private practice...just wondering

[FightingIrish01]

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Hey,

I was wondering about the nature of private practices. My parents tell me that my family practice doctor makes a million at least because of his private practice. He basically can charge a lot for all the tests and will obtain a majority of the income generated from his practice. Is there such thing as a cardiologist (non-interventional) private practice? It seems like running a private businesss and providing health care at the same time. What sort of wealth do "private-practice" cardiologists, neorologists, and these specialized doctors generate?

Thank you.

 

[FightingIrish01]

Yo

 

[Captain Fantastic]

I saw an article this week in Medical Economics discussing the virtues of Private Practice verus Academia. One of the cases was a private practice Family Medicine doc who had $600,000 in receipts last year. His take home was $125,000. I can't imagine the volume of patients needed to net a million bucks as a single provider primary care practice.

 

[SeminoleFan3]

Hey,

I was wondering about the nature of private practices. My parents tell me that my family practice doctor makes a million at least because of his private practice. He basically can charge a lot for all the tests and will obtain a majority of the income generated from his practice. Is there such thing as a cardiologist (non-interventional) private practice? It seems like running a private businesss and providing health care at the same time. What sort of wealth do "private-practice" cardiologists, neorologists, and these specialized doctors generate?

Thank you.

People forget to calculate things such as overhead. You need to buy/rent the office space, pay the bills, pay the staff, etc. And, while you could charge whatever you want for tests and such, the insurance companies aren't going to reimburse you that much.
I find it hard to believe that any family doc is making a million bucks.

 

[ryandote]

Hey,

I was wondering about the nature of private practices. My parents tell me that my family practice doctor makes a million at least because of his private practice. He basically can charge a lot for all the tests and will obtain a majority of the income generated from his practice. Is there such thing as a cardiologist (non-interventional) private practice? It seems like running a private businesss and providing health care at the same time. What sort of wealth do "private-practice" cardiologists, neorologists, and these specialized doctors generate?

Thank you.

With the use of google and a little ingenuity brainstorming up words like "average physician income" or "cardiologist salary" you are bound to realize that taking home 1 million dollars would be far from common. Generating 1 million in revenue isn't quite as hard to imagine, but still a stretch- and hardly something I would call wealth.

Sorry, but your parents are probably off on this one...

 

[MossPoh]

No idea where your parents get that. 7 figures is very uncommon now. Certain fields like spine surgery, and pain medicine can make pretty big bucks but even then 7 figures is pretty rare. Family practice? If you are very entrepenuerial and run it as a business and not a doctor perhaps you could build it up to that level. Keep buying practices, hiring doctors for a little less than they are worth but with comfortable times, run a bunch of procedures in house if possible (even if it is kind of sketch to do), etc. Then you essentially become a manager of a bunch of quick stop medicine places though...I might be a little cynical about it. The vast vast vast majority of family practice guys will make in the 100-200 range. 200 is being very optimistic. What you bill out per month or year is drastically different than what you stick in your wallet.

There are bill codes fyi...certain set prices for procedures. I'll let someone that knows more get into that stuff though. You can charge as much as you want, but the insurance people will only give you a certain amount back usually.

 

[ssquared]

The only way I could imagine that a private practice doctor could take home that much money would be to do a lot of procedures that aren't covered by insurance. Dermatologists probably pocket a good chunk of money from cosmetic stuff, so if they ran a cosmetic-focused practice maybe then they could get really wealthy. But no pediatrician is making a million bucks a year unless they managed to patent something along the way...

 

[zeff]

Hey,

I was wondering about the nature of private practices. My parents tell me that my family practice doctor makes a million at least because of his private practice. He basically can charge a lot for all the tests and will obtain a majority of the income generated from his practice. Is there such thing as a cardiologist (non-interventional) private practice? It seems like running a private businesss and providing health care at the same time. What sort of wealth do "private-practice" cardiologists, neorologists, and these specialized doctors generate?

Thank you.

I work for a very large health insurance company, touching all kinds of practice setups in the DC/Maryland market, one of the most expensive in the country. Having spent some time with our pay codes, I can say with about 99% confidence that there is no way a family practive physician in the U.S. nets $1 million a year. The only way I could conceivably imagine such a case would be a GP who has a boutique practice in, say, Georgetown, or on the Upper West side of Manhattan, with a clientele able to pay out-of-pocket for everything, and willing to pay far more than market rates for their care. We offer a very high-end insurance package (we call it the "ambassador line" around the office) that still would not get a GP to that kind of income. Your family practitioner must have one hell of a personality to keep patients willing to spend that kind of money.

 

[sehnsucht]

Hey,

I was wondering about the nature of private practices. My parents tell me that my family practice doctor makes a million at least because of his private practice. He basically can charge a lot for all the tests and will obtain a majority of the income generated from his practice. Is there such thing as a cardiologist (non-interventional) private practice? It seems like running a private businesss and providing health care at the same time. What sort of wealth do "private-practice" cardiologists, neorologists, and these specialized doctors generate?

Thank you.

I am familiar with the private practice situation having grown up around one and I don't know where your numbers are from at all. If anything, the overhead cost of running your own operation cost more to pay out of your own pocket versus being part of a group practice.

 

[littlealex]

I think what they're saying is don't believe everything your mommy tells you, because she probably heard it from her friends.

And hearsy isn't admittable evidence.

 

[blargh]

i shadowed in a non-interventional cardiology private practice, so yes.

also, they do not make millions.

 

[dutchman]

Hey,

I was wondering about the nature of private practices. My parents tell me that my family practice doctor makes a million at least because of his private practice. He basically can charge a lot for all the tests and will obtain a majority of the income generated from his practice. Is there such thing as a cardiologist (non-interventional) private practice? It seems like running a private businesss and providing health care at the same time. What sort of wealth do "private-practice" cardiologists, neorologists, and these specialized doctors generate?

Thank you.

all physicians combined average less than 190k. If you are a premed, expect that to drop significantly by the time you start practice.

 

[littlealex]

If you want to make money and do it quickly, go into dentistry. Quick education, decent money starting off, and a specialist can make quite a bit of money.

 

[NCF145]

all physicians combined average less than 190k. If you are a premed, expect that to drop significantly by the time you start practice.

Have any proof or sources for this little bit of info?

 

[Law2Doc]

Hey,

I was wondering about the nature of private practices. My parents tell me that my family practice doctor makes a million at least because of his private practice. He basically can charge a lot for all the tests and will obtain a majority of the income generated from his practice. Is there such thing as a cardiologist (non-interventional) private practice? It seems like running a private businesss and providing health care at the same time. What sort of wealth do "private-practice" cardiologists, neorologists, and these specialized doctors generate?

Thank you.

Your parents are likely misinformed, or know someone who is an exception. Bear in mind that medicine (whether private practice or not) is now largely a business of reinbursements from insurance companies. What the doctor "bills" may not bear any resemblance to the amount he actually collects (gets reimbursed). As a result, some physicians, particularly those in primary care (such as FP) are barely breaking six digits. As reimbursements decline (as the insurance companies get a greater strangle hold) each year, you see physician salaries decreasing or alternatively many increase their hours to keep pace. Family practice is one of the harder hit areas because they don't have as many big money procedures. This trend is predicted by many to continue. Expect to be comfortable, but nothing close to a millionaire in this career path. Sorry.

 

[sillydoc2230]

I work for a dermatologist on the Upper East Side of Manhattan who is very well known and does not accept any insurance. She does a lot of cosmetic procedures and also specialized surgeries that many derms aren't trained in and has a lot of high profile clients. Believe me, she is making lots of money, probably in the upper hundred thousands even after overhead costs, but definitely not millions. That's pretty hard to do my friend. Your parents assuming the doctor makes so much money is simply another case of patients thinking doctors make way too much money. HAHA, my boyfriend thought the head of cardiology at one of the NYC hospitals makes $5mil, so it's pretty common for people to overestimate.

 

[TheRealMD]

I think being pre-med, people forget that the average salary for most people in America is only around $40k. Even if we were to double that because of extended hours that doctors work, $80k will still get you somewhere.

 

[Law2Doc]

I think being pre-med, people forget that the average salary for most people in America is only around $40k. Even if we were to double that because of extended hours that doctors work, $80k will still get you somewhere.

Trust me, when you are earning a salary over $40k you aren't going to be thinking "wow, I'm doing great because I'm making more than the average American". You will more likely be scratching your head wondering why you have so little in the bank after your monthly expenses.

 

[GoSouthernGo]

I think what they're saying is don't believe everything your mommy tells you, because she probably heard it from her friends.

And hearsy isn't admittable evidence.

unless your mommy is a physician and owns her own practice like mine does 😉

 

[GoSouthernGo]

Trust me, when you are earning a salary over $40k you aren't going to be thinking "wow, I'm doing great because I'm making more than the average American". You will more likely be scratching your head wondering why you have so little in the bank after your monthly expenses.

No kidding. I made close to 6 figures last year and I'm still scratching my head wondering where it went!

 

[Auron]

I hear the sky is the limit with cardiology, you can make half a million with relative ease, and over a million if you want. I know a doc with his own practice who does, thats preety awesome for one man.


Demand is huge and the money is great.

 

[Law2Doc]

The sky is the limit with cardiology, you can make half a million with relative ease, and over a million if you want. I know a doc with his own practice who does, thats preety awesome for one man.


Demand is huge and the money is great.

Well according to Salary.com (which is not an authoritative site but more often than not tends to overestimate rather than underestimate things), "The median expected salary for a typical Physician - Cardiology - Non-Invasive in the United States is $263,722." So expecting half a million to a million "with relative ease" is pretty off the mark. The folks you may know who got to this point did so at a time when it was easier to set up practices and earn big paychecks. Those days are largely over -- the profession has changed. If you didn't get in back then, you won't likely get to that level. Not that a quarter mill is anything to cry about, but it is one of those fields where you have to do a fairly lengthy residency, and the high end ceiling salary keeps getting lower.

 

[TheRealMD]

Trust me, when you are earning a salary over $40k you aren't going to be thinking "wow, I'm doing great because I'm making more than the average American". You will more likely be scratching your head wondering why you have so little in the bank after your monthly expenses.

I didn't mean that you'd have some cushy job, especially with all the loans we have to pay back, but it's just important to remind ourselves that some people have it much worse, even when we factor in the kind of debt we're getting ourselves into. Though we'd like to be compensated somehow for our hard work, I'd hope money isn't the #1 reason for getting into medicine (but it certainlly makes the list for every pre-med, no doubt).

 

[trichomoniasis]

it's not too late to change careers and become an International Man of Intrigue.


I hear that's lucrative.

 

[Law2Doc]

(but it certainlly makes the list for every pre-med, no doubt).

Actually not true. Quite a few nontrads who go the medicine route are knowingly taking a loss. Salary is more of a driving force early on in your professional life, until you realize it really doesn't matter as much to your next 40+ years of happiness as really enjoying/being interested in/feeling challenged at what you do. You need to have enough to live nicely, but after that there are simply more important things that have to be in place to get you up each morning. Which is probably why applications for medicine keep going up even while salaries have been receding over the last decade.

 

[Bolo]

Some of you people have been brainwashed into thinking there is no 'money' to be made in medicine. First of all, none of those 'salary' websites are very reliable. There are so many different ways to practice medicine, whether it be private, academics, or a salaried position in a hospital. Take those 'averages' with a grain of salt. They may be the 'average' for someone who has no business acumen and decides that they rather work for someone else. But for the entrepreneur who owns his own practice, and only accepts private insurance that pays well or cash, one can possibly make much more than the quoted aforementioned 'averages.'

A million dollar a year income is very difficult to achieve in ANY profession. But it is NOT impossible in medicine. If you accept cash only as a family practice physician, charge a yearly fee, and work in a wealthy community, it is very conceivable to hit that 7 figure mark with some hard work and maybe a little luck. But just don't expect that you will be one of the FEW doctors on the far right side of the bell curve that pulls that kind of money.

I personally know a rad onc doc in Florida who makes close to $1 million a year because he owns his own equipment, a urologist living in New Hampshire who makes upwards of $800k a year because he only accepts private insurance, and a park avenue plastic surgeon who makes well over $2 million a year.

Oh yea...and then there was this ophthalmologist in San Diego who made over $10 million in a year a few years ago. He recently mysteriously died in a hotel in Mexico. He was indited on tax evasion, and from what I heard was practicing unethical medicine, although he got his medical license reinstated. Definitely not a good example of the 'ideal' physician, but just an example convey my point. http://www.signonsandiego.com/uniontrib/20070317/news_1m17kawesch.html

Don't let the nay sayers discourage you into thinking you can't make a great income. Just don't think that you will get 'rich' off of it, or that you will be like one of these rare examples.

 

[Zippership]

There's an interesting section in Atul Gawande's new book, Better about this. In it, he describes a doctor in private practice who simply chose not to negotiate with insurance and instead set his own fee schedules. The man still has an active practice with a constant stream of patients and is making considerably more than $1 million. I'm not saying that this is the norm, but it's certainly possible if that's your goal.

 

[Law2Doc]

Some of you people have been brainwashed into thinking there is no 'money' to be made in medicine. First of all, none of those 'salary' websites are very reliable. There are so many different ways to practice medicine, whether it be private, academics, or a salaried position in a hospital. Take those 'averages' with a grain of salt. They may be the 'average' for someone who has no business acumen and decides that they rather work for someone else. But for the entrepreneur who owns his own practice, and only accepts private insurance that pays well or cash, one can possibly make much more than the quoted aforementioned 'averages.'

A million dollar a year income is very difficult to achieve in ANY profession. But it is NOT impossible in medicine. If you accept cash only as a family practice physician, charge a yearly fee, and work in a wealthy community, it is very conceivable to hit that 7 figure mark with some hard work and maybe a little luck. But just don't expect that you will be one of the FEW doctors on the far right side of the bell curve that pulls that kind of money.

I personally know a rad onc doc in Florida who makes close to $1 million a year because he owns his own equipment, a urologist living in New Hampshire who makes upwards of $800k a year because he only accepts private insurance, and a park avenue plastic surgeon who makes well over $2 million a year.

Oh yea...and then there was this ophthalmologist in San Diego who made over $10 million in a year a few years ago. He recently mysteriously died in a hotel in Mexico. He was indited on tax evasion, and from what I heard was practicing unethical medicine, although he got his medical license reinstated. Definitely not a good example of the 'ideal' physician, but just an example convey my point. http://www.signonsandiego.com/uniontrib/20070317/news_1m17kawesch.html

Don't let the nay sayers discourage you into thinking you can't make a great income. Just don't think that you will get 'rich' off of it, or that you will be like one of these rare examples.

I think your last sentence gets to the heart of the issue better than the rest of your response. Everybody knows "this guy" who makes a million dollars a year in XYZ. But the averages take into account these people. Most people earn around average or below (moreso below considering these rare multimillionaires are factored into these 100-250k average figures). Sure there will always be exceptions who do great, but you don't go into a field requiring 4 years of school and 3+ years of residency on the hope that some day you will get to be a rare exception.

Bear in mind that it has become progressively harder to set up practices, salaries in these days of reimbursements are lower. For most people it is pretty safe to say you will not be a millionaire if you go into medicine. You probably won't be much above average, and it is entirely conceivable that tomorrow's average will not be as high as today's. But all that doesn't really matter because you will hopefully be earning a "comfortable" (but not extravagant) living doing what you enjoy. If you need more than this, you might want to consider looking elsewhere.

 

[Law2Doc]

There's an interesting section in Atul Gawande's new book, Better about this. In it, he describes a doctor in private practice who simply chose not to negotiate with insurance and instead set his own fee schedules. The man still has an active practice with a constant stream of patients and is making considerably more than $1 million. I'm not saying that this is the norm, but it's certainly possible if that's your goal.

These "conceirge" services pop up now and then. Tend to only really do well in cosmetic surgery/elective type stuff that some insurance policies won't cover. You have to select your market carefully, finding regions with lots of rich people willing to pay cash rather than use their insurance (which every upper class person gets through work these days), but with little similar competition. The key is that these businesses only survive if they are the only conceirge game in town. I have personally (in my prior career) seen conceirge medical practices go bankrupt because too many people set up similar shops in the same town, and the market wasn't strong enough to support multiple such businesses. So this isn't really the answer because it only works if nobody else is doing it, and you have to be willing to relocate to someplace that supports such business -- you cannot choose where you want to live, your practice needs dictate this.

 

[jae9970]

For most people it is pretty safe to say you will not be a millionaire if you go into medicine.

Do you define millionaires as people whose annual income exceeds $ 1 million?

 

[Law2Doc]

Do you define millionaires as people whose annual income exceeds $ 1 million?

Fair enough. I guess if you bank (or pay into real estate equity) 25k a year for 40+ years (pretty realistic for a professional) you will technically have a net worth of a mill. So yeah, that's not what I meant.

I'm just saying you won't be rolling in it.