PP salary in the Bay Area, CA

[doctro dre]

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Hi, long-time lurker. I've seen the PP offers/packages thread that is advised by some of the moderators of the page. I didn't see Bay Area postings or do not remember any.

I am curious if any have experience with salaries in the Bay Area (PP, hospital-employed) and would be willing to share. I'm an M4 in SoCal, and would love to go back north for IM/future training. Just curious of ballpark salary, and how practitioners afford the HCOL. I'm originally from Sacramento but also have a community in the Bay.

Appreciate anything at all.

 

[HemeOncHopeful19]

Treefiddy

 

[gutonc]

But I thought you wanted to do Cards. Or wait...was it GI?

Start with matching in IM. Whatever you see now won't be the case in 6-8 years when you're ready to find a job.

 

[checkpointinhibitor]

Hi, long-time lurker. I've seen the PP offers/packages thread that is advised by some of the moderators of the page. I didn't see Bay Area postings or do not remember any.

I am curious if any have experience with salaries in the Bay Area (PP, hospital-employed) and would be willing to share. I'm an M4 in SoCal, and would love to go back north for IM/future training. Just curious of ballpark salary, and how practitioners afford the HCOL. I'm originally from Sacramento but also have a community in the Bay.

Appreciate anything at all.

Wow ! Some real long term planning here.
My advise is to get in to good IM program. Get a good sense of what you envision 'satisfying' you for next 30 years of life. Where you get a sense of fulfillment.
Warning - do not select specialty based on pay, select what you like doing. You will regret your choice even if you make $1mm per year and be 'that' salty attending always counting the beans and not focusing on patient care.
You should focus on getting in to good program, becoming an excellent internist so you can be a better specialist.
My 2 cents, whether you like it or not.

 

[doctro dre]

Wow ! Some real long term planning here.
My advise is to get in to good IM program. Get a good sense of what you envision 'satisfying' you for next 30 years of life. Where you get a sense of fulfillment.
Warning - do not select specialty based on pay, select what you like doing. You will regret your choice even if you make $1mm per year and be 'that' salty attending always counting the beans and not focusing on patient care.
You should focus on getting in to good program, becoming an excellent internist so you can be a better specialist.
My 2 cents, whether you like it or not.

Thanks for the reply, and to the others too. I’ve read a lot of your replies and they’ve been awesome. Honestly I came into school wanting to do Heme/Onc, I think I’ve wanted to do it since high school. But after my surgery rotation, I think having some procedures in my career would be very nice. So I’m stuck. I love the content of Heme/Onc (a lot) but having little procedures is something I’m struggling with. This is why I posted in Cards/GI as well. Also I really want to stay in the Bay Area, or at least California. And I know especially the Bay is HCOL so I wanted to get a sense of the lifestyle/pay there.

It’s honestly hard for me to focus if I don’t have a set goal (fellowship) which is why I want to know so bad. The reason I’m looking further ahead is because my school’s IM program is (almost) a sure fire for the students if we are interested and did not outright fail/professionalism at risk. And I’m not sure if my grades will allow me to jump to a stronger program, but I will try. I was thinking if I could get insight now I could plan and overall have a better chance/journey to fellowship. But yeah appreciate any thoughts.

 

[checkpointinhibitor]

Thanks for the reply, and to the others too. I’ve read a lot of your replies and they’ve been awesome. Honestly I came into school wanting to do Heme/Onc, I think I’ve wanted to do it since high school. But after my surgery rotation, I think having some procedures in my career would be very nice. So I’m stuck. I love the content of Heme/Onc (a lot) but having little procedures is something I’m struggling with. This is why I posted in Cards/GI as well. Also I really want to stay in the Bay Area, or at least California. And I know especially the Bay is HCOL so I wanted to get a sense of the lifestyle/pay there.

It’s honestly hard for me to focus if I don’t have a set goal (fellowship) which is why I want to know so bad. The reason I’m looking further ahead is because my school’s IM program is (almost) a sure fire for the students if we are interested and did not outright fail/professionalism at risk. And I’m not sure if my grades will allow me to jump to a stronger program, but I will try. I was thinking if I could get insight now I could plan and overall have a better chance/journey to fellowship. But yeah appreciate any thoughts.

Honestly, 8-9 years from now, when you will be in PP, no one knows what the outlook for compensation would be. For all that matters, we may have a medicare for all and everyone will get fixed salary no matter where you are. The payment structure can change from fee for service to bundled payments, hospitals may get bankrupt and PPs may be on the rise again. Oncology will pay more, or much much less. One thing that is sure is uncertainty about the future of medicine and compensation. We all say, make hay while the sun shines.
All the best on your journey.

 

[osprey099]

Generally speaking for heme onc, and for most if not all specialties: the more desirable the location, the less money you will make. And the contrary is true as well: the more undesirable the location, the more money you will make.

Since most doctors would say Bay Area or Cali in general is very desirable, therefore you will likely not make much in Cali. When I was browsing ASCO job posts couple of years ago, I think I saw a job based in SF that would pay around 500k for 5 days a week, which is low for heme onc

 

[osprey099]

Honestly, 8-9 years from now, when you will be in PP, no one knows what the outlook for compensation would be. For all that matters, we may have a medicare for all and everyone will get fixed salary no matter where you are. The payment structure can change from fee for service to bundled payments, hospitals may get bankrupt and PPs may be on the rise again. Oncology will pay more, or much much less. One thing that is sure is uncertainty about the future of medicine and compensation. We all say, make hay while the sun shines.
All the best on your journey.

Very true. Nobody knows what compensation will look like in the future. Oncology is lucrative right now, but could change at any moment

 

[bobsmith]

Since most doctors would say Bay Area or Cali in general is very desirable, therefore you will likely not make much in Cali. When I was browsing ASCO job posts couple of years ago, I think I saw a job based in SF that would pay around 500k for 5 days a week, which is low for heme onc

It's just wild to me how much salaries have changed since I was in training

For example, here's a link to a post from ~7 years ago (2018) asking how common it would be to make 400k/year in CA as a starting salary and the OP was pretty much just laughed at.

In short, OP: as mentioned by other posters, things can change a lot by the time you actually get your first job, so we really do mean it when we tell you not to focus too much on it. You can find examples throughout various SDN forums of things going in the opposite direction over the last decade, also

 

[HemeOncHopeful19]

It's just wild to me how much salaries have changed since I was in training

For example, here's a link to a post from ~7 years ago (2018) asking how common it would be to make 400k/year in CA as a starting salary and the OP was pretty much just laughed at.

In short, OP: as mentioned by other posters, things can change a lot by the time you actually get your first job, so we really do mean it when we tell you not to focus too much on it. You can find examples throughout various SDN forums of things going in the opposite direction over the last decade, also

Sadly, 400k in 2018 is equivalent to 504k in 2025…

 

[MD46]

Kaiser is still in the low 400s for 4.5 work week with avg 16-18 patients a day, with partnership around 650 for 20-22ish a day. They have a good pension like retirement plan and get Kaiser insurance in the future too if you spend enough time. ( this is per a friend )

 

[onconc]

Kaiser is still in the low 400s for 4.5 work week with avg 16-18 patients a day, with partnership around 650 for 20-22ish a day. They have a good pension like retirement plan and get Kaiser insurance in the future too if you spend enough time. ( this is per a friend )

Could you elaborate on the partnership track ? I mean is it not guaranteed to everyone based on tenure ? Is it something that has to be earned by seeing more patients ?
thanks

 

[sloh]

Kaiser is still in the low 400s for 4.5 work week with avg 16-18 patients a day, with partnership around 650 for 20-22ish a day. They have a good pension like retirement plan and get Kaiser insurance in the future too if you spend enough time. ( this is per a friend )

Wow Kaiser gig is pretty good after partnership

 

[osprey099]

Wow Kaiser gig is pretty good after partnership

650k for 20-22/day 4.5 days/wk is not that good of a deal. I guess depends on the location though.

That pension is very nice though and it's the main reason docs choose to work for Kaiser

 

[gutonc]

650k for 20-22/day 4.5 days/wk is not that good of a deal. I guess depends on the location though.

My current job would pay me $900K-1.1M for that workload. Not in CA of course but in a HCOL area.

That pension is very nice though and it's the main reason docs choose to work for Kaiser

Yes, that's how they get you and keep you. A co-fellow of mine has worked for Kaiser since graduation and is constantly badgering another co-fellow and I to join her. The base they quote for the workload and having to essentially start at the bottom of their scale, despite over a decade of experience, is laughable. If they fully vested my pension after 6 months, I might consider it. But I asked about that was told that wasn't an option.

 

[osprey099]

Yes, that's how they get you and keep you. A co-fellow of mine has worked for Kaiser since graduation and is constantly badgering another co-fellow and I to join her. The base they quote for the workload and having to essentially start at the bottom of their scale, despite over a decade of experience, is laughable. If they fully vested my pension after 6 months, I might consider it. But I asked about that was told that wasn't an option.

Agree. I think their pension kicks in after 20 years of service. I guess if you graduate fellowship early 30s and go straight for Kaiser, work your 20 years, and then retire on their pension -> this does sound quite attractive cause you can retire early 50s and get paid enough to live a very comfortably life and can always supplement with some locums PRN if you need some more cash.

 

[onconc]

How much is Kaiser pension ?

 

[ShuperNewbie]

Kaiser pension is something like half your highest earned salary paid out every year. Also no oncologists are seeing 20-22 patients a day at Kaiser (at least in NorCal). As Gutonc said, that load should reimburse much more, so if this were true, no one would work for Kaiser. We oncologists aren't dumb (or unemployable) so if people were being forced to see 20-22 patients a day, there'd be a mass exodus out of Kaiser. Patient load there is more like 12 patients a day or something. I know someone personally who started out seeing like... 3-6 patients a day for the first few months of her job. You're very protected there.

 

[osprey099]

I think the pension is 60% of your max salary paid out annually

 

[sloh]

Kaiser pension is something like half your highest earned salary paid out every year. Also no oncologists are seeing 20-22 patients a day at Kaiser (at least in NorCal). As Gutonc said, that load should reimburse much more, so if this were true, no one would work for Kaiser. We oncologists aren't dumb (or unemployable) so if people were being forced to see 20-22 patients a day, there'd be a mass exodus out of Kaiser. Patient load there is more like 12 patients a day or something. I know someone personally who started out seeing like... 3-6 patients a day for the first few months of her job. You're very protected there.

So the pension would be something like 325k paid out every year at around 50 yo if a heme onc doc started working for Kaiser at 30. Not bad

 

[osprey099]

So the pension would be something like 325k paid out every year at around 50 yo if a heme onc doc started working for Kaiser at 30. Not bad

Not to mention that you won't have to deal with insurance since everything is in-house

 

[sloh]

So the pension would be something like 325k paid out every year at around 50 yo if a heme onc doc started working for Kaiser at 30. Not bad

To put this into context: applying the 4% withdrawal rule, if someone wanted to spend 325k per year after retiring and they did not have a pension, they would need to have $8.125 million in their investment portfolio. It's very rare for a physician to achieve this, much less at 50 yo. I don't think Kaiser is a good gig for many physicians but depending on one's specialty and location, it can be a good gig.

 

[onconc]

To put this into context: applying the 4% withdrawal rule, if someone wanted to spend 325k per year after retiring and they did not have a pension, they would need to have $8.125 million in their investment portfolio. It's very rare for a physician to achieve this, much less at 50 yo. I don't think Kaiser is a good gig for many physicians but depending on one's specialty and location, it can be a good gig.

The 4% rule is the correct way to model present-value-of-future-payments. I too do the same math.

I agree kaiser $325k pension is a sweet deal. Many non-kaiser oncologists would not be able to accumulate that much by 50

 

[onconc]

So based on the above math, Kaiser is indeed a sweet deal financially if you stay until pension. So I wonder why is Kaiser not one of the most desirable employers ? as far as I see, the main downwide is that you defer pay. So instead of enjoying life in your 30s and 40s, you enjoy them in your 50s and 60s. Second downside is bankruptcy. What if kaiser goes bankrupt when you are ready to collect your pension ? I guess there is some pension protection insurance and alls. But I doubt they will cover a $325k per year in perpetuity pension in case the kaiser does go bankrupt

 

[osprey099]

So based on the above math, Kaiser is indeed a sweet deal financially if you stay until pension. So I wonder why is Kaiser not one of the most desirable employers ? as far as I see, the main downwide is that you defer pay. So instead of enjoying life in your 30s and 40s, you enjoy them in your 50s and 60s. Second downside is bankruptcy. What if kaiser goes bankrupt when you are ready to collect your pension ? I guess there is some pension protection insurance and alls. But I doubt they will cover a $325k per year in perpetuity pension in case the kaiser does go bankrupt

Well, outside of the 2 coasts (west coast and Northeast), Kaiser really doesn't have that big of a presence elsewhere. I'm sure if you're in flyover-country USA, there aren't any Kaiser onc jobs

 

[MifflinDunder]

How is the support system and inbox management at Kaiser?

 

[sloh]

So based on the above math, Kaiser is indeed a sweet deal financially if you stay until pension. So I wonder why is Kaiser not one of the most desirable employers ? as far as I see, the main downwide is that you defer pay. So instead of enjoying life in your 30s and 40s, you enjoy them in your 50s and 60s. Second downside is bankruptcy. What if kaiser goes bankrupt when you are ready to collect your pension ? I guess there is some pension protection insurance and alls. But I doubt they will cover a $325k per year in perpetuity pension in case the kaiser does go bankrupt

Ya I'm curious about this as well. Even if we limit to the coasts where Kaiser is more prevalent, are there a lot of heme onc docs finding other gigs where the income is ABOVE 650k?

With Kaiser, you're getting paid 650k (after partnership), pretty chill workload, benefits, pension.

 

[sloh]

So based on the above math, Kaiser is indeed a sweet deal financially if you stay until pension. So I wonder why is Kaiser not one of the most desirable employers ? as far as I see, the main downwide is that you defer pay. So instead of enjoying life in your 30s and 40s, you enjoy them in your 50s and 60s. Second downside is bankruptcy. What if kaiser goes bankrupt when you are ready to collect your pension ? I guess there is some pension protection insurance and alls. But I doubt they will cover a $325k per year in perpetuity pension in case the kaiser does go bankrupt

The one thing I’ll mention about the Bay Area (and SoCal) is that it’s not uncommon a lot of the houses physicians want which are in good school districts cost around 2-2.5M at least. It’s nuts to say that even on a 650k income, the houses are hard to afford in HCOL locations.

 

[onconc]

The one thing I’ll mention about the Bay Area (and SoCal) is that it’s not uncommon a lot of the houses physicians want which are in good school districts cost around 2-2.5M at least. It’s nuts to say that even on a 650k income, the houses are hard to afford in HCOL locations.

Agree. In both the main 2 metros of CA, 650k will be a stretch to afford to live in good school districts. Likely need a spouse earning high income as well

 

[ShuperNewbie]

Ok I'll say this before this gets out of control. I live in the Bay Area right now. In a very very high cost of living area. I make around that much. My wife is not working. We're fine. We're not struggling. Yes, south bay is expensive but thankfully, we're not tech workers and no one here HAS to buy a house in south bay. You're not married to having to live in palo alto or santa clara or the peninsula and anyone who thinks they are is just kidding themselves at this point. There are PLENTY of nice areas to live outside of south bay (and let's be honest, south bay is kind of a boring suburb that tech workers flock to just because the FAANG companies are there). Berkeley, Walnut Creek, Mt Diablo, and even SF, are PERFECTLY livable and thrivable with that kind of salary. Don't kid yourselves guys.

 

[sloh]

Ok I'll say this before this gets out of control. I live in the Bay Area right now. In a very very high cost of living area. I make around that much. My wife is not working. We're fine. We're not struggling. Yes, south bay is expensive but thankfully, we're not tech workers and no one here HAS to buy a house in south bay. You're not married to having to live in palo alto or santa clara or the peninsula and anyone who thinks they are is just kidding themselves at this point. There are PLENTY of nice areas to live outside of south bay (and let's be honest, south bay is kind of a boring suburb that tech workers flock to just because the FAANG companies are there). Berkeley, Walnut Creek, Mt Diablo, and even SF, are PERFECTLY livable and thrivable with that kind of salary. Don't kid yourselves guys.

Weren’t you the one saying that you and people you knew did fine in the OC and NY on 150-250k HHI? With kids and a 3000 sqft house in a decent neighborhood, that’s really hard to fathom.

 

[ShuperNewbie]

Weren’t you the one saying that you and people you knew did fine in the OC and NY on 150-250k HHI? With kids and a 3000 sqft house in a decent neighborhood, that’s really hard to fathom.

Yup. Not gonna feed the troll on this one here. Muting thread. See ya. Feel free to argue amongst yourselves

 

[onconc]

Weren’t you the one saying that you and people you knew did fine in the OC and NY on 150-250k HHI? With kids and a 3000 sqft house in a decent neighborhood, that’s really hard to fathom.

It's hard to fathom only if you are good at math. For the mathematically challenged, it is easy to fathom.

 

[bobsmith]

So the pension would be something like 325k paid out every year at around 50 yo if a heme onc doc started working for Kaiser at 30. Not bad

Well, it's 2% per year for the first 20 years and then 1% per year for each of the 10 years after that (which is probably how some people have come up with the shortcut to ~half your salary since most are planning to work until retirement) [reference]

Especially since you also can't get the pension until age 65 (or 60 in certain cases), I can see why the people I know at Kaiser don't really seem to retire early.

And honestly? If the job is pretty manageable / not back breaking in terms of volume, I can see getting pretty used to it after 20 years and thinking "yeah I could do this for another 10-15"