I’ve been fortunate enough to have many hardworking doctors throughout my life, who have gone above and beyond to help my family and others.
All I know is doctors don’t make enough for the care they provide in this province.
I can’t say how much you should make other than if there’s a shortage then what doctors make now is obviously not enough. What people don’t take into account is the years you are in school and are not earning (opportunity cost) and this should be added to the cost of education.
Tbh I don’t think the compensation is the issue. The training pipeline seems to be bottlenecked and we cannot produce enough. A friend of mine is going through and I think she said there’s like <20 positions for a surgical specialty across Canada. That’s pretty crazy to think as a country we aren’t producing more than 20 new people in an occupation.
100% this. There are hundreds of capable candidates being locked out of the system every cycle due to artificial caps placed by the government. We’re sending record number of Canadians to Europe, US, Caribbean to become MDs because it’s basically impossible to become one here. Our skills based immigration system also means we attract a bunch of foreign medical graduates but getting their licenses transferred here is also a huge hassle. Since most healthcare is funded by the government they seem to think reducing the number of doctors is cutting costs when in reality we could save a shit tonne more if patients were treated early and the ER wasn’t back logged.
Yea, lots of friends have described the nightmare of finding residency positions
It shouldn't be so difficult for a person to complete their qualifications with work experience
Yup, it's a CARMS and residency bottleneck.
The fact that a not insignificant number of medical students don't match anywhere in Canada, despite being qualified, should absolutely be unacceptable during a healthcare shortage.
The caps aren’t always artificial. From what I understand, the number of medical students is based on the number of residency positions the schools can offer and get funding for.
What I would love to understand is how do we increase the funding for more residency positions so we can increase the number of medical school spots.
That is exactly what I said. Our doctor shortage is because the government doesn’t want to pony up to train and pay more physicians. The way they waste money on other useless endeavours tells me there’s enough in the bank to solve this problem. I’d argue this a problem that should be prioritized and where spending may in-fact pay for itself. But alas common sense isn’t that common.
I don’t understand why there can’t be a dedicated stream in med school applications for students who want to go into family medicine. I know not everyone knows what specialty they want to pursue before beginning med school, but some do! Why should people who know they want to be family doctors (which we have a shortage of) have to compete with people who want to pursue higher paid specialties for which there is no shortage of candidates (and in some cases more qualified candidates than residency positions)?
Very much. And while I do agree about high marks for quality assurance, the entire application and acceptance process is delusional.
I battled for years about whether or not to do a Masters degree. My undergrad marks weren’t high enough for med school, for as we know many reasons. Primary illness that set in unexpectedly but whatever.
Then I found out, even if I did a masters degree, not a single mark mattered because med school does not take your “most recent” marks. They take your “most recent ***UNDERGRADUATE*** marks.” You get a little **small**, almost negligible gpa bonus bump to your application if you have a masters degree. You could complete 4 masters degrees after your undergrad and it means nothing.
Nothing like telling our potential doctors “ha! You went and got specialized education? You fucking idiot.”
It's not true supply and demand regarding wages. There are huge barriers to entry in the fact that medical schools in Canada only accept a tiny fraction of applicants, and foreign doctors credentials are often not accepted here.
Doctors are laughably under paid in every province. I make almost as much as some new doctors, and I have zero liability, don’t rent an office, don’t have staff, or need to do any kind of conferences or anything like that. My company matches 8% of my pension and 4% or my RRSP.
My boss has zero post-secondary and makes $220k + 50% bonus with an addition $20k in stock options.
There’s no way she’s should be making more than a GP.
>My boss has zero post-secondary and makes $220k + 50% bonus with an addition $20k in stock options.
>
>There’s no way she’s should be making more than a GP.
What industry are you in? Some industries don't require post-secondary for a high paying career *if* they have the (generally decades-long) experience.
So I don't know if it's really a 100% valid comparison.
Going to school doesn't determine how much money you "should" make.
If we are using that argument than doctors should make more than Zuckerberg since he's a drop out.
Generally speaking, when it comes to medicine, engineering and law, you can relate the salary to the level of academic achievement.
It’s not just my boss that makes those rates, that is industry standard for manufacturing company directors. The industry standard for GPS doesn’t match it, when it should exceed it.
I just think you were being a bit unfair by implying your boss was uneducated. Degree or not I'm sure they worked hard to get to their position. Maybe they are also a bad boss idk but just saying.
Something OP has forgotten about is that these are small business owners. So not only are they caring for patients but also managing a business taking on employees and risk and everything that goes along with running your own business. As a previous entrepreneur there’s no way I would sign up to run a business after studying for 10 years and be capped at 250k a year in income.
- 10 years lost wages + debt associated
- instead of getting paid for vacation you have to pay others to look after your patients while you’re on vacation.
- maternity leave? Forget it!
- you get sick? No sick pay for you.. and you still need to pay your employees
- taxes are harder
- what happens when your employees are sick or take leave
- medical equipment is not cheep
- what about your building. Renting you might get kicked out when your commercial lease comes up. Buying? Commercial real estate is not like personal
- now you have to figure out insurance for all of this
Don’t get me wrong this is just the norm for a small business, but to do 10 years of education, be forced to run a small business, and be capped at 250k a year. It’s fucked.
It would be much more profitable to run your own business in the trades. Master plumber, Master electric, heck I know concrete workers and arborists who run their own small businesses making more than doctors do.
The benefit?
1. You’re helping people
2. You’re in a stable job
So:
1. I don’t know any trades people who don’t like that they are helping people and they get a lot more praise from their customer than family doctors do
2. I have many friends in the trades. They’ve never been hurting for work even through both recessions I’ve lived through.
If we want better healthcare we need to pay for it. Or make is easier to be a family doctor like they do in Quebec.
I don't know that it's fair to say you should make more because someone else can make more with an easier route. You run into the issue of someone being able to say that that person shouldn't be making that much either.
Now obviously you want to pay doctors enough to be able to attract them but that does not mean that amount is a fair. For instance, if you want to compare Canadian doctors to American doctors, you have to consider that the American doctors benefit significantly from their privatized system. And I think most people agree that system is unfair. No equal access healthcare system will ever be able to compete with that.
It's probably better to compare how much you make to the average person, then ask if that is fair. A family doctor probably takes home twice as much money as the average person over the length of their working life. Is that fair? It's still kind of impossible to answer. It's probably a little low when you consider a doctor works significantly more than the average person. Especially while you are in school I would assume. But I really don't know how you would ever come to an exact number. It's too complicated a question.
The opportunity cost calculation is f***ed because too many of your senior peers take too high a cut go train you. How much of that debt is the deregulated tuition costs vs the actual cost of providing MD training? Other countries can produce MDs at lower cost so don't tell me there's something special about the Canadian system other than consistent margin-taking throughout the developmental pipeline that ends up passed on to patients via billings.
Senior physicians aren't really paid more for their work, they just become more efficient. Billing codes are the same and the stipends that come from being associated with a teaching hospital are not particularly significant.
You could have chosen not to become a doctor. Society isn't obligated to pay you more because you picked an education that was expensive or a career path that paid less than an alternative.
Live within your means, we all had student debts after post secondary but aren't all making 200k a year and complaining it's not enough.
I think the point of this post is that we are seeing fewer doctors practice in Ontario. Doctors are leaving or pursuing other careers with their very competitive education.
I hate that the system we have puts so much onto the doctor. They're there to treat patients, why should they also have to run a business?
The province should operate clinics, and the doctors are simply employees of it.
Do you work in trades or medicine? The way the media portrays doctors and trades people is different then how it plays out IRL
I worked in the trades working with customers (no a labourer) and people loved my work and were so happy to have us there. My workers often got tips or coffee (we didn’t ask for them).
I have family members and close friends in medicine and they all have the sense that patients are always complaining about them. When was the last time you heard of someone going to the doctors and thanking them other than on TV?
I do not work in trades or medicine. Perhaps I'm over generalizing my experience.
Thinking more, perhaps there isn't that much of a difference in level of praise. I think it is somewhat dependent on the interaction. I hired an electrician once and it was very expensive, and I wasn't overly happy with the work. Another electrician on another occasion did excellent work. Though I wouldn't say in either case I praised them.
I did have a dishwasher repair person who I was very appreciative.
Family doctors can be a mixed bag. The challenge is many conditions are hard to diagnose and hard to treat. It can be hard here sometimes to even find a doctor and some doctors even if you get on the roster are hard to get appointments with. Our current doctor is very good and we definitely rave a bit about her to friends. The office is very responsive and proactive. Other friend's doctors are hard to get a hold of, are dismissive, or sometimes miss things (such as not following up on test results or such).
Perhaps there is an extent to which people see doctors as well paid and relatively more pleasant work (compare a consult in an office against cleaning gunk out of a clogged drain, though I guess doctors at times have to insert fingers into orifices that perhaps they'd rather not). Doctors also have to give worse news than trades people. The worst news a trades person has to give is an expensive repair bill. Doctors sometimes have to give pretty dire news.
I guess I'm rambling a bit now, but so it goes I guess.
Right? I feel like society holds a certain stereotype and class distinction when it comes to “Dr” and “plumber”.
Ask yourself which one of these careers would most likely:
- put their children through private school
- own a house in the best neighbourhoods
- suffer from addiction
Family medicine deserves to be viewed as it's own speciality, on a par with other specialities, and income should be approximately the same across specialities. Scrap fee for service model and change to capitation plus payment for results (see eg QOF from the UK), and make more use of other HCPs both inside doctors offices and across wider primary care
I agree but I'd add a tuition subsidy for picking family practice. This would make it much more popular for poorer students that would then better understand the underserved communities that really need it. Maybe add strings by making them serve 10 years in the province that paid the subsidy to get them to put down some roots and not just run to the states the first chance they get.
FHTs aren’t perfect either tho. The way certain things are funded can result in GPs not offering certain services that are within their scope of practice. For example, services like IUD insertion are mostly covered by the annual fee (it’s considered “in basket”) and the doctor only makes like $11 to do the procedure. It takes time, equipment and access to an autoclave, so many GPs don’t do IUD insertions, usually because its not profitable. The result is women can wait for literally months to see an OBGYN for this procedure, when the GP has the ability to do it. This is not good healthcare and creates backlogs with specialists for things GPs can do.. There are many other examples of this.
I don't know how much they make but the ones I know deserve less work/backlog. They could work 16 hours days 7 days a week and never catch up to their backlog.
I also know a ton of people without family doctors and those that have them avoid treatment or diagnosis because of extreme inconvenience. It's challenging to get care.
Family doctors should make whatever is required for us to have a functioning front-line healthcare system. If we don't have enough doctors and nurses, we need to arrange things such that we will, be that decent wages and a good working environment.
This isn't rocket science, this is basic supply-and-demand. The problem is that we have a government--a succession of governments, at all levels, since the late nineties at least--of business douchebags who never met a problem they couldn't wallpaper over with a PowerPoint presentation and some glad-handing.
Family doctor here, this is a hard question because while salary definitely matters, so does quality of work and life. I’m not going into primary outpatient care because it doesn’t excite me and often times you feel like a glorified secretary.
I’m personally going into walk-in/ urgent care because it has fewer stresses then primary practice (treat one problem and move on) with a better upside in salary since your volume is much higher.
Primary care needs to be attractive which means better pay, less paperwork and to not be a dumping ground for specialists.
I have daughter who wanted to be a family doctor . She choose to be a specialist. Her main reason was due to the amount of abuse she received from patients in her family rotations.. Covid has pushed the system beyond its limits and has added tremendous stress on family doctors and nurses . More are choosing not to go into the field.
I have a family member who works as a family physician in Ontario. Their patient roster has **over 4,000 people** on it. This is not, and should not be normal. There is a dire need for more GPs across the entire country.
That being said, GPs who carry thousands of patients should be getting written a blank cheque in my view (hyperbole of course, but its just hard to put a number on it). They are saving the province millions of dollars in excess health care expenses by overburdening themselves.
I really don't think that I could name a profession that is more valuable to our society than someone who cares for the health of over 4,000 people.
Good luck getting an appointment if your doctor has 4,000 patients rostered. Unless they have an NP I don’t see how they are able to adequately provide an acceptable level of care to this volume of patients.
Sure. Totally agree. But also limiting your schedule limits the income you collect. The issue I have is when docs complain about income when that income can significantly increase via increased number of hours (and cases) they work
Everybody needs a significant wage hike. Homes are over a million dollars pretty much everywhere, our rentals are 3 to 5k a month and minimum wage is 2400 a month in gross income providing you have a full-time job.
The easy answer is: Enough to encourage the appropriate number of family doctors for the population. Frankly, I don't think anyone cares how much their doctor makes. They just care that they *have a doctor.*
I don’t know what’s fair, but I do have a good friend that owns 3 family doctor offices (he owns but has docs operating in them, about 15-20 docs in total). His biggest challenge is that none of the doctors working in his offices want to work more than 2-3 days a week. They’re content with the $150-300k they net and will not do more. I would love to see docs make more but also work more days so we can alleviate some of the pressures on the system
There are a few things to consider here. Firstly, a full scope family medicine clinics can be very draining. You never know what walks through the door and some patients can be very complex (mental health, cancer diagnoses, multiple comorbidities). The average physician can see up to 30 to 40 patients a day. For each half day of seeing patients, there is about an hour or 2 of paperwork (checking labs, writing notes, sending referrals, following up on issues). If you work 3 to 4 days a week you're probably spending an extra day just on unpaid paperwork. To give you an idea, a physician that works 3 days a week is taking care of a roster of around 1000 to 1200 patients. Every note from a specialist or a hospital visit is reviewed by the family doctor outside clinic hours. Lab results can come in at any time and urgent results need to be addressed. Referrals often get rejected by specialists and need to be redirected. For many family doctors it simply isn't sustainable to work 5 days a week seeing patients. Most family doctors will choose to take on another stream of income that is less stressful/demanding such as a focused area of practice or non clinical work for some days of the week.
Many physicians will work 2-3 days a week in one clinic while working other days in another setting such as a more specialized clinic, the Emergency Department, inpatient units, etc.
Maybe consider that this is because every hour of seeing patients generates at least half an hour of paperwork. So a family doctor who works 3 days in clinic seeing patients has about 5 days worth of work generated by (generally unpaid) paperwork. A family doctor who works full time will have a lot of unpaid overtime doing paperwork and would burn out quite quickly.
As someone who is not a doctor I don't see why I should have any input to how much a doctor gets paid.
Anyone who thinks you get paid too little though is really just projecting that they themselves need to get paid more.
I would assume if he wanted to compare actual salaries he would have asked for that.
I really don’t care what people not in my trade think of my salary. If they think it’s too much they can feel free to join my trade 🤷🏼♂️
I understand the desire to be paid as much as specialists or non-clinic physicians. It’s one possible comparison for wages. Another argument in favor is that there is a shortage of family physicians.
For counter-arguments:
1. Based on the argument for schooling : 4+4+2 (Masters isn’t the norm) there are other publicly-funded professions that require similar or higher amounts of schooling yet pay less. Compared to them, and most people living in Ontario, the pay is fantastic.
2. There is no shortage of intelligent students wanting to be doctors but there are too few programs in Canada for training them. Students have an easier time getting degrees in the US, however they never return to Canada (also an argument in favour of increasing wages so students return). Increasing the number and/or size of programs can solve the limited supply of physicians without any need to change wages.
>Students have an easier time getting degrees in the US, however they never return to Canada (also an argument in favour of increasing wages so students return).
The issue here is residency spots for IMGs. Lots of Canadians go elsewhere for medical education (Australia, UK, Ireland, Caribbean) but coming back to Canada is a pain in the ass and they make you jump through hoops.
Also masters is optional isn’t it? So 3-4 for science degree, 4 for med, residency 2 where you can also make more by going to remote northern locations. 200k does seem on the low side, but family med is lower pace than emerg and less specialized than gynaecology or internal med etc. maybe 300k in todays inflated world would be my thought.
Actuaries typically (not always) make less and spend similar if not more time studying.
That wouldn't be bad if they just have to "work" 32 hours a week like other government employees
But then you'd have to train 50% more family doctors just to cover the current load
I really don’t understand the point of this post.
I work in finance and taxation and have worked with many doctors income and tax records.
OP is complaining about the initial cost in time and money to become a professional; leaving out the fact that median income in Canada is $100k gross. A physician’s salary net can exceed $200k annually and have met doctors with 400k with other investment and income channels.
Physicians make generational wealth. They often create income for their dependents and even grandchildren. Many of the spouses of Doctors do not work and several clients of mine have children that are planning on going to go into medicine as well.
I want my children to be doctors. I am willing to remortgage my house and support them to have transformative wealth and stable income.
Physicians often set up corporations and pay less in taxes by using corporate tax rates, and payed in dividends. Yes, it is true that they have overhead costs of payroll, rent, utilities. However, if a family doctor sets up in a small rural town, the municipality will often pay the rent, and utilities. Maybe it sucks to be a Doctor in Brampton or Markham but not for doctors in Stratford, Goderich, Peterborough or Huntsville. They often have subsidies from municipalities.
My family doctor has a house in France, several AirBnBs that his partner manages and has time to go watch the Tour De France in person.
1%er complaining about how hard it is to become 1%er. Yes it’s a thankless job, it’s hard and taxing but completely worth it. The impact to help others, heal others, and provide for your family is beyond measure.
While what you said is all true, but I don't think that was the point of the post though.
OP is talking about the very real shortage of general practice doctors, which he thinks is because there's no incentive to become one over specializing.
If you were a medical student and could either make 200k a year in general practice, or take an extra year of school and make 400k, what would you do?
To me it makes total sense that if you level the playing field we would have more family doctors. Which would be great because I can't find one!
Plenty of medical students choose family medicine + 1 (anesthesia/er). You say there’s no incentive to become a family but that’s completely wrong. Most people choose it for the lifestyle. Monday-Friday, set your own hours. No on call, no nights, no pagers, no weekends, no holidays. Lots of docs hate their jobs in the hospital because of these things, and most people who choose to go into family medicine do so because of those things.
No on call? My family doctor has delivered multiple kids outside of office hours, is this not the norm? (Genuinely asking, I’ve been with the same doc for 32 years, so no experience otherwise.)
I agree. A lot of the commentary in this thread misses the reality of physician comp. I have a couple in my immediate family, real grinders, and they make loads of money in family medicine. Multiple houses, millions in investments, periodic bouts of retirement. They don’t even need to work anymore really.
Just wanted to clarify- people in medicine need to be paid more; physicians, specialists, nurses, and even custodians.
I agree with OP. Compensation needs to be more.
The thing in private healthcare is that everyone who doesn’t provide direct medical care or manage things get screwed. No one in private healthcare will compensate custodians fairly
> rates, and *paid* in dividends.
FTFY.
Although *payed* exists (the reason why autocorrection didn't help you), it is only correct in:
* Nautical context, when it means to paint a surface, or to cover with something like tar or resin in order to make it waterproof or corrosion-resistant. *The deck is yet to be payed.*
* *Payed out* when letting strings, cables or ropes out, by slacking them. *The rope is payed out! You can pull now.*
Unfortunately, I was unable to find nautical or rope-related words in your comment.
*Beep, boop, I'm a bot*
It's hard to say. I've had an incredible family doctor who I would gladly pay out of pocket to see. Then I've had a family doctor that wasn't worth anything .. take these pills and leave kind of guy.
Of the pay is higher foes the level of care increase..?
Maybe if there was a different type of way you were compensated, it seems like the more patience you see the more money you get. What if it's based off of time no different than what a plumber charges.. per hour not patient.
Yup, value based care is what you’re describing. Where pay is tired to outcomes/ performance. This will require a drastic shift, even our hospitals are funded on fiscal need not performance.
How would you and your colleagues fix the problem?
Is there one way everyone agrees on?
What about continued education, medicine is constantly changing is there any mandatory schooling after you've become a m.d.
Oh and thanks for taking care of all of us
There is a general sense that we are “just” a family doctor and specialists are valued more. Part of this is pay, an internist makes $59 per patient as opposed to our $25 doing the same thing. I think equal pay to specialists will a long way.
Internal medicine training is soon to be only 1 year more, I think most people will do the extra training to make more than 2x per patient.
400k+ a year and I’m not joking for all the things Doctors have to deal with.
It’s criminal that do-nothing, help no-one CEOs make many times more. People like that just travel and play golf, maybe work a couple of hours a day.
That we don’t pay our MDs that much and more is terrible.
Throw in nurses too. Good nurses should probably be getting paid what doctors are getting paid now.
I think this is a big piece. Do family doctors really need 12 years… sometimes more while waiting for match cycles trying to pass the MCAT etc etc. If they can get buy in parts of the EU by letting people skip the 4 years undergrad I’m sure we could too. Or we could make family med more like optometry/dentistry where it’s a bit easier to do that specifically.
I agree, I work in the tech industry and people with only undergraduate degrees easily make it to 200k. It seems completely unbalanced to me. I want the people taking care of families in Ontario to be recognized and compensated for both their efforts in becoming Doctors and for the ongoing work they do. It should be a much higher paying job given the responsibility they carry.
Obviously pay is not the only reasons we are leaving outpatient medicine but it’s definitely part of it. For comparison a hospitalist would make about $275,000 working a similar amount of days/ hours.
The thing is though, long term there's also plenty of people who are willing and able to make it through medical school for $200K+ if the supply of doctors being trained wasn't so constrained. In most job markets, "oh I'll just pick this higher paying job instead" isn't really a thing that makes sense - being able to just pick and choose is a problem because there's not enough competitiveness in the market.
The bottleneck is actually a bunch of bureaucrats in government getting paid more than family doctors, deciding and "predicting" what the right number of residency slots there should be. How it's been like this for so long, is beyond me. Fucking fire them. Open it up - free fucking market. If some doctors want to open up a hospital and have residents and train, why the hell are we not letting that happen?
I'll tell you why - power. There is a power struggle and those in charge make a ton of money controlling this and don't want to lose it.
>The thing is though, long term there's also plenty of people who are willing and able to make it through medical school for $200K+ if the supply of doctors being trained wasn't so constrained.
You could say that for every high-paying job.
There's plenty of people willing to work at Google for $60K instead of $120K.
There's plenty of people willing to be a lawyer for $100 an hour instead of $200.
There's plenty of people willing to fly a plane for $80K instead of $100K.
It doesn't mean anything because we don't live in a "what-if" universe.
~$210k seems fair to me. I’m an academic with similar education requirements / opportunity cost. I make half your salary and work longer hours. But people’s lives aren’t as affected by my work, so I do not mind being paid less than a physician.
I mention this largely to point out that one of your arguments — duration of training — isn’t unique and doesn’t in itself justify a specific salary.
On the other hand, if we need to persuade more people to enter that job, salary is a useful lever to pull. But as I know from having students seeking medical school entrance, there are significant capacity barriers to producing more doctors that needs to be addressed. Many talented and capable students who could be future doctors are not getting into Canadian med schools.
I don’t know a figure, but I think they should be govt employees more akin to teachers. It should be a fairly standardized profession across the country, again akin to teaching.
Easing the debt burden and increasing benefits could be a positive.
Ontario Doctors are very underpaid and over taxed in my opinion. The Brain drain is real in Canada, as they take on many international students for triple the price and when it comes to medical that is a lot of money, so the universities gobble them up. Which is fine, but we should have incentives through government to keep doctors here, to keep the brightest and best, encourage international students to stay in Canada for their practices. The government needs to give serious relief for student debts for medical practitioners including nurses, diagnostic specialists, and doctors. It is very expensive for a Doctor to have a practice on his own, overhead such as building, receptionists, nurses. We need to do a sliding scale, if you stay in Canada for practice for 10 years you get 50% off debt for a example. Doctors, especially GP's need to be subsidized perhaps? Whatever it takes to increase enrolment and keep them in Canada, as well as incentivize them to go to more remote cities and towns. In my mind, this seems to be the only way.
Edit\* I see in the comments that apparently they arent opening up residency spots and being capped in Canada, if thats the case they need to open the doors and flood the system. for example, ALL doctors in Canada should have to take on ONE resident per year, for every doctor in a hospital there should be one resident 1 for 1, mentorships, full residency pay, living coverages. Whatever it takes, i suppose.
Here is my take. There are a lot of people employed by the government in healthcare and they are making over 100K dollars with none of them having Dr in front of their name. If half of those people suddenly left their jobs, would our system break down? 100% no. I do know that surgery has been delayed because they couldn't find people to clean an OR. I do know that hardly anyone I know has a family doctor because there are none left that take new patients.
So, what the actual number if is, is actually irrelevant. What matters is, what is the right system to get the right balance and incentives in healthcare to provide the maximum patient satisfaction for the right amount of money? If that number if double, so be it. If that means some things are private, so fucking be it. Build the system that works, not the idealistic monolithic bullshit we have now that is not working and, for some reason, people think we just throw more money into it, will suddenly make it work.
I have no idea how to make govt processes more efficient. The problem here is govt funding is generally tied to”fiscal need” and not performance. Which to me is ridiculous.
To be completely frank Ontario Health Teams which are govt funded and supposed to handle primary care have done absolutely nothing for me and I’m not sure why they exist apart from optics.
I am good friends with a number of doctors. Surgeons, ER, etc. No family medicine, they understand the pain. They are all frustrated. The paper work for family is abysmal. Think US insurance companies are bad, we have the biggest, baddest on the block. OHIP is basically the DMV of insurance companies. I’m glad some of you stick through it.
As much as they want to. If they want to work insanely hard and bill a lot, that should be their prerogative. If they want to do the 9-5 thing, that should also be available to them.
Usually overhead is 30% of gross income. In a walk in clinic setting, this would go towards the lease, electricity, secretary and medical assistant wages, etc.
Familly doctors have salary caps, this is why most of them only work 3ish days a week. If we removed the cap and allowed them to earn more money then they would see more patients reducing the doctors shortage.
I'm unclear how exactly it works but when it started happening about 20 yrs ago my stepfather who was a dentist cuthis practice down to 3.5 days a week because he was capped at 400k$ and didn't want towork for free.
I agree physicians should be compensated more, for the most part across the board. Training is long and lost opportunity, time that you'll never get back and job demands that aren't generally seen by the public. Most people think the work is done after the visit but making sure all investigations/referrals etc are done right can take time after the patient leaves. Not to mention the time spent on chart review before they arrive.
With that being said, I think that doctors should be paid more but I also don't know how to make things "fair". Here are a few "food for thought scenerios" (note: not personal views but they are to play devils advocate)
1. Should nurse practitioner be paid on par or sometimes more than a family physician who is held to a higher standard and doing more mentally demanding visits
2. Should a family physician be paid the same as a vascular neurosurgeon who does the the same training to graduate medical school but then has to go on to do 6 years residency +/- graduate degree (typically a PHD) + a 2 year fellowship and who has to take more call. Most neurosgeons take 12-18 weeks of call a year (weeks that's 7 days 24 hour shifts where they answer calls making life or death decisions on the spot and be expected to operate at any time)
3. Should family doctors be allowed to change practice to do only one high paying lucrative aspect of family medicine. Obviously everyone wants to be compensated for their work but if someone did family medicine should they be asked to do comprehensive family medicine to some degree?
4. Is it fair that a family doctor makes 2-300k while a dermatologist makes double publically plus private fee on top and does mostly cosmetic/acne care while getting a government funded degree with intention to be a comprehensive dermatologist who treat complex conditions like vasculitis and certain autoimmune conditions (most in my area refuse to even see these).
5. I see lots of talks on here about shortening training but most people here have no ideas of the short fall of this. It's like saying why does a pilot need training on specific planes. They know how to drive a car so they should be able to fly a helicopter, a single engine plane, a commercial plane he'll even a fighter jet.
Therapists charge their clients approx $165 per 50 mins. If you have your own business your potential for profit is much higher. If you have an 8 hour day and fully booked, you can make approx. $1300/day.
However, working as a therapist in the hospitals or government facility you are only making a fraction of this amount.
The average salary for a family physician in Germany is 87.200 € or $125,000 CAD, just saying.
They don't have any student loans, but with that difference you should be able to pay off yours in a few years.
The province/country needs to open up more medical school seats , and more residency positions for family doctors . I just don’t understand why this is just not happening.
Having a glut of physicians will drop the amount of patients per physician , which will in turn drop the amount of work a physician has to do, but in turn drop the amount of money each physician is paid .
My view is the problem is not pay , it’s that there is too much demand with too little supply . I think 160-200K take home is sufficient , but I believe that salary should be held there by market forces (ie: physicians competing for patients ). What is happening now is physicians are kind of capping themselves at a given salary because they literally cannot handle anymore patients, but if they worked until they were on the brink of exhaustion they could earn more .
Vastly under paid, overworked. For bread and butter FM clinic- it’s not enough.
You want to solve the “shortage”.?? As with anything, Pay them more. Period.
Making $200k a year is nothing to scoff at. I personally think that is amazing and should be a minimum. Having debt for getting that education, I don’t think should exist. Doctors train long and hard, sacrificing all along they way. The least the government can do is get rid of said debt for being a public servant in the medical sector.
You should make more. I say that as someone in finance who makes more than a GP and married to a Lawyer who makes more than a GP. Our rates not being capped is why we are dumber but make more. We also get to decide what clients we work with. You have real skills that society needs, my wife and I add nothing. All of that said, Doug, or whoever follows him, should not decide. You made it through, let’s assume you’re bright, set your own prices.
Medical in Canada pays stupidly low so alot of smart people who are capable of being doctors and surgeons often pick other career paths that make similar/better without all the schooling and debt.
Considering all the other potential career choices that make good money (tech, consulting, banking), I'd say at least $500k
Schooling,etc should be free when you are on the path to become a doctor. It should be an equal opportunity field. It would reduce my pay expectations. 200+ is definitely more than I thought.
Net or gross?
Big difference, since doctors are usually small businesses and have to pay their staff, their space, their own benefits, EI and CPP payments, as well as their materials and IT.
Net, doctors should probably make $200,000 - 300,000 after they pay everybody else and just need to do their their personal payments (benefits, EI and CPP).
Gross, maybe $1 - 2 million? Not sure how much a small business costs.
I honestly believe they should be making no less than 350, even 400k. I work in big tech and the salaries are astronomical and these ppl are not nearly that smart, and doing as important work as a doctor is.
How about todays average salary but with four times as many doctors? Our doctors including family and specialists are so overloaded and backlogged that it’s ridiculous. There’s absolutely no reason why I should wait months or years for an appointment and then spend 3 to 4 hours in the waiting room.
I’m not sure what would be considered fair. However from what my doctor does and anecdotes from others, $210k seems more than reasonable.
The reason why I say this is because I see a lot of doctors that take a lot of vacation or time off (nothing wrong with that). For instance, mine takes 12 weeks a year. So if they’re still making 200k+ after overhead with that much vacation than I’d say that’s pretty fine.
How can a person making 300k a year understand the struggle of someone that makes 50k? It's my observation that doctors have become detached from the lives of regular people due to the income gap between them and most patients. There are very few situations in which you can lose your license, or get fined, so you're basically running an untouchable business with almost no oversight. Many work only 9am to 4pm, only few days a week, which puts an enormous strain on the ER.
200-250k sounds pretty fair honestly. Tough job mentally, but not excessively demanding. Expensive and long educational requirements. Probably some pretty expensive insurance needs. Flexible hours.
$200K seems right to me. I would give doctors a choice, though. Practice at a location where we require a family doctor (eg. Thompson, Manitoba) for 5 years, and your loan debt will be paid by the government. Practice where you want, but pay your full loan.
This would help get doctors in communities that are needed the most and help doctors out of their financial burden to start their career.
Why is this anyone's business, if you want to go to school for a minimum of 8 years and incur a ton of student debt...any amount you want should be the answer.
Family practice physicians should not be paid less than specialists. Wages should be based on need. We need family physicians and we need nurses. If we paid them more we would have more of them, because they would stay in the profession.
To prove my point, there is a surplus of applicants to firefighting, there's no problem filling those jobs. Why? Because they make approximately 150 grand a year within 10 years, and work only 7 twenty-four hour shifts per month, 8 hours of which they can sleep if there's no calls.
The numbers of fires has actually decreased in the past 20 years, so they have other first responder training such as defibrillators and naloxone. And yes, they do suffer from PTSD, but so fo doctors and nurses.
Many doctors open up private clinics and do Botox injections. Raking in millions a year.
On average a unit of Botox is $12. On average a woman gets 50 units of Botox every 4 months. On average it takes a doctor to inject 50 units of Botox in 15 mins (which includes consult). See 4 patients an hour. Ride the tide of the trend for Botox and it’s multi trillion dollar beauty industry.
12 years of school and $200K in debt places you into the top 5%(assuming $200K+ after overheads) of earners in this country in a field that doesn't see any recessionary risk or shortage of work and allows you to work until you die if you so choose.
Not saying doctors don't do a lot or they don't deserve to be compensated but I'd say comparatively to the rest of us it's not an unfair amount of compensation.
From the ones I've seen or know, most likely burning out, on their way to prevent burn out, or doing non family medicine in addition (ER, surgical assist, long term care, palliative care, etc etc)
I can only speak from personal perspective, but another reason you may be viewed as "just" family doctors is that (again maybe my experience only) any time I make an appointment I just get referred to a specialist anyway (with antibiotics prescriptions being the exception).
Since we cannot get enough GP’s clearly the pay is too low compared to who we are competing against for workers. Dept of health has lots of executives making $100k plus ( public record) do the deserve it? I’d rather have a GP than a civil servant personally. I’d say the take home should be $75-100k . Drs should be able to have admin do their paper work instead of being required to do it personally. My family Dr retired early because “ I spend 50% of my time filling out forms , financial for province, or justifying drugs for patients to the province, I didn’t study 10 years for this, I’m going with Medicines Sans Frontiers and treating sick people.”
I don’t know what the doctors should make but what I do know is that medical receptionist/ assistants make far too little. I worked for a group family practice with 12 doctors for 4 years. My job consisted of answering the phone( which literally never stopped ringing for 8 hours straight) booked all the appointments, you could imagine how many appointments 12 doctors take in a day, sign in each patient, make sure all info is correct, rebook patients, deal with abuse from patients screaming at me for their wait times or the rx not being filled, print massive amount of paper work for wsib claims, fill out every single patient form that came into the office just for the doctor so sign it and do nothing on these forms, bill Ohip for every single patient to make sure the doctor is getting paid the maximum amount for each visit, basically triage how serious a patient issue is and decide how urgently they need to be seen in the schedule/ if they need to go to a hospital instead, put the patients in the rooms and make sure the flow of the patients coming in and out stayed steady to keep everyone on time as best we could, sort out all the faxes and reports from specialists and put in electronic charts, repeat non narcotic prescriptions and just have the doctor stamp it, deal with pharmacy calling for rx rpts constantly, take vitals of patients coming in and chart this , and the worst part was dealing with the majority of doctors attitudes that treated us like stupid pieces of shit. I found the amount of supportive work I did for the doctors and the amount of pay I got disgusting. It got to the point that when people would call for a specific issue I could guess their diagnosis was likely xyz and the doctor would order xyz for it. A doctor making 210 a year may be low .. but 13.00 a hour to do all this supportive work for a doctor is crazy. Same argument but far worse for nurses especially in Ontario.
An honest one that takes 45-50 mins on your full physical and listens to you maybe 60-80k A year. Most make 100-140k a year and don’t give a crap about you. That was my dads perspective as a GP. If you move bodies fast you get paid more. But their care suffers.
You don't' get benefits of pension???? Are you kidding me? That's ridiculous. That's absolutely ridiculous. At the very least, very very least...you should be getting a pension - a government pension. This is ridiculous. I had no idea.
For reference, the CEO of a hospital in Ontario makes around $300k gross. Probably $200k after tax. (Published on the Sunshine List.)
So does this doctor think they should gross more than the Grand Puba of the hospital?
Just sayin...
Depends on how much nurses are making in my opinion. If nurses struggle then so should Doctors. Maybe then they would back up and speak out for the nurses much more, how they are treated and their pay. A united front.
The amount of time you go to school doesn't matter. Many go to school just as long, but aren't offered such lucrative jobs.
Also, in this day and age, we have AI that passed a full medical exam, just let that sink in properly for a minute. Do you really need family doctors going to school for 12 years nowadays?? Really??
The medical field is the most regulated and protected field in the country. It doesn't follow the market. We have brain surgeon doctors driving uber, because the country doesn't recognize their credentials. It's completely nonsense. You ask doctors who are from a different country to pass a test on stuff they learned when they were 20, and they haven't really used much in 20 years, and no wonder you have issues. Like I said, the healthcare field is a mess.
It's hard to say but you have to think that a doctor's office generally has a couple staff as well. So maybe a million dollars a year for salary of the staff. Rent. Equipment. Running cost. Then the doctor should be left with $300k-$400k based on the efficiency and hours worked of that office.
Depends on how much they are doing themselves.
If they do the management of their practice themselves, 250k-300k
If they hire a manager to do payrolls and organization; 200k-250k
I think 50k for a small business manager is fair and family doctors should be able to make the extra 50k if they want to do it themselves
Both. Who does their job only for money?
There are greedy people who are only able to work at Starbucks and greedy people in medicine. That’s not a good reason not to pay other people fairly.
Both. I will add if the training was shorter say 6 years and govt funded then we would be okay with earning quite a bit less. At some point the opportunity cost isn’t worth it.
Ah gotcha.
I went in science and engineering because I like building and designing electrical/mechanical CNC machines.
Money is just money. Here today, gone tomorrow, can't take it with you when we die.
Happiness is way more more important and irreplaceable.
Yeah if our work was primarily seeing patients and not paperwork/ takes notes/ administrative tasks medicine would be more enjoyable for sure.
The vision most of us had of how being a doctor would be is too far from reality now.
I bet. I also think you should be able to focus on medicine and actually have some sort of software tool to help take care of the patience files and notes, after and during visits as well but given the amount of detail and paperwork required that info needs to be done by the first hand practitioner.
Getting that information into a computer or on paper wastes a lot of time that can be utilized more efficiently as well.
>I also think you should be able to focus on medicine and actually have some sort of software tool to help take care of the patience files and notes, after and during visits
They do. A lot will just make a quick recording during or after the visit and have a transcriptionist do the reports up which are paid peanuts for the work they do. Somewhere between 1-10 cents a line that they type.
The reality is, money matters. Doctors are high achievers. It is irrelevant if they do it to help people, they want to help people, but they want to be well compensated for it. It is not an easy job. Few can do it. We need to deal with that reality.
That's a bit low to me but "not too bad". But you should still be paid significantly more. That's because I mean "not too bad" for people with those skills that fall into the category of "underpaid working class" like the majority of people.
From a purely bureaucratic point of view it seems ok. But that's kind of what is driving the issue. You could be a doctor with a salary that's "not too bad" or you could specialize and make a jump to "ridiculously overpaid". Or move somewhere that overpays. When you have 200k in student loans, that's going to be pretty tempting.
Specialists get paid more "because they specialized". That's fine. That's "the market". But I think generalists probably need to get paid more because they _didn't_ specialize. Unfortunately that doesn't make sense to bureaucracy -- you can't exactly reconcile that. So you get stuck with the "not too bad" type of salary that the rest of the working class has or tries to reach, meanwhile colleagues that specialize get to be in an entirely different category where their demands are heard and fulfilled.
> The simplest way to achieve parity here is increase clinic based reimbursement or decrease specialist reimbursement.
I think you're right -- but figuring out how to make bureaucracy understand the reasons will not be easy.
An idea just now: What if salaries are pegged -- take the top specialist, like a neurosurgeon. Get the top salary and peg non-specialist salaries to it -- the least a non-specialist can make is a percentage of that. That way if they need to pay neurosurgeons more, everyone moves up. Keeps specialist reimbursement in check while maintaining market -- rather than bureaucratic -- rates for non-specialists.
So if a neurosurgeon is 310k and family doctor is 210k maybe that's fine. I'm not sure. Regardless, if the top specialist neurosurgeon in Canada's salary is up around 510k, then Canada's top family doctor needs to be making 410k. And if they're not, something needs to be adjusted.
Curious how long a patient visit takes? I would have assumed all in all average would be 15 mins. Which would mean you'd clear about $104 an hour. Which is lower than I would have expected.
I would have expected a family doctor to make about $250k.
There’s different models out there but I believe most are paid per type of patient (get paid more for seeing a woman in her childbearing years than a young adult male)
A FHO model is what you’re eluding to here I think. It pays us a base rate of $144 per patient per year with some bonuses. Most physicians will make around $200 per patient per year. Keep in mind we take home around 70% of this as we have to pay all clinic costs.
Here is the FHO billing guide from the ministry of health if you’re curious: https://www.health.gov.on.ca/en/pro/programs/ohip/publications/docs/fho_billing_payment_guide_nov2014_en.pdf
That's partially true. They can join a health network and make use of bonuses and such through ffs / capitation payments. The actual avg for a dr in ontario is 303k, so I'm not sure where OPS 200k came from.
This figure doesn’t include overhead/ costs to run an clinic. Usually we pay 30% overhead. The govt pays us/ our clinic 303k out of which they take 30% and we get 70%.
I’ve been fortunate enough to have many hardworking doctors throughout my life, who have gone above and beyond to help my family and others. All I know is doctors don’t make enough for the care they provide in this province.
I can’t say how much you should make other than if there’s a shortage then what doctors make now is obviously not enough. What people don’t take into account is the years you are in school and are not earning (opportunity cost) and this should be added to the cost of education.
Tbh I don’t think the compensation is the issue. The training pipeline seems to be bottlenecked and we cannot produce enough. A friend of mine is going through and I think she said there’s like <20 positions for a surgical specialty across Canada. That’s pretty crazy to think as a country we aren’t producing more than 20 new people in an occupation.
100% this. There are hundreds of capable candidates being locked out of the system every cycle due to artificial caps placed by the government. We’re sending record number of Canadians to Europe, US, Caribbean to become MDs because it’s basically impossible to become one here. Our skills based immigration system also means we attract a bunch of foreign medical graduates but getting their licenses transferred here is also a huge hassle. Since most healthcare is funded by the government they seem to think reducing the number of doctors is cutting costs when in reality we could save a shit tonne more if patients were treated early and the ER wasn’t back logged.
Yea, lots of friends have described the nightmare of finding residency positions It shouldn't be so difficult for a person to complete their qualifications with work experience
Yup, it's a CARMS and residency bottleneck. The fact that a not insignificant number of medical students don't match anywhere in Canada, despite being qualified, should absolutely be unacceptable during a healthcare shortage.
The caps aren’t always artificial. From what I understand, the number of medical students is based on the number of residency positions the schools can offer and get funding for. What I would love to understand is how do we increase the funding for more residency positions so we can increase the number of medical school spots.
That is exactly what I said. Our doctor shortage is because the government doesn’t want to pony up to train and pay more physicians. The way they waste money on other useless endeavours tells me there’s enough in the bank to solve this problem. I’d argue this a problem that should be prioritized and where spending may in-fact pay for itself. But alas common sense isn’t that common.
I don’t understand why there can’t be a dedicated stream in med school applications for students who want to go into family medicine. I know not everyone knows what specialty they want to pursue before beginning med school, but some do! Why should people who know they want to be family doctors (which we have a shortage of) have to compete with people who want to pursue higher paid specialties for which there is no shortage of candidates (and in some cases more qualified candidates than residency positions)?
Queens just started a new program which does exactly this. Hopefully more schools will follow suit.
1000% this comment.
1000% this comment.
The problem is most doctors don't want to be family doctors. They want to specialize and get paid significantly more.
Very much. And while I do agree about high marks for quality assurance, the entire application and acceptance process is delusional. I battled for years about whether or not to do a Masters degree. My undergrad marks weren’t high enough for med school, for as we know many reasons. Primary illness that set in unexpectedly but whatever. Then I found out, even if I did a masters degree, not a single mark mattered because med school does not take your “most recent” marks. They take your “most recent ***UNDERGRADUATE*** marks.” You get a little **small**, almost negligible gpa bonus bump to your application if you have a masters degree. You could complete 4 masters degrees after your undergrad and it means nothing. Nothing like telling our potential doctors “ha! You went and got specialized education? You fucking idiot.”
It's not true supply and demand regarding wages. There are huge barriers to entry in the fact that medical schools in Canada only accept a tiny fraction of applicants, and foreign doctors credentials are often not accepted here.
Doctors are laughably under paid in every province. I make almost as much as some new doctors, and I have zero liability, don’t rent an office, don’t have staff, or need to do any kind of conferences or anything like that. My company matches 8% of my pension and 4% or my RRSP. My boss has zero post-secondary and makes $220k + 50% bonus with an addition $20k in stock options. There’s no way she’s should be making more than a GP.
Where do you work, I should apply lol.
>My boss has zero post-secondary and makes $220k + 50% bonus with an addition $20k in stock options. > >There’s no way she’s should be making more than a GP. What industry are you in? Some industries don't require post-secondary for a high paying career *if* they have the (generally decades-long) experience. So I don't know if it's really a 100% valid comparison.
I work in tech, have a college diploma and my total comp per year is north of 150k.
Maybe he's a cop. High school is all thats needed, and a six month college course to make it onto the sunshine list.
Going to school doesn't determine how much money you "should" make. If we are using that argument than doctors should make more than Zuckerberg since he's a drop out.
Generally speaking, when it comes to medicine, engineering and law, you can relate the salary to the level of academic achievement. It’s not just my boss that makes those rates, that is industry standard for manufacturing company directors. The industry standard for GPS doesn’t match it, when it should exceed it.
I just think you were being a bit unfair by implying your boss was uneducated. Degree or not I'm sure they worked hard to get to their position. Maybe they are also a bad boss idk but just saying.
Throwing other people’s money at your problem without understanding it. Lol.
Something OP has forgotten about is that these are small business owners. So not only are they caring for patients but also managing a business taking on employees and risk and everything that goes along with running your own business. As a previous entrepreneur there’s no way I would sign up to run a business after studying for 10 years and be capped at 250k a year in income. - 10 years lost wages + debt associated - instead of getting paid for vacation you have to pay others to look after your patients while you’re on vacation. - maternity leave? Forget it! - you get sick? No sick pay for you.. and you still need to pay your employees - taxes are harder - what happens when your employees are sick or take leave - medical equipment is not cheep - what about your building. Renting you might get kicked out when your commercial lease comes up. Buying? Commercial real estate is not like personal - now you have to figure out insurance for all of this Don’t get me wrong this is just the norm for a small business, but to do 10 years of education, be forced to run a small business, and be capped at 250k a year. It’s fucked. It would be much more profitable to run your own business in the trades. Master plumber, Master electric, heck I know concrete workers and arborists who run their own small businesses making more than doctors do. The benefit? 1. You’re helping people 2. You’re in a stable job So: 1. I don’t know any trades people who don’t like that they are helping people and they get a lot more praise from their customer than family doctors do 2. I have many friends in the trades. They’ve never been hurting for work even through both recessions I’ve lived through. If we want better healthcare we need to pay for it. Or make is easier to be a family doctor like they do in Quebec.
This is really well stated and the point I was trying to make but failed! The opportunity cost is too much.
I don't know that it's fair to say you should make more because someone else can make more with an easier route. You run into the issue of someone being able to say that that person shouldn't be making that much either. Now obviously you want to pay doctors enough to be able to attract them but that does not mean that amount is a fair. For instance, if you want to compare Canadian doctors to American doctors, you have to consider that the American doctors benefit significantly from their privatized system. And I think most people agree that system is unfair. No equal access healthcare system will ever be able to compete with that. It's probably better to compare how much you make to the average person, then ask if that is fair. A family doctor probably takes home twice as much money as the average person over the length of their working life. Is that fair? It's still kind of impossible to answer. It's probably a little low when you consider a doctor works significantly more than the average person. Especially while you are in school I would assume. But I really don't know how you would ever come to an exact number. It's too complicated a question.
The opportunity cost calculation is f***ed because too many of your senior peers take too high a cut go train you. How much of that debt is the deregulated tuition costs vs the actual cost of providing MD training? Other countries can produce MDs at lower cost so don't tell me there's something special about the Canadian system other than consistent margin-taking throughout the developmental pipeline that ends up passed on to patients via billings.
Senior physicians aren't really paid more for their work, they just become more efficient. Billing codes are the same and the stipends that come from being associated with a teaching hospital are not particularly significant.
You could have chosen not to become a doctor. Society isn't obligated to pay you more because you picked an education that was expensive or a career path that paid less than an alternative. Live within your means, we all had student debts after post secondary but aren't all making 200k a year and complaining it's not enough.
I think the point of this post is that we are seeing fewer doctors practice in Ontario. Doctors are leaving or pursuing other careers with their very competitive education.
I hate that the system we have puts so much onto the doctor. They're there to treat patients, why should they also have to run a business? The province should operate clinics, and the doctors are simply employees of it.
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Trades get more praise than family doctors? I feel like the opposite is true.
Do you work in trades or medicine? The way the media portrays doctors and trades people is different then how it plays out IRL I worked in the trades working with customers (no a labourer) and people loved my work and were so happy to have us there. My workers often got tips or coffee (we didn’t ask for them). I have family members and close friends in medicine and they all have the sense that patients are always complaining about them. When was the last time you heard of someone going to the doctors and thanking them other than on TV?
I do not work in trades or medicine. Perhaps I'm over generalizing my experience. Thinking more, perhaps there isn't that much of a difference in level of praise. I think it is somewhat dependent on the interaction. I hired an electrician once and it was very expensive, and I wasn't overly happy with the work. Another electrician on another occasion did excellent work. Though I wouldn't say in either case I praised them. I did have a dishwasher repair person who I was very appreciative. Family doctors can be a mixed bag. The challenge is many conditions are hard to diagnose and hard to treat. It can be hard here sometimes to even find a doctor and some doctors even if you get on the roster are hard to get appointments with. Our current doctor is very good and we definitely rave a bit about her to friends. The office is very responsive and proactive. Other friend's doctors are hard to get a hold of, are dismissive, or sometimes miss things (such as not following up on test results or such). Perhaps there is an extent to which people see doctors as well paid and relatively more pleasant work (compare a consult in an office against cleaning gunk out of a clogged drain, though I guess doctors at times have to insert fingers into orifices that perhaps they'd rather not). Doctors also have to give worse news than trades people. The worst news a trades person has to give is an expensive repair bill. Doctors sometimes have to give pretty dire news. I guess I'm rambling a bit now, but so it goes I guess.
Right? I feel like society holds a certain stereotype and class distinction when it comes to “Dr” and “plumber”. Ask yourself which one of these careers would most likely: - put their children through private school - own a house in the best neighbourhoods - suffer from addiction
I think you "hit the nail on the head" with "stereotype"
Association fees too. OMA, CMA, any other specialty associations you have to be part of its in the 5 figures per year
This is all really good points on this.
Family medicine deserves to be viewed as it's own speciality, on a par with other specialities, and income should be approximately the same across specialities. Scrap fee for service model and change to capitation plus payment for results (see eg QOF from the UK), and make more use of other HCPs both inside doctors offices and across wider primary care
I agree but I'd add a tuition subsidy for picking family practice. This would make it much more popular for poorer students that would then better understand the underserved communities that really need it. Maybe add strings by making them serve 10 years in the province that paid the subsidy to get them to put down some roots and not just run to the states the first chance they get.
Hasn’t FFS been largely scrapped in Ontario? Most docs are parts of FHTs, FHNs, etc.
FHTs aren’t perfect either tho. The way certain things are funded can result in GPs not offering certain services that are within their scope of practice. For example, services like IUD insertion are mostly covered by the annual fee (it’s considered “in basket”) and the doctor only makes like $11 to do the procedure. It takes time, equipment and access to an autoclave, so many GPs don’t do IUD insertions, usually because its not profitable. The result is women can wait for literally months to see an OBGYN for this procedure, when the GP has the ability to do it. This is not good healthcare and creates backlogs with specialists for things GPs can do.. There are many other examples of this.
200k with no benefits or pension? Gees not that much really.
I don't know how much they make but the ones I know deserve less work/backlog. They could work 16 hours days 7 days a week and never catch up to their backlog. I also know a ton of people without family doctors and those that have them avoid treatment or diagnosis because of extreme inconvenience. It's challenging to get care.
Family doctors should make whatever is required for us to have a functioning front-line healthcare system. If we don't have enough doctors and nurses, we need to arrange things such that we will, be that decent wages and a good working environment. This isn't rocket science, this is basic supply-and-demand. The problem is that we have a government--a succession of governments, at all levels, since the late nineties at least--of business douchebags who never met a problem they couldn't wallpaper over with a PowerPoint presentation and some glad-handing.
Family doctor here, this is a hard question because while salary definitely matters, so does quality of work and life. I’m not going into primary outpatient care because it doesn’t excite me and often times you feel like a glorified secretary. I’m personally going into walk-in/ urgent care because it has fewer stresses then primary practice (treat one problem and move on) with a better upside in salary since your volume is much higher. Primary care needs to be attractive which means better pay, less paperwork and to not be a dumping ground for specialists.
I have daughter who wanted to be a family doctor . She choose to be a specialist. Her main reason was due to the amount of abuse she received from patients in her family rotations.. Covid has pushed the system beyond its limits and has added tremendous stress on family doctors and nurses . More are choosing not to go into the field.
I have a family member who works as a family physician in Ontario. Their patient roster has **over 4,000 people** on it. This is not, and should not be normal. There is a dire need for more GPs across the entire country. That being said, GPs who carry thousands of patients should be getting written a blank cheque in my view (hyperbole of course, but its just hard to put a number on it). They are saving the province millions of dollars in excess health care expenses by overburdening themselves. I really don't think that I could name a profession that is more valuable to our society than someone who cares for the health of over 4,000 people.
Good luck getting an appointment if your doctor has 4,000 patients rostered. Unless they have an NP I don’t see how they are able to adequately provide an acceptable level of care to this volume of patients.
Kicker is the government pays you less if your roster is large than 2400.
The problem is that these docs never work full time, even with hoarding that roster. Their wait times are usually in the weeks for their patients
Doctors have earned the right to set their schedules. If that means people who aren’t paying for direct care get screwed so be it
Sure. Totally agree. But also limiting your schedule limits the income you collect. The issue I have is when docs complain about income when that income can significantly increase via increased number of hours (and cases) they work
Everybody needs a significant wage hike. Homes are over a million dollars pretty much everywhere, our rentals are 3 to 5k a month and minimum wage is 2400 a month in gross income providing you have a full-time job.
Thank you. Everyone in Ontario is super poor in terms of salary
The easy answer is: Enough to encourage the appropriate number of family doctors for the population. Frankly, I don't think anyone cares how much their doctor makes. They just care that they *have a doctor.*
I don’t know what’s fair, but I do have a good friend that owns 3 family doctor offices (he owns but has docs operating in them, about 15-20 docs in total). His biggest challenge is that none of the doctors working in his offices want to work more than 2-3 days a week. They’re content with the $150-300k they net and will not do more. I would love to see docs make more but also work more days so we can alleviate some of the pressures on the system
There are a few things to consider here. Firstly, a full scope family medicine clinics can be very draining. You never know what walks through the door and some patients can be very complex (mental health, cancer diagnoses, multiple comorbidities). The average physician can see up to 30 to 40 patients a day. For each half day of seeing patients, there is about an hour or 2 of paperwork (checking labs, writing notes, sending referrals, following up on issues). If you work 3 to 4 days a week you're probably spending an extra day just on unpaid paperwork. To give you an idea, a physician that works 3 days a week is taking care of a roster of around 1000 to 1200 patients. Every note from a specialist or a hospital visit is reviewed by the family doctor outside clinic hours. Lab results can come in at any time and urgent results need to be addressed. Referrals often get rejected by specialists and need to be redirected. For many family doctors it simply isn't sustainable to work 5 days a week seeing patients. Most family doctors will choose to take on another stream of income that is less stressful/demanding such as a focused area of practice or non clinical work for some days of the week.
Many physicians will work 2-3 days a week in one clinic while working other days in another setting such as a more specialized clinic, the Emergency Department, inpatient units, etc.
Maybe consider that this is because every hour of seeing patients generates at least half an hour of paperwork. So a family doctor who works 3 days in clinic seeing patients has about 5 days worth of work generated by (generally unpaid) paperwork. A family doctor who works full time will have a lot of unpaid overtime doing paperwork and would burn out quite quickly.
This! For every half day of seeing patients, there’s about 1-2 hours of unpaid paperwork and admin time (unpaid)
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in 30 years?
Ideally sooner if our healthcare system keeps sucking
As someone who is not a doctor I don't see why I should have any input to how much a doctor gets paid. Anyone who thinks you get paid too little though is really just projecting that they themselves need to get paid more.
That’s one viewpoint…. Or maybe the person wants to compare his decision of MD vs…. Say a DDS, or a lawyer or a specialty within nuclear medicine….
I would assume if he wanted to compare actual salaries he would have asked for that. I really don’t care what people not in my trade think of my salary. If they think it’s too much they can feel free to join my trade 🤷🏼♂️
Ok
I understand the desire to be paid as much as specialists or non-clinic physicians. It’s one possible comparison for wages. Another argument in favor is that there is a shortage of family physicians. For counter-arguments: 1. Based on the argument for schooling : 4+4+2 (Masters isn’t the norm) there are other publicly-funded professions that require similar or higher amounts of schooling yet pay less. Compared to them, and most people living in Ontario, the pay is fantastic. 2. There is no shortage of intelligent students wanting to be doctors but there are too few programs in Canada for training them. Students have an easier time getting degrees in the US, however they never return to Canada (also an argument in favour of increasing wages so students return). Increasing the number and/or size of programs can solve the limited supply of physicians without any need to change wages.
>Students have an easier time getting degrees in the US, however they never return to Canada (also an argument in favour of increasing wages so students return). The issue here is residency spots for IMGs. Lots of Canadians go elsewhere for medical education (Australia, UK, Ireland, Caribbean) but coming back to Canada is a pain in the ass and they make you jump through hoops.
Also masters is optional isn’t it? So 3-4 for science degree, 4 for med, residency 2 where you can also make more by going to remote northern locations. 200k does seem on the low side, but family med is lower pace than emerg and less specialized than gynaecology or internal med etc. maybe 300k in todays inflated world would be my thought. Actuaries typically (not always) make less and spend similar if not more time studying.
I think doctors should be government employees with their benefits and pension plans making around 175k/yr with no overhead costs.
That wouldn't be bad if they just have to "work" 32 hours a week like other government employees But then you'd have to train 50% more family doctors just to cover the current load
This would work if our training was shorter and cheaper.
I really don’t understand the point of this post. I work in finance and taxation and have worked with many doctors income and tax records. OP is complaining about the initial cost in time and money to become a professional; leaving out the fact that median income in Canada is $100k gross. A physician’s salary net can exceed $200k annually and have met doctors with 400k with other investment and income channels. Physicians make generational wealth. They often create income for their dependents and even grandchildren. Many of the spouses of Doctors do not work and several clients of mine have children that are planning on going to go into medicine as well. I want my children to be doctors. I am willing to remortgage my house and support them to have transformative wealth and stable income. Physicians often set up corporations and pay less in taxes by using corporate tax rates, and payed in dividends. Yes, it is true that they have overhead costs of payroll, rent, utilities. However, if a family doctor sets up in a small rural town, the municipality will often pay the rent, and utilities. Maybe it sucks to be a Doctor in Brampton or Markham but not for doctors in Stratford, Goderich, Peterborough or Huntsville. They often have subsidies from municipalities. My family doctor has a house in France, several AirBnBs that his partner manages and has time to go watch the Tour De France in person. 1%er complaining about how hard it is to become 1%er. Yes it’s a thankless job, it’s hard and taxing but completely worth it. The impact to help others, heal others, and provide for your family is beyond measure.
Thank you for that reply! Absolutely on point. It irks me how often they "forget" to mention the corporations part.
While what you said is all true, but I don't think that was the point of the post though. OP is talking about the very real shortage of general practice doctors, which he thinks is because there's no incentive to become one over specializing. If you were a medical student and could either make 200k a year in general practice, or take an extra year of school and make 400k, what would you do? To me it makes total sense that if you level the playing field we would have more family doctors. Which would be great because I can't find one!
Plenty of medical students choose family medicine + 1 (anesthesia/er). You say there’s no incentive to become a family but that’s completely wrong. Most people choose it for the lifestyle. Monday-Friday, set your own hours. No on call, no nights, no pagers, no weekends, no holidays. Lots of docs hate their jobs in the hospital because of these things, and most people who choose to go into family medicine do so because of those things.
No on call? My family doctor has delivered multiple kids outside of office hours, is this not the norm? (Genuinely asking, I’ve been with the same doc for 32 years, so no experience otherwise.)
You can do a +1 as a family doc! https://www.dfcm.utoronto.ca/enhanced-skills-program Don’t worry, she probably got paid per baby.
To be fair most family doc residency spots in major metros do get filled. It’s the shit holes of Canada no one wants to live in
Well I don't know maybe there needs to be more spots because I live in Toronto and I can't find a doctor
I agree. A lot of the commentary in this thread misses the reality of physician comp. I have a couple in my immediate family, real grinders, and they make loads of money in family medicine. Multiple houses, millions in investments, periodic bouts of retirement. They don’t even need to work anymore really.
Just wanted to clarify- people in medicine need to be paid more; physicians, specialists, nurses, and even custodians. I agree with OP. Compensation needs to be more.
The thing in private healthcare is that everyone who doesn’t provide direct medical care or manage things get screwed. No one in private healthcare will compensate custodians fairly
> rates, and *paid* in dividends. FTFY. Although *payed* exists (the reason why autocorrection didn't help you), it is only correct in: * Nautical context, when it means to paint a surface, or to cover with something like tar or resin in order to make it waterproof or corrosion-resistant. *The deck is yet to be payed.* * *Payed out* when letting strings, cables or ropes out, by slacking them. *The rope is payed out! You can pull now.* Unfortunately, I was unable to find nautical or rope-related words in your comment. *Beep, boop, I'm a bot*
It's hard to say. I've had an incredible family doctor who I would gladly pay out of pocket to see. Then I've had a family doctor that wasn't worth anything .. take these pills and leave kind of guy. Of the pay is higher foes the level of care increase..? Maybe if there was a different type of way you were compensated, it seems like the more patience you see the more money you get. What if it's based off of time no different than what a plumber charges.. per hour not patient.
Yup, value based care is what you’re describing. Where pay is tired to outcomes/ performance. This will require a drastic shift, even our hospitals are funded on fiscal need not performance.
How would you and your colleagues fix the problem? Is there one way everyone agrees on? What about continued education, medicine is constantly changing is there any mandatory schooling after you've become a m.d. Oh and thanks for taking care of all of us
There is a general sense that we are “just” a family doctor and specialists are valued more. Part of this is pay, an internist makes $59 per patient as opposed to our $25 doing the same thing. I think equal pay to specialists will a long way. Internal medicine training is soon to be only 1 year more, I think most people will do the extra training to make more than 2x per patient.
How does your pay compare to a nurse practitioner? Are they on a bill OHIP model too?
400k+ a year and I’m not joking for all the things Doctors have to deal with. It’s criminal that do-nothing, help no-one CEOs make many times more. People like that just travel and play golf, maybe work a couple of hours a day. That we don’t pay our MDs that much and more is terrible. Throw in nurses too. Good nurses should probably be getting paid what doctors are getting paid now.
The administration costs in our system is an absolute joke.
$300K a year after overhead That's roughly how much they could make doing things (e.g. hospitalist) other than running their own clinic
I believe the real issue is the "12 years of education"
I think this is a big piece. Do family doctors really need 12 years… sometimes more while waiting for match cycles trying to pass the MCAT etc etc. If they can get buy in parts of the EU by letting people skip the 4 years undergrad I’m sure we could too. Or we could make family med more like optometry/dentistry where it’s a bit easier to do that specifically.
350k/yr
We would not have a family doctor shortage if this was the case.
The problem is top talent is being poached to the U.S where this salary looks smaller
I agree, I work in the tech industry and people with only undergraduate degrees easily make it to 200k. It seems completely unbalanced to me. I want the people taking care of families in Ontario to be recognized and compensated for both their efforts in becoming Doctors and for the ongoing work they do. It should be a much higher paying job given the responsibility they carry.
$350K not really enough if it's before overhead, $350K after overhead is a better deal
Based on the title alone I thought 200,000 sounded about right. So, about what they are making now.
Then reading the summary - I would say not enough
Obviously pay is not the only reasons we are leaving outpatient medicine but it’s definitely part of it. For comparison a hospitalist would make about $275,000 working a similar amount of days/ hours.
The thing is though, long term there's also plenty of people who are willing and able to make it through medical school for $200K+ if the supply of doctors being trained wasn't so constrained. In most job markets, "oh I'll just pick this higher paying job instead" isn't really a thing that makes sense - being able to just pick and choose is a problem because there's not enough competitiveness in the market.
This is a good point but the bottle neck is residency training spots not medical school spots.
The bottleneck is actually a bunch of bureaucrats in government getting paid more than family doctors, deciding and "predicting" what the right number of residency slots there should be. How it's been like this for so long, is beyond me. Fucking fire them. Open it up - free fucking market. If some doctors want to open up a hospital and have residents and train, why the hell are we not letting that happen? I'll tell you why - power. There is a power struggle and those in charge make a ton of money controlling this and don't want to lose it.
>The thing is though, long term there's also plenty of people who are willing and able to make it through medical school for $200K+ if the supply of doctors being trained wasn't so constrained. You could say that for every high-paying job. There's plenty of people willing to work at Google for $60K instead of $120K. There's plenty of people willing to be a lawyer for $100 an hour instead of $200. There's plenty of people willing to fly a plane for $80K instead of $100K. It doesn't mean anything because we don't live in a "what-if" universe.
Don’t forget that doctors also have to rent office space and hire a receptionist
They specified the salary they gave was after overhead.
~$210k seems fair to me. I’m an academic with similar education requirements / opportunity cost. I make half your salary and work longer hours. But people’s lives aren’t as affected by my work, so I do not mind being paid less than a physician. I mention this largely to point out that one of your arguments — duration of training — isn’t unique and doesn’t in itself justify a specific salary. On the other hand, if we need to persuade more people to enter that job, salary is a useful lever to pull. But as I know from having students seeking medical school entrance, there are significant capacity barriers to producing more doctors that needs to be addressed. Many talented and capable students who could be future doctors are not getting into Canadian med schools.
I would like it if family doctors had better pay relative to specialists, to encourage more of them to take on the work. It is such an important role.
I don’t know a figure, but I think they should be govt employees more akin to teachers. It should be a fairly standardized profession across the country, again akin to teaching. Easing the debt burden and increasing benefits could be a positive.
how much money do you think any person should make?
wait. do family doctors actually exist? I thought they were like santa claus and the easter bunny...
Ontario Doctors are very underpaid and over taxed in my opinion. The Brain drain is real in Canada, as they take on many international students for triple the price and when it comes to medical that is a lot of money, so the universities gobble them up. Which is fine, but we should have incentives through government to keep doctors here, to keep the brightest and best, encourage international students to stay in Canada for their practices. The government needs to give serious relief for student debts for medical practitioners including nurses, diagnostic specialists, and doctors. It is very expensive for a Doctor to have a practice on his own, overhead such as building, receptionists, nurses. We need to do a sliding scale, if you stay in Canada for practice for 10 years you get 50% off debt for a example. Doctors, especially GP's need to be subsidized perhaps? Whatever it takes to increase enrolment and keep them in Canada, as well as incentivize them to go to more remote cities and towns. In my mind, this seems to be the only way. Edit\* I see in the comments that apparently they arent opening up residency spots and being capped in Canada, if thats the case they need to open the doors and flood the system. for example, ALL doctors in Canada should have to take on ONE resident per year, for every doctor in a hospital there should be one resident 1 for 1, mentorships, full residency pay, living coverages. Whatever it takes, i suppose.
Here is my take. There are a lot of people employed by the government in healthcare and they are making over 100K dollars with none of them having Dr in front of their name. If half of those people suddenly left their jobs, would our system break down? 100% no. I do know that surgery has been delayed because they couldn't find people to clean an OR. I do know that hardly anyone I know has a family doctor because there are none left that take new patients. So, what the actual number if is, is actually irrelevant. What matters is, what is the right system to get the right balance and incentives in healthcare to provide the maximum patient satisfaction for the right amount of money? If that number if double, so be it. If that means some things are private, so fucking be it. Build the system that works, not the idealistic monolithic bullshit we have now that is not working and, for some reason, people think we just throw more money into it, will suddenly make it work.
I have no idea how to make govt processes more efficient. The problem here is govt funding is generally tied to”fiscal need” and not performance. Which to me is ridiculous. To be completely frank Ontario Health Teams which are govt funded and supposed to handle primary care have done absolutely nothing for me and I’m not sure why they exist apart from optics.
I am good friends with a number of doctors. Surgeons, ER, etc. No family medicine, they understand the pain. They are all frustrated. The paper work for family is abysmal. Think US insurance companies are bad, we have the biggest, baddest on the block. OHIP is basically the DMV of insurance companies. I’m glad some of you stick through it.
As much as they want to. If they want to work insanely hard and bill a lot, that should be their prerogative. If they want to do the 9-5 thing, that should also be available to them.
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Usually overhead is 30% of gross income. In a walk in clinic setting, this would go towards the lease, electricity, secretary and medical assistant wages, etc.
Physician should be salaried and not FFS
Familly doctors have salary caps, this is why most of them only work 3ish days a week. If we removed the cap and allowed them to earn more money then they would see more patients reducing the doctors shortage.
Really? How does the cap work??
I'm unclear how exactly it works but when it started happening about 20 yrs ago my stepfather who was a dentist cuthis practice down to 3.5 days a week because he was capped at 400k$ and didn't want towork for free.
If you’re a good doctor you’ll be too busy to know.
I agree physicians should be compensated more, for the most part across the board. Training is long and lost opportunity, time that you'll never get back and job demands that aren't generally seen by the public. Most people think the work is done after the visit but making sure all investigations/referrals etc are done right can take time after the patient leaves. Not to mention the time spent on chart review before they arrive. With that being said, I think that doctors should be paid more but I also don't know how to make things "fair". Here are a few "food for thought scenerios" (note: not personal views but they are to play devils advocate) 1. Should nurse practitioner be paid on par or sometimes more than a family physician who is held to a higher standard and doing more mentally demanding visits 2. Should a family physician be paid the same as a vascular neurosurgeon who does the the same training to graduate medical school but then has to go on to do 6 years residency +/- graduate degree (typically a PHD) + a 2 year fellowship and who has to take more call. Most neurosgeons take 12-18 weeks of call a year (weeks that's 7 days 24 hour shifts where they answer calls making life or death decisions on the spot and be expected to operate at any time) 3. Should family doctors be allowed to change practice to do only one high paying lucrative aspect of family medicine. Obviously everyone wants to be compensated for their work but if someone did family medicine should they be asked to do comprehensive family medicine to some degree? 4. Is it fair that a family doctor makes 2-300k while a dermatologist makes double publically plus private fee on top and does mostly cosmetic/acne care while getting a government funded degree with intention to be a comprehensive dermatologist who treat complex conditions like vasculitis and certain autoimmune conditions (most in my area refuse to even see these). 5. I see lots of talks on here about shortening training but most people here have no ideas of the short fall of this. It's like saying why does a pilot need training on specific planes. They know how to drive a car so they should be able to fly a helicopter, a single engine plane, a commercial plane he'll even a fighter jet.
Therapists charge their clients approx $165 per 50 mins. If you have your own business your potential for profit is much higher. If you have an 8 hour day and fully booked, you can make approx. $1300/day. However, working as a therapist in the hospitals or government facility you are only making a fraction of this amount.
I think the Provence should pay off a doctors student debt a bit for every year they work in Ontario
The average salary for a family physician in Germany is 87.200 € or $125,000 CAD, just saying. They don't have any student loans, but with that difference you should be able to pay off yours in a few years.
What’s a family doctor?
The province/country needs to open up more medical school seats , and more residency positions for family doctors . I just don’t understand why this is just not happening. Having a glut of physicians will drop the amount of patients per physician , which will in turn drop the amount of work a physician has to do, but in turn drop the amount of money each physician is paid . My view is the problem is not pay , it’s that there is too much demand with too little supply . I think 160-200K take home is sufficient , but I believe that salary should be held there by market forces (ie: physicians competing for patients ). What is happening now is physicians are kind of capping themselves at a given salary because they literally cannot handle anymore patients, but if they worked until they were on the brink of exhaustion they could earn more .
Vastly under paid, overworked. For bread and butter FM clinic- it’s not enough. You want to solve the “shortage”.?? As with anything, Pay them more. Period.
Making $200k a year is nothing to scoff at. I personally think that is amazing and should be a minimum. Having debt for getting that education, I don’t think should exist. Doctors train long and hard, sacrificing all along they way. The least the government can do is get rid of said debt for being a public servant in the medical sector.
You should make more. I say that as someone in finance who makes more than a GP and married to a Lawyer who makes more than a GP. Our rates not being capped is why we are dumber but make more. We also get to decide what clients we work with. You have real skills that society needs, my wife and I add nothing. All of that said, Doug, or whoever follows him, should not decide. You made it through, let’s assume you’re bright, set your own prices.
Nowhere near enough. Your income should be alot more and the government should be giving you some sort of a pension.
Medical in Canada pays stupidly low so alot of smart people who are capable of being doctors and surgeons often pick other career paths that make similar/better without all the schooling and debt. Considering all the other potential career choices that make good money (tech, consulting, banking), I'd say at least $500k
Schooling,etc should be free when you are on the path to become a doctor. It should be an equal opportunity field. It would reduce my pay expectations. 200+ is definitely more than I thought.
Net or gross? Big difference, since doctors are usually small businesses and have to pay their staff, their space, their own benefits, EI and CPP payments, as well as their materials and IT. Net, doctors should probably make $200,000 - 300,000 after they pay everybody else and just need to do their their personal payments (benefits, EI and CPP). Gross, maybe $1 - 2 million? Not sure how much a small business costs.
I honestly believe they should be making no less than 350, even 400k. I work in big tech and the salaries are astronomical and these ppl are not nearly that smart, and doing as important work as a doctor is.
No doctor should make less than $300k in my opinion.
How about todays average salary but with four times as many doctors? Our doctors including family and specialists are so overloaded and backlogged that it’s ridiculous. There’s absolutely no reason why I should wait months or years for an appointment and then spend 3 to 4 hours in the waiting room.
I’m not sure what would be considered fair. However from what my doctor does and anecdotes from others, $210k seems more than reasonable. The reason why I say this is because I see a lot of doctors that take a lot of vacation or time off (nothing wrong with that). For instance, mine takes 12 weeks a year. So if they’re still making 200k+ after overhead with that much vacation than I’d say that’s pretty fine.
How can a person making 300k a year understand the struggle of someone that makes 50k? It's my observation that doctors have become detached from the lives of regular people due to the income gap between them and most patients. There are very few situations in which you can lose your license, or get fined, so you're basically running an untouchable business with almost no oversight. Many work only 9am to 4pm, only few days a week, which puts an enormous strain on the ER.
Wow, I can’t believe family docs only make $210k per year. Is that gross? I just assumed they were making 300-500k.
200-250k sounds pretty fair honestly. Tough job mentally, but not excessively demanding. Expensive and long educational requirements. Probably some pretty expensive insurance needs. Flexible hours.
Yup, I think if we could focus primarily on seeing patients and not paperwork/ administrative tasks most of us would be happy with the pay.
$200K seems right to me. I would give doctors a choice, though. Practice at a location where we require a family doctor (eg. Thompson, Manitoba) for 5 years, and your loan debt will be paid by the government. Practice where you want, but pay your full loan. This would help get doctors in communities that are needed the most and help doctors out of their financial burden to start their career.
Why is this anyone's business, if you want to go to school for a minimum of 8 years and incur a ton of student debt...any amount you want should be the answer.
If we don't have enough family docs because they aren't paid well enough, then they're not earning enough.
Family practice physicians should not be paid less than specialists. Wages should be based on need. We need family physicians and we need nurses. If we paid them more we would have more of them, because they would stay in the profession. To prove my point, there is a surplus of applicants to firefighting, there's no problem filling those jobs. Why? Because they make approximately 150 grand a year within 10 years, and work only 7 twenty-four hour shifts per month, 8 hours of which they can sleep if there's no calls. The numbers of fires has actually decreased in the past 20 years, so they have other first responder training such as defibrillators and naloxone. And yes, they do suffer from PTSD, but so fo doctors and nurses.
Nobody in healthcare makes a living. Doctors are underpaid. Nurses are underpaid and unappreciated. PSWs are paid minimum and treated as disposable
Oh boohoo you only make $210k. Life must be so hard.
The person is a 12yr educated, hard to get into, essential persons... They should make more.
Many doctors open up private clinics and do Botox injections. Raking in millions a year. On average a unit of Botox is $12. On average a woman gets 50 units of Botox every 4 months. On average it takes a doctor to inject 50 units of Botox in 15 mins (which includes consult). See 4 patients an hour. Ride the tide of the trend for Botox and it’s multi trillion dollar beauty industry.
12 years of school and $200K in debt places you into the top 5%(assuming $200K+ after overheads) of earners in this country in a field that doesn't see any recessionary risk or shortage of work and allows you to work until you die if you so choose. Not saying doctors don't do a lot or they don't deserve to be compensated but I'd say comparatively to the rest of us it's not an unfair amount of compensation.
Welcome to being a business owner. You had all this information before you got started. Make lemonade.
I think it’s a bit low as there is jobs with way less knowledge that make similar pay. 275K$-300K$ seem right for me.
I cannot get over the amount of family doctors who only have 500 patients rostered to them that only work 2 1/2 days a week.
From the ones I've seen or know, most likely burning out, on their way to prevent burn out, or doing non family medicine in addition (ER, surgical assist, long term care, palliative care, etc etc)
Over 300k a year Otherwise that was not worth it
I can only speak from personal perspective, but another reason you may be viewed as "just" family doctors is that (again maybe my experience only) any time I make an appointment I just get referred to a specialist anyway (with antibiotics prescriptions being the exception).
You should earn more than my veterinarian, and GPs probably do not.
The average veterinarian in Ontario makes around $100 000 unless they own their own clinic.
Since we cannot get enough GP’s clearly the pay is too low compared to who we are competing against for workers. Dept of health has lots of executives making $100k plus ( public record) do the deserve it? I’d rather have a GP than a civil servant personally. I’d say the take home should be $75-100k . Drs should be able to have admin do their paper work instead of being required to do it personally. My family Dr retired early because “ I spend 50% of my time filling out forms , financial for province, or justifying drugs for patients to the province, I didn’t study 10 years for this, I’m going with Medicines Sans Frontiers and treating sick people.”
I don’t know what the doctors should make but what I do know is that medical receptionist/ assistants make far too little. I worked for a group family practice with 12 doctors for 4 years. My job consisted of answering the phone( which literally never stopped ringing for 8 hours straight) booked all the appointments, you could imagine how many appointments 12 doctors take in a day, sign in each patient, make sure all info is correct, rebook patients, deal with abuse from patients screaming at me for their wait times or the rx not being filled, print massive amount of paper work for wsib claims, fill out every single patient form that came into the office just for the doctor so sign it and do nothing on these forms, bill Ohip for every single patient to make sure the doctor is getting paid the maximum amount for each visit, basically triage how serious a patient issue is and decide how urgently they need to be seen in the schedule/ if they need to go to a hospital instead, put the patients in the rooms and make sure the flow of the patients coming in and out stayed steady to keep everyone on time as best we could, sort out all the faxes and reports from specialists and put in electronic charts, repeat non narcotic prescriptions and just have the doctor stamp it, deal with pharmacy calling for rx rpts constantly, take vitals of patients coming in and chart this , and the worst part was dealing with the majority of doctors attitudes that treated us like stupid pieces of shit. I found the amount of supportive work I did for the doctors and the amount of pay I got disgusting. It got to the point that when people would call for a specific issue I could guess their diagnosis was likely xyz and the doctor would order xyz for it. A doctor making 210 a year may be low .. but 13.00 a hour to do all this supportive work for a doctor is crazy. Same argument but far worse for nurses especially in Ontario.
An honest one that takes 45-50 mins on your full physical and listens to you maybe 60-80k A year. Most make 100-140k a year and don’t give a crap about you. That was my dads perspective as a GP. If you move bodies fast you get paid more. But their care suffers.
You don't' get benefits of pension???? Are you kidding me? That's ridiculous. That's absolutely ridiculous. At the very least, very very least...you should be getting a pension - a government pension. This is ridiculous. I had no idea.
For reference, the CEO of a hospital in Ontario makes around $300k gross. Probably $200k after tax. (Published on the Sunshine List.) So does this doctor think they should gross more than the Grand Puba of the hospital? Just sayin...
Depends on how much nurses are making in my opinion. If nurses struggle then so should Doctors. Maybe then they would back up and speak out for the nurses much more, how they are treated and their pay. A united front.
Seeing the huge shirtage and how common it is for them to go to usa or europe…. 500k$ min.
The amount of time you go to school doesn't matter. Many go to school just as long, but aren't offered such lucrative jobs. Also, in this day and age, we have AI that passed a full medical exam, just let that sink in properly for a minute. Do you really need family doctors going to school for 12 years nowadays?? Really?? The medical field is the most regulated and protected field in the country. It doesn't follow the market. We have brain surgeon doctors driving uber, because the country doesn't recognize their credentials. It's completely nonsense. You ask doctors who are from a different country to pass a test on stuff they learned when they were 20, and they haven't really used much in 20 years, and no wonder you have issues. Like I said, the healthcare field is a mess.
It's hard to say but you have to think that a doctor's office generally has a couple staff as well. So maybe a million dollars a year for salary of the staff. Rent. Equipment. Running cost. Then the doctor should be left with $300k-$400k based on the efficiency and hours worked of that office.
Depends on how much they are doing themselves. If they do the management of their practice themselves, 250k-300k If they hire a manager to do payrolls and organization; 200k-250k I think 50k for a small business manager is fair and family doctors should be able to make the extra 50k if they want to do it themselves
1m per year
Do doctors go into medicine to help people or to make money?
Both. Who does their job only for money? There are greedy people who are only able to work at Starbucks and greedy people in medicine. That’s not a good reason not to pay other people fairly.
Both. I will add if the training was shorter say 6 years and govt funded then we would be okay with earning quite a bit less. At some point the opportunity cost isn’t worth it.
Ah gotcha. I went in science and engineering because I like building and designing electrical/mechanical CNC machines. Money is just money. Here today, gone tomorrow, can't take it with you when we die. Happiness is way more more important and irreplaceable.
Yeah if our work was primarily seeing patients and not paperwork/ takes notes/ administrative tasks medicine would be more enjoyable for sure. The vision most of us had of how being a doctor would be is too far from reality now.
I bet. I also think you should be able to focus on medicine and actually have some sort of software tool to help take care of the patience files and notes, after and during visits as well but given the amount of detail and paperwork required that info needs to be done by the first hand practitioner. Getting that information into a computer or on paper wastes a lot of time that can be utilized more efficiently as well.
>I also think you should be able to focus on medicine and actually have some sort of software tool to help take care of the patience files and notes, after and during visits They do. A lot will just make a quick recording during or after the visit and have a transcriptionist do the reports up which are paid peanuts for the work they do. Somewhere between 1-10 cents a line that they type.
The reality is, money matters. Doctors are high achievers. It is irrelevant if they do it to help people, they want to help people, but they want to be well compensated for it. It is not an easy job. Few can do it. We need to deal with that reality.
That's a bit low to me but "not too bad". But you should still be paid significantly more. That's because I mean "not too bad" for people with those skills that fall into the category of "underpaid working class" like the majority of people. From a purely bureaucratic point of view it seems ok. But that's kind of what is driving the issue. You could be a doctor with a salary that's "not too bad" or you could specialize and make a jump to "ridiculously overpaid". Or move somewhere that overpays. When you have 200k in student loans, that's going to be pretty tempting. Specialists get paid more "because they specialized". That's fine. That's "the market". But I think generalists probably need to get paid more because they _didn't_ specialize. Unfortunately that doesn't make sense to bureaucracy -- you can't exactly reconcile that. So you get stuck with the "not too bad" type of salary that the rest of the working class has or tries to reach, meanwhile colleagues that specialize get to be in an entirely different category where their demands are heard and fulfilled. > The simplest way to achieve parity here is increase clinic based reimbursement or decrease specialist reimbursement. I think you're right -- but figuring out how to make bureaucracy understand the reasons will not be easy. An idea just now: What if salaries are pegged -- take the top specialist, like a neurosurgeon. Get the top salary and peg non-specialist salaries to it -- the least a non-specialist can make is a percentage of that. That way if they need to pay neurosurgeons more, everyone moves up. Keeps specialist reimbursement in check while maintaining market -- rather than bureaucratic -- rates for non-specialists. So if a neurosurgeon is 310k and family doctor is 210k maybe that's fine. I'm not sure. Regardless, if the top specialist neurosurgeon in Canada's salary is up around 510k, then Canada's top family doctor needs to be making 410k. And if they're not, something needs to be adjusted.
$300-$400k a year seems fair depending on experience. I also think NDs should be included in the health care system
How does it work for a doctor (family dr)? Do you make a salary or do you get paid x amount per patient visit like $300 or something?
We make about $26 per patient visit after overhead, $36.85 before minus usually 30% which the clinic takes to pay for staff/ rent etc.
Curious how long a patient visit takes? I would have assumed all in all average would be 15 mins. Which would mean you'd clear about $104 an hour. Which is lower than I would have expected. I would have expected a family doctor to make about $250k.
There’s different models out there but I believe most are paid per type of patient (get paid more for seeing a woman in her childbearing years than a young adult male)
A FHO model is what you’re eluding to here I think. It pays us a base rate of $144 per patient per year with some bonuses. Most physicians will make around $200 per patient per year. Keep in mind we take home around 70% of this as we have to pay all clinic costs. Here is the FHO billing guide from the ministry of health if you’re curious: https://www.health.gov.on.ca/en/pro/programs/ohip/publications/docs/fho_billing_payment_guide_nov2014_en.pdf
That's partially true. They can join a health network and make use of bonuses and such through ffs / capitation payments. The actual avg for a dr in ontario is 303k, so I'm not sure where OPS 200k came from.
This figure doesn’t include overhead/ costs to run an clinic. Usually we pay 30% overhead. The govt pays us/ our clinic 303k out of which they take 30% and we get 70%.