Doctor Salaries

[Guest Donnie Darko]

I was digging around the site trying to find info on Canadian doctors salary, which is one thing I've been having trouble getting info on, and I came across this article:

 

www.caribbeanmedicine.com/article9.htm

 

Basically says after costs a FP makes less than many autoplant workers... that's a pretty sad state of affairs if you ask me. No wonder so many Canadian med school graduates move to the states to practice. I want to stay in Canada and be a doctor, but damn the salary figures they give in that article are pretty sad.

 

Anyone have more/better info on Canadian doctors salary? I don't want to sound like I'm too hung up on what doctors make, I'm not at all. I do think it is kind of lame if they make less than auto plant workers though. All the other info I wanted (mcat, premed, interview etc) is readily available on this site, but salary info seems hard to come by. Of the 2 links in the faq in this forumn regarding salary, one link is dead, and one points to info that doesnt give any actual salary numbers.

 

Thanks,

 

--DD

[Guest kosmo14]

check out this:

 

www.cma.ca/staticContent/...income.pdf

 

make sure to take off between 30-40% overhead off of those numbers, also remember they are almost 5 years old now, most provinces have slightly increased thier fee schedules.

[Guest Donnie Darko]

Thank you sir, you're a scholar and a gentleman and there's damn few of us left.

[Guest LestatZinnie]

are you sure you need to take off 30-40% overhead for specialties? Arent they salary based, like in hospitals? I thought you only need to take off overhead for family doctors becuz they open their own clinics.

 

if the salaries are really gross salaries including overhead then many specialists earn only equal to, and probably even less than self-employed dentists.

 

p.s. in the bottom footnote it says it's gross payment and does not include salaries, so I guess these are payments for physicians who open their own clinic, and does not include salary-based positions like in hospitals??

[Guest LestatZinnie]

by the way, the general gross income for private dental practioners is between as low as 300k to high of 1 million. The median range I've seen is around 500k. However the overhead is around 60% for a dental clinic, so the average net income is between 120-200k. Associates make less.

 

The published ADA avg salary is 160k USD for general dental practioner and 260k USD for dental specialists.

[Guest Steve U of T]

I recall reading something a few years ago about family practitioners being allowed to bill no more than $325k to OHIP (in Ontario, that is) and specialists having a $400k billing cap (overhead to be subtracted, of course). I don't recall the source, but it seemed trustworthy (probably a newspaper). Anyone know if these values are still accurate?

 

Also, I heard from another source (word of mouth from a med student) that coronary bypass surgery is the only procedure that has no cap, explaining why cardiovascular surgeons make much more money on average.

[Guest LestatZinnie]

forgive my ignorance, but why would cardiac surgeons have overheads? don't they all work in the hospital? or are there private cardiac surgeons who own their own clinics??!!

 

i know for certain areas like ophthamology, plastics, urologists, radiologists, they may have private clinics, but it's a bit weird to me that cardiac surgeons would also have own clinic/practice, and thus incur overhead.

[Guest UWOMED2005]

LestatZinnie - The overhead depends greatly on the specialty. You're right, some specialties are salaried (ie most emerg) and some other specialties (aka the "socks and underwear" specialties because that is all you need to perform them) such as anaesthesia can have very little overhead. It's pretty complicated.

 

As for caps, yes there are caps for OHIP billings. I can't remember what they are off-hand, but I do know that for family medicine was less than the specialties, but was recently increased to be either closer or on par (like it will do any good, considering I doubt most family physicians approached the lower cap anyways.) The thing with the "cap" is that it's not that you don't get paid after you've hit the cap, you just don't get paid as much (analagous to a graduated income tax system) once you've hit that cap. I'm not sure of the details, but I'm pretty sure the figures are that you get 2/3 of your billings over that first cap that's often quoted, and then there might be a cap beyond that where you get 1/3 of the billings. Doctors often don't want to go beyond their cap because they work damn hard as it is and it makes little sense to go from 70 hrs/wk to 90 hrs/wk when for the last 20 hrs you're only getting 2/3 of what you make. (Anyone find it ironic that this is the exact OPPOSITE situation than the auto worker who works overtime?!?)

 

There's a much better link for salaries in the CaRMS/Residency forum. I don't have time to find the link right now, but it's under "BC Physician Salaries" or something like that. One of the moderators posted a chart from the OMA showing OHIP billing avg, median, averages over $50k (very key number to look at as their are a lot of semi-retired physicians out there who bill once or twice to the system, artificially deflating the stats) and average for the top 75th percentile (what you will probably make when you first graduate and are working your balls off to try to pay back your loans. . . after that many doctors tend to take things a little bit easier.)

 

I'm not going to deny physicians can make money, particularly, depending on the specialty you choose. I did an elective recently in a specialty where the docs work 30 hr weeks and make on avg something around $500k, with at least one guy over $1 million (after overhead) last year and a few others close to that figure (though in this specialty 80% of the billings are non-OHIP in nature.) But there aren't many specialties like that, most of the ones where you're making near $500k you're working so damn hard you never get to spend it. And I'd say MOST specialties are WAY below that, closer to $100k-$200k (after overhead, but before couting time in school, debt, lack of benefits, lack of pension, etc.) But I still say going into medicine strictly for the money is stupid. Why? Four reasons:

a) There's no guarantee you'll get into a specialty where you're making more than an auto worker or plumber

There's no guarantee you won't get to third year and realize you despise the lucrative specialties and couldn't stomach them for a career

c) If you're interest is $$, the 10 odd years ( med school + residency + years paying off debt) you're going to be a pauper will kill you

d) There's a good chance you'll despise medicine period when you realize you aren't making as much as you thought you were

e) If you're real interest is $$, then you'll probably never be satisfied in medicine. $1 million/yr is pretty much the most any doctor could make doing clinical medicine. If you've got that personality such that your goal in life is to make more than Mr. Jones, well if Mr. Jones is a business owner, in investments, invented some new technology, well then you'll never beat Mr. Jones.

 

On that last point, I was out last night with a bunch of guys I play rugby with who are from the Ivey School of Business (ie UWO MBA program.) We were talking about a lot of these themes, in relation to both our careers. Basically the consensus was that medicine was a safer bet to make money (as there are unemployed MBAs but few unemployed doctors, unless they've had their licence removed) but you could make way more in an MBA. . . and you'd get access to that cash sooner (some of the Ivey guys are already driving beamers and the like.)

[Guest LestatZinnie]

good answer UWOMED

 

but can someone still explain to me why surgeons performing complicated procedures, eg cardiac surgeons, would have overhead, since they all work in the hospital?

 

if they have private practice, how do they do these big procedures requiring tons of equipment and medical personnel then??

 

thx...this is really bewildering to me....

[Guest Steve U of T]

I know some types of surgeons can open private practices, including general, vascular, and plastic surgeons. This is only speculation, but I'd imagine setting up an OR would be incredibly expensive, although affordable in the long term, especially for a large practice with several surgeons. I also think surgeons in private practice can book time in hospital ORs.

 

If I or a family member were having cardiac surgery, I'd probably want it done at Toronto General (by Tirone David, perhaps) rather than some private clinic, but (although this is only speculation) I imagine there could be cardiac surgeons in private practice too. It's more likely to be true in the U.S. than Canada.

 

More speculation, but if there are hospital-based doctors who work on fee-for-service rather than salary, they would allocate part of their income to secretaries, OR usage, nurses, etc.

[Guest Kirsteen]

Hi there,

 

I work for a burn surgeon whose office is situated at Sunnybrook Hospital. All of his clinics and surgeries are performed at Sunnybrook, and he is paid a salary (although his secretary still has to report each billing code for each service he performs). Thus, he is not considered to be a private practitioner. (Incidentally, these surgeons can receive bonuses in addition to their negotiated salaries if they manage to rack up high billings. Conversely, if they do not submit ample billings they can be reviewed and/or have their hospital/surgical privileges suspended.)

 

My boss does pay overhead from his salary, given that he does have an office with a secretary within Sunnybrook. His overhead includes a certain amount of money for the office space, telephone and fax lines, photocopying, stationery (business cards), etc. Essentially, he pays for items that are similar to those paid for by a private practitioner. In addition, in the event that he wishes to make changes to his office, e.g., expand it, repaint it, recarpet it, or add some new phone/data lines, he has to pay the exhorbitant fees that the hospital charges to provide these services. He is not permitted to outsource. I was pretty shocked to hear how badly these guys are ripped off for services that would cost about 500 percent less if you or I picked up the Yellow Pages and hired people to perform these services ourselves.

 

Finally, yes, it is expensive to run ORs, particularly in terms of human resources and consumables such as dressings, sutures, etc. Our burn unit has its own OR that is located on the same floor. Although there are three staff surgeons who regularly rotate through this OR, they do not pay for the OR directly themselves. The Director of the burn unit (one of the surgeons) is allocated a budget for the ward (including the OR) by the hospital, from which he determines how his funds are allocated. These budgetary funds do not come from the surgeons' own pockets.

 

Cheers,

Kirsteen

[Guest ioncannon97]

From the specialists within my own family and friends a popular pay theme for specialists these days seems to be minimum salary from the hospital with no overhead and then fee for service if the doctor's billing (which is handled by secretaries hired by the hospital) goes above this minimum. For example, an internist who is a relative recently accepted a position in a Toronto hopital in which he does not pay overhead (secretaries salary etc) but recieved no benefits (has to pay licensing fee, etc himself, but this all usally totals to about 10-15K only). He has a minimum guaranteed salary of $200 (so he can take as long as he wants to see individual patients but will still make $200....obviously he can't take TOO long with any patient). The hospital bills OHIP for the doctor's work and if they recieve more than $200K, they give him the difference (some hospitals only give a proportion of the difference). This individual says he makes about $250K before taxes which seems to be a typical number for an average specialty like internal medicine. I'm guessing more lucrative surgery specialties may have different pay structures in place.

[Guest ioncannon97]

Note: in the above post $200 = $200K

Whoops, :rollin

[Guest Donnie Darko]

Thanks for the info. Ioncannon, which province is the internist you mention from?

[Guest cheech10]

Ontario, since he's billing OHIP.

[Guest ioncannon97]

He is an Ontario graduate and is working at a Toronto hospital.