In almost, every physician salary compensation report posted out there, the top rows are filled with surgical specialties. Orthopedic Surgery, Plastic Surgery and a sprinkle of medical specialties like Intervention Cardiology and Gastroenterology are the ones with top salaries. According to Medscape’s 2017 salary survey, average annual physician compensation for Orthopedics Surgery was 489K. At the bottom rungs, is an average of 202K for Pediatrics, 209K for Family Medicine and 225K for Internal Medicine.
What if I tell you it is possible to earn more than 500K as an internist ? And this is without any additional fellowship training. Not by any questionable pill clinic type operation.
That has been my average salary the past 3 years. This will like go down in the next year or two as we will have more employees heading into employer-ranks.
Private Practice Is the Way to Go, Find a Good Place and Stick with It
Since graduating residency, I had worked with the same group. I started working here as an employee with a salary of 150K annually in Hospital Medicine. Over the past 10 years, I have risen in ranks. I am now part-shareholder. We have a very fair system where qualifying employees are offered equal position as a shareholder after several years. Despite the pains of running a private practice, the rewards far outweigh it.
Besides the autonomy, salary surveys have always proven that doctor working in self-owned group practices – either single or multi-specialty group, tend to earn the most.
There are risks at times: an unexpected low paycheck where the month Medicare takes a hiatus in processing claims, it will normally catch up in the next few months.
Consider Working in a Rural/Semi-rural Location
I graduated residency in New York City, where physician salaries (across specialties) are among the lowest in the country Cost of living, on the other hand, among the highest. Many of my fellow-residents have chosen to remain in the city after graduating, due to personal preferences and family ties. I do not know of a single friend living in NYC who earns more than 225K in Internal Medicine, 10 years on. If you are willing to move away from major cities, such as New York, Boston and San Francisco, you will definitely find higher paying jobs.
Hospital Based Practice (Generally) Pays Better
After speaking to other medical doctors in clinic practice, I would say it is safe to conclude that practicing inpatient medicine pays better – a lot better. The starting pay for a general internist in my area would be in the 200K range, for hospital medicine, it is at least 50-70K more.
Obviously, the hours are more demanding: I count on working 2-3 weekends a month, alternate holidays with my colleagues (and generally work 2/3 major holidays). I work ungodly hours: the dreaded swing shift and night shift. In exchange, especially after garnering some seniority in the group, my pay is likely 2-3 times that of a general internist.
While it is true that burnout rate can be high, as it is with many shift-work type jobs, and I do feel that having the extra autonomy as part-owner helps off-set this to a certain extent. Besides, despite its banker hours, many primary care providers are bogged down by paperwork even after their regular day is over. At least, that is what my friends often complain about.
I find that my Type A personality works well for the challenges that come with dealing with the sicker inpatient population.
Work More Shifts
For all shift-based specialties, one can easily earn more money by working more shifts. In hospital medicine, as our shifts are 12 hours long, 15 shifts a month is considered full time work. In order to earn a higher compensation, I often pick up 1-2 extra shifts every month.
Several of my colleagues pick up extra locum shifts, which pays even better, and more deductions can potentially be made as those are paid under 1099 terms instead of W2. However, that would entail travel (which would mean less time with my family) and working in a different work environment, all of which makes this less desirable to me. One employee in our group made over 350K working full time for us and another 120K with locum tenens work!
Consider Part-Time Gigs/Passive Income
This, I am still looking into, and have not explored in-depth yet. There are many forums and facebook sites where physicians share interesting part time gigs, which may or may not be related to Medicine. White Coat Investor and Physician On Fire are probably the two most prominent personal finance bloggers who have made it big in the blogsphere.
Passive Income MD reported in one of his latest posts that his side gigs, which includes real estate investments, real estate crowdfunding ventures and with his wife, Mrs PIMD – into direct sales marketing, and is now financially free from medicine.
Other bloggers have reported substantial income from pharmaceutical writing and speaking gigs, utilization management consulting, venturing into media, advertising and other interesting jobs.
Do you have an interesting side gig? How much do you earn from your side gig? I would love to learn more and venture into other passive income opportunities beyond my regular medical practice.
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