Practicing pain and making no money

[W222]

I have heard this from a few people, granted its second hand info, but some complain about making no money in pain and going back to their old gen anesthesia gigs. How can it be that they are not surviving doing pain? Is this really true or merely someone with a bad practice?

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[mille125]

I have heard this from a few people, granted its second hand info, but some complain about making no money in pain and going back to their old gen anesthesia gigs. How can it be that they are not surviving doing pain? Is this really true or merely someone with a bad practice?

In any specialty, if the doctor is not making the average salary it is one of a few things.

1) Bad marketing
2) Doctor not liked by patients or referrers (bedside manner, etc.)
3) Mismanagement of funds
4) Practice startup in wrong area (ie intense competition)
5) Poor advisor or not listening to advisors


Everyone is not cut out for private practice. You dont just show up and practice medicine. It takes more than that. There are academic jobs. If the docs you know went back to anesthesia, more than likely they just didnt like pain.

 

[ampaphb]

In any specialty, if the doctor is not making the average salary ...

Then he or she is in the 50 percent that are below average.

Otherwise, we'd all live in Lake Wobegon , where "all the women are strong, all the men are good looking, and all the children are above average."

 

[bedrock]

The 2010 MGMA numbers show the GAS and pain $ are very similar for 25%, median, and 75% percentile earning physicians, only the 90% percentile pain docs are shown to be earning significantly more.


-------------Median----75th-----90th
Anesthesia-- $423,657 $496,769 $571,819
Anes-Pain--- $410,611 $524,879 $859,777

 

[mille125]

Then he or she is in the 50 percent that are below average.

Otherwise, we'd all live in Lake Wobegon , where "all the women are strong, all the men are good looking, and all the children are above average."

This time you are correct and my statement is misleading. I meant to say "average new grad". Lower salary than expected is not the one reason that a practice "fails". The statements that I listed proved some reasons why.

 

[mille125]

The 2010 MGMA numbers show the GAS and pain $ are very similar for 25%, median, and 75% percentile earning physicians, only the 90% percentile pain docs are shown to be earning significantly more.


-------------Median----75th-----90th
Anesthesia-- $423,657 $496,769 $571,819
Anes-Pain--- $410,611 $524,879 $859,777

My main criticism of MGMA data is that it does not separate docs by years in practice. It would be so much more relevant and helpful if they included percentiles based on years in practice. Pain docs and anesthesia docs who join a practice out of residency/fellowship do not typically approach 70-75% of even the median salaries listed here.

 

[Tenesma]

the docs that I have heard complaining about income are typically those that are
1) academic with crappy depts or crappy contracts
2) multi-specialty groups where their good income is being shared amongst all partners in a communist way and their contract doesn't reward them for their productivity
3) being taken advantage of....

 

[Pain Applicant1]

My main criticism of MGMA data is that it does not separate docs by years in practice. It would be so much more relevant and helpful if they included percentiles based on years in practice. Pain docs and anesthesia docs who join a practice out of residency/fellowship do not typically approach 70-75% of even the median salaries listed here.

fwiw, MGMA does sometimes separate out the data. They have different listings during different years but last years data did contain one breakdown of data according to years in practice.

 

[anynoise]

the docs that I have heard complaining about income are typically those that are
1) academic with crappy depts or crappy contracts
2) multi-specialty groups where their good income is being shared amongst all partners in a communist way and their contract doesn't reward them for their productivity
3) being taken advantage of....

Which is most of anesthesia since it is so easy to take advantage of us as a group! We need somewhere to work. and I agree, Most anesthesia doc dont even come close to the median and will never approach the 75th percentile so right away i think those numbers are bogus and mgma is not to be taken seriously

 

[Jcm800]

Which is most of anesthesia since it is so easy to take advantage of us as a group! We need somewhere to work. and I agree, Most anesthesia doc dont even come close to the median and will never approach the 75th percentile so right away i think those numbers are bogus and mgma is not to be taken seriously

i have to agree. i have not seen many salaries that meet those standards...

 

[clubdeac]

i have to agree. i have not seen many salaries that meet those standards...

Oh we meet them in the VA system

 

[foxtrot]

i have to agree. i have not seen many salaries that meet those standards...

I also agree. I think these numbers are misleading.

 

[clubdeac]

Hold up, are you guys saying not many salaries meet the anesthesia numbers or the pain numbers? Which are misleading?

 

[Ducttape]

working to change that soon.

payor mix plays a big part of it, unfortunately.

its a hospital based clinic that had been bleeding money for a few years, with a high percentage of a particular insurance that pays very poorly...

also, im salaried so that factors into it, but i wouldnt have taken the job without a salary (cause i was aware of the payor mix prior).