Why do about 10% of physicians make less than $100,000?

CarlosDanger

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So I was browsing the interwebz and came across the Medscape physician compensation survey. It's got some pretty interesting stuff in addition to average salaries that I'm sure many people on here have already seen. Anyways, it looks like there is a chunk of about 10% of physicians across all specialties who are making less than $100K - even in the high paying jobs like cardiology, plastic surgery, etc etc.

Why is this? It says all physicians surveyed are working full time, and I'm not sure how taxes play in, but still. Obviously, it's nothing to be alarmed about given that most docs seem to be making over $150 and on up from there. Is it docs who are now running labs full time and out of clinical practice? Is it just undesirable jobs in undesirable areas?

Its not that I feel entitled to piles and piles of money but I'm just curious, and considering the debt I'll be facing $100K seems like less than it ever has. Anyone have any ideas? Hopefully I haven't missed something obvious.
 

sinombre

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Can you post a link?
 

TheWeeIceMan

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Does the survey include residents?
 
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Salaries at big name academic centers/hospitals are also on the low end... But probably not that low.
 

karayaa

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Government work, eg military, CDC, agencies etc? Overseas work?
 

Lya

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Salaries at big name academic centers/hospitals are also on the low end... But probably not that low.
That's something I didn't know before. So other than the prestige of such academic hospitals and perhaps relatively more flexibility in schedules, what are other benefits that come with low salary? Are you referring to academic medicine in general?
 

darkjedi

how did this get here I am not good with computer
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My guess is that they have special circumstance, like working only part time. Academic institutions may pay a bit lower, but generally not below $100,000.
 

Law2Doc

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Residents and fellows, part timers, semi-retired, locums/temp physicians, and physicians in their first year of starting a practice probably are likely included in this category. Additionally, the fact that some of the lower paid primary care field earn $150k on average probably means that a handful earn a Lot more and a few earn a lot less. I could imagine there are some pediatricins, family doctors etc pulling in $90k to balance out the few outlier pulling in $250k. Unlikely academics is paying as poorly as some of you guys suggest.
 
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Your source is probably averaging beginning salaries for new attendings in all fields. General surgeons, believe it or not, may start with a base salary under $100K but have a contract for quarterly incentive bonuses based on performance. Additional sources of income include any research grant money and paid administrative roles (ex: Chief of a section, Residency Program Director, etc.). Don't let those figures scare you--you get out what you put in. There is probably also some sort of regional algorithm going into those estimates which would even out rural vs. urban salaries.
 

Carl Seitan

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I'd wager that physicians working for various non-profit charity organizations may earn on the lower end of the bell curve, since those orgs may not be able to pay as much but physicians do it for the cause.
 

Microglia

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Your source is probably averaging beginning salaries for new attendings in all fields. General surgeons, believe it or not, may start with a base salary under $100K but have a contract for quarterly incentive bonuses based on performance. Additional sources of income include any research grant money and paid administrative roles (ex: Chief of a section, Residency Program Director, etc.). Don't let those figures scare you--you get out what you put in. There is probably also some sort of regional algorithm going into those estimates which would even out rural vs. urban salaries.
This. Also, when beginning in academic medicine as an MD/PhD (or even an MD) and trying to get your own protected research time, generally your salary for those first 1-2 years after residency is 70-120k. Once you get assistant professor and some R01s it starts climbing. I would believe that the 10% comes from a mixture of a few docs with personal problems and people just getting started in academia.
 
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CarlosDanger

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My guess is that they have special circumstance, like working only part time. Academic institutions may pay a bit lower, but generally not below $100,000.
Part time?
The study says that all physicians surveyed are working "full time" but doesn't explicitly say what that means. My feeling is if something like 30 hours/week is considered full time, then that could account for some of it?

This. Also, when beginning in academic medicine as an MD/PhD (or even an MD) and trying to get your own protected research time, generally your salary for those first 1-2 years after residency is 70-120k. Once you get assistant professor and some R01s it starts climbing.
This makes a lot of sense.

Does the survey include residents?
Does the survey include residents?
I don't think so, only because it wouldn't make a ton of sense to call a PGY1 neurosurgery resident a neurosurgeon. I'll try to look more into this one.
 

MEN2C

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If you do almost exclusively research you can make less than $100k. Also in general terms, the more prestigious the university you work for, the lower your salary. A friend of mine at a very high ranked uni/hospital says you almost have to pay them for the privilege of working there.
 
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gettheleadout

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This. Also, when beginning in academic medicine as an MD/PhD (or even an MD) and trying to get your own protected research time, generally your salary for those first 1-2 years after residency is 70-120k. Once you get assistant professor and some R01s it starts climbing. I would believe that the 10% comes from a mixture of a few docs with personal problems and people just getting started in academia.
I remember seeing a salary posted for an assistant professor position in neurosurgery at $135k, and thinking how ridiculous that was. I still can't believe that's legit.