<p>I was wondering abotu the possibility of working in a hospital as a doctor.</p>
<p>-Do you have to pay for malpractice (probably not, but just checking)?
-What is the pay like?
-Typical hours compared to if you have a private practice?
-Do most people spend a couple years in a hospital after their internship/residency to pay off their debt?</p>
<p>Any other important information would be helpful</p>
<p>Most physicians who work in a hospital are private practice doctors. Most of your questions are moot. They pay for malpractice, make the usual salary, etc. just like all private practice docs.</p>
<p>You might mean working directly for a hospital, which is relatively rare except in: (1) the VA system, (2) Academic medical centers, (3) California’s Kaiser system. Pay is lower, malpractice is usually covered, and most people who don’t intend to be there as a career usually don’t stay there as a stopgap. Pay is lower anyway, so it doesn’t make sense to use this as a chance to pay off debt.</p>
<p>Yes, i was talking about working directly for a hospital. I wasnt aware it was so limited though</p>
<p>btw, since you dont pay malpractice, wouldnt that offset the lower wages. Or is your “profit” still significant lower than a private practice doctor</p>
<p>The pay decrease is usually substantially larger than the savings from not paying malpractice. There are probably some exceptions in fields like ob-gyn.</p>
<p>I see, thanks for you help</p>
<p>Would disagree with blue devil.</p>
<p>Most docs have admission priv’s at a hospital and admit patients and see them in hospital.</p>
<p>Some docs are paid for by the hospital (hospitalists) and their malpractice is paid for by the hospital. Some docs are in groups that are hired by the hospital (anesthesiologists, er docs, etc) that are paid by the group.</p>
<p>PD: Most of the arrangements you describe are still considered private practice docs, aren’t they?</p>
<p>I have some questions.</p>
<p>I’d prefer not to join or start a private practice, and rather i’d like to work in a hospital. From the research i’ve done, i have found that i’m most interested in Pathology/Dermatology/Hematology. </p>
<p>Are you saying that if I was in the direct employ of a hospital under one of these specializations my pay would be low enough to the extent that it would be more lucrative to start/join a private practice despite the costs of malpractice insurance and taxes?</p>
<p>It’s always more profitable to be an entrepreneur. Of course it’s also a lot more hassle.</p>
<p>How much more profitable though? On average of course.</p>
<p>I mean, is the difference something like 20-50k a year? or 100+k a year?</p>
<p>I don’t know much about the fields you’ve mentioned. From what I’ve seen, the jump from academics to private practice is roughly a factor of two or three; but that’s in high-compensation fields like GI, NSurg, Cards, etc.</p>
<p>I would assume Derm is around the same – probably 2x or 3x. Not sure about Path/Heme.</p>
<p>I’m not looking into academics.</p>
<p>I think there are some details about employment as a medical doctor that im missing.</p>
<p>I’m talking about being employed as a Dermatologist/Pathologist in a hospital. Basically doing the same things a Dermatologist/Pathologist would do in a Private Practice, but under the employ of the hospital.</p>
<p>How much is the difference in pay and hours?</p>
<p>Basically what im trying to ask is, is the increased pay from starting/joining a private practice in Dermatology/Pathology worth dealing with the increased hours and business stress that I would not have to worry about if I were employed by a hospital, or is the extra salary not enough compensation for the added stress/hours?</p>
<p>I’m trying to explain to you that such arrangements are very rare outside of academia/the VA system. Hospitals do not, as a general rule, employ their own dermatologists and pathologists.</p>
<p>What is the VA system?</p>
<p>So I could not work in a hospital as a Pathologist/Dermatologist?</p>
<p>I’m a little confused haha. I’ve just learned that everything I thought about employment as an MD was wrong. Could you kind of explain the different ways you can be employed/work?</p>
<p>The VA is the Veteran’s Affairs system; government-run system for former military people.</p>
<hr>
<p>Of course you’d work *in *a hospital, but you would not usually be working *for *the hospital. You would almost certainly be a member of a private practice group. You would have “privileges” at that hospital – meaning that you would work in it, at least some of the time – but that does not make you a hospital employee.</p>
<p>In other words, you provide your services as a physician and are paid accordingly by the insurance company; the hospital provides the space in which that physician works to the patient. The money goes straight from the insurance company to the physician; it doesn’t go through the hospital.</p>
<p>There are exceptions. The most prominent exceptions, again, are the VA system and academic settings.</p>
<hr>
<p>Here’s an analogy. I walk over to Ikea and buy a television stand. I then walk over to Best Buy and buy a television. The fact that the television will go into the television stand doesn’t make it an Ikea Television, and it doesn’t mean that I will pay Ikea any money for the television.</p>
<p>There are some stores which sell both televisions and television stands, but (in the analogy) these are relatively rare arrangements.</p>
<hr>
<p>Private practice physicians may (and usually do) work in a hospital, but they are not paid by the hospital.</p>
<p>Ahh I understand now :).</p>
<p>How much is the income of a doctor taxed by federal/state and malpractice? Let’s say he makes 200k/year.</p>
<p>The general rule of thumb is that you’d pay about half your income in taxes of various kinds: Federal income (~30%), Payroll Taxes (~10%), State taxes (depends on the state). If you start including typical sales, property, etc. taxes, then you might be up in the 60% range. This is roughly the same percentage depending on whether you’re academic or private practice. The current administration ran on a plan in which taxes would increase, so it’s likely that these numbers will rise.</p>
<p>Malpractice varies by specialty and state. The average is apparently about $20,000 a year, but it varies considerably. Neurosurgeons at my hospital have premiums of ~$140K, and I know some ob/gyns who were charged more than $250K. But the average is apparently around $20,000 a year.</p>
<p>So if a doctor made 200k/year then after losing 50% to taxes, and then another 20,000 to malpractice (If this is indeed the average) they’d only end up with a profit of 80,000 to spend on home/family/food/vacation/etc etc?</p>
<p>That seems a little ridiculous to me. </p>
<p>How do people even remotely think that doctors are over paid?</p>
<p>Well, the same argument applies to almost any field. Big firm lawyers who make $200K a year also pay about 50% in taxes, so they bring home about $100K. Mechanics who make $50K a year probably pay about 40% in taxes, so they bring home about $30K. Etc.</p>
<p>I didnt realize taxes took away so much income haha.</p>
<p>But then, How do people afford homes that are 400k+?</p>
<p>My father is a professor and receives 100k per year. So due to taxes he only gets 50-60k a year. How is he able to afford a 270k house? and money for food/family/etc?</p>
<p>It feels like the government is robbing people.</p>