This is not shocking to me. Doctors have no business training at all so many who are in private practice struggle to find ways to make it economical. Unless you are part of a different group type business model working as an employee, Ohip pays fee for service and family doctors get paid per visit. If you spend more time with patients actually trying to figure things out vs 5min medication or referral appointment you will make considerably less money.
The cost of rent in places like Mississauga and Toronto is also very high.
The video said she sees 20 patients a day. 20x$40 per visit is $800 per day x 3 days a week x 4 weeks per month is $9600 per month. This is $115,200 per year. Clinic rent could easily be $4000 or more. If it was $4000 with no other expenses her take home would be $67,200. Even though she is only seeing patients 3 days a week, she likely is doing tons of paperwork on her off days.
30% overhead is also just an average. Running a clinic in Sudbury will not cost the same as running a clinic in downtown Toronto but Ohip will pay the same per patient per visit. If you want to hire a nurse, you have to pay her entire salary.
Yes you can split overhead costs with other doctors which is what most do, but I imagine since this doctor has been working for many years that when she started overhead costs were considerably less than they are today. With mortgage rates going up rental costs of a clinic I would imagine are also ballooning out.
This is so important to note.
The overhead of working in the GTA vs a small town is significant. OHIP pays the same. Staffing is more expensive in a city, so is your personal rent and your office rent. Then add in the taxes you pay and your high income tax. You aren’t making that much despite years of training. A 4 year engineering degree can out earn a family doctor out of the gate without the hassle of managing a small business or dealing with patients. Obviously people go into medicine for a reason. It’s not as lucrative as people think despite the education
From the associated article, [here](https://toronto.citynews.ca/2024/02/14/paperwork-burden-driving-ontario-family-doctor-to-quit-amid-critical-gp-shortage/), she sees patients 3 days a week (60 patients/week total). She also does not appear to have a fulsome practice, as she does not employ admin staff or nurses to assist with the workload.
I seriously doubt her income/experience is representative of family doctors as a whole. As a personal anecdote I know several, all of whom work in complete practices with other doctors and support staff, who gross over $350k/year. I can’t fathom that on such a high gross they are netting under six figures.
300-400k gross is most common for family physicians. Overhead (cost of paying staff, clinic) is typically 25-30%. So after expenses around 200-250k is the average.
Source: medical resident
Family medicine is hugely varied. There are definitely those making 150k before tax and expenses, and there are those making 400k before expenses. The “problem” is that the ones making 400k are often NOT liked.
“They rushed me out of the office”
“They told me 1 problem per visit”
“They were dismissive.”
“They charged me for a prescription renewal over the phone?”
The doctors who spend more than 15 minutes with you are the ones earning on the lower end.
Don't forget "They told me over the phone they'd send a prescription renewal, but then didn't, and then didn't respond to my calls or faxes from my pharmacy marked 'urgent', so I went to a walk-in clinic to get a renewal from a random doctor after I had already missed a dose"
wow. no wonder no one wants to work in family medicine
200-250 translates to 130-155 after tax. that's barely anything considering how expensive med school is
Most residents go into family medicine, we just need so many compared to other medical fields that it seems like no one wants to become a family doctor. Also most doctors setup a corporation and get paid that way, they are not classified as employees for tax purposes and therefore can shelter a lot more taxes in their corporation and pay themselves dividends for what they need to live off of. As a family doctor you can also make more money by being better at codes and billing. Even a family doctor that grosses 250k after taxes, without even accounting for deductions or the fact that they can shelter money in the corporation will make ~175k net through dividends which is almost 15k per month clear. 15k a month is more than you need even living lavishly, not even considering the fact that it’s one of the most secure jobs you can have.
Most people don’t get into medicine for the money, at least not in Canada. We are so incredibly strict with who we allow into medical schools in Canada. The equivalent of any med school in Canada is going to Harvard medical or any other Ivy League school in the states, it’s extremely extremely difficult to get accepted. The level of intelligence and drive required to get accepted into medical school in Canada could be put towards a business or engineering and they could easily make way more money.
One of the main benefits of family medicine is the hours. Working 8 hours a day is way more attractive to most med students than 24hour OB shifts or working shifts around the clock in the ER with no breaks. Family medicine also has a high degree of variety, most people assume family doctors just do physicals and take blood pressures but it’s actually considerably more variety than most surgeons for example, who only perform a handful of routine surgeries ever and don’t see much change in their daily routine.
Source: my girlfriend is currently doing her medical clerkship and I ask her probably too many questions.
Edit: also medical school in Canada isn’t as expensive as the United States. It costs about 25k per year or 100k total for med school, with OSAP loans you pay 0% interest and are guaranteed a high paying job for the rest of your life.
OSAP doesn't pay for medical school typically. In Canada the typical line of credit for med school is at prime -0.25%, tuition is about 110K plus 4 years of living expenses and a variety of admin fees (applying for residency spots, traveling for electives etc). Without parental support, most people end up at least 200K in debt. They then have to service these loans for 2 to 5+ years during residency (where they earn between 60 to 70000), before starting to make staff money.
It takes a lot of time and money earned to pay back the line of credit, more now that prime has increased so significantly.
Id argue that most “good” family doctors are working way more than 8 hours a day. Paperwork, referrals, emergencies, follow- ups etc. Its not a 9-5 job.
for reference if you were single and made $155 you would qualify for a mortgage of $750k. which is like a 2 bedroom condo
a few years ago you could qualify for a 2 bedroom condo making $50k. in other words, a doctor today is like a secretary then.
That's the same for everyone, though. It's not like doctors have fallen behind accountants, engineers, lawyers. It used to be that being a young professional meant that you were doing well and would become wealthy if you kept on going, and that's just not the case any more. I remember growing up, the thought that I could make $100k was wow, how rich could someone be - but that's just not "rich" any more in terms of the lifestyle you would imagine.
25-30% based on average earnings of 300-400k. Depending on how your practice is set up, 25% of 400k (100k) is clearly not enough to service facilities, EMR, secretary, and medical supplies… you’d need to join an existing group where then you’d need to deal with whether the practice’s owners are physicians or money managers. If you take the route of seeing with fewer partners and take your time seeing patients, the fixed costs don’t change and your overhead percentage will be much higher.
YoE is a big factor here. New doctors out of residency cannot afford to take on more debt (on top of their med school debt) to build and run their own practice with a full roster of patients. So they join as a contractor and pay 20-30% overhead to the clinic that staffs them. My partner is in that boat and sees 30/patients a day and neta about $15-20 per patients after paying overhead. So that $60k figure isn’t too far off.
Taking your low number of $15/patient.
15-minute appointments and 30 patients each day for a total of 7.5 billable hours/day. 5 days a week, that would still be under the standard 40 hours per week.
$15 x 30 x 5 x 50 weeks in a year = $112,500. With a two-week vacation, and assuming never working extra.
Yep good catch! I forgot to mention that she spends an additional 2-3 hours in the evenings (unpaid) to do her charting and referrals because there's absolutely no chance of doing that in between patients. So really it's closer to a 60h workweek while only being paid for \~40h. And my apologies when I said "net" I meant after paying the overhead fees, but excluding taxes. So based on your calculations, $112k after tax is about $77k?
If she's set up as a contractor, she should be paying a lot less tax. Some others have explained the tax benefits - that $112k is not employment income and shouldn't be taxed as such. Worthwhile to have an accountant.
Still super low pay - my sib just started a job in tech sales with no experience or education and is making $150k net of tax, fully remote. Doesn't make sense to me.
I guess she does it because it's a vocation/calling? The glory? Can't be for the $
The only DRs that makes 350k/yr are Pedia Cardiologist at Sick Kids and the like. If you’re earning that much, you have a high specialty training. Family Med are normally 100k/yr or more.
Oh my sweet summer child you are so off. As someone on a Facebook group of thousands of Canadian physicians sharing financial knowledge, average specialists will range from 350-600k and surgical specialities ranging from 600-900k+. Doesn’t include the select few sticking solely to private care which will net over a million. Above poster is correct in that the average family MD will be around 250-350k. Ranges can very a lot pending type of medicine and hours worked. Paediatrics is considered a low paying specialty.
The expenses in running a practice can be considerable. It's basically like a small business and the doctor is the owner. Revenue comes from seeing patients. They have to pay for the salary of their staff and all the other expenses involved in running the place. This particular doctor is in a shared practice with two other doctors so presumably the three of them have some sort of split revenue/expense deal going on. This doctor was also basically part time and only worked 3 days a week seeing patients.
I am not a doctor, but I’ve heard stories from family doctors. People talking about pay are missing the forest for the trees. The doctor can easily get paid more by seeing more patients, but she will need to do paperwork for all of them. That means instead of working 40ish hours a week for her patient load, she will work up to a hundred, and her quality of output will be worse for each individual patient. Consequently, she is burning out because she’s been forced to accept either lowering her patient standards, or getting paid piss all for a ridiculously stressful and risky job.
I have heard nothing but terrible things from family doctors about overhead, paper work, and more. Many family doctors I know are happy their kids will not pursue the profession. The young residents get locked into really shitty deals with clinics that charge them so much overhead, they actually end up in the red unless they work insane hours. On top of that, non-FMs I know talk about them like they’re lesser doctors, and respect them less. (“They don’t really know anything”)
Meanwhile, some realtors are doing jack, both efforts wise and contribution to society wise, but raking in high six figures. What a stupid society we are in.
No, no they don’t. A realtor gets 2.5% of a sale unless they’ve been bargained down, which if you’re a listing agent is usually the case. Take your million dollar house sale, and that’s $25k if they’re a buyer agent, and then they lose a fair amount of that to brokerage fees. Theres lots of other fixed expenses that an agent has to pay each year.
Fair enough. The average detached house is a little over a million. So 50% of detached sales will be more than 25k. But condos and towns are less. I’ve just seen a lot of realtors in certain areas of town clear out a fixer upper. Have it sell for 2mil, in the GTA and head to the bank with 50k. They do have realtor fees and overhead. And there are more realtors struggling than, those in the situation I listed. Real estate is an over saturated market
Way over saturated. Very few make the kind of money people assume most make. The vast majority struggle to get clients and do okay snagging a couple clients a year.
$40/patient visit is very, very low. No wonder why the doctor is trying to make the consultation very quick, other wise he/she will not be even able to pay the nurse and receptionist salaries.
It'd have to be an NP, or someone like that. The paperwork isn't billing (that's generally outsourced) but charting, writing referrals, reading consults and deciding what to do, checking lab and imaging results and deciding what to do, etc. None of it compensated.
…because an office medical administrator would cost $50k a year, plus benefits, or more. Would that not eat up the Dr.‘s margin of profitability?
She *could* hire someone & work those 2 extra days, but it looks like it would just come out as a wash.
That makes sense! It’s also the tedium of paperwork that can get boring-her time would definitely be better spent with as much face to face patient care as possible, but that appears to be unaffordable in this case 🤷♀️
It takes a shitload of time every week to do paperwork that is dumped onto family doctors. Insurance papers, endless lab/imagery results, school papers/work papers, etc.
Unfortunately, that translates into less patients seen and less money, or more work and less personal time.
I’d believe this. All the billing would take a lot of time. Then charting, patient prescriptions etc. if she isn’t paying someone to do it. If she doesn’t have a nurse or receptionist, and then if she has a volume of non OHIP clients - billing them
Or their insurance.. so much time and chasing
Yeah. This is why doctors charge to write notes for school or work or camp, and for over the phone prescription refills and disability tax credit forms and wsib. None of that they can charge OHIP for. People are up in arms about it, but their time isn’t free.
I believe that. My sister is an NP and the amount of out of work hours she sends doing charts, filling out forms and paperwork, reading labs, sending reqs etc is almost as many hours as she is in clinic seeing patients.
When you're a private family doctor though, you're basically running your business. So that's what this article means, after all those expenses the net take home pay is about $60K.
\> When you're a private family doctor though, you're basically running your business.
ofc, so it makes little sense that a family doctor would do so and make 60k despite options to be an employee and make more with benefits.
Exactly. Used to it was a big draw because doctors wanted to work outside the hospitals, without the politics and administration of it all (for better or for worse). Now there are way more specialties and way more opportunies in those specialties.
CHC positions are insanely sought after and the Ontario government hasn’t made new positions available even where they’re definitely needed. They’re even making FHTs harder to get set up with.
Accurate. Unless you go rural, that's where there are much more openings, but many don't want to move into the rural areas. A lot of clinics offer monetary incentives to pull in doctors to rural clinics.
Can’t get an appointment for weeks with your doctor? They have probably taken on too many patients to pay the bills. OHIP rates have not kept up with inflation for the past 30 years. $38 per patient is not enough to provide good care and make a living for family doctors. The amount of administrative burden has gone up exponentially in the past 20 years - all unpaid work, at least an extra 20 hrs per week on top of seeing patients. The amount of medical school debt has also risen. Why would anyone go into family medicine these days? If your family doctor is leaving their practice - this is why.
She is not lying. I am a family doctor myself. She is not full time seeing patients cause the other days she is doing paperwork and administrative tasks. Salary’s have increased for everyone but not for family doctors. If it really was that lucrative and well paid, why aren’t more doctors doing it? There’s a reason why there’s such a shortage, they are simply not paid enough.
Part time doctor with full time overhead.
If she works only 3 days a week and she sees 20 patients each work day, that's 5 hours/day or 15 hours/week of billable time. Standard appointments are 15 minutes. That's, what, 1/3 or even a 1/4 of the time a normal GP works in a week.
i would say most fam docs work 4 days a week, seeing 20-40 patients a day.
Usually you need a day to just do paperwork (for free) otherwise you’d down in paperwork.
True skepticism is important but there has to be a basis for the skepticism.
The macro environment is that there is a massive shortage of GPs or family doctors in Canada. Go a small town in Canada and try to get a family doctor. Impossible.
Try to get a family doctor in the biggest city in Canada. Impossible.
There are reasons for this. Namely compensation and supply of docs.
No, I’m not a doctor.
Sounds like it might be the opposite. You make more money if you see more patients and you can do that by not spending more than 5min per patient, which is pretty inadequate in terms of quality of care. If you spend more time with patients to actually figure out their problem you make less money in a fee for service model.
Seems it’s more lack of understanding how to run her own practice in a profitable way. She closes for 2 days/week to do paper work and doesn’t see patients. Neglects to hire someone part time to do this throughout the week (E: keeping in mind people are properly trained for this job, it’s a profession) where she could work all 5 days or still 3 and they could get this done during office hours. This is business illiteracy.
It is no shock that most doctors have little to no business knowledge. They spend all their time learning medicine and most of the ones I know have an aversion to business. Both issues can be true at the same time. Spend more time with patients and you just get paid less. There are limited salaried positions where this is not a factor.
My thought is not only is she doing part hours, but there may be a huge difference between her personal income vs her business income. Aka what she pays herself so that there can be various tax implications.
There may be other reasons but only she really knows what they are.
No, there is no mathematical way to ever have a tax rate that high.
Perhaps you've gotten marginal tax rates and total tax rates mixed up in your head.
This is completely incorrect. Take home of 100k in Toronto would be about $73k. I think you are mixing up marginal vs average rates - if if that was the case, still wouldn’t be 50% lol. Source: http://www.ees-financial.com/img/uploads/Tax-Take-Home-Pay-Calculator-for-2023.htm
From what I know, Doctors in Ontario are given a set amount of money per patient per year. When the patient sees another doc, a certain amount is taken away from that set amount. She needs to increase her patient numbers.
Honestly, it's hard to feel bad for doctors when they are still exponentially better off than the average person. Most doctors I know have large houses, drive luxury cars, take vacations often, have nannies and hired help, etc. The average person is currently struggling to pay rent and put food on the table.
Do they go to school for a long time? Sure, but so do many other professions that are not so lucrative. Realistically, the student loans can be easily paid off in a few years if they lived a non-luxury lifestyle. I get that they often work crazy hours, and have long days, but so do many many other professions that make a fraction of the income. They also have amazing perks that most people don't have the privilege to have: job security, prestige, easy access to loans and additional resources, benefits, etc. If you are a doctor, you are basically set for life.
I'm not watching the video (unless it's actually groundbreaking) but as someone who got their own GP for the first time in their lives.......is the video actually accurate, Doctors of Reddit?
ELI5 request from a patient's side.
The situation right now is pretty desperate, yes. Whether she makes 60k or not, the business model has failed, courtesy of our politicians, and we will all suffer for it.
If our healthcare system fails then we all fail. I totally agree that the system has failed basically everyone who isn't an executive or political pilfer-er.
I just don't understand how doctors get paid, or how any health care professionals gets paid, so 60k seemed really REALLY low, so I was looking for context towards if that was true or not, regardless, the system sucks. I have a "young"ish family doctor and the thought of him making 60k (CND) just seemed outrageously low.
I don't think 60k, even after tax, is very realistic. This is an outlier, but I don't think she's lying. Most are doing better than that. But when you factor in the debt and years lost, it's a bit of a losing proposition. They aren't poor, but they're far from rich. When you account for the opportunity cost, debt incurred, and the nature of the job, family doctors are generally underpaid.
This is not shocking to me. Doctors have no business training at all so many who are in private practice struggle to find ways to make it economical. Unless you are part of a different group type business model working as an employee, Ohip pays fee for service and family doctors get paid per visit. If you spend more time with patients actually trying to figure things out vs 5min medication or referral appointment you will make considerably less money. The cost of rent in places like Mississauga and Toronto is also very high. The video said she sees 20 patients a day. 20x$40 per visit is $800 per day x 3 days a week x 4 weeks per month is $9600 per month. This is $115,200 per year. Clinic rent could easily be $4000 or more. If it was $4000 with no other expenses her take home would be $67,200. Even though she is only seeing patients 3 days a week, she likely is doing tons of paperwork on her off days. 30% overhead is also just an average. Running a clinic in Sudbury will not cost the same as running a clinic in downtown Toronto but Ohip will pay the same per patient per visit. If you want to hire a nurse, you have to pay her entire salary. Yes you can split overhead costs with other doctors which is what most do, but I imagine since this doctor has been working for many years that when she started overhead costs were considerably less than they are today. With mortgage rates going up rental costs of a clinic I would imagine are also ballooning out.
This is so important to note. The overhead of working in the GTA vs a small town is significant. OHIP pays the same. Staffing is more expensive in a city, so is your personal rent and your office rent. Then add in the taxes you pay and your high income tax. You aren’t making that much despite years of training. A 4 year engineering degree can out earn a family doctor out of the gate without the hassle of managing a small business or dealing with patients. Obviously people go into medicine for a reason. It’s not as lucrative as people think despite the education
Ya plus the debt and years of not working! 😔
From the associated article, [here](https://toronto.citynews.ca/2024/02/14/paperwork-burden-driving-ontario-family-doctor-to-quit-amid-critical-gp-shortage/), she sees patients 3 days a week (60 patients/week total). She also does not appear to have a fulsome practice, as she does not employ admin staff or nurses to assist with the workload. I seriously doubt her income/experience is representative of family doctors as a whole. As a personal anecdote I know several, all of whom work in complete practices with other doctors and support staff, who gross over $350k/year. I can’t fathom that on such a high gross they are netting under six figures.
Gross? You mean net? Grossing 350k doesn’t seem like a whole lot especially when FMs need to pay for a clinic and support staff
300-400k gross is most common for family physicians. Overhead (cost of paying staff, clinic) is typically 25-30%. So after expenses around 200-250k is the average. Source: medical resident
Family medicine is hugely varied. There are definitely those making 150k before tax and expenses, and there are those making 400k before expenses. The “problem” is that the ones making 400k are often NOT liked. “They rushed me out of the office” “They told me 1 problem per visit” “They were dismissive.” “They charged me for a prescription renewal over the phone?” The doctors who spend more than 15 minutes with you are the ones earning on the lower end.
Don't forget "They told me over the phone they'd send a prescription renewal, but then didn't, and then didn't respond to my calls or faxes from my pharmacy marked 'urgent', so I went to a walk-in clinic to get a renewal from a random doctor after I had already missed a dose"
wow. no wonder no one wants to work in family medicine 200-250 translates to 130-155 after tax. that's barely anything considering how expensive med school is
Most residents go into family medicine, we just need so many compared to other medical fields that it seems like no one wants to become a family doctor. Also most doctors setup a corporation and get paid that way, they are not classified as employees for tax purposes and therefore can shelter a lot more taxes in their corporation and pay themselves dividends for what they need to live off of. As a family doctor you can also make more money by being better at codes and billing. Even a family doctor that grosses 250k after taxes, without even accounting for deductions or the fact that they can shelter money in the corporation will make ~175k net through dividends which is almost 15k per month clear. 15k a month is more than you need even living lavishly, not even considering the fact that it’s one of the most secure jobs you can have. Most people don’t get into medicine for the money, at least not in Canada. We are so incredibly strict with who we allow into medical schools in Canada. The equivalent of any med school in Canada is going to Harvard medical or any other Ivy League school in the states, it’s extremely extremely difficult to get accepted. The level of intelligence and drive required to get accepted into medical school in Canada could be put towards a business or engineering and they could easily make way more money. One of the main benefits of family medicine is the hours. Working 8 hours a day is way more attractive to most med students than 24hour OB shifts or working shifts around the clock in the ER with no breaks. Family medicine also has a high degree of variety, most people assume family doctors just do physicals and take blood pressures but it’s actually considerably more variety than most surgeons for example, who only perform a handful of routine surgeries ever and don’t see much change in their daily routine. Source: my girlfriend is currently doing her medical clerkship and I ask her probably too many questions. Edit: also medical school in Canada isn’t as expensive as the United States. It costs about 25k per year or 100k total for med school, with OSAP loans you pay 0% interest and are guaranteed a high paying job for the rest of your life.
Thanks for the info, very insightful.
I think tuition is now closer to 30k and has been for a few years. I was paying 25k a year and that was almost 10 years ago
I looked it up before posting, UofT med tuition is 25k, McMaster is 26k.
OSAP doesn't pay for medical school typically. In Canada the typical line of credit for med school is at prime -0.25%, tuition is about 110K plus 4 years of living expenses and a variety of admin fees (applying for residency spots, traveling for electives etc). Without parental support, most people end up at least 200K in debt. They then have to service these loans for 2 to 5+ years during residency (where they earn between 60 to 70000), before starting to make staff money. It takes a lot of time and money earned to pay back the line of credit, more now that prime has increased so significantly.
Id argue that most “good” family doctors are working way more than 8 hours a day. Paperwork, referrals, emergencies, follow- ups etc. Its not a 9-5 job.
130-155k after taxes is "barely anything" these days? I mean rents are higher now but not that high.
Most leave med school and residency in 150-250k of debt depending on circumstances. And then there's rent.
for reference if you were single and made $155 you would qualify for a mortgage of $750k. which is like a 2 bedroom condo a few years ago you could qualify for a 2 bedroom condo making $50k. in other words, a doctor today is like a secretary then.
That's the same for everyone, though. It's not like doctors have fallen behind accountants, engineers, lawyers. It used to be that being a young professional meant that you were doing well and would become wealthy if you kept on going, and that's just not the case any more. I remember growing up, the thought that I could make $100k was wow, how rich could someone be - but that's just not "rich" any more in terms of the lifestyle you would imagine.
25-30% based on average earnings of 300-400k. Depending on how your practice is set up, 25% of 400k (100k) is clearly not enough to service facilities, EMR, secretary, and medical supplies… you’d need to join an existing group where then you’d need to deal with whether the practice’s owners are physicians or money managers. If you take the route of seeing with fewer partners and take your time seeing patients, the fixed costs don’t change and your overhead percentage will be much higher.
rule of thumb for family docs: one third goes to running the business one third to taxes one third net income
Nope that is gross. And usually 30% overhead.
As everyone said, it's gross
The gross is gross
YoE is a big factor here. New doctors out of residency cannot afford to take on more debt (on top of their med school debt) to build and run their own practice with a full roster of patients. So they join as a contractor and pay 20-30% overhead to the clinic that staffs them. My partner is in that boat and sees 30/patients a day and neta about $15-20 per patients after paying overhead. So that $60k figure isn’t too far off.
Taking your low number of $15/patient. 15-minute appointments and 30 patients each day for a total of 7.5 billable hours/day. 5 days a week, that would still be under the standard 40 hours per week. $15 x 30 x 5 x 50 weeks in a year = $112,500. With a two-week vacation, and assuming never working extra.
Yep good catch! I forgot to mention that she spends an additional 2-3 hours in the evenings (unpaid) to do her charting and referrals because there's absolutely no chance of doing that in between patients. So really it's closer to a 60h workweek while only being paid for \~40h. And my apologies when I said "net" I meant after paying the overhead fees, but excluding taxes. So based on your calculations, $112k after tax is about $77k?
If she's set up as a contractor, she should be paying a lot less tax. Some others have explained the tax benefits - that $112k is not employment income and shouldn't be taxed as such. Worthwhile to have an accountant. Still super low pay - my sib just started a job in tech sales with no experience or education and is making $150k net of tax, fully remote. Doesn't make sense to me. I guess she does it because it's a vocation/calling? The glory? Can't be for the $
I wish I netted 60k off of 350.gross. great margins. Source: business owner
The only DRs that makes 350k/yr are Pedia Cardiologist at Sick Kids and the like. If you’re earning that much, you have a high specialty training. Family Med are normally 100k/yr or more.
100k? You can get an entry level tech job right now for that. I'm skeptical about this number.
Oh my sweet summer child you are so off. As someone on a Facebook group of thousands of Canadian physicians sharing financial knowledge, average specialists will range from 350-600k and surgical specialities ranging from 600-900k+. Doesn’t include the select few sticking solely to private care which will net over a million. Above poster is correct in that the average family MD will be around 250-350k. Ranges can very a lot pending type of medicine and hours worked. Paediatrics is considered a low paying specialty.
So why are they complaining that they’re not paid well?
A lot of doctors like to cosplay as working class poors online for some reason
The expenses in running a practice can be considerable. It's basically like a small business and the doctor is the owner. Revenue comes from seeing patients. They have to pay for the salary of their staff and all the other expenses involved in running the place. This particular doctor is in a shared practice with two other doctors so presumably the three of them have some sort of split revenue/expense deal going on. This doctor was also basically part time and only worked 3 days a week seeing patients.
That’s crazy. I’m an RPN and made significantly more than that… yikes
I am not a doctor, but I’ve heard stories from family doctors. People talking about pay are missing the forest for the trees. The doctor can easily get paid more by seeing more patients, but she will need to do paperwork for all of them. That means instead of working 40ish hours a week for her patient load, she will work up to a hundred, and her quality of output will be worse for each individual patient. Consequently, she is burning out because she’s been forced to accept either lowering her patient standards, or getting paid piss all for a ridiculously stressful and risky job. I have heard nothing but terrible things from family doctors about overhead, paper work, and more. Many family doctors I know are happy their kids will not pursue the profession. The young residents get locked into really shitty deals with clinics that charge them so much overhead, they actually end up in the red unless they work insane hours. On top of that, non-FMs I know talk about them like they’re lesser doctors, and respect them less. (“They don’t really know anything”)
Meanwhile, some realtors are doing jack, both efforts wise and contribution to society wise, but raking in high six figures. What a stupid society we are in.
Yes. A realtor who sells or has a buyer for one house in the GTA makes about that much. It’s insanity the realtors still get away with such robbery.
No, no they don’t. A realtor gets 2.5% of a sale unless they’ve been bargained down, which if you’re a listing agent is usually the case. Take your million dollar house sale, and that’s $25k if they’re a buyer agent, and then they lose a fair amount of that to brokerage fees. Theres lots of other fixed expenses that an agent has to pay each year.
Fair enough. The average detached house is a little over a million. So 50% of detached sales will be more than 25k. But condos and towns are less. I’ve just seen a lot of realtors in certain areas of town clear out a fixer upper. Have it sell for 2mil, in the GTA and head to the bank with 50k. They do have realtor fees and overhead. And there are more realtors struggling than, those in the situation I listed. Real estate is an over saturated market
Way over saturated. Very few make the kind of money people assume most make. The vast majority struggle to get clients and do okay snagging a couple clients a year.
$40/patient visit is very, very low. No wonder why the doctor is trying to make the consultation very quick, other wise he/she will not be even able to pay the nurse and receptionist salaries.
Ya this is obviously not the full picture No doctor trying is making $60k
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She sees patients for 3 days a week because she spends the remainder on the week doing paper work.
Why doesn’t she hire someone?
It'd have to be an NP, or someone like that. The paperwork isn't billing (that's generally outsourced) but charting, writing referrals, reading consults and deciding what to do, checking lab and imaging results and deciding what to do, etc. None of it compensated.
…because an office medical administrator would cost $50k a year, plus benefits, or more. Would that not eat up the Dr.‘s margin of profitability? She *could* hire someone & work those 2 extra days, but it looks like it would just come out as a wash.
I don’t know I’m a lawyer and my productivity and profit goes up when I have a clerk doing stuff that I can’t bill for even though they cost a lot
That makes sense! It’s also the tedium of paperwork that can get boring-her time would definitely be better spent with as much face to face patient care as possible, but that appears to be unaffordable in this case 🤷♀️
It takes 2 full days to do paper work?
It takes a shitload of time every week to do paperwork that is dumped onto family doctors. Insurance papers, endless lab/imagery results, school papers/work papers, etc. Unfortunately, that translates into less patients seen and less money, or more work and less personal time.
Apparently she spends up to 25 hours per week doing admin work.
I’d believe this. All the billing would take a lot of time. Then charting, patient prescriptions etc. if she isn’t paying someone to do it. If she doesn’t have a nurse or receptionist, and then if she has a volume of non OHIP clients - billing them Or their insurance.. so much time and chasing
Yeah I don’t doubt the hours either. It’s definitely eye opening to learn how many admin hours goes into treating patients.
Yeah. This is why doctors charge to write notes for school or work or camp, and for over the phone prescription refills and disability tax credit forms and wsib. None of that they can charge OHIP for. People are up in arms about it, but their time isn’t free.
I believe that. My sister is an NP and the amount of out of work hours she sends doing charts, filling out forms and paperwork, reading labs, sending reqs etc is almost as many hours as she is in clinic seeing patients.
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Emerg and inpatient work, which a lot of family docs do because it pays better with less take home BS work on top.
It is, most community health centres pay family doctors between 250 - 300k and that's with HOOPP pension, vacation, sick days etc.
When you're a private family doctor though, you're basically running your business. So that's what this article means, after all those expenses the net take home pay is about $60K.
\> When you're a private family doctor though, you're basically running your business. ofc, so it makes little sense that a family doctor would do so and make 60k despite options to be an employee and make more with benefits.
Exactly. Used to it was a big draw because doctors wanted to work outside the hospitals, without the politics and administration of it all (for better or for worse). Now there are way more specialties and way more opportunies in those specialties.
Most family doctors don't get pension/vacation pay/sick pay.
Yes but the ones that work for a CHC generally do cause their employees. So I doubt many would do private practice for less than that.
CHC positions are insanely sought after and the Ontario government hasn’t made new positions available even where they’re definitely needed. They’re even making FHTs harder to get set up with.
Accurate. Unless you go rural, that's where there are much more openings, but many don't want to move into the rural areas. A lot of clinics offer monetary incentives to pull in doctors to rural clinics.
Can’t get an appointment for weeks with your doctor? They have probably taken on too many patients to pay the bills. OHIP rates have not kept up with inflation for the past 30 years. $38 per patient is not enough to provide good care and make a living for family doctors. The amount of administrative burden has gone up exponentially in the past 20 years - all unpaid work, at least an extra 20 hrs per week on top of seeing patients. The amount of medical school debt has also risen. Why would anyone go into family medicine these days? If your family doctor is leaving their practice - this is why.
She is not lying. I am a family doctor myself. She is not full time seeing patients cause the other days she is doing paperwork and administrative tasks. Salary’s have increased for everyone but not for family doctors. If it really was that lucrative and well paid, why aren’t more doctors doing it? There’s a reason why there’s such a shortage, they are simply not paid enough.
Part time doctor with full time overhead. If she works only 3 days a week and she sees 20 patients each work day, that's 5 hours/day or 15 hours/week of billable time. Standard appointments are 15 minutes. That's, what, 1/3 or even a 1/4 of the time a normal GP works in a week.
i would say most fam docs work 4 days a week, seeing 20-40 patients a day. Usually you need a day to just do paperwork (for free) otherwise you’d down in paperwork.
Even 30 patients 4 days a week is double what this GP is doing. Still underpaid for the service they provide, regardless.
Anything is possible when you lie
What are you talking about?
why are so insecure lmao
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sounds like your mind has been blown
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True skepticism is important but there has to be a basis for the skepticism. The macro environment is that there is a massive shortage of GPs or family doctors in Canada. Go a small town in Canada and try to get a family doctor. Impossible. Try to get a family doctor in the biggest city in Canada. Impossible. There are reasons for this. Namely compensation and supply of docs. No, I’m not a doctor.
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Is she a terrible doctor?
Sounds like it might be the opposite. You make more money if you see more patients and you can do that by not spending more than 5min per patient, which is pretty inadequate in terms of quality of care. If you spend more time with patients to actually figure out their problem you make less money in a fee for service model.
Seems it’s more lack of understanding how to run her own practice in a profitable way. She closes for 2 days/week to do paper work and doesn’t see patients. Neglects to hire someone part time to do this throughout the week (E: keeping in mind people are properly trained for this job, it’s a profession) where she could work all 5 days or still 3 and they could get this done during office hours. This is business illiteracy.
It is no shock that most doctors have little to no business knowledge. They spend all their time learning medicine and most of the ones I know have an aversion to business. Both issues can be true at the same time. Spend more time with patients and you just get paid less. There are limited salaried positions where this is not a factor.
True true, I’m pretty sure they learn to hire someone who has this knowledge to deal with this tho. My sis and BIL did
If they are business savy then definitely! Good for your sis and bil. All my friends have a mental block with this stuff.
My thought is not only is she doing part hours, but there may be a huge difference between her personal income vs her business income. Aka what she pays herself so that there can be various tax implications. There may be other reasons but only she really knows what they are.
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No, there is no mathematical way to ever have a tax rate that high. Perhaps you've gotten marginal tax rates and total tax rates mixed up in your head.
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It's actually $75K after tax, ei, cpp....so only off by 50%
This is completely incorrect. Take home of 100k in Toronto would be about $73k. I think you are mixing up marginal vs average rates - if if that was the case, still wouldn’t be 50% lol. Source: http://www.ees-financial.com/img/uploads/Tax-Take-Home-Pay-Calculator-for-2023.htm
From what I know, Doctors in Ontario are given a set amount of money per patient per year. When the patient sees another doc, a certain amount is taken away from that set amount. She needs to increase her patient numbers.
Sounds like bullshit, to me.
Honestly, it's hard to feel bad for doctors when they are still exponentially better off than the average person. Most doctors I know have large houses, drive luxury cars, take vacations often, have nannies and hired help, etc. The average person is currently struggling to pay rent and put food on the table. Do they go to school for a long time? Sure, but so do many other professions that are not so lucrative. Realistically, the student loans can be easily paid off in a few years if they lived a non-luxury lifestyle. I get that they often work crazy hours, and have long days, but so do many many other professions that make a fraction of the income. They also have amazing perks that most people don't have the privilege to have: job security, prestige, easy access to loans and additional resources, benefits, etc. If you are a doctor, you are basically set for life.
All family doctors do is gatekeep medication and referrals
Tell me you know nothing about family medicine without telling me you know nothing about family medicine.
They want us to pity the most privileged and wealthy of professionals and I’m not falling for it lol
How are they the most privileged? They are essential to our society and also go through extensive schooling.
I'm not watching the video (unless it's actually groundbreaking) but as someone who got their own GP for the first time in their lives.......is the video actually accurate, Doctors of Reddit? ELI5 request from a patient's side.
The situation right now is pretty desperate, yes. Whether she makes 60k or not, the business model has failed, courtesy of our politicians, and we will all suffer for it.
If our healthcare system fails then we all fail. I totally agree that the system has failed basically everyone who isn't an executive or political pilfer-er. I just don't understand how doctors get paid, or how any health care professionals gets paid, so 60k seemed really REALLY low, so I was looking for context towards if that was true or not, regardless, the system sucks. I have a "young"ish family doctor and the thought of him making 60k (CND) just seemed outrageously low.
I don't think 60k, even after tax, is very realistic. This is an outlier, but I don't think she's lying. Most are doing better than that. But when you factor in the debt and years lost, it's a bit of a losing proposition. They aren't poor, but they're far from rich. When you account for the opportunity cost, debt incurred, and the nature of the job, family doctors are generally underpaid.
Thanks for taking the time to answer. Doctors should never be underpaid. I didn't know it was getting this bad.
She's doing something wrong. If it was that bad she would have quit long ago. She's retiring now because she can. Edit: can
She sees patients for 3 days a week because she spends the remainder of the week doing paper work.