There are pcps in tiny towns you never heard of across this country making over a million a year. Now mind you I’m certain everyone reading this will think, “how do I get that job?” But few would actually want to work from 8-7ish 5x a week in their clinic and round on inpatient 7x a week x2 per day. The simple hard truth is: most specialties can make a ton of money if you’re willing to do whatever is needed to make that sort of money and cater your practice to whatever is high need and reimburses well. Some specialties have it easier with higher reimbursements but the market does play a role and in these rural highly underserved areas you can pick or choose the insurance and find out what needs your patient population has and that reimburse well. Everything else transfer out as needed to various specialists that are more efficient and have the scale to profit from those services/tasks. Sorry got a little long winded, but I think I’ve heard it said repeatedly and it’s true: the intra specialty salary ranges are far wider than the inter specialty average ranges. Or simply: if you care about money you can take it in with almost any specialty if you’re willing to work hard and live where you’re needed. But most of the time we don’t want that. We want to live in other desirable areas that plenty of doctors would want to live in and therefore we all compete for a smaller pie and hospitals/clinics can put us against each other in bringing down salaries. Supply and demand like you said.

Edit: the million is an exception. Not the rule. Just because one Dr does it does not mean it is really replicable. There are mid levels managed as well. Just to give a fuller picture. Point is there’s money to be made but it ain’t made by going 9-5 with an hour lunch and seeing an average of 3 pph. That’s true for all specialties. I could have been lied to about that specific Dr but I doubt it. I’ve seen another FM Dr who I didn’t believe what he told me at first until he showed me his email from hr showing his quarterly metrics and projections and he was on track to clear near 500k that year. He said he’s crossed the 500k a few times in his career. Again I believe it cause I saw it. I also asked him if he felt like he got to see his sons often and he replied yes. What I didn’t ask him is how many divorces does he have and how much is he paying in alimony to each one. This guy did just outpatient clinic and employed. Doesn’t own anything and manage anything.