Fm Ways To Add To Income

[liammo29]

So I am trying to pick what to do my residency in and am leaning towards family and am trying to get to the bottom of what the income potential of Family Med is. I would be in St. John's NL. Upon first read there is so much negativity but it seems that several of these articles are plain wrong or are based on doctors not working 40 hours. So my questions are:

 

- Working 40-50 hours a week in a busy clinic is it normal to do over 200k (after overhead)?

 

- I am seriously looking at plus 1 options such as OB. Does this cause much of an increase in salary? 

 

- Are there any other popular ways to supplement income, I have read about things such as lumps and bumps and walk-ins

 

Thanks!

[hking03]

I can't speak to your province, but I can tell you in BC it is fairly straight forward to have a full scope practice and practice Obs and make over 200k.

 

In BC the average office visit is 33.00. If you see 24 patients a day as a new grad you'd make 800.00 per day. If you worked 5 days a week that would be 4K per week. If you took 6 weeks vacation you'd make 184k. Just from straight clinic.

 

If you did Obs as well and joined a call group you'd get an additional 8k per year as a stipend. You'd also receive 25k in bonuses for delivering 25 babies in a year. And for every baby you deliver and do prenatal care on you would receive approximately 1k. So, if you delivered 1 baby a week and did the prenatal care you'd make an additional ~55k.

 

For a grand total of roughly 240K.

 

Oh, also I'm not sure if you would absolutely need to do a full year of Obs... I believe they have 3-6 month preceptorships where you work with an experienced Obs gp and they teach you the ropes. You get paid. They get paid. And then you can go out on your own.

 

Hopefully that helps...

[ralk]

1) 200k after overhead is on the higher end, but certainly achievable in a 50 hour work week. Maybe a bit harder with straight clinic work.

 

2) +1's don't add much to income, aside from EM +1's (since they end up essentially being equivalent to 5-year EM docs in terms of salary). They're there to help your tailor your career, not increase your compensation. Going straight into the workforce is generally the best decision from a pure financial perspective. As hking03 says, 6 month OB training courses are available.

 

3) Specialized high-volume clinics can be good income support. I've heard less favourable things about walk-ins, though I don't have direct experience. Hospitalist care, ER shifts (for rural practitioners), and nursing home care can all be ways to supplement income.

[WomboCombo]

What is a reasonable # of patients an FM sees per day without rushing/compromising the standard of care? Hking03, is 24 in an 8 hour day reasonable (is that factoring in the charting and documentation/note writing that takes up time after patient visits)?

[Snowmen]

I've always heard that 15 minutes/patient was the usual average.

[Intel21]

 

 

3) Specialized high-volume clinics can be good income support. I've heard less favourable things about walk-ins, though I don't have direct experience. Hospitalist care, ER shifts (for rural practitioners), and nursing home care can all be ways to supplement income.

If one did strictly high volume walk-ins after graduating, how much would you gross?

[criselda]

Re: FM and obstetrics. If you had enough OB exposure in residency through electives, you may not even need additional training. I know of recent grads who jumped right in. Personally I'd be interested in doing a few more supervised deliveries - in BC we have the MC4BC program.

 

I've also seen group prenatal clinics, where the majority of patients are uncomplicated and one could easily get through 40 of those a day.

 

24 patients per day sounds reasonable. As a resident I see about that many as a maximum, working from 9-4 with a one hour lunch break. My preceptors do paperwork before/after the day, in between pts, during lunch hour, etc.

[ralk]

If one did strictly high volume walk-ins after graduating, how much would you gross?

 

Depends on the set-up of the clinic, location, volume, hours, etc. At my stage in training, I haven't had too much direct exposure to walk-in clinics, let alone finances, but I believe the income wouldn't be much different than a similarly busy standard FM clinic. Walk-ins might have somewhat better volume just based on patient population, but I don't think the absolute earnings are likely to be that much higher than the average for full-time FM.

[p0tus]

With walk-in clinics, one benefit is that you rarely need to take your work home with you. Generally you work for 4-6 hours and are done for the day, since your colleagues take over after you and are generally responsible for any labs/reports that arrive during that shift. The issues are generally straightforward and you can get through patients every 5-10 minutes. I know of some walk in docs who routinely go through 50 patients in a 6 hour shift, for most the average is probably close to 35-40. Now whether the medicine you practice is fulfilling, that's a different discussion altogether.

 

With a regular practice, you have your own patients you are responsible for and have to follow up on labs you order, act on specialist reports etc. You have to cover your own after hours call or find colleagues to cover you. You have to deal with complex patient issues and it will generally take 15 minutes per appointment. During the day you will probably see 30-35 patients. You will like spend 8-10 hours per day doing medicine related work. With complex care billing and time modifiers etc you will probably make $ similar to a walk in clinic shift. Now many would probably say that the medicine practiced in this setting is much more fulfilling, but you will be spending a lot more of your time in clinic and work.

[medisforme]

My preceptor is really into nutrition and one way he supplements his income is running nutrition counseling sessions for 6-8 patients at a time in the evening after clinic.  Depending on how many patients show up he said he can make between $300-$600 for a 45 - 60 min session.