Kaiser vs. Private Practice

[mohandess]

I was looking for some advice and/or opinions:

I am about 2 years out and am working at a private pain practice that is very busy and is not a pill mill making 450k+. The job has zero benefits and partnership is not an option at this practice.

Vs. Kaiser which is filled with benefits but you will be stuck making 300k a year for the rest of your days.

With the current economic climate of Medicine and particularly pain medicine what are your thoughts on the benefits of each and which is better.

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[Ligament]

If you are making that bank in private practice stick with it.

 

[sblau001]

There are some other benefits working for Kaiser. Once you retire, you get a nice pension (depending on how many years you are with them, and your final salary). Also, you don't have to deal with a lot of the insurance bs. That being said, there are a lot of downsides. First, more recently Kaiser has been pushing docs to see more and more non-Kaiser patients. As it turns out, the malpractice policies that they have for their docs will not cover you seeing these patients. (This is a major insider problem that most of their docs aren't even aware of.) Second, you can't pick and choose which patients you want to see or not see. One of the nice things about being in private practice is that I can weed out many of the drug seekers before they even step foot in my office by first requiring referrals and med lists. Third, you are pressured to only prescribe what's in their formulary. Namely, the cheapest drugs out there. So little to no abuse-deterrent opioids. In my neck of the woods, they seem to have a high turnover rate of their pain docs.

 

[SSdoc33]

Vs. Kaiser which is filled with benefits but you will be stuck making 300k a year for the rest of your days.

If you are making that bank in private practice stick with it.

i think he meant he was NOT making 450k. im assuming the gender is male.

 

[101N]

Realize that when you say Kaiser it doesnt mean that each facility and staff is identicle. I think you need to interview at a specific facility and then decide if
you like the docs, the area, the PIC, etc.

My experience was over-all very good.

 

[pmrrulez]

I was looking for some advice and/or opinions:

I am about 2 years out and am working at a private pain practice that is very busy and is not a pill mill making 450k+. The job has zero benefits and partnership is not an option at this practice.

Vs. Kaiser which is filled with benefits but you will be stuck making 300k a year for the rest of your days.

With the current economic climate of Medicine and particularly pain medicine what are your thoughts on the benefits of each and which is better.

Doesn't Kaiser set your pay based on your primary specialty?

 

[Ligament]

i think he meant he was NOT making 450k. im assuming the gender is male.

I am about 2 years out and am working at a private pain practice that is very busy and is not a pill mill making 450k+

i think he is making 450k

 

[mohandess]

Yes, I am making that much.

That is correct they do base your salary on your primary specialty.

I appreciate everyones input. It still remains a tough decision.

 

[Papa Lou]

Realize that when you say Kaiser it doesnt mean that each facility and staff is identicle. I think you need to interview at a specific facility and then decide if
you like the docs, the area, the PIC, etc.

My experience was over-all very good.

it this identicle like testicle? If you're talking about Kaiser then I probably agree. Come on fella why succumb to the teat (or testicle) of the Big Corp? Stay entrepreneurially oriented. This is America!

 

[oreosandsake]

what's the base salary for anesthesia, and anesthesia pain?

 

[bedrock]

About 230 base for anesthesia and 190 for PMR, base pay. You get an extra $65,000 annual bonus for completing an ACGME pain fellowship.

So if someone completed the Brigham pain fellowship and was ACGME pain certified, they'd get paid, in total, 295K if they did anesthesia residency and 255K if they did a PMR residency, even though they went to the same fellowship.

Kaiser pension sounds nice, but too many towns/companies have gone under or cut their promised pension plans in half after the fact. I don't trust anyone to provide for me and mine, but myself.

So in pp, I make twice what a kaiser doc makes, but I'll be funding my own pension plan, thank you. And the fact I did a PMR residency, doesn't decrease how much I make each year.

 

[drusso]

About 230 base for anesthesia and 190 for PMR, base pay. You get an extra $65,000 annual bonus for completing an ACGME pain fellowship.

So if someone completed the Brigham pain fellowship and was ACGME pain certified, they'd get paid, in total, 295K if they did anesthesia residency and 255K if they did a PMR residency, even though they went to the same fellowship.

Kaiser pension sounds nice, but too many towns/companies have gone under or cut their promised pension plans in half after the fact. I don't trust anyone to provide for me and mine, but myself.

So in pp, I make twice what a kaiser doc makes, but I'll be funding my own pension plan, thank you. And the fact I did a PMR residency, doesn't decrease how much I make each year.

More importantly, you won't have population-based pseudo-science forced down your throat every time you turn around. In PP you're actually able to look patients in the eye and tell them "I'm accountable" when there's a problem and not just throw up and your arms and blame it on "a system."

 

[SSdoc33]

the kaiser job isnt going anywhere. you'll be able to land that job or that type of job later if things change. stick with the PP for now

 

[y2janitor]

295k is the salary for anesthesia/pain for all kaiser hospitals?

 

[oreosandsake]

295k is the salary for anesthesia/pain for all kaiser hospitals?

it'd be 295 starting with small bumps every year.

 

[oreosandsake]

About 230 base for anesthesia and 190 for PMR, base pay. You get an extra $65,000 annual bonus for completing an ACGME pain fellowship.

So if someone completed the Brigham pain fellowship and was ACGME pain certified, they'd get paid, in total, 295K if they did anesthesia residency and 255K if they did a PMR residency, even though they went to the same fellowship.

Kaiser pension sounds nice, but too many towns/companies have gone under or cut their promised pension plans in half after the fact. I don't trust anyone to provide for me and mine, but myself.

So in pp, I make twice what a kaiser doc makes, but I'll be funding my own pension plan, thank you. And the fact I did a PMR residency, doesn't decrease how much I make each year.

do you know if that $65k per year is across the entire kaiser system?

 

[101N]

You need to pose this question to the physician in charge (PIC) at the facility you interview at. He has some discretion on your salary curve.

 

[SCIronMike]

I left my academic practice at USC back in 2011 and joined Southern California Permanente Medical Group. I just made partner. For PM&R / pain, the current 4th year physician salary is about $290,000 / year (the pain stipend for finish a fellowshp is $42,000 / year). There is also a draw at the end of the year which is profit sharing with the group. This is generally another $10,000 to $20,000 depending on how the group does. The salary continues to go up every year until a max at year 12. After that, it is just adjustments based on market changes and also based on cost of living increases.

The benefits package is very nice. I pay $32 / month for $1,500,000 term life insurance (as I get older and the price goes up, the med group pays a larger percentage). Long term specialty specific disability is completely paid for. I'm able to invest $51,000 / year tax deferred in a 401K and a Keogh plan. I also have the option of a Roth 401k if I opt for it. Health, dental, and vision are completely covered for the family. I don't pay any premiums for health and dental insurance. I have no copays for any medical care. I will retire with 53% of my salary as a pension. My understanding is tha the pension plan is very well funded.

I work 4.5 days a week. I get a half day off every week for my own academic time. I'm only on call 1 in 10 weeks, and it is all from home. I've never been called after 7:30 PM. If I have to come in on the weekend to do a consult, I get paid for call-back. Currently I get 23 vacation days per year wtih another 5 days for conferences. Partners here for 10 years get something like 33 vacation days per year + 5 days for educational leave. We can acrue vacation up to 90 days, then we get cashed out at our typical hourly rate.

The practice of pain is pretty different at each Kaiser medical center. I've been VERY happy with my practice here at Kaiser Permanente Downey. My colleagues in PM&R, PM&R pain, and Anesthesia / pain management are REALLY great people and are excellent physicians. We have a lot of autonomy in patient care. In my department, we are seeing patients within 3-4 days of a referral. Patient satisfaction is high. I just got authorization to start performing PRP injections. Patients will be able to get PRP for their regular office co-pay. I get two half days a week of fluoro time. I also get to perform electrodiagnostic studies on a regular basis.

 

[DOctorJay]

How many pts do you see per day and how much time do you get for consults and follow ups?

 

[SCIronMike]

Depends on whether I do electrodiagnostic studies in that half day and also depends on whether it is a PM&R or a pain clinic for me. In PM&R clinic, I see 8 patients per half day (if there are no EMG/NCS). In Pain clinic, I see 6 patients per half day. In PM&R, we get 30 min for a consultation, 30 min for a long follow-up (depends on diagnosis and time since last visit), and 20 minutes for a standard follow-up. In Pain, we get 45 min for a consultation and 30 min for a follow-up. We get 40 minutes for a basic nerve conduction study, 60 minutes for a peripheral neuropathy screen or a EMG for radiculopathy. We get PLENTY of time for fluoro cases. We have two great fluoro suites.