Internal Medicine · Evidence depth: moderate
Concierge / Direct Primary Care
Ownership-sensitivity model
The 10 vectors of a physician career.
Every path is scored 0-100 across 10 critical dimensions using public-data signals, modeled assumptions, and verification prompts. Modeled estimate. Not a salary survey. See methodology.
70/100
Income ceiling
Income ceiling
Strong, entirely decoupled from RVUs and insurance companies.
The reality
Your income scales perfectly with your subscription panel size (e.g., 400 patients paying $2000/year).
The signal
You remove the massive overhead required to hire medical billers and coders.
The catch
While it doesn't match the surgical ASC ceiling, it is drastically higher than employed primary care.
The verdict
A highly scalable, highly predictable recurring revenue stream.
90/100
Lifestyle control
Lifestyle control
Exceptional control.
The reality
You dictate exactly how many patients you see (e.g., 5-8 a day instead of 25-30).
The signal
Appointments can be 45-60 minutes long, allowing for actual, thoughtful medicine.
The catch
You are the boss; there are no hospital administrators tracking your clicks.
The verdict
The absolute gold standard for outpatient cognitive lifestyle.
30/100
Sleep / call burden
Sleep / call burden
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Ownership / facility upside
Ownership / facility upside
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Geography flexibility
Geography flexibility
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Innovation / industry adjacency
Innovation / industry adjacency
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Training opportunity cost
Training opportunity cost
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Job-market density
Job-market density
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Malpractice / litigation pressure
Malpractice / litigation pressure
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Burnout-mismatch risk
Burnout-mismatch risk
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Derived model. DirectionalModeled base range
$300k - $470k
Panel-price economics; wide band for membership size and pricing.
Production upside
$450k - $565k
Membership economics: small panels, high touch, low payer overhead; growth is marketing-limited.
Ownership upside
High
The practice IS the lever: membership pricing × panel size, retained fully by the owner.
Salary-only gap
Moderate
This lane exists because of the gap. Direct-pay panels at scale out-earn employed IM substantially.
Modeled estimate. Not a salary survey. Derived model. Directional only. Verify against real offers, contracts, and local mentors. Income scales with payer mix, ownership, and geography. See methodology.
Want the code-level view behind numbers like these? Open the RVU calculator for this specialty's procedures, CMS times, and locality-adjusted Medicare rates.
External benchmark reference
Verify independentlyN/A (Cash Pay)
External benchmark reference - verify independently. Not ingested DoctorCalculator source data.
Best fit
- The Entrepreneurial Physician. Income comes from building things, not only from seeing patients.
- The Lifestyle-First Clinician. A good life on sane hours, and the math actually works.
Poor fit
- The Acute-Care Identity Seeker. Energized by intensity, emergencies, and high-stakes work.
This path is described at validated confidence (Evidence depth: moderate). Detailed evidence cards are added as the module is validated; we will not manufacture precision before then.