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brady23

Internal Sub-specialties Salary

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Any idea of how the salary of an: endocrinologist, geriatrician, rheumatologist or allergist would compare to general FM?

I've heard lifestyle IM specialties are less lucrative, but I was wondering if anyone has numbers (whether anecdotal or from sources). I've heard they all make around 300k (before overhead + taxes, but not sure how true that is). 

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8 hours ago, brady23 said:

What do you mean lifestyle better than FM? Difference in hours?

Usually more slack or slightly less hours, usually fewer patients per day, usually much less acuity/stress, usually group practices so vacation is a bit easier, usually minimal call, and more likely to be salaried positions through a university so less need to worry about billing. However, like every specialty, there’s a ton of variability in everything I just listed. Some earn more than FM, some earn less, some work more hours, some work less and same goes for FM. Truly the best way to see what they’re all like is to just get some clinical experience in these specialties and chat with residents/staff as the CMA data only goes so far (though I’d doubt you actually have clinical interest in all of them, as they’re pretty different). To that end, based on your recent posts about various specialties, I think your best bet is to do some soul searching as to what it is you really want in a specialty. There’s no shortage of specialties with good lifestyles, and really most specialties can be tailored to some extent to get you close to the lifestyle and salary you want (either scaled up or down), so I think rather than wondering about the average lifestyle/salary ratio for everything you should focus on what you actually want to be doing clinically with your time, then narrow in from that. 

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See some of my other posts for details. 

Both are clinic-based specialties. Endo/Rheum/Allergy/Geri have better billing codes per pt than FM due to them being specialists (typical consult fee of 157 + special premiums for managing chronic patients. Additional tests or procedures like patch testing, joint injections. The caveat is the consults may take long (~20-30 mins), but it's variable up to each individual on how to make it efficient (i.e. simple seasonal allergy consult may take 15 mins, or new diabetes mgmt may take 15-20 mins vs. complicated diabetic patient with complications or immunodeficiency work-up). Geri will have long consults (1hr or more) but they have a special code for comprehensive geriatric assessment (~$330). So per day you may see 6-7 patients in Geri but make the same as a FM who may see 20-30 a day).

Generally speaking, as subspecialists you could see less patients/day ($100-200/pt depending on whether it's a simple follow-up vs. new consult) and bill similar to a family doc who sees more a day ($40/pt). So the psychological stress of having more patients may be different for a similar amount of income.

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Thank you! So it looks like, more or less, IM subspecialties (300K before overhead + taxes) probably make slightly more than family docs (250K before overhead + taxes)?

 

 

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On 6/5/2018 at 12:02 AM, brady23 said:

Thank you! So it looks like, more or less, IM subspecialties (300K before overhead + taxes) probably make slightly more than family docs (250K before overhead + taxes)?

 

 

Depends which ones

 

no cardiologist or nephrologist or GI doc or ICU doc is making that little. At least double, maybe triple or more. Jobs are hard to come by though. 

 

Thats probably more in line wih rheum and endo. However those guys can streamline a clinic for one issue (ie - DM2, OA) and see way more patients in a day and bill higher paying codes. Also can supplement with lucrative medicine night call

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5 hours ago, Aconitase said:

Depends which ones

 

no cardiologist or nephrologist or GI doc or ICU doc is making that little. At least double, maybe triple or more. Jobs are hard to come by though. 

 

Thats probably more in line wih rheum and endo. However those guys can streamline a clinic for one issue (ie - DM2, OA) and see way more patients in a day and bill higher paying codes. Also can supplement with lucrative medicine night call

I have read the CMA official data that average FM in Ontario make 360 K before overhead, whereas internal specialists make around 450 K before overhead.

Endocrinologists and rheumatologists could definitely bill more if they see high volume of patients. For medicine calls, they do have to be affiliated with hospitals. The GTA hospitals tend to prefer general internists for medicine calls, given the saturation of new grads looking for jobs. In smaller hospitals or rural, it's definitely doable!

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3 hours ago, LittleDaisy said:

 The GTA hospitals tend to prefer general internists for medicine calls, given the saturation of new grads looking for jobs. In smaller hospitals or rural, it's definitely doable!

This is NOT true. I personally know lots of sub-specialty fellows (PGY-5's and above) that do GIM call at large GTA hospitals (North York, TEGH, St Joes). Alot of the GIM people start to give away their overnight/weekend calls because they can still make 350-375k without having to do too much overnight work

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27 minutes ago, ACHQ said:

This is NOT true. I personally know lots of sub-specialty fellows (PGY-5's and above) that do GIM call at large GTA hospitals (North York, TEGH, St Joes). Alot of the GIM people start to give away their overnight/weekend calls because they can still make 350-375k without having to do too much overnight work

Exactly. Super easy to get these work. Don’t forget EGH, BCH and Trillium and CVH too. Humbar River, Scarborough there are tons. 

 

So so easy to find a couple of high paying night shifts. 

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17 hours ago, LittleDaisy said:

I have read the CMA official data that average FM in Ontario make 360 K before overhead, whereas internal specialists make around 450 K before overhead.

Endocrinologists and rheumatologists could definitely bill more if they see high volume of patients. For medicine calls, they do have to be affiliated with hospitals. The GTA hospitals tend to prefer general internists for medicine calls, given the saturation of new grads looking for jobs. In smaller hospitals or rural, it's definitely doable!

The problem is that they don't account for the fact that a higher % of family doctors work part time than internal specialists. Also, you have internal specialists in cardio, nephro, gi, icu who are skewing the numbers. From an hour to hour point of view, I don't think we know the answer but I do think that family doctors are likely as well paid as many internal specialties, especially those who are in FHTs. 

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5 hours ago, Edict said:

The problem is that they don't account for the fact that a higher % of family doctors work part time than internal specialists. Also, you have internal specialists in cardio, nephro, gi, icu who are skewing the numbers. From an hour to hour point of view, I don't think we know the answer but I do think that family doctors are likely as well paid as many internal specialties, especially those who are in FHTs. 

The CMA data doesn't take account the number of part time family physicians, there are perhaps more part-time GPs than internal specialists . I agree that a lot of FHT family physicians get fairly well remunerated from personal experience, but those positions are hard to come by in cities, mostly in demand in suburbia or rural. 

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