why do pediatricians make less money?

[poormedstudent]

I have heard from money people that pediatricians make less money than their adult counterparts. Why is this? It seems to me kids are generally less complex and take less time to see and treat, so you would probably be able to see more patients in an hour compared with adult internal medicine patients who have 50 other comorbidities.

 

Any thoughts?

[Handsome88]

I have heard from money people that pediatricians make less money than their adult counterparts. Why is this? It seems to me kids are generally less complex and take less time to see and treat, so you would probably be able to see more patients in an hour compared with adult internal medicine patients who have 50 other comorbidities.

 

Any thoughts?

 

They don't really make significantly less. Where did you get this information from? I think hey may make slightly less because they do less procedures (no need for as many stress tests, EKGs, scopes...etc).

I heard they are less stressed than their "adult counterparts" though.

[TheCat'sMeow]

I've heard they make significantly less (according to pediatricians who i have worked with)

[aaronjw]

Money in meds, like most careers, is relative to the amount you work.

[thehumanmacbook]

They don't really make significantly less. Where did you get this information from? I think hey may make slightly less because they do less procedures (no need for as many stress tests, EKGs, scopes...etc).

I heard they are less stressed than their "adult counterparts" though.

 

This is what I've heard too about the pay discrepancy...which isn't too big, but yes some do get paid less than their "adult counterparts".

[A-Stark]

Money in meds, like most careers, is relative to the amount you work.

 

Nonsense. In medicine, money is directly connected to the number of procedures you can bill for, which in peds really isn't very many. And you'd be hard pressed to say that ophthalmologists work more than rural family docs.

[goleafsgochris]

Nonsense. In medicine, money is directly connected to the number of procedures you can bill for, which in peds really isn't very many. And you'd be hard pressed to say that ophthalmologists work more than rural family docs.

 

++++, it is very very well known that peds earn less than any other specialty (besides psych). Do people really think this is because peds dont work that hard? Really?!?!

 

Amount of work done and pay are extremely weakly correlated in the medical specialties. Peds generally work similar hours/do similar call as IM, and make significantly less...and yes, this includes in the peds and IM sub-specialties. In clerkship this was quite obvious to me IMO

[Handsome88]

I've heard they make significantly less (according to pediatricians who i have worked with)

 

I've heard that in countries in Asia (like Singapore), parts of Africa and Middle east, pediatrics is the most competitive specialty you can get into. Only the top students actually get it. I found that funny at first but it makes sense, as in those countries they are not paid by procedures. So picking a less stressful job is best.

 

Remember, money isn't everything.

[aaronjw]

Nonsense. In medicine, money is directly connected to the number of procedures you can bill for, which in peds really isn't very many. And you'd be hard pressed to say that ophthalmologists work more than rural family docs.

 

So my family DR that works reg office hours + 3 sessions of evening hours + 3 saturday full day sessions each month makes less than 2 other DR's in his clinic that work 10-4 hours 4 days a week and half day on Fridays so they can go golfing?

[A-Stark]

Eh? Obviously a family doc that works more than another family doc also bills more and hence makes more money. That has no bearing on comparisons between different specialties.

[aaronjw]

Eh? Obviously a family doc that works more than another family doc also bills more and hence makes more money. That has no bearing on comparisons between different specialties.

 

And neither did my original post.

[peachy]

I don't think the money thing makes a huge amount of sense in any area of medicine -- billing schedules are based on historic quirks more often than not.

 

It seems to me kids are generally less complex and take less time to see and treat, so you would probably be able to see more patients in an hour compared with adult internal medicine patients who have 50 other comorbidities.

That has not generally been my experience on pediatric rotations. Sure, like in adult medicine, there are some fast complaints, like strep throats. But with a minimally cooperative child, examination can take a lot longer. Mostly, though, parents frequently need a lot of reassurance which can take a lot of time.

[crockett]

And neither did my original post.

 

Than what exactly was your original post about? That people in the same field who work more generally make more than those who work less? Mind-boggling...

[A-Stark]

And neither did my original post.

 

Uh, you explicitly said that remuneration is directly related to the number of hours worked. Pediatricians work a lot and have to go in during the middle of the night to see patients in emerg. As staff. Forever. General peds is a lot of time-consuming reassurance, behavioural issues, constipation, and a few congenital chronic issues.

 

Even among family docs the number of hours is somewhat beside the point; it's all in the billing. A physician in a walk-in clinic who churns through 4-5 patients in an hour is going to make more than one who sees only 2-3 per hour. It can be argued that the latter may be providing better care, and though working the same hours, has lower gross billings.

 

So, no, remuneration is not especially related to "how hard" a physician works.

[TheCat'sMeow]

I've heard that in countries in Asia (like Singapore), parts of Africa and Middle east, pediatrics is the most competitive specialty you can get into. Only the top students actually get it. I found that funny at first but it makes sense, as in those countries they are not paid by procedures. So picking a less stressful job is best.

 

Remember, money isn't everything.

 

I think it's interesting that you say this now. Why the change in opinion since last year.

 

"I'm in first year Med in Ireland. I'm planning to go into IM because I'm assuming (correct me if I'm wrong) it is a safe option for IMGs but it does not really help me out with my 250k+ debt. So I am relying on sub-specializing in Cardiology/GI, or going into Critical Care/Neurology after first year of residency for the higher pay." Handsome88 (2010)

[NLengr]

I would expect that the pay differential may have something to do with a higher number of peds docs being salaried vs. adult docs when you look at medium sized centers. Sure in Toronto, Montreal and Vancouver you would have lots of kids to keep, say, a pediatric rheumatologist busy enough to be FFS, but in a medium sized center, probably not so much. As a result, more of them seem to be salaried.

 

Now, many of these centers still need to provide the required peds services, so they need to have the docs on salary.

 

Salary pay is generally lower than full time FFS. As a result, when you look at average numbers, peds looks lower.

 

That's my take on it anyway.

[aaronjw]

Uh, you explicitly said that remuneration is directly related to the number of hours worked. Pediatricians work a lot and have to go in during the middle of the night to see patients in emerg. As staff. Forever. General peds is a lot of time-consuming reassurance, behavioural issues, constipation, and a few congenital chronic issues.

 

Even among family docs the number of hours is somewhat beside the point; it's all in the billing. A physician in a walk-in clinic who churns through 4-5 patients in an hour is going to make more than one who sees only 2-3 per hour. It can be argued that the latter may be providing better care, and though working the same hours, has lower gross billings.

 

So, no, remuneration is not especially related to "how hard" a physician works.

 

Actually, this is what I said:

 

Money in meds, like most careers, is relative to the amount you work.

 

I mentioned meds. Not ped's or some other speciality of medicine. Meds was generalized.

 

Also, I didn't place any emphasis on how hard someone works. I placed emphasis on the amount that someone works and typically, it is true in ALL industries that the more you work the more you make.

[A-Stark]

And, in general, that is not true of medicine.

[thebouque]

I've heard that in countries in Asia (like Singapore), parts of Africa and Middle east, pediatrics is the most competitive specialty you can get into. Only the top students actually get it. I found that funny at first but it makes sense, as in those countries they are not paid by procedures. So picking a less stressful job is best.

 

 

In Quebec peds is very competitive

[goleafsgochris]

^^^ Peds is competative throughout Canada. But not because its well paid--because people like kids generally more than they like dealing with IM adults who are generally obese, have terrible lifestyles, and have 45 co-morbidities.

[thebouque]

^^^ Peds is competative throughout Canada. But not because its well paid--because people like kids generally more than they like dealing with IM adults who are generally obese, have terrible lifestyles, and have 45 co-morbidities.

 

And because there are lots of girls in medicine

[olecranon]

don't know where you guys are from but all the pediatricians i've worked with in BC bill over 400k based on the bluebook. each consult is 200 bucks. follow ups are 60...if they do call even more. each newborn assessment which takes basically 5 min is 200 bucks.

[moo]

Pediatricians don't make a lot in the US. My friend who is a general pediatrician in southern California has a salary of about 80K working at Kaiser. She does about 40 hours of outpatient clinic, about half of which are urgent care shifts (walk-ins).

 

In Canada, you can do well as a general consultant pediatrician in private practice. From looking up the blue book of several of my pediatrician colleagues, they bill about 300-400K a year. However, this is probably ALL they bill. (Their overhead is probably similar to a family doctor's) Whereas a family doc can bill for ICBC, WCB, and tons of private billings, pediatricians probably don't have this option. For example, for me, I bill lawyers about 950 bucks for a medicolegal which is usually about 2 hours of work (and there is no overhead on medicolegals). Because of the nature of my work as a walk in doc, I see a lot of MVC's and thus I end up getting a lot of lawyer requests for these things. I can't imagine a pediatrician writing a medicolegal, as they rarely see patients due to MVCs. Serious MVCs go to ortho/trauma, and your soft tissue injuries go to family docs. Thus you can't really directly compare what a family doc bills in the blue book versus what a pediatrician bills.

 

The other thing is, if you are employed by a Health Authority, your pay will vary significantly based on your specialty. From the salary lookup on Vancouversun.com for public sector salaries, pediatricians can be very low paying (for example, peds rheumatologists or peds nephros don't make more than 180K TOPS for the department heads). If you are a neonatologist, you will probably make more (300K+ SALARY, meaning plus benefits, probably equivalent to 450-500K gross billings). The other thing is if you are a subspecialist, there is the difficulty in finding a job in a major centre of your choosing. You can't just establish a private practice in peds rheum, for instance, simply because there isn't a big need for it and you would never survive just on private billings. (I can count on one hand the number of people i've referred to peds rheum and neprho on one hand over the 3 years I've been in private practice.)

[leviathan]

You have to remember that pediatrics in Canada is a consultant service, not a primary care service like in the US, so the compensation is probably a bit better. As far as I know, you need a referral from a family doctor before you can see a pediatrician, yes/no?

[Typical Premed]

You have to remember that pediatrics in Canada is a consultant service, not a primary care service like in the US, so the compensation is probably a bit better. As far as I know, you need a referral from a family doctor before you can see a pediatrician, yes/no?

Not in Ontario, particularly in the Toronto area. Many pediatricians do primary care here. However, where I go to med school in NL, pediatrics is primarily a consultant service. Not sure about the other provinces.