Avg New Fam Grads

[toastman]

anyone have an idea of how new FM grads are doing with their salaries...whether it be locuming, fho, etc

[rmorelan]

anyone have an idea of how new FM grads are doing with their salaries...whether it be locuming, fho, etc

 

small data point but on Locum friends of mine were earning about 900 a day as new family grads.

[rebeib]

According to page 13 (https://www.cma.ca/Assets/assets-library/document/en/advocacy/Family-e.pdf):

 

Cdn family physicians (those earning > $60k) have an average gross income of $249 154 with an average reported overhead of 28.2%.

 

249154 * 0.718 = $178 892.572 average income pre-tax

 

Now I'm not sure what Cdn family physicians would pay in terms of taxes on average, but their actual take-home pay would be lower than the last figure above.

 

You can try searching up family physician job listings on the database of the respective provinces you are looking into or on locums.ca

[mononoke]

locums.ca seems to be only show BC listings, what about for other places like alberta 

[rebeib]

http://www.doctorjobsalberta.com

 

Ontario: https://hfojobs.healthforceontario.ca/en/list/?p=1

 

Does anyone know what the average tax rate for a family physician would be, based on the above numbers? Or how incorporation would benefit a physician? 

 

Basically, how much would a family physician based on the above numbers actually be taking home?

[youngdad]

http://www.doctorjobsalberta.com

 

Ontario: https://hfojobs.healthforceontario.ca/en/list/?p=1

 

Does anyone know what the average tax rate for a family physician would be, based on the above numbers? Or how incorporation would benefit a physician? 

 

Basically, how much would a family physician based on the above numbers actually be taking home?

Depends if you are incorporated or not.  You can look up corporate tax rates and personal income tax rates on the CMA website.

[rmorelan]

Depends if you are incorporated or not.  You can look up corporate tax rates and personal income tax rates on the CMA website.

And to be clear it will depend on how much you take out of the corporation- the governments goal is to to have the tax the same both routes if you take the full amount out. To do that they have to adjust things from time to time when they fall out of sync.

[blacktowel]

small data point but on Locum friends of mine were earning about 900 a day as new family grads.

Is that before or after overhead and tax?

[rmorelan]

Is that before or after overhead and tax?

 

that locum didn't involve overhead. Personal income tax is a separate matter (I mean you cannot really discuss that until you know the total for the year as the marginal rate will change. Plus there is incorporation as well to mess things up a bit.).

[JohnGrisham]

Is that before or after overhead and tax?

That is probably their take of billings. 

 

If you use a safe value of 70:30 split(so you keep 70% of billings and 30% goes to the practice for overhead etc), they are probably seeing 40+ patients a day when they get 900 gross billings paid.

 

i think some people get better splits like 80:20, havent really heard of people getting much better than that. I mean, the clinic owner has to make their money and pay for the building etc

 

Then taxes and all that.

 

 

OR is my understanding of how locums work wrong? I always assumed the locum would take over, but still have to pay some split of their billings to the clinic for operations. 

[hking03]

That is probably their take of billings.

 

If you use a safe value of 70:30 split(so you keep 70% of billings and 30% goes to the practice for overhead etc), they are probably seeing 40+ patients a day when they get 900 gross billings paid.

 

i think some people get better splits like 80:20, havent really heard of people getting much better than that. I mean, the clinic owner has to make their money and pay for the building etc

 

Then taxes and all that.

 

 

OR is my understanding of how locums work wrong? I always assumed the locum would take over, but still have to pay some split of their billings to the clinic for operations.

From my understanding that 900.00 a day locum is not dependent on you seeing 40+ patients a day...

 

It's what you take home for doing the locum. The overhead is the responsibility of the physician you are covering.

 

And realistically... If you have a somewhat diverse practice you can make 1500.00 (less 30% overhead would be about 1000.00 a day take home) a day without seeing 40+ patients a day, but you have to be willing to manage complex care patients and learn how to bill.

[JohnGrisham]

From my understanding that 900.00 a day locum is not dependent on you seeing 40+ patients a day...

 

It's what you take home for doing the locum. The overhead is the responsibility of the physician you are covering.

 

And realistically... If you have a somewhat diverse practice you can make 1500.00 (less 30% overhead would be about 1000.00 a day take home) a day without seeing 40+ patients a day, but you have to be willing to manage complex care patients and learn how to bill.

Yeah, you're right - I was just going by the basic 30$ fee for a normal visit, and assuming that a fresh grad may not have the same proficiency as a 5 years out person etc. (30*40 - 30% = 900). 

 

Complex patients though also take more time (at least in theory), so it likely evens out. At least according to all the FM docs i've been talking to lately complaining how much harder it is to make money doing "good real medicine" with complex care patients v.s. quick simple cold/flu/nonspecific pain walk-in types.  Either way, see 20 complex patients or 40 simpler ones, forgive the simplifications, you're still looking at a very full day if you want to be making 900$ billings.

 

That makes sense though about overhead, so if you cover for someone you take the full billings? That definitely changes the math then. 

 

 

Any idea on if locum companies in Canada are similiar to the US, where you can negotiate minimum take-home pays, or accomodation/relocation expenses etc? 

[hking03]

Yeah, you're right - I was just going by the basic 30$ fee for a normal visit, and assuming that a fresh grad may not have the same proficiency as a 5 years out person etc. (30*40 - 30% = 900).

 

Complex patients though also take more time (at least in theory), so it likely evens out. At least according to all the FM docs i've been talking to lately complaining how much harder it is to make money doing "good real medicine" with complex care patients v.s. quick simple cold/flu/nonspecific pain walk-in types. Either way, see 20 complex patients or 40 simpler ones, forgive the simplifications, you're still looking at a very full day if you want to be making 900$ billings.

 

That makes sense though about overhead, so if you cover for someone you take the full billings? That definitely changes the math then.

 

 

Any idea on if locum companies in Canada are similiar to the US, where you can negotiate minimum take-home pays, or accomodation/relocation expenses etc?

Just to clarify a bit further... If a family doc solidifies their skills at billing and understanding the fees they can easily bill 1500.00 a day and see 20-25 patients a day.

 

The billing code for a complex care patient allows for you to bill approximately 350-400 once a year for that patient visit. If you have a patient list of about 2000-2500 and 10-15% of your patients are chronic care you can very easily see 1 a day for most of the year and bill about 400 per visit. You have to spend an hour reviewing and examining and counseling. But thats worth it...

 

If you work 8 hours a day that still leaves 6-7 hours to see another 24 patients at roughly 33.00 per visit (remember that the fee increases for older people as well). So, in 8 hours you see 25 patients and you bill for 1200.00. Plus if you are involved in hospital inpatient medicine you see your patients in the AM and those billings are overhead free. If you are in a call group for Obs, hospitalist or anything else you also benefit from quarterly bonuses of ~2k. If you are rural you have even more incentives.

 

Honestly, if family docs are complaining about not being able to Bill enough they aren't doing it right... Sure, overhead is expensive and there is a ton of paperwork to fill out for each patient. But if you work hard and use half your brain to figure out the business side it's easy to make a lot of money.

 

Of the two dozen or so family docs I've worked with over my entire medical school career the only ones that complained were the ones who were lazy with their billings. And the average salary msp billings for the docs I worked with easily topped 350k.

 

Anyways, that's not the point of this thread.

 

I don't know how the US locum stuff works and I'm not really keen on the Canadian locum companies aside from the ones that offer 900.00 a day to cover a practice.

 

Typically, from what I've seen in practice if a doc is going on vacation they will negotiate with the doc who is covering for them. Either 80-20 or 70-30. Or if it's a short vacation and a large enough group practice they won't even hire a locum. They'll just cover for each other with the expectation that when the other people take vacation the group steps up to the plate.

[JohnGrisham]

Thanks hking!! Very valuable insight

 

I think my mind has been set a drift by a current FM mentor who only does mostly geriatrics and complex patients. So they always envy docs who can see patients in 10 minutes and always makes it a point to say "there's no way I can do good medicine by seeing them for any less than 20mins" etc.

 

33*3*7(hrs)= 693 and then a few hours of paper work and contacting other docs and social work etc etc. Of course some patients are quicker and some slower..and then there's that complex care once a year you mentioned.

 

To their benefit, they are very seasoned and just dont like to rush things. Perhaps if they wanted to they could definitely cut time off but they feel the need to spell it out in full to their patients.

[booradley83]

I've realized that if you see 40 patients a day for 5 days a week; you will average around 300k after overhead in Canada.  This is a VERY NICE income.

[booradley83]

Correction, if you see 40 patients a day, you will make a take home of $1k.....so 5x week X 50 weeks will net you $250k.......you would have to add in occasional weekends and evenings to reach 300k. Doable, but working hard you can reach 300k net.

[hking03]

Correction, if you see 40 patients a day, you will make a take home of $1k.....so 5x week X 50 weeks will net you $250k.......you would have to add in occasional weekends and evenings to reach 300k. Doable, but working hard you can reach 300k net.

your numbers are based on either doctors who don't know how to bill... Or they are based on an incorrect assumption that each patient visit is worth the same 30.00...

 

Either way, both scenarios are incorrect.

 

I've mentioned it several times all over this forum, but if you learn how to Bill for your patient visits and you engage in a practice of medicine that is actually full scope and utilizing your skills beyond writing prescriptions and doing walk in clinic visits you will make a killing.

 

For instance, if you were interested in maternity care in BC you can join a call group and work one call shift once a week. For being a part of that call group you get paid 9k over the year through MSP. You also get paid a bonus on 25 deliveries throughout the year that adds 400.00 to the standard delivery fee. If you do prenatals at a clinic you bill 30.00 per prenatal and can crank out dozens in a day.

 

A family doctor I worked with made ~150k after expenses (the prenatal clinic has overhead, the hospital did not) just from their one call shift a week. On average they would participate in 1-2 deliveries per call shift, which is about 100 deliveries per year.

 

If you incorporate any sort of complex care into your family practice you can also do quite well... complex care physical exams allow you to Bill ~300-400 for the physical and review session once per year for that patient...

 

If you work in a smaller community you can qualify for top ups that apply to your billings.

 

If you are a part of a call group you can also receive top ups every quarter (similar to the maternity call group).

 

If you have hospital privileges and care for your patients while they are admitted you Bill for those visits and they are usually overhead free. There is also a first patient of the day fee code that helps make it worth while.

 

If you want to work as a hospitalist once a week you can usually do this for around 1200-1500.00 per shift...

 

If you want to be a surgical assist you can get paid hundreds of dollars per surgery...

 

my family doctor works part time, takes 8+ weeks of vacation and is near the end of his career and still makes 250k per year...

 

The docs I've worked with across BC have all made 300-600k (before overhead). The lower end of the spectrum is usually reserved for docs in urban areas who don't want to do the work that pays.

 

Hopefully that clears up some misconceptions.

 

Granted, this may not be the type of medicine you

Or others want to practice and these numbers

May not apply to different provinces...

[booradley83]

Yeah but taking into account all of these bonuses, I'm averaging about ~40 dollars per visit as a conservative estimate. I'm saying if you see the 40 patients a day, you will conservatively bill roughly 360-400k working just an office/outpatient practice. Doing just that, making $250k net is very possible. Yeah, with all the stuff you mentioned you can probably go up to $350-375k net as a family doctor.

[MD2015:)]

Seeing 40 patients per day x 5 days per week is quite a grind unless you are pretty efficient. Maybe in several years it wouldn't be hard to be that efficient especially if you know all your patients, but if you work 9-5 with 1 hour break you would have to see patients one every 10 min and then deal with all the paperwork. The only people I see doing 40 patients a day x 5 days a week are older docs. Most younger ones like to do work outside of the clinic rather than clinic 5 days per week and new docs typically wouldn't be seeing 200 patients a week.

[dynomedasaur]

Just came onto this thread (my bad on posting on the previous one!). 

I'm curious, is it possible for rural GP's to bill for things like - colposcopy exams (with acetic acid/lugols) // cervical biopsies? I can see it being indicated for rural GP's who have marginalized patients with no way of getting access to a gynaecologist within 100kms. But I cannot find any type of billing code under the GP Billing guide.

[bloh]

Seeing 40 patients per day x 5 days per week is quite a grind unless you are pretty efficient. Maybe in several years it wouldn't be hard to be that efficient especially if you know all your patients, but if you work 9-5 with 1 hour break you would have to see patients one every 10 min and then deal with all the paperwork. The only people I see doing 40 patients a day x 5 days a week are older docs. Most younger ones like to do work outside of the clinic rather than clinic 5 days per week and new docs typically wouldn't be seeing 200 patients a week.

 

Those docs are also typically ones that are mismanaging their patients and doing shit medicine.

[ralk]

Just came onto this thread (my bad on posting on the previous one!). 

 

I'm curious, is it possible for rural GP's to bill for things like - colposcopy exams (with acetic acid/lugols) // cervical biopsies? I can see it being indicated for rural GP's who have marginalized patients with no way of getting access to a gynaecologist within 100kms. But I cannot find any type of billing code under the GP Billing guide.

 

Colposcopy is pretty tightly regulated - in Ontario at least, even a fully qualified OBGYN can't perform them without specific certification. Can't imagine any GPs performing them, even in remote locations with advanced training.

[Iamokayyyyyy]

I know that this is an old thread - but is there a website for locums for Montreal? Can you do short-term locums in Montreal as a GP?