booradley83 Posted June 10, 2016 Report Share Posted June 10, 2016 If you were to start your practice today, where would you practice and why? Overall practicing FP appears to be similar, but are vastly different in both countries. Pros For USA: 1. Just the vastly superior opportunities that a country of 330 Million can give you 2. Ability to work hospitalist medicine/urgent care/FP 3. Income ceiling probably higher if you are business savvy; however average incomes appears to be the same in both countries with a reported median of around 200k NET 4. Benefits/vacation Cons for USA: 1. More bureucracy, more insurance hassles, etc 2. Having to practice in a way to get 'paid' meaning unncessary vital signs on every patient, endless ROS, 3. Higher costs of running practices due to the insurance companies etc 4. Model of being an 'employee' - benefits but you are 'owned' Pros for Canada: 1. Single payer 2. Less bureucracy 3. Self-employment Cons: 1. Less payment per patient 2. Higher volumes patients to see to make similar income 3. CLAWBACKS 4. Government bureucracy THOUGHTS? Link to comment Share on other sites More sharing options...
Rorzo Posted June 10, 2016 Report Share Posted June 10, 2016 You can definitely work as a hospitalist or in urgent care as a family doc in Canada Link to comment Share on other sites More sharing options...
robclem21 Posted June 10, 2016 Report Share Posted June 10, 2016 I would also argue against less bureaucracy in Canada... Also not sure about "vastly superior" opportunities. I would say there are a lot of opportunities in Canada as well with just as much variety in practice. Link to comment Share on other sites More sharing options...
NLengr Posted June 10, 2016 Report Share Posted June 10, 2016 Clawbacks are an Ontario issue. Link to comment Share on other sites More sharing options...
Edict Posted June 13, 2016 Report Share Posted June 13, 2016 I'm pretty sure family medicine is one of the areas that it is definitively better to work in Canada for. Canadian family doctors are gatekeepers, in the states you don't even need to see a family doctor to get a referral to a specialist and very few american medical students become family doctors. The top 10 medical schools in the states regularly send less than 3 students each year into family medicine. Link to comment Share on other sites More sharing options...
JohnGrisham Posted June 13, 2016 Report Share Posted June 13, 2016 If you were to start your practice today, where would you practice and why? Overall practicing FP appears to be similar, but are vastly different in both countries. Pros For USA: 1. Just the vastly superior opportunities that a country of 330 Million can give you 2. Ability to work hospitalist medicine/urgent care/FP 3. Income ceiling probably higher if you are business savvy; however average incomes appears to be the same in both countries with a reported median of around 200k NET 4. Benefits/vacation Cons for USA: 1. More bureucracy, more insurance hassles, etc 2. Having to practice in a way to get 'paid' meaning unncessary vital signs on every patient, endless ROS, 3. Higher costs of running practices due to the insurance companies etc 4. Model of being an 'employee' - benefits but you are 'owned' Pros for Canada: 1. Single payer 2. Less bureucracy 3. Self-employment Cons: 1. Less payment per patient 2. Higher volumes patients to see to make similar income 3. CLAWBACKS 4. Government bureucracy THOUGHTS? lol FM in the US is way "worse" than Canada in the relative sense. Canada, you are an independent business owner and bill fee for service. The U.S. you are the HMO's slave, have to deal with an abundance of insurance BS and paperwork, and competition from mid levels. Business saavy for FM? As you know most FM in the US are not independents like in Canada. Your business saavy is irrelevant when you are at the whim of your employer. They have overpaid MBAs/MHAs etc for that. Some FM docs form group practices, but its hard to compete with big name HMOs who can spread their fixed costs and overheads over larger numbers of emplyoees. And not to mention the vast amount of extra unpaid work you'd have to do if you were to do your own group practice. And the cons for Canada FM about payment is COMPLETELY off base. Having been in a few different FM offices in the US, the reimbursements are actually much more likely to have problems because of so many insurance companies, and their sole goal of trying their best to NOT pay you. Not to mention, volumes of patients is definitely comparable if you want to make comparable amounts of income (excluding currency conversion). You can't compare the US with Canada for FM. Link to comment Share on other sites More sharing options...
FeministKilljoy Posted June 13, 2016 Report Share Posted June 13, 2016 The U.S. you are the HMO's slave, have to deal with an abundance of insurance BS and paperwork, and competition from mid levels. Ding! Ding! Ding! Winner, winner! Chicken dinner! Link to comment Share on other sites More sharing options...
JohnGrisham Posted June 13, 2016 Report Share Posted June 13, 2016 Ding! Ding! Ding! Winner, winner! Chicken dinner! I'll take Church's Chicken please. Link to comment Share on other sites More sharing options...
booradley83 Posted June 13, 2016 Author Report Share Posted June 13, 2016 Wow, so it's definitely better in Canada, even if Ontario is facing a rough patch right now. Do you guys see any major negatives coming to our system here in Canada like the US? Also, do you expect our incomes to go up or down in the future? Link to comment Share on other sites More sharing options...
JohnGrisham Posted June 14, 2016 Report Share Posted June 14, 2016 Wow, so it's definitely better in Canada, even if Ontario is facing a rough patch right now. Do you guys see any major negatives coming to our system here in Canada like the US? Also, do you expect our incomes to go up or down in the future? There seems to be a common theme to most of your posts. Honestly, medicine pays well but there are other ways to make money as well. The big benefit of medicine is that there's a steady supply of patients/clients, so if you work more hours seeing more patients you get paid more (within certain constraints). My close friends in tech are making 6 figures in their early 20s, with significantly less schooling, debt and other downsides of medicine. But I'm not going to say "go tech" or "go dent" as those are generally broad and absurd statements. Different people are good at different things. And I fully expect physician pay to go down in the future, still comfortable but definitely down. With that I'd expect more supply of physicians per capita, when govts finally override the physician monopolies that CMGs have created. Link to comment Share on other sites More sharing options...
booradley83 Posted June 14, 2016 Author Report Share Posted June 14, 2016 Well yeah I'm interested in the financial viability and income potential of my future practice. Most attendings don't want to discuss the business side of medicine and there is a RIDICULOUS variance in 'average income.' Some attendings say it's possible to make 300k net working normal hours, while others say it's closer to 175k. So which is it? Sorry, but they don't teach any of this stuff in residency or medical school..........................these forums are literally the only way to get an unbiased view from different doctors. Link to comment Share on other sites More sharing options...
hking03 Posted June 14, 2016 Report Share Posted June 14, 2016 Well yeah I'm interested in the financial viability and income potential of my future practice. Most attendings don't want to discuss the business side of medicine and there is a RIDICULOUS variance in 'average income.' Some attendings say it's possible to make 300k net working normal hours, while others say it's closer to 175k. So which is it? Sorry, but they don't teach any of this stuff in residency or medical school..........................these forums are literally the only way to get an unbiased view from different doctors. Problem is that most of the people on this forum are biased or don't know I'm hoping that family physicians will actually get paid more... And physicians overall will see a restructuring of the fee scale, but who knows if that will happen. Your earning potential in family medicine is only limited by your creativity and willingness to work... If I were you, and it sounds like you are a couple years ahead of me in training, I'd say to myself, I'm going to work hard doing the things I enjoy and learn the billing system and the money will come... I'd also take advantage of student loan forgiveness programs And locum around the province to get your feet wet. I'd worry about what I'm making in about 3-5 years... Just my perspective There are a few family docs who have posted how to make money or how they run their practice, but like I said earlier- do what you like to do, learn the billing fees, work with a solid MOA and you'll be fine. Good luck! Link to comment Share on other sites More sharing options...
thegame11 Posted June 15, 2016 Report Share Posted June 15, 2016 Pros For USA: 2. Ability to work hospitalist medicine/urgent care/FP Most of the hospitalist work in the US is done by internists not family docs. Not sure about Canada. Link to comment Share on other sites More sharing options...
JohnGrisham Posted June 15, 2016 Report Share Posted June 15, 2016 Most of the hospitalist work in the US is done by internists not family docs. Not sure about Canada. Anecdotally, there are quite a fair amount of older FM docs who do hospitalist work in Canada. Link to comment Share on other sites More sharing options...
hking03 Posted June 15, 2016 Report Share Posted June 15, 2016 Anecdotally, there are quite a fair amount of older FM docs who do hospitalist work in Canada. Having worked in several hospitals across BC I'd say many FM docs, young and old, are responsible for the hospitalist work in the hospital. I know of other provinces that have offered lucrative salaries for ANY family doctors to do hospitalist work. Regardless of experience or age. However, it seems a lot of new grads are a little nervous to run the show on a hospitalist shift as you are responsible for too many patients and don't have enough resources so it can be overwhelming in the beginning. Link to comment Share on other sites More sharing options...
MD2015:) Posted June 21, 2016 Report Share Posted June 21, 2016 There is a huge discrepancy in FM pay because family doc work is so varied. If you are efficient, hunt down every billing fee you are entitled to, and do work outside of clinic that is lucrative, you will make more. If you are slow and do not work hard to optimize billing you will make less. Some people are more savvy then others about billings, some like more time off work to enjoy their social/family life, and the amount that people care about how much they make varies. Many reasons why some make more and some make less. Efficiency and priorities will dictate what you make. Link to comment Share on other sites More sharing options...
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