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Salary in Family medicine


Staphed

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Not the response I expected, but given your background I'm more than a little puzzled at why you're maintaining that an individual with an income over twice that of the median income for a Canadian *family* is impoverished.

 

The compensation of FPs vs specialists is a reasonable topic for discussion. However, crying that you're going to be poor if you go into family medicine is -- quite frankly -- an untenable position.

 

Cheers,

 

pb

 

1) median Canadian family income in 2006 was $70 400.

http://www40.statcan.gc.ca/l01/cst01/famil106a-eng.htm

Relative poverty? What BS. I didn't go to a private school, never had a cottage, and winter vacations meant driving to Ottawa for Christmas. And I come from a physician family. By any relative measure, all full-time physicians are in the top 1% of income earners in Canada.

I suspect we come from different backgrounds and assumptions. Don't want to start a fight, but I feel that private school, winter vacations and a cottage are very much over and above "basic lifestyle".

I totally agree with this.

 

Future_doc, it seems like you want to be acknowledged by everyone as being a humanitarian but at the same time you don't want to admit that money comes before patients for you. Yes, it's true in family meds that you have to see a lottt of patients in order to make a lot of money. But it is possible to see less patients but also be compensated less too.

 

 

 

I've seen the private clinic discussion. Personally I disagree with the idea of co-payment as I don't think it will do much to improve the system or patients health, it will primarily benefit doctors. You yourself said a person making $65000 (which by the way is WELL above the Canadian average) can't get out from under the burden, so having to pay a copayment to a doctor already making triple that income for a visit is just not appropriate, IMO.

Just to add to what medordie said, there is nothing in the co-payment system that would really stop family doctors from trying to make even more money by continuing to see more patients than they should. Co-payment is clearly also a deterrent for some when it comes to getting their health checked. Something as obvious as that being ignored is a clear sign of doctor greed.

 

I don't think the government will pay you more money to see less patients. Get paid far more? I'm all for it(!) but it seems tax dollars are limited so where will the money come from, who will it be taken away from, for docs to get it?

Oh boy! Wouldn't we all like to get paid more for less!

 

There's already a shortage of family docs. So suggesting that family doctors see even less patients each than they do now is just ridiculous.

 

If we could afford to pay family doctors more (and thus attract more to the profession) then I'm sure the government would've since it's much cheaper to treat patients at the primary care level than it is at the specialist level. The money has to come from somewhere and all those in favour of making their patients dig deeper into their pockets to pay themselves clearly aren't so interested in the well being of the patients as they claim to be.

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Thank you desiguy at bringing reality to our doorstep. Do I understand correctly that doing outpatient medicine your expenses are minimal? If this is the case, then the possibility does indeed exist to have a well remunerated FM practice doing good for the patients, while creating a lifestyle for the family and even being able to do 3-4 weeks humanitarian work abroad if one is so inclined.

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Outpatient means in an office or clinic, and that usually means you have to pay lease, utilities, secretarial, and other expenses, unless they are covered as they are occasionally in hospital-based clinics. Ususally overhead is higher in an outpatient practice than an inpatient practice.

 

As for income, family med is not quite comparable to internal medicine, where the average billing was $350,000 for 2004 (http://secure.cihi.ca/cihiweb/products/app_average_payment_per_physician_report_2004_e.pdf page 25) - last year I could find data for.

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Oops, thanks for setting me straight cheech. I have not been able to open the site you gave yet, but if expenses run at 40%, then $150,000 would be left as taxable income (unless expenses are brought down b/c of a group practice or staggered practice allowing more than one doc to use same office.

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well 250000 is net income.you can gross around 30000 per month.overhead these days range from 25-30%.now to get this kind of money you need to have decent size practice with 1500 patients and working less than 40hrs per week.one can go up to 300000$ net income if working 5 days a week but very few people do that as most people that go in family medicine appreciate quality of life too!the numbers that show internal medicine at 350000 are misleading as it includes high paying specialities like cardio and GI.I vividly remember my perceptor in general internal medicine always complaining that her family doctor wife makes more money than him!cheers.

 

Its tremendous to have that possiblity and I for one will review the FM option which I had thought was off the drawing board. Thanks for the info.:P desi.

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high paying specialities like cardio and GI.I vividly remember my perceptor in general internal medicine always complaining that her family doctor wife makes more money than him!cheers.

 

He's not joking about those being high paid. Cardiology is the second highest paid specialty in Ontario - averaged $687k in 2005. I'm sure that skews the average a bit.

 

I've heard Kaiser Permanente starts new internists off at $180k...

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I've heard Kaiser Permanente starts new internists off at $180k...

 

As a caveat, there are huge differences in the amount GIM gets paid in USA vs. Canada, with Canadian GIMs being more highly paid. Two reasons: 1) GIM generally does primary care in the USA, fulfilling the role most family docs fulfil in Canada and 2) The USA has many more specialists than Canada, and therefore primary care is not regarded as highly, both in regards to prestige and income.

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$150,000 before tax is somewhat above poverty level but if you have 3 or 4 kids, it does not go that far really

 

For reals?! I have been reading this thread lately and have been mildly obsessed. My parents raised 3 children on a combined income of probably in the $50 000 area. We were by no means poor, but we understand the value of a dollar. We went on family vacations, lived in house that my parents owned, played baseball, went to summer camp. It all has to do with your choices. Do I want to drive a BMW? Do I want a stupid-sized house? Do I want to own a cottage in Spain? Will I lower myself to buy no-name soup?

 

It's about choice and management, not absoulte salary. Why are some (future) doctors so hung up on making $500k a year?

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For reals?! I have been reading this thread lately and have been mildly obsessed. My parents raised 3 children on a combined income of probably in the $50 000 area. We were by no means poor, but we understand the value of a dollar. We went on family vacations, lived in house that my parents owned, played baseball, went to summer camp. It all has to do with your choices. Do I want to drive a BMW? Do I want a stupid-sized house? Do I want to own a cottage in Spain? Will I lower myself to buy no-name soup?

 

It's about choice and management, not absoulte salary. Why are some (future) doctors so hung up on making $500k a year?

 

I think cost-of-living has a lot to do with it, so it depends what part of the country you're in and how long ago this was.

 

Also depends whether or not you have to subsidize your education/living expenses entirely on your own and therefore will have large student loan payments? Would help if you have some inheritance coming in the future to pay off your mortgage?

 

Personally I could care less about 500k a year but bottom-line is I'm aware I need a certain amount per month to allow me to pay student loans, mortgage, disability, critical illness, life insurance, RRSP etc. And nothing wrong with a BMW.

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For reals?! I have been reading this thread lately and have been mildly obsessed. My parents raised 3 children on a combined income of probably in the $50 000 area. We were by no means poor, but we understand the value of a dollar. We went on family vacations, lived in house that my parents owned, played baseball, went to summer camp. It all has to do with your choices. Do I want to drive a BMW? Do I want a stupid-sized house? Do I want to own a cottage in Spain? Will I lower myself to buy no-name soup?

 

It's about choice and management, not absoulte salary. Why are some (future) doctors so hung up on making $500k a year?

 

I have been brought up "on air", came to Canada with not a penny, got a fabulous trilingual private school education, all subsidized, all kinds of extra lessons in a range of activities, all subsidized. No family cactions, no summer camp. Now its my turn, I intend to pay my way, I am a capitalist, a hiumanitarian and a Canadian living in a free country where I can make my dreams come true by hard work and planning. For me medicine is a calling, I am sure I can earn more money elsewhere, so money is not the issue. Having said that, I will need a certain min. to put my future children into private school and obtain all the benefits I obtained and more - at my sole expense. It is my turn to give back to society, my future family and to the world as a humanitarian. I will need a big income to accomplish this and don't apologize. We each have different expectations and goals, personally, professionally and financially. I know what mine are. When I was in high school at age 16 I got a sales job and stayed for years. Within weeks, I was top salesperson outperforming fulltime adults who had experience, I was a novice and highly successful. I have every confidence that I shall achieve each of my goals, make my familt proud and be a highly productive citizen professionally, as tax payer and in the wider world. May each of us each attain our goals! Each to his/her own.

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well 250000 is net income.you can gross around 30000 per month.overhead these days range from 25-30%.now to get this kind of money you need to have decent size practice with 1500 patients and working less than 40hrs per week.one can go up to 300000$ net income if working 5 days a week but very few people do that as most people that go in family medicine appreciate quality of life too!

 

300000 net income with 40 hr work week, 49 weeks a year (3 week vacation), boils down to approx $150/hour.

 

Each patient (basic office visit) earns you approx $20 net (in BC, assuming 30% overhead)

 

$150/hr requires consistent 6-7 patients/hour (certain fee codes/uninsured services allow for higher pay per patient)

 

Do-able but tiring.

 

Much easily achievable in provinces such as Alberta though, with the better fee schedule

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correct, plus we get into patient load, ideally the patient makes a 'small' payment per visit that is set in accordance with what may be affordable for the poorest patient. I guess I am talking about seriously tinkering with the existing model for the benefit of all that has been explored by the powers that be. There has been an ongoing discussion on this topic in Private Clinics Discussion.

 

The "poorest of patients" likely could not afford even $0.25

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I think that when money is exchanged in a doctor's office, whether the patient is 'rich' or 'poor' or whether poor folk don't have to pay, there inevitably will be a differential of power or treatment. I can see healthcare providers *non-intentionally* reacting differently to the "payers" and the "non-payers" or at least creating a healthcare system in which non-paying patients would feel inadequate, embarassed or ashamed to have to apply for non-payment. Ultimately this could lead to these people not accessing heatlhcare as much as they should.

 

I like the way it is now - no one ever sees money change (except of course for non-covered/elective procedures) and no one has to prove that they are poor enough or rich enough to be placed in a category.

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I would be only too happy to put up the small payment per visit of any of my patients who could not afford such payment

Yeahhh okayyyy.

 

that is a good matter to addressed - it should promt us to solve that problem rather than give us permission to commit the same fault elsewhere.

My thoughts exactly.

 

Disparity somewhere else is not a good reason at all for more disparity.

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Because its not total earnings, or average earnings relative to the entire population that is important. Rather, it is earnings relative to your peers.

 

There is always going to be a sense of resentment for one's own path in life when they see their old classmate, who was no better a student in medical school(and maybe even worse) drive around in their Porsche and live in a sweet downtown penthouse condo just because they landed a specialty that is very lucrative. One might feel a bit underappreciated when on the wrong end of such a pay disparity, and will thus "phone-in" their work from that point on. It happens. It's common. It's the first step towards burn-out.

 

Right. I'd say that such people should get over themselves and stop comparing their status to others. If money and status are that important, medicine was not the right choice in the first place.

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if one seeks money and status, better go into investment banking, money management or law.......and a pleasing personality without substance can often get you far, e.g., in the marekting end of money management, you don't manage money, just people by bringing in and retaining clients, investment banking requires good communication skills that can allow you to be forgiven for some lack of substance..and I know one incompetent lawyer who was very lieable and blamed all his losses on the Court as he fought and lost useless cases for which his clients paid without objection........in medicine, we need to be competent as patients lives are at stake

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if one seeks money and status, better go into investment banking, money management or law.......and a pleasing personality without substance can often get you far, e.g., in the marekting end of money management, you don't manage money, just people by bringing in and retaining clients, investment banking requires good communication skills that can allow you to be forgiven for some lack of substance..and I know one incompetent lawyer who was very lieable and blamed all his losses on the Court as he fought and lost useless cases for which his clients paid without objection........in medicine, we need to be competent as patients lives are at stake

 

I actually used to think along the same lines, in some ways I still do. There's no doubt in the world, if you want to be rich, like money will last for a generation rich, the only possible way to do that is through your own business. You can never get that working for someone else, so in that sense I agree with you and others who argue that point.

 

At the same token when you start to weigh in the stability that medicine provides, it's second to none when it comes to careers. No other profession can promise such a large steady paycheck. So when you weigh both you have to decide if you would prefer high risk high reward, or stability and comfort.

 

Sorta makes me believe that medicine tends to draw the more (at least financially) conservative folks, well the more adventurous people tend to become entrepreneurs. (obviously there are tonnes of adventurous docs and cautious entrepreneurs)

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Right. I'd say that such people should get over themselves and stop comparing their status to others. If money and status are that important, medicine was not the right choice in the first place.

 

Moreover, just because someone has flashier property than the next person doesn't mean they are richer and more financially secure (Scott Storch, anyone?). Some people choose to limit excessive spending and invest wisely. Some might even donate income that they don't know what to do with to charity. If you have time, I'd recommend reading "The Millionaire Next Door."

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I actually used to think along the same lines, in some ways I still do. There's no doubt in the world, if you want to be rich, like money will last for a generation rich, the only possible way to do that is through your own business. You can never get that working for someone else, so in that sense I agree with you and others who argue that point.

 

At the same token when you start to weigh in the stability that medicine provides, it's second to none when it comes to careers. No other profession can promise such a large steady paycheck. So when you weigh both you have to decide if you would prefer high risk high reward, or stability and comfort.

 

Sorta makes me believe that medicine tends to draw the more (at least financially) conservative folks, well the more adventurous people tend to become entrepreneurs. (obviously there are tonnes of adventurous docs and cautious entrepreneurs)

 

One other point. Yes, we want reasonably decent lives with some of the extras, however, our focus is directed toward helping others first - as opposed to the strict greed motive of helping just ourselves, which, in large measures, is what these other avenues are about (although arguably, lwas is can be an hoonurable profession if you can weed out the incompetents and d-bags of which there are many). Self-interest in moderation can be okay, I want to provide optimum care to my future patients, do humanitarian work throughout my professional life, and yes, have an above average lifestyle that perhaps some of you consider is excessive, but if I am a ble to accomplish my goals, why not? FFor sure, I am not entering med for the money, and I am well aware that I could more elsewhere and for considerably less effort.

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Many people live leveraged lives, they seem to be wealthy but can barely meet expenses and it is all just show. It is not about what others think of your lifestyle or wealth or lack of it. It is for each of us to choose a path that will result in a fulfilling professional and personal life that allows us to live reasonably and in accordance with our means, while supporting our future families and giving our kids the education and opportunities we believe they require, deserve or we can reasonably provide, thereby giving them a good start in life.

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