Where does the income come from?

[OnMyWayThere]

A lot of people raving about pay in Derm in almost all of the forums... where does this pay come from - exclusively for Dermatologists? I know the cosmetic stuff is not limited to Derm (even OBGYNs are doing those now).

Are the other procedures making money then (biopsies, nail, etc.)?

Some FPs advertise "Dermatology" and do a lot of these procedures, isn't their compensation the same from insurance companies as BC Derms?

I just don't understand why '$' is always brought up about this field if these procedures may be done by other docs and compensation does not differ. I am sure I'm missing something.

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[ny skindoc]

A lot of people raving about pay in Derm in almost all of the forums... where does this pay come from - exclusively for Dermatologists? I know the cosmetic stuff is not limited to Derm (even OBGYNs are doing those now).

Are the other procedures making money then (biopsies, nail, etc.)?

Some FPs advertise "Dermatology" and do a lot of these procedures, isn't their compensation the same from insurance companies as BC Derms?

I just don't understand why '$' is always brought up about this field if these procedures may be done by other docs and compensation does not differ. I am sure I'm missing something.

The draw of Derm is not the amont of money per se, as its possible to earn far more in Rads, Anes etc,the attraction is the amount of work needed to generate its income tends to be much less.Little night or weekend call. Regular work hours.. low stress. High volume of patients and procedures generates the income for most derms not really cosmetic procedures.FPs can do much of this but their knowledge base of Dermatology and clinical expertise is not comparable to certified dermatologists except for rare individuals.It is very difficult for a generalist interested in derm to generate the large volume of new patients and referrals from primary care docs and HMOs,hospitals etc needed to run a busy derm practice.Fully trained dermatologists are in great demand and will build up an active practice quickly.

 

[OnMyWayThere]

The draw of Derm is not the amont of money per se, as its possible to earn far more in Rads, Anes etc,the attraction is the amount of work needed to generate its income tends to be much less.Little night or weekend call. Regular work hours.. low stress. High volume of patients and procedures generates the income for most derms not really cosmetic procedures.FPs can do much of this but their knowledge base of Dermatology and clinical expertise is not comparable to certified dermatologists except for rare individuals.It is very difficult for a generalist interested in derm to generate the large volume of new patients and referrals from primary care docs and HMOs,hospitals etc needed to run a busy derm practice.Fully trained dermatologists are in great demand and will build up an active practice quickly.

Makes a lot more sense. Thanks for the clarification!

 

[macrosky]

So the only thing that distinguishes Derm from FPs is their expertise on derm? Assuming a FP has solid expertise on derm (may learn by himself ), assuming he has good connections and marketing strategy(as a derm), so he could make the similar salary as a derm?

The draw of Derm is not the amont of money per se, as its possible to earn far more in Rads, Anes etc,the attraction is the amount of work needed to generate its income tends to be much less.Little night or weekend call. Regular work hours.. low stress. High volume of patients and procedures generates the income for most derms not really cosmetic procedures.FPs can do much of this but their knowledge base of Dermatology and clinical expertise is not comparable to certified dermatologists except for rare individuals.It is very difficult for a generalist interested in derm to generate the large volume of new patients and referrals from primary care docs and HMOs,hospitals etc needed to run a busy derm practice.Fully trained dermatologists are in great demand and will build up an active practice quickly.

 

[OnMyWayThere]

So the only thing that distinguishes Derm from FPs is their expertise on derm? Assuming a FP has solid expertise on derm (may learn by himself ), assuming he has good connections and marketing strategy(as a derm), so he could make the similar salary as a derm?

If it is a cash based business, then yes. The only reason I say that is because I hear that insurance companies will not reimburse you the same amount, if any, that they would a board certified dermatologist would be reimbursed for a procedure that should be done by a derm. This is word of mouth - however in a cash based business, with the strategies you mentioned, I believe (from what I've seen) you can make a comparable salary with comparable work.

 

[cdql]

I would say an FP with a solid expertise in derm, good connections, marketing strategy, and most importantly, good BUSINESS SENSE, would earn even more than a dermatologist!

More people come to see FP's, it's often easier to see FP's (my derm actually requires a referral from a primary care provider to get an appointment!), and when it comes to private practice, business sense trumps everything!

And cash-based businesses never hurt either

 

[MOHS_01]

Reimbursement rates have absolutely nothing to do with chosen specialty or board certification status. When you agree to participate with a plan (insurance), you agree to accept their fee schedule. That determines what you get paid -- you do a biopsy, bill the cpt code for the biopsy, and you get paid for it.

 

[OnMyWayThere]

Reimbursement rates have absolutely nothing to do with chosen specialty or board certification status. When you agree to participate with a plan (insurance), you agree to accept their fee schedule. That determines what you get paid -- you do a biopsy, bill the cpt code for the biopsy, and you get paid for it.

So is it true that a General practice physician doing a biopsy will be reimbursed the same as a board certified dermatologist?

 

[HTD]

I would say an FP with a solid expertise in derm, good connections, marketing strategy, and most importantly, good BUSINESS SENSE, would earn even more than a dermatologist!

possible but not probable. This seems more like a case of rationalizing. If you want to practice derm, do a derm residency.