Understanding Pay for EM Physicians

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yurtboat

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Hello all,

I'm wondering about the compensation rates and employment types for EM physicians.

Correct me where I'm wrong as I'm sure don't have this all straight


Independent contractors (1099 workers)
- Paid per hour. Probably the highest income, can exceed 400k but is liable for indemnity cover, accountant bills, no pension, no medical/dental. Can have a recurring contract with a hospital for years or can locum on the road.

Salaried Positions
- Somewhere from 200-300k. May include benefits. Tax deducted from payroll. Has a commitment to X number of hours which will include unsociable.

Salaried / Incentive - Lower salary but includes incentives regarding turnover. Rewards productivity.

Academic Positions - Lower rate of pay, typically 180k - 220k. Usually has good benefits. Typically involves heavy clinical work in urban Tertiary centers. Potential to progress to APD or PD.

Democratic Group
- Typically paid per hour 150-300 plus incentives. Can sacrifice salary for shares in group.

Urgent Care - I have no idea.

Thank you.

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Hello all,

I'm wondering about the compensation rates and employment types for EM physicians.

Correct me where I'm wrong as I'm sure don't have this all straight


Independent contractors (1099 workers)
- Paid per hour. Probably the highest income, can exceed 400k but is liable for indemnity cover, accountant bills, no pension, no medical/dental. Can have a recurring contract with a hospital for years or can locum on the road.

Salaried Positions
- Somewhere from 200-300k. May include benefits. Tax deducted from payroll. Has a commitment to X number of hours which will include unsociable.

Salaried / Incentive - Lower salary but includes incentives regarding turnover. Rewards productivity.

Academic Positions - Lower rate of pay, typically 180k - 220k. Usually has good benefits. Typically involves heavy clinical work in urban Tertiary centers. Potential to progress to APD or PD.

Democratic Group
- Typically paid per hour 150-300 plus incentives. Can sacrifice salary for shares in group.

Urgent Care - I have no idea.

Thank you.


In one way, you are oversimplifying it, in another you are overcomplicating it. I only know of 1099 jobs that pay malpractice and it isn't necessarily only hourly - could be RVU. Salary positions can be higher. Academics can pay more, and I think a couple places may actually pay less. Some places are entirely RVU.

Basically, pay breaks down as follows:
Strictly hourly vs. hourly + RVU/incentive vs. strictly RVU.

Payment can be on a W2, 1099 or K1. There are positives and negatives for all.

Employers can be hospital or group. Academic, Private practice or a hybrid.

Pay should be higher when you don't get benefits, but that doesn't mean they always are.
 
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Hello all,

I'm wondering about the compensation rates and employment types for EM physicians.

Correct me where I'm wrong as I'm sure don't have this all straight


Independent contractors (1099 workers)
- Paid per hour. Probably the highest income, can exceed 400k but is liable for indemnity cover, accountant bills, no pension, no medical/dental. Can have a recurring contract with a hospital for years or can locum on the road.

Salaried Positions
- Somewhere from 200-300k. May include benefits. Tax deducted from payroll. Has a commitment to X number of hours which will include unsociable.

Salaried / Incentive - Lower salary but includes incentives regarding turnover. Rewards productivity.

Academic Positions - Lower rate of pay, typically 180k - 220k. Usually has good benefits. Typically involves heavy clinical work in urban Tertiary centers. Potential to progress to APD or PD.

Democratic Group
- Typically paid per hour 150-300 plus incentives. Can sacrifice salary for shares in group.

Urgent Care - I have no idea.

Thank you.

I'm not even sure what to say to this except I applaud your desire to understand.

Independent contractors are paid on a 1099. True. They're the highest paid. Not necessarily true, but generally expect your gross pay to be higher than that of an employee since no one is covering your benefits or half of your payroll taxes (nor withholding taxes for you.)
Partners are paid on a K-1. Very unusual for a partner to only make $150 an hour. $200-400/hour more typical. If the group isn't democratic and you're milking a bunch of employees/partners of some other class then this is probably the highest paid EM position.
Employees are paid on a W-2. Academic docs are generally but not always employees and since academic activities don't generally bring in much money (except research grants) they do tend to be paid less than someone that is 100% clinical. But pay is still highly variable.

If you own an urgent care, a group, or a free-standing ED you have more risk but potentially more reward as you wear two hats- physician and businessman.
 
If Trump's tax plan passes and independent contractors are taxed at corporate rates (15%), there will be a flood of EM physicians flocking to IC jobs.

I can virtually guarantee you now that this won't happen. The proposed cut has already gone down from 15% to 35%, and legislators specifically mentioned excluding pass through entities (like the PLLCs and S corps that most of us ICs have) from the tax cuts. These cuts are all for the multinational corporations, never intended you or me.
 
Yeah, sorry dude its complicated. I work three different hospitals in the same townish and they each got different pay rates and schedules.

Not sure why but IC recruiters keep trying to get me to work in the boonies 2 hours out from town and the pay rate is lower than my main site where im an employee. Maybe I should try and negotiate ? Maybe cause its less patients per hour ?

Couple years out and its still a mystery. Id try not to worry bout it too much till you're actually applying for jobs. Apply to a couple regions, a couple practice types and compare with contract and pay rate in hand.

(But know even then it's still potentially opaque if there's an sdg in play. I applied to a couple who wouldnt tell me what the rate would be if I made partner cause that info was confidential )
 
I can virtually guarantee you now that this won't happen. The proposed cut has already gone down from 15% to 35%, and legislators specifically mentioned excluding pass through entities (like the PLLCs and S corps that most of us ICs have) from the tax cuts. These cuts are all for the multinational corporations, never intended you or me.

I don't have high hopes of it passing, but anything is possible with this administration.
 
Except passing meaningful legislation apparently....

Correctly. The "Swamp Creatures" posing as Republicans are too beholden to the special interests to have meaningful tax reform. They are also afraid of being painted as "cruel" by the opposition.

The reality is that large corporations DO need a tax cut if the goal of the tax cut is to create jobs and expand the economy. As much as I would welcome a tax cut for myself, cutting taxes for passthrough corporations is unlikely to create significant business expansion and employment.
 
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Corporations who get tax cuts DO NOT create jobs and expand the economy. They use the money primarily for stock buybacks to increase their stock prices, and mergers and acquisitions, which leads to more layoffs, which has happened time and time again with every single corporate tax cut.
 
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Corporations who get tax cuts DO NOT create jobs and expand the economy. They use the money primarily for stock buybacks to increase their stock prices, and mergers and acquisitions, which leads to more layoffs, which has happened time and time again with every single corporate tax cut.

As opposed to the ones who get tax increases, who move their jobs overseas and shutter their U.S. operations entirely. Sorry, I don't buy this left-wing load of BS.
 
...and I don't buy your completely unproven BS republican talking point either, sorry. Corporations that moved their operations overseas did so because of labor costs, not taxation.

You can drive a truck through the corporate tax loopholes in this country, with the end result being corporations paying next to nothing in taxes. Verizon's tax rate last year was actually a NEGATIVE net rate.

Also, way to completely move the goalposts in the discussion. First it was 'corporations expand the economy when given tax cuts', and when called out on that, then it was 'corporations move overseas when you increase their taxes'.
 
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Also, way to completely move the goalposts in the discussion. First it was 'corporations expand the economy when given tax cuts', and when called out on that, then it was 'corporations move overseas when you increase their taxes'.

Both of those things are economically correct.
 
I'm not going to bother trying to convince people that a dollar kept in the private sector does more than a dollar taken by government. If you don't fundamentally believe that philosophy, then we will have to agree to disagree.
 
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