Why do they earn less?

[directdoc]

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Just wondering...why do pediatricians earn less than family practitioners if in fact they essentially do the same thing (except on kids)?

Also, would you rather start an office in a rural area that is known to have a lot of malpractice lawsuits or would you rather go to an area where you would make less but without having to deal with as many malpractice lawsuits. Pretty much, anywhere is South Texas is asking for litigation...but just wondering what you guys thought about it.

 

[Law2Doc]

Just wondering...why do pediatricians earn less than family practitioners if in fact they essentially do the same thing (except on kids)?

Also, would you rather start an office in a rural area that is known to have a lot of malpractice lawsuits or would you rather go to an area where you would make less but without having to deal with as many malpractice lawsuits. Pretty much, anywhere is South Texas is asking for litigation...but just wondering what you guys thought about it.

I think peds and FP earn pretty close to the same ballpark. If you see them earning a lot less, you might want to check on what hours they are working.
As far as where you set up your practice, you always look at the net in terms of what you make. Presumably if an area has more litigation, your premiums will be accordingly higher, and so your net income will be that much lower (insurance companies are very good at accounting for this kind of stuff).

 

[Miami_med]

Kids are generally low acuity, so they bill at low billing codes. That's really most of it. Outpatient IM, Outpatient Peds, and FM all have similar average incomes, with peds being slightly lower due to an overall slightly lower acuity. Of course, it depends on your practice, and there are pediatric intensivists who do a lot of inpatient work who can make significantly more. In general however, peds equals less money.

Anyone can correct anything that I said wrong 😉

 

[Biscuit799]

A. FPs can also do somethings OBs can do like deliveries or women's once a year check ups that they'd go to the OB/GYNs for.

IM can do women's check up exams amongst other GYN stuff. It's the OB that their generally not trained to do.

 

[Non-TradTulsa]

Just wondering...why do pediatricians earn less than family practitioners if in fact they essentially do the same thing (except on kids)?

Also, would you rather start an office in a rural area that is known to have a lot of malpractice lawsuits or would you rather go to an area where you would make less but without having to deal with as many malpractice lawsuits. Pretty much, anywhere is South Texas is asking for litigation...but just wondering what you guys thought about it.

Peds do often bill at lower-level intensity billing codes for Evaluation and Management. Despite the lower acuity, however, peds visits can often take more time than adults (working with the parents, etc - not to mention the fact that infants/toddlers can't describe symptoms accurately!) and it's difficult to see as many patients in a day as an IM doc would.

The second reason is that E&M codes aren't enough to pay a physician's salary, and they haven't been for a long time. Peds patients need fewer procedures and fewer in-house lab/x-ray - which is where a substantial amount of a practice's margin comes from.

Third reason is that a lot of children have only Medicaid for coverage and it doesn't pay terribly well.

Fourth reason is that pediatrics is considered by many graduating students to be a "happy" line of work to be in. All the primary care disciplines have a shortage to some degree, but there are still plenty of people who are naturally attracted to pediatrics. Nothing wrong with that, but greater supply = less competition = lower salaries.

 

[directdoc]

Sorry to sound like a *****, but what are the billing codes that you guys are talking about?

 

[Non-TradTulsa]

Sorry to sound like a *****, but what are the billing codes that you guys are talking about?

CPT, the Current Procedural Terminology for Physicians. A routine office visit is billed using what is called an "E&M" - Evaluation and Management code. There are five levels, one set for a new patient and one set for an established patient. The levels are based not on time (as is popularly supposed), but on medical complexity. If you do something for the patient outside the routine office visit, that is a "procedure," which also has a code. Sewing up a laceration on someone's arm, for instance, would be a procedure. Sometimes you can bill both an E&M code and a procedure, sometimes you can't. The rules are very complex, and that's what paid my mortgage when I was a CPA.

 

[directdoc]

Thanks for everyone's help.

 

[Blade28]

Totally different fields. Depending on where you practice, FPs may be involved in OB, minor/major surgical procedures, sports medicine, basic ortho, etc. HUGE scope of practice.

Oh, and they can see adults and kids too.

 

[AmoryBlaine]

Nobody goes into Peds to make money, because you won't. You just have to really like kids and get alot of satisfaction out of comforting and counseling. That doesn't mean that kids don't get very sick, but your average outpatient pediatrician has a pretty low-stress job that is as much counseling as medicine.

What am I trying to say? I guess that there's a trade off, peds pays less than just about any other specialty, but it is also less stressful as a rule.

 

[maxflash04]

Totally different fields. Depending on where you practice, FPs may be involved in OB, minor/major surgical procedures, sports medicine, basic ortho, etc. HUGE scope of practice.

Oh, and they can see adults and kids too.

I like your sig; do you update it often?

 

[Old_Mil]

Also, would you rather start an office in a rural area that is known to have a lot of malpractice lawsuits or would you rather go to an area where you would make less but without having to deal with as many malpractice lawsuits. Pretty much, anywhere is South Texas is asking for litigation...but just wondering what you guys thought about it.

Absolutely avoid an area known to have a large number of malpractice suits. Your premiums will be high enough to make up for the difference in pay. However, keep cost of living in mind as well...

 

[group_theory]

Peds pay less than FP because Peds sees more kids than FP 😛

Reimbursement for pediatric population is generally lower than reimbursement for adult population. The more kids the FP sees, the lower the income when compared to FP who sees fewer kids. In addition, depending on practice location and patient demographics, if the majority of your kids are on medicaid, or state-sponsored children health insurance, then reimbursement will be lower than those who have commercial insurance.




PEDIATRICS Vol. 115 No. 4 April 2005, pp. 833-838

"On average, physicians were reimbursed $22.19 PMPM for ambulatory care activities: office visits, preventive care, immunizations/injections, and hearing examinations. Reimbursement values ranged from a low of $16.88 in Missouri to $32.06 in Indiana."

PMPM = per member per month

 

[shivasHeroLike]

great discussion. i also wondered that.

 

[Blade28]

I like your sig; do you update it often?

Sorry, didn't see this until now! I had been updating it when I had time, but nothing for the next two years as I'm in the lab doing research.

I keep all my scut sheets, and am a "numbers" person, so I like to keep counts of how many total patients I've seen, how many ER consults/admissions, how many traumas, etc.

 

[Northerner]

Sorry, didn't see this until now! I had been updating it when I had time, but nothing for the next two years as I'm in the lab doing research.

I keep all my scut sheets, and am a "numbers" person, so I like to keep counts of how many total patients I've seen, how many ER consults/admissions, how many traumas, etc.

As long as there's no heavily populated "kills" column I think you're fine.

 

[Blade28]

As long as there's no heavily populated "kills" column I think you're fine.

No, we keep that column secret. 🙂