PracticeLink Magazine

Winter 2018

The career development quarterly for physicians of all specialties, PracticeLink Magazine provides readers with feature articles, compensation stats, helpful job search tips—as well as recruitment ads from organizations across the U.S.

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T HE Qua L I T Y of L I f E ISS u E D E P A R T M E N T S Financial Fitness 22 W INTER 2018 PracticeLink.com ▼ T HE Qua L I T Y of L I f E ISS u E D E P A R T M E N T S Financial Fitness M a RC ia H o RN N oye S t he surprising ways geography plays into your compensation Choosing a rural location could mean higher compensation — and a better quality of life. a S P aul a G uillo N, M.D., N ea R e D C o MP letio N of H i S R e S i D e NC y in the Robert Wood Johnson Family Medicine Program at Rutgers University at CentraState, he shared his long-term plans with colleagues: return to rural Delaware and practice family medicine there. Some of Aguillon's peers warned that such a move would be a bad financial decision. Aguillon made the move anyway. For him, the decision to do private practice in a rural area made sense, both financially and for his desired lifestyle. In a 2017 Medscape Physician Compensation Report, culled from a survey of 19,270 physicians across more than 27 specialties, the top earning states for physicians overall derived from more rural states like North Dakota ($361,000), followed by Alaska ($359,000), South Dakota ($354,000) and Nebraska ($346,000). Contrary to what many would think likely, physician salaries in highly populated New York state and Washington, D.C., came out at or near the bottom. The main driver in this flip in physician compensation from both coasts to the heartland is supply and demand. Pennsylvania attorney Dennis Hursh of Hursh & Hursh, PC says he has reviewed physician contracts for a rural area where the health system offered almost the 90th percentile of compensation for a physician. "To entice [physicians] to move to the country, you must pay them very well," says Hursh. When recruiters came knocking at Aguillon's door while in residency, he looked at the nearby cities of Baltimore, Washington, D.C., and Philadelphia — all about three hours away from his hometown of 1,500 in Blades, Delaware. But, he says, those areas didn't even compare. "It's the entire package, but money is number one," he says. To illustrate, Aguillon lays out the financial scenario, sharing that if a physician is offered $150,000 in Washington, D.C., and the same amount in Delaware, it may look equal on paper — but it's not. "Here, you would get a sign-on bonus that could be $20,000 or more, probably moving assistance and also have a chance to apply for student loan reimbursement, all because the area is rural," he says. Aguillon also points to lower taxes and a lower cost of living that allows doctors who practice in rural areas to keep more of what they make. In central New Jersey, where Aguillon did his residency, his peers didn't see the financial potential that Aguillon saw in the rural area. They could see he had family

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