Here's what I posted in the other thread for you.
It's not rocket science. Private practice (or productivity based) income depends primarily on 2 things.
Volume.
Payer mix.
That's it.
Maybe you can scam some named academic professorship for an extra $100k/yr for being great or the only one in the division, or be a research god and chairman and command a slice of everyone's pie for a few hundred thousand more, but it's still all about volume and payer mix.
Work 3 1/2 days a week in an area/system full of Medicare/Medicaid/self pay/trauma and you're at the bottom, bust your hump in a practice full of insured patients and you're at the top. I know 2 ENT surgeons in the same group, though they have different subspecialties, one works like a dog 7-7, little vaca, but many 3 day weekends, and makes about $1M, the other works as little as possible, takes extra vacation, golfing 1/2 days at least 1 day a week, out early most days, etc. and barely makes over 300k. They're both thrilled with their jobs.
Some of these averages you see can exclude call compensation, which for a neurosurgeon can be very high. Split call with 2 other guys at a place offering 2-3k/night and you're looking at an extra 2-400k. But you're on call for trauma 120+ nights a year. Our neurosurgeons all make over $1m, and they work their a$$es off for it. Their first wives are very happy.
And as WS noted above, ownership of a procedural facility can be extremely lucrative as you are getting fees for your services plus a share of the facility fee. One group I looked at owned their own anesthesia billing company. Partners took home a share of the profits of that company for a very reasonable buy in. It was not a fortune, but ~20k a year in passive income for a profitable, established, growing, and independent business isn't a bad deal at all.
I didn't pick the highest paying job I was offered, but I thought long and hard about where I wanted to be to weather the coming storm and chose a place where I don't work very hard (50hrs/wk), take little call (<2x/month), have good vaca/non clinical time, and still make a good income because of efficiency in the system and good payer mix, and very important for me- a very long and very stable history at a growing practice that is a regional and national (and international) leader. I didn't want to relocate if at all possible. If you want to make as much money as possible, there are jobs for you, but you will work 2x as hard.
