Academics vs Pp

[GatorBait1548]

Take an academic job for 300k or join a New PP group which is an n=2. New pp has just bought new office space, immediate partner, one flouro procedure room. Would be adding procedural aspect to already established pain practice from other physician.

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[willabeast]

since you are asking, methinks you should take the academic job for 300K.
300K is not bad, and when you decide what you really want to do, you will have more options than with PP.
YMMV.

 

[NEA]

In my opinion limitations and oversight can sometimes be too overpowering in academics. I switched from pp to academics but now I am missing my independence!!


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[drusso]

Are you kidding? No brainer. You will probably be the last generation of physicians have the opportunity to own your own practice. Start investing your "sweat" and "equity" now. Salaried academic gigs will always be available and posted routinely.

 

[emd123]

I'm in private practice with a doctor run group. We have 25 docs, but I'm one of five on the board of directors. I come and go as I please. It's absolutely great.

 

[Stim4me]

If you are hard worker, ethical and can sell your services, go pp... If you are somewhat motivated and don't want to sacrifice a lot of your free time go academics... If you want to retire early after working like a dog go pp. if you want three months vacation go academics or large ortho group.... If you can't deal with lame ass administrations and are a badass narsacist go private practice cause you ain't going to make it in the academic conformist world.... Good luck whatever you choose...

 

[Ducttape]

if you are seriously considering the difference, dont listen only to the unabashed PP lovers.

if you are going pure academic, you will have to work as hard or harder than anyone in PP. anyone who says that academics is not hard work has never done academics. not getting promoted is just as stressful as going broke, and you will have to do do research and work full time clinically and keep up to date on all aspects of your specialty because med students/residents/fellows will push you (rightfully so).


dont go into private practice just because you might "have the opportunity to own your own practice" - thats meaningless if you have no financial sense or interest. if you have a lot of debt, and cannot go into more debt, if you have little to no business sense, then i would wonder about private practice as an option. if your first love is spreadsheets, payrolls, AR #, marketing, etc...

if you prefer pouring over pubmed, have an interest in statistical analysis, know the difference between the Fisher's T test and a Barnards test, can perform a power analysis in your head, know the exact input the 3rd name in a publication had, how to get published, etc., then...

 

[Stim4me]

if you are seriously considering the difference, dont listen only to the unabashed PP lovers.

if you are going pure academic, you will have to work as hard or harder than anyone in PP. anyone who says that academics is not hard work has never done academics. not getting promoted is just as stressful as going broke, and you will have to do do research and work full time clinically and keep up to date on all aspects of your specialty because med students/residents/fellows will push you (rightfully so).


dont go into private practice just because you might "have the opportunity to own your own practice" - thats meaningless if you have no financial sense or interest. if you have a lot of debt, and cannot go into more debt, if you have little to no business sense, then i would wonder about private practice as an option. if your first love is spreadsheets, payrolls, AR #, marketing, etc...

if you prefer pouring over pubmed, have an interest in statistical analysis, know the difference between the Fisher's T test and a Barnards test, can perform a power analysis in your head, know the exact input the 3rd name in a publication had, how to get published, etc., then...

Then Go into pp... You can publish in pp just as easily... I have published in conjunction with local universities and actually got out of my moca boards... Neurologists have ongoing studies in pp all the time.... As for statistical analysis, you can refresh you mind during recertification or even better use the students helping you with your study.... My take is that academics think the world evolves around them, it doesn't...

 

[Stim4me]

The sad truth is that most pp is being consumed by aco's and thus you are subject to academic and administrator policies. There is rarely a truly pp model, and if are lucky enough to be in a pure pp, then bask in it. Most of the pcps around me have hospital based policies in terms of vacation, staff, reps, lunches, mitigation issues, etc...and they don't like it but are too old to stay in pp.

 

[lonelobo]

if you are seriously considering the difference, dont listen only to the unabashed PP lovers.

if you are going pure academic, you will have to work as hard or harder than anyone in PP. anyone who says that academics is not hard work has never done academics. not getting promoted is just as stressful as going broke, and you will have to do do research and work full time clinically and keep up to date on all aspects of your specialty because med students/residents/fellows will push you (rightfully so).


...

You have to be F''king kidding right?, I have friends that went into academics because of the cush life style, there is no comparison.

 

[SeniorWrangler]

Be careful about what your role will be in that private practice. Being the junior guy who will never be allowed to become partner is a crappy way to live.
But you have to figure out what you want and what your priorities are. If you have little kids at home, academics is probably a great way to go. If you want a yacht and an island to park it at, then 300K a year won't be enough. It all comes down to what you want.

 

[Stim4me]

Be careful about what your role will be in that private practice. Being the junior guy who will never be allowed to become partner is a crappy way to live.
But you have to figure out what you want and what your priorities are. If you have little kids at home, academics is probably a great way to go. If you want a yacht and an island to park it at, then 300K a year won't be enough. It all comes down to what you want.

Money brings freedom which in my book brings happiness, thus I choose pp...

 

[soccerpunk600]

How much does the average PP pain doc make a few years into practice? It sounds like a lot from the way 300k is being discussed, but is it really that much more? Can you expect to be bringing in 600-700k say 5 years out w/partnership at a reasonably busy practice?

 

[Stim4me]

How much does the average PP pain doc make a few years into practice? It sounds like a lot from the way 300k is being discussed, but is it really that much more? Can you expect to be bringing in 600-700k say 5 years out w/partnership at a reasonably busy practice?

That's about right. But it's more about freedom of owning your own pp and setting your own rules... You want a Cush life go into pp dermatology or interventional rads...

 

[emd123]

Relevant story from today:

I know some guys in a local group which at one point was Neuro, Neuro Surg and ortho. A few years ago, the local hospital offered to buy them out. Apparently their group was having some trouble, crappy building they invested in and were losing some money, or at a minimum not making as much as they thought they should. So the hospital makes them a supposedly good offer and they decide that for LONG TERM SECURITY, they should take it. Well, fast forward a couple years and one day out of the blue, the hospital tells them they're all fired, they're not getting their contracts renewed, not even for $1 per year. Rumor has it they weren't "profitable enough." They're closing the whole department. (Except the surgeons of course, because that cow is still producing milk.) Now they're all desperate, trying to scramble and find new jobs. Of course, private practice isn't a feasible option unless they want to start from scratch again because their practice was swallowed and shuttered, or unless they want to go be the ground level b¡tch of one of their former competing groups.

I just texted back and forth with one of the guys offering to give him a job as my group is looking to expand and add more specialties. He responded with telling me the above story, and with "Its so crazy, I can't believe it. It's so crazy, man" mixed in too many times to count.

My conclusion is that taking a hospital employee job, though it may work for the right people in the right situation, involves giving up autonomy for "security" which in many cases, may be a false promise and not at all secure. Although I know there are no guarantees (false or real) in private practice and that my salary could drop, at least I know I won't be told by some administrator it's dropping to zero, by no fault of my own.

 

[Stim4me]

Physicians are a clueless bunch...

 

[drusso]

Relevant story from today:

I know some guys in a local group which at one point was Neuro, Neuro Surg and ortho. A few years ago, the local hospital offered to buy them out. Apparently their group was having some trouble, crappy building they invested in and were losing some money, or at a minimum not making as much as they thought they should. So the hospital makes them a supposedly good offer and they decide that for LONG TERM SECURITY, they should take it. Well, fast forward a couple years and one day out of the blue, the hospital tells them they're all fired, they're not getting their contracts renewed, not even for $1 per year. Rumor has it they weren't "profitable enough." They're closing the whole department. (Except the surgeons of course, because that cow is still producing milk.) Now they're all desperate, trying to scramble and find new jobs. Of course, private practice isn't a feasible option unless they want to start from scratch again because their practice was swallowed and shuttered, or unless they want to go be the ground level b¡tch of one of their former competing groups.

I just texted back and forth with one of the guys offering to give him a job as my group is looking to expand and add more specialties. He responded with telling me the above story, and with "Its so crazy, I can't believe it. It's so crazy, man" mixed in too many times to count.

My conclusion is that taking a hospital employee job, though it may work for the right people in the right situation, involves giving up autonomy for "security" which in many cases, may be a false promise and not at all secure. Although I know there are no guarantees (false or real) in private practice and that my salary could drop, at least I know I won't be told by some administrator it's dropping to zero, by no fault of my own.

Expect to see more of this. MD's have traded their autonomy for magic beans of ACO's, "gains-sharing," and creative accounting, etc. All of it financed by physician employer groups vis-a-vis bloated site of service differential fees. None of it furthers the interests of an autonomous, self-regulated profession.

 

[Ducttape]

they did get a healthy check when they "sold" their practice, right? if they get fired, then there is nothing prohibiting them from opening a PP - at least they wont have the debts and lack of experience a new grad carries.

this thread is about academics vs PP, but there is a very pertinent point to be made. in academics, doctors are monitored not only for their financials but also for their academics. they can be fired at whims notice by either the admin or the research directors. i personally know docs who have been fired for financial reasons and those fired for not producing enough academically.

to make it in academics, you have to work hard. those who think its cush havent been up for review yet.

ive been told it is the most rewarding to see your name cited in journals, by other respected physicians, etc. so maybe you have to have narcissistic tendencies to be an academician...

 

[Stim4me]

they did get a healthy check when they "sold" their practice, right? if they get fired, then there is nothing prohibiting them from opening a PP - at least they wont have the debts and lack of experience a new grad carries.

this thread is about academics vs PP, but there is a very pertinent point to be made. in academics, doctors are monitored not only for their financials but also for their academics. they can be fired at whims notice by either the admin or the research directors. i personally know docs who have been fired for financial reasons and those fired for not producing enough academically.

to make it in academics, you have to work hard. those who think its cush havent been up for review yet.

ive been told it is the most rewarding to see your name cited in journals, by other respected physicians, etc. so maybe you have to have narcissistic tendencies to be an academician...

There are academic physicians and non academic physicians in tertiary centers. There are several pathways in university medical centers. You don't have to publish if you don't want to. there are research vs clinical pathways, as well as clinical non teaching pathways.... Let's be specific here....You can simple work, teach, and go home if you like.... Cush life (ie anesthesia, hospitalist, physiatrist, etc)....you know that so this concept that academics is soooo tough is foolhardy...

 

[SSdoc33]

Relevant story from today:

I know some guys in a local group which at one point was Neuro, Neuro Surg and ortho. A few years ago, the local hospital offered to buy them out. Apparently their group was having some trouble, crappy building they invested in and were losing some money, or at a minimum not making as much as they thought they should. So the hospital makes them a supposedly good offer and they decide that for LONG TERM SECURITY, they should take it. Well, fast forward a couple years and one day out of the blue, the hospital tells them they're all fired, they're not getting their contracts renewed, not even for $1 per year. Rumor has it they weren't "profitable enough." They're closing the whole department. (Except the surgeons of course, because that cow is still producing milk.) Now they're all desperate, trying to scramble and find new jobs. Of course, private practice isn't a feasible option unless they want to start from scratch again because their practice was swallowed and shuttered, or unless they want to go be the ground level b¡tch of one of their former competing groups.

I just texted back and forth with one of the guys offering to give him a job as my group is looking to expand and add more specialties. He responded with telling me the above story, and with "Its so crazy, I can't believe it. It's so crazy, man" mixed in too many times to count.

My conclusion is that taking a hospital employee job, though it may work for the right people in the right situation, involves giving up autonomy for "security" which in many cases, may be a false promise and not at all secure. Although I know there are no guarantees (false or real) in private practice and that my salary could drop, at least I know I won't be told by some administrator it's dropping to zero, by no fault of my own.

right, so, this story sounds fishy.

why is an ortho group losing money? why did they sign a contract that lets this happen? why was neurology even around, as they surely weighed down the bottom line. i think we are not hearing the whole story.

 

[Stim4me]

right, so, this story sounds fishy.

why is an ortho group losing money? why did they sign a contract that lets this happen? why was neurology even around, as they surely weighed down the bottom line. i think we are not hearing the whole story.

I've seen the opposite. That is an ob-gyn group doesn't join a hospital system, so the aco brings in competing physicians... Just as bad

 

[tchoupdoc]

I work academics, and I love it. The students keep you sharp, and there are days all of us don't like to be at work. Having an eternal rotating cadre of 26-30 year olds who can handle the needy patients makes those days tolerable.

Not every academic job requires research. But every one of them is at best a benign dictatorship. Your chair never has to share numbers with you if s/he doesn't want to. Definitely be skittish if this job is being offered by a chair who hasn't been there for at least 1 year.

Not to doubt you, but to warn you: 300k for a first job in academics sounds too good to be true. I interviewed at another university and it was quite clear there was no evil plan, the new chair and business manager didn't know what they were doing regarding billing for interventional pain in that setting.

 

[emd123]

right, so, this story sounds fishy.

why is an ortho group losing money? why did they sign a contract that lets this happen? why was neurology even around, as they surely weighed down the bottom line. i think we are not hearing the whole story.

It was mainly Neuro (4) with only 2 orthos, and the ortho guys left the group when they went hospital employee status, and then it was just Neuro and neurosurg as hospital employees. The neuros were canned and neurosurgeons were not. I'm not holding anything back, as I was not personally involved and don't know every detail. I just know that a handful of neurology employees of a hospital got canned without warning and weren't too pleased. I'll update if I get any details. It just hits a little close to home as its a group I interviewed with 4 years ago and I would have been too happy, if after four years I was booted out without cause.