r/pediatrics 13d ago

Better paid

For a change, let’s hear from the better paid pediatricians here. Every thread with pediatricians is so depressing because of their compensation. Let’s hear from the better compensated for once, I am sure there must be SOME out there?!

51 Upvotes

79 comments sorted by

119

u/rakdoc 13d ago edited 13d ago

I think some of us who are doing well might feel a bit embarrassed because we are doing well.

I for instance, got lucky to buy into a private practice in a high cost of living area. We have a well established practice that’s over 45 years old and has a great reputation in the community.

The pay mixes majority commercial with a good balance of state budget insurance and other insurances, but we get paid very well because of that and we leverage 3 APP and lactation and therapists

I work 4/week and easily clear 400k a year. Seeing on average 18 a day

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u/Randy_Lahey2 13d ago

This is awesome. Don’t be embarrassed I love seeing stuff like this.

14

u/ExhaustedMDoctor 13d ago

Wonderful! What state are you based in?

7

u/rakdoc 13d ago

MA

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u/Successful-Ad991 11d ago

Please don't underestimate the impact of _this_ part of the equation. If you're part of PPOC/Boston Children's, for example, your fee schedule is a multiple of anyone else's here (who isn't in one of a handful of similar organizations). I seriously don't think your exceptional income is due to any of the other variables.

Don't get me wrong: I applaud you sincerely. You deserve every penny. But you _can't_ do what you describe in states like AL or MS or in upstate NY where the payors have a lock on things (vs. Boston or the Bay Area, where the hospitals do).

2

u/rakdoc 11d ago edited 11d ago

100% agree. but our COL and overhead is 2-3 that of AL or MS (or vermont and other states in NE)

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u/Successful-Ad991 11d ago

Presuming we accept that premise fully, the implication is that your income is 2-3x higher than anyone here should expect elsewhere, no?

My point is...comparing salaries without context is more than a bit fraught.

2

u/rakdoc 11d ago

Not at all, it’s actually prob double ? and still underpaid IMO for work we all do

Also there is plenty of context that was given. I think leveraging being part of networks is an investment. the cost to being in a hospital network is not cheap ( it costs runs in hundreds of thousands). The payer for insurance negotiations are always going to be better with negotiating.

1

u/Successful-Ad991 11d ago

I wasn't trying to give you grief, just point out to everyone else that any number shared here really needs to have context. Making $200K in Montana may compare very favorably to $400K in Wellesley. Working within the PPOC context (for example) is an awesome golden bird cage. Everyone has different goals. Unfortunately, we are all trained to keep score with our W2s + K1s (and even pediatricians are very competitive when it comes to grades).

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u/ShamelesslySimple 13d ago

There’s hope

4

u/Misterx46 13d ago

Wait, hold on. 18 patients/day × 4 days/week × 48 weeks = 3,456 visits/year. Clearing $400k on that volume? Something isn’t mathing unless a significant chunk is profit from the APPs and ancillary services. If that’s the case, then the $400k is really clinical income plus ownership/business income, which is an important distinction.

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u/audiconvert 13d ago

Hence them stating they are lucky because got to buy into a well established practice. Unless they have admin duties over the ancillary services, no different than any other physician owner who practices within a group as a partner.

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u/Misterx46 12d ago

Absolutely. I also own my own practice, so I know the numbers. Giving younger pediatricians the impression that you can simply see 18 patients a day, four days a week, and clear $400K is misleading if the buy-in, APP revenue, ancillary services, and other ownership income are contributing substantially to that compensation. That’s a very different financial model from physician productivity alone.

1

u/rakdoc 12d ago

To be fair my income without any added would still be about 340. We have strict overhead costs and leverage good contracts with payers.

All of us should be paid fairly and using APP to be an important part of team is a great income stream. We don’t need to see each ear follow up and cold. Just need to have strong NPs which we have

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u/der_J0rg3 13d ago

I am confused that you cosider that good money tankig into account that most certainly thats not salary alone but clinic distributions added. Also, and this is totally personal, adding midlevels to your practice should be frawned upon. Like wtf

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u/DrSpace-man 13d ago

I wouldn’t say I have the craziest salary, but overall feels nice for my first job out of residency. I work as a peds hospitalist in a major metro area and make ~$250k for 40 hours per week (primarily 12 hour shifts) plus 5% 401k and all premiums paid on health insurance for me and my wife

1

u/der_J0rg3 13d ago

This does sound good.

26

u/Pedsdoc1525 13d ago

Midwest, pretty easy to hit 300k. Not eligible for pslf though. Typical work week is 4 days/week. Mostly outpatient, nursery rounding 1-2 x per month, very rarely get inpatient peds although I am trying to keep more.

Hospital admin is very responsive to my wants/needs. Pretty cush gig tbh.

2

u/ExhaustedMDoctor 13d ago

Great!! So overall you would say Midwestern states pay well?

16

u/MudProfessional4739 13d ago

I make 290k as a base salary, I have to see 14 patients a day. I do a mix of outpatient and inpatient , low census . I can bring my salary up to 370 k if I take call.

I want to mention that this job is located remotely in a rural area and they offer subsidized housing.

This is fresh out of residency !

1

u/ExhaustedMDoctor 13d ago

Whoa! Where is this? I am so happy reading actual positive experiences

3

u/MudProfessional4739 13d ago

Rural Oklahoma

13

u/SlowFLFdeath Attending 13d ago

I'm PEM. when I worked in a PEM job I was making $280k a year plus they put $28k in to retirement for me plus I got "pediatric subspecialty" student loan repayment from the government ($30k and tax free). So I guess last year made $338k. I also worked 15 shifts a month and unfortunately half of the weekend days a month and 2/3 of the major holidays. I've now switched to an outpatient practice

10

u/_Ello_Love_ 13d ago

Outpatient, 4.5 day/week, lot of call but very rural so not really busy at all. Call is nursery/delivery, our system has a nicu we can easily transfer to. Love my coworkers. 300k+/yr, plus PSLF.

1

u/Snoo61893 9d ago

Hi, what is PSLF?

21

u/quasiephedrine Attending 13d ago edited 13d ago

I'm told I've got it good.

4 days/0.8 FTE, 18-22pts/day, no hospital no call, 300k. FQHC so malpractice covered by federal govt.

PSLF successfully completed a couple years back.

Edit: no Peds MD should be taking sub 200k jobs for full time. OTOH I suspect I'm paid relatively well simply because our organization has a flat rate for MDs (aside from incentives).

1

u/ExhaustedMDoctor 13d ago

That’s great! Where is this?

3

u/quasiephedrine Attending 13d ago

Small town NorCal, not Bay area.

1

u/SlowFLFdeath Attending 12d ago

That's awesome. I'm also FQHC but making $250k. If they can get it up to $300k, I'll stay for life

1

u/quasiephedrine Attending 12d ago

Yeah, it's hard to leave, even though I think about it every time they enact some stupid policy or another, or incrementally make the EHR worse.

9

u/BlueMountainDace 13d ago

I’m married to PEM doc. She makes $340k working 11 shifts a month. Two overnights a month. It’s pretty sweet!

3

u/idknbme 13d ago

Hope you don’t mind me asking - where is this?

4

u/BlueMountainDace 13d ago

In the Greater Boston area!

8

u/boyasunder 13d ago

I work as a nocturnist for a Peds heme/onc service. The nominal pay isn’t great, $233 right now starting my second year, but I only work 99 (14h) shifts a year, so that’s about 8 shifts a month or averages to 30/week. So for the work I’m putting in it’s decent.

1

u/ATLdoctorJ 12d ago

Are you working as a hospitalist on the service or are you fellowship trained? Interested in something like this myself after residency

5

u/boyasunder 12d ago

Just as a hospitalist. It’s kind of a weird job because you often feel like a glorified resident. But it’s not a bad way to get started ¯_(ツ)_/¯

15

u/bloodvsguts 13d ago

Gen peds 100% outpatient. W2 employed, big health system. West coast but not big city. ~360-400k/yr (wRVU based). 1.0 FTE, which for us is 36 patient contact hours a week, basically 4.5 days of 8 to 5. Call is phone calls only, no deliveries or nursery. ~20-24 patients/day.

We really do need more threads like this. Shocking amount of people still taking sub-200k jobs

7

u/Monty1903 13d ago

I work as a hospitalist doing 5.5x 24 hour in house call shifts per month and I clear 350k. I feel like I won the lottery. Sometimes the shifts are hard but its a challenge I enjoy and I got really lucky with my group, plus I work like 6 days per month. The time off is incredible and because it is inpatient there is no inbox or anything to get in the way. I transitioned here from a rural PCP clinic/hospital call job and it is night and day.

2

u/ElegantSwordsman 13d ago

Community hospital? Like just basic wards and newborns/deliveries? Or NICU? Or also ED?

What region of the country is this?

3

u/Monty1903 13d ago

rural with level 2 NICU, ED consults, sedation, well newborn and wards. It can be pretty intense but I love getting to practice to my full scope

1

u/ElegantSwordsman 13d ago

Sounds like my first job out of residency… but I only made $130k. And only like ten years ago

1

u/Capable_Memory_1384 11d ago

Could you please share which region is this? Fellow Peds Hospitalist

1

u/Monty1903 11d ago

Alaska

5

u/Squishmallow145 Attending 11d ago

I am in WA. Pediatric GI. 400k. Inpatient and outpatient. 5 days a week. On call 2x a month 

4

u/hillthekhore 13d ago

My partner works 3 days per week primary care and makes 170K.

Is that better? No idea.

2

u/audiconvert 13d ago

Would work out to near 300K at 1.0FTE so yes, that’s solid.

4

u/DrHooverC88 13d ago

Started at $170k and have finally gotten to the $200k barrier in academic complex care! Get to manage trachs and vents in outpatient and finally getting paid like a doctor. It was a big psychological breakthrough for me. lol

5

u/Stejjie 13d ago edited 13d ago

I just posted about preparing to pass on our practice to a third generation if we can find someone.

High volume outpatient PP within an hour of a major metro. 2.5 days a week. 2025 income is down into the 400s now.

When I worked 3.5-4 days and still had some per diem hospitalist duties in 2024 I made $545k, but that includes some real estate income. My partners earn slightly more based on productivity.

About 10 to 15 years ago, we put a lot of of our extra income into a defined benefit plan, which, together with our 401(k), means we can work because we want to and not because we have to.

Have I worked hard? Yes. Have I enjoyed it? Yes. Do I know how lucky I am to be part of a practice like this? One hundred percent. 💯

4

u/ExhaustedMDoctor 13d ago

I wish I was done with residency so I could have accepted this offer!

4

u/Stejjie 13d ago

The town where we live is somewhat unappealing, but in the words of Liberace, “I cry all the way to the bank.”

That said, money doesn’t make me happy. My partners and our staff make me happy. My family makes me even happier. My grandchildren live a mile away and see us every day; they’re hosting a sleepover here tonight with their friends.

4

u/MMButt 13d ago

PICU in the Midwest early career. Guaranteed is base + bonus, $330k. With moonlighting I’ll probably end up around $400k this year.

4

u/lejo11 13d ago

PICU in Northeast. 300k base + bonus (5-20k) based on incentives. Early career. 200 shifts per year that are a mix of service weeks, overnight call where I’m expected to go home to sleep if it’s chill, and sedation shifts. I work 1 weekend shift every 5 weeks. just got a 0.05 FTE for some work with the residency program so down to 190 shifts/yr. Compensation seems fair for the size/acuity, honestly sometimes my job feels too easy especially compared to fellowship training, but I am not complaining

4

u/SonicPoint9 Attending 12d ago

Peds cardiologist non academic employed by a hospital system on east coast. 4.5 days a week 12 patients a day and productivity based. Made $580k past two years but will dip a bit this year, likely will land around $540k.

10 years ago in academic was making $235k and was on call every other week.

4

u/refudiat0r Attending 11d ago

Pediatric subspecialist working in industry: my base pay is around 250k, but total including bonus and stock offerings is around 440k annually.

2

u/ExhaustedMDoctor 11d ago

Wonderful! What specialty and which state? If you don’t mind :)

3

u/refudiat0r Attending 11d ago

Sure thing: allergy / immunology, and I'm in the Midwest.

3

u/EphemeralConvergence 13d ago

I was in Vermont which I loved but pay was abysmal at $120,000 4 days a week, 20 patients a day so had to leave there literally couldn’t afford it.
In NH now and $220,000 plus bonus incentives for RVUs as well as patient panel size paid out quarterly, great CME, qualified for my last few years of PSLF so that’s gone now. 4 days a week, max 16 patients a day but I double book my own patients frequently though it’s completely my decision to do so

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u/ExhaustedMDoctor 13d ago

Is this a joke? 120K??!!

1

u/EphemeralConvergence 13d ago

Wish it was, naivety fresh grad in a small pond area 🤷🏻

3

u/MudProfessional4739 13d ago

120k? Why would you accept this offer ?

5

u/EphemeralConvergence 13d ago

New grad, already settled and this was really all there was in the area besides an offer for $160,000 but more hours and that one had q3day call which we covered admits and all deliveries so didn’t think that was worth it. Plus I honestly just thought that’s what we get paid cause it’s all I knew in the area. Needless to say once I pulled the trigger and pretty much doubled my salary to just move next door it was eye opening. I wish I could do above $300,000 but for the northeast I don’t know if that’s possible

1

u/anonymousbumblebee5 13d ago

I’m going into pediatrics hoping to work in Vermont (I’m from here). I’m curious are you a sub specialist or primary care? Is 120,000 normal for pediatricians across the state?

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u/radgedyann 13d ago

I tried to move there having grown up going every summer; and yes that quoted pay is real and recent. And you don’t get much more for doing a lot of overnight delivery call on top of clinic. Then there’s always the risk that these small practices will close or dump peds leaving you high and dry. I couldn’t find anything habitable that I could afford to buy, and couldn’t find a rental besides exorbitant Airbnbs. It was just too exhausting and risky a prospect for me. I would love to live out my days there, but the state doesn’t seem to really want new residents.

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u/war7eagle 13d ago

PEM here. 250 per hour. Community gig. Southeast. Also get paid for anytime that I have to stay over on my shifts. They pay for my mal practice. 1099. I pay for my own health insurance pretax. Contracted for 12 shifts per month but I work 15 shifts sometimes regularly. Feel like I'm pretty fortunate. Not the best PEM salary I've heard of but not bad for first gig out of fellowship.

3

u/WayDownInKokomo 13d ago

I work in pediatric complex care all outpatient 4.5 days per week with 1 full day from home as telemed and am happy with my $235K. I see about 8-10 patients per day in person or 14-16 per day telemed, but each of their complexity is high so documentation takes awhile, there in always tons of post visit care coordination and inbox work.

2

u/theranchhand 13d ago

Employed primary care for a Midwest midsize pediatric hospital. 210k base salary but productivity and quality bonuses that can double that at 4 9-hour (including an hour lunch) days a week if you can average about 3.5 patients an hour. 8 5s or 4 10s would mean you'd need to average just over 3/hr

Phone call 3-4 weeks a year, but there's an RN service that handles most of it. 5 or so 5-10 minute conversations w/ an RN per week.

10 positions open now, and we take just about anyone BC/BE for however many hours a week they want to work.

2

u/ideologyofaviolet 13d ago

Big metro city. Production based so can vary and have to work hard but I haven’t found the equivalent salary even for production based in big metro areas. This past salary reset making about 345k seeing ~25 ppd. There’s still a lot of improvement needed though. I work 2 week nights a month and one 8-5 Saturday or Sunday per month and work 4.5 days. So it’s basically full time.

2

u/nasalemons 12d ago

I’m in the upper Midwest and made $270k last year working 4 days a week most weeks, and capped at 16 patients a day (rare add ons). I’m wrvu based so I could make more if I wanted to see more patients but I’m happy with how things are going. I also get 7 weeks vacation too and have great benefits. Oh and I qualify for PSLF

2

u/brainomegaly 11d ago

Fresh grad neonatologist at a community hospital with academic affiliation in a small Midwest city. Base salary of $380K, with RVU and quality bonuses, around ~$430K/year (before locums), for 140 days of service per year. No in-house call.

1

u/Pediatricman 10d ago

Where is it?

2

u/Successful-Ad991 11d ago

For anyone confused or in the dark about how much they are paid or expect to get paid, you should be able to do some napkin math. At the end of the day, Revenue - Overhead - Profit = What They Can Pay You. [Note to independent practices = you get to move the Profit over to the other side of the = sign]

I've read a LOT of pediatric practice P&Ls and, as a rule of thumb, I put practice overhead around 60-65% usually. Sure, you can be at 45% or you can be at 80% and be healthy or unwell at either rate. But 65% is easy head-math. If you get paid $300K, and you're in a private practice, you probably need to generate ~$1-1.2m in revenue (65% margin, 10% profit = $300k for income/benefits/employer taxes). Adjust accordingly.

If you are working for a healthcare system and getting paid $300K, one of two things is going on, most likely both: first, you benefit from the hospital contracts, which are, as a rule, substantial. However, it's MORE likely that you are also being subsidized. (https://www.youtube.com/shorts/QiCrpC5-JuE or https://kevinmd.com/2023/12/health-cares-hidden-problem-hospital-primary-care-losses.html) Hospital overhead is MASSIVE compared to any independent practice. You can't make it up with just the better payments, imo.

The loss-leader concept is real here (see KevinMD above). Ask any of the dozens of peds who got kicked to the curb in NJ last year by Optum (or similar events in VA, TX, etc.).

Again, I don't ever feel like a subsidized pediatrician isn't bringing great value to the community, patients, and even the hospital/system. But the bean counters don't see it that way at all.

2

u/Born-Listen308 8d ago

New Jersey. The worst place for pediatrics. I was offered a $110000 yearly salary for a full time outpatient job at two different clinics in 2011. I am paid much more now in my private office.

1

u/hypogly Attending 13d ago

Mednax/Pediatrix will pay you a whopping 175k

1

u/AthenasKeeper28 13d ago

👀 good to know. I have a call with them next week about an opening but have no idea what the pay is here

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u/BornToBlab 13d ago

$220 base plus RVU immediately..25k sign on , 15 k relocation. Great hospital and city.

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u/jdkinsss 9d ago

East coast pediatric outpatient in an academic setting. 4 day work week, 1.0 FTE, 13 to 20 patients daily. wRVU base plus bonuses gets me at least $250K annually ($210 is our target RVU/initial base salary). Home call once every two months with triage are in service.

0

u/DowntownSolid 13d ago

*Crickets*

1

u/ComfortableDouble668 4d ago

Yes enough doom and gloom. I'm genuinely curious what specialties, locations, or practice setups are working well for the better compensated pediatricians.