a minimum of 16pts per day average.

I’ve moved locations to a more suburban clinic (was in the rurals back in 2019) so I don’t see quite as much of a variety since there are specialists and and ER close by; but I still am rarely bored.

I work urgent care in the off season (I mountain bike when the weather is conducive, work for extra scratch when it isn’t). My urgent care side hustle is 100% self driven. I get a list of open shifts at a local urgent care center and I sign up for the ones I want. If I don’t want to work, I don’t have to sign up at all, but if I want to work a lot I can. I get paid $160 per hour for that, and some months I’ll even work 24-30 extra hours (usually in 6-12hr chunks) there which amounts to $3800 to $4800 per month (pre-tax) on months I want it.

I just signed with this company and am pumped to join!

 

[SLC]

I just signed with this company and am pumped to join!

They just updated salary, base is now ~$300k ($298k+ change.)

 

[Angus Avagadro]

They just updated salary, base is now ~$300k ($298k+ change.)

One large primary care group in our area has partner salaries in the 450k+ range. 0830 to 5 with rare phone call as PAs field most of the calls. 6 weeks travel and dues for partners. This is a private group and outside the norm of employed practices. Good salaries can still be had in primary care.

 

[AlbinoHawk DO]

Hello everyone! I’m an upcoming OMS I here and am really interested in family medicine. I like the diversity as well as the family-friendly work hours. However I am wondering what is the salary potential behind this career? I’ve looked up the average income but can PCP easily make more/less? What if you are willing to practice in underserved areas? What can PCP do to increase their income? Thanks!

It depends on where you're employed and what business model you follow. If you want to be private practice and have NPs, I've seen people making >1 million. You want to be a hospitalist? 280-400k depending on location and hours. Work for a place like Kaiser? 300k