Academics vs Private Practice

[count2ten]

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I was just curious if anyone had any idea of how much academic anesthesiologists made. I did a google search regarding this and I did find a pretty detailed survey study about Emergency Medicine faculty attendings making about $150 K/year (this was in 1998, it's probably more like 170 now) working on average 40 hours/wk (20 hours clinical duties, 20 hours non-clinical duties). I would also like to start a discussion regarding the pros and cons of having a academic job vs private practice job. Here's some things to start off with:

Some comparisons:
1. Employee benefits--Academics get lots of employee benefits ie free health/dental insurance, free malpractice insurance, often discounted life/disability insurance etc. For privates malpractice MAY be included but probably not.

2. Income--Academics have a lower income (by how much I don't know, hope someone here will enlighten me on this) where in private you have the potential to make way more $$$ (250K+). Another flip side of this in academics your income is generally pretty stable and predictable regardless of the amount of work you do or how well insured the patient is (can be good or bad depending on how you look at it)

3. Day to day workload--For academic: Most of the actual clinical work/OR monitoring time is done by residents, freeing you from the boring part of simply monitoring vitals/charting once the patient is stabilized and allowing you to take lots of breaks during the day. In private: Unlikely any such luxury, usually do all your own cases unless you supervise other CRNA's.

4. Miscellaneous duties: Academics may have to do administrative and/or research which may or may not appeal to you. For privates usually there is no such obligation

5. Call schedules: Not really sure about this one, anyone care to enlighten me?

6. Job availability: If there is a particular location you really want to live, especially if its a big city, it is generally much easier to find an academic job in that location than a private job.

7. Vacation time: My impression is that academic and private is pretty similar.

Thoughts anyone?

 

[Goose...Fraba]

great post, I hope we get alot of people to throw in what they know, as I have been thinking about this myself.

One thing though, as far as vacation goes, I would think academics would offer a better vacation schedule compared to private practice?

 

[Laurel123]

At my program in academics,

The attendings make $220K. They have five weeks vacation. They work 7-4pm five days a week. Malpractice, health and dental are all taken care of. Sometimes one of two of those days, instead of working the day shift, they will do a night call. 12 hour shift.

If they stay late the one day, they often get out around 1 or 2 the next day.

It's a pretty good deal - if you want to work with residents.

Don't know anything about the private world! But I am eager to hear some details.

 

[jwk]

That would make another good political thread 😉

Hospitals employing CRNA's in rural areas can "pass through" their extra costs (using Medicare Part A) involved with having CRNA's available for cases. That same pass-through does not apply to anesthesiologists.

 

[count2ten]

At my program in academics,

The attendings make $220K. They have five weeks vacation. They work 7-4pm five days a week. Malpractice, health and dental are all taken care of. Sometimes one of two of those days, instead of working the day shift, they will do a night call. 12 hour shift.

If they stay late the one day, they often get out around 1 or 2 the next day.

It's a pretty good deal - if you want to work with residents.

Don't know anything about the private world! But I am eager to hear some details.

I'd probably have to say those attendings are paid pretty damn well considering the amount of actual work they have to do. I think that level of income for academics is above the norm as it is not all that far from a private practicing physician who does that similar amount of work. That being said, what was the academic rank of those attendings you mentioned? Were they tenured faculty members, associate professors, assistant professors, or department heads/directors? Academic rank does seem to make a difference in salary. I'm also curious, which program are you at and how did you find out that info?

 

[jetproppilot]

I'd probably have to say those attendings are paid pretty damn well considering the amount of actual work they have to do. I think that level of income for academics is above the norm as it is not all that far from a private practicing physician who does that similar amount of work. That being said, what was the academic rank of those attendings you mentioned? Were they tenured faculty members, associate professors, assistant professors, or department heads/directors? Academic rank does seem to make a difference in salary. I'm also curious, which program are you at and how did you find out that info?

OK Dudes, heres my take on the academic vs private practice thing.

ACADEMIA:

1)Surrounded by academics, which is good when you're right outta residency. Motivates you to study (for your boards). Alot of time to study since you're doing very little grunt work.
2)Research opportunity, if you are so inclined.
3)Relatively few night calls at some places. The problem, though, is call distribution, at least at the places I'm familiar with, is not equal. The old time tenured dudes may not take ANY night call and are probably making more money than you. Night call is the nemesis of this business. It sucks. It makes you old before your time if you do alot of it. And if you're in at place where the younger dudes do more (if not all) of the call, it doesnt bother you at first, but it will bother you eventually and make you resentful. Thats why successful private groups distribute call evenly, whether you've been there one year or twenty years.
4)Low pay relative to non-academic jobs.
5)Low vacation compared to non-academic jobs, usually in the 4-5 week range. Many private groups have 9+ weeks vacation.
6) LONG cases. Lap chole 2-3 hours, ELAP 3-5 hours, TAH 2-3 hours, CABG...well we wont even go there.
7)Teaching: teaching residents is fun. I'd love to teach, to tell you the truth.
8)Comraderie: If you're in a likeable place this could be very positive, making your work day fun.
9) Incredible OR inefficiency, which gets real old real fast.
10)Obstructionalist attitude, which also gets old. Instead of saying "what can I do RIGHT NOW to get this case done? its.. "what stupid study do we need that hasnt been done?" or cancelling a case for a low Na, a minimally elevated K+, the medicine doc hasnt seen the patient yet even though they were (needlessly) consulted yesterday, etc etc
11) Someone mentioned good benefits. Health, Malpractice insurance are usually pretty good. Most places have it set up so your kids can go to the affiliated college for a big discount, or even free. This is a big attraction. One of the heart surgeons I know just left his practice for the local academic center, and this was a big factor, since he's got several young ones.
Retirement and life insurance are typically not as good as with a private group.

PRIVATE PRACTICE
1) Hard work, but this is offset by the fact that you make your own schedule, and most places have it set up so you have double or triple the vacation time over the academic dudes.
2)The ability to make a difference concerning OR efficiency, start times, and turnover times.
3)Pay: The skies the limit. No comparison in income potential compared to academics.
4)More night call than academics.
5)Usually few nightmare cases. Quick cases..lap chole 30-45 minutes, TAH 45 minutes to an hour, total knee 1.5 hours, CABG 3 hours. Although you still have some slow surgeons. Not as prevalent as academics, though.
6)Benefits are usually MUCH better. Most groups have it set up where you maximize your annual tax deferred investments (>40K annually), better health insurance, etc

I'd still say theres no comparison (Private better than academics) but academic centers, it seems, are seeing the light and raising salaries somewhat.
I'd love for academic medicine to change and be more attractive. Maybe it will someday.

 

[Laurel123]

I'd probably have to say those attendings are paid pretty damn well considering the amount of actual work they have to do. I think that level of income for academics is above the norm as it is not all that far from a private practicing physician who does that similar amount of work. That being said, what was the academic rank of those attendings you mentioned? Were they tenured faculty members, associate professors, assistant professors, or department heads/directors? Academic rank does seem to make a difference in salary. I'm also curious, which program are you at and how did you find out that info?

The stats that I stated are for full time attendings, starting from day 1. It might be higher for tenured attendings and attendings that take like cardiac, pedi or liver call. I don't know. I know that the older associate professors don't ever have to take any weekend or night call if they don't want to, but I don't know if they are paid more. The attendings also have academica responsibilities, like giving lectures and stuff.

But otherwise, it is a pretty good deal if you want to deal with the headaches of teaching residents and the politics of the university.

If you want to know exactly where this is, I will email it to you.