Internal Medicine · Evidence depth: moderate

Concierge / Direct Primary Care

High, subscription-based.

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.

Premium analysis

8 more dimensions scored, with the reasoning behind each

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The scores are below. Premium adds what sits behind each one: the claim, the signal supporting it, the limitation that weakens it, and what it should change about your decision.

  • Sleep / call burdenLower is better30/100
  • Ownership / facility upsideHigher is better70/100
  • Geography flexibilityHigher is better60/100
  • Innovation / industry adjacencyHigher is better30/100
  • Training opportunity costLower is better20/100
  • Job-market densityHigher is better50/100
  • Malpractice / litigation pressureLower is better20/100
  • Burnout-mismatch riskLower is better20/100

Scores are modeled from the specialty module's evidence and are estimates, not measurements. Confidence and data depth are labeled inside every premium card.

DoctorCalculator modeled income structure

Derived model. Directional

Modeled 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 independently

N/A (Cash Pay)

External benchmark reference - verify independently. Not ingested DoctorCalculator source data.

Private Practice

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.

Premium detail

Common regrets on this path

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2 documented regrets for this path, each with the burnout driver behind it and the question to verify it against a real schedule before you commit. Written from field notes on this specialty, not generic career advice.

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.