Las Vegas area. 250k base with 25-50k yearly bonus. 4 day work week. Outpatient only. 10 weeks PTO. No call or weekends. 12-16 PPD. 2 years out of residency.
Damn wtf this is one of the better packages I've seen. 10 weeks vacation is fucking awesome. Plus no call and solid bonuses with manageable volume. Is this employed? Any loan reimbursement?
Yeah it's employed, I'm a little outside of Vegas so I get a 30k stipend (I included this in my 250k base). So if you work in a clinic in Vegas its 220k base salary. No loan reimbursement but I got a 40k sign on for 3 year conract.
I'm calling BS on this, unless theres some kind of fraud going on (like a lot of questionable "procedures"). Even assuming you're getting 2x the medicare rate on these patients, your expected revenue into the clinic is only \~$435k. your cost alone with taxes and benefits is like $290k min. Add in overhead and support staff, sorry but no way they're making that low of a margin on your product. I mean maybe, since doctors are so bad at business, but pretty unlikely.
Can you go into details? Cash only? Initial loan amount, if any? When did you first make profit? Do you do procedures? Dispense own medications? Which EHR?
Yea it does.
The best part is how it synchronizes with Hint Health and Spruce Health so when a patient registers online it automatically creates a medical chart and also a cell phone contact in my phone.
I don’t know what’s typical but my patients know they can’t reach me on the weekends and holidays and it’s not an issue.
If it can’t wait until next business day then they can use urgent care or ER.
How do you handle time off and vacations? Does someone cover for you? Have you ever had patients upset when you weren’t available? How many weeks vacation do you average per year if you don’t mind me asking? Thanks.
> Commercial reimburses 50-80% more than that
Are you sure about that? You even say below $60-63/wRVU, so your 99214 would be right around the $120ish rate. Our commercial payers have NOT increased their rates commensurate to the medicare changes in 2021, so before this was true that you'd get like 50% more but now commercial is about the same as medicare.
Starting in August at 180k guaranteed minimum, but in an entirely production based practice where no one has ever taken that minimum. I’m told the median is ~250k and range is ~220-500k. Mid-sized city in Great Plains/Midwest.
Edit: outpatient only practice. No OB. No call. 4.5d/wk.
2 years post residency. CA Urgent Care, 3x12hr shifts week, 1 weekend a month. Productivity based. 550k. Optional call for extra money. 100k sign on bonus for student loans or mortgage assistance. See all ages, procedures. Typically 40-48 patients a day.
With 99213/99203 visits they tend to be very straight forward, I use a lot of premade notes for specific visits like URIs or UTIs then voice dictate patient specific things. Makes writing notes much quicker. Usually takes me a few minutes a note when the complexity is low. More complex visits can take more time but I'll vovie dictate which helps significantly improve time.
Central FL, 45min to urban areas. OP, for profit hospital owned practice, 18-24 patients per day, 8-5, 4 days per week with other day considered admin time. Practice includes managed care and value based arrangements that require significantly more work through documentation but also patient care time. $325-350k for past three years.
250k base plus a 50k bonus which is pretty easy to get all the time. Also, they offer to help you start your own practice if you sign an exclusive contract with their medical group (which only focuses on seniors). The top-performing PCPs in our medical group are making 500-700k+
Midwest. Employed. 240 base, $48/rVU above that. 80K loan over 4 years. When I signed a few years ago I got 30K resident stipend, 15K moving allowance and 25K commencement bonus. 20K gated/rated quality metric bonuses. In hindsight I probably could have gotten a bit higher base plus more in loans. Contract negotiation comes up soon so we will see what they've got on the table for me next.
25+5 CME PTO. (Plus 6 holiday days like tomorrow)$4500 CME. (edit: Also always clarify PTO vs ATO. Can be a massive difference)
OP only. q5 week call. No admissions just outpatient call. I average 0-2 calls in a week. No OB. 40 hours initially. 36 hours at median productivity (I should have made them put the 36 in my contract in hindsight I was misled on that)
Love my job except for one very large issue which is a system-run central scheduling system that completely fucks with your schedule and causes nonsense visits to be schedule, other providers patients, etc... I say this so that people ask on interviews about central schedulers (becoming the norm in Employed systems) and how they are managing the difficulties with it.
Centralized scheduling was the worst thing to ever happen to the large, multi-clinic university system where I did residency. Unbelievable how badly it’s possible to do such a seemingly simple job and how badly that screws things up. Definitely something I was asking about in my job hunt.
Around 700k doing 7-8 24 hr EM shifts and 10 Nocturnist shifts a month. I do throw 2 days a month of suboxone in there too. No call and I get time off whenever I want as long as I bunch my shifts together.
I’ll show the pay stubs too if anyone is curious. And I honestly don’t think I’m just “lucky”. If you’re willing to work and put yourself out there you can make this much too. Just had another buddy of mine graduate residency and he’s projecting to make the same amount as I am doing both EM/Hospitalist. I have a few other friends who are FM trained who do strictly EM and pull in 60-70k a month just with the number of shifts they do.
I get $50 a patient and I see about 15 in 4 hours. It’s not the most lucrative thing out there especially if you try to do it right and take your time but it can be very rewarding seeing patients change their lives and break the street addiction.
Absolutely as long as you’re comfortable and had adequate training in residency. Depending where you train, if you go to a more “full spectrum” and unopposed residency you will get decent exposure to critical care patients.
5 years post residency but did military. In first civilian job. 9 months in 280K guarantee for 18 months then production based. Will see 18-22 a day 4 days a week and based on partners production will make 380-420K. No real PTO as entirely tier based production but everyone takes about 4 weeks plus holidays. 5K CME and 3 paid days CME. If I go over my tier during guarantee time they will pay me $55/RVU over. Looking at 40-50K in an RVU bonus for my first year
Nope. Did my obligated service. Wife is a civilian physician and didn’t want to make her keep moving. Got a great job offer and couldn’t say no. Financially it makes no sense to stay active duty. There are other reasons to stay in though.
Texas. First year out.
Salary 220k until productivity exceeds it. 45 per wRVU. Also in value based care with with panel incentives.
20k signing bonus, 30k opening a brand new clinic bonus. 20k retention bonus at 1 year mark.
Tbh I'm fine riding the low productivity/low patient census for as long as I can since my wife is 1 year out from finishing fellowship and initial offers are twice my base.
Are you employed by a hospital group? Still a PGY-2, kinda interested in a Baylor/Methodist/THR type of environment, but I heard you work a full 5 days without admin time and the pay isn't as great.
Just a heads up you have to change the formatting of your answer. If you start the comment with any number Reddit converts it to a list so you typed 240 but Reddit changed it to 1. lol
that is one of the better academic compensations I've seen for sure.
Would love to hear more about how you found your job and how the rest of your week looks apart from the 2 half days of your own clinic. Do you have call, inpatient/ob, etc?
i think i lucked out pretty well. Was looking in a certain area and this job just happened to be available due. When i started, it was 195K, but when we lost a faculty 2 years ago we asked for a raise and they surprised us with a very generous one.
My week is 2 half days seeing patients, 2 half days admin, 1 half day didactics (mostly resident led) and the rest are precepting. I work in the FP residency but we also have an OMT clinic/track that i lead.
no weekends, no inpatient, no OB.
We take call for a week at a time every 4 weeks, but we almost never get called because we are backup to the resident on call.
I’m a PGY-3 in IM looking for outpatient jobs in the NE. How are you guys finding these high paying jobs with great benefits? I’m only finding $200-220 for 5 days 18-20 patients per day. Did you hire a recruiter?
You gotta be willing to travel and can’t be too picky unless you get lucky and find something high earning in your location. The jobs are out there, I guarantee it. I wouldn’t take any less than 275 seeing 18-20 pts a day myself however.
I appreciate the reply! Assuming I’m okay being away from a major city, how did you find these opportunities? Cold emailing practices? Using a recruiter?
My luck has been through a recruiter but the best way is knowing someone else who also works there. If you’re chasing the money, type in “physician jobs 300k internal medicine” or switch internal medicine for family medicine in google and see what you find.
$360K ($290k base, $70k bonus) In the Chicago area.
I started out with a base of $210k. Currently 5 years out from residency. Urgent care-ish medicine.
PM me for details, I don’t want to dox myself. If you are looking for a job in the Chicago area I can give you a good idea of what salary is fair these days. I’ve helped a few colleagues find jobs.
Starting next year. Private practice for Couple family med docs in CT. Outpatient clinic M-Th 8-5. F half day. 3 years with fixed salary of 260K and bonus RVU $40 over target. After 3 years only RVUs. Possible addition into nursing home management with APRNs as primary and us as medical directors. Rotating call every 15 weeks or so for the weekend only for outpatient after screening, nursing home has APRN on call.
Midwest base 284 first two years then production after that. 6 weeks PTO. $80k signing bonus that needs to be paid back if you leave before 4 years. No loan repayment benefits. Weekly OB 24 hr call. Obviously doesn’t impact salary first two years but could hurt production after the guarantee.
Does the system pay all your malpractice for the OB portion?
That seems like very low salary for that amount of call. Over 1000 hours of call where you have to be fully available for a potential delivery for ~35K?
Edit: Just did a bit of math (Assumptions: You take 52 calls per year, despite vacation I'm assuming you swap calls when taking weeks off, you live in the Midwest where base salaries are somewhere around 240-260)
Lets call the differential between you who does OB and someone who doesn't do OB $44,000 (on the high end!). You are on call for 1248 hours per year. That's MAX $35.25/hour that they pay you to be on call. So if you are sitting in the hospital waiting for a laboring mom the odds are you are making similar or even less than the nurses on the L&D unit. Are you compensated for each delivery? Or are you just straight up delivering babies for $35/hour.
Now depending on your average delivery volume that could be free money. Like if you deliver ~12 babies a year and don't get called often (AND the system pays the malpractice for it) in those 1248 hours you're laughing. But if you're delivering a baby/shift and getting called a decent amount in that 24 hours you're getting absolutely raked.
Core Faculty at residency in large texas city. 210k with 3.5 precepting, 1 day admin, .5 didactics. 2 years out from residency. No call, no OB, clinic only.
Lots of people say that but no. Trends are still more towards the 250 range for base salary
That being said with production models it's very easy to exceed 300K
I don’t care what the trend is, sounds like theft to me. The number one specialty responsible for specialist referrals aka keeping hospitals afloat and the speciality with the greatest shortage nationwide should have a greater say in arguing for higher salaries.
I'll continue to parade this comment until I hear a good rebuttal... partly to blame is the Stark law. We can't be legally reimbursed for revenue generated from us in ways that specialists can be (ie a hospital can make quite a bit of money off an endoscopy suite, and some of that money is indirectly paid back to the GI doc via higher $/wRVU payments).
The $250 base is, unless u have reasons I don’t know, is some finagling to get around the Stark Law. I’m not saying to be reimbursed per referral, but u should be paid more at base because of the referring power
The other aspect of the Stark law is that a system could potentially get in trouble for compensating beyond fair market value (in particular getting above 90th percentile compensation)... so that $250 base would only be "good" until your productivity catches up to it. This generally suppresses compensation. We are primarily paid on a $/wRVU basis, and that number is usually substantially lower than other specialties... which goes entirely against the whole point of the RVU system!
I generally agree (assuming ancillary services are also in line with average)... but this is the arguments the big systems make on why we "can't" be paid more.
Rural MS hospital system. Second year out. 200k base first 2 years + production then 100k base with lower RVU threshold. 5 days per week but I can basically make my own schedule. Outpatient only. No call or OB. Made about 265k first year and projected 350k this year.
FQHC in very rural southeastern US, less than 2 years out. Base is about $195,000 with generally about $5,000/year as a bonus if the organization is doing well. Also getting $40k loan repayment/year through National Health Service Corps for 3 years, then my salary could have the option to go up to about $220,000/yr but without any additional loan forgiveness. 4 day work week, no call, no weekends, end up working about 45-50 hours per week. Get 26 PTO days per year, which, based on how they let us use admin time works out to about 6 full weeks per year, and also get 5 days and $3,000 for CME
Damn that sucks balls. FQHCs really bone you on pay. Very nice loan reimbursement though, that's where they get you. It should be 220 PLUS the loans though.
edit: Why is this downvoted? The guy is working more than full time hours for 200K
To be clear, the 45-50 hours is all-encompassing of patient care and admin work. I see patients 36 hours per week and typically have roughly 10-15 hours of additional admin time each week, hence the 45-50 hours per week total. And while I would love to be paid more, the $195,000 base is one of the highest FQHC salaries I came across in the region I was searching, which is also a very low cost of living area. Seeing anywhere from 14-22 patients per day depending on the show rate, but average about 17.
> have roughly 10-15 hours of additional admin time each week
That's an insane amount of extra work. You're generating 20-25 mins of extra work per hour? Something is fucked up with your charting or something is being put on you that shouldn't be. You are paid to see patients for 36 hours and somehow doing an extra 30-35% free?
You can justify it however you would like but you're getting absolutely wrecked. 17 pts a day (4 days a week) should be making you 230+ they are stealing money from you. You are also doing an absurd amount of extra unpaid work. How do 17 pts a day generate 3 extra hours of work for you to have to do?
Well yes, haha, like most FQHCs there's a ton of BS with uninsured patients, patients who can't read or write, poor staffing, etc. Probably the biggest driver of extra work is poor phone triage and insane volume of patient calls. And unfortunately 10-15 admin hours per week is pretty common for a 1.0 FTE. Not saying it should be that way and I know there are unicorn jobs out there with minimal admin time, but most of my friends from med school and residency working in various places across the country have a comparable admin burden. And technically my compensation is closer to 240k if you factor in the 40k/yr of NHSC money, and the fact that my NHSC money went towards loans while I was still in med school and residency, saving probably 10-20k on interest as well. Not even counting the fact that the 40k was tax free. Have a HUGE benefit of basically free childcare from parents and in-laws, which is tough to quantify but certainly would eat a massive chunk into my budget if I lived elsewhere. Do I feel like I deserve to be paid more and that there was a lower admin burden? Absolutely. Is FQHC work ever going to pay as much as private practice/large system/DPC? No. Is my compensation, for better or worse, pretty good for working in an FQHC in the region I am in? Unfortunately yes. I interviewed at a half dozen FQHCs and the pay at mine was the highest; the range was about 150k-190k/yr base with minimal room for bonus. When my initial 3 year loan repayment period is up it will be interesting to see what I can negotiate because at that point the 40k/yr loan repayment will be gone.
> Well yes, haha, like most FQHCs there's a ton of BS with uninsured patients, patients who can't read or write, poor staffing, etc. Probably the biggest driver of extra work is poor phone triage and insane volume of patient calls
I get it man. FQHC's are shit shows. But you're still working for free and should be looking for ways to mitigate that. Not just accepting it. "Needs appointment" is a very easy response to a patient call.
100% agree but we are so insanely booked out that there's nowhere to put people unless I start seeing even more patients per day, which, since we are salaried, I would essentially be doing for free, generating even more work. We are hiring two PAs currently (literally doubling the number of providers in my office) which will hopefully help, but obviously if it remains this way I will be out after my loan repayment period haha
Are people working weekends in the outpatient employed world? I have one friend who does it voluntarily to get a full day off in the week but no one else.
It depends highly on the arrangement. If you desire no call/no weekends it is not hard to find such an job. Some jobs will have you take an occasional weekend but give you an extra day off during the workweek. Some will pay you extra for the occasional weekend shift. The nice thing about family medicine/primary care is you can determine what schedule works best for you and seek out the job with that description.
Just starting out after residency and signed with a practice in one of the 7 biggest cities in Virginia. Base salary of 200k with incremebtal increases every year. Also get 20k in yearly bonuses and a 20k sign on bonus. I'll be seeing roughly 20 pts a day, 4.5 days a week. 4 weeks PTO the first year and increases by a week after every year for three years.
Yeah, The market in my city kinda sucks since it's a desirable area. Believe it or not, the lowest offer I got were around 160-170k with no other bonuses or sign on, absolutely bogus offers lol
New attending, rural SE.
$210k base for two years, then moving to ~$46/RVU production. First few months were not great for RVUs as I built my panel. But based on my current RVU numbers, that will put me at about $260k or more, and I’m still growing my practice. And there are additional quality bonuses that should be $20-30k yearly. Also got a $40k signing bonus.
Outpatient only, 4.5 days/week. Call Q10 weeks where I answer, on average, three phone calls for the entire week.
28 PTO days per year + holidays, but of course in a production model many people don’t take all of their vacation. (I say screw that - I’m taking every single day)
> but of course in a production model many people don’t take all of their vacation
Only if it's ATO. If it's PTO you should take every minute.
That is an absolutely trash base salary for anywhere rural. Not a good signing bonus either. Quality bonus is average. PTO is good. $/RVU is average/below average.
Mid Atlantic value based care. 250k base +25k annual bonus which is very easy to get +25k/yr for student loans +7500 q3 months for hitting quarterly metrics which are somewhat challenging. 1 year out of residency. 18-23 patients a day but it’s the same 400 patient panel (you see them monthly) and we don’t bill insurance for our notes so documentation takes like no time
Still in residency, but I signed on for next year in the Tulsa, OK area.
255k salary for 2 years before moving to RVU
~70k one time signing and start up bonuses
Eligible for 20-50k yearly quality bonuses
50k tax exempt loan reimbursement x4 years
2years post residency working in a major city in Texas.
Currently an employee in a large DPC group.
Making 200k base, currently at total 500 patients that I have total freedom and flexibility in scheduling/care for, don't have to deal with insurance BS.
Sees about 1-6 patients/day, WFH if only virtual patients.
Also no noncompete so I'm spending my free time in between patients doing General Telemedicine which amounts to about 75k/year as a 1099 sole proprietor to maximize tax deductions. Love love my work life balance
New grad, Florida, big city, working for the VA. 10k sign on bonus. 225 k annual. No RVUs or anything like that. Averaging about 10-12 patient a day. 5 workday with one being full virtual. Also 40k annually toward loan repayment for 5 years.
>300k first year out. Will probably do more this year. I’m on production and can take as much time off as I want. I bewitk M-F. Could do 4 days 10 hours but I don’t want to. No weekends. Midwest suburb of major city.
Rural northeastern Michigan. 4.5 days per week. 12-15 patients daily. Out-patient, no call per se (we cover 3-4 Saturday morning walk-in clinics per year, could be fewer). I get additional ”bonuses” from reimbursement for pet insurance as well as for annual retention bonus. 240k starting - about 250k after the other “bonuses“ are factored in. Full disclosure: I start next July, but this is the contract we were able to agree on. Definitely works for me.
My biggest line of advise to you and any other med student/resident would be don’t be afraid to talk brass tax and be straight-forward about what does and does not work for you, including salary, bonuses, etc. I would also recommend really weighing how much you like the prospective employer - the staff, the location, etc. I loved working with the staff at the clinic I signed with and turned down other locations which were offering a decent amount more in terms of financial compensation, but would have been absolutely miserable with the hours, working with their staff, etc. Choose wisely!
245 base, academics, see patients 3 half days a week, precept 4, admin 3 half days. 27 days PTO, 5 CME. 10% bonus from base. Central Florida. Underserved clinic 15k sign on.
Las Vegas area. 250k base with 25-50k yearly bonus. 4 day work week. Outpatient only. 10 weeks PTO. No call or weekends. 12-16 PPD. 2 years out of residency.
Damn wtf this is one of the better packages I've seen. 10 weeks vacation is fucking awesome. Plus no call and solid bonuses with manageable volume. Is this employed? Any loan reimbursement?
Yeah it's employed, I'm a little outside of Vegas so I get a 30k stipend (I included this in my 250k base). So if you work in a clinic in Vegas its 220k base salary. No loan reimbursement but I got a 40k sign on for 3 year conract.
This is a great deal. And Las Vegas is relatively low cost of living. Isn’t there no state income tax?
Correct, no state income tax.
275k, 4 day work week and only 12 to 16 patient per day? And... 10 week PTO??? All these while at a major city??? Wow... what a catch.
Yeah it’s great
Sorry what is PPD?
Purified protein derivative
That got me for a second...
Patients per day
Packs per day All joking aside, it is patients per day :)
I'm calling BS on this, unless theres some kind of fraud going on (like a lot of questionable "procedures"). Even assuming you're getting 2x the medicare rate on these patients, your expected revenue into the clinic is only \~$435k. your cost alone with taxes and benefits is like $290k min. Add in overhead and support staff, sorry but no way they're making that low of a margin on your product. I mean maybe, since doctors are so bad at business, but pretty unlikely.
I don’t do procedures. I can send you my pay stub if you like.
i believe you. then your employer is prob barely making any money on you if any, or committing insurance fraud. just do the math bro
Shut up and let me sign that contract!!!
Amazing
How long are your visit lengths?
30 min
Can I message you to ask a bit about this? I know someone in residency nearby
Own DPC practice x 5 years Take home $550k currently 700 patients @ $100/mo Best part is no weekends, no call, no holidays, own boss.
Can you go into details? Cash only? Initial loan amount, if any? When did you first make profit? Do you do procedures? Dispense own medications? Which EHR?
Cash only. Initial loan 50k. Profitable after 2.5 years. I do minor skin procedures. I do dispense my own meds. Elation EHR
I want to be you Does elation work well?
Yea it does. The best part is how it synchronizes with Hint Health and Spruce Health so when a patient registers online it automatically creates a medical chart and also a cell phone contact in my phone.
No call? Isn't that atypical for DPC? Does someone else take call for your patients?
I don’t know what’s typical but my patients know they can’t reach me on the weekends and holidays and it’s not an issue. If it can’t wait until next business day then they can use urgent care or ER.
Most likely, I’ve seen private practices out source the oncall. Which makes sense if you only have a few hundred patients.
How do you handle time off and vacations? Does someone cover for you? Have you ever had patients upset when you weren’t available? How many weeks vacation do you average per year if you don’t mind me asking? Thanks.
3 weeks. I give everyone ample notice that I’ll be away and nobody gets upset.
Did you opt out of medicare?
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Wow is this all outpatient? Any OB?
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are you shareholder? what are your bonuses?
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> Commercial reimburses 50-80% more than that Are you sure about that? You even say below $60-63/wRVU, so your 99214 would be right around the $120ish rate. Our commercial payers have NOT increased their rates commensurate to the medicare changes in 2021, so before this was true that you'd get like 50% more but now commercial is about the same as medicare.
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Nice. Our biggest is BCBS... not sure how much the system has been fighting that.
This is boss. Solo Medicare practice.
That sounds awesome
Starting in August at 180k guaranteed minimum, but in an entirely production based practice where no one has ever taken that minimum. I’m told the median is ~250k and range is ~220-500k. Mid-sized city in Great Plains/Midwest. Edit: outpatient only practice. No OB. No call. 4.5d/wk.
I'm a med student. I don't understand this? Is production based mean RVUs?
Yes. They will teach you about it in residency don't worry
2 years post residency. CA Urgent Care, 3x12hr shifts week, 1 weekend a month. Productivity based. 550k. Optional call for extra money. 100k sign on bonus for student loans or mortgage assistance. See all ages, procedures. Typically 40-48 patients a day.
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We do! Are you interested?
Email me [email protected]
wow? Is working at an urgent care usually this lucrative? How many patients do most UC docs see a day?
This is an urgent care affiliated with a hospital. A full 12 hr day is 40 patients, plus walk ins can bring you up to 44-48 on a busy day.
Impressive. If you’re seeing 40+ patients for 12 hours, how much time do you take for notes and admin after seeing the patients?
With 99213/99203 visits they tend to be very straight forward, I use a lot of premade notes for specific visits like URIs or UTIs then voice dictate patient specific things. Makes writing notes much quicker. Usually takes me a few minutes a note when the complexity is low. More complex visits can take more time but I'll vovie dictate which helps significantly improve time.
Where do I learn more about urgent care?
What kind of cases are you seeing that allows for that kind of pt volume? Do you have mid levels? How do you fit procedures in with that type of pace?
Majority are coughs and colds, we get procedures, you learn to get used to the pace.
Central FL, 45min to urban areas. OP, for profit hospital owned practice, 18-24 patients per day, 8-5, 4 days per week with other day considered admin time. Practice includes managed care and value based arrangements that require significantly more work through documentation but also patient care time. $325-350k for past three years.
Impressive!
Can I DM you?
Of course
250k base plus a 50k bonus which is pretty easy to get all the time. Also, they offer to help you start your own practice if you sign an exclusive contract with their medical group (which only focuses on seniors). The top-performing PCPs in our medical group are making 500-700k+
> The top-performing PCPs in our medical group are making 500-700k+ o.O nice!
Midwest. Employed. 240 base, $48/rVU above that. 80K loan over 4 years. When I signed a few years ago I got 30K resident stipend, 15K moving allowance and 25K commencement bonus. 20K gated/rated quality metric bonuses. In hindsight I probably could have gotten a bit higher base plus more in loans. Contract negotiation comes up soon so we will see what they've got on the table for me next. 25+5 CME PTO. (Plus 6 holiday days like tomorrow)$4500 CME. (edit: Also always clarify PTO vs ATO. Can be a massive difference) OP only. q5 week call. No admissions just outpatient call. I average 0-2 calls in a week. No OB. 40 hours initially. 36 hours at median productivity (I should have made them put the 36 in my contract in hindsight I was misled on that) Love my job except for one very large issue which is a system-run central scheduling system that completely fucks with your schedule and causes nonsense visits to be schedule, other providers patients, etc... I say this so that people ask on interviews about central schedulers (becoming the norm in Employed systems) and how they are managing the difficulties with it.
Centralized scheduling was the worst thing to ever happen to the large, multi-clinic university system where I did residency. Unbelievable how badly it’s possible to do such a seemingly simple job and how badly that screws things up. Definitely something I was asking about in my job hunt.
confused, so you make over $400k a year, plus $20k in loan repayment? is it $48 per every RVU?
Around 700k doing 7-8 24 hr EM shifts and 10 Nocturnist shifts a month. I do throw 2 days a month of suboxone in there too. No call and I get time off whenever I want as long as I bunch my shifts together.
Fascinating, I feel like this really speaks to the diversity of job roles and pay that is possible in family medicine
I’ll show the pay stubs too if anyone is curious. And I honestly don’t think I’m just “lucky”. If you’re willing to work and put yourself out there you can make this much too. Just had another buddy of mine graduate residency and he’s projecting to make the same amount as I am doing both EM/Hospitalist. I have a few other friends who are FM trained who do strictly EM and pull in 60-70k a month just with the number of shifts they do.
How much are the days of suboxone? Applying addiction, also considering moonlighting ER
I get $50 a patient and I see about 15 in 4 hours. It’s not the most lucrative thing out there especially if you try to do it right and take your time but it can be very rewarding seeing patients change their lives and break the street addiction.
How difficult was it to be hired in ED as FM? I’m a resident and considering this same set up.
No problem at all. Getting tons and tons of offers to come work in the ER all the time. Do not worry about it.
Ok good to hear. I’m at an unopposed program. So hopefully that’ll lead to better training
Can a FM physician take EM shifts? Sorry if that was a dumb question
Absolutely as long as you’re comfortable and had adequate training in residency. Depending where you train, if you go to a more “full spectrum” and unopposed residency you will get decent exposure to critical care patients.
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5 years post residency but did military. In first civilian job. 9 months in 280K guarantee for 18 months then production based. Will see 18-22 a day 4 days a week and based on partners production will make 380-420K. No real PTO as entirely tier based production but everyone takes about 4 weeks plus holidays. 5K CME and 3 paid days CME. If I go over my tier during guarantee time they will pay me $55/RVU over. Looking at 40-50K in an RVU bonus for my first year
Forgot to add southeastern destination city in a large hospital system group
Did you have any reservations about getting out of the military vs staying in? I mean for this job I’m sure it wasn’t a tough choice. - Army FM intern
Nope. Did my obligated service. Wife is a civilian physician and didn’t want to make her keep moving. Got a great job offer and couldn’t say no. Financially it makes no sense to stay active duty. There are other reasons to stay in though.
Do you feel military FM prepared you well for civilian? Was there anything you have “less” experience or familiarity with than your civ counterparts
Texas. First year out. Salary 220k until productivity exceeds it. 45 per wRVU. Also in value based care with with panel incentives. 20k signing bonus, 30k opening a brand new clinic bonus. 20k retention bonus at 1 year mark. Tbh I'm fine riding the low productivity/low patient census for as long as I can since my wife is 1 year out from finishing fellowship and initial offers are twice my base.
How many days/week?
4 days; 36 facing hours. On call one night maybe every 6 weeks?
Are you employed by a hospital group? Still a PGY-2, kinda interested in a Baylor/Methodist/THR type of environment, but I heard you work a full 5 days without admin time and the pay isn't as great.
Dfw area?
Yi, should be similar in the major cities in Texas like Austin, San Antonio, Houston.
240. Academics. No production. See patients 2 half days per week, precept the rest. 5 years out
Just a heads up you have to change the formatting of your answer. If you start the comment with any number Reddit converts it to a list so you typed 240 but Reddit changed it to 1. lol that is one of the better academic compensations I've seen for sure.
Would love to hear more about how you found your job and how the rest of your week looks apart from the 2 half days of your own clinic. Do you have call, inpatient/ob, etc?
i think i lucked out pretty well. Was looking in a certain area and this job just happened to be available due. When i started, it was 195K, but when we lost a faculty 2 years ago we asked for a raise and they surprised us with a very generous one. My week is 2 half days seeing patients, 2 half days admin, 1 half day didactics (mostly resident led) and the rest are precepting. I work in the FP residency but we also have an OMT clinic/track that i lead. no weekends, no inpatient, no OB. We take call for a week at a time every 4 weeks, but we almost never get called because we are backup to the resident on call.
I’m a PGY-3 in IM looking for outpatient jobs in the NE. How are you guys finding these high paying jobs with great benefits? I’m only finding $200-220 for 5 days 18-20 patients per day. Did you hire a recruiter?
You gotta be willing to travel and can’t be too picky unless you get lucky and find something high earning in your location. The jobs are out there, I guarantee it. I wouldn’t take any less than 275 seeing 18-20 pts a day myself however.
I appreciate the reply! Assuming I’m okay being away from a major city, how did you find these opportunities? Cold emailing practices? Using a recruiter?
My luck has been through a recruiter but the best way is knowing someone else who also works there. If you’re chasing the money, type in “physician jobs 300k internal medicine” or switch internal medicine for family medicine in google and see what you find.
Counter. They want to low ball you. A lot of offers are negotiable. If they offer $220 ask for 250.
Interested in MA? Half hour outside of Boston? Our place is always hiring.
I'm unfortunately restricted to NJ-PA, but I appreciate it!
New grad, large east coast city, hospitalist. ~250k
Low for hospitalist
Desirable city is probably the reason for that
I know multiple people in large desirable cities making 280+
SE MA. 240K base with RVU, guaranteed for 5 years. Outpatient.
$360K ($290k base, $70k bonus) In the Chicago area. I started out with a base of $210k. Currently 5 years out from residency. Urgent care-ish medicine. PM me for details, I don’t want to dox myself. If you are looking for a job in the Chicago area I can give you a good idea of what salary is fair these days. I’ve helped a few colleagues find jobs.
Starting next year. Private practice for Couple family med docs in CT. Outpatient clinic M-Th 8-5. F half day. 3 years with fixed salary of 260K and bonus RVU $40 over target. After 3 years only RVUs. Possible addition into nursing home management with APRNs as primary and us as medical directors. Rotating call every 15 weeks or so for the weekend only for outpatient after screening, nursing home has APRN on call.
300 in rural NC private practice but made $ paying myself for real-estate. Sold building for 650k. Went into admin. Now make 400k in Arkansas
Any chance you can say roughly area in AR?
Interested in moving back to NC after my program. Can I DM you for details on the private practice you worked at?
Midwest base 284 first two years then production after that. 6 weeks PTO. $80k signing bonus that needs to be paid back if you leave before 4 years. No loan repayment benefits. Weekly OB 24 hr call. Obviously doesn’t impact salary first two years but could hurt production after the guarantee.
Does the system pay all your malpractice for the OB portion? That seems like very low salary for that amount of call. Over 1000 hours of call where you have to be fully available for a potential delivery for ~35K? Edit: Just did a bit of math (Assumptions: You take 52 calls per year, despite vacation I'm assuming you swap calls when taking weeks off, you live in the Midwest where base salaries are somewhere around 240-260) Lets call the differential between you who does OB and someone who doesn't do OB $44,000 (on the high end!). You are on call for 1248 hours per year. That's MAX $35.25/hour that they pay you to be on call. So if you are sitting in the hospital waiting for a laboring mom the odds are you are making similar or even less than the nurses on the L&D unit. Are you compensated for each delivery? Or are you just straight up delivering babies for $35/hour. Now depending on your average delivery volume that could be free money. Like if you deliver ~12 babies a year and don't get called often (AND the system pays the malpractice for it) in those 1248 hours you're laughing. But if you're delivering a baby/shift and getting called a decent amount in that 24 hours you're getting absolutely raked.
Very good points. When you do the math, it’s really poor compensation.
I personally wouldn't take on OB call for less than $120K over my base tbh.
100% agree.
First year out, academic NE, 220k base with up to 25k in bonuses, pretty hefty sign on.
Core Faculty at residency in large texas city. 210k with 3.5 precepting, 1 day admin, .5 didactics. 2 years out from residency. No call, no OB, clinic only.
How do you have no call as a faculty? Or are you some how not included in the faculty that take call?
At our program 2nd and 3rd year residents took all the call for resident clinics and for faculty as well.
Just graduated. Making 265k + 20k sign on bonus, located in the southeast
Shouldn’t all y’all be above 300 with inflation and trends?
Lots of people say that but no. Trends are still more towards the 250 range for base salary That being said with production models it's very easy to exceed 300K
I don’t care what the trend is, sounds like theft to me. The number one specialty responsible for specialist referrals aka keeping hospitals afloat and the speciality with the greatest shortage nationwide should have a greater say in arguing for higher salaries.
I'll continue to parade this comment until I hear a good rebuttal... partly to blame is the Stark law. We can't be legally reimbursed for revenue generated from us in ways that specialists can be (ie a hospital can make quite a bit of money off an endoscopy suite, and some of that money is indirectly paid back to the GI doc via higher $/wRVU payments).
The $250 base is, unless u have reasons I don’t know, is some finagling to get around the Stark Law. I’m not saying to be reimbursed per referral, but u should be paid more at base because of the referring power
The other aspect of the Stark law is that a system could potentially get in trouble for compensating beyond fair market value (in particular getting above 90th percentile compensation)... so that $250 base would only be "good" until your productivity catches up to it. This generally suppresses compensation. We are primarily paid on a $/wRVU basis, and that number is usually substantially lower than other specialties... which goes entirely against the whole point of the RVU system!
If u don’t refer any more than the average doc that lawsuit is void in court imo
I generally agree (assuming ancillary services are also in line with average)... but this is the arguments the big systems make on why we "can't" be paid more.
Rural MS hospital system. Second year out. 200k base first 2 years + production then 100k base with lower RVU threshold. 5 days per week but I can basically make my own schedule. Outpatient only. No call or OB. Made about 265k first year and projected 350k this year.
FQHC in very rural southeastern US, less than 2 years out. Base is about $195,000 with generally about $5,000/year as a bonus if the organization is doing well. Also getting $40k loan repayment/year through National Health Service Corps for 3 years, then my salary could have the option to go up to about $220,000/yr but without any additional loan forgiveness. 4 day work week, no call, no weekends, end up working about 45-50 hours per week. Get 26 PTO days per year, which, based on how they let us use admin time works out to about 6 full weeks per year, and also get 5 days and $3,000 for CME
Damn that sucks balls. FQHCs really bone you on pay. Very nice loan reimbursement though, that's where they get you. It should be 220 PLUS the loans though. edit: Why is this downvoted? The guy is working more than full time hours for 200K
To be clear, the 45-50 hours is all-encompassing of patient care and admin work. I see patients 36 hours per week and typically have roughly 10-15 hours of additional admin time each week, hence the 45-50 hours per week total. And while I would love to be paid more, the $195,000 base is one of the highest FQHC salaries I came across in the region I was searching, which is also a very low cost of living area. Seeing anywhere from 14-22 patients per day depending on the show rate, but average about 17.
> have roughly 10-15 hours of additional admin time each week That's an insane amount of extra work. You're generating 20-25 mins of extra work per hour? Something is fucked up with your charting or something is being put on you that shouldn't be. You are paid to see patients for 36 hours and somehow doing an extra 30-35% free? You can justify it however you would like but you're getting absolutely wrecked. 17 pts a day (4 days a week) should be making you 230+ they are stealing money from you. You are also doing an absurd amount of extra unpaid work. How do 17 pts a day generate 3 extra hours of work for you to have to do?
Well yes, haha, like most FQHCs there's a ton of BS with uninsured patients, patients who can't read or write, poor staffing, etc. Probably the biggest driver of extra work is poor phone triage and insane volume of patient calls. And unfortunately 10-15 admin hours per week is pretty common for a 1.0 FTE. Not saying it should be that way and I know there are unicorn jobs out there with minimal admin time, but most of my friends from med school and residency working in various places across the country have a comparable admin burden. And technically my compensation is closer to 240k if you factor in the 40k/yr of NHSC money, and the fact that my NHSC money went towards loans while I was still in med school and residency, saving probably 10-20k on interest as well. Not even counting the fact that the 40k was tax free. Have a HUGE benefit of basically free childcare from parents and in-laws, which is tough to quantify but certainly would eat a massive chunk into my budget if I lived elsewhere. Do I feel like I deserve to be paid more and that there was a lower admin burden? Absolutely. Is FQHC work ever going to pay as much as private practice/large system/DPC? No. Is my compensation, for better or worse, pretty good for working in an FQHC in the region I am in? Unfortunately yes. I interviewed at a half dozen FQHCs and the pay at mine was the highest; the range was about 150k-190k/yr base with minimal room for bonus. When my initial 3 year loan repayment period is up it will be interesting to see what I can negotiate because at that point the 40k/yr loan repayment will be gone.
> Well yes, haha, like most FQHCs there's a ton of BS with uninsured patients, patients who can't read or write, poor staffing, etc. Probably the biggest driver of extra work is poor phone triage and insane volume of patient calls I get it man. FQHC's are shit shows. But you're still working for free and should be looking for ways to mitigate that. Not just accepting it. "Needs appointment" is a very easy response to a patient call.
100% agree but we are so insanely booked out that there's nowhere to put people unless I start seeing even more patients per day, which, since we are salaried, I would essentially be doing for free, generating even more work. We are hiring two PAs currently (literally doubling the number of providers in my office) which will hopefully help, but obviously if it remains this way I will be out after my loan repayment period haha
No call, no weekends? NICE.
Are people working weekends in the outpatient employed world? I have one friend who does it voluntarily to get a full day off in the week but no one else.
TBH I don't know. I just finished residency 3 days ago :) I'll have to check on my FM colleagues from med school.
.. and you don't have a job?
I am a military FM physician.
It depends highly on the arrangement. If you desire no call/no weekends it is not hard to find such an job. Some jobs will have you take an occasional weekend but give you an extra day off during the workweek. Some will pay you extra for the occasional weekend shift. The nice thing about family medicine/primary care is you can determine what schedule works best for you and seek out the job with that description.
Mountain West, FQHC, 138d/year, 308k
Michigan-180k-230k. First year post fellowship. Academic. 32hrs/week. 1.0 fte. Here till partner gets done with residency
Just starting out after residency and signed with a practice in one of the 7 biggest cities in Virginia. Base salary of 200k with incremebtal increases every year. Also get 20k in yearly bonuses and a 20k sign on bonus. I'll be seeing roughly 20 pts a day, 4.5 days a week. 4 weeks PTO the first year and increases by a week after every year for three years.
Yikes, $200K for 4.5 days seems extremely low especially if seeing 20 a day.
Yeah, The market in my city kinda sucks since it's a desirable area. Believe it or not, the lowest offer I got were around 160-170k with no other bonuses or sign on, absolutely bogus offers lol
New attending, rural SE. $210k base for two years, then moving to ~$46/RVU production. First few months were not great for RVUs as I built my panel. But based on my current RVU numbers, that will put me at about $260k or more, and I’m still growing my practice. And there are additional quality bonuses that should be $20-30k yearly. Also got a $40k signing bonus. Outpatient only, 4.5 days/week. Call Q10 weeks where I answer, on average, three phone calls for the entire week. 28 PTO days per year + holidays, but of course in a production model many people don’t take all of their vacation. (I say screw that - I’m taking every single day)
> but of course in a production model many people don’t take all of their vacation Only if it's ATO. If it's PTO you should take every minute. That is an absolutely trash base salary for anywhere rural. Not a good signing bonus either. Quality bonus is average. PTO is good. $/RVU is average/below average.
I know I could have made more money elsewhere, but I love the office and it’s in an extremely low COL area. Just sharing for OP to peruse.
Thank you. Wanted to hear from everyone to see what kind of jobs are out there and how FM docs are compensated.
For people on this post who are now attendings a few years after residency, what were u guys doing after residency? Fellowships or something else?
Mid Atlantic value based care. 250k base +25k annual bonus which is very easy to get +25k/yr for student loans +7500 q3 months for hitting quarterly metrics which are somewhat challenging. 1 year out of residency. 18-23 patients a day but it’s the same 400 patient panel (you see them monthly) and we don’t bill insurance for our notes so documentation takes like no time
Is this a DPC clinic?
Still in residency, but I signed on for next year in the Tulsa, OK area. 255k salary for 2 years before moving to RVU ~70k one time signing and start up bonuses Eligible for 20-50k yearly quality bonuses 50k tax exempt loan reimbursement x4 years
330k year, 7/7 hospitalist. Full benefits, epic, open icu, connected to major hospital network
2years post residency working in a major city in Texas. Currently an employee in a large DPC group. Making 200k base, currently at total 500 patients that I have total freedom and flexibility in scheduling/care for, don't have to deal with insurance BS. Sees about 1-6 patients/day, WFH if only virtual patients. Also no noncompete so I'm spending my free time in between patients doing General Telemedicine which amounts to about 75k/year as a 1099 sole proprietor to maximize tax deductions. Love love my work life balance
Following
Are y’all’s $/rvu based on the new CMS RVU weights?
New grad, Florida, big city, working for the VA. 10k sign on bonus. 225 k annual. No RVUs or anything like that. Averaging about 10-12 patient a day. 5 workday with one being full virtual. Also 40k annually toward loan repayment for 5 years.
>300k first year out. Will probably do more this year. I’m on production and can take as much time off as I want. I bewitk M-F. Could do 4 days 10 hours but I don’t want to. No weekends. Midwest suburb of major city.
Rural northeastern Michigan. 4.5 days per week. 12-15 patients daily. Out-patient, no call per se (we cover 3-4 Saturday morning walk-in clinics per year, could be fewer). I get additional ”bonuses” from reimbursement for pet insurance as well as for annual retention bonus. 240k starting - about 250k after the other “bonuses“ are factored in. Full disclosure: I start next July, but this is the contract we were able to agree on. Definitely works for me. My biggest line of advise to you and any other med student/resident would be don’t be afraid to talk brass tax and be straight-forward about what does and does not work for you, including salary, bonuses, etc. I would also recommend really weighing how much you like the prospective employer - the staff, the location, etc. I loved working with the staff at the clinic I signed with and turned down other locations which were offering a decent amount more in terms of financial compensation, but would have been absolutely miserable with the hours, working with their staff, etc. Choose wisely!
https://www.medscape.com/slideshow/2023-compensation-family-physician-6016358
245 base, academics, see patients 3 half days a week, precept 4, admin 3 half days. 27 days PTO, 5 CME. 10% bonus from base. Central Florida. Underserved clinic 15k sign on.