surgeons making millions

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doc-oc!

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I've heard that salaries certain surgery subspecialties can range from 500 k to million(s) of dollars per year. Does anybody know what distinguishes those making 6 figure salaries and those making 7 figure salaries?
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doc-oc! said:
I've heard that salaries certain surgery subspecialties can range from 500 k to million(s) of dollars per year. Does anybody know what distinguishes those making 6 figure salaries and those making 7 figure salaries?
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I know a general surgeon who allegedly pulls 1.5 million per year. He works like a dog. Very efficient in the OR. He does a ton of outpatient surgery center procedures. Obviously he's well into his practice and has a well oiled machine.
 
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lazymed said:
I know a general surgeon who allegedly pulls 1.5 million per year. He works like a dog. Very efficient in the OR. He does a ton of outpatient surgery center procedures. Obviously he's well into his practice and has a well oiled machine.
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Is he part owner of the ASC? Taking home facility fee in addition to the technical can increase revenue.
 
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.
 
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doc-oc! said:
I've heard that salaries certain surgery subspecialties can range from 500 k to million(s) of dollars per year. Does anybody know what distinguishes those making 6 figure salaries and those making 7 figure salaries?
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Yeah right. You are truly misinformed about the reality of the medical profession if you think surgeons make "millions of dollars". You are way off about the salary range as well.

There are some who can make close to a million but not "millions of dollars". Very few doctors earn that kind of money.
 
An easier way to make millions as a surgeon is probably to just work a reasonable load and use your free time to invest in some property in high growth areas. One day those properties/investments will probably make more money for you than your job. I think the real benefit of having a high paying job isn't necessarily the high pay but the fact that that level of income allows you to own other things. Capitalism.
 
Experience. Obviously you're not gonna land a top paying job right after finishing training.

Heads of ortho, cardio thoracic, and transplant divisions at my state school (academic med!) are all pulling in $1mil+.

I verified this through an annual state employee salary database based on tax returns.

Cleveland Clinic has a million dollar club of like 18 senior docs.

And so on and so on. It's a lot more common than you probably think.
 
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Seth Joo said:
Yeah right. You are truly misinformed about the reality of the medical profession if you think surgeons make "millions of dollars". You are way off about the salary range as well.

There are some who can make close to a million but not "millions of dollars". Very few doctors earn that kind of money.
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Actually, OP said "salaries (0f) certain surgery subspecialties can range from 500 k to million(s)" so if one person makes millions the range is correct. And they're out there, my friend.

Seth Joo said:
The last two are not medical doctors. I think the last one only graduated high school, but he is still rich.
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He/she knows that.
 
I don't think you will ever see a salary that high unless you own the practice or bussiness group. At that point it is more of a business income than just surgical revenue.
 
Seth Joo said:
Yeah right. You are truly misinformed about the reality of the medical profession if you think surgeons make "millions of dollars". You are way off about the salary range as well.

There are some who can make close to a million but not "millions of dollars". Very few doctors earn that kind of money.
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You are right that very few do, but some do, and OP is asking what the difference is.

UPMC publishes the salaries of its top paid employees. After the CEO ($6.5M) and his second (2.4), several surgeons are paid well above a million. The top of the list, in the 2 million range, are department heads from neurosurg, peds cardiothoracic, and... hmmm... trauma surgery? I think that is right. Google if you want exact figures. These are a just the ones paid by UPMC. I'd wager that there are a few more paid by UPP (University of Pittsburgh Physicians) who make as much or more, but aren't required to disclose it.

So, some surgeons do earn millions. Not a lot, but some.
 
Mad institutional prestige + mad research to get into a top specialty and consequently hired by a top-paying hospital.
Connections.
Business sense.
Own the practice.
Own the surg center.
Own as many profitable things as you can.
 
http://www.utimes.pitt.edu/?p=16613

These figures are a couple years out of date. The specifics shift a little year to year, but there are surgeons who are certainly paid millions.

Note the ones paid by UPP. The compensation figures listed are not their total income for the year. It only represents the portion of their income that was directly paid by UPMC, disclosed in its IRS filing. Compensation from their employment as faculty at Pitt is not included, nor is any private practice or other income derived from clinical activities outside UPMC employment. Not all income sources are matters of public disclosure.

So... how does one pull down millions as a doctor? From what I can see here:

1. Be important in a department at a major university health system, and
2. Do a lot of surgery, so that you are a profit center for the institution.

It is possible, if that is the life you want, and you are very lucky, and very good... then all you have to do is be willing to make all the sacrifices necessary to get there.
 
Maybe if you buy a surgery center
 
If you want get rich in medicine, become a surgeon... There is no primary care doc in that list🙁

No wonder physicians here have been saying that a lot of these salary surveys are bogus...
 
Yeah, the couple surgeons I personally know pulling well into seven figures do it from a combination of business income and the fact that they're 100% OR with insane volume... all their office followup is done by midlevels (note, there are some ethical issues with this).

I'm not surgical so my compensation is below what most of the surgeons on this board would consider acceptable, but I also have a pretty cushy job right now. I would get paid a lot more by working farther out in the suburbs or working more hours in a private setting, but I have the advantage of less debt than most people, and quite simply I know a lot of miserable people in medicine who don't protect their lifestyle. There are few professions that pay as much as I get for 40 hours per week, and few jobs in medicine with such a low RVU requirement than what I have.
 
WingedOx said:
Yeah, the couple surgeons I personally know pulling well into seven figures do it from a combination of business income and the fact that they're 100% OR with insane volume... all their office followup is done by midlevels (note, there are some ethical issues with this).

I'm not surgical so my compensation is below what most of the surgeons on this board would consider acceptable, but I also have a pretty cushy job right now. I would get paid a lot more by working farther out in the suburbs or working more hours in a private setting, but I have the advantage of less debt than most people, and quite simply I know a lot of miserable people in medicine who don't protect their lifestyle. There are few professions that pay as much as I get for 40 hours per week, and few jobs in medicine with such a low RVU requirement than what I have.
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I guess patients' well-being be damned!
 
This obituary caught my eye. Granted, this guy didn't make bank until he was in his 80s but
"In 1981, Dr. Balazs, his wife and his son, Andre, founded Biomatrix, a biotechnology company that developed six hyaluronan products. It was sold in 2000 to Genzyme for an estimated $738 million."
 
Lucca said:
An easier way to make millions as a surgeon is probably to just work a reasonable load and use your free time to invest in some property in high growth areas. One day those properties/investments will probably make more money for you than your job. I think the real benefit of having a high paying job isn't necessarily the high pay but the fact that that level of income allows you to own other things. Capitalism.
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Yeah it's all about diversifying your income. Stock investments is a good starter point.
 
WFU2015 said:
My friend's dad is an orthopedic spinal surgeon and he is absolutely loaded. 19,000 square foot house in the best neighborhood in Philadelphia loaded. However, he is also head of ortho at a med school, president of a hospital, has 650+ publications, orthopedic surgeon for the Eagles, on tons of committees and boards, etc. Hope that helps to answer your question OP. His kid hates it, dad works so much they never see him
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That's tight. You can make a great living from sports medicine alone I heard.
 
W19 said:
If you want get rich in medicine, become a surgeon... There is no primary care doc in that list🙁

No wonder physicians here have been saying that a lot of these salary surveys are bogus...
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This is actually true, but for those of us at DO schools the odds are stacked against us for becoming surgeons and specialists, many DO schools like to state that DO students want to become primary care doctors, but this is false, because of high debt levels, and most DO schools are private with tuition and fees that are higher than MD institutions we tend to carry higher levels of student debt.

I saw the example of a CEO of a Health System, that does not mean much in my view, most surgeons make a great living compare to the average American worker, but very few earn millions a year. And whatever they earn they work extremely hard for that money anyway.
 
500k is not unheard of in oral surgery (the average is 460, and 600 for top 25%), and no you don't have to work like a dog (averages are 41 and 45 hours respectively).
 
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allantois said:
500k is not unheard of in oral surgery, and no you don't have to work like a dog, that is more than 40 hours a week (actually, the average is 38 hours).
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Most surgeons work more than double that.
 
SouthernSurgeon said:
Explain the ethical issue with having mid level providers take care of routine postop care?
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American Academy of [that guy's specialty] frowns upon it from what I remember. hardly a hard and fast ethical contraindication. More of a facial expression than a policy.

I'll defer to those of you who actually cut people though. I have enough ethical pitfalls in my own specialty to manage.
 
WingedOx said:
That Ferrari looks really good when you're driving 3 MPH on the 405 during your morning commute.
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Many of those high performance European cars are such a wasteful indulgence anyway. It would be better to rent one for a day and drive it like it was meant to be driven on a private road or race track. There are places where you can actually do this.
 
Seth Joo said:
Many of those high performance European cars are such a wasteful indulgence anyway. It would be better to rent one for a day and drive it like it was meant to be driven on a private road or race track. There are places where you can actually do this.
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I think if you work that hard for such a long time and sacrifice so much you want to walk to your garage in the morning and feel excited and awesome about what you drive, not really about driving the car to its potential.
 
I know at Hospital for Special Surgery, the #1 orthopedic program in the country where all the famous athletes go, the orthopedists are pulling in 3-5 mil. It's located in downtown Manhattan and they make like 10-14k a surgery and they operate 3/5 days of the week. James Andrews (most famous orthopedic surgeon) owns his own hospital...he prob pulls in 5-10Mil a year.. but if your aiming to make seven figures this is def not the profession to go into.
 
youngmo said:
I know at Hospital for Special Surgery, the #1 orthopedic program in the country where all the famous athletes go, the orthopedists are pulling in 3-5 mil. It's located in downtown Manhattan and they make like 10-14k a surgery and they operate 3/5 days of the week. James Andrews (most famous orthopedic surgeon) owns his own hospital...he prob pulls in 5-10Mil a year..
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...how do you know they pull 3-5 million?
 
youngmo said:
I know at Hospital for Special Surgery, the #1 orthopedic program in the country where all the famous athletes go, the orthopedists are pulling in 3-5 mil. It's located in downtown Manhattan and they make like 10-14k a surgery and they operate 3/5 days of the week. James Andrews (most famous orthopedic surgeon) owns his own hospital...he prob pulls in 5-10Mil a year..
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That's sadly still such low reimbursement for how hard those masochists work (IMO layman opinion).
 
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