WaPO: Physician salaries

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Kryptocoin

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We're usually top 3 for most of the bad stuff in medicine (early death, burnout, lawsuits, poor sleep etc) . For pay, we're #39. Behind pathology.
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Years are 2005-2017. I know for interventional pain which is highlighted above the reimbursement has taken a nosedive since then. Recent MGMA 50th percentile median total compensation including benefits is like 450-500k if I recall. Anecdotally it seems like EM has remained flat over the years. With inflation that’s a pay cut, too, but some specialties have seen it even worse.
 
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RadOnc sub forum covering this very well:

Agree. Actually salary data here represents, by and large, much more than 6 years ago.

So we have wistful ruminations on a 2018 test and outdated information with a one line narrative that radonc is paid better per work performed than any other specialty.

The pertinent points of the articles are:

1. The boomers had it good (Like perhaps the most privileged population of college educated folks ever. This is peak return on college generation).

2. Peak radonc was begat by peak compensation

3. There has historically been a very wealthy physician ownership class. This is a dwindling population (largely boomers) and many have benefited from sale to PE or larger systems in recent years. Pareto gets more pareto. Late stage capitalism has less room for rich professionals.

4. Physician compensation has never been the main driver of health care expenditures

A narrative that is no longer pertinent: That radoncs are compensated better per hour worked than any other specialty. This may have been true at one point in time.

In the absence of physician ownership and overwhelming employment or PSA arrangements, Supply/demand is king.

Listen to the stories of the persons on this board. They represent reality. Some of the PP owners here are honest about how much they made in the former era. How good are young faculty feeling relative to the whims of their institutions/departments. How good are a lot of younger radoncs feeling about their career choice. Don't ask 2nd year faculty BTW, they are completely aspirational, ask docs 5-10 years into their career (at that point, they are getting a sense of whether or not they are building something meaningful).

Second year was about when I started to realize that we aren’t all in this together.
 
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GatorCHOMPions said:
Years are 2005-2017. I know for interventional pain which is highlighted above the reimbursement has taken a nosedive since then. Recent MGMA 50th percentile median total compensation including benefits is like 450-500k if I recall. Anecdotally it seems like EM has remained flat over the years. With inflation that’s a pay cut, too, but some specialties have seen it even worse.
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Weren't those the golden years for EM though? We were ranked pretty low even during the peak earnings decade. I do agree that some specialties have since taken some sizable haircuts, particularly Rad Onc.

I'm surprised how high IP is ranked. But then again that time period was also during the opiate epidemic.
 
always.chillin said:
This author is a clown. Why doesn't he go hate on mainstream celebrities and the millions they make annually for the garbage they contribute to our society instead of making it seem like physicians are overpaid. I don't know a single ER physician who works 44/hours per week and clears $343k, especially at the ripe age of 40 per this article. I work just over 40 hours/week and my total comp over the next 12 months will be twice the quoted number in this article.
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So you make $330-350/hr? That's not the norm at all.
 
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A little surprised by how high hem-onc is. Always thought of it as more of a 350-400k kind of a specialty. Old data but is heme-onc really breaking 600k on average?

@Birdstrike - are you pulling 700k as interventional pain? What’s the average now?
 
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Kryptocoin said:
So you make $330-350/hr? That's not the norm at all.
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It’s not the norm, but definitely possible. A sdg near me averages 350/hr. Everyone is partner starting day 1, no buy in.

Terrible staffing by choice to maximize income. 3 pph on average.
 
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Doctor salaries, esp EM is typically higher than what is stated.

There are lost of semi retired, part timers, momma track docs who work 1/4-1//2 time. These numbers are no way full time esp for 40 hrs/wk EM Docs.
 
Kryptocoin said:

Error - Cookies Turned Off

onlinelibrary.wiley.com onlinelibrary.wiley.com

This was a UK study. Average EM was 58, anesthesiologists and radiologists was 75.
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Is EM an actual specialty there? That study seems very… odd.

I get that shift work is unhealthy but a near 20 year difference between EM and the next lowest specialty really makes me wonder how accurate that can be. You guys aren’t the only field that works nights I don’t see why you’d be SUCH an outlier
 
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Umm if you’re working 176 hours a month and only getting $343k, you need a new job.
 
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HemeOncHopeful19 said:
Is EM an actual specialty there? That study seems very… odd.

I get that shift work is unhealthy but a near 20 year difference between EM and the next lowest specialty really makes me wonder how accurate that can be. You guys aren’t the only field that works nights I don’t see why you’d be SUCH an outlier
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From the article:
"general practitioners living the longest and emergency physicians the shortest, with proportionately more accidental deaths. Likely due to its recency as a separate specialty, the emergency physician group is the smallest, which may censor and falsely reduce this group's age at death."

TL;DR: the authors think the data is suspect as well, and they attribute it to our extreme sports hobbies.
 
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HemeOncHopeful19 said:
Is EM an actual specialty there? That study seems very… odd.

I get that shift work is unhealthy but a near 20 year difference between EM and the next lowest specialty really makes me wonder how accurate that can be. You guys aren’t the only field that works nights I don’t see why you’d be SUCH an outlier
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It's a bit of an outlier, I agree. However, EM is unique in the shift work arena that's why we're #1 in burnout. I've driven home once or twice drowsy after working a night shift. Luckily no accidents but it has made me limit the number of nights I work per month to a max of 4. Hope to bring that number to zero in the near future.
 
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Wtf is phlebology lol
Even that gets more than us
OTOH I never have to get up before noon
 
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Kryptocoin said:
I've driven home once or twice drowsy after working a night shift. Luckily no accidents but it has made me limit the number of nights I work per month to a max of 4. Hope to bring that number to zero in the near future.
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Yeah that’s scary man. I think we’ve all been there at some point. If the math made sense, I’d ditch driving for rideshare on my work commute.
 
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bravotwozero said:
Yeah that’s scary man. I think we’ve all been there at some point. If the math made sense, I’d ditch driving for rideshare on my work commute.
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Hopefully we'll have complete self-driving cars in our lifetime.
 
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Tenk said:
Umm if you’re working 176 hours a month and only getting $343k, you need a new job.
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Must be working for USACS in Denver.

They offered me $125/hour in 2018. I noped out of there faster than the Millennium Falcon jumping to hyperspace.

Punch it, Chewie.

Screenshot 2023-08-05 at 3.54.17 PM.png
 
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cyanide12345678 said:
A little surprised by how high hem-onc is. Always thought of it as more of a 350-400k kind of a specialty. Old data but is heme-onc really breaking 600k on average?

@Birdstrike - are you pulling 700k as interventional pain? What’s the average now?
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I don't know that 600K is average these days, but I wouldn't be surprised if the median was north of 500K. Infusion income can really bump the numbers up if you get a piece of that.
 
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cyanide12345678 said:
A little surprised by how high hem-onc is. Always thought of it as more of a 350-400k kind of a specialty. Old data but is heme-onc really breaking 600k on average?

@Birdstrike - are you pulling 700k as interventional pain? What’s the average now?
Click to expand...
This is hospitalist money these days.
 
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cyanide12345678 said:
A little surprised by how high hem-onc is. Always thought of it as more of a 350-400k kind of a specialty. Old data but is heme-onc really breaking 600k on average?

@Birdstrike - are you pulling 700k as interventional pain? What’s the average now?
Click to expand...
No. Not sure what the average is.
 
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Kryptocoin said:
It's a bit of an outlier, I agree. However, EM is unique in the shift work arena that's why we're #1 in burnout. I've driven home once or twice drowsy after working a night shift. Luckily no accidents but it has made me limit the number of nights I work per month to a max of 4. Hope to bring that number to zero in the near future.
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I have a 1 hour 10 minute commute from one of my rural sites. I’ve had too many days where I’ve been just almost falling asleep. Once I think i did fall asleep for 1-1.5 miles on a Highway. Usually i get sleep at work on night shift, the few days i don’t, it’s a genuine struggle to get home.
 
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cyanide12345678 said:
I have a 1 hour 10 minute commute from one of my rural sites. I’ve had too many days where I’ve been just almost falling asleep. Once I think i did fall asleep for 1-1.5 miles on a Highway. Usually i get sleep at work on night shift, the few days i don’t, it’s a genuine struggle to get home.
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I just got into a car accident falling asleep. Totaled my car. It was after a morning shift of all things!
So I bought a tesla so it can drive for me (theoretically) if I fall asleep.
Problem is if you fall asleep...it takes you out of autopilot. Stupid. It should be the opposite.
 
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thegenius said:
I just got into a car accident falling asleep. Totaled my car. It was after a morning shift of all things!
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Exact same thing happened to me a few months back.
 
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This chart is flawed.

Lists nephro, "hypertension specialist", allergy, etc maling more than EM.

The medican for onc is def not 600k.

Once again, this forums skews ridiculous.
 
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cyanide12345678 said:
A little surprised by how high hem-onc is. Always thought of it as more of a 350-400k kind of a specialty. Old data but is heme-onc really breaking 600k on average?

@Birdstrike - are you pulling 700k as interventional pain? What’s the average now?
Click to expand...
Chemo bills as a procedure. Heme onc in a well setup practice is making $600k+. Academics doing research is going to drive down the average.
 
GonnaBeADoc2222 said:
This chart is flawed.

Lists nephro, "hypertension specialist", allergy, etc maling more than EM.

The medican for onc is def not 600k.

Once again, this forums skews ridiculous.
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Allergy and heme onc salaries are prob correct or at least in the ballpark for private practice.

It’s unclear what a hypertension specialist is, but I bet it includes some end-of-career cardiologists who call themselves that in order to be 100% clinic.
 
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Damn phlebologists, always making us look bad.
 
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MGMA median for heme/onc is ~$500k. Briefly perusing their forum it seems reasonable to break 700k.

forums.studentdoctor.net

2022 MGMA median salary

I just heard from a practice currently hiring that the new median income for hem/onc is $495k, and RVU is ~$100. Do practices that are currently hiring use the latest MGMA data or do they use last year's?
forums.studentdoctor.net forums.studentdoctor.net

Just found out that one of my employed interventional cards makes >$1.5M. o_O
 
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Also, no way is CT surg making $600k. Maybe peds CT.
 
Arcan57 said:
Chemo bills as a procedure. Heme onc in a well setup practice is making $600k+. Academics doing research is going to drive down the average.
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Plus, they sell the drugs. Probably making a lot more than that.
 
coachB said:
Plus, they sell the drugs. Probably making a lot more than that.
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Breaking Bad?

You got terminal cancer and want some treatment? Here’s some chemo.

You want something different? Check out this crystal.

Brilliant dual strategy. This is why we aren’t making as much money in EM.
 
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I have the 2021 MGMA median for pain. I have not been able to get the current one (2022).

Pain Management: Nonanesthesia $437,869

Anesthesiology: Pain Management $494,488
 
cyanide12345678 said:
I have a 1 hour 10 minute commute from one of my rural sites. I’ve had too many days where I’ve been just almost falling asleep. Once I think i did fall asleep for 1-1.5 miles on a Highway. Usually i get sleep at work on night shift, the few days i don’t, it’s a genuine struggle to get home.
Click to expand...

It's easy to happen. One minute you're driving home from work, and the next minute, you're waking up to the sound of the car brushing up against the sleeper strip line on the side of the road; that sound has saved my as$ a few times.

If you're working only a few nights per month (3-4), it might be safer if you just block your shifts together and stay in a hotel. Something I'm considering doing for one of my rural sites.
 
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Kryptocoin said:
It's easy to happen. One minute you're driving home from work, and the next minute, you're waking up to the sound of the car brushing up against the sleeper strip line on the side of the road; that sound has saved my as$ a few times.

If you're working only a few nights per month (3-4), it might be safer if you just block your shifts together and stay in a hotel. Something I'm considering doing for one of my rural sites.
Click to expand...

It’s 8500 annual volume. 70-80 percent of times ive been able to get 2-5 hours of sleep. If I’ve slept even a little bit, i feel fine. Starting October I’m doing 10 shifts a month anyway, so 4-5 nights.

Where I’ve screwed up is running podcasts on my way home, if i put really loud music, i usually stay awake. But the sleeper strip line has saved me a few times as well.

I’m also looking at a few other critical access/low volume shops nearby. I just found out 2 weeks ago that i have 2 low volume gigs within 30 minutes of me.
 
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I've heard chewing gum can help keep you awake while driving.

A weird one I've heard was to take off your left shoe and sock. The constant feedback to the exposed foot is apparently annoying enough to work.
 
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Hold a hundred dollar bill out the window.

Never tried it, but always wanted to.
 
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wendalltwolf said:
I've heard chewing gum can help keep you awake while driving.

A weird one I've heard was to take off your left shoe and sock. The constant feedback to the exposed foot is apparently annoying enough to work.
Click to expand...

Manual transmission driver here. I would like a word.
 
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www.justice.gov

Detroit Area Doctor Sentenced to 45 Years in Prison for Providing Medically Unnecessary Chemotherapy to Patients

www.justice.gov www.justice.gov

For those surprised that heme-oncs can make $600k+, need to look up Dr. Fata. The guy billed Medicare $34m in just six years, giving unnecessary chemo to healthy. cancer-free patients. It was his own office manager that turned him in to the feds else he'd probably still be practicing.

He'd probably be making great money if he practiced ethically but greed got the best of him.
 
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