Earning Potential as a Doctor

[chinaski]

I am not a GP. However, the main issue here appears to be an assumption (?) that GPs earn a salary from government employment, which in the vast majority of cases, is not true. Unless you are employed by the state government, you would not be on an EBA salary. GPs largely work in the private sector, and so earnings are contingent on number of patients seen and how they are billed. Income (incoming and outgoing) is also variable according to whether you work as a contractor for the business, or if you hold stakes in the business itself.

 

[nateOstrike]

I am not a GP. However, the main issue here appears to be an assumption (?) that GPs earn a salary from government employment, which in the vast majority of cases, is not true. Unless you are employed by the state government, you would not be on an EBA salary. GPs largely work in the private sector, and so earnings are contingent on number of patients seen and how they are billed. Income (incoming and outgoing) is also variable according to whether you work as a contractor for the business, or if you hold stakes in the business itself.

Hi chinaski. Thanks for the reply. I am trying to not assume anything however the attached are the L brackets I have been looking at. However it works doesn't concern me much I am just wanting to know generally how long it takes to get to that earning level. In my profession I can tell someone it takes generally about 7-8 years and you should be about there but as for a GP I don't know the answer. Thanks. Kind regards

 

[chinaski]

Doctors working in the private sector ARE NOT ON THOSE BRACKETS.

 

[nateOstrike]

Doctors working in the private sector ARE NOT ON THOSE BRACKETS.

Hi chinaski

Yes, I do understand that. There is no need to yell though. Perhaps if you are not happy about it then I might suggest a new career but I think being a doctor would be an amazing profession.

Kind regards

 

[chinaski]

I'm happy being a doctor. However, my time is limited so I won't waste it trying to explain further why a public service award is irrelevant and not comparable to the private market. Good luck.

 

[nateOstrike]

Yes... Ok... So if anyone actually knows the answer to my question please just PM me a quick answer. Cheers

 

[whoartthou]

Hello

Just a quick question to any GP doctors out there because I don't understand how quickly the L1, L2, L3, L4... levels progress in the QLD salary document. Once a person graduates and starts their first year getting paid (resident I think). How long does it take (generally speaking) to get to a level of earning 140K a year, if that person follows the GP pathway? (without owning a practice or relying on overtime and assuming a GP does get to that level eventually).

Kind regards

Are you talking about $140k with super, leave, sick leave entitlements? Most GPs are contractors so they don't get all the other benefits from full time employment so an income of $250k may only really be equivalent to $200k employed income.

It really depends on how busy your practice is and how smart you become with your billings. The more patients you see the more billings you can achieve which usually means more pay for you. It gets tricky with GP registrars as you will be paid a base salary but you get an additional top up if your billings are higher than your base salary.

I would say I would be earning more than most of my colleagues and I would be hitting the $150k+ mark not including super etc. as a final year GP registrar (PGY5 but I took a year off to locum). One of my friends in the same stage of training as me earns $250k+ because he has a constant flow of patients. It usually takes a bit of time to establish yourself in a practice before you get a constant stream of patients. So if you start at an absolutely brand new practice you could earn nothing at the start. If you are starting in an established practice where most of the other GPs are booked out you can easily earn over $150k per annum as a full qualified GP. Right now establishing a new practice is not easy as there are huge issues with recruiting GPs to work for you full time. I have spoken to many practice owners who are finding it difficult to find doctors due to changes in DWS. Given I am in the process of starting a practice the start up costs is probably ~$800k to establish a 8 room practice so you wouldn't be making any profit for a while. .

The GPRA gives a base salary for registrars.

NTCER

NTCERis an agreement that outlines the minimum employment terms and conditions for all GP registrars*.

gpra.org.au

TLDR - It depends

 

[nateOstrike]

Are you talking about $140k with super, leave, sick leave entitlements? Most GPs are contractors so they don't get all the other benefits from full time employment so an income of $250k may only really be equivalent to $200k employed income.

It really depends on how busy your practice is and how smart you become with your billings. The more patients you see the more billings you can achieve which usually means more pay for you. It gets tricky with GP registrars as you will be paid a base salary but you get an additional top up if your billings are higher than your base salary.

I would say I would be earning more than most of my colleagues and I would be hitting the $150k+ mark not including super etc. as a final year GP registrar (PGY5 but I took a year off to locum). One of my friends in the same stage of training as me earns $250k+ because he has a constant flow of patients. It usually takes a bit of time to establish yourself in a practice before you get a constant stream of patients. So if you start at an absolutely brand new practice you could earn nothing at the start. If you are starting in an established practice where most of the other GPs are booked out you can easily earn over $150k per annum as a full qualified GP. Right now establishing a new practice is not easy as there are huge issues with recruiting GPs to work for you full time. I have spoken to many practice owners who are finding it difficult to find doctors due to changes in DWS. Given I am in the process of starting a practice the start up costs is probably ~$800k to establish a 8 room practice so you wouldn't be making any profit for a while. .

The GPRA gives a base salary for registrars.

NTCER

NTCERis an agreement that outlines the minimum employment terms and conditions for all GP registrars*.

gpra.org.au

TLDR - It depends

TBH Being a doctor isn't that great. Sometimes you make a huge difference in people's lives. However, depending on where you work you may encounter people who abuse the shit out of you and get angry at you for not breaking the law to get what they want. As a bulk billing GP you will really get the cream of the crop patients sometimes but I digress.

Hello whoartthou

Thank you very much for your reply it has been extremely helpful.

Kind regards

 

[whoartthou]

Hello whoartthou

Thank you very much for your reply it has been extremely helpful.

Kind regards

You're welcome. I work in NSW and in a bulk billing clinic. I believe QLD has more private GPs. Private work is harder to establish especially if there are lots of bulk billing clinics around. People tend to under appreciate healthcare and go to the "cheapest" doctor they can find. To be earning well as a bulk billing doctor you need to be on top of your billings so you also need to think from a business perpective which unfortunately, is not always in convenient for the patient.

 

[Tomato]

Are you talking about $140k with super, leave, sick leave entitlements? Most GPs are contractors so they don't get all the other benefits from full time employment so an income of $250k may only really be equivalent to $200k employed income.

It really depends on how busy your practice is and how smart you become with your billings. The more patients you see the more billings you can achieve which usually means more pay for you. It gets tricky with GP registrars as you will be paid a base salary but you get an additional top up if your billings are higher than your base salary.

I would say I would be earning more than most of my colleagues and I would be hitting the $150k+ mark not including super etc. as a final year GP registrar (PGY5 but I took a year off to locum). One of my friends in the same stage of training as me earns $250k+ because he has a constant flow of patients. It usually takes a bit of time to establish yourself in a practice before you get a constant stream of patients. So if you start at an absolutely brand new practice you could earn nothing at the start. If you are starting in an established practice where most of the other GPs are booked out you can easily earn over $150k per annum as a full qualified GP. Right now establishing a new practice is not easy as there are huge issues with recruiting GPs to work for you full time. I have spoken to many practice owners who are finding it difficult to find doctors due to changes in DWS. Given I am in the process of starting a practice the start up costs is probably ~$800k to establish a 8 room practice so you wouldn't be making any profit for a while. .

The GPRA gives a base salary for registrars.

NTCER

NTCERis an agreement that outlines the minimum employment terms and conditions for all GP registrars*.

gpra.org.au

TLDR - It depends

TBH Being a doctor isn't that great. Sometimes you make a huge difference in people's lives. However, depending on where you work you may encounter people who abuse the shit out of you and get angry at you for not breaking the law to get what they want. As a bulk billing GP you will really get the cream of the crop patients sometimes but I digress.

When you say the start up costs is about $800k, is that the costs of fit-out plus equipment?

 

[whoartthou]

When you say the start up costs is about $800k, is that the costs of fit-out plus equipment?

Yup but it doesn't take into account the outgoings on a yearly basis. It covers about 6 months worth of rent and other outgoings.

 

[Totolier]

I can't find any info but can someone give me a range $ amount of how much I could earn each year in medicine (money isn't motivating me rn!)

e.g.

1st yr- 70-90k
2nd yr- ...

 

[A1]

I can't find any info but can someone give me a range $ amount of how much I could earn each year in medicine (money isn't motivating me rn!)
e.g.
1st yr- 70-90k
2nd yr- ...

> https://advancemed.com.au/blog/intern-pay/

"It Goes Up From Here
And, of course it does improve significantly from this position. By the time a doctor becomes a Registrar in Victoria for example, their regular pay has increased to $105,000 per annum (after a period of 2 or 3 years). And a first year Staff Specialist in NSW can earn upwards from $234,566 per annum."

 

[chinaski]

Google each state's medical officer enterprise bargaining agreement and salaries. Most are easily available.

 

[lordgarlic]

Google each state's medical officer enterprise bargaining agreement and salaries. Most are easily available.

I agree, if you're interested you should be looking this up yourself

 

[Benjamin]

[...] I don't understand how quickly the L1, L2, L3, L4... levels progress in the QLD salary document.

FYI to all. Looks like L9 - L10 bracket is around that amount (140K) but I have no idea how long it takes to get to that bracket.

Just to clarify this section of the above posts as I don't think anyone has done it so far - I am aware it isn't the exact question asked in the OP.

In QLD you increase your pay bracket by 1 level each year within each cut-off, i.e. L1-L3 is intern to resident pay. As a PGY2 resident you will be level 2, as a PGY3 you will be level 3. However, it doesn't go up further than that if you reach into the next cut-off, i.e. a PGY4 resident will still be paid as level 3 because the level 4 section is a registrar job. The cut-offs and pay scales are available in the medical award for QLD..

Base salaries are also not very reflective of actual pay in most states & especially in Qld - they do not reflect your pay loading for working nights/evenings (+15%) or saturdays (+50%) or sundays (+100%). Similarly, they don't reflect overtime, fatigue pay, on-call etc. As an intern in a hospital that happily paid overtime I made ~95k. As a registrar for half this tax year I think my pay was ~140-150k -- I work an extra 8 hour shift every fortnight, work a full weekend in every fortnight, half night shifts & get paid overtime 2hrs every shift. One of my surgical colleagues made ~240k as a L4 registrar (PGY3) last year but did so at the expense of his sanity working a 1:2 on call roster and doing constant fatigue shifts.

 

[chinaski]

Base salaries are also not very reflective of actual pay in most states & especially in Qld

Why "especially in Qld"?

 

[Benjamin]

Why "especially in Qld"?

I guess I should have been more clear - my opinion / impression is that QLD more frequently pays out on unrostered overtime claims. QLD certainly has issues with paying overtime at specific hospitals but anecdotally is better than other states which are notorious for not paying overtime. This could quickly turn into a "my state is better" argument & I don't have the answers or objective information but for some further details:

The AMA is currently involved in setting up a class action lawsuit in WA for wage theft ( https://www.commerce.wa.gov.au/site...uiry_into_wage_theft_in_western_australia.pdf).

Tasmanian hospitals have very recently been in the spotlight: Tasmania News: Royal Hobart Hospital pays intern doctors $220k in overtime, fire weather warning - ABC News (Australian Broadcasting Corporation) & Royal Hobart Hospital junior medical staff set to issue ultimatum over 'safety' - ABC News (Australian Broadcasting Corporation)

ASMOF & AMA hospital health check for NSW survey has 42% junior doctors doing 10 - 25hrs, 31% 5 - 10 hrs unrostered overtime with 50% of junior doctors never claiming. Full details: Hospital Health Check 2019 – AMA (NSW) / ASMOF (NSW) Alliance & SMH article: https://www.smh.com.au/national/nsw...ction-against-government-20190828-p52lmn.html

 

[chinaski]

I don't think you can generalise in terms of one state being better at paying entitlements than another, because as you say, there are bad hospitals everywhere, and ultimately it's the hospital managers who engender these practices, not directives at a state level. I've worked in four states and cannot attest to any being "better" at respecting the EBA than others. Individual hospitals, yes.

 

[Ian Naga]

From another jurisdiction, with similar type of billing structure.

How much do doctors bill OHIP for services? Star database reveals figures for 30,000 physicians

The Star is able to share this database following a five-year quest for public access to the billing records. After Ontario’s health ministry denied a freedom-of-information request for data on top billers in 2014, the Star successfully appealed to the office of the Information and Privacy...

www.thestar.com

HOW MUCH DOES YOUR DOCTOR BILL?
The Star launches searchable database of OHIP billings, after five-year quest for public access to health-care records


The gap within the gap : Disparities in billings within highly paid specialties

Search the Star’s database of Ontario’s doctors:

Operation Transparency | Investigation | The Star

In depth coverage of Ontario's top-billing doctors, following the Star's Freedom-of-Information request to the Ministry of Health. Visit thestar.com today.

www.thestar.com

It also reveals big gaps in pay within specialty groups. For example, the 90th-percentile pay for diagnostic radiolo-gists is $1,096,541 while the median pay is $622,281

Fee-for-service pay gaps between specialty groups
Examples of disparities in average fee-for-service payments among some lower-and higher-paid specialties. This issue is known as "relativity."

Opthalmologists $724,183
Diagnostic radiologists $654,389
Cardiologist $587,234
Pediatricians $286,661
Geriatricians $251,863
Psychiatrists $227,479


MEDIAN/90th PERCENTILE
Diagnostic radiology $622,281/$1,096,541
Opthalmology $604,750/$1,008,000
Cardiology $534,806/$1,415,606

Last year, an internal Ontario Medical Association report obtained by the Star showed that the highest-billing specialties are overpaid to the tune of 52 per cent and the lowest-billing ones are underpaid by about 30 per cent. It called for pay cuts to the highest-paid specialties and top-ups to the lowest-paid ones

The Star's database shows that of those who billed more than $1 million, 158 were diagnostic radiologists,96 were ophthalmologists and 64 were cardiologists. Of 61 family doctors and general practitioners on the list, many work in pain clinics. Another 482 family doctors and general practitioners - many also practising pain medicine - billed between $500,000 and $1million.

Fee-for-service payments are not the same as take home pay, because doctors pay for their own overhead expenses - staff salaries, offices, equipment and supplies - out of their OHIP billings.
The database reveals big gaps in billings for different specialty groups. For example, ophthalmologists receive on average $724,183 in fee-for-service payments while psychiatrists receive $227,479.