I think we're all about the same and nothing has change in the last 15 years. There is this mirage and promise of switching to value based care and that the metrics/PCMH we are furiously trying to measure and report are going to yield something. We are currently still at volume based care. As IMPs we chose to cut our volume and pay for flexibility and balance in our life. The "average" and recruitment salaries that are often posted no doubt come with the volume to support it. We could all answer an ad, potentially sell or integrate our practices or take an employed position if we wanted to. Employed positions may give us higher salaries but we will either be patient mill or chain gang. It seems like more and more the employed positions don't push on volume but focus on process, metrics and quality and downstream revenue from having primary care patients in the system. If we want to increase our salaries, we will need to see the same old 80-110 patients per week that was required of us years ago or we have to have an alternate revenue stream. $80K on Mike S is thus far the highest for 24-28 patients per week. I need to see 35-55 patients per week to make that. I agree with Mike B overhead about 60% for this low volume. My rent is $3750 per month going up to $4000 and I probably chose a space that is too large for me, but I still like it. I did the 1200 sq. foot office for 3 years and wanted to upgrade. I have 3 years left on my lease but I might consider integration with a hospital if it is offered to me (congrats Dr. Oaks). I did provide health insurance and good hourly pay to 3 employees (including myself) in 2017 but not sure what will happen to health insurance next year. Practice Fusion is free and my billing that I personally do through NueMD is about $200-$225 per month I, too, have a part-time NP as of this year and take all my own call. We do our own cleaning!!! Ugh. Roomba it is.