Salary Survey

[Postictal Raiden]

That's true but the trend I've been seeing is these large corps buying out the little guys. Starting your own practice comes with more stress such as the overhead and hiring/managing other employees. Even with these flaws, I believe it's worth it (especially if you can add something extra to your practice eg blocks for migraines and maybe build a niche practice?)

100% agree. It’s more often than not that these physician-owned practices are much more malignant than corporates. I repeatedly hear stories of how junior members are worked to ground chasing after the partnership carrot.

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[sharkbaitwhohaha]

100% agree. It’s more often than not that these physician-owned practices are much more malignant than corporates. I repeatedly hear stories of how junior members are worked to ground chasing after the partnership carrot.

Depends on the group. Clear documentation in contracts tend to avoid ambiguous interview discussions and helps set expectations. But clearly no good can come from a local hospital system owning >70% of the neurologists in a particular community.

 

[neglect]

100% agree. It’s more often than not that these physician-owned practices are much more malignant than corporates. I repeatedly hear stories of how junior members are worked to ground chasing after the partnership carrot.

Do not agree about malignant doc-owned vs. corporate medicine. While there are bad apples and bad stories, in general I hear much worse storied from big systems (although here you can find good apples and good stories as well).

To weed out the bad apples, it is vital to have partners you can trust. When you can look your partners in the eyes and work with them in the trenches, you'll find a ton of support, loyalty, and transparency. For those of you who are employed docs at big systems, you have a boss who owes you none of that.

 

[deathmerchant]

The moral of the story, don't join hospital systems. Join small to large physician owns practices. If you want to "fight the man" and support your autonomy and the future of private practice, stop being employed by them.

That is true in general, but not always. There are hospitals that want to provide a service (Neurology) to their community/patients and other admitting physicians. You can get paid a lot over what you make for the hospital directly. This is also true for locums.
In private practice or physician owned groups you have to earn your keep.

This is how my contract is structured, I get paid more than double (maybe triple if you count benefits) of what I would have if not employed. Basically I had around 2500 wRVUs last year and got paid over 300k. Obviously my ceiling in that model is low and hard to make more money if I wanted to.

 

[Postictal Raiden]

That is true in general, but not always. There are hospitals that want to provide a service (Neurology) to their community/patients and other admitting physicians. You can get paid a lot over what you make for the hospital directly. This is also true for locums.
In private practice or physician owned groups you have to earn your keep.

This is how my contract is structured, I get paid more than double (maybe triple if you count benefits) of what I would have if not employed. Basically I had around 2500 wRVUs last year and got paid over 300k. Obviously my ceiling in that model is low and hard to make more money if I wanted to.

120/wRVU. Great rate. I just did the calculation for my current job. 54/wRVU

 

[Postictal Raiden]

That is true in general, but not always. There are hospitals that want to provide a service (Neurology) to their community/patients and other admitting physicians. You can get paid a lot over what you make for the hospital directly. This is also true for locums.
In private practice or physician owned groups you have to earn your keep.

This is how my contract is structured, I get paid more than double (maybe triple if you count benefits) of what I would have if not employed. Basically I had around 2500 wRVUs last year and got paid over 300k. Obviously my ceiling in that model is low and hard to make more money if I wanted to.

Are you seeing 6-7 patients a day…total?

 

[deathmerchant]

Are you seeing 6-7 patients a day…total?

Its not really RVU based, its a fixed salary no matter how many patients. Yea I typically have 40-45 patient encounters a week plus 5-8 EEGs. Also because I am not RVU based, I don't keep following nonsults. I see them once or twice and adios. I guess effectively it is a good rate per RVU and esp per hour, because I was doing like 3 hours a day, every other week! That is one advantage of Hospital employed job. Usually only possible in less desirable places, like mine.

That being said, there was no scope for growth and I have started to look into adding outpatient and tele on the side.

 

[Jim Manderin]

570K contract for 44 weeks (note: 5 day weeks) per year. 70/15/15 for clinical/admin/education and research. Average 3 call per month.

I work in a medium-sized Canadian city. I primarily do stroke, but do have a small general neurology outpatient practice. I do not read EEGs or perform NCS/EMG.

 

[scoopdaboop]

570K contract for 44 weeks (note: 5 day weeks) per year. 70/15/15 for clinical/admin/education and research. Average 3 call per month.

I work in a medium-sized Canadian city. I primarily do stroke, but do have a small general neurology outpatient practice. I do not read EEGs or perform NCS/EMG.

How much you keep after tax?

 

[Jim Manderin]

How much you keep after tax?

I draw ~250K per year from my med corp, which would have an average tax rate of ~37%. The remaining 270k (320k minus 50k overhead) is kept in the med corp, which is taxed at 12%.

 

[WhereMyLiberalsAt]

570K contract for 44 weeks (note: 5 day weeks) per year. 70/15/15 for clinical/admin/education and research. Average 3 call per month.

I work in a medium-sized Canadian city. I primarily do stroke, but do have a small general neurology outpatient practice. I do not read EEGs or perform NCS/EMG.

Ha! Nice try buddy! I was getting ready to sign on the dotted line!

 

[DrSatan]

I've had multiple 1st job contracts that do not provide tail coverage. Is this expected for 1st jobs? Is tail coverage typically covered if I then sign with a new practice in order to cover my malpractice from when I was working with my first group?

I guess my question is: do I need tail coverage guaranteed right out of fellowship, or is this something that can defer until/if I change jobs?

 

[Postictal Raiden]

I've had multiple 1st job contracts that do not provide tail coverage. Is this expected for 1st jobs? Is tail coverage typically covered if I then sign with a new practice in order to cover my malpractice from when I was working with my first group?

I guess my question is: do I need tail coverage guaranteed right out of fellowship, or is this something that can defer until/if I change jobs?

Tail is obtained upon departure from a job.

Do NOT sign a contract that doesn’t have a clause that burdens the employer of carrying the tail cost.

FYI, the cost is significant. It’s about 2x that of the annual cost of malpractice premiums. It goes up every year you’re in practice (makes sense since the more patients you see the more risk).

An average annual malpractice premium for a neurologist is about 15k. Imagine having to pay 2x that when you decide to leave a practice.

Therefore, make sure you make your future employer responsible for it.

 

[anonperson]

I've had multiple 1st job contracts that do not provide tail coverage. Is this expected for 1st jobs? Is tail coverage typically covered if I then sign with a new practice in order to cover my malpractice from when I was working with my first group?

I guess my question is: do I need tail coverage guaranteed right out of fellowship, or is this something that can defer until/if I change jobs?

Never sign a job contract unless it is explicitly stated that your employer will cover your tail if you leave regardless of whether you leave with or without cause.

Also make sure the tail length is specified so it covers the reporting period in your state you are practicing.

That is a huge cost for a physician to absorb so it should never be your burden.

Some jobs will use it as a handcuff to keep you at a garbage job.

To piggyback on the prior poster, not only is the cost significant, the cost is due within a relatively short time frame, think 30 to 60 days. It is not common for tail insurance to have payment plans.

 

[CnsCrit]

So I guess I'm confused. Are you saying tail coverage should be part of the first job contract, or picked up by the next employer, i.e. the one you are leaving the first job for?

 

[Telamir]

First job contract. They should provide malpractice with tail.

 

[Neurogeneral]

Definitely only accept an offer with tail coverage. I made the mistake of accepting one without it and it was daunting thinking about having to pay $20k to leave my job. Luckily, the mailpractice carrier changed and now includes tail.

 

[DrSatan]

I'm 0/3 with contracts offering tail...At some point I'm going to have to eat the tail coverage.

 

[Postictal Raiden]

I'm 0/3 with contracts offering tail...At some point I'm going to have to eat the tail coverage.

Negotiate. It covers them as much as it covers you.

Minimum, you should have them agree to a graduated expense burden. For example, for each year you stay with them, they carry 20% of it. Like that, if you stay 5 years, they carry the whole amount. Win win.

Remember, OP neuro is in a huge demand. Much more than IP neuro. You have the upper hand even if they make it seem that you don’t.

 

[ProReduction]

Until this thread, I'd never heard of a Neurology job offer not offering tail coverage and I certainly would never sign any contract that does not include it, fully paid at no expense to me.

 

[kidthor]

I’ve seen a lot of PP jobs refuse to cover tail insurance, especially if you’re paid 1099. I wonder if the hospital/institutional employers are also refusing to cover it? Since a lot of them are covered as an institution I’d think they would?

 

[anonperson]

So I guess I'm confused. Are you saying tail coverage should be part of the first job contract, or picked up by the next employer, i.e. the one you are leaving the first job for?

The job you are with( current job).

Most jobs offer claims made insurance policies which require a tail when you leave.

You need it in writing that your employer will provide a tail because it is a huge cost. If you have an occurrence policy, then you are fine.

If you leave without a tail, a future employer could purchase nose coverage but that isn't a guarantee.

 

[xenotype]

I've had multiple 1st job contracts that do not provide tail coverage. Is this expected for 1st jobs? Is tail coverage typically covered if I then sign with a new practice in order to cover my malpractice from when I was working with my first group?

I guess my question is: do I need tail coverage guaranteed right out of fellowship, or is this something that can defer until/if I change jobs?

You must be in an area with no demand for neurologists. Not being offered tail is crazy and an immediate dealbreaker.

 

[Postictal Raiden]

For a first job out of training, B is better IMO. Cog in the wheel is OK initially till you become comfortable with attendinghood and billing

Plus from my experience, small groups tend to be more exploitive towards the new grads

 

[415kid]

Looking at a couple offers right now that are pretty similar in a lot of ways as far as numbers and benefits but am curious to hear any input. This will be my first job out of fellowship, essentially outpatient only. Both groups are private practice.

A) Very small practice. Fewer than 5 neurologists in the practice.

B) Very large multi-subspecialty neurology & other medical specialty practice. More than 50 neurologists and a large subspecialty group in my own field (5-10). Huge hospital system with a couple hospitals and many clinics with continued plan for expansion. Non-compete will run me out of town.

I feel that A will give me flexibility and B resources/job security. I have some concerns about "being a cog in the machine." Anyone with experience?

Curious if you would be willing to provide salary and region

 

[MC47]

I have been offer 270000 salary guarantee for 3 days per week work, outpatient neurology clinic. This include EEG/EMG/Botox
No additional RVU bonus. Work hour 8:30-4. about 10-12 patients a day. Basic benefits 403, 457, 4000 CME, malpractice coverage and tail coverage. No Call

Is this a reasonable offer? I was doing both hospital/clinic and making 550-600k but burn out after doing that for 4 yrs.

 

[Postictal Raiden]

I have been offer 270000 salary guarantee for 3 days per week work, outpatient neurology clinic. This include EEG/EMG/Botox
No additional RVU bonus. Work hour 8:30-4. about 10-12 patients a day. Basic benefits 403, 457, 4000 CME, malpractice coverage and tail coverage. No Call

Is this a reasonable offer? I was doing both hospital/clinic and making 550-600k but burn out after doing that for 4 yrs.

Yes, that’s equivalent to making 450k working 5 days. I think it’s a good deal.

That would be my dream set up once I’m tired of doing inpatient

Which region of the country is this?
Also, could you tell us more about your previous job?

 

[MC47]

I am in MIDWEST, lived in a mid size city (500k population) but practice is in a clinic that is about 15 minutes a way in a small city (70k population).
I was doing both Clinic/hospital, solo position. Rounding patients and doing clinic daily, covering weekend. I generates close to 10000 RVU yearly but physically just could not do it any more.

 

[Postictal Raiden]

I am in MIDWEST, lived in a mid size city (500k population) but practice is in a clinic that is about 15 minutes a way in a small city (70k population).
I was doing both Clinic/hospital, solo position. Rounding patients and doing clinic daily, covering weekend. I generates close to 10000 RVU yearly but physically just could not do it any more.

Sounds brutal. Congrats on the money tho

I interviewed for a similar job, except it was part of a group that rotates for an inpatient coverage at a large very busy hospital. They see 30+ patients a day. Then, 3 weeks of outpatient. Each of them generated 9-11k RVUs.

It was very tempting but I’m glad I didn’t take it