Salaries of primary care physicians

[Adapt]

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I was under the impression that general pediatricians and FPs make about on average $120,000 while General Internists make about $140,000. Are these figures accurate?

Someone said in another thread that FPs make more than both general pediatricians and general internists which doesn't seem right to me.

Also, does anyone think that the salaries of primary care physicians will soon decrease in the future as a result of how our current health system is?

 

[rirriri]

FP is the bottom of the barrel.

 

[bigmuny]

i wondered about those figures as well, so i asked. the two private practive fp's i know make at least twice that figure(4 day work week, though the hours can be bad), and one of them said one year(busting his ass) that he made four times that figure.

 

[madcadaver]

salaries in all specialties are highly variable. In general a average general outpatient internist and an average FP make about the same amount of money-- within about $1000-2000, according to the best survey I have seen (sorry, don't have the link right now). If you search the forums for "salary" you will find many sources for information of MD salaries.
MadC

 

[Adapt]

Originally posted by madcadaver
salaries in all specialties are highly variable. In general a average general outpatient internist and an average FP make about the same amount of money

Well that's good news. So does anyone think these salaries will go down any time soon or are they pretty much stable.

 

[Pilot Doc]

It's hard to imagine IM/FP salaries going substantially lower. Big money proceduralists can (and have) taken 30-50% cuts in income and still make attractive salaries. If PCP's took those cuts, I expect many people would exit the market. While the persistent medicare cuts are a threat to income, PCP fees are not the juicy targets that procedures and imaging are.

 

[RADRULES]

The answer is botox. If you do this like several gen. IM guys I know do in their offices, you can make mad bank. One guy easily clears $350,000/yr. Couple that with only 3 years in residency means these guys made out.

 

[bigmuny]

actually, the one of the fp's i talked to told me exactly what RADRULES said. to make money in fp you need a gimmick, something that people want and will preferably pay cash for. Botox, trigger point injections, vasectomies, ect...

 

[Imhotep]

Salaries in FP/IM can vary tremendously depending on locale and how hard you want to work. Several FP friends of mine recently out of residency are making 150k + while working 4 days a week...mainly out pt clinic work.. In internal medicine...the hot field these days is the Hospitalist. You can get a job in virtually any city...of course, the less desirable locales offer more money. Someone I know recently started somewhere in South Dakota at 200k his schedule is 7 day on, 7 day off..so in effect, he is getting 26 wks off per year
Now...the 7 days he works are tremendously busy...10-12 hour days..but the payoff is great, at least as per him.
Some FPs work at small town ERs and make around 100-120 bucks an hour...this roughly translates into 200k+ per year.

 

[16846]

Originally posted by bigmuny
actually, the one of the fp's i talked to told me exactly what RADRULES said. to make money in fp you need a gimmick, something that people want and will preferably pay cash for ...vasectomies, ect...

FP's aren't qualified to perform vasectomies, right? This is a joke?

 

[bigmuny]

no joke, there are fp's who do them.

 

[gungho]

FP for 18+ yr. do vasectomies all the time. great procedure.

 

[droliver]

It would show extremely poor judgement on the patients part to go to an FP or Internist for trigger point injections or BOTOX. These are a good bit more involved then just sticking needles in & there is nothing in their training that would make me think they're qualified to do these

 

[seattledoc]

Droliver or any other informed reader,
First of all the disclaimer, I have no interest in ever doing botox injections, giving or receiving ... but

Regarding who's qualified to do botox...
How have the majority of dermatologists learned to do botox injections, most likely it was learned after residency since it's fairly new, correct?

 

[droliver]

Most Dermatologists & Plastic Surgeons in practice currently would have learned Botox, other injectable fillers, Lasers, any most other recent advances in post graduate education courses. People who have trained in recent years would have had experience with these during their residency. Neurologists and Opthomologists also recieve proctored training in Botox for therapeutic purposes.

It's hard to argue that it should be included in the scope of practice for many of the other fields dabbling with it.

 

[ckent]

Forgive my ignorance on the subject, but what is so difficult about giving a botox injection? It looks like any other IM injection that any physician or nurse should be trained enough to "handle". I don't see why anyone who took an hour course couldn't give these shots. With botox, if you botch it up (ie inject in all the wrong places), at least it will wear off in a few months. The big complications that I have heard about are when people use things other then botox like collagen or some sort of plastic beads.

 

[Ligament]

PM&R docs are the kings of botox for non-cosmetic use. Specifically, spasticity in spinal cord injury, brain injury patients. I have often put in 400Units per patient (thats about $2000 of botox alone).

 

[DigableCat]

Originally posted by ckent
Forgive my ignorance on the subject, but what is so difficult about giving a botox injection? It looks like any other IM injection that any physician or nurse should be trained enough to "handle". I don't see why anyone who took an hour course couldn't give these shots. With botox, if you botch it up (ie inject in all the wrong places), at least it will wear off in a few months. The big complications that I have heard about are when people use things other then botox like collagen or some sort of plastic beads.

There is a potential for many things to go wrong if you "inject in all the wrong places". A rare but serious side effect is dysphagia which could lead little old Grandma Madison, who just wanted to get rid of the crows feet of her eyes, down the road of Aspiration Pneumonia Blvd and a nice 21 day hospital stay.

 

[chef]

there r several FPs in my area who do extensive derm procedures like botox, peels, lasers, etc ($$$$$$)

FP is a nice backdoor into dermatology

 

[droliver]

Originally posted by chef
there r several FPs in my area who do extensive derm procedures like botox, peels, lasers, etc ($$$$$$)

They will have very little to stand on when (not if) they get a major complication and I'd be surprised if they were able to get malpractice insurance for many of these procedures. You will not also have to look hard for other professionals willing to testify that their scope of practice has been exceeded

 

[Tenesma]

i hate to say this but a lot of the cosmetic procedures that are not truly invasive - can be performed in most states with just an MD and no residency.... you take a few evening courses and voila: you can now do laser dermabrasion/depilation, botox...

of course legally it looks bad if you aren't a dermatologist or a plastic surgeon - but most patients who choose to go to a non-cosmetic specialist for these procedures are doing this because of how much cheaper it is...

i have heard of many stories of guys finishing medical school in california opening a few botox clinics - operating them (cash upfront) for a few months and then closing them down , just to open up in a differenty county... and those guys are making mad-cash...

do i approve? no.... can it suck for the patient if they screw up? yes... does it happen? you bet

 

[Meat Cookie]

Any physician can do any procedure for which they are suitably trained, period. There are FPs that do full cosmetic surgery...but they cannot call themselves a surgeon. You especially don't need to be derm to do botox.

 

[Tenesma]

"there are FPs doing full cosmetic surgery"

i haven't laughed so hard in a long time let me tell you something: family practice can be summed up with two words: USMLE 3

 

[droliver]

Anyone with a liscence they can pretty much do anything they want in their office. However, when you get complications from these things (happens to everyone) it can be financially devastating. I would presume that it wound be near impossible to get malpractice coverage for some of these people & you'd have to have to look real hard @ the personal risk/benefit for your practice. People have been sued & settled for ptosis of the lids & lips after botox as well as the inevitable attempt to link injections to auto-immune phenomena (I saw this on one of the TV newsmagazine shows after a woman was injected by a neurologist for migranes & developed fibromyalgia). The take home lesson is that even something like Botox has associated liability

 

[maxheadroom]

People seem to assume that elective cosmetic surgery and cosmetic office procedures are without risk. Not true. While they are low risk in the hands of properly trained, board certified professionals, they can become devastating in the hands of unqualified physicians. Ever see a patient who can't oppose his thumb after a carpal tunnel release? I saw one a few days ago in clinic. His FP "took a course" in CTR and offered it to him. Too bad his FP didn't recognize the recurrent motor branch for the thenars. Oops. A couple of years ago I saw a patient who'd gone to Mexico for a facelift. She came back with a facial nerve palsy on the right side. Oops. But hey, it's only cosmetic surgery. What could go wrong? Why do you think we train for at least 5 years (with most doing 6-8 years of training)?

I don't manage essential hypertension, hyperlipidemia, or pregnancies. Why? Because it's outside of my training. Good doctors practice the medicine that they're trained for, not just anything that they can get away with.