2023 Anesthesia Pain Management Salary

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BillsMafia28

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Saw a similar thread on Reddit anesthesiology… let’s see how they stack up! Post your most recent earnings, type of practice, weeks vacation , etc.
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Prior employer:
400k base
63/RVU after meeting base (400,000/63) quarterly bonus
5 weeks vacation
Hospital system employee
On average 600-700 rvu/month
Significant issues with efficiency

New employer:
480k base
$50/RVU after 7,000 RVUs
8 weeks vacation
Hospital system employee
Anticipate similar RVU/month
Anticipate same issues with efficiency
Much better benefits package

Both are in the southeast. First job is in a big metro area, second is more rural setting but driving distance from the big metro area
 
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gaspasser127 said:
Prior employer:
400k base
63/RVU after meeting base (400,000/63) quarterly bonus
5 weeks vacation
Hospital system employee
On average 600-700 rvu/month
Significant issues with efficiency

New employer:
480k base
$50/RVU after 7,000 RVUs
8 weeks vacation
Hospital system employee
Anticipate similar RVU/month
Anticipate same issues with efficiency
Much better benefits package

Both are in the southeast. First job is in a big metro area, second is more rural setting but driving distance from the big metro area
Click to expand...
I like that second contract much better. Is 8 weeks vacation pretty rare to come by?
 
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Hospital employed
Northeast

No base salary, all production
$75/wrvu

Typically 800-900 wrvu per month
$4k CME
$10k director stipend
4 weeks vacation and 1 week CME (although technically there is 0 vacation since I don't earn wrvu during this time)
 
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gaspasser127 said:
Prior employer:
400k base
63/RVU after meeting base (400,000/63) quarterly bonus
5 weeks vacation
Hospital system employee
On average 600-700 rvu/month
Significant issues with efficiency

New employer:
480k base
$50/RVU after 7,000 RVUs
8 weeks vacation
Hospital system employee
Anticipate similar RVU/month
Anticipate same issues with efficiency
Much better benefits package

Both are in the southeast. First job is in a big metro area, second is more rural setting but driving distance from the big metro area
Click to expand...

Help me understand why hospitals would want to disincentivize productivity with a model like the new employer.

Agree it’s a better deal than the first but how far above 7,000 would you go?
 
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Prior employed job
employed-very rural Northeast

base-560 (2 years then only production)
5 weeks PTO
staff-2 part time LPNs onlyu, limited OR/procedure time)
$62/wrvu over 9,000)
(hard to see >800 wRVUs with 2 part time staff

new job
-private practice
Me + 2 midlevels- 225 pts per week. (One mid-level very experienced, one just starting.)
this will be the first month where our office is open and doing procedures in office. Hopefully bringing in 150 to 175K per month Revenue.
 
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PP single specialty
big city california
40% collections . all in office procedures. 8-4pm m-thurs, 7-1p fridays.
made about 350k
only took 2 weeks off
#lifestyle
 
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very unique employment , Private non-profit multi-specialty clinic with affiliated hospital and own insurance company in Midwest;
small city;
11% of gross professional charge; decreased to 9% in last several years;
one np, two RNs;
all asc procedures;
50% time doing procedures
start 450k;
4 wks vacation, 2 wka cme;
401k, erp, 457b some matching, caping 50k
high 6 digits W2 income
 
First job - Rural/slightly suburban NE

Private practice 100% pain.
Base $265,000, bonus after first year (never clearly defined what this would have been)
Three weeks vaca with 1 week CME
Equal partner after two years with buy in
All procedures in ASC owned solely by pain group. Ability to buy into this at three years.
Ability to buy into real estate at five years.
Maybe only 10% of the time doing procedures. Alot of med management. Alot of it poorly done prior to me coming in. Alot of resistance to me weaning patients off of high MME to suboxone or getting patients to discontinue concurrent benzos/MJ by managing partners.

Bye-bye.

Current job

Suburban NE
Split Anesthesia/pain 50:50
No pain incentive. Straight salary. Additional income by taking on more call, working longer hours
$435,000 + $25,000 signing. Have to hang around a year to retain sign on bonus.
7 weeks vacay.
Partnership after three years. Income up to around 600,000 after this with eight weeks of vacay.
No med management.
Level 1 trauma center and high risk OB.

Still have my eyes out for a better 100% pain or 80% pain, 20% anesthesia gig. Just doesn't exist in my neck of the woods for right now.
 
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afob100 said:
Hospital employed
Northeast

No base salary, all production
$75/wrvu

Typically 800-900 wrvu per month
$4k CME
$10k director stipend
4 weeks vacation and 1 week CME (although technically there is 0 vacation since I don't earn wrvu during this time)
Click to expand...
Pretty much the same here except no directorship. I need to tell them I’m a director and should be paid as such
 
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clubdeac said:
Pretty much the same here except no directorship. I need to tell them I’m a director and should be paid as such
Click to expand...

Ya, technically I supervise the inpatient pain service (which is just 1 Nurse practioner M-F). When she first started, there were a lot of calls. Now, I rarely hear from her, but I negotiated 10k/yr directorship since she can technically call me any time for help with a consult (even if I'm on vacation).
 
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afob100 said:
Ya, technically I supervise the inpatient pain service (which is just 1 Nurse practioner M-F). When she first started, there were a lot of calls. Now, I rarely hear from her, but I negotiated 10k/yr directorship since she can technically call me any time for help with a consult (even if I'm on vacation).
Click to expand...
doesn't sound like a bad deal
 
Hospital employed
Northeast
50:50 pain:anesthesia
$560k salary + $20k pain stipend
8 weeks vacation
Full benefits (medical insurance, 401k, family leave, CME, etc)
 
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agolden1 said:
First job - Rural/slightly suburban NE

Private practice 100% pain.
Base $265,000, bonus after first year (never clearly defined what this would have been)
Three weeks vaca with 1 week CME
Equal partner after two years with buy in
All procedures in ASC owned solely by pain group. Ability to buy into this at three years.
Ability to buy into real estate at five years.
Maybe only 10% of the time doing procedures. Alot of med management. Alot of it poorly done prior to me coming in. Alot of resistance to me weaning patients off of high MME to suboxone or getting patients to discontinue concurrent benzos/MJ by managing partners.

Bye-bye.

Current job

Suburban NE
Split Anesthesia/pain 50:50
No pain incentive. Straight salary. Additional income by taking on more call, working longer hours
$435,000 + $25,000 signing. Have to hang around a year to retain sign on bonus.
7 weeks vacay.
Partnership after three years. Income up to around 600,000 after this with eight weeks of vacay.
No med management.
Level 1 trauma center and high risk OB.

Still have my eyes out for a better 100% pain or 80% pain, 20% anesthesia gig. Just doesn't exist in my neck of the woods for right now.
Click to expand...
This is awesome! Best of both worlds and making good money and will stay sharp will Anesthsia skills at level 1! Good vacation, where can I sign up???
 
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Greenbayslacker said:
Hospital employed
Northeast
50:50 pain:anesthesia
$560k salary + $20k pain stipend
8 weeks vacation
Full benefits (medical insurance, 401k, family leave, CME, etc)
Click to expand...
Dang didn’t realize the numbers work out well for 50:50
 
TIVAndy said:
shouldn't these kind of discussion go into private forum?
Click to expand...

Why? More physicians should be educated about the financial realities without having barriers to accessing that information. Financial ignorance leads to exploitation of physicians. We shouldn’t contribute to that.
 
Last edited:
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mdo1738 said:
Why? More physicians should be educated about the financial realities without having barriers to accessing that information. Financial ignorance leads to exploitation of physicians. We shouldn’t contribute to that.
Click to expand...
Agree, what's the harm? Lack of knowledge of how your offer stacks up can only hurt.
 
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Yeah I’m curious how a split position would work.
 
Any solo private practice docs wanna chime in ?
 
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thecentral09 said:
Prior employed job
employed-very rural Northeast

base-560 (2 years then only production)
5 weeks PTO
staff-2 part time LPNs onlyu, limited OR/procedure time)
$62/wrvu over 9,000)
(hard to see >800 wRVUs with 2 part time staff

new job
-private practice
Me + 2 midlevels- 225 pts per week. (One mid-level very experienced, one just starting.)
this will be the first month where our office is open and doing procedures in office. Hopefully bringing in 150 to 175K per month Revenue.
Click to expand...
What does 150-175 in revenue translate to in earnings?
 
1.2 million…if no mid levels
 
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@thecentral09 you are over staffed with your NP’s. That is only 75 visits per provider per week. You need 1 or no mid level providers at your current volume.
 
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BillsMafia28 said:
Does that mean you’re always “on call” or do you have someone else field calls in off hours?
Click to expand...
We have strict rules for refills of meds in that no refills made after hours or weekends. If pain worsens go to ER. As far as procedures, I don't do pump or stim implants anymore so any complication happens pretty quick usually. I will not schedule procedures if I am going to be out of town a few days prior. Give staff instructions when I am out so very little if any "Call"
 
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40%. If u are collecting 2million your overhead % should be relatively lower
 
What does the "overhead" include? Staffing costs? Rent? Payroll taxes? Health insurance? All of the above?
 
Fungible number depending on your goals.

Lower ur taxable income- increase retirement contributions

Sell to PE -decrease the rent u pay yourself

Have an employee who splits overhead-pay your wife as marketing director
 
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Are you splitting costs on the locations? You are going to get eaten up with overhead with two locations if not.
 
Fpg1245 said:
Yeah I’m curious how a split position would work.
Click to expand...
It's not that complicated. For whatever reason, this is a fairly popular option in the Northeast and I can think of several groups that staff this model. In most of these situations, the group is looking for an anesthesiologist who also happens to do pain. Meaning, you primarily function as an anesthesiologist (80-55% of the time) and have some clinic days interspersed with this.

You still are in the call pool with the other anesthesia folks. Most of these gigs are no medication management which can make them attractive. More often than not (but not always), you are straight salaried based on your anesthesia work. Supplemental income is gained either by taking additional call or making partner (if available), but you aren't incentivized by procedures.

Vacation tends to be higher than straight pain jobs (6-10 weeks), but comes at the cost of taking call.

One of my cofellows has a job with four days a week of pain, one day of anesthesia with may be a weekend of call a month and six weeks of vacation. His days of pain are consistent. My schedule since I moved jobs is a little more variable. Pain days are randomly intermixed with anesthesia days which can be a bit of a nightmare for our schedulers, but they make it work.

As some others in the past have noted, one complication is trying to keep both sets of knowledge (anesthesia and pain) up to date. To offset this, Some of these split jobs, keep things very simple on the pain side. Essentially the pain physicans are only doing ESIs, no RFA or advanced procedures. Other places, they pain physicians might not be on more complex case teams (i.e. Neuro or thoracic), but spend more time staffing regional.
 
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agolden1 said:
It's not that complicated. For whatever reason, this is a fairly popular option in the Northeast and I can think of several groups that staff this model. In most of these situations, the group is looking for an anesthesiologist who also happens to do pain. Meaning, you primarily function as an anesthesiologist (80-55% of the time) and have some clinic days interspersed with this.

You still are in the call pool with the other anesthesia folks. Most of these gigs are no medication management which can make them attractive. More often than not (but not always), you are straight salaried based on your anesthesia work. Supplemental income is gained either by taking additional call or making partner (if available), but you aren't incentivized by procedures.

Vacation tends to be higher than straight pain jobs (6-10 weeks), but comes at the cost of taking call.

One of my cofellows has a job with four days a week of pain, one day of anesthesia with may be a weekend of call a month and six weeks of vacation. His days of pain are consistent. My schedule since I moved jobs is a little more variable. Pain days are randomly intermixed with anesthesia days which can be a bit of a nightmare for our schedulers, but they make it work.

As some others in the past have noted, one complication is trying to keep both sets of knowledge (anesthesia and pain) up to date. To offset this, Some of these split jobs, keep things very simple on the pain side. Essentially the pain physicans are only doing ESIs, no RFA or advanced procedures. Other places, they pain physicians might not be on more complex case teams (i.e. Neuro or thoracic), but spend more time staffing regional.
Click to expand...

Im not in anesthesia but I think it would also work perfectly dividing up my time like that.
 
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