How Much Money do Doctors Earn in the US? | US Doctor Salaries
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- āđāļāļĒāđāļāļĢāđāđāļĄāļ·āđāļ 22 āļŠ.āļ. 2024
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I'm speaking as an American:
1. Medscape isn't necessarily the most reliable physician salary/compensation survey.
2. MGMA is a better estimate and (it seems) what many recruiters use. But I'd even say MGMA underestimates how much we make in the US.
3. How much we make in the US depends on many factors. Such as:
a. Geographic location. For example, West and East Coasts tend to make less than Midwest and South.
b. Urban vs. suburban vs. rural. For example, if you work in the center of Manhattan or downtown LA, then you tend to make less than if you work in rural Iowa.
c. Volume of patients seen. If you see more, then you make more, generally speaking.
d. Payor mix. How many are insured, uninsured, some health insurance are better than others, etc. By the way, many Brits think our health care system is private (it's not 100% private e.g. Medicare, VA) and thus unethical (unlike the NHS). But I'd argue our health care system is ethical. It's a myth we reject patients who don't have insurance or can't pay (cf. EMTALA). In fact, there's often financial assistance (e.g. an uninsured friend had a hospital bill over $40k and the entire amount was forgiven so he didn't pay a cent - this is not uncommon in the US).
e. Hours. People in the same specialty can often make more if they work more. For example, most contracts for a primary care physician like a family physician aka GP at the attending level in the US are for 36 hours. Most family physicians work around 4.5 days per week, minimal call, no nights, no weekends. However, if they want to work more, then they can make more, generally speaking.
f. wRVUs. RVUs can be negotiated with a practice or an employer. Of course, the higher the RVU, the more you'll get paid. For example, a PCP aka GP can make $40/RVU vs. $50/RVU.
g. Employment type. Whether one is working for a health care system, hospital-employed, in a multispecialty group, etc.
h. Specialty choice. In general, procedural specialties tend to make more than non-procedural specialties.
i. Starting salaries vs. mid-career salaries. Mid-career salaries tend to be higher. As far as I'm aware, physician compensation surveys like Medscape don't draw this distinction.
j. Side gigs or hustles. I'm referring to side gigs in medicine, not side gigs like investing in real estate, which can make a lot of money, but I'm just keeping it within medicine. Physicians can add to their salaries by doing side gigs. Say someone is a PCP aka GP in the US. They can be part of a practice, but they can also pick up locums in urgent care, emergency departments, even hospitalist work (for $150-$200+ per hour). They can pick up a side gig as a medical director for an urgent care center. They can do telemedicine from home. They can cover nursing home patients. They can do chart reviews for $90/hour. And so on.
k. Sign-on bonuses. Many places will offer sign-on bonuses. Usually these are in less desirable places, but "less desirable" isn't necessarily undesirable. I know people in or near large cities in the Midwest and South who have gotten nice sign-on bonuses. $75k-$100k sign-on bonuses.
l. Other incentives. Like loan repayments. If you agree to work x number of years with them.
m. Academic vs. community. Academic med tends to be paid less. There's a lot of truth to the idea that the more "prestigious" the institution, the less you'll make! If you want to work at a place like MGH or Hopkins, then expect to make a lot less than private practice. Usually the more research and teaching, the less clinic time, which means less money. I'm sure there are exceptions. Some hybrid models can get the best of both worlds - academic interests with private compensation.
4. Keep in mind that the current political climate in the US is hugely in favor of reforming our health care system. If this happens, it could impact physician compensation. This is true for both Republicans and Democrats. Both want to change the US health care system. The question is how "much" we want to change it. Simplifying, Republicans generally favor mild to moderate reform of our health care system while Democrats generally favor more radical reform or entire overhaul of our health care system. The zeitgeist in US politics today is volatile to put it mildly, which has ramifications for our health care system. Political debates over our health care system are highly contentious. There's no way to perfectly predict what will happen in the future. Let alone how it will impact physician compensation, for better or for poorer. If I had to guess, I think primary care physicians will always be needed and their salaries are likely to change the least, whereas specialists are more likely to see oversaturation in major markets and wider swings in their salaries (e.g. look at all the new emergency medicine residencies already flooding saturated markets and significantly lowering compensation for EPs). Anyway this gets into debates over things like physician compensation models (e.g. fee for service, bundled payments) and the role for midlevel providers in the US health care system (e.g. nurse practioners, physician assistants) where some say the expanding role of midlevels may cause a downward trend in most physician compensation.
5. I should say I'm originally from Southern California, but hopefully I'll be moving out of state soon because California is way too expensive with super high taxes and many other problems. I'm obviously speaking from the perspective of an American, but perhaps someone from, say, London would think Los Angeles is affordable. I also have other physician friends from all over the country and even other parts of the world including Canada, Australia, UK, Ireland, various parts of continental Europe. I mention all this so people know where I'm coming from.
6. I'll give a ballpark figure for what primary care physicians (PCPs) make in the US. By PCPs, I mean family medicine (aka GPs in Britspeak), but internists and pediatricians can also be PCPs (whereas in the UK internists and pediatricians are considered specialists if I'm not mistaken). Starting salaries are around $200k per year, give or take. This is usually a base salary + productivity. Depending on the place, the base salary is usually guaranteed for about 1-3 years, then transitions to productivity. By then, a PCP can make around $275-$300k per year working 4-4.5 days per week (36 hours per week), minimal call, no nights, no weekends. If they want to make more, they can work more or make use of the factors I mentioned above such as side gigs, which can add like $50k-$100k per year to their salaries.
7. Many specialists won't necessarily make more than PCPs in the US. For example, endocrinologists and rheumatologists don't make more than PCPs. They make maybe around the same or similar, though sometimes a little bit less. But seeing endo or rheum patients as a specialist in a primarily outpatient setting has its own rewards (e.g. less BS).
8. However, many other specialists will make a lot more than PCPs. All the surgical specialties will. In IM, cardiologists, gastroenterologists, hematologist-oncologists, and pulmonary and critical care physicians will all tend to make a lot more than PCPs. I'm talking near double the salary or more.
9. Dermatology. I don't know derm, Liberty Medics would know far better than I, but I've heard they can easily make $350k-$400k per year working regular Mon-Fri type of hours even in or near NYC. Well, maybe not Manhattan, or certain parts of Brooklyn, but the other buroughs? I think patient volume tends to be high in derm though. Possibility for lots of procedures which are currently lucrative. And many dermatologists make significantly more than $400k per year with a pretty decent lifestyle.
10. For people trained in the British system, my Australian physician friends tell me that Australia is a great place to work. From what they've told me, Australian physicians can make almost as much as American physicians, but with a better lifestyle, and in a more stable health care system. I know an anesthesiologist who was trained in the US who moved to Australia. He's a "staff specialist" in a big Sydney hospital (staff specialists are like being an academic physician in the US, I think). He starts around $350k per year for around 40 hours per week. This doesn't include call and other things that can make him more money. He's trying to pick up more private patients and if he does his salary can be far higher. Comparable to American anesthesiologists. And my understanding is no CRNAs to deal with in Australia, nor huge health care systems or anesthesia management companies trying to buy out private groups. I know an oncologist in Australia who makes about $500k per year with reasonable hours. I know a Canadian GP who moved to Australia and practices near Canberra. She says she made about $300k last year working 35-40 hours per week. Australia seems to have a lot less headaches with bureaucracy, insurance, and the like than America (e.g. we spend several extra uncompensated hours per week doing non-medical admin type work). And my understanding is Australia's health care system is much less volatile than the US right now, so physician compensation is likely to be more stable in Australia than here. A lot could change in the next decade or so in the US, which could significantly change US physician salaries, for better or worse. So I mention Australia because it's another good option for people coming from the UK. There also seem to be a lot less hurdles for a UK physician going to Australia vs. going to the US (e.g. no USMLEs, part of the Commonwealth).
Just some of my thoughts.
Nice real life information.
Wow! Just wow!
Definitely the best reply here
The details, my god!
Thank you so much ðĪ âĪïļ
What issues are faced by people living in California? Can you elaborate on this too
Yah, $16,000 is going to be the price of the Rolex watch you buy the first year after residency.
Sir tell about usmle and which is the highest paying specialist on 2030 in usa even tell about the scores of usmle steps and highest score in usmle from past years
In psychiatry is not uncommon to get $325K plus RVus right after residency.
Great work ð
Sir what is the salary do a specialist get including taxes,health insurance and others
Sir tell about the salaries of specialist in usa
At 4:00 the graph shows consultant salaries for each specialty.