How to Make Bank

The second installment in our series Family Physician Competitive Pay

If you look at money alone, you’re probably going to end up with a job you hate.

Let’s take a look at 11 factors that will increase your income as a physician. Simply put, family and internal medicine physicians are not immune to the Law of Supply and Demand. Each of these factors considers how valuable you are to a particular market.

  1. Avoid the Hot Spots Family physicians disproportionately pursue population hot spots like Tampa, Dallas/Ft. Worth and Atlanta. That means more money in small towns and mid-size cities.
  2. Search for Sign-On Bonuses, but NOT just for the short-term money. Highly-motivated practices will often pull the “sign-on bonus” lever first to attract candidates to a hard-to-fill position. A big sign-on bonus is, as you might expect, more common in remote or rural areas where qualified applicants are few and far between. What most physicians don’t realize, however, is that some of these rural practices are also willing to discuss a more competitive salary than their big city counterparts, which means greater short-term and long-term financial gain for you. Case in point? Let’s talk about Logan, WV with a $47,000 bonus on Day 1.
  3. Look for Bad Schools Family Physicians typically graduate residency around 29 years old. They also tend to start families around that time. A good school system is a big determining factor of where they live. If an area has a surplus of doctors, someone will cave, take the pay cut, and lower normal compensation in the area. Skip the crowd and Google the worst public schools in the US then blast your CV.
  4. Consider the Cost of Living  My favorite cost of living calculator is through the Economic Research Institute. They get very granular on geographies. I’ve compared results in small tests and they tend to be about middle of the pack for other cost of living calculators. Never on the extremes and getting down to the zip code makes this one pretty good.
  5. Be Board Certified Being BC makes you more sought after. The American Board of Family Physicians and the American Osteopathic Board of Family Physicians are more prestigious than the American Board of Medical Specialists.
  6. Factor In Taxes Alaska has no income tax and no property tax. Tennessee, Texas, Nevada, South Dakota, Washington, Wyoming, and Florida don’t have state income taxes. Avoid California and New York like the plague if taxes or total compensation are key considerations for you. States with low-income tax tend to make it up in other areas (e.g., sales tax, property tax).* Take a lesson from the citizens of Bristol. The city straddles the state line of VA and TN. Property tax and income tax are lower in TN so they live and work there. Sales tax is lower in VA so they go shopping there. Less money to the man = more money for your financial plan.*
  7. Go Nocturnist You’re a doctor. You’ve had a sleepless night. Did you like it? Most people hate it. Jobs with seven days in a row of 7 pm to 7 am shifts have fewer applicants (shocker). That’s good news for the bank account.
  8. Be Production Based We’re looking at you, fee-for-service, 40 patients per day people. If you take the risk for your income, you’ll make more. Aim for the upside of a bigger paycheck when you produce more for the practice. Get that upside by taking on the risk of the downside. Let the practice pay you less when less money is coming in.
  9. Partnership Potential Build an asset that you can sell later by becoming a partner. Alternatively, do not sell it and collect profits/dividends.
  10. Get Multiple Offers Apply everywhere. Follow-up with every hiring authority. Take every phone interview. Give them your all. Asking a practice to up their offer by 15% goes a lot smoother when you have 5 other offers that are all 15% higher. Start a bidding war. Your time is very valuable and this is a lot to manage. Have an independent, specialized recruiter apply everywhere for you.
  11. Oversee Mid-levels Most practices throw in more cash for doctors who are the supervising physician for mid-levels.

Sound awful?

If you Googled “worst neighborhoods in Alaska”, found the nearest practices, and already submitted your application, then you are truly money-motivated. The core of all of this is to go where other physicians don’t want to go.

If you look at compensation in a vacuum, you’re going to end up with an answer that doesn’t make sense for you. Your next position will affect almost every single aspect of your life. Take the time to consider whether you are willing to make lifestyle sacrifices to make more money.

Talk through the broader picture with a specialized, independent recruiter for family medicine physicians. Call or text me, Ben Kennedy, at (540) 400-7641 or email me at

*I am not a tax expert and this is not legal advice. Consult a qualified accountant before making any tax-related decisions.


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