10+ Year Member
5+ Year Member
Dec 25, 2004
Can somebody set the record straight for me. How does private practice in America actually work?

A surgeon in the UK with no allegiance to the NHS makes his money by charging a set fee per operation, about £2,000 for a standard two hour operation.

Looking at surgeon jobs on a US jobsite, they all seem to be based on a set salary without any sign of commission.

Blue Dog

Fides et ratio.
Gold Donor
10+ Year Member
Jan 21, 2006
Attending Physician
drbruce said:
How does private practice in America actually work?
In a nutshell, physicians contract with selected third-party payers, including the federal and state governments (Medicare and Medicaid), and agree to accept the contracted amounts for covered services. Non-covered services (such as cosmetic surgery) are paid for directly by the patient. Physicians or physician groups are sometimes able to negotiate more favorable fee schedules with third-party payers, depending on various factors. However, Medicare fee schedules, on which most third-party fee schedules are based, are not negotiable. Generally, physicians are free to choose which insurance plans they participate in, including Medicare/Medicaid, and (rarely) may opt out of insurance altogether and contract directly with patients for payment.

Most physicians are compensated on a productivity basis, not a guaranteed salary, making "salary" figures somewhat dubious. In most cases, "salaried" physicians are paid a base salary with some sort of productivity bonus based on collections. In general, the more (or the smarter) you work, the more money you make. To maximize profitability, you also need to run your practice efficiently, and make smart decisions regarding payer mix, billing, coding, etc.

I'm not sure if that answers your question, but hopefully it helps. :)


Junior Member
10+ Year Member
Jul 24, 2006
Other Health Professions Student
yeah I was wonderin abt the same thing as I dont live in AMERICA...always wanted to no abt it, did hear from some pple though, but datz all!!
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