Salary in Family medicine

[olecranon]

osmosis family medicine is pretty much guaranteed...i wouldn't worry. I hope more people choose family like you!

 

On another note i looked up all the anesthesiologists at the hospital i'm rotating at today...all average 400 grand....with zero overhead...fine maybe 1% to hire someone to do the billing....

 

MSP is messed up. Ophthalmologists and anesthesiologists don't need to be making this much money....even if you don't give it to the GPs put it towards something else that will be good for society...1-2 million dollars for ophtho a year? seriously....allocate appropriately.

[Mandibular]

osmosis family medicine is pretty much guaranteed...i wouldn't worry. I hope more people choose family like you!

 

On another note i looked up all the anesthesiologists at the hospital i'm rotating at today...all average 400 grand....with zero overhead...fine maybe 1% to hire someone to do the billing....

 

MSP is messed up. Ophthalmologists and anesthesiologists don't need to be making this much money....even if you don't give it to the GPs put it towards something else that will be good for society...1-2 million dollars for ophtho a year? seriously....allocate appropriately.

 

out of curiosity, what province you in?

[olecranon]

british columbia

[Guest copacetic]

ophthalmologists have high overhead. as much as 60%.

[narco]

i have enjoyed reading moo's posts very much. however, looking at his patient ratings, i'm not very convinced they are that happy with the quality of care received. i think family is great and people and allows you to do a whole lot of good but i liked the term assembly line medicine and unfortunately walk in clinics are exactly that.

 

 

 

I don't know why FM gets such a bad rap. Maybe it's because when you're on the wards doing IM, or surgery or subspecialties, you always get the stupid consults from family docs. So med students strive not to be a family doc. But what specialists don't realize is that it's no easy feat to see 50 patients a day, deal with multiple complaints and DEMANDS from patients. A lot of patients just demand to see a "specialist" because they want a 2nd opinion. I've trained a lot of my patients that a lot of times it's not necessary to see a specialist if I don't think they need to and a lot of them end up trusting me. I think it has to do with the fact that 1) I am also a specialist-in-training, albeit in public health and epidemiology, and 2) I act very confident and I give them reasons why someone should or shouldn't see a specialist. Many times, you say to patients, look, you have these options and spell it out to them. I tell them, why and when it's necessary to get a consult (for instance, the specialist does a procedure that I don't do, they treat a disease that I don't do, or I myself just don't know what the hell is going on). Most patients are fine with that.

 

As for the lifestyle thing, FM is great. You can work as much or as little as you want. Do what you are comfortable with. I know some family docs end up just doing vasectomies for instance. They make a lot of money doing so and they act as a specialist of sorts. Look up Dr Barry Rich, MSP blue book. He made 310K off MSP last year, minus expenses that's still well over 200k with no call and probably working only 3-4 days a week. I'm pretty sure that's all he does is vasectomies day in day out.

 

That's why I get annoyed when family docs or residents or students say that you are going to be poor when you do family med. Yes, you will be poor if you have no idea how to bill (no, we don't just bill 30 bucks per patient, like I said there are so many other fees, including chronic disease management fees, hospital/long term care phone calls, WSBC phone calls, etc. on top of that that add 30-40% on top of you base billings) or are too lazy and work 1 day a week. (Yes, I have friends who work 1-2 days a week and wonder why they can't afford to move to Vancouver.) Does family med have its annoyances? Yes, it does. Patients can get annoying. Specialists can be annoying when you're talked down to. But in the end I think it's still rewarding. That's why I still plan on doing some clinical work even after I'm done my CM residency. I will plan on doing probably HIV, cancer or infectious disease epidemiology with a faculty position, and then maintaining a small private practice.

[future_doc]

My impression is the opposite of yours in regard to the happiness of his patients with his services.

[narco]

My impression is the opposite of yours in regard to the happiness of his patients with his services.

 

certainly that was my impression too but ratemd.com says otherwise although it may be biased as only the ones who had bad experiences post.

[future_doc]

There you go. You cannot please all of the people all of the time.

 

Speaking from the perspective of the forum, moo is deeply appreciated for thre information and knowledge he shares with us all. I for one religiously read and learn from his posts.

[olecranon]

i agree but you could do that with derm or rheum or GIM among others for example. its the fact that you finish in 2 years and start making money instead of slaving away at call. why not just start making 200-300k doing family anywhere you want and go on vacation once or twice a year. work a couple of years you can practice share and work 8 months out of the year or less. future flexibility is also huge.

[apache]

i totally agree, you can get a job anywhere, work whatever hours you want, develop your own niche interests, it's sooo flexible

 

I think the strength of FM doesn't necessarily lie in how much you can make, but the lifestyle that it can potentially afford you, the ability of practically setting up a practice ANYWHERE (and I've totally underestimated the importance of this in my quest for a specific subspecialty), and the wide variety of healthcare services you can deliver.

[supafield]

i totally agree, you can get a job anywhere, work whatever hours you want, develop your own niche interests, it's sooo flexible

 

I'm still in my first year, and already I can't explain how much this appeals to me.

 

With all the plus one programs you can really direct family medicine in a lot of different areas. It would take A LOT to lure me towards a 5 + year residency, when I enjoy family medicine and it's loaded with job flexibility.

[olecranon]

During my family rotation sometimes I feel like we were simply a means to specialists though. One patient even said this to me directly when my preceptor left and we were chatting saying she sees the gp as merely a means to see the real doctors or the doctors she really wants to see. I don't know how rampant this notion is out there but as someone who is interested in family but doesnt want to merely feel like a tool to get what people want how does one get over this??

[Guest copacetic]

During my family rotation sometimes I feel like we were simply a means to specialists though. One patient even said this to me directly when my preceptor left and we were chatting saying she sees the gp as merely a means to see the real doctors or the doctors she really wants to see. I don't know how rampant this notion is out there but as someone who is interested in family but doesnt want to merely feel like a tool to get what people want how does one get over this??

 

its your responsibility to educate your patients as to your role. Just view it as part of the job. They need to know that you are more than just a conduit and a gatekeeper.

[bloh]

During my family rotation sometimes I feel like we were simply a means to specialists though. One patient even said this to me directly when my preceptor left and we were chatting saying she sees the gp as merely a means to see the real doctors or the doctors she really wants to see. I don't know how rampant this notion is out there but as someone who is interested in family but doesnt want to merely feel like a tool to get what people want how does one get over this??

 

In some cases, this is true and unavoidable. If your family physician has been unable to clear your acne up, the next logical step is to see a dermatologist. If you are unable to control your diabetes/hypertension, through the simple methods, then see an endocrinologist, etc...

 

This is more prevalent in the 'edumacated' people aka 'the ones that know about google'.

[olecranon]

Can someone please explain the benefits of incorporation if the money cannot be applied for personal use even though it's at the reduced 14% rate (this is the bc rate)? Once you pay yourself from the corporation you must then pay the personal tax rate again unless you hold the money in the corporation and later on in retirement slowly issue some dividends or salary out to yourself to be taxed at a lower bracket....would like some insight on this. Thanks.

[moo]

Can someone please explain the benefits of incorporation if the money cannot be applied for personal use even though it's at the reduced 14% rate (this is the bc rate)? Once you pay yourself from the corporation you must then pay the personal tax rate again unless you hold the money in the corporation and later on in retirement slowly issue some dividends or salary out to yourself to be taxed at a lower bracket....would like some insight on this. Thanks.

 

There are lots of advantages to incorporating. First, the tax benefits. Second, you can spread income out. So for example, if you have parents who are retired, you can pay them a salary and since they have no income, they are taxed at a lower rate. Similarly, if you have a spouse who does not work or is not a doctor, pay him/her a salary and get taxed at a lower rate. Another advantage is that you can "borrow" money with "interest" from the company to purchase a house (home purchase loan). Thus this money is taxed at a lower rate than if you had just used your personal income. Keep in mind that you have to repay your company at a certain interest rate (currently 1%)... this is typically done via a dividend... speaking of which, you can draw out money as a dividend which is taxed at a lower rate as well. As well you can write many things off that you normally won't be able to if you had just a personal income.

 

Disadvantages are mostly that it's a pain to set up, you need to pay lawyer, accounting fees. You also need to be careful about how to draw out your money and keep tabs on everything. But in the end, the tax savings are worth it, esp if you gross over 80K.

[Guest copacetic]

There are lots of advantages to incorporating. First, the tax benefits. Second, you can spread income out. So for example, if you have parents who are retired, you can pay them a salary and since they have no income, they are taxed at a lower rate. Similarly, if you have a spouse who does not work or is not a doctor, pay him/her a salary and get taxed at a lower rate. Another advantage is that you can "borrow" money with "interest" from the company to purchase a house (home purchase loan). Thus this money is taxed at a lower rate than if you had just used your personal income. Keep in mind that you have to repay your company at a certain interest rate (currently 1%)... this is typically done via a dividend... speaking of which, you can draw out money as a dividend which is taxed at a lower rate as well. As well you can write many things off that you normally won't be able to if you had just a personal income.

 

Disadvantages are mostly that it's a pain to set up, you need to pay lawyer, accounting fees. You also need to be careful about how to draw out your money and keep tabs on everything. But in the end, the tax savings are worth it, esp if you gross over 80K.

 

I was under the impression that in order to pay family members income they ahd to provide services that would be commensurate with their duties. Do I can just pay my wife 80K if she doesnt actually work at the clinic. correct me if im wrong on this.

[moo]

I was under the impression that in order to pay family members income they ahd to provide services that would be commensurate with their duties. Do I can just pay my wife 80K if she doesnt actually work at the clinic. correct me if im wrong on this.

 

Yeah.. but my mom does my bookkeeping and my dad does my computer stuff. My spouse could conceivably even do my childcare (and yes it would count). You can always find something for them to do and pay them accordingly.

 

Don't forget that you can also have them as shareholders (they will not be voting shareholders but they're shareholders nonetheless). You can also give them a dividend. My accountant told me that the first 34K in dividend is tax-free.

[cheech10]

You can still pay them a dividend (as large as you like), even if they do no work. Bonus: dividends are taxed at a lower rate than salary. Drawback: dividends do not create RRSP contribution room.

[VTeight7]

Does anyone know if family practitioners working in Canada make more money than those working in the US? I've tried to google the numbers, and it does allude towards Canadian family doctors making more - does anyone else have a view on this?

[Guest copacetic]

this question is often asked but difficult to answer. you cant just look at gross billings, or net income because of the different tax rates. the dollar are also worth different amounts, and the cost of living is different depending on what area and province/state. not to mention malpractice insurance costs and what not.

 

It was 'popular knowledge' that american made more than canadians for much of the 80s and 90s, but this is not necessarily the case now, and may not be the case starting sometime around the mid 2000s. what exactly this meant im not exactly sure. certainly they billed more than canadians, but they also had more expenses, and lower taxes, and a lower cost of living.

 

from an economic standpoint the question is best answer through refrraming the question itself to ask, which physicians have greater purchasing power parity (PPP). By this youre basically asking how far does your income go in terms of standard of living relative to the cost of living in each individual country. PPP is the best way to compare salaries and incomes across countries.

 

much of the work that has been done using this sort of analysis is done using data that is typically older and does not reflect the situation on the ground right now. having said all this right now, the most simplistic answer right now is that with the developement and widespread implementation of the FHT models (at least in ontario), GPs there earn more income (net) than the average GP in the states. this is a relatively recent development however, and has resulted in family medicine becoming popular again.

 

http://www.practicelink.com/magazine/vital-stats/physician-compensation-worldwide/

[hp18]

Yeah.. but my mom does my bookkeeping and my dad does my computer stuff. My spouse could conceivably even do my childcare (and yes it would count). You can always find something for them to do and pay them accordingly.

 

Don't forget that you can also have them as shareholders (they will not be voting shareholders but they're shareholders nonetheless). You can also give them a dividend. My accountant told me that the first 34K in dividend is tax-free.

 

Can I employ my parents or my brother to do some work for me while I work in a family health team or as locum or in walk in clinic? Can I incorporate my business in this situation?

[cheech10]

You can probably incorporate (unless you are an employee who gets paid a salary from the health team or clinic, but I think this would be rare).

 

Even without incorporation, you can employ whoever you want and pay them from the business. The only limitations are that they have to actually do the work, and you have to pay them a reasonable salary for what they do, eg. $10/hr for administrative work, not $100/hr. Drawbacks of having employees include having to do payroll remittances, CPP, EI, and tax withholdings for them, prepare T4s at tax time, more record keeping.

 

The alternative is paying them a dividend from the corporation. No remittances, fewer records to keep, they don't actually have to do any work for the corp, and they are taxed at a lower rate. Drawbacks are that they don't create RRSP contribution room, and setting up a corporation costs a bit of money.

 

Generally, incorporating makes the most sense for those making over $150,000 per year and not requiring their entire income for living expenses.

[hp18]

You can probably incorporate (unless you are an employee who gets paid a salary from the health team or clinic, but I think this would be rare).

 

Even without incorporation, you can employ whoever you want and pay them from the business. The only limitations are that they have to actually do the work, and you have to pay them a reasonable salary for what they do, eg. $10/hr for administrative work, not $100/hr. Drawbacks of having employees include having to do payroll remittances, CPP, EI, and tax withholdings for them, prepare T4s at tax time, more record keeping.

 

The alternative is paying them a dividend from the corporation. No remittances, fewer records to keep, they don't actually have to do any work for the corp, and they are taxed at a lower rate. Drawbacks are that they don't create RRSP contribution room, and setting up a corporation costs a bit of money.

 

Generally, incorporating makes the most sense for those making over $150,000 per year and not requiring their entire income for living expenses.

 

Great Info!

[The Cat in the Hat]

Bringing back a dead topic here, but I know a GP and pediatrician who make around 900k in BC. Outliers, yes. But it is still possible.