<p>According to many posts I’ve read on CC, it seems like doctors are completely overwhelmed by their working hours. However, according to personal experience, I know that some doctors don’t work THAT much. An internal medecine doctor I know, for example, works 35-40 hours a week, and that’s it.
If doctors can control their working hours, why so many of them have to work so long (>50hrs)?</p>
<p>Are you saying that they only have 35-40 office hours a week? </p>
<p>Because, just there are lots of extra hours that most patients/friends don’t see - like going to the hospital to round on your admitted patients or the nights/weekends spent on call covering any and all emergencies for you and your partner’s patients. All those things add into the avg hours worked per week…</p>
<p>I am in solo private practice, and I have total control over my schedule. However, I have no control over my reimbursements from insurance companies or Medicare. I also have little control over many of my expenses, especially my liability insurance, my rent, and my employees health insurance, to name a few. And while I can control my staff salaries, I have to pay a decent wage, and one that keep my employees from turning over. Same for their retirement fund. Therefore, I have to work a schedule that will meet my expenses and result in a decent income. So while I can totally control my schedule, with so many expenses fixed or rising, with reimburements dropping, just because I am in control, doesn’t mean I can afford to only work a part-time schedule. And if I take any time off, there is no income coming in, but the same expenses. So, to take off a “40 hour week”, I have to work an extra hour a week for 40 weeks.</p>
<p>So, basically, a doctor has full control but has to expend so much (malpractice premiums, tax, employees…) that he obligatorily has to work in the 45-60 hrs a week range to keep himself from being destitute (having no house, no cars, not being able to afford for your kids to go to college).</p>
<p>Florida, I know some doctors who work together (2 primary care and 1 dentist) who share the same office with only 1 secretary and occasionally a janitor. There expense is greatly reduced and they manage a handsome living without working so much (40hrs a week WITHOUT being assigned rounds at a hospital). However, this kind of practice I have witnessed was not in the US. I wondered if it would be possible in the US. BTW, their NET income are around 65-70k a year (which I think is very good)</p>
<p>Another cardiologist I knew only worked Monday-Friday 7-8 hrs each day. Indeed, he is affiliated to a hospital but goes there extremely rarely (that’s what he told my mother). Only once a month or so. He has time to go to ski with his kids on week ends, play sports, bicycle around and hike regularly. Once again, he is not in the US. Do you know if this kind of life exists in the US for a doctor who brings decent money home (around 70k NET a year)?</p>
<p>1.) They almost certainly still had to take call.</p>
<p>2.) It depends on what you mean by “net”. What have you subtracted to reach this $75K figure?</p>
<p>I have substracted tax, malpractice (very low because not in US), janitor pay, secretary pay, debt (nil because not in US), tax for house, electricity, water, AC, car insurance.<br>
The remaining is for eating, paying a car, paying a house, affording toys for your kids or any other expense in the category “pleasure”.</p>
<p>If you’ve subtracted taxes – especially non-US taxes, holy smokes – then $75K is a very good yearly income indeed for a primary care physician. Or, better stated, it compares favorably to what you’d expect to see in the US, especially if 40-hour-weeks are strictly adhered to.</p>
<p>*EDIT: I’m thinking about it and would have to do the math in better detail to feel confident of this answer. It’s late and maybe I’ll feel bored tomorrow.</p>
<p>Sorry, but I have been too optimist, and as you see, I have lowered a bit 75k to 65k for primary care_which in my opinion is still very high for net income. One reason may be that they share the same office (1 secretary only). Very economic and savvy doctors indeed. Also, remember that as opposed to their US counterpart, they have not debt to pay.</p>
<p>“to do the math in better detail to feel confident of this answer” Lol, did you plan to use your skills on CC when you decided to major in economics?</p>
<p>It will take more than 1/3 of a secretary and a janitor to staff a doctor’s office in America. Most physician offices have net one front office person and one nurse in support per doc. The front office staff serve as receptionist, scheduler, coder and billing/collections clerk.</p>
<p>Well, it’s not a hard calculation, just slightly tedious to work through because of progressive income taxes combined with regressive payroll taxes. Anyway, a little algebra work gives us pretty good approximations, I think.</p>
<p>For a person in the US to take home $65K after payroll and federal income taxes, he has to make about $120K. That’s not including state income taxes, sales taxes, property taxes, capital gains taxes, or estate taxes. It’s also not including malpractice insurance. Taking the midpoint of family practice without ob premiums mentioned, that’s about $15K. State income taxes in CA are about 10%. So we’re looking at about $150K in income before spending power reaches $65K.</p>
<p>I have no idea what water, AC, car insurance, property taxes could reasonably be expected to be, but I suspect they can usually be suggested to fill in the gap if CA’s income taxes are a little higher than normal.</p>
<p>$150K works out almost exactly to where the bell curve for a family practice physician in 27708 peaks.</p>
<p>So, in other words, it’s about the same.</p>
<p><a href=“http://www.irs.gov/formspubs/article/0,,id=150856,00.html[/url]”>http://www.irs.gov/formspubs/article/0,,id=150856,00.html</a>
<a href=“http://www.aafp.org/fpm/20020600/monitor.html[/url]”>http://www.aafp.org/fpm/20020600/monitor.html</a>
<a href=“Personal Salary Reports and Small Business Compensation Solutions | Salary.com”>Personal Salary Reports and Small Business Compensation Solutions | Salary.com;
<p>malpractice is out of control. say goodbye to the obstetricians.</p>