> i m applying this match-2006, but wondering about obg-gyne.
We ALL wonder about OB/gyns sometime.
> i really like the subject, but i ve heard that these guys spend
> a significant sum of their salary on insurance costs.
It is a problem, but it is also way overblown in the public. The OB and neurosurg insurance rates are the largest number, so when our representatives try to go to parliament to get something done, they will frequently citie the OB number.
> any idea how much is the cost for covering urself when u join the
> practice after residency, n how much do u actually take home??
In most situations, if you join a practice fresh out of residency, the malpractice insurance is paid by the employer, before you get paid. So, if you come out of residency and you get a contract paying you 180k, you get 180k !
The way malpractice insurance works these days, the premium increases from 10% of the 'basic premium' in year 1 to 130% in year 8. This accounts for the fact, that even if you mess up in year 1, you are not going to get sued until year 3.
The 'basic premium' of 100% is the number you will typically hear quoted, and that is for someone in a mature practice.
There is no single number, or not even a range you can give. In New York Co, NY (the island of manhattan), a mature 'claims made' policy might cost you 150k per year (or in Miami Dade Co or other places with too many atttorneys). In Crampacosa county, WI, it might cost you 20k. Some states have 'patient compensation funds'. A more politically correct way of saying: 'all physicians, including people wo see some low risk internal medicine cases in semi retirement are forced to chip in for the OB and neurosurg insurance premiums'. Other states have passed caps on noneconomic damages and on attorneys fees (e.g. CA), these states tend to be more attractive (many specialists from Illinois have fled to neighboring Wisconsin because it is easier to run a viable practice there these days)
So, while it is a problem, it is a bit overblown. If you practice for a larger hospital or larger multispecialty practice, you will never see your insurance bill (they might subsidize your insurance policy because they know that you generate a lot of 'technical' income for the hospital through admissions and deliveries). If you are however out on your own or in a small single specialty group, a sudden increase in premium can break your back.
> one of my friend told me that avg. salary of obg-MD after
> residency is about 200k and insurance cost is about 60k
> leaving the poor chaps with 120-140k effectively.
Well, a 120-140k is still money. Considering that you are stuck in the hospital every 3rd night, it is peanuts.
The more likely scenario is something like this (arbitrary numbers don't know what OB's bill):
550k collected professional billings
200k overhead (secretary office etc)
80k insurance
20k health insurance
----
250k take home before taxes
The OB's are a bit winy. They like to quote their insurance premiums, but forget that they still take home a decent check every month.
Don't get hung up about the numbers too much. It is not the money that is the problem in OB. It is the feeling of impending doom with every kid you pull out of somebody. You know, 20 years down the line if this kid doesn't make it into an ivy league school, someone will pull out your tokogram and with the 'impeccable retrospectoscope' decide that you should have done a c-section.
addendum:
Look at the survey for 3 years in practice by the national association of physician recruiters. They quote 184k as lowest, 248k as average and 350k as highest in their responses. From what I know, their data is after malpractice (it is considered part of the overhead, typically borne by the practice).
http://www.napr.org/physiciancompensationsurvey.asp
Good luck with your endeavour. You are on an immigration forum, so I would guess that you are a foreign graduate as well. OB/gyn was very competitive for many years now. With the drive to 'lifestyle controlled' specialties as well as the malpractice crisis, qualified US students have shied away from it in the last 2 or 3 years. So, if you have good credentials, you have a good chance of matching into a OB/Gyn residency. If it doesn't work out, consider a surgical prelim. Maybe you can learn to operate the real way before the OB/Gyns get their hands on you (pure prejudice from someone who doesn't operate at all and would barely know what end of the scalpel to hold on to
)
