sprinkles Posted December 31, 2011 Report Share Posted December 31, 2011 I would really appreciate it if someone could post the info as a .pdf or .jpeg or something... some of us don't have access to the OMA website! I second that And Moo thats really clever! Its true...if you can afford to go on an expensive vacation you can afford to pay for the vaccine! Link to comment Share on other sites More sharing options...
bnface Posted December 31, 2011 Report Share Posted December 31, 2011 I would really appreciate it if someone could post the info as a .pdf or .jpeg or something... some of us don't have access to the OMA website! join OMA, its like 30$ for med students.... Also, there is a reason that the information is password protected; I'm not sure posting it on a public forum is an advisable strategy, especially given the upcoming contract negotiatons and media surrounding them.... Link to comment Share on other sites More sharing options...
Lunasly Posted January 3, 2012 Report Share Posted January 3, 2012 Do dermatologist also make a considerable amount if they follow the same principals that moo follows? I mean, 250k on 25 hours a week is really good and it takes efficiency and knowledge of billing. I just wonder now why something like dermatology is so lucrative if you can work similar hours in FM and still make a great living. Link to comment Share on other sites More sharing options...
Prince Medward Posted January 3, 2012 Report Share Posted January 3, 2012 Did any one hear CBC's "Cross Country Check-Up" with guest host Dr. Brian Goldman? It was all about the state of the health care system. A number of policy wonks cited physician salaries and physician resistance to reform as the greatest obstacles to improving the health system (or a least reigning in costs). I wonder if the golden age of physician salaries is drawing to a close. Link to comment Share on other sites More sharing options...
aaronjw Posted January 3, 2012 Report Share Posted January 3, 2012 Did any one hear CBC's "Cross Country Check-Up" with guest host Dr. Brian Goldman? It was all about the state of the health care system. A number of policy wonks cited physician salaries and physician resistance to reform as the greatest obstacles to improving the health system (or a least reigning in costs). I wonder if the golden age of physician salaries is drawing to a close. What i hate is single minded data hacks. Yeah, physician billables went up in 09-10 compared to 08-09. My questions: Did the fee for service payment structure go up as well? How many patients saw non-salaried physicians in 09-10 compared to 08-09. Was there an increase? Media and gov't love to jump on single data points to leverage in their pursuits but so far i've not heard any discussion of the two questions i just posed. Media just keep spouting physicians made more money. Link to comment Share on other sites More sharing options...
moo Posted January 3, 2012 Report Share Posted January 3, 2012 How about the fact that in BC, fees to GPs have hardly changed over the past 10 years while cost of living, especially in Vancouver, have skyrocketed? How about the fact that we in BC accept that the more we work, the less we make (patients 51-65 we get paid 50%, and anything above that we get paid 0)? Can you imagine if you told nurses or other union workers that we'd half your pay if you worked overtime? The BCNU/HEU/etc. would be up in arms. I straddle both the policy world and the clinical world. I have to say that while I do think the FFS model rewards mediocre, even poor care, I don't think you can paint all MDs with the same brush. (I have had many patients come to me complaining that their family doc would say stuff like, "oh I can't ask another question because he tells me he could be seeing another patient and making another 30 bucks" and they're surprised that I would allow them to ask another question.) I understand why policy analysts feel that way, but the real cost of the health care system is not just MD salaries. If you're going to train more physicians, more people will have access to a physician and naturally, costs in salaries will go up. However, the true driver of the increase in health care costs is in pharmaceuticals and advanced diagnostics that may make a minimal impact on true health outcomes. This is why the US system is so expensive but health outcomes are no better than Cuba's. When you look at the most cost effective interventions, it's not the sexy new MRIs or PET scans that make the difference, it's the investment upstream that does. I'm not saying we don't need advanced diagnostics, because statistics is meaningless to the few patients that do need it. But we have to take a long hard look at why costs are increasing and make cost effective investments to the system as a whole. A politician can spend a ton of money upgrading diagnostic equipment, covering these drugs that may or may not truly make a difference in prolonging lives, and can get a great photo op out of it. And therein lies the real problem. Link to comment Share on other sites More sharing options...
NLengr Posted January 3, 2012 Report Share Posted January 3, 2012 I am convinced that a part of the idiocy coming out of politicians and the think tanks about cutting spending is because Ontario is broke. Ontario has never been a have not province before and it seems like no policy people or politicians in the province know how to handle it. Unfortunately the talking heads seem to be centered on ONT. So nationwide (thanks to the media) we get bombarded with stupid ideas that are driven by Ontario based talking heads and mediocre politicians. Instead of thinking about where to cut efficiently with minimal impact policy makers and politicians are just running around like chickens with their heads cut off trying to hack away things that are essential and used daily (hence look bigger on a budget sheet). For example, Ontario still funds a separate catholic only school system along side it's public system. Huge amounts of duplication and waste. A smart, cost effective govt. would integrate everything under a single public system, like most provinces and save loads of cash. Unfortunately, ONT politicians can't figure this out. Link to comment Share on other sites More sharing options...
ghost dog Posted January 11, 2012 Report Share Posted January 11, 2012 so true, there was a huge discrepency between what the academic centre salaried psychs made and what the private practice psychiatrists made, but when you throw in workers comp stuff, hiring a psychologist or counsellor you refer too so you can split overhead and take a third of their billings for referal, earning potential increases by quite a bit. my psych doesn't split overhead per se, but three different doctors all split a portion of a house which causes a drastic cut down in overhead, plus you can tailor your practice to particular demographics or throw in cash cow procedures, i spent a day with a guy who did vasectomies all day, once a week (a gp)... that one day a week increased his earnings substantially. get training in some specialized, highly paid procedure, or privately billed thing... or pick up ect in psychiatry (which isn't necessarily performed by the in house psychs believe it or not) for example, and yeah... money lots of people are pretty shameless in talking about the money, my personal fave, thelastpsychiatrist.com has 10 long ass ideas: http://thelastpsychiatrist.com/2006/09/how_to_get_rich_in_psychiatry_1.html http://thelastpsychiatrist.com/2006/12/how_to_get_rich_in_psychiatry_2.html he even goes on about giving talks for drug companies, i'm not sure what that's like in canada, but the idea is to be creative The " last psychiatrist " does have a few good money making ideas (eg. doing independent medical assessments - bills multiple times that of OHIP). However, he lost me at the mention of NPs. If I referred a patient, and they told me they were seen by noctor - that would be the first and last time I referred to that joker. When I refer a pt to psych, I have already exhausted the usual approach to managing such a patient. I expect such a referral to be taken over by an expert, not by someone with 10 times less clinical experience than myself. This is just laziness and outright greed; there is no excuse for this sort of practice. Link to comment Share on other sites More sharing options...
silverjelly Posted January 12, 2012 Report Share Posted January 12, 2012 There are many tax planning seminars put on by various accountants, your local and provincial medical associations, etc. (In fact, I was at a talk with an accountant yesterday with free dinner and a Canucks game--he obviously wanted our business.) My undergrad was in math and physics--so not related to finance at all but it doesn't take a genius to learn quickly. It pays to also start researching this stuff while you are in residency and even in medical school so you know what you are getting into when you choose your specialty. Do not neglect this part of your training. Medical schools do a horrible job preparing their students for the financial aspect of medicine but there are ways to make this up. If you plan well, you will be happier, and less stressed about making money. But in the end, even if you are totally financially inept and only net 150K a year, and don't know anything about investments, that is a ton of money! Thanks for all your help and information on this, moo. As a PGY-1 in family medicine, I am starting to concern myself with how I will do my taxes, manage my money better, etc., both now and in the near future. For one, I haven't really heard much about tax planning seminars. I have an advisor through MD Management, but I want to get a private accountant that is outside of medicine. What's the best way to find one? Is it enough to have a good accountant that you trust, or should you understand your taxes on your own? In medical school, I tried to do some basic reading around money management, investing, and so on. But after a while, the information overwhelmed me and started to sound like gibberish. Like you, I also have some interest in the private sector, not only in medicine but also out of it, such as real estate. What do you think are the best venues to learn more information about all of this? Thanks in advance. Link to comment Share on other sites More sharing options...
ghost dog Posted January 12, 2012 Report Share Posted January 12, 2012 Thanks for all your help and information on this, moo. As a PGY-1 in family medicine, I am starting to concern myself with how I will do my taxes, manage my money better, etc., both now and in the near future. For one, I haven't really heard much about tax planning seminars. I have an advisor through MD Management, but I want to get a private accountant that is outside of medicine. What's the best way to find one? Is it enough to have a good accountant that you trust, or should you understand your taxes on your own? In medical school, I tried to do some basic reading around money management, investing, and so on. But after a while, the information overwhelmed me and started to sound like gibberish. Like you, I also have some interest in the private sector, not only in medicine but also out of it, such as real estate. What do you think are the best venues to learn more information about all of this? Thanks in advance. Word of mouth from your colleagues would be a reasonable way to start. Link to comment Share on other sites More sharing options...
moo Posted January 12, 2012 Report Share Posted January 12, 2012 Thanks for all your help and information on this, moo. As a PGY-1 in family medicine, I am starting to concern myself with how I will do my taxes, manage my money better, etc., both now and in the near future. For one, I haven't really heard much about tax planning seminars. I have an advisor through MD Management, but I want to get a private accountant that is outside of medicine. What's the best way to find one? Is it enough to have a good accountant that you trust, or should you understand your taxes on your own? In medical school, I tried to do some basic reading around money management, investing, and so on. But after a while, the information overwhelmed me and started to sound like gibberish. Like you, I also have some interest in the private sector, not only in medicine but also out of it, such as real estate. What do you think are the best venues to learn more information about all of this? Thanks in advance. There was an accountant who was advertising his services to MDs around town and he was offering free hockey tickets and a dinner for anyone who would come to his seminars. I'm sure you'll come across some as a resident and when you're in practice. As for real estate, our real estate market right now is a big reason why the rich get richer and the poor get poorer. Link to comment Share on other sites More sharing options...
thebouque Posted January 12, 2012 Report Share Posted January 12, 2012 As for real estate, our real estate market right now is a big reason why the rich get richer and the poor get poorer. The rich get rich, the poor stay poor, that's how it goes, everybody knows Link to comment Share on other sites More sharing options...
Man_2ba Posted January 12, 2012 Report Share Posted January 12, 2012 I just met couple of nurse practitioners making over 200000 a year. Link to comment Share on other sites More sharing options...
Man_2ba Posted January 12, 2012 Report Share Posted January 12, 2012 Also I think the best specialty, that pays the most is Optho Link to comment Share on other sites More sharing options...
Erk Posted January 13, 2012 Report Share Posted January 13, 2012 The further along I get the more I realise how little this matters. Even the part-time FM doc I shadow (working solo in a too-large, high-overhead clinic in Calgary) makes a sustainable living. Even a small amount of financial acumen and hard work sets up any specialty to make plenty of money. If you're splitting hairs over 200k or 400k, your priorities are a bit confused. Link to comment Share on other sites More sharing options...
BoyInTheBubble Posted January 13, 2012 Report Share Posted January 13, 2012 The further along I get the more I realise how little this matters. Even the part-time FM doc I shadow (working solo in a too-large, high-overhead clinic in Calgary) makes a sustainable living. Even a small amount of financial acumen and hard work sets up any specialty to make plenty of money. If you're splitting hairs over 200k or 400k, your priorities are a bit confused. Sure it's splitting hairs over a 'sustainable living'. But 200+k after tax income gives you so much more disposable income to purchase things/holidays/ski trips for the fam than 200k pretax! Especially over a career! That extra money will sort out your kids and grandkids for university, savings, getting cheaper mortgages, and better bank rates. It also gives you money to invest, buy property, and perpetuate the rich getting richer cycle. The difference between 400k and 600k is probably not as significant. But imagine how much you'd enjoy your medical work, if you have investments and property that are substituting your need to make money as a doctor... Link to comment Share on other sites More sharing options...
cheech10 Posted January 13, 2012 Report Share Posted January 13, 2012 The problem right now is that for many specialties, finding ANY work is a challenge, even away from major urban centres. Surgery without OR time, GI with no endo suite, Cardio with no cath lab and other tests, and Critical Care without an ICU are just not viable careers. Link to comment Share on other sites More sharing options...
ghost dog Posted January 13, 2012 Report Share Posted January 13, 2012 There was an accountant who was advertising his services to MDs around town and he was offering free hockey tickets and a dinner for anyone who would come to his seminars. I'm sure you'll come across some as a resident and when you're in practice. As for real estate, our real estate market right now is a big reason why the rich get richer and the poor get poorer. The problem with real estate , if you buy other than your own property: tenants and maintaining the property. Massive headaches. Link to comment Share on other sites More sharing options...
moo Posted January 13, 2012 Report Share Posted January 13, 2012 You can hire rental maintenance companies for you who will maintain all of your properties for you, for a nominal fee. Cuts down on phone calls and the headaches of which you speak. Why do you think Canadians are buying up all the cheap property in the US and renting it out? That money is better placed in real estate than in the bank. At least you'll get some income per month out of it. Link to comment Share on other sites More sharing options...
ontariomed0002 Posted March 14, 2012 Report Share Posted March 14, 2012 Hey does anyone have any insight into approximately how much Allergist and Immunologists make? The ones say who focus mostly on practice vs. the research side of that specialty for instance. I know it's a specialty that takes a certain type of person because aside from the rare immunological stuff that could come in it's typically just rashes, itchy eyes, runny nose and sneezing for the most part. I've just never heard much discussion about it on here but isn't there potential for some 'extras' from allergy shots, skin patch testing, skin prick testing, spirometry etc...?? Link to comment Share on other sites More sharing options...
cheech10 Posted March 14, 2012 Report Share Posted March 14, 2012 Those procedures are all covered by the provincial health plans, so not really "extras" in that sense. There are very few allergists, so it's tough to get a sense of the income levels for them, unless you know one personally. Link to comment Share on other sites More sharing options...
ontariomed0002 Posted March 14, 2012 Report Share Posted March 14, 2012 Thanks for the info. So they are not extra billable kinda mini-procedures on top of the actual office visit? Are allergy shots covered by the provincial plan? I just know my parents paid for mine out of pocket was I was a teen but maybe that's changed? Thanks again for the input Link to comment Share on other sites More sharing options...
moo Posted March 14, 2012 Report Share Posted March 14, 2012 Thanks for the info. So they are not extra billable kinda mini-procedures on top of the actual office visit? Are allergy shots covered by the provincial plan? I just know my parents paid for mine out of pocket was I was a teen but maybe that's changed? Thanks again for the input You have to buy the allergen. I'm not sure if the cut goes to the allergist or if you buy it from somewhere else (like a pharmacy) but the allergens themselves are expensive. Giving allergy shots is not that lucrative. After the first shot, everyone goes to a walk in clinic or their family doc to get the shots done. It's about 10.20 a shot. For 2 shots, double that. Only lucrative part of this is that the patient has to come back frequently for shots. That and it's an easy procedure, unless something goes wrong... Link to comment Share on other sites More sharing options...
cheech10 Posted March 14, 2012 Report Share Posted March 14, 2012 Sorry, I meant they are billable on top of office visits, but reimbursed at a rate set by the provincial health plans, which is lower than they would be if they were paid for privately, out of pocket. Actually, now that I look at the OHIP schedule of benefits, the allergy shots are not covered, but skin and patch testing is. Regardless, the procedures do not pay well at all (patch test is $2.39 per patch, skin test is $0.90 per prick, and outpatient provocation challenges are $15 per hour), so I don't think allergists are billing very well. For comparison, Foley catheter insertion pays $8.55 Link to comment Share on other sites More sharing options...
jerkstore Posted April 10, 2012 Report Share Posted April 10, 2012 Derm, path, neuro, opthal, plastics, rads are IMO the most epic fields in medicine and you really dont get to experience them in significant ways (if at all) in clerkship. DO ELECTIVES!!!! Hah that's funny, besides plastics those are actually my least desirable. I think by "epic" he means most relaxed schedule with most pay. Link to comment Share on other sites More sharing options...
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