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PM&R Salary

Discussion in 'PM&R' started by J Bone, Jan 23, 2010.

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  1. J Bone

    J Bone

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    Wondering if there is any updated info on PM&R salaries. The group I am working for is looking at hiring a Physiatrist and we are having some trouble finding salary info. The census is that a new grad is in the range of $150,000 -180,000. Any thoughts? Thank everyone!
  2. axm397

    axm397 SDN Moderator Moderator SDN Advisor

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    there is a sticky on this topic look at top of page
  3. J Bone

    J Bone

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    I read it but it is from 2003! Last true update was from 2007. Was looking for something a little more recent than 3 years ago though.
  4. specepic

    specepic

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    I'd say 150-180 sounds a bit low.

    It depends on rural v urban and private vs. academic. I'll make up a spread of 150 to 250 depedning on those factors with 180-190 being average.
  5. ampaphb

    ampaphb

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    Cause as a pre-med, this data will be relevant to your residency completion date of sometime in at least 2018 how, exactly?
  6. lobelsteve

    lobelsteve www.stevenlobel.com Lifetime Donor

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    Because I am not an owner or a partner, I could not take a salary of $1.
    I was able to negotiate down to $150k. Boarded in PMR and Pain.

    I could ask for less, but I don't think they would cut my pay any further. And it does cover all I really need. Mortgage, 1 car, loans, food, etc.
  7. dreambig2night

    dreambig2night Senior Member

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    on salary.com

    a general physiatrist makes between $170,000-219,000, 25% to 75% percentile. It was updated in 2010.

    I am curious to know how much the subspecialists make.

    I know how much pain docs make, but how about:

    Physiatry- Neuromuscular medicine
    Physiatry- Sports Medicine
    Physiatry- SCI medicine
    Physiatry- TBI medicine

    The umbrella of sports medicine will include FP's, Orthos, Physiatrist, and EM docs. So that doesnt tell me anything.
  8. RUOkie

    RUOkie

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    hope that helps you but choose your field of practice on what you love, not how much money you make!
  9. dreambig2night

    dreambig2night Senior Member

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    more or less compared to pain docs or general physiatry?
  10. RUOkie

    RUOkie

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    General physiatry.

    Oh, one more thing. Nobody knows what will happen in the reimbursement see-saw. By the time you finish, injections may pay crap. There may be changes in coverage for injections/emg/E&M coding. Some will go up, some will go down.

    That is why you choose your field based on love. You will be comfortable as a physician (I hope :scared:), but 10 years is a long time.
  11. eljefe

    eljefe

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    as a PGY4 looking for employment, MGMA salary data doesn't mean squat unless you are one of two things: a) out in the sticks where the practice can't recruit or b) you are ready to work your arse off. Coming out of residency, your buddies in medicine will probably get much higher, and many more, offers than you (a year earlier too). Coming out of residency: academics $110K-$140K, VA $140K, and private practice varies tremendously. Out in the sticks $175-225... Don't get me wrong, there are some nice private practice gigs (in nice cities) coming out that pay $200K+, but these are not the norm.

    From my limited experience, PM&R may stand for "plenty of money and relaxation" but it is definitely not a gravy train with buscuit wheels coming out.

    Pain/interventional is by far the most lucrative in PM&R coming out of fellowship (excluding the rare private practice set-up)...Surf the Pain forum for better ideas... From what I've heard $250K-$275 on average out of a decent fellowship...

    Roukie sounds dead-on...
    SCI/TBI=academics and comparable low pay (even with fellowship training; few rare exceptions with heavy botox/baclofen pumps); Sports=low pay (limited good reimbursable procedures); Neuromuscular=beats me, I would guess better pay if lots of EMG
  12. JaggerPlate

    JaggerPlate

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    With this talk of NMM fellowship trained PM&R docs, has anyone here ever worked with or referred to a DO that did a NMM/OMM residency? I know most of these guys open up OMM clinics, but just wondering.
  13. Finally M3

    Finally M3 Senior Member

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    Gravy train with biscuit wheels....:laugh::laugh::laugh:

    Also, the caveat with MGMA is that the most-often quoted figures are those of ALL physicians in the field responding. There is a subset (if there is a large enough sample) looking at physicians in the 1st 1-5 years of practice that is probably more accurate of what you'll be making.
  14. DistantMets

    DistantMets Member

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    Looks like you're just starting DO medical school so I wanted to address this (from a fellow DO). You're thinking of one of the OMM type DO fellowships that go by many different names and I've seen some that sound very close to Neuromuscular Medicine. We're talking about the ACGME subspeciality of neurology and (very recently) PM&R that focuses on the diagnosis and treatment of diseases like ALS, muscular dystrophy, myopathies, nerve disorders etc. It's heavy in EMG, muscle/nerve biopsies, genetics, and they end up needing lots of rehab care, equipment etc.
  15. RUOkie

    RUOkie

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    Guys, the one piece of advice I would give to any PGY4 is : "What do you love?" Because if you chase the money for a deal that is too good to be true, it is because it is. If you want to make money in medicine in 2010, you had better be willing to work VERY hard. OR, you could do something less desirable. Many (not all) "pain" docs pay a lot for new grads, cause the new guy becomes the narcotic doc. Imagine for a minute seeing 30 patients/day all of whom are chronic painers on narcotics. If you are seeing 4-5/day, that is doable, but 30+, you will want to commit hari-kari in about 6 months.

    Look at a 3-5 year projection when you negotiate a contract. My first job was in a major metro area with a guarantee of 200K/yr. I made my bonus in year 1 but worked >80hrs/wk. My collections exceeded 800K! After a few years of this (working for someone else, so the partners could buy a new Porsche every 2 years), I bailed to take a MUCH lower paying job. I needed to regroup, and discover what I loved. Now I am in the sticks, in solo practice and love my job. I still work 7d/wk, 60+hrs/wk, but I am my own boss.

    The advantage to being solo is that you can controll your patient population, and work less or more if you want. This week I did 2 IMEs, 10 EMGs, saw 10-15 chronic pain pts., a boatload of MSK back and shoulder pain, and am doing BoTox on a C5 quad over the weekend at a LTAC for his elbow flexor spasticity. I have 15 inpatients (consults/rehab pts) spread over 3 hospitals. Oh, and I am flying to Houston tonight for a Pfizer meeting (since I am a speaker for them) and coming home tomorow night. I am never bored!
  16. JaggerPlate

    JaggerPlate

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    Yeah, no I knew the NMM fellowships you guys were talking about were not the same NMM/OMM +1 year or 2 year OMM/NMM residencies, but since it was in the physical med forum and brought up some type of Neuromus. medicine, I was just curious. It's surprisingly difficult to figure out information concerning DOs that run straight OMM practices. Sorry, wasn't trying to hijack the thread, just wanted to know if anyone in PM&R knows of DOs that do straight OMM practices or if they ever refer to them, etc.
  17. joseppi

    joseppi Member

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    DO's that do straight OMM typically do cash pay... which makes it difficult to find salary data, you probably won't. Just like most hair cutters/ waitresses etc.. don't have an accurate salary because there all vary in earnings, and actual earning are probably different than reported to ir.s

    But, I hear once they are established they do quite well. IT slow going I imagine at the start up. You should have a back up cushion. Overhead is low.
  18. JaggerPlate

    JaggerPlate

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    Thanks for the response. Do you ever refer to these docs, or come across them often in the field?
  19. bedrock

    bedrock Member

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    Jaggerplate,

    I'm an MD physiatrist, but I know a DO in Rhode Island who did an NMM/OMM residency after med school and has a completely musculoskeletal practice. He's partnered up with a couple physiatrists which complements everyone's interests perfectly. He is able to do straight MSK medicine and does OMM on the vast majority of his patients. He refers to his partners when a patient needs an EMG, botox, or spine interventions, and they refer patients to him that could benefit from OMM, prolotherapy, or a deeper biomechanical eval.

    Personally, I thought it was a great setup that benefited each of the partners and all of the patients. I wouldn't discount this type of setting as a career option, but you'll have to do some digging to find the right fit, i.e. (find partners that aren't needle jockeys, but take an equally balanced approach to patient care and also appreciate what you bring to the table). In general, physiatrists/ with interventional/pain training will appreciate an OMM residency-trained DO much more than anesthesia pain docs.

    PM me if you want more specifics.
    Last edited: Feb 7, 2010
  20. MSKmonky

    MSKmonky

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    .... you had me at hello
  21. Sharpie1

    Sharpie1

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    i was talking to a pm&r resident about this, but she didn't answer my question at all... is there such a thing as private practice pm&r? if so, what do they do? it seems that all i hear about is inpatient pm&r or clinic type work... just wondering
  22. axm397

    axm397 SDN Moderator Moderator SDN Advisor

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    huh??

    majority of physiatrists are in private practice. you can do inpatient or outpatient in private practice.

    There are many types of potential practices in physiatry. Academic, Hospital employee, multi-specialty private practice group, single-specialty group, or solo are only some of them.
  23. RUOkie

    RUOkie

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    You must mean like on the TV show. No we are not that glamorous.:rolleyes:

    :p
  24. yobynaes

    yobynaes yoby-playa

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    Very thought provoking comment, RUOkie! you mentioned that you worked 80+/wk at your first job. was it post general PMR residency? or was it post fellowship? when you say "in the sticks", how big the town (if you don't mind me asking)?

    I'm a 3rd yr medical student trying to decide between ortho and pmr. I think i really like the continuity of care in pmr, but i do worry about the reimbursement. I had the same question as OP, my pmr specialty adviser told me that new graduates start around 120k which is lower than what i expected.
  25. RUOkie

    RUOkie

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    My first job was out of a general residency. I never did a fellowship. I now live in a town of 45K, 1 hr from the nearest city (of 400K). I am 3 hrs from Dallas.

    There is one decision to make when deciding between PM&R and Ortho. Do you LOVE the OR. I had the same dillemma 15 yrs ago, but decided I liked the patient care more than the Operating room. Most orthopedists see patients 1-2 days/wk (sometimes up to 50-60pts/day!:eek:) then spend the bulk of their time in the OR. If you can do that, and like that, and have the grades/board scores for ortho, then do it. If you can answer yes to question #3, but prefer the office type work/biomechanics, then do PM&R (and go to one of the top programs!!!)
  26. axm397

    axm397 SDN Moderator Moderator SDN Advisor

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    From talking to a few PM&R docs in a orthopedic groups, the PM&R docs seem to be billing/collecting around 50%ile of the other orthos in the group.

    surgeries really don't reimburse as much as they used to and if u do a lot of surgeries at a hospital (the more complex ones that require inpatient admission), your reimbursement is not that great.

    A lot of revenue actually comes from clinic based on sheer volume - u have to do at least 7-8 half days of clinic to support 2-3 half days of surgeries.

    I wouldn't make the choice based on $$ because there is a way to make $$ in any field of medicine and reimbursement is looking bad for all fields except maybe IM/FP. Also take into consideration lifestyle - Ortho usually means harder hours during training, more hours of work, ER call, and inpatient hospital call. If you like the OR and doing surgeries, then pick Ortho.

    120k sounds low for starting PM&R private practice - although 120k is probably about right for academics and/or very desirable locations (i.e. big cities)
  27. PMR2008

    PMR2008 PM&R

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    After a quick survey of my senior graduating class I found out that the lowest someone was offered was $160,000 in a suburb of Chicago to work 50/50 outpatient and inpatient. The highest offer was to join a PM&R group practice in Florida and make $200,000. That did not include bringing in 50% of the profit for the first 2 years and becoming partner after that and bringing in 100% of the profit you generate. This is all without fellowships. Fellowships seems to add atleast 50-75 grand on top of that.
  28. predodoc

    predodoc Junior Member

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    I think this is the type of answer most of the Med students want to know.
  29. RUOkie

    RUOkie

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    But for a med student it is meaningless information. The reimbursement for procedures (and now for E&M coding) changes regularly. 6 years ago BoTox paid real well when done in a private practice office. Then 3 years ago, the Medicare reimbursement for injectable medications changed significantly. In 2007, I LOST $10/vial when I injected Medicare patients. (that came to losing $50-$60/patient). I figured it out only after 4 months.

    That is why us old guys are telling you to relax and find an area of medicine that you love. That way you will not be (too) disapointed when your reimbursement isn't what you thought it would be.
  30. yobynaes

    yobynaes yoby-playa

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    Thanks for the follow up comments, guys!!
    predodoc, you are right, this is definitely the postive types of information I am looking for. :thumbup:

    PMR2008, I assume that you are trained in a top program, is that right? Do you also happened to know what percentage of your class went on to fellowship and what percentage of them joined the line of private practice?

    RUOkie, you are right that it's so hard to make a decision between ortho and pmr. I know I have a good shot at ortho and I do love the OR, but I am not sure I will enjoy the 80 hr/wk + call lifestyle especially in 20 years from now. May be this is off the topic of this thread, but I am curious how you started your solo private practice. How/how quickly were you able to establish your patient base? I think a solo or joined private practice will be my eventual goal :)

    Also, a quick (and possibly a more insider kind of) question regarding the dynamics of a joined practice of ortho and pmr's (like the one mentioned by axm387). How are the pmr's treated by their ortho colleagues? Do the ortho guys take the pmr's presence for granted like how a lot of the gen surg's see the presence of anesthesiologist?
  31. RUOkie

    RUOkie

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    1)My EMG practice grew for the first 4-5 years and has now leveled off. I came to my town with an income guarantee. (so you know, hospitals in OK are offering $500-750K to orthopedists as hospital employes:eek::eek:-with no production minimums, just call Q4)

    2) If you are intelligent and know your anatomy/physiology/mechanics, ortho/neuro/neurosurg will treat you like peers. I have a neurosurgeon send my patients for second opinions before operating. When I worked in an academic ortho group, the spine surgeons would run stuff by me before operating. I have even been asked to scrub into a BK amputation to help the surgeon with optimal length. That stuff takes time. The neurolgist in my town was very territorial for 4-5 years. He would refuse to see any patient that I did a EMG on! Now we send each other EMG's for second opinions (for AIDP/CIDP, ALS etc.)

    The other thing is, ask them questions too! If you don't know something, ask them! Everyone likes to show off!
  32. RUOkie

    RUOkie

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    ^^
    one more thing. If you read the other posts, As a solo PM&R doc, I sometimes work 80-90 hr weeks. While no ER backup, I am on call 24/7/365. The ortho guys work less during the week/during the day, but a lot more at night.

    Once you are out there for 10 years or so, most every doc works similar hours. (at least in my community that is true) The internists work the most.
  33. PMR 4 MSK

    PMR 4 MSK Large Member SDN Advisor

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    Totally depends on the group. If you are confident and good, and so are they, you'll get a long fine. I'm in a group with 20 other docs, 13 are ortho. We get along fine.

    There are orthos out there who won't give you the time of day, and people in other specialties that look down on PM&R as inferior. Arrogance is everywhere in medicine. You get the respect you earn.
  34. PMR2008

    PMR2008 PM&R

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    I would say I am from a middle tier program. Out of 6 seniors 3 are doing sports and spine fellowships and 3 are going into private practice. One of them just got offered to work with a PM&R group in St. Louis outpatient/inpatient/emg/consults and start at 180,000. So far everyone who is looking for jobs has told me that there are tons of jobs out there for both fellowship and non fellowship trained residents.
  35. drdolittle1

    drdolittle1 New Member

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    .
    Last edited: Jun 13, 2012
  36. RUOkie

    RUOkie

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    yes/yes.

    No it is not that much. I work from 6-6 M-F and then paperwork and hosp rounds on the weekends. BUT, I am my own boss, and can close the office when I want. I usually take an extra day off every week or two.
  37. SportsMed09

    SportsMed09

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    Since we're talking about salary here, I was wondering how much physiatrists branch out and do things like cash only practices, or other means of compensation? Bash me if you wish, but i was reading about the banishing of consultant codes per Medscape Business of medicine articles, and as we know, healthcare reform is a big deal. EVen though physician salaries are a small part of the puzzle, this seems to be getting targeted more often. Do people know how physiatrists, with the chronicity of even getting recognition for what we do, can navigate this terrain moving forward?
  38. Disciple

    Disciple Senior Member

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    The question is,

    As a Physiatrist, what services are you going to offer that someone will want to pay out of pocket for, at a rate that will allow you to make a decent living?
  39. foresident

    foresident

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    Hi
    This may be a little bit out of context but I would like to know the resident stipend for SUNY, brooklyn for 2010
  40. axm397

    axm397 SDN Moderator Moderator SDN Advisor

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    Getting ppl to pay cash has more to do with how good of a salesman you are and not really about whether ppl know what a "physiatrist" is. There 's a physiatrist in LA who is on TV all the time selling a "back pain" rocker device. He also does anti-aging and PRP. There are family docs who are doing botox cosmetics and juviderm. There are "concierge medicine" doctors who will not take insurance. There are doctors who will make house calls for cash. You can go to another country and make a ton of $$$ - they were recruiting in Dubai and Thailand. You can open a med spa.

    I don't think it matters what specialty you are in - really depends on what you are selling and whether ppl want to pay cash for it.
  41. ampaphb

    ampaphb

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    To those who want to specialize in pain, another rate limiting step is perception. After all, what do you call a doc who sells narcotic prescriptions for cash? The DEA sometimes calls them drug dealers, and prosecutes accordingly.
  42. PMR 4 MSK

    PMR 4 MSK Large Member SDN Advisor

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    botox!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
  43. RUOkie

    RUOkie

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    +1000:(
  44. MedBronc23

    MedBronc23

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    Attached are some recent figures one of my med students gave me on PM&R salary and Pain Med non-anesthesia

    Attached Files:

  45. oreosandsake

    oreosandsake

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    any info re the source?
  46. loveoforganic

    loveoforganic -Account Deactivated-

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    I was under the impression mean salary hovered just under/around the 25th percentile in that spreadsheet
  47. MedBronc23

    MedBronc23

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    The source is from all the graduates who have matched into specialities and sent back surveys on their salaries from 2 midwestern medical schools in the same city that combined their data.

    The PM&R numbers include all specialties other than Pain Medicine: SCI, TBI, Sports, PEDS, & General Rehab ect.
  48. Gauss

    Gauss Damnit Jim!

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    Those numbers are dubious at best especially for new grads. I have never seen MGMA or AMGA numbers that high. I can guarantee you that those 25th percentile salaries are the best you'd get in desirable locations starting out.
  49. slammer922

    slammer922

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  50. PMR2008

    PMR2008 PM&R

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    Wow. Some of those numbers are shockingly low. I think the numbers are probably similar across the board in all academic institutions +/- 20,000.



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