Am I underpaid ?

[DayDoc]

I see 27pts on average (about 20 -22 fu, 5-7 np) a day, 3.5-4 days a week and roughly 35-40 procedures (bread and butter, scs and kypho once in a blue moon) a week. I'm employed and my base is 350k or 40% total collections on the west coast single specialty private practice in office only.

I have a chill life but I'm probably underpaid. Also planning to negotiate up the next contract.

If I were you I'd never quit your job

Thanks.

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[painfree23]

Do u have any incentive bonus? Also are you in a big city?

Thanks.

 

[Iamnew2]

I don't really know. I've heard pay sucks in cali and the northeast but honestly most things suck in those areas except for the weather in Cali. If you're in Cali making that much maybe that's the best you can hope for. Getting screwed may be worth the weather. If you're in the NE, good luck and god speed. Everyone up there's leaving and moving to my neck of the woods

What is the NE considered ? and what is the pay there considered that's poor? just curious

 

[painballer27]

@duy24 Are you in private practice with other pain docs or is it an ortho/neurosurg group? Is this a large city or a smaller place? What was your base specialty?

 

[Agast]

It’s a *great* compensation, but when your bosses are making a killing off of you I can see why you’re wondering if your piece of the pie should be bigger. I knew of someone in a similar situation who was very unhappy because he was blocked from receiving ancillary income and would never be made partner in the ortho group. I’m not sure leaving for a pure pain group was any better. If you look at MGMA the majority of us don’t make $800k so personally, I would not be looking elsewhere if total compensation was my greatest concern.

 

[Ducttape]

you are not underpaid.

particularly given your patient population. 75% medicare/medicaid and bringing home 800K suggests that you are getting a lot more assistance than you realize in attaining that salary.

if you were to try to duplicate this in private practice, you would have to go to an underserved area, work much harder than you are now, and have significantly increased concerns because you would have to include financials et al in to your work load.

What is the NE considered ? and what is the pay there considered that's poor? just curious

i have heard of salary offers of $250K + 40% collections after 1 million, with no fringe benefits

 

[TeslaCoil]

Wanna hear about underpaid? Between myself and 2 PA's I'm seeing 40-60 pts per day, 5 days a week and performing 50-70 procedures per week. Usually this consists of mostly axial injections, 1 stim trial a week, and anywhere from 6-15 RFA's/week. Fridays I travel 2 hours each way to one of our clinics. Also I'm an area director, which means I have a bunch of managerial crap to do. I make 520k plus benefits. Total comp is probably 550k with retirement account matching. By my calculation between me and my two PA's we are doing something like 12-15k work RVU's/yr. Each of them gets 120k/year. Overhead is relatively low because the owner owns the buildings. So every cent that goes to "rent" goes into his holdings company. But hey im not miserable... 550k aint bad. One of these days though I will either negotiate up or high tail it.

 

[drusso]

Guys; being the practice owner does not always mean more money, and in fact it is much more work in general. If you are making this type of money employed, you are lucky.

It's basically a 5 AM to 9 PM job. And, Lig can attest that when he called me last to chat, what was I doing, hosting a business meeting at my home...

 

[Iamnew2]

Wanna hear about underpaid? Between myself and 2 PA's I'm seeing 40-60 pts per day, 5 days a week and performing 50-70 procedures per week. Usually this consists of mostly axial injections, 1 stim trial a week, and anywhere from 6-15 RFA's/week. Fridays I travel 2 hours each way to one of our clinics. Also I'm an area director, which means I have a bunch of managerial crap to do. I make 520k plus benefits. Total comp is probably 550k with retirement account matching. By my calculation between me and my two PA's we are doing something like 12-15k work RVU's/yr. Each of them gets 120k/year. Overhead is relatively low because the owner owns the buildings. So every cent that goes to "rent" goes into his holdings company. But hey im not miserable... 550k aint bad. One of these days though I will either negotiate up or high tail it.

You work hard no doubt, but no one is going to be crying a river for you making that kind of money - just saying. I'm making in the range of what OP said and I thought I worked hard when I have to take work home frequently (I don't work in pain at this time - just saying though) - and my husband frequently reminds me of how I am blessed to make what I do and I would say most of us including you and OP are blessed to make what you do. Most people don't make anywhere near what we make. Most people who make this kind of money works hard - one way or another. I manage the clinical side of my hospital and have to deal with challenging personalities, protocols, admin, CMS, patients who berate the staff and are aggressive, etc etc. Just saying.

 

[TeslaCoil]

You work hard no doubt, but no one is going to be crying a river for you making that kind of money - just saying. I'm making in the range of what OP said and I thought I worked hard when I have to take work home frequently (I don't work in pain at this time - just saying though) - and my husband frequently reminds me of how I am blessed to make what I do and I would say most of us including you and OP are blessed to make what you do. Most people don't make anywhere near what we make. Most people who make this kind of money works hard - one way or another. I manage the clinical side of my hospital and have to deal with challenging personalities, protocols, admin, CMS, patients who berate the staff and are aggressive, etc etc. Just saying.

Please see the part where I said "hey im not miserable... 550k aint bad." Im grateful for what I make. Thats not the point. Im tired of putting money in other people's pockets with my hard work. Every doctor should be. And complacency is the only reason why those other doctors are now in the situation they're in. Im not that guy. These fat cat bastards should pay people what they're worth. Across all specialties.

 

[GoBeers]

Please see the part where I said "hey im not miserable... 550k aint bad." Im grateful for what I make. Thats not the point. Im tired of putting money in other people's pockets with my hard work. Every doctor should be. And complacency is the only reason why those other doctors are now in the situation they're in. Im not that guy. These fat cat bastards should pay people what they're worth. Across all specialties.

I hear you. But as others have said, it ain't easy being the boss either. A lot of risk assumed that we employees don't see.

Plus, what is fair? 50, 60, 70% collections? All employees are replaceable

 

[Iamnew2]

Please see the part where I said "hey im not miserable... 550k aint bad." Im grateful for what I make. Thats not the point. Im tired of putting money in other people's pockets with my hard work. Every doctor should be. And complacency is the only reason why those other doctors are now in the situation they're in. Im not that guy. These fat cat bastards should pay people what they're worth. Across all specialties.

Well what are people worth? What are we as physicians worth? 500K? a million? 10 million? The same as when the fast food employees said we are worth $15 an hour. Well many employers didn't feel that. So being the boss as someone said doesn't always translate into better $$. Lots of overhead and expenses. Also you have to realize that coming up and establishing a clinic/business, etc takes hard work and there are no guarantees. So some might make it big but many flounder.

 

[MitchLevi]

If you're an employed physician you really have no idea what you're worth, and more importantly you have no idea what you cost. Hint - You're expensive.

 

[GoBeers]

If you're an employed physician you really have no idea what you're worth, and more importantly you have no idea what you cost. Hint - You're expensive.

I keep track of every patient and billed code, as well as what procedures I've ordered but also separately what procedures I've actually performed. Even then I have no idea what's actually collected. But at least with these numbers, it gives me some sense of what I think I should make.

 

[so55b]

Wanna hear about underpaid? Between myself and 2 PA's I'm seeing 40-60 pts per day, 5 days a week and performing 50-70 procedures per week. Usually this consists of mostly axial injections, 1 stim trial a week, and anywhere from 6-15 RFA's/week. Fridays I travel 2 hours each way to one of our clinics. Also I'm an area director, which means I have a bunch of managerial crap to do. I make 520k plus benefits. Total comp is probably 550k with retirement account matching. By my calculation between me and my two PA's we are doing something like 12-15k work RVU's/yr. Each of them gets 120k/year. Overhead is relatively low because the owner owns the buildings. So every cent that goes to "rent" goes into his holdings company. But hey im not miserable... 550k aint bad. One of these days though I will either negotiate up or high tail it.

I guess you are working in a competitive market or in a desirable city? that sounds like a very high volume for me.

 

[MitchLevi]

I keep track of every patient and billed code, as well as what procedures I've ordered but also separately what procedures I've actually performed. Even then I have no idea what's actually collected. But at least with these numbers, it gives me some sense of what I think I should make.

Of course. You also cost good bit of dough too.

 

[TeslaCoil]

Well what are people worth? What are we as physicians worth? 500K? a million? 10 million? The same as when the fast food employees said we are worth $15 an hour. Well many employers didn't feel that. So being the boss as someone said doesn't always translate into better $$. Lots of overhead and expenses. Also you have to realize that coming up and establishing a clinic/business, etc takes hard work and there are no guarantees. So some might make it big but many flounder.

Umm its very simple. People keep data on salary norms per specialty. I am currently payed at around the 65th-ish percentile and generating WELL above my pay grade in wRVU's. Ever hear of sullivan cotter? MGMA? the data is out there and readily available.

 

[GoBeers]

Of course. You also cost good bit of dough too.

any idea of how to calculate general cost?
salary, employee hourly, rent, utilities, emr?
for private practice in office, it's relatively calculable i would think....
i'd have a hard time believing it's more than $250,000 with employee hourly and rent being the two biggest issues

 

[TeslaCoil]

I guess you are working in a competitive market or in a desirable city? that sounds like a very high

I live in a city of approx 1 million. It is a capital city but I would not call it highly desirable. The catchment is good, and thats what I do on minimal marketing.

any idea of how to calculate general cost?
salary, employee hourly, rent, utilities, emr?
for private practice in office, it's relatively calculable i would think....
i'd have a hard time believing it's more than $250,000 with employee hourly and rent being the two biggest issues

very calculable if you know the figures (i.e. what people are getting paid and what rent is, etc)

 

[MitchLevi]

any idea of how to calculate general cost?
salary, employee hourly, rent, utilities, emr?
for private practice in office, it's relatively calculable i would think....
i'd have a hard time believing it's more than $250,000 with employee hourly and rent being the two biggest issues

Your service line isn't as cheap as you may believe. Equipment costs and maintenance of the things you use (XRAY, US, computers, etc), your staff and their benefits as well. Insurance.

Employed doctors seem to believe their overhead is limited to themselves, and then they want to negotiate higher collection percentages, higher salaries, another MA on their staff, a scribe and a midlevel.

Your cost is your entire service line, not just you as an individual.

Having said that, make yourself profitable and negotiate hard. Stick up for yourself, just don't automatically assume you deserve more bc you collect 1.3M.

BTW, the OP is wrong about revenue. He/She said like 1.3M, but over 250 procedures a month and 2-3 trials per week is far higher than 1.3M. Come on...That's 8-12 trials per month, and around 3000 procedures per yr...

I'd expect that would give me over 1.5M at least. That is well over 100 trials per yr.

 

[BobBarker]

2.5 trials per week would make you squarely in the 1% of trialing physicians. 40/year is a really desirable account for the reps.

 

[TeslaCoil]

Your service line isn't as cheap as you may believe. Equipment costs and maintenance of the things you use (XRAY, US, computers, etc), your staff and their benefits as well. Insurance.

Employed doctors seem to believe their overhead is limited to themselves, and then they want to negotiate higher collection percentages, higher salaries, another MA on their staff, a scribe and a midlevel.

Your cost is your entire service line, not just you as an individual.

Having said that, make yourself profitable and negotiate hard. Stick up for yourself, just don't automatically assume you deserve more bc you collect 1.3M.

BTW, the OP is wrong about revenue. He/She said like 1.3M, but over 250 procedures a month and 2-3 trials per week is far higher than 1.3M. Come on...That's 8-12 trials per month, and around 3000 procedures per yr...

I'd expect that would give me over 1.5M at least. That is well over 100 trials per yr.

Even considering all of this pain physicians overall are highly profitable...

 

[GoBeers]

Your service line isn't as cheap as you may believe. Equipment costs and maintenance of the things you use (XRAY, US, computers, etc), your staff and their benefits as well. Insurance.

Employed doctors seem to believe their overhead is limited to themselves, and then they want to negotiate higher collection percentages, higher salaries, another MA on their staff, a scribe and a midlevel.

Your cost is your entire service line, not just you as an individual.

Having said that, make yourself profitable and negotiate hard. Stick up for yourself, just don't automatically assume you deserve more bc you collect 1.3M.

BTW, the OP is wrong about revenue. He/She said like 1.3M, but over 250 procedures a month and 2-3 trials per week is far higher than 1.3M. Come on...That's 8-12 trials per month, and around 3000 procedures per yr...

I'd expect that would give me over 1.5M at least. That is well over 100 trials per yr.

true but xrays, US, computers, are all shared cost and would be there, sitting idle, whether or not I"m there. but yes, hard to ballpark those figures. that's why I'm only thinking on generalities. even if you penny pinch every single thing, I can't imagine "overhead" costs more than a physician's salary.

 

[MitchLevi]

true but xrays, US, computers, are all shared cost and would be there, sitting idle, whether or not I"m there. but yes, hard to ballpark those figures. that's why I'm only thinking on generalities. even if you penny pinch every single thing, I can't imagine "overhead" costs more than a physician's salary.

Those devices don't exist if there's no one to use them. The practice bought those pieces of equipment and that investment needs to see a healthy return.

You put quotes on the word "overhead" but the dollars spent on you are real, tangible dollars that weren't picked from a money tree in the backyard. It is often very expensive to run a productive and busy pain service line, and the practice owners have legit risk working against them.

You get audited and there's a clawback, who pays for that? You're sued and where does that money come from? The practice may keep an attorney on retainer (we do). We're a large ortho group and basically have no choice.

Practice has a bad quarter and loses money, you (the employed MD) aren't hurt. Your contract gets you paid no matter what. The partners eat that.

Again, you cost a lot of money, your practice and the partners deserve to make a lot of money off you, and you usually deserve to make a lot of money too.

It's a bigger game than just the individual employed MD.

I've heard ppl ask for 70% of their collections FFS. LOL.

 

[MitchLevi]

Even considering all of this pain physicians overall are highly profitable...

Not always true. At all...

We've had several completely fail to even meet their overhead in my practice.

 

[GoBeers]

Not always true. At all...

We've had several completely fail to even meet their overhead in my practice.

did that mean they couldn't cover their own salary? or all the other costs we discussed?
care to share what "overhead" may be ? obviously speaking in very broad generalities. i'm likely as clueless as 99% pain employed physicians out there.

to pivot, why do you think they couldn't cover cost? were these physicians responsible for their own marketing and getting patients in themselves or were they all being fed overflow patients? wasteful spending in the procedure rooms? too slow and not seeing enough patients? not generating enough follow-ups because they don't prescribe opioids or lousy personality? not generating enough procedures? thank you for the insight. just here to learn

 

[TeslaCoil]

Not always true. At all...

We've had several completely fail to even meet their overhead in my practice.

Okay yes im saying great profitability potential. Sure there are schmucks who suck out there.

 

[MitchLevi]

did that mean they couldn't cover their own salary? or all the other costs we discussed?
care to share what "overhead" may be ? obviously speaking in very broad generalities. i'm likely as clueless as 99% pain employed physicians out there.

to pivot, why do you think they couldn't cover cost? were these physicians responsible for their own marketing and getting patients in themselves or were they all being fed overflow patients? wasteful spending in the procedure rooms? too slow and not seeing enough patients? not generating enough follow-ups because they don't prescribe opioids or lousy personality? not generating enough procedures? thank you for the insight. just here to learn

Two of them couldn't cover their overhead of 750k. One currently pays the overhead and no more. Two of these individuals are gone, one remains but he is not very profitable.

I am profitable.

A large, busy ortho group costs a lot to keep the doors open, and our overheads are high. That comes with a lot of benefits and is overall very desirable however.

Every practice has its own comp model and these vary widely.

I have no issue with a high overhead given my patient population that comes with my overhead is enviable.

Edit - Each of these doctors was slow, limited in skills and simply not good at their job. Further, they weren't team players and one was a complete ***** who tried to start a bunch of BS with me, but never to my face.

Here's the thing...The people who pay for the practice (partners) allocate money to various projects within the practice. We need a new procedure room, and those costs come out of the money the partners make. They buy you a new C-Arm and they keep less money for themselves. You better make that investment worth it, and that means work hard and get profitable quickly.

One of these guys had to completely rebuild one of our procedure rooms (one I'd been using for a yr with no issues) bc he didn't like it. We did it to make him happy. He then finds a way to F it up. He would invent problems that didn't exist in real life. Ultimately he leaves bc he started getting paid less bc he can't meet his overhead. That procedure room is currently NOT in use.

All that money wasted. No employed doctor lost money in that transaction.

 

[GoBeers]

Two of them couldn't cover their overhead of 750k. One currently pays the overhead and no more. Two of these individuals are gone, one remains but he is not very profitable.

I am profitable.

A large, busy ortho group costs a lot to keep the doors open, and our overheads are high. That comes with a lot of benefits and is overall very desirable however.

Every practice has its own comp model and these vary widely.

I have no issue with a high overhead given my patient population that comes with my overhead is enviable.

yes but would you be able to expand on why they weren't profitable?
can't help but compare myself and see where I may be inefficient or lacking. I don't get a lot of communication from the office I am in. even if i directly asked the owner, I'll take whatever he says with a grain of salt. we're all here to make money so no hard feelings.

 

[MitchLevi]

yes but would you be able to expand on why they weren't profitable?
can't help but compare myself and see where I may be inefficient or lacking. I don't get a lot of communication from the office I am in. even if i directly asked the owner, I'll take whatever he says with a grain of salt. we're all here to make money so no hard feelings.

See my edit. Too slow. Limited in the skills they can offer pts.

 

[Iamnew2]

Those devices don't exist if there's no one to use them. The practice bought those pieces of equipment and that investment needs to see a healthy return.

You put quotes on the word "overhead" but the dollars spent on you are real, tangible dollars that weren't picked from a money tree in the backyard. It is often very expensive to run a productive and busy pain service line, and the practice owners have legit risk working against them.

You get audited and there's a clawback, who pays for that? You're sued and where does that money come from? The practice may keep an attorney on retainer (we do). We're a large ortho group and basically have no choice.

Practice has a bad quarter and loses money, you (the employed MD) aren't hurt. Your contract gets you paid no matter what. The partners eat that.

Again, you cost a lot of money, your practice and the partners deserve to make a lot of money off you, and you usually deserve to make a lot of money too.

It's a bigger game than just the individual employed MD.

I've heard ppl ask for 70% of their collections FFS. LOL.

I would agree with this statement. When I went from employed to contractor, I saw in real life and understood how/why former employers paid and why they paid what they paid, the costs, etc. I't s not easy to run a practice, and there are many associated costs that the employee doesn't see as you state. Pain in particular has a high overhead - between rent, equipment, staff, billing, non-collected, legal stuff, etc. - it adds up. It costs quite a bit of money to employ a doc.

 

[DayDoc]

Do u have any incentive bonus? Also are you in a big city?

I have a productivity bonus that makes up half my income

 

[DayDoc]

@duy24 Are you in private practice with other pain docs or is it an ortho/neurosurg group? Is this a large city or a smaller place? What was your base specialty?

I'm in PP with two other pain docs in a medium size city. We are all anesthesia trained

 

[DayDoc]

It’s a *great* compensation, but when your bosses are making a killing off of you I can see why you’re wondering if your piece of the pie should be bigger. I knew of someone in a similar situation who was very unhappy because he was blocked from receiving ancillary income and would never be made partner in the ortho group. I’m not sure leaving for a pure pain group was any better. If you look at MGMA the majority of us don’t make $800k so personally, I would not be looking elsewhere if total compensation was my greatest concern.

This is how I feel. I think I'm making a lot of asc fees for the boss and getting no piece of it.

 

[BobBarker]

Well, where is this huge amount of stim patients coming from and who is implanting?

 

[DayDoc]

Wanna hear about underpaid? Between myself and 2 PA's I'm seeing 40-60 pts per day, 5 days a week and performing 50-70 procedures per week. Usually this consists of mostly axial injections, 1 stim trial a week, and anywhere from 6-15 RFA's/week. Fridays I travel 2 hours each way to one of our clinics. Also I'm an area director, which means I have a bunch of managerial crap to do. I make 520k plus benefits. Total comp is probably 550k with retirement account matching. By my calculation between me and my two PA's we are doing something like 12-15k work RVU's/yr. Each of them gets 120k/year. Overhead is relatively low because the owner owns the buildings. So every cent that goes to "rent" goes into his holdings company. But hey im not miserable... 550k aint bad. One of these days though I will either negotiate up or high tail it.

Sounds like you are underpaid then

 

[mid|ine]

I see >600 patients per month. Of that, >300 are procedures, ~70-80 news and the rest are f/u. I am a partner and 100% eat what I kill (get paid all of my collections after expenses). I see all of the numbers and know exactly what the overhead/expenses are. I haven't taken anything beyond a handful of days off in the last 6 years. I take home in the ballpark of the original poster.

I don't think you are leaving much on the table. You could leave, but would have a lot more risk, and are more likely to work harder to make less then the other way around.

 

[DayDoc]

I see >600 patients per month. Of that, >300 are procedures, ~70-80 news and the rest are f/u. I am a partner and 100% eat what I kill (get paid all of my collections after expenses). I see all of the numbers and know exactly what the overhead/expenses are. I haven't taken anything beyond a handful of days off in the last 6 years. I take home in the ballpark of the original poster.

I don't think you are leaving much on the table. You could leave, but would have a lot more risk, and are more likely to work harder to make less then the other way around.

Thanks for the advice. It seems the consensus is to stay and try to negotiate for more vs leaving and taking on the risk of ownership.

 

[DayDoc]

Well, where is this huge amount of stim patients coming from and who is implanting?

Both me and the owners are implanting as well. Obviously not everyone go on to perm.

 

[DayDoc]

I see >600 patients per month. Of that, >300 are procedures, ~70-80 news and the rest are f/u. I am a partner and 100% eat what I kill (get paid all of my collections after expenses). I see all of the numbers and know exactly what the overhead/expenses are. I haven't taken anything beyond a handful of days off in the last 6 years. I take home in the ballpark of the original poster.

I don't think you are leaving much on the table. You could leave, but would have a lot more risk, and are more likely to work harder to make less then the other way around.

Is this all office based or do you have ownership in an asc?

 

[mid|ine]

Thanks for the advice. It seems the consensus is to stay and try to negotiate for more vs leaving and taking on the risk of ownership.

You can ask for more, but Im not sure there is much more to give you.

 

[mid|ine]

Is this all office based or do you have ownership in an asc?

Office based

 

[DayDoc]

You can ask for more, but Im not sure there is much more to give you.

Probably would expect me to see more patients and do more procedures for more.

 

[MitchLevi]

Both me and the owners are implanting as well. Obviously not everyone go on to perm.

So you're doing 8-12 stimulators per month, a combination of trials and perms, and 250 procedures per month out of 30 clinic visits per day 3-4 days per week.

If you were doing that volume your revenue would probably be closer to...I'd guess off top of my head 1.6-1.8M per yr?

That is A LOT of stimulators and puts you at the level of Huntoon (during a lecture at NANS he does "about 100 per yr").

How long have you been in practice?

 

[Pain Applicant1]

Please see the part where I said "hey im not miserable... 550k aint bad." Im grateful for what I make. Thats not the point. Im tired of putting money in other people's pockets with my hard work. Every doctor should be. And complacency is the only reason why those other doctors are now in the situation they're in. Im not that guy. These fat cat bastards should pay people what they're worth. Across all specialties.

Not to be a douche but no one is forcing you to stay at your job. If you don't want to put money in someone else's pocket then don't. Start your own practice and then see how you feel. There's a reason the market rate is the market rate.

I run a few businesses including my own medical practice. Labor vs admin will always be at odds because each thinks the other is taking advantage. Not necessarily you, but in general people tend to overvalue themselves all the way around.

 

[GoBeers]

I see >600 patients per month. Of that, >300 are procedures, ~70-80 news and the rest are f/u. I am a partner and 100% eat what I kill (get paid all of my collections after expenses). I see all of the numbers and know exactly what the overhead/expenses are. I haven't taken anything beyond a handful of days off in the last 6 years. I take home in the ballpark of the original poster.

I don't think you are leaving much on the table. You could leave, but would have a lot more risk, and are more likely to work harder to make less then the other way around.

out of 600 patient encounters and 300 of them are procedures, you're only seeing on average 4NP and 10fu a day, 5 clinic days a week. how do you get so much procedural volume? midlevels?

 

[mid|ine]

out of 600 patient encounters and 300 of them are procedures, you're only seeing on average 4NP and 10fu a day, 5 clinic days a week. how do you get so much procedural volume? midlevels?

Yes, I have 2 NPs and do a fair number of procedure for my partners patients as well as he is slowing down.

 

[GoBeers]

So we have multiple midlevels and pain providers in my practice. everyone tries to order procedures, but the way it's distributed is completely "random". I know I have scheduled 70 procedures a month personally for each month in the last 3 months , all of which were completed, but i definitely am not doing all of those procedures. for example, i do the work to get SCS trial authorized and then of course it lands on the practice owner's procedural schedule...

so my procedural volume is artificially low while the other providers are many times propped up. This is another reason why I try to keep track of all personal numbers (fu, np, procedures done, also procedures independently ordered) to show my productivity value to the practice.

 

[Iamnew2]

I see >600 patients per month. Of that, >300 are procedures, ~70-80 news and the rest are f/u. I am a partner and 100% eat what I kill (get paid all of my collections after expenses). I see all of the numbers and know exactly what the overhead/expenses are. I haven't taken anything beyond a handful of days off in the last 6 years. I take home in the ballpark of the original poster.

I don't think you are leaving much on the table. You could leave, but would have a lot more risk, and are more likely to work harder to make less then the other way around.

Wow you haven't taken off but a handful of days? Why?

 

[Iamnew2]

You can ask for more, but Im not sure there is much more to give you.

Agreed. IfOP is truly making in the 800k range, not sure there is a ton more to make. That is certainly an above average wage in any part of the country.