FAMILY PHYSICIAN SALARIES

Primary Care Pays too...

• Houston, TX = $152,000/-
• Los Angeles = $165,000/-
• Miami, FL = $168,000/-
  
• New York, NY = $170,000/-
• Seattle, WA = $155,000/-

According to this article:

"At the University of Minnesota, the starting salary for a family physician is $115,000 to $125,000. In rural areas, family physicians with years of experience might earn up to $300,000 because they do the full scope of care, including pediatrics and obstetrics"

The average NATIONAL annual salary offers for Internal medicine as per the 2006 Physician Compensation report was $162,000/- as compared to $145,000/- for Family medicine. Compare this with National averages of $342,000/- for Cardiology and $351,000/- for Radiology - that's why the American Grads with huge loans take up the specialties while Foreign grads with much lesser or nil loans increasingly do not mind taking up primary care.

Shortage is According to the Oct. 2006 American Academy of Family Physicians study, USA needs 39% more Family Physicians.


Family Medicine / Practice Residency Pros:

• Cool and 'un-hectic' Residency, easier to get
• If you prepared work hard - pays can match IM and even more in the rural areas as you handle more than just family medicine - like psychiatry, pediatrics and ob-gyn
  
• Due to the restructuring of health system economy in the US, aimed to cut down spending on specialist and improve primary care, the demand for Family practitioners has seen a whopping growth over the decade. Click here to read the news report.
  

Family Medicine /Practice Cons:

• You get a 'Jack-of-All-Master-of-None' Feeling
• Few Fellowship options - Geriatrics, Sports Medicine, Emergency Medicine, OB-GYN
  
• Got to stick to the primary care-world
• Apparently, there's a perceived "lack of respect" from other specialties
  
• Though a majority report career satisfaction, a recent survey tells us most of the primary care physicians are not happy with their salaries.
  

But again, there are ways to increase that bottom-line with Family practice, which you will begin to understand better once you know how the insurance system and physician compensation works. Here are some that you should know:

1. Office Procedures and Cosmetic procedures will shoot your incomes up, so if you are planning on a residency or end up doing a residency in family medicine, make sure you choose a program that trains you well enough in these - like colonoscopies, etc. Some residency programs even offer dual training - like Family Practice-Psychiatry, which by the way is pretty hot at the moment. As a friend tells me, his senior resident in Family-Psychiatry program recently accepted a job offer in an underserved area of Texas for a salary of $335,000/- per annum !!

2. Another pathway is gaining hotness with family practice guys and also with other primary care folks (internal medicine, pediatrics, etc.) is the Hospitalist Pathway. Technically, a hospitalist would be defined as a physician who devotes more than 25% of his work-time to a hospital. But hospitalists today prefer to be full-time with better pays and benefits. What's more, Internal medicine board is coming up with a hospitalist track fellowship that will accept residents from internal medicine, family medicine, pediatrics and psychiatry into the track.

3. Yet another pathway that's helping family physicians rope in big money and have a more relaxed, controlled lifestyles is that of "concierge medicine", "concierge practice" or "concierge doctoring". Also know as "Boutique" or "Retainer Practice". The principle is simple - instead of cramming tons of patients in a single day that are insured by third party payers like Medicare, Medicaid and private insurances, you let loyal patients in your area 'sign-up' or 'subscribe' to your clinical primary care service for a yearly fee. In other words, you provide your own insurance and provide a prepaid primary care model.
This makes both patients and the physician happy ..how ? The primary care physicians no longer needs to work 12 hours a day just to have critical volume to make a good salary rather only needs to see about 2 to 5 patients a day or less and make the same or even MORE money. The patients in-turn get more quality time with their doctor and less waiting time. I once read an article on how a family physician made 300,000/- a year with 3-4 hours work a day after having about 200 patients subscribe to his practice at two-levels. Basic service at about $1200/- a year and Plus-service that includes round-the-clock access even on weekends at a higher fee.

Who loses ? The Medicare-Medicaid patients who cannot afford those rates....even if they could afford, it is illegal for a physician to charge "extra" for services already covered for paitients paying through their Medicare coverage. As this article that appeared on the AAFP says:

"Physicians who charge Medicare beneficiaries additional fees for "boutique" or "concierge" care might be violating Medicare laws. An alert issued recently by the Department of Health and Human Services Office of Inspector General (OIG) reminded physicians that charging extra for services that are already covered by Medicare could result in fines or exclusion from Medicare."


Read how Harvard-Trained Dr. Emma McCarty started her Concierge Practice Here

Also read how Dr. Vic Wood made Concierge Medicine possible after three years of court-battles here, and the article that made waves on 'Medical Econimics' here, coz' the insurance companies were obviously not happy.


4. And finally, the latest trend amongst all physician non-specialists and specialists in USA (and probably will catch on with the world) is setting up a parallel "medical spa" practice for cosmetic treatments like Botox, laser hair removal and lip remodelling - Read more on this here.


Q. How to Be a Family Physician In the USA ?

A. A Three Year Residency in Family Medicine following Medical school makes one a Family Practice Physician. Most Family Medicine programs have urban tracks or rural tracks or both and also train doctors in routing Obstetrics and Gynecology.

Q. What fellowship / Specialization Options are available after Family Medicine Residency ?

A. Not as many as Internal Medicine, but here are some:

- Sports Medicine
- Geriatrics
- Internal Medicine
- Emergency Medicine
- Hospitalist
- Urgent Care



Also Read:

- The Color Atlas of Family Medicine
- Bratton's Family Medicine Board Review
- Family Practice Examination and Board Review





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