McMasterHopeful Posted March 9, 2012 Report Share Posted March 9, 2012 I hear tales of GP's making $300k+ (some posts as high as $650k with no life) but I wonder if this is reality - even if you are willing to sell your soul. In BC, as many of you know, the fees charged per appointment are cut by 50% after a certain number, and beyond 66 appointments, they are cut 100% i.e. you are volunteering out of the goodness of your heart. Can anyone comment on how this compares with other provinces? Link to comment Share on other sites More sharing options...
cheech10 Posted March 9, 2012 Report Share Posted March 9, 2012 There is no claw-back in Ontario. Link to comment Share on other sites More sharing options...
Wachaa Posted March 10, 2012 Report Share Posted March 10, 2012 I've met many GPs through my training so far, and many of them I've worked under a few times. $300k can be easily done in less than 30 hours a week. You don't have to work in a walk-in either. If you want to make more... one GP I saw would have very long waiting times and he would book to see 65 patients a day, 5 days a week for 40 hours a week in total. He made $630k. Other GPs had long waiting times too, but worked about 30 hours a week and billed a bit over $505k. So it's possible to have a life too. Oh, and also they have paper, not EMR. It depends on what kind of doctor you want to be, right? A lot of the time I find that patients go on and on and tell you things that aren't relevant to their visit. i.e. The things that develop rapport and a good relationship and they will like you more. However, you're not going to make a buck if you spend half an hour with each patient. And if you've already diagnosed it as a cold, for example, there's not really an absolute need to talk more. Also, it just so happens that a lot of the time, even if those GPs I mentioned above make a lot of money for what they do as a GP, it doesn't mean they are not caring; patients still feel loyal and will come see him/her for many years. So at the end of the day, you can still be efficient, compassionate, make a good salary, and your patients will appreciate you, even if you rush them a bit. Link to comment Share on other sites More sharing options...
McMasterHopeful Posted March 10, 2012 Author Report Share Posted March 10, 2012 I've met many GPs through my training so far, and many of them I've worked under a few times. $300k can be easily done in less than 30 hours a week. You don't have to work in a walk-in either. If you want to make more... one GP I saw would have very long waiting times and he would book to see 65 patients a day, 5 days a week for 40 hours a week in total. He made $630k. Other GPs had long waiting times too, but worked about 30 hours a week and billed a bit over $505k. So it's possible to have a life too. Oh, and also they have paper, not EMR. It depends on what kind of doctor you want to be, right? A lot of the time I find that patients go on and on and tell you things that aren't relevant to their visit. i.e. The things that develop rapport and a good relationship and they will like you more. However, you're not going to make a buck if you spend half an hour with each patient. And if you've already diagnosed it as a cold, for example, there's not really an absolute need to talk more. Also, it just so happens that a lot of the time, even if those GPs I mentioned above make a lot of money for what they do as a GP, it doesn't mean they are not caring; patients still feel loyal and will come see him/her for many years. So at the end of the day, you can still be efficient, compassionate, make a good salary, and your patients will appreciate you, even if you rush them a bit. Thanks for the information here mate. Which province are they in? Do you know what the average fee is for a patient visit? On another topic you mentioned, does paper really slow you down vs EMR or? This is an aspect of running a practice I have yet to look in to. Thanks again Link to comment Share on other sites More sharing options...
justletmein Posted March 10, 2012 Report Share Posted March 10, 2012 On another topic you mentioned, does paper really slow you down vs EMR or? This is an aspect of running a practice I have yet to look in to. Thanks again EMR is only quicker once you get used to it. It can be a steep learning curve for older doctors. Especially the ones seeing 65 patients a day, whose idea of charting is scribbling a few illegible lines and signing at the bottom. Link to comment Share on other sites More sharing options...
Wachaa Posted March 11, 2012 Report Share Posted March 11, 2012 It's in BC, and the pay schedules can be found here http://www.health.gov.bc.ca/msp/infoprac/physbilling/payschedule/pdf/7-general-practice.pdf Link to comment Share on other sites More sharing options...
leviathan Posted March 12, 2012 Report Share Posted March 12, 2012 I think there is a trick to being caring compassionate and someone who lends an ear to their patients' numerous problems, while also being efficient and using time effectively. It takes a good GP to balance both of those things. One trick I learned was to ask what all of their concerns are up front, so that you don't get through a full workup and then find out about some alarming problem ("Oh, by the way, doc...") right as you're about to send them out the door. Then you can tell them you will address the most concerning issues today and book another appointment for the other issues. Link to comment Share on other sites More sharing options...
moo Posted March 13, 2012 Report Share Posted March 13, 2012 I hear tales of GP's making $300k+ (some posts as high as $650k with no life) but I wonder if this is reality - even if you are willing to sell your soul. In BC, as many of you know, the fees charged per appointment are cut by 50% after a certain number, and beyond 66 appointments, they are cut 100% i.e. you are volunteering out of the goodness of your heart. Can anyone comment on how this compares with other provinces? Billings encompass way more than just straight up MSP 30-45 dollar visits. A good portion of my income comes from a lot of other things (WCB, ICBC, sick notes, forms, medicolegals, chronic care fees, nursing home visits, immigration medicals, private medicals, private patients, driver's medicals, minor cosmetic surgery, travel advice/shots etc.). It's very easy to GROSS over 500K, once you have an established practice (about 1 year out of residency). And as you bill more the percentage of overhead goes down (as overhead costs are fixed--staff costs, rent, equipment, etc.), provided you have bought in to your practice (which you usually would consider after being out of residency for a few years). There are docs who just like to locum but financially that is unwise as you are just giving your money away in overhead to the clinic owner. (For example, of the 30-35% in overhead typically charged to locums, only about 15-20% actually goes to rent, staff and equipment, the rest goes to the owner(s). And if you bill/work more, the amount that goes into the owner(s)' pockets goes up, as like I said before overhead is FIXED and doesn't change even if you work more... you may use more equipment (syringes, cotton swabs, etc), but equipment costs are a very very small percentage of overhead). Link to comment Share on other sites More sharing options...
Knovecc Posted March 14, 2012 Report Share Posted March 14, 2012 Does anyone know if there is a certain kind of incentives for FP working in aboriginal reserves, or up the north of BC? is it like a package deal (like xxx $ per year), or a xx% more pay per act? Link to comment Share on other sites More sharing options...
moo Posted March 14, 2012 Report Share Posted March 14, 2012 Does anyone know if there is a certain kind of incentives for FP working in aboriginal reserves, or up the north of BC? is it like a package deal (like xxx $ per year), or a xx% more pay per act? Yes there is. Usually it's an x% more for billings, depending on remoteness of the site. The most remote sites get an extra 30% on top of their gross billings. Still not enough for me to go up there. Some places may have very low overhead too (or they will cover your overhead if desperate). GPs4BC is also a program that the government has or had that pays you about 100K bonus just for signing to agree to work in an underserved area. Link to comment Share on other sites More sharing options...
Prince Medward Posted March 14, 2012 Report Share Posted March 14, 2012 The GPs4BC program was a sweet deal. Especially when places like Surrey (a vancouver suburb) were listed as underserved. However the program will end in August of this year. Too bad for new grads. Link to comment Share on other sites More sharing options...
McMasterHopeful Posted March 14, 2012 Author Report Share Posted March 14, 2012 Billings encompass way more than just straight up MSP 30-45 dollar visits. A good portion of my income comes from a lot of other things (WCB, ICBC, sick notes, forms, medicolegals, chronic care fees, nursing home visits, immigration medicals, private medicals, private patients, driver's medicals, minor cosmetic surgery, travel advice/shots etc.). It's very easy to GROSS over 500K, once you have an established practice (about 1 year out of residency). And as you bill more the percentage of overhead goes down (as overhead costs are fixed--staff costs, rent, equipment, etc.), provided you have bought in to your practice (which you usually would consider after being out of residency for a few years). There are docs who just like to locum but financially that is unwise as you are just giving your money away in overhead to the clinic owner. (For example, of the 30-35% in overhead typically charged to locums, only about 15-20% actually goes to rent, staff and equipment, the rest goes to the owner(s). And if you bill/work more, the amount that goes into the owner(s)' pockets goes up, as like I said before overhead is FIXED and doesn't change even if you work more... you may use more equipment (syringes, cotton swabs, etc), but equipment costs are a very very small percentage of overhead). Moo this is excellent information thank you. You brought up an interesting point about having locums work at your practice. I see these jobs posted all over the place (30-35% overhead off the top of your gross billings). I wondered if that variation was to cover costs only, or if there was net profit at the end of the day. Based on your post, there is profit to be made by running a larger clinic. Are you aware of any ethical issues or is it fairly standard practice? I see no reason why, assuming you can find the FP staff, you could not run a profitable clinic above and beyond your own billings. Link to comment Share on other sites More sharing options...
ghost dog Posted March 15, 2012 Report Share Posted March 15, 2012 Moo this is excellent information thank you. You brought up an interesting point about having locums work at your practice. I see these jobs posted all over the place (30-35% overhead off the top of your gross billings). I wondered if that variation was to cover costs only, or if there was net profit at the end of the day. Based on your post, there is profit to be made by running a larger clinic. Are you aware of any ethical issues or is it fairly standard practice? I see no reason why, assuming you can find the FP staff, you could not run a profitable clinic above and beyond your own billings. In my practice experience, it would be very difficult to cut your overhead to less than about 20 - 25 %. Having said that, it's definitely worth it to work for yourself (putting aside the additional income). You call all the shots. However, you do have to set things up intially, which is a headache, but it's worth it. Once things are up and running, it tends to be self sustaining ( i.e. regular ordering of incidentals, etc.). One piece of advice - make sure you get a good secretary. Don't cheap out here, as this will bite you in the ass in the long run , guaranteed / 100 %. The number of times I call up another docs office to chat with them about something and get an admin on the phone who can barely speak english, or who is a complete idiot - this really reflects poorly on the practice. Patients hate it. Link to comment Share on other sites More sharing options...
moo Posted March 15, 2012 Report Share Posted March 15, 2012 Moo this is excellent information thank you. You brought up an interesting point about having locums work at your practice. I see these jobs posted all over the place (30-35% overhead off the top of your gross billings). I wondered if that variation was to cover costs only, or if there was net profit at the end of the day. Based on your post, there is profit to be made by running a larger clinic. Are you aware of any ethical issues or is it fairly standard practice? I see no reason why, assuming you can find the FP staff, you could not run a profitable clinic above and beyond your own billings. Of course there is profit and of course this is ethical. As I said before, the more you work (and bill), the more your overhead as a percentage of your total billings should go down. However, for short-term locums (or even "long-term locums" who don't bother to buy in), your overhead is fixed as a percentage. Thus, as clinic owner, you make about 10-15% off the locum right off the bat (providing that he/she sees enough patients, which isn't hard if your clinic is well-established, has a good reputation, etc.). Pocketing $10-15 for every $100 the locum bills is pretty sweet. Of course, running a practice has responsibilities. And this is why owners charge more than is needed for overhead--to account for all the extra work you have to do. You have to hire staff, make sure the clinic is well-stocked, has a good reputation, is branded, have an accountant, buy computers, etc. Some docs don't like doing the business side of medicine and so will just want to locum but they are losing out financially, and many are fine with that. For me though I like the autonomy of making decisions (along with my partners), and the financial rewards that come with it. We also have specialists in our clinic that stop by once a week or so (we have an eye room and procedure room). We charge them 30% overhead, which offsets a lot of the overhead that we have to pay, as they generally bill more than GPs. Link to comment Share on other sites More sharing options...
McMasterHopeful Posted March 16, 2012 Author Report Share Posted March 16, 2012 Thank you for the info. Im an older applicant and have been running a staffed company for several years so i can relate to all points. I agree that having good staff makes all the difference. Ive been thinking em but running a fm practice is a good option. It seems to be one of the few options (aside from running a biotech or taking a salaried position) where you can take a day off or semi-retire and still have some income. Link to comment Share on other sites More sharing options...
JohnGrisham Posted June 9, 2016 Report Share Posted June 9, 2016 There is no claw-back in Ontario. How 4 short years can change the tides... Link to comment Share on other sites More sharing options...
NeuroD Posted June 9, 2016 Report Share Posted June 9, 2016 How 4 short years can change the tides... Ha.. I didn't realize the thread was that old until I read your post. I was about to reply with "is that meant to be sarcasm?" Link to comment Share on other sites More sharing options...
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