Family Physician Salary

[~FutureFamDoc~]

Can someone explain the different pay models??

 

Also, I was looking as to how much a family physician makes in Ontario? Billing and after taxes - just to get a sense as to how quickly or slowly I can expect to pay back my loans!

 

Thanks a bunch

[amska]

This thread answers your questions:

 

http://www.premed101.com/forums/showthread.php?t=31720

[MrKhiladi]

does a fm doc make more working at a walk in clinic or having there own clinic?

[Guest copacetic]

walk-in...but working at a walk-in is EXHAUSTING!

[gb35]

I'm seeing lots of postings that offer salary, plus "22% of shadowed bill claims". Can somebody explain to me what this means? Thanks!

[bloh]

I'm presuming it means you get a flat salary + 22% of the billings to encourage you to be efficient (sort of like commission).

[gb35]

I'm presuming it means you get a flat salary + 22% of the billings to encourage you to be efficient (sort of like commission).

 

Yeah I'd hoped it meant something like that.

[leviathan]

I'm seeing lots of postings that offer salary, plus "22% of shadowed bill claims". Can somebody explain to me what this means? Thanks!

I think it actually refers to claims that are denied payment. Most clinics already work by reimbursing docs a portion of all billings, usually 60-70% of the total. Some offer minimum hourly or daily rates in case the clinic is slow so the doc doesn't end up wasting a day if the clinic is slow.

[justletmein]

I think it actually refers to claims that are denied payment. Most clinics already work by reimbursing docs a portion of all billings, usually 60-70% of the total. Some offer minimum hourly or daily rates in case the clinic is slow so the doc doesn't end up wasting a day if the clinic is slow.

 

Not exactly...

 

Here is an explanation of shadow billing from another thread by Moo:

"So you see a patient, you bill for it, and the money goes to the hospital. It then gets divided up amongst your group based on hours worked. So there's no incentive for you to see more patients, it all goes into the pot. The good thing about shadow billing is that you get paid no matter how many you see. The bad thing is, you don't get rewarded for seeing more"

[leviathan]

Not exactly...

 

Here is an explanation of shadow billing from another thread by Moo:

"So you see a patient, you bill for it, and the money goes to the hospital. It then gets divided up amongst your group based on hours worked. So there's no incentive for you to see more patients, it all goes into the pot. The good thing about shadow billing is that you get paid no matter how many you see. The bad thing is, you don't get rewarded for seeing more"

That sounds like it's referring to hospital work though. This isn't how clinics work. You already get 60-70% of your billings in clinics. Shadow billing may refer to other types of billings or to things that are denied payment, that's my guess anyway.

[gb35]

That sounds like it's referring to hospital work though. This isn't how clinics work. You already get 60-70% of your billings in clinics. Shadow billing may refer to other types of billings or to things that are denied payment, that's my guess anyway.

 

But in the clinics I'm referring to, you wouldn't be getting 60-70% of your billings because you're already getting a salary.

 

I saw one link in particular, which I will find and post tomorrow, that offered 130k salary, 22% shadow billing, and some pay for covering the ER. I'll find the link and then maybe be able to get some input on that person's total income.

[justletmein]

That sounds like it's referring to hospital work though. This isn't how clinics work. You already get 60-70% of your billings in clinics. Shadow billing may refer to other types of billings or to things that are denied payment, that's my guess anyway.

 

some things are procedures, for example, that nurses do, which can be billed and are then put into a pool from which you get a percentage.

[mavrik13]

Shadow billing is when a doc is paid on salary, but they still submit the billings claims for the work they do as if they were FFS (fee for service). They don't actually get paid FFS, but (someone) still has to submit the paperwork.

 

This can be done in any healthcare setting - hospital, clinic, etc., just like the posting gb35 was referring to.

[rmorelan]

Shadow billing is when a doc is paid on salary, but they still submit the billings claims for the work they do as if they were FFS (fee for service). They don't actually get paid FFS, but (someone) still has to submit the paperwork.

 

This can be done in any healthcare setting - hospital, clinic, etc., just like the posting gb35 was referring to.

 

Yeah it is so the government can make sure you aren't slacking off just because you are on salary or paid per patient enrolled in your clinic etc

[leviathan]

But in the clinics I'm referring to, you wouldn't be getting 60-70% of your billings because you're already getting a salary.

 

I saw one link in particular, which I will find and post tomorrow, that offered 130k salary, 22% shadow billing, and some pay for covering the ER. I'll find the link and then maybe be able to get some input on that person's total income.

 

Ahhh okay. I've never heard of them being paid on a salary basis, thanks for the info.

[gb35]

Here's the link I was referring to: http://www.healthjobspei.ca/index.php?number=1030950〈=E

 

Does anyone care to venture a guess as to how much they make per year?

 

I figured:

-140k a year salary

-22% of shadowed billings, so let's say they bill 250k, then that is 55k

-an extra 300-450$ per month for the retainer for 1 in 4 weekends, plus FFS for whatever you actually do that weekend.

-The 1 in 4 call for Monday to Thursday works out to 600$ a month for the retainer, again plus FFS.

-So I'm guessing just a little more than 200k, plus the FFS for whatever you do on call?

 

Can anyone check my math or provide a more accurate estimate?

 

EDIT: If you click on job opportunities on the left, there's a similar position for Montague (the one I linked is Souris). I'd be very interested to get a similar estimate for that one as well.

[RDB]

does the salary from hospital imply hospital benefits included and a retirement fund cuz you're salaried? That's quite a competitive benefit over straight up FFS.

[rmorelan]

Interestingly enough, I was told today that all those averages you see online are gross under-estimates of what many doctors truly make. Apparently a lot of doctors keep their earnings secret .

 

if true you can see why - it is not in the fields best interest to sound over paid. There really isn`t anything to gain by advertising things

[olecranon]

maybe its a bc thing but family docs seem to get paid very well here although taxes here are higher and living costs are higher. my gp bills 500K and my classmates gp's all bill over 300K...they aren't even rural. good money. complete freedom. good variety. if you do OB you can bill even more. but i really do fear the vague complaints and hate how patients these days come with demands and tell YOU what to do. I'm probably doing family anyways but i hate when ppl tell me they see family docs as a mere conduit to other specialties....i also feel overwhelmed by the amount family docs have to know...obs/peds/internal...jesus....

[Dany]

my gp bills 500K and my classmates gp's all bill over 300K...they aren't even rural. good money.

 

after ripped 40-50% for overhead, then taxed for another 30-40%, the take-home $ of a 350k billing GP is...120k:confused:

 

Tell me I'm wrong...pls

[olecranon]

after ripped 40-50% for overhead, then taxed for another 30-40%, the take-home $ of a 350k billing GP is...120k:confused:

 

Tell me I'm wrong...pls

 

well mostly true although overhead is about 30%. but even specialists have overhead and tax so it doesn't make a difference....even general surgeons have clinic too.

[cheech10]

Not all specialists have overhead... (outside of college fees, etc.)

[olecranon]

that's why i said specialists with clinic. obviously anesthesiologists and pathologists don't have overhead. nor do those who are salaried like rad oncs etc. if they do clinic in the hospital they might not have overhead either.

 

i mean i've never heard of overhead of 50%...if you do have that you clearly need some advice in running your office better. but 30-40% is the norm from everybody i've talked to. in vancouver at least.

[moo]

Overhead is NOT 50%, nowhere near it. If you start out and locum, overhead is about 30-35% (you just want to get your feet wet and practice medicine, and not worry about the business aspects of medicine). If you are an associate (like I was in my first year and a half) overhead was about 20-25%. If you end up owning your own clinic later on (you may not think about that now, but once you're in practice for a while you'll want to stop getting ripped off by clinic owners), overhead can be as low as 15%, and lower if you PHYSICALLY own your own clinic (no rent). Not to mention you can have others work for you and in turn, charge THEM 30-35% overhead. That's why older docs want to take so much time off. They own their own clinic, and just want locums to work for them. They bill 100 bucks, only about 15 bucks go to overhead, and if you charge them 35%, 20 bucks go into your pocket. Not to mention the more they work, the less as a percentage overhead SHOULD be. After all you're still paying your staff the same and rent (if you don't own the building) stays the same, so you can really make a killing off of others working for you. My mom does taxes for some family docs, and with some of the best run clinics in ideal locations (high density areas in urban areas with busy walk-ins), the owner(s) can each make 1 million or more just from the revenue from the clinic (not including their own billings). Of course, this varies from place to place. Some of the quieter clinics in low density areas won't make as much money. But from my experience, if you're going to open your own clinic, open one in an area that is high density, with high visibility.

 

And an after-tax salary of even 120K is a ton of money, even in a place like Vancouver. After-tax salary is a bit complicated though, because most docs are incorporated nowadays and so it's not as straight forward as "this is your take-home pay". My corporation pays 14% tax, but if I take the money out into my personal account then that gets taxed at the usual rate. You can take money out as a dividend and not get taxed as much. You can also pay your spouse a salary if she does some work for you (bookkeeping). You can also "borrow" money from your corporation to buy your first house, which won't get taxed but you have to "pay it back" with interest. Corporate tax laws are complicated so it pays to have a good accountant.

 

Bottom line is you won't be poor as a family doc. I don't touch the money in my corporation. AFTER overhead and taxes my PART-TIME FM income in my corporation was over 3 times what my resident salary last year was BEFORE taxes. I just live on my resident salary, which is more than enough to live on, even in Vancouver.

 

I can't speak for other specialties, but some specialties like ophthal, even if they bill over 1 million bucks, their overhead is very expensive (equipment costs mostly). If you run your own office, and have your own surgical suite, you may or may not hire an anesthesiologist, etc. And as for dentists, my cousin tells me his overhead is about 70% (yes, he pays 70% of whatever he bills to the clinic). That's why you see dentists billing a ton but their take-home is actually relatively low.

[moo]

maybe its a bc thing but family docs seem to get paid very well here although taxes here are higher and living costs are higher. my gp bills 500K and my classmates gp's all bill over 300K...they aren't even rural. good money. complete freedom. good variety. if you do OB you can bill even more. but i really do fear the vague complaints and hate how patients these days come with demands and tell YOU what to do. I'm probably doing family anyways but i hate when ppl tell me they see family docs as a mere conduit to other specialties....i also feel overwhelmed by the amount family docs have to know...obs/peds/internal...jesus....

 

This happens with any specialty, although as a specialist you would have more authority, but still even as a FP I get patients coming in requesting a "2nd opinion" after seeing one specialist and "not trusting them". You'd also be surprised at the number of patients who put as much weight on your opinion as they do on the specialists', especially after you get to know them for a while. Still FM can get annoying at times and that's why I'm also in public health.