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Operate, operate operate if you want to make over $400 grand/year in the US. Think, think and feel if you want to make less than $200 grand/year. i have posted serveral times about the perverse compensation and work environments for primary care physicians. Forbes magazine adds to the data, as if we needed any more evidence. If you want to make a lot of money you go into the surgical specialities. if you want to be an Internist and still make a lot of money, go into the procedurally orientedsubspecialities such as GI or invasive cardiology. By all means stay out of primary care.