Salaries at FQHC | Any physicians here? [Federally Qualified Health Center]

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Demisaba
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Salaries at FQHC | Any physicians here? [Federally Qualified Health Center]

Post by Demisaba » Tue Jun 25, 2019 7:12 pm

My girlfriend is starting her last year of residency in internal medicine and has a contract with HRSA as part of a loan repayment program. She will need to work in clinics with HPSA scores of 14 or higher, like federally qualified health centers.

What is the salary range at these places compared to the numbers reported at Medscape? Thanks!

Dunder Mifflin
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Re: Salaries at FQHC | Any physicians here?

Post by Dunder Mifflin » Tue Jun 25, 2019 8:17 pm

Primary Care Physician here,


Is this scholarship program through the NHSC? Unfortunately, she should expect a much lower salary offer than her peers heading into hospital owned or private practice. There really is no free lunch. Last I checked numbers ranged anywhere from $150,000-$180,000 for most FQHC's and will probably require significant over sight of mid-level practitioners depending on the state. In contrast, I work in a hospital owned practice four days a week and pick up urgent care on the side at my leisure and am closer the $300,000 range. For what it's worth I do have friends who work in FQHC's who are quite happy taking care of this patient population. Congratulations to your girlfriend on being so close to the finish line!

Topic Author
Demisaba
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Re: Salaries at FQHC | Any physicians here?

Post by Demisaba » Tue Jun 25, 2019 9:07 pm

Dunder Mifflin wrote:
Tue Jun 25, 2019 8:17 pm
Primary Care Physician here,


Is this scholarship program through the NHSC? Unfortunately, she should expect a much lower salary offer than her peers heading into hospital owned or private practice. There really is no free lunch. Last I checked numbers ranged anywhere from $150,000-$180,000 for most FQHC's and will probably require significant over sight of mid-level practitioners depending on the state. In contrast, I work in a hospital owned practice four days a week and pick up urgent care on the side at my leisure and am closer the $300,000 range. For what it's worth I do have friends who work in FQHC's who are quite happy taking care of this patient population. Congratulations to your girlfriend on being so close to the finish line!
Thanks for the response! Yes, the scholarship is through the NHSC. She indicated to me a few times that the salary is a bit less than what she would have earned without this arrangement. I thought I ask for her here as I found this forum to be extremely helpful!

AkwardDoct@rd
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Re: Salaries at FQHC | Any physicians here?

Post by AkwardDoct@rd » Tue Jun 25, 2019 9:59 pm

Primary care at FQHC will be about 110-150K for 1.0 FTE. I know a few people working at FQHC's and those that share their salary it is ~115K starting out (in an urban setting). Typically won't break even with loan repayment but if she wants to work with that patient population it couldn't hurt.

Topic Author
Demisaba
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Re: Salaries at FQHC | Any physicians here?

Post by Demisaba » Wed Jun 26, 2019 4:25 pm

AkwardDoct@rd wrote:
Tue Jun 25, 2019 9:59 pm
Primary care at FQHC will be about 110-150K for 1.0 FTE. I know a few people working at FQHC's and those that share their salary it is ~115K starting out (in an urban setting). Typically won't break even with loan repayment but if she wants to work with that patient population it couldn't hurt.
Oh waw... that is very low!

Am I thinking this right? The contract does not stipulate how much she will get paid. It only restricts her on the type of clinics she will work. So, it is up to her and the clinic to negotiate the pay. However, she should expect a lower pay since FQHC clinics don't generate as much revenue as other clinics.

jayk238
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Re: Salaries at FQHC | Any physicians here?

Post by jayk238 » Wed Jun 26, 2019 5:02 pm

There are restrictions on pay afaik

Topic Author
Demisaba
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Re: Salaries at FQHC | Any physicians here?

Post by Demisaba » Wed Jun 26, 2019 5:47 pm

jayk238 wrote:
Wed Jun 26, 2019 5:02 pm
There are restrictions on pay afaik
Could you please elaborate? This is getting interesting. I guess I will just need to read the whole legal document she signed.

chessknt
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Re: Salaries at FQHC | Any physicians here?

Post by chessknt » Wed Jun 26, 2019 5:50 pm

I would look in to the math of breaking the contract too. If she can come out ahead and build a panel of patients that have insurance and support an appropriate salary it makes more sense to start that process now instead of in 4 years or however long they expect her to be paid at 2nd percentile wages.

NxNW
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Re: Salaries at FQHC | Any physicians here?

Post by NxNW » Wed Jun 26, 2019 6:00 pm

This is your girlfriends decision. She almost certainly knew the salary would be lower in this clinic when she signed the contract and has probably thought about it. She may/may not value your opinion on the topic — tread carefully.

Topic Author
Demisaba
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Re: Salaries at FQHC | Any physicians here?

Post by Demisaba » Wed Jun 26, 2019 6:16 pm

chessknt wrote:
Wed Jun 26, 2019 5:50 pm
I would look in to the math of breaking the contract too. If she can come out ahead and build a panel of patients that have insurance and support an appropriate salary it makes more sense to start that process now instead of in 4 years or however long they expect her to be paid at 2nd percentile wages.
She and I have discussed this as well. We will do the math and see if it makes sense. Thanks for pointing it out!

Topic Author
Demisaba
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Re: Salaries at FQHC | Any physicians here?

Post by Demisaba » Wed Jun 26, 2019 6:33 pm

NxNW wrote:
Wed Jun 26, 2019 6:00 pm
This is your girlfriends decision. She almost certainly knew the salary would be lower in this clinic when she signed the contract and has probably thought about it. She may/may not value your opinion on the topic — tread carefully.
Fair point and you are right it is her decision. But to give you a perspective, this post is a follow up of a discussion she and I had. And she wrote the original question. (She doesn't have a bogleheads account.)

Katietsu
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Re: Salaries at FQHC | Any physicians here?

Post by Katietsu » Wed Jun 26, 2019 7:20 pm

Demisaba wrote:
Wed Jun 26, 2019 6:16 pm
chessknt wrote:
Wed Jun 26, 2019 5:50 pm
I would look in to the math of breaking the contract too. If she can come out ahead and build a panel of patients that have insurance and support an appropriate salary it makes more sense to start that process now instead of in 4 years or however long they expect her to be paid at 2nd percentile wages.
She and I have discussed this as well. We will do the math and see if it makes sense. Thanks for pointing it out!
Just be careful about the numbers you are using for comparison. I think physicians who post salary on sites like BH and WCI, are bringing in more than the typical doc. You need to be comparing apples to apples.

bayview
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Re: Salaries at FQHC | Any physicians here? [Federally Qualified Health Center]

Post by bayview » Wed Jun 26, 2019 8:36 pm

Also, if she has a child during the loan repayment period, she may want to drop down to part time, and that extends the repayment period.

Note that “part time” for my daughter is four days a week, 37-40 hours a week, unlike her original 50+ hours.
The continuous execution of a sound strategy gives you the benefit of the strategy. That's what it's all about. --Rick Ferri

BSBHead
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Re: Salaries at FQHC | Any physicians here? [Federally Qualified Health Center]

Post by BSBHead » Wed Jun 26, 2019 8:43 pm

I'm not a physician, but I've worked with FQHC's in my past.

As FQHC's are non-profits, you can pull salary info from director level physicians from their IRS Form 990's on Guidestar (sign up for a free account). Look up the name the FQHC and look in section 7 (I believe) and you'l see what the highest paid physicians make at the respective FQHC. Maybe that can help you gauge your wife's starting point. Form 990's are the for profit version of a tax return.

wubdemil
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Re: Salaries at FQHC | Any physicians here? [Federally Qualified Health Center]

Post by wubdemil » Sun Aug 11, 2019 3:21 am

BSBHead wrote:
Wed Jun 26, 2019 8:43 pm
I'm not a physician, but I've worked with FQHC's in my past.

As FQHC's are non-profits, you can pull salary info from director level physicians from their IRS Form 990's on Guidestar (sign up for a free account). Look up the name the FQHC and look in section 7 (I believe) and you'l see what the highest paid physicians make at the respective FQHC. Maybe that can help you gauge your wife's starting point. Form 990's are the for profit version of a tax return.
OP - this is your best resource. I checked for local FQHCs and saw salaries between 175 to 220 for physicians (not admins) for 2017. The website has data for three years and there seems to be about 10k per year salary growth, so you can project the 2017 data to the start date.

Cyanide123
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Re: Salaries at FQHC | Any physicians here? [Federally Qualified Health Center]

Post by Cyanide123 » Sun Aug 11, 2019 4:59 am

Why has she signed something where she isn't even sure what her compensation is going to be?

The average IM hospitalist makes around 220-230k. Some private gigs pay upwards of 300k depending on location.

Most contracts have a 90 day out clause, so your girlfriend could probably still cancel things. The problem becomes when you take large sign on bonus that you've already started using.

She's probably looking at a 20-40k pay cut, if anything more, then if I were her, I'd reassess my situation and look at options. If loan repayment was the biggest concern, then a lot of gigs are offering large loan repayment options without pay cuts. I'm in EM, I had 2 different contracts where I could receive 150k in loan repayment over 3 years for a private company. Can't imagine it would be hard to find private jobs with large bonuses/loan repayment options in IM.

Arlington2019
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Re: Salaries at FQHC | Any physicians here? [Federally Qualified Health Center]

Post by Arlington2019 » Sun Aug 11, 2019 10:55 am

I have worked in the administrative level for several FQHCs, and if money is her primary objective, she will not be a good fit for a FQHC. I know many physicians who went to top schools and residencies and choose to work in a FQHC to help the medically underserved, when they could be making far more money in a corporate practice. There are many providers who work at a FQHC until the loan is repaid and then they are off to private practice, and I have been surprised at the number of providers who stay at the FQHC even after the loans are repaid. They like working with that sometimes challenging patient population.

In terms of finding specific salaries, have a look at the websites and the job postings of the FQHCs in the area that she wishes to work. Many of them list the salary range for all positions, including physicians.

ArcticMike
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Re: Salaries at FQHC | Any physicians here? [Federally Qualified Health Center]

Post by ArcticMike » Sun Aug 11, 2019 5:05 pm

I did the NHSC program out of my internal medicine area and it worked out ok for me.

The NHSC is a great program for folks interested in primary care, despite the potential for low salaries. The estimate of $115-$140k is probably close to target at an FQHC, although there are other options if you're willing to work outside a large metro area (IHS clinics, private practice options in some HPSA areas, etc.). I was able to do quite a bit of clinical teaching at a university hospital and that was fun; it also meant a reduced office patient load at my clinic.

One of my associates bought out the contract after one year to do a cardiology fellowship. It was very expensive for him and took him a long time to break even.

Bottom line: it's a program intended to get people to do primary care in a less desirable setting. As others have pointed out, that was well explained going in and I wasn't surprised at the end, and even enjoyed it much of the time.

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