If you are a GP in the UK, an Ontario family medicine job ad can look like it is written in code. “$380,000 to $520,000 a year, gross billings, 80/20 split, FHG, 1,200 patients ready to attach.” Every one of those phrases changes what you will actually take home and how your week will look. This guide explains each one, using a real ad from our listings as the example.
The money in the ad is usually not a salary
Most family doctors in Ontario are not employees. They are independent physicians who bill the province’s health plan, OHIP (the Ontario Health Insurance Plan), for the care they provide. The clinic provides the room, the staff and the systems, and takes a share of what you bill in return.
So when an ad says “$380,000 to $520,000 a year, gross billings”, it means the total OHIP is expected to pay for your work in a year, before the clinic’s share and before your own costs. It is not the number on a payslip, and it is not comparable to an NHS salaried GP salary until you take the clinic’s share off.
Some ads say “net to physician” (after the clinic’s share) or “salary” (an employed post, more common in hospitals and community health centres). On GoodDayDoc every physician job says which one the number is, right after the amount.
Overhead and the “80/20 split”
Overhead is the share of your billings that goes to the clinic. An “80/20 split” means you keep 80% and the clinic keeps 20%. A 20% overhead and an 80/20 split are the same thing.
Worked through on the example ad:
| Low end | High end | |
|---|---|---|
| Gross billings | $380,000 | $520,000 |
| Clinic’s share (20%) | $76,000 | $104,000 |
| To you, before tax and your own costs | $304,000 | $416,000 |
Two things to check every time:
- What the overhead covers. Front-desk staff, nurses, the electronic medical record, supplies, rent and parking can each be in or out. An ad with a low percentage that leaves out staff can cost you more than a higher one that includes everything.
- What it is charged on. Some clinics take their share of everything you bill, including bonuses and premiums; others exclude some. Ask for it in writing.
FHO, FHG, FHN and fee-for-service
Ontario pays family doctors through several models. The model decides how you are paid and what you have to provide. In the Ministry of Health’s own words:
- Fee-for-service (FFS): you are paid for each service you bill, such as each visit or procedure.
- Family Health Group (FHG): for groups of three or more physicians. Doctors are “compensated primarily through FFS but are also eligible for specific bonuses and premiums based on patient enrolment”, and the group provides comprehensive care and after-hours services to its enrolled patients. This is sometimes called enhanced fee-for-service.
- Comprehensive Care Model (CCM): the solo-physician version of the FHG model.
- Family Health Organization (FHO) and Family Health Network (FHN): groups of six or more physicians, “compensated primarily through capitation payments but also receive FFS payments”. Capitation means a payment for each patient enrolled with you, whether or not they visit that month.
What that means day to day:
- In an FHG or fee-for-service practice, your income tracks how many patients you see. More visits, more billing.
- In an FHO, much of your income comes from the size of your enrolled roster. A full roster pays even in a quiet week, but you are also responsible for those patients’ care, including when they go to a walk-in clinic instead of you.
- FHG, FHO and FHN groups all carry after-hours obligations. Ask how many evening or weekend sessions you will cover and how they are shared.
On GoodDayDoc, each job shows the billing model the employer stated, so you can compare like with like.
“Patients ready to attach”
Ontario has a long list of people without a family doctor. “1,200 patients ready to attach” means the clinic already has that many people waiting to be enrolled with a new doctor. For you, that means a full practice quickly rather than building one from scratch over a year or more. In an FHO that also means capitation income from early on.
What to ask before you go further
Every GoodDayDoc job page has a Worth asking about list for anything the ad leaves out. For family medicine, the questions that change the numbers most are:
- Is the pay figure gross billings, net to physician, or salary?
- What does the overhead cover, and is it charged on all billings, including bonuses?
- Which billing model is the practice in, and is a change planned?
- How many after-hours or weekend sessions will you cover?
- How many patients will you start with, and how quickly will the roster grow?
- Is there an income guarantee while your roster builds?
The example, in one line
Read with all of the above, the example ad says: you bill OHIP somewhere between $380,000 and $520,000 a year depending on your days and roster, the clinic keeps 20% for running the practice, it is a fee-for-service group with enrolment bonuses, and a full list of patients is waiting for you. That is a very different picture from “$520k salary”, and it is the picture you need before an interview.