Medicine pay

[Hayden]

Wow, really? I knew it was a popular specialty but didn't think it would be *that* popular... Roughly what proportion of graduates end up in other specialties? This kinda sucks to know, because I'd really have liked to have a good shot at specialising in whatever I find most interesting or suitable for me...

It's not necessarily a bad thing. Many med students/junior doctors realise that they want a life they can more or less control and that general practice is much more for them than what they originally thought. You might find after seeing the sort of work involved in training for other specialties that general practice is for you as well.

 

[Matt]

Agree with Hayden. Specialising may sound like the be all and end all but in a lot of ways General Practice is where its at. Good pay and decent lifestyle... that's hard to beat.

This study says that, 8 years after graduating in 1995, 33% became GPs.

Given there's a massive shortage of GPs, the medical student tsunami, and government efforts to increase the number of locally trained GPs. I'd say that'll probably be around the 50% whe you graduate, n33b. I'm only guessing though, I can't find any better information that'd make my guess better informed.

 

[forevafrensbear]

I wouldn't say a locum got paid 'large' fees.

You have to take into account that their rate of pay does not include leave loading, penalties or any leave entitlements and it takes that into account.

For a junior medical officer, the locum rates of pay are still less than what you'd pay your plumber

Speciality positions are largely limited by funding for training positions and availability which isn't reassuring to the increasing number of medical graduates coming through the system. Applying for one is the same as applying for a job, your success depends upon how you compete against the others and demand for that speciality.

I don't know the exact number who will become GP's.

 

[chinaski]

I wouldn't say a locum got paid 'large' fees.

You have to take into account that their rate of pay does not include leave loading, penalties or any leave entitlements and it takes that into account.

For a junior medical officer, the locum rates of pay are still less than what you'd pay your plumber

The pay also reflects the current workforce shortage. These guys take home a princely sum for working in an area of shortfall. Once the workforce flips over to oversupply, the demand will drop, as will the price they can command.

I've had the unique experience of having two residents work in the same team: one locum (filling in at short notice, thanks to an unforeseen absence), and one was a regular RMO. The regular RMO was quite put out to find the locum (who was a lazy so-and-so, incidentally) got paid roughly three times more for doing the same job. Jipped.

 

[drdave]

To get an idea of what specialists/GPs earn, the medicare rebates are freely available on this Health Dept. Website (use the 75% rebate fee):

https://www9.health.gov.au/mbs/search.cfm

Practice costs for a solo practitioner can be around $10,000-$15,000 per month. (ie room rents, secretaries etc). Medical indemnity insurance is highly variable, eg. a gastroenterologist is around $20,000 per year. Anaesthetists tend to have much lower overheads because they are in much larger groups eg. 10-15, so sharing costs of secretaries/rent/billing costs can work out around $3,000 per month. They don't need expensive equipment or flash rooms similar to GPs or specialists as their offices are mainly billing rooms and occasionally patients will come in for a pre-op consult. Insurance for anaesthetists is around $8,000-$10,000 per year.

Compared to working in private, a specialist (regardless of specialty), at least in Qld, earns a minimum of around $250,000 + overtime
https://www.health.qld.gov.au/medical/packages/Staff_Sp.pdf . 5 weeks annual leave + super + 2 weeks conference leave + salary sacrifice.

A private health fund pays more to the doctor than the medicare rebates. These schedules are freely available too on respective health fund websites. Now, most specialists charge over what a health fund rebates (ie a gap), so their earnings are well above what is estimated from medicare rebates or health fund rebates.

eg. gastroenterologist doing 17 colonoscopies in a day (15- 20 minute procedure) = item # 32093 = $5525 (bulk billing fee). MBF no gap fee is $561/colonoscopy = $ $9537. Of course, some patients have a combined gastroscopy / colonoscopy, and some have a gastroscopy without a colonoscopy etc. These fees are without gaps. If you do two different procedures at the one time, you get paid 100% of fee for the highest item, 50% of the second item, 25% of the fee for the third procedure etc.

eg. ENT surgeon removing tonsils in 10 patients in a day = (30 minute procedure) = item # 41789 - Bulk bill rate - $204. MBF rate $427

eg. Anaesthetist are renumerated slightly differently from medicare/health funds. they are paid for type of procedure (based on difficulty) as well as length of procedure (to compensate for slow surgeons). eg. doing 5 knee arthroscopies in a morning on an orthopaedic list = item 17610 (pre op consult), 21382 (knee arthroscopy), 23033 (time 40-45 minutes) = $182 bulk billing fee / $305 MBF fee. Few anaesthetist do not charge a gap. They spend the majority of their working week in the operating theater so are always doing "procedures" ie. anaesthetising rather than "in-room consults" like other specialists.

Generally, the longer, more complex operations don't compensate in remuneration for shorter quick procedures, eg. doing one major complex bowel resection in a morning isn't as financially benficial compared to doing 4 laparoscopic cholecystecomies in that morning.

hope this helps!

 

[forevafrensbear]

Things to also take into account:
- The private practice or hospital make take a significant 'cut' out of that amount. The income generated also goes towards paying overheads, which could be >$100000 a year (e.g. secretary, rooms hire etc...)
- The luminal gastroenterologist doing nothing but endoscopy lists all day is on the extreme end of the scale, similar to an opthalmologist who does nothing but cataracts all day. In reality, you would also spend a few sessions a week in clinic, outpatient work etc...
- The MBS is an indication only and you can see procedural items pay more than non-procedural items.

Public practice is an entirely different kettle of fish.

It's hard work training and then setting up a practice but an established consultant physician has a reasonable income. The amount varies depending on lifestyle, occupation and how you've structured your work. Someone who sees 40 inpatients a day from 7am to 8pm is going to earn more than someone working 0.5 FTE in a public hospital and doing research on the side.

But it is fair to say most registrars can earn >$100000/yr gross when you take into account on-call/overtime on top of base salary (not including superannuation/salary sacrifice/leave loading). Consultants obviously earn more; interns less (unless they sell their soul to their friends and do all their after hours cover shifts)

So do most engineers 5 years out or lawyers who are senior associates -_-

But there's something attractive about my GP colleagues who have a lovely lifestyle, time for their kids and a totally flexible lifestyle. Who really needs ridiculous amounts of money spending all day inserting flexible black tubes into people's bottom end?