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I am wondering. With all the foreign (non American) born doctors, physicians, dentists that there seems to be in America today, are they accepting less pay than Native-born Americans to do their jobs??
I have no clue but I believe Kaiser docs earn a salary from that foundation. I would think no matter from what country, docs too start at the bottom of the ladder and work to go up.
Will hospitals and practices hire physicians at the lowest negotiated compensation rate they can manage? Gladly. Do they take advantage of people when they can? Sometimes.
But, FMG's (Foreign Medical Graduates) tend to practice in the lowest paying specialties like Family Practice, Internal Medicine (and its subspecialties) and psychiatry, so by definition, they tend to have lower compensation. These are the same specialties that consistently have residency slots go unfilled with American allopathic medical graduates, and thus are forced to match FMG's to fill those slots. Additionally, it is very hard to recruit (and more importantly, retain) physicians in rural markets, so you will also see a great many FMG's there as well.
Physician compensation is almost never as straight forward as a base "salary" only, and compensation rates are not based on experience, at least not the vast majority of the time. The Kasier model is an exception, not the rule. VA and Indian Health Service also sometimes have a salary approach, but for the majority of physicians, regardless of model, their compensation is based on how well they negotiate their contract, how efficient and productive they are with clinical activity and can control their expenses, and where they are willing to work. It is not at all unusual for a brand new grad to negotiate well and be much more productive than a physician who has been in practice for 20 years, and thus earn more. Working ones way up the ladder like in most careers, so to speak, is not as applicable in medicine, with the exception of academics (and then, not always).
Last edited by Texas Ag 93; 08-13-2017 at 10:12 AM..
Will hospitals and practices hire physicians at the lowest negotiated compensation rate they can manage? Gladly. Do they take advantage of people when they can? Sometimes.
But, FMG's (Foreign Medical Graduates) tend to practice in the lowest paying specialties like Family Practice, Internal Medicine (and its subspecialties) and psychiatry, so by definition, they tend to have lower compensation. These are the same specialties that consistently have residency slots go unfilled with American allopathic medical graduates, and thus are forced to match FMG's to fill those slots. Additionally, it is very hard to recruit (and more importantly, retain) physicians in rural markets, so you will also see a great many FMG's there as well.
Physician compensation is almost never as straight forward as a base "salary" only, and compensation rates are not based on experience, at least not the vast majority of the time. The Kasier model is an exception, not the rule. VA and Indian Health Service also sometimes have a salary approach, but for the majority of physicians, regardless of model, their compensation is based on how well they negotiate their contract, how efficient and productive they are with clinical activity and can control their expenses, and where they are willing to work. It is not at all unusual for a brand new grad to negotiate well and be much more productive than a physician who has been in practice for 20 years, and thus earn more. Working ones way up the ladder like in most careers, so to speak, is not as applicable in medicine, with the exception of academics (and then, not always).
Will hospitals and practices hire physicians at the lowest negotiated compensation rate they can manage? Gladly. Do they take advantage of people when they can? Sometimes.
But, FMG's (Foreign Medical Graduates) tend to practice in the lowest paying specialties like Family Practice, Internal Medicine (and its subspecialties) and psychiatry, so by definition, they tend to have lower compensation. These are the same specialties that consistently have residency slots go unfilled with American allopathic medical graduates, and thus are forced to match FMG's to fill those slots. Additionally, it is very hard to recruit (and more importantly, retain) physicians in rural markets, so you will also see a great many FMG's there as well.
Physician compensation is almost never as straight forward as a base "salary" only, and compensation rates are not based on experience, at least not the vast majority of the time. The Kasier model is an exception, not the rule. VA and Indian Health Service also sometimes have a salary approach, but for the majority of physicians, regardless of model, their compensation is based on how well they negotiate their contract, how efficient and productive they are with clinical activity and can control their expenses, and where they are willing to work. It is not at all unusual for a brand new grad to negotiate well and be much more productive than a physician who has been in practice for 20 years, and thus earn more. Working ones way up the ladder like in most careers, so to speak, is not as applicable in medicine, with the exception of academics (and then, not always).
I think these comments only apply to employed physicians. A private practice physician has completely different dynamics, although private practice is becoming extinct.
I think these comments only apply to employed physicians. A private practice physician has completely different dynamics, although private practice is becoming extinct.
True, in private practice, it's still more comparable to any small business owner, where income is still the net of revenue over expenses. But, unless you are in solo practice, you're still probably going to have a contract which will spell out your rights and responsibilities, and there's risk that comes with the rewards. Some people don't want to chance it.
I agree with your assessment that these arrangements are quickly going by the wayside. What percentage of physicians are still in true private practice now? Maybe 40%? You have an interesting perspective since your practice seems to be a hybrid of compensation models based on the two very different offices you run.
Last edited by Texas Ag 93; 08-13-2017 at 12:42 PM..
I am wondering. With all the foreign (non American) born doctors, physicians, dentists that there seems to be in America today, are they accepting less pay than Native-born Americans to do their jobs??
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