Academic Neurology combined with private practice

[BrianUM]

Hey everyone,

I had a question regarding the viability of working as an academic physician and having a part time private practice on the side.

There is a neurologist at my school who is the clerkship director and works as an academic neurologist. However, she also mentioned that she has her own private patients.

How common is this? I am interested in both Interventional Neurology and in Behavioral Neurology and was wondering if it would be feasible to be an academic neurologist specialzing in Behavioral Neurology (research, teaching, clinic) and to have a base salary of say 130-150 k from the school and also have a part time (maybe 15 hrs/wk) general neurology/behavioral neuro private practice to further add to my salary to possibly bump it up above 200 k.

Thanks in advance

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[typhoonegator]

I'm not sure I know what you mean by "private practice". Do you mean a separate stand-alone business entity? Joining a community group with admission privileges? Or just having patients you call your own?

If you join a department at an academic medical center, then you work for them. They pay you a salary, which may or may not have some incentives for productivity goals, like seeing X number of patients per year in clinic, or generating X billing units. Right out of residency, you usually will be expected to spend some time on the consult service, the inpatient service (if they have one) and in clinic. If you have a big research grant like an R01, then you have your own money which can lead to a contract that allows you to spend more time doing your research and less on clinic and whatnot.

Most clinicians in an academic medical center will have at least a half-day of clinic per week, and if you're going into Behavioral, then probably significantly more than that. As you build up your portfolio, these patients will be referred to see YOU, and they will become YOUR patients, to be followed longitudinally and done with as you see fit. In that sense, they are somewhat like your private patients, but the practice still belongs to the department. As I mentioned above, there are some incentives for people who generate a lot of billing, but usually not to the same degree as you'd see in private practice. Most of the attendings in my department see billing as a pain, and have to be flogged even to get credit for their time.

Now, at some hospitals there are community private practice groups that attend on the ward services of the affiliated academic medical center, and therefore they spend some amount of time teaching and seeing ward patients. However, this is more unusual, and gets somewhat complicated. However, those physicians would probably hesitate to call themselves "academic neurologists" because 90% of the time they are at their freestanding clinic generating money for the practice. Because they are not actually employed by the medical center, getting grants approved and getting lab space would be nigh-impossible, and why would the partners of the practice allow you to spend less time generating money in clinic to pursue your research goals?

Bottom line, you get to see you "own" patients in your clinic through your academic appointment. You could theoretically sign a part-time contract with both an academic center and a private practice, but you would get paid half a salary, and your life would likely be a living-hell, because neither would really be a part-time job.

By the way, a base salary of 150K for a new hire at an academic center is pretty high.

 

[neurologist]

Hey everyone,

I had a question regarding the viability of working as an academic physician and having a part time private practice on the side.

There is a neurologist at my school who is the clerkship director and works as an academic neurologist. However, she also mentioned that she has her own private patients.

How common is this? I am interested in both Interventional Neurology and in Behavioral Neurology and was wondering if it would be feasible to be an academic neurologist specialzing in Behavioral Neurology (research, teaching, clinic) and to have a base salary of say 130-150 k from the school and also have a part time (maybe 15 hrs/wk) general neurology/behavioral neuro private practice to further add to my salary to possibly bump it up above 200 k.

Thanks in advance

Interesting question, especially the behavioral neurology aspect, because one of the faculty at my residency did exactly that as a behavioral neuro subspecialist. He was full time at the hospital, but then also part time with a private neuro/psych group. He would see patients there occasionally "after hours" from his regular job (I guess after 5 pm or maybe even on weekends).

This is basically a form of moonlighting. I doubt that your primary academic job would allow you time off from regular duties to go work privately -- you'd have to do it on your own time. Also, if you're hospital employed, you may need to get their sign-off to do any moonlighting.

So, yes, it's possible, but probably not done too much. Another angle to consider would be to join a private practice group that is tied in with research studies and has a teaching affiliation. There are any number of large neuro practices that do this. This might be another way to keep up your interest in academics but maybe make more $.