Specialties that are 40 hours a week and pay well

[YCAGA]

I think you are reading wayyy to many negative nannies on the EM board. Sure EM is not as good as it was 5+ yrs ago where I would put it up against any specialty when you take into account it is 3 yrs.

You or I have no clue what the market will be in 3-5 yrs, no one does and it is useless to even predict. I heard the same thing 10 yrs ago and the gloom never came true. But you can say this for almost every specialty. You think Radiology is so great- ask them what the market was like 15 yrs ago.

All hospital based specialties complain like there is no tomorrow. Every time they came to the ER, they looked like someone stole their lunch money. Complaints left and right when I called them.

Patients never spit or physically attacked me. Maybe I am smart and stand far away from the dangerous looking one. Patients will scream and yell but its not that hard to walk away. Who cares if a stranger yells at you?

In 20 yrs of doing hospital based EM, I probably did 5 overnight shifts. We always had a nocturnist who we paid more. Even if we didn't have a nocturnist, I could always pay someone to do my nights. It all depends on if money or overnight sleep is more important to you. Did I also mention I never did Thanksgiving, Christmas, Christmas Eve? We just paid more and people picked them up.

To you point of a bad sleep schedule, I had a better sleep schedule than almost all of the specialist. I worked 9 hr shifts, 14 dys a month and avg about 450-500K plus benefits over 20 yrs. As I never did overnight, my latest shift was 1am, home by 130am, sleep by 2am where no one bothers me.

Talk to any OB/Gyn, Gen Surg, cards. Imagine having a full day schedule and taking overnight call. If they were lucky they would not get called in. But when they did and had a big surgery then they were up all night, then another full day clinic schedule the next dy. Miserable.

To your CMG point, almost every specialist is selling their souls. Radiology, Anesthesiology, Orthopedics, Cards, etc... Its rare to actually have an independent practice or small practice. Most are working for large hospital systems, CMGS, private equity and punch the clock just like most EM docs.

It’s honestly nice to hear a counterpoint to all the doom and gloom. Great post

---

Members don't see this ad.

 

[The Last Ankibender]

It’s honestly nice to hear a counterpoint to all the doom and gloom. Great post

This is sdn any field that doesn’t make 500k and work less than 40 hours is doom by their standard. Truth is medicine is not the same as before but is a field where you can make 200k with less than 40hours easy.

 

[Dr.SPAC3MAN]

Lol. The ones you know suck at negotiating. I'm in a large urban center on the east coast (pop. near 1M) and I haven't met an FM who works more than 40 hours a week, and nearly all are near or above 300k.

Nice to see you again Jack! Hope the ole ticker is doing alright.

 

[YCAGA]

This is sdn any field that doesn’t make 500k and work less than 40 hours is doom by their standard. Truth is medicine is not the same as before but is a field where you can make 200k with less than 40hours easy.

Or they have made the same mistake I have made and looked at the 75th percentile, not even 90th, for ortho spine...everything seems like peanuts once you see what 6 years of residency+fellowship could get you.

(Most likely kidding...there are a million reasons why this a joke...sad I have to say this but I know I do on SDN).

 

[Student189045]

What's your take on healthcare reform (e.g. public option, single payer, etc...)? Is it the death knell for physician salaries everyone says it is?

I’m not a doctor but imo there’s no logical reason why the government would continue to pay physicians at current rates. They would have a monopsony and could pay whatever they wanted. People say “physicians would leave the profession” but we all know most don’t have the skills to just becoming a software engineer or work on Wall Street. And there’s obviously no shortage of medical school applicants currently. If salaries were halved med school would still be competitive, likely less so, but still plenty of apps to fill the seats. Why wouldn’t they save money by paying as little as possible?

 

[The Last Ankibender]

I’m not a doctor but imo there’s no logical reason why the government would continue to pay physicians at current rates. They would have a monopsony and could pay whatever they wanted. People say “physicians would leave the profession” but we all know most don’t have the skills to just becoming a software engineer or work on Wall Street. And there’s obviously no shortage of medical school applicants currently. If salaries were halved med school would still be competitive, likely less so, but still plenty of apps to fill the seats. Why wouldn’t they save money by paying as little as possible?

Maybe because we same F*cking lives and the goverment dont want to saturated the fill with mediocre medical student because the smart ones will leave to do another profesion. If salary halves and debt stays the same

 

[ace_inhibitor111]

Averages online are always wrong. Check the Ophtho forum for better #s. Very poor response rate + response bias online. If you're a comprehensive Ophtho in private practice (most), you should be able to get $500k on 45 hours a week, provided you aren't in New York, Cali. Retina? 600-700k. Much higher is possible, but that requires much more effort (and I don't mean more hours working). There is even the rare pure cataract position that easily nets 7 figures in under 50 hrs/w. Emphasis on rare.

Ophtho is competitive because it's basically the only specialty still majority private practice, offers a lifestyle on par with Derm (and very friendly to part-time in late life), is cool as ****, and has that wonderful mix of clinic and OR. The great pay is more of an afterthought here, but sky is the limit depending on your business skills. $/hr in Ophtho is very high.

It should be known that to be get that salary you have to gain partnership, which means a buy-in, anywhere from $500k-$1mil of your income over 5 years, taken from your paycheck. You can start your own business, but will be making 150k-200k net for several years until you gain traction. The end salary is good but you probably won’t reach those numbers until 6-8 years after residency.

 

[VA Hopeful Dr]

Maybe because we same F*cking lives and the goverment dont want to saturated the fill with mediocre medical student because the smart ones will leave to do another profesion. If salary halves and debt stays the same

So which jobs will droves of doctors leave to do, exactly?

I think you will see lots of older doctors pull the trigger on retirement. But I'd wager that most of the rest of us don't have skills that could land jobs for even half what current doctor pay is.

 

[sunshinefl]

So which jobs will droves of doctors leave to do, exactly?

I think you will see lots of older doctors pull the trigger on retirement. But I'd wager that most of the rest of us don't have skills that could land jobs for even half what current doctor pay is.

Not current doctors, but would be new doctors avoiding entering the field to begin with..

 

[VA Hopeful Dr]

Not current doctors, but would be new doctors avoiding entering the field to begin with..

Doubt it. Look how competitive med school is in countries that don't pay anywhere near what we do.

 

[Chibucks15]

Doubt it. Look how competitive med school is in countries that don't pay anywhere near what we do.

People underestimate the stability of the job being a large factor too. I know for a fact there’s a lot of students like me who’s family got slammed during the 08 recession and Jon stability is one of the big reasons I went through med school. Pair that with the good pay and the overrated nature of classic office nonsense jobs and it’s the best gig out there

 

[Thesimplelifeofamyloid]

Doubt it. Look how competitive med school is in countries that don't pay anywhere near what we do.

Look at the NHS in the UK. Pay is at most 120k a year for physicians. The NHS is bleeding doctors, sadly. They started to have nurses carry surgeries because there's not enough doctors. The best places for attending physicians in terms of compensation are consistently the US, Canada, Australia and Switzerland .

Nurses 'will be trained to perform surgery' in bid to slash NHS waiting times

NURSES are to be trained to perform certain surgeries as part of new plans to halt a rise in NHS waiting times. The plans will see nurses given the option to take a two-year course to qualify as &#…

www.thesun.co.uk

 

[VA Hopeful Dr]

Look at the NHS in the UK. The NHS is bleeding doctors, sadly. They started to have nurses carry surgeries because there's not enough doctors

Nurses to carry out surgery under NHS plans to slash waiting times

Nursing staff will be urged to undertake a two year course to become 'surgical care practitioners'

www.telegraph.co.uk

Paywall

 

[Thesimplelifeofamyloid]

Paywall

Updated to different source

 

[The Last Ankibender]

People underestimate the stability of the job being a large factor too. I know for a fact there’s a lot of students like me who’s family got slammed during the 08 recession and Jon stability is one of the big reasons I went through med school. Pair that with the good pay and the overrated nature of classic office nonsense jobs and it’s the best gig out there

True, job stability is nice

 

[VA Hopeful Dr]

Updated to different source

Great, thanks!

So they also have a severe nursing shortage it seems. That suggests the problem is something intrinsic to the NHS in the UK and not to physicians alone.

 

[YCAGA]

Look at the NHS in the UK. Pay is at most 120k a year for physicians. The NHS is bleeding doctors, sadly. They started to have nurses carry surgeries because there's not enough doctors. The best places for attending physicians in terms of compensation are consistently the US, Canada, Australia and Switzerland .

Nurses 'will be trained to perform surgery' in bid to slash NHS waiting times

NURSES are to be trained to perform certain surgeries as part of new plans to halt a rise in NHS waiting times. The plans will see nurses given the option to take a two-year course to qualify as &#…

www.thesun.co.uk

This discussion is always funny to me. Do people really think it is politically tenable to cut physician pay to max $150k a year in a single-payer system, when specialists currently make a median $300-500k in dozens of specialties? If it was such an easy way of cutting costs, it would have happened in countries with similar GDP/capita but better insurance coverage like the Netherlands, Switzerland, Australia and Canada. These countries spend significantly less than the US on healthcare per capita, but they still pay specialists maybe 75-100% of US salaries. 3 out of 4 of those countries do not even have single-payer yet still achieve much better insurance coverage of their population for lower costs. There are almost 1 million physicians in the US and many have a lot of respect and lobbying power in their communities. Are we just going to roll over, not unionize (physicians are unionized in every high-income Western country I know of other than the US), and accept giant pay cuts?

In a hypothetical world of 75-100% of physician salaries but with the same level of prestige, job security, and sense of purpose (at least before they become salty SDN attendings), there will be no change in the quality of applicants to US medical schools. Nor would it stop the 12,000+ IMGs that come to the US every year for residency because the US is one of the best gigs in the world, and would remain so in a more government controlled healthcare system.

 

[Beans203]

Can anyone speak a little bit about the pay and lifestyle of private practice ENT? It’s hard to get a good sense of it in medical school when all the attendings are doing super complex multiple hour head and neck reconstructions/skull base surgeries/etc, which is probably not representative of the lifestyle of an average community ENT. @efle or anyone else with info

 

[efle]

ENT 25th/median/75th is 358k / 452k / 595k

regional

East 355 443 589
Midwest 376 463 598
South 324 400 600
West 392 452 581

 

[FireInWonderland]

It heavily depends on practice setting

Yes, this is true; but therein lies the problem with the question. Many specialties can be 40hrs/week depending on the practice setting, but that doesn't necessarily make it the norm.

 

[BuildingMyOwnLuck]

I’m not a doctor but imo there’s no logical reason why the government would continue to pay physicians at current rates. They would have a monopsony and could pay whatever they wanted.
...
Why wouldn’t they save money by paying as little as possible?

At that point, it is really not worth wasting 12+ years of your life (including some very stressful years) to get a measly salary, not including the hundreds of thousands of dollars of interest accruing debt. Plus, don't hospitals already pay 100kish for some NPs?

The natural course for admins would be to lower nurses' salaries too, but if there's 1 thing AANP is great at, it is lobbying. So while that battle is going on, the physicians will finally have a real reason to start seriously lobbying as well. Which will create a massive mess for admins.

Just my 2c

 

[bochaw]

How about im subspecialty like rheum and endocrine?

 

[Prehealth1011]

How about im subspecialty like rheum and endocrine?

Doesn’t fall under the “pay well” part for many people

 

[efle]

How about im subspecialty like rheum and endocrine?

unfortunately those are similar to FM/unspecialized IM in terms of $/hr

Spoiler: hourly by specialty

 

[bochaw]

is that from recent survey? I think last couple years those subspecialties had increased in salary

unfortunately those are similar to FM/unspecialized IM in terms of $/hr

Spoiler: hourly by specialty

View attachment 331817

 

[confuzzled10]

unfortunately those are similar to FM/unspecialized IM in terms of $/hr

Spoiler: hourly by specialty

View attachment 331817

where did you get this? I thought EM was at least in the 200 range.

 

[efle]

here's the manuscript, the data isn't perfect (globally lower than MGMA) but it's good for getting a gist of where each field falls

http://www.rimed.org/rimedicaljournal/2018/10/2018-10-50-cont-eltorai.pdf

320k isn't wildly inaccurate for emed, but the hours are too high, most EM docs work a lot less than 45 hours per week. This is useful for the general ordering rather than the exact figures

where did you get this? I thought EM was at least in the 200 range.

 

[Splenda88]

is that from recent survey? I think last couple years those subspecialties had increased in salary

These numbers seem low


I am seeing $115-125/hr for IM hospitalist.

 

[VA Hopeful Dr]

These numbers seem low


I am seeing $115-125/hr for IM hospitalist.

And $80/hour for FM is ludicrous. My starting salary at my current job was 96/hour and that's on the lower end of starting salaries for FM. Now that I'm busy it's always over 140/hour, usually 180+.

 

[emergentmd]

This data is completely wrong. I would say the avg EM still makes close to 200/hr.

 

[Thesimplelifeofamyloid]

And $80/hour for FM is ludicrous. My starting salary at my current job was 96/hour and that's on the lower end of starting salaries for FM. Now that I'm busy it's always over 140/hour, usually 180+.

I was working in a clinic and a NP told us he was getting 110/hour offers. He had a lot of experience though

 

[VA Hopeful Dr]

I was working in a clinic and a NP told us he was getting 110/hour offers. He had a lot of experience though

NPs are usually salaried, physicians often aren't so our ceiling is significantly higher.

 

[Cauchy]

I was working in a clinic and a NP told us he was getting 110/hour offers. He had a lot of experience though

$210k per year isn’t bad for a 1 year online degree.

 

[Splenda88]

NPs are usually salaried, physicians often aren't so our ceiling is significantly higher.

But $110/hr for a NP in primary care is extremely good.

 

[Thesimplelifeofamyloid]

NPs are usually salaried, physicians often aren't so our ceiling is significantly higher.

$210k per year isn’t bad for a 1 year online degree.

Probably should add it was for a startup type business, where you admistered rejuvenating detoxifers via IV or something like that.

 

[9blade]

I was working in a clinic and a NP told us he was getting 110/hour offers. He had a lot of experience though

not a bad gig

 

[BuildingMyOwnLuck]

here's the manuscript, the data isn't perfect (globally lower than MGMA) but it's good for getting a gist of where each field falls

http://www.rimed.org/rimedicaljournal/2018/10/2018-10-50-cont-eltorai.pdf

320k isn't wildly inaccurate for emed, but the hours are too high, most EM docs work a lot less than 45 hours per week. This is useful for the general ordering rather than the exact figures

What's up with 70h/week for vascular? 60 is bad enough already. Is there cocaine in the physician lounge to make them keep going or something? Genuinely curious why they put themselves through that.

 

[efle]

What's up with 70h/week for vascular? 60 is bad enough already. Is there cocaine in the physician lounge to make them keep going or something? Genuinely curious why they put themselves through that.

Dont ask me dude. I dont know why anyone picks any of the hardcore surgical fields. Then again, there was some study in psych that showed many people would rather self-administer mild shocks than sit quietly with their thoughts, so...

 

[subparman]

Maybe because we same F*cking lives and the goverment dont want to saturated the fill with mediocre medical student because the smart ones will leave to do another profesion. If salary halves and debt stays the same

you'd think, but it's politicians we're talking about. they're either making money pretending to solve a problem, or creating a problem to campaign over and make money from.