There are many myths about the medical profession and the doctor's salary. Physicians are described as raking in big bucks or slaving away around the clock, fobbed off with constantly lower fees. Both are inaccurate. We provide clarity and give an overview of physician compensation in this article.
What are the requirements of the medical profession?
The high responsibility of the physician for the health of his patients is undisputed. Before someone can work as a doctor, many hours of learning at home, in the lecture hall, in the clinic and in practices are necessary. The medical study includes the standard study time of 12 semesters, some make it only in 13, 14 or more semesters. That's more than 6 years of life, during which future doctors earn effectively nothing compared to their peers.
The study of medicine is divided into 3 main sections. 2 years students devote to the functions of the healthy body and mind. This time is called preclinical. In the clinical part of a total of 3 years, students deal with diseases, healing options and therapeutic procedures. In the subsequent practical year (PJ), practical skills and abilities on patients in the clinic or hospital are required. Focus on internal medicine, surgery and an elective subject. After passing the 3 state exams, the graduate can apply for his license to practice medicine. By this time, he has only invested time and money in his education. The if necessary. The maximum remuneration of 597 euros received in the PJ cannot be equated with the performance-related remuneration of a doctor. Young doctors are therefore particularly proud of their first doctor's salary.
What do I earn as a resident?
On the first rung of the medical career ladder, physicians with a license to practice medicine and without having completed professional training work as assistant physicians. The graduate may practice medicine and is usually employed as a resident for a few years. In the meantime, he specializes in a specialty in order to work as a specialist later on. An assistant physician's duties include direct care of patients on the ward; he or she acts as a ward physician. Mainly an assistant physician is used for routine work such as patient admission, taking blood samples, examination and diagnosis or determining therapies. Often, a physician's professional life begins in the clinic or hospital where the training for the chosen specialty takes place. For this reason, assistant physicians are also called physicians in further training. Residency training generally lasts 5 to 6 years. The starting salary as an assistant physician depends on the place of work and the duration of the professional activity.
An assistant physician is paid according to the collective agreement. A distinction is made between collective agreements for university hospitals and municipal hospitals with public collective agreements and those of private hospital groups such as Helios or Rhön. The collective agreements are based on a weekly working time of 42 hours. The starting salary as an assistant physician is approx. 4.800 euros gross per month; municipal hospitals usually pay slightly less. Depending on professional experience, the physician salary can increase up to 6.200 Euro gross monthly increase. After 3 years of work, an assistant physician in a municipal hospital receives, for example, 5.480 euros, while at a university hospital he receives 5.652 euros earned. The remuneration of private hospital associations is similar, but sometimes varies both upwards and downwards. Resident physicians can supplement their salary in the form of basic pay by taking on night, weekend or on-call duties. Increase on-call duties or the on-call service.
Tip: Residents who change locations or specialties don't have to start over at the entry-level salary, but can get credit for their years on the job. According to the 6. year as an assistant physician, however, the remuneration according to the collective bargaining agreement no longer increases.
What do I earn as a specialist?
Within the specialist training the salary of the assistant physician increases. While the starting salary is just under or. around 60.000 euros per year, can exceed 70 euros in the residency training.000 euros per year can be achieved. If you have completed your specialist training, this pays off immediately in financial terms. Specialists are automatically placed in the next higher pay scale group. The salary as a specialist also increases according to the type of collective agreement and years of work. Currently, for example, after 9 years in a university hospital, a specialist earns 7.661 euros gross. The range can be from 65.000 to 95.000 euros gross annual salary is sufficient. However, the specialty has no influence on the salary as a specialist, in contrast to the resident physician. After 13 years in the profession, the highest level of remuneration for specialists is approx. 8.000 Euro gross per month is reached.
What do I earn as a senior physician?
The following career steps bring an adequate salary. The salary for senior physicians is differentiated between the remuneration of a senior physician and a senior physician. A senior physician is in charge of one or more wards in the hospital, managing specialists and residents. The senior physician performs both the medical care of patients and tasks related to the organization of the workflow and the management of employees. The senior physician also represents the chief physician in all matters during his absence. The senior physician at a university hospital receives from the 7. year 9.148 Euro gross salary. A senior physician is subject to a different pay scale group, which is defined in the 7. year at 10.624 euros per month starts. This basic salary can increase significantly due to bonus payments, services and supplements. After a few years of service, the likelihood increases for a senior consultant to be able to arrange his or her salary as a senior consultant individually and outside the collective bargaining agreement. Clinics try to counter the shortage of doctors with such contractual arrangements.
What do I earn as a chief physician?
A chief physician is responsible for the entire hospital that he manages. This applies not only in medical terms, but also to the efficiency of work processes. He reports directly to the medical director and his salary is no longer regulated by collective bargaining agreements. In addition to his negotiating skills, the level of his remuneration depends primarily on the size, equipment, location and sponsor of the hospital, as well as his professional skills and reputation in the industry. The chief physician's salary can therefore vary greatly, ranging up to twice the earnings as a senior physician. In addition, the physician's specialty has a great influence on the chief physician's salary. For orthopedics, surgery, radiology and internal medicine, it is considerably higher than for neurology or urology. The range of chief physician salaries extends from an initial 100.000 euros up to 500.000 Euro per year. In individual cases it can be significantly higher. Variable compensation such as bonus agreements and supplements now account for a growing share of chief physician compensation. Chief physicians are among the top earners in Germany; they can also generate additional income through outpatient care or expert activities.
What do I earn as a physician in private practice??
A freelance physician who has set up his own practice has better opportunities to earn money. He earns his salary as a resident physician himself. Thus, his income depends on the number, structure and disease disposition of his patients, the practice location, its equipment and his specialty. In addition, the proportion of private and statutory health insurance patients he treats is a decisive factor. The earnings figures are only indicative, as they are also strongly influenced by the personality of the physician.
Salary as a physician in private practice, which is achieved with panel patients, can keep pace with a senior physician's salary. Nevertheless, it is difficult to compare the salary of a senior physician with the salary of a physician in private practice. The commitment and workload of the practicing physician must be taken into account. His working hours include not only consultations, but also house calls, training, emergency and on-call duties, administrative activities, staff training, etc. v. m. For this, physicians in private practice often spend far more than 55 hours per week.
What to consider before becoming self-employed?
Nevertheless, the step to own a practice should not be underestimated and well considered. The advantage of self-employment lies in professional self-realization. Practice physicians can decide for themselves how their daily practice routine should run and how they treat their patients. They can independently decide on staff, rooms, equipment, etc. determine. The disadvantages are the entrepreneurial risk, the burden of bureaucracy and the sole responsibility that the physician has to bear around the clock. Financially, physicians in private practice are bound to the agreements with health insurance companies and the allocations of the Associations of Statutory Health Insurance Physicians.
Decisive for the remuneration of the practicing physician are his annual turnover and the practice costs. This results in the annual net income of the practice, which is roughly comparable to the gross annual income of an employed physician. According to the German Federal Statistical Office, the average net income per practice owner in 2015 was 192.000 euros. The specialties record extraordinarily different annual net incomes per practice owner. Among the top earners, with 356.000 euros in net earnings were recorded by the equipment-intensive radiologists, nuclear medicine specialists and radiation therapists, with the lowest figure of 163.000 Euro neurologists and psychologists.
However, the net income does not embody what physicians in private practice actually earn. The loans taken out for practice foundation and investments have to be paid back. In addition, taxes, social security contributions and insurance premiums must be taken into account. For the personnel the employer's contribution to the health, care, pension, unemployment and accident insurance as well as for the owner the obligation contributions to the pension scheme of the physicians are to be carried. The employed physician pays only the employee portion and its wage tax. Self-employed physicians must also financially secure their own person, this concerns the entire contributions to health, nursing care and pension insurance. Your income tax burden depends on your personal tax rate. Regardless, there are insurance premiums for physician insurance such as mandatory professional liability insurance or practice inventory, business interruption and loss of practice insurance, which are not mandatory insurance but are useful for freelance physicians.
What are the alternatives to a solo practice?
Doctors, for whom the personal responsibility for patients, staff, accounting and profitability seems too much, do not, however, have to remain continuously employed. There are various options for sharing responsibility as a practicing physician with other physicians, for example by establishing a group practice. This is characterized by joint billing, joint staff and a joint patient base. Thus, organizational and administrative tasks as well as the economic risk and practice costs can be distributed on several shoulders. On the other hand, the advantage of being your own boss is not lost. Several doctors can also join together to form a joint practice in order to save costs for rooms, staff and equipment. The own patient base guarantees the economic independence. You can find more details on this topic in our guide "Professional association".
Which factors are decisive for the payment of a doctor??
The average gross annual salary at entry level for a salaried physician is as:
- Assistant doctor: about 55.000 Euro,
- Specialist: more than 70.000 euros,
- Senior doctor: at least 90.000 euros,
- Chief physician: ca. 300.000 Euro.
In principle, the medical remuneration depends on the employer, professional experience and qualification of the medical practitioner. Which career path is best for you depends on many personal factors. Initial strategic considerations should be self-evident. Young physicians thinking about career planning and compensation must first make fundamental decisions:
- Do I want to be employed or self-employed?
- Is a fixed doctor's salary or entrepreneurial freedom as a practice owner more important to me??
- Does my place of work pay standard wages or not?
- In which position do I see myself as an employed doctor in 5 or 10 years time?
Not unimportant answer arises from the question, how high the workload should be, because a medical employment can have also disadvantages. Enormous personal demands are just as possible in the hospital. Due to substitutions, additional services and fewer rest breaks due to a shortage of doctors, a high stress level can quickly be reached. Salaried physicians have little influence on their own working hours, which can lead to a difficult work-life balance, for example, due to shift work. Even professional and organizational inadequacies can influence employed physicians only to a certain extent.
Salaries for salaried entry-level employees are fixed according to the collective bargaining agreement. The higher the position of the physician, the larger deviations upward and individual salary agreements are attainable. You have better earning potential as a practicing doctor if you are willing to go through the difficult early years of self-employment. However, physician salary alone should never be the exclusive criterion for a career decision. An objective physician consultation supports you with your considerations whether the free establishment is suitable for you.
When does a medical degree pay off?
Already at the beginning of their career the years of torture have paid off, future doctors receive one of the highest starting salaries of all academic professions. Career starters such as residents in residency training or salaried physicians must expect lower salaries, while senior physicians or established specialists with their own practice earn more. However, the highest salary is of little use if the money is spent again. The topic of asset accumulation should therefore be on the agenda for every young doctor at the latest after graduation. This means you don't have to fear the financial consequences of unplanned events and can reap the rewards of your hard work. Also the later takeover of an own practice can be meaningful and effective. For this you need as much equity capital as possible. Without a professional approach and independent advice, you will find it difficult to achieve the optimal investment result with your doctor's salary. Building a fortune over a long period of time requires patience, expertise and a decent income.
If you have questions about professional and financial decisions, the experienced and independent specialists of our medical advisory service will be at your side with advice and support. For years we have been advising and assisting physicians at the beginning of their careers as well as physicians at the end of their working lives. We accompany you in the accumulation of assets and in the protection with medical insurances. Arrange your consultation online or in person.