Salary for IM vs ID

[Prop]

Hi.

So I recently looked at the allied-physicians website with their salary survey, and I became quite puzzled over something.
On their website, it's stated that people in IM will make ~176K 3 years after completing residency, while people in ID will make ~178K 3 years after fellowship.
Why would anyone do 2 years of extra training, just to make a lousy 2K extra a year??? To me, ID seems really interesting, but I just don't understand why they aren't compensated better...
Anyone with any thoughts on this? Are ID really not compensated better than what's stated above?

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[c5a]

in a recent physician satisfaction survey, ID was one of the most satisfying specialties. geriatrics might have been the highest. geriatrics also doesn't pay more than IM. so why do it? for 1-2 extra years of your life, you'll be doing that for the next 30 years. if you love what you do, what's 2 years for no extra income. most ID docs i've talked to really love what they do. they wouldn't have chosen anything else.

i'm going into ID by the way, but the salary thing does bring into question if this is what you really want to do.

 

[Prop]

I do realize that satisfaction with your job should be the most important factor when deciding on which fellowship to pursue, not what kind of income it generates.
I did a rotation in ID and it was really interesting, and furthermore the physicians seemed so on top of things!!! I've heard several times that ID physicians are considered among the best diagnosticians around, and my rotation only emphasized that point.
Still, I have a hard time understanding why the compensation isn't better!
Are procedures scarce, or do they just generate fewer money than Cards or GI? Is it possible to go into private practice as an ID, and would that generate more money?
Please don't get me wrong, it's not because I'm fixated on making money. In my world, 150K is a lot of money, so I would "survive" making that... I just wondered why IDs aren't compensated better taking into acount 2 years fellowship, and the general condition of their patients.

 

[smq123]

Are procedures scarce, or do they just generate fewer money than Cards or GI? Is it possible to go into private practice as an ID, and would that generate more money?

* ID doctors do not do many "procedures." I can't think of any procedures that ID doctors do regularly. So, of course, with fewer procedures, you have less compensation.

* You CAN go into ID private practice and that would definitely make more money. But you would have a much busier and more hectic lifestyle. There is a private practice of ID doctors in my area - they consult at 3 different community hospitals, so they are constantly driving back and forth between the hospitals. Plus, since the community hospitals are small and do not have fellows, the private practice ID doctors MUST drive in to the hospital whenever there is a problem or an emergency - even if it is 3 AM.

* Many ID doctors take care of HIV/AIDS patients. Many of these patients are on government assistance healthcare programs (at least in my area), and cannot afford to pay much.

 

[Hurricane95]

I'm just a lowly second year med student but my guess as to the pay discrepancy is that most of the geriatricians and ID specialists are not in private practice, but are hospital staff, which typically leads to far lower pay than private practice. The numbers for internists include many who are in private practice, and hence raking in more cash. You would probably see a greater difference if you compared just to internists who are not private practice.

 

[usatravel]

hi, c5a , can you elaborate more on why ID was one of the most satisfying specialties?
I can think of two:
1, disease is usualytreatbale as long as the infection cause is found. Not like cancer , etc.
2. large part of ID physician's work is consulting. So do not need to worry too much on-call, emergency.
anything else?

Thanks

 

[PeepshowJohnny]

hi, c5a , can you elaborate more on why ID was one of the most satisfying specialties?
I can think of two:
1, disease is usualytreatbale as long as the infection cause is found. Not like cancer , etc.
2. large part of ID physician's work is consulting. So do not need to worry too much on-call, emergency.
anything else?

Thanks

I think people think it's satisfying because there's no pressure to go into it for money or esteem. So it attracts people who simply like ID topics. They like playing detective and asking about pets, travel history, how old their house is, if they've been swimming in any lakes, etc. They like antibiotics more than just throwing Vancomycin and Zosyn at everything. It's not like, say, Cardiology where some people are interested in it for prestige and money, and not for the love of the heart.

Also, this may be hospital and region specific, but the ID doctors I know simply don't work that many hours. They spend time on consult service, as well as the HIV clinic, but also spend considerable time in the lab doing research, doing education, working with the hospital on policy, much more so than other IM specialties. Lots of time their days end early. So, they may not make substantially more because they work less total hours and less time doing things that "pay."

 

[VCMM414]

I think people think it's satisfying because there's no pressure to go into it for money or esteem. So it attracts people who simply like ID topics. They like playing detective and asking about pets, travel history, how old their house is, if they've been swimming in any lakes, etc. They like antibiotics more than just throwing Vancomycin and Zosyn at everything. It's not like, say, Cardiology where some people are interested in it for prestige and money, and not for the love of the heart.

This basically hits the nail on the head.

 

[timebomb]

numerically, ID is a low-paying specialty. A good practice should pay around $200K per year. Average salaries are less than IM, but keep in mind IM can boost its production with minor procedures. ID can as well, but typically the time is not worth the reimbursement for most of them. A major factor to consider is that as a specialist, you are a consultant and do not deal with most of the primary care paperwork, management, and non-medical BS that a lot of internists deal with. Also, hours are nice, as there is little reason to come in at night and hours are typically flexible. Even with similar salaries, ID lifestyle easily beats IM.

 

[drfunktacular]

numerically, ID is a low-paying specialty. A good practice should pay around $200K per year. Average salaries are less than IM, but keep in mind IM can boost its production with minor procedures. ID can as well, but typically the time is not worth the reimbursement for most of them. A major factor to consider is that as a specialist, you are a consultant and do not deal with most of the primary care paperwork, management, and non-medical BS that a lot of internists deal with. Also, hours are nice, as there is little reason to come in at night and hours are typically flexible. Even with similar salaries, ID lifestyle easily beats IM.

Is this true? I was under the impression that most ID docs get worked pretty hard, e.g. people in ID that I've talked to have HUGE (~50-70) censuses to round on when they are on weekend call.

 

[Finding Chi]

A census of 50 - 70 has not been my experience with ID rotations at my program. Sometimes the fellows will cover more than one hospital on weekends, so in those cases, maybe the total census would be that high. Even so, they usually not round on every single patient each day (i.e. the guy with osteo who is on day 22 of a million of vanc they may see MWF).

The ID staff seem to live pretty good lifestyles, split between academics, clinic, inpatient, and research. And, as earlier posters have said, they clearly love their field (I think one of the things I find most attractive about ID is their tendency to wax prolific about obscure microbiological topics... but that may be because I'm kind of a gas bag🙂).

 

[angel80]

You can find ways to make money in ID if you really want to. I'm surprised that no one has mentioned infusion centers. The ID physicians who run these can easily make double the salary of the rest of their ID colleagues. My cousin is an ID physician who has a private practice. He also owns several infusion centers and brings in close to $500,000 a year as his salary.

 

[gclax30]

You can find ways to make money in ID if you really want to. I'm surprised that no one has mentioned infusion centers. The ID physicians who run these can easily make double the salary of the rest of their ID colleagues. My cousin is an ID physician who has a private practice. He also owns several infusion centers and brings in close to $500,000 a year as his salary.

And what exactly is an infusion center???

 

[angel80]

It's a place where patients go to get outpatient antibiotic infusions. For example, if a patient has osteomyelitis and needs IV antibiotics for 6-8 weeks, they can come to the infusion center everyday and get the antibiotics, instead of having to sit in a hospital or nursing home for 2 months. It saves the health care system a lot of money. A lot of these centers are operated by ID doctors. They get paid to give antibiotics, similar to the way that oncologists get paid to give chemo.

 

[193250]

It's been asked in other forums, but not anything too recent. Just wondering if you could do another fellowship after ID, and if so, what would be the best combo. Has anyone ever done Hema/Onc or CCM with ID before?

 

[augmel]

CCM and ID is a not uncommon combination. Dennis Maki at U Wisconsin is an ID doc who also works in the surgical ICU.

 

[193250]

CCM and ID is a not uncommon combination. Dennis Maki at U Wisconsin is an ID doc who also works in the surgical ICU.

Thank you for the reply. What is a typical day at work for him, if it's possible to say?

 

[augmel]

I'm not sure but I would guess that he switches between separate weeks in the ICU, research/academic time, and ID consult service. I know a renal/CCM guy who does 2 weeks a month of CCM then does a few scattered days of renal clinic to help out a local group.

 

[DiaHuq]

I don't know about good lifestyle, many of the ID doctors I know, work really long hours.
However all of the ones I have met are
1)passionate about it, they went into as mentioned above for their love of the subject
2)ID encompasses all of medicine and every organ system, It's a medical mystery where you have to use the sum total of what you learned during medical school/residency/etc.
3)There are many paths to go in ID: transplant, HIV, tropical, travel medicine, Infection control, epidemiology etc.
4)If you are interested in global health, amazing opportunities to make a change and earn some good karma 🙂

 

[JeetKuneDo]

It's a place where patients go to get outpatient antibiotic infusions. For example, if a patient has osteomyelitis and needs IV antibiotics for 6-8 weeks, they can come to the infusion center everyday and get the antibiotics, instead of having to sit in a hospital or nursing home for 2 months. It saves the health care system a lot of money. A lot of these centers are operated by ID doctors. They get paid to give antibiotics, similar to the way that oncologists get paid to give chemo.

Anyone know how common infusion centers are? This is probably just my ignorance and lack of knowledge, but this is the first time I've heard of infusion centers. Do most ID docs operate Infusion centers? Just wondering, are ID docs ever "on call" at infusion centers?

 

[Bluemirage]

Anyone know how common infusion centers are? This is probably just my ignorance and lack of knowledge, but this is the first time I've heard of infusion centers. Do most ID docs operate Infusion centers? Just wondering, are ID docs ever "on call" at infusion centers?

They are pretty common. Do a google search for infectious disease and infusion center and you will pull up a number of infectious disease practices in the community that offer infusion center services.

 

[Captopril]

I read this thread a few days ago and have become fascinated with the concept of infusion centers. I am definitely into ID, but income has always been a concern so I never took it too seriously as a possible track to pursue after IM. The whole infusion center bit changes things though...anyone have any further details about them? Are they difficult to open/run?