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Looking at the current job market academic or private: Is doing a year of ACGME accredited HF fellowship worth it ? Can anyone comment on the lifestyle and salaries... thanks
Looking at the current job market academic or private: Is doing a year of ACGME accredited HF fellowship worth it ? Can anyone comment on the lifestyle and salaries... thanks
Looking at the current job market academic or private: Is doing a year of ACGME accredited HF fellowship worth it ? Can anyone comment on the lifestyle and salaries... thanks
I will echo some of what others have been saying. The specific market for HF-trained cardiologists out there in private practice is exceedingly small. I know two people who do it: both are in extremely large single-specialty groups and even then they are mostly doing general cardiology. Almost all of these jobs are going to be at transplant centers. At the five transplant centers that I have had some degree of personal experience with, four of them boasted only one or two HF docs who were working themselves to death. The reimbursement:work ratio in these scenarios is probably the least favorable in all of cardiology.Looking at the current job market academic or private: Is doing a year of ACGME accredited HF fellowship worth it ? Can anyone comment on the lifestyle and salaries... thanks
Hmm, I was told by one of our fellows that the job market for HF is the best out of any of the cardio subspecialties. I also heard that EP is basically over-saturated in any city with >500k people. From your guys' experiences, which of the subspecialties looks the best going forward?
Hmm, I was told by one of our fellows that the job market for HF is the best out of any of the cardio subspecialties. I also heard that EP is basically over-saturated in any city with >500k people. From your guys' experiences, which of the subspecialties looks the best going forward?
Looking at the current job market academic or private: Is doing a year of ACGME accredited HF fellowship worth it ? Can anyone comment on the lifestyle and salaries... thanks
I've heard the same thing about EP.
Also, even out in the boonies, you might have some difficulty getting ICD/PPM referrals. Again, other's experiences may be different than mine, but I've seen a lot of these private guys who've been doing ICD's for years without any EP fellowship training. They aren't just going to start throwing their device placements your way because you've set up shop in their neighborhood. Those procedures pay well - they're going to keep them for themselves. I've seen this even within a group itself.
I haven't seen much of a difference between interventional and non-invasive opportunities, at least from the email spam I get. Lots of offers in places of around 100k population. Usually around 300-400k to start. Interventional paying maybe 50k more per year, so not really worth the extra training unless it's something you enjoy, IMO.
I agree that the difference between noninvasive and interventional salaries is not much up front, but it is often quite significant a few years in. Interventional guys just have an easier time generating RVU's because they can do so many more billable procedures, some of which reimburse quite well especially in the peripheral realm (Including venous procedures such as EVLT). It is not uncommon for the difference in income to be 100-200k. But given the added call responsibility, I agree that it's still not worth it unless it's something you enjoy.
As for the original question regarding heart failure fellowships, I agree with the consensus opinion that it is only worth while if you want to work at a transplant center and enjoy taking care of very sick patients.
As a HF boarded cardiologist, why don't I provide some actual experience and perspective.
It is true that the payoff in private practice may not be worth it. You'd have to be part of a large group with enough patients who need that expertise. It certainly doesn't make sense to get this certification if you're going solo (but who is nowadays?).
Remember that the landscape is changing. Groups are affiliated with hospitals, and in the future more and more community hospitals will be implanting LVADs, both as destination therapy (if not affiliated with a transplant center) or BTT. Who is going to take care of those patients in the community? Certainly not a general cardiologist. Transplant volume is flat, but VAD volume is skyrocketing. That's why HF is attractive as a field - there's a lot of sick patients that need advanced therapies that a general cardiologist isn't equipped to care for.
I'd also be careful about generalizing one center's experience to all HF jobs. OHSU cardiology is/was a ****storm, but I think that says more about the institution rather than HF as a specialty.
As far as reimbursement, remember that HF specialists spend a lot of time in the CCU (critical care billing) and do perform procedures (RHC, absymal reimbursement, I know, but also VAD interrogation). No HF specialist I know is making 100K more as a hospitalist; again that example says more about the debacle that is OHSU than anything about HF cardiology as a profession. I enjoy taking care of these challenging patients, and the compensation matches up.
I'd recommend pursuing the fellowship if you want to practice in a VAD/transplant center, which again does not have to be an academic center, but could easily be in the community.
p diddy
Anyone have an update on the current advanced heart failure job market? Is it mostly academia or are there private jobs available? Can any current advanced heart failure physician comment on their current day to day experience? Thanks.
Anyone have an update on the current advanced heart failure job market? Is it mostly academia or are there private jobs available? Can any current advanced heart failure physician comment on their current day to day experience? Thanks.
The current advanced heart failure job market is even stronger than it was when I last posted, because as expected, non academic VAD centers have proliferated. There are probably more non-academic than academic jobs available now.
re: day to day experience, it's different for every HF specialist. I read echos, do RHC/LHC/biopsy, inpatient and outpatient HF service. PM me for details.
re: compensation, it is quite good. for a benchmark, you can look at academic salaries and extrapolate upward. state universities often have to post all salaries for public view. one of the best sites I've seen for this is
type in 'Eric Adler,' Teresa De Marco,' and 'Ali Nsair' for examples of academic HF salaries. Those are directors so their underlings make less, but I know that private practice HF makes more than that yearly.
p diddy
The current advanced heart failure job market is even stronger than it was when I last posted, because as expected, non academic VAD centers have proliferated. There are probably more non-academic than academic jobs available now.
re: day to day experience, it's different for every HF specialist. I read echos, do RHC/LHC/biopsy, inpatient and outpatient HF service. PM me for details.
re: compensation, it is quite good. for a benchmark, you can look at academic salaries and extrapolate upward. state universities often have to post all salaries for public view. one of the best sites I've seen for this is California's:
All salaries | Transparent California
type in 'Eric Adler,' Teresa De Marco,' and 'Ali Nsair' for examples of academic HF salaries. Those are directors so their underlings make less, but I know that private practice HF makes more than that yearly.
p diddy
What does "other pay" refer to? Is that for consulting, research funds etc?
I agree.....I am HF and interventional trained with a 50/50 split of the two. You can get a good job doing HF easily. My salary is north of 475K not including bonus. Best thing I did was do my HF year. However pp HF is very difficult to do.
How is the break down of your typical day as a HF specialist? Are you seeing mostly patients in the CCU? Do you see patients with the generic NYHA II and III HF? Do you read nucs, as well as do echos, RHC/LHC/Bx?
How is your total RVU generated? Do you have a lower minimum then other cardiologists?
Are there jobs in metropolitan center or are the jobs mostly in rural community hospitals starting a VAD program?
Appreciate you response to these questions.
How is the break down of your typical day as a HF specialist? Are you seeing mostly patients in the CCU? Do you see patients with the generic NYHA II and III HF? Do you read nucs, as well as do echos, RHC/LHC/Bx?
My day is broken down into gen/IC cards where I read nukes, echoes And round on afib, chest pain. This provides me with plenty of IC volume. I am on pace for 150+ PCI’s. I also all the interventional work for the HF team. Never lose your roots.....it will provide you your volume. I also do weeks on service for the transplant team.
How is your total RVU generated? Do you have a lower minimum then other cardiologists?
I have the rvu’s for IC not HF. I have been working 4 months and will be ~4,000 rvu’s over target so about 14,000.
Are there jobs in metropolitan center or are the jobs mostly in rural community hospitals starting a VAD program?
I am on the coast in the southeast. PM me...
Appreciate you response to these questions.
Is anyone able to answer my questions?
Thanks.
How is the break down of your typical day as a HF specialist? Are you seeing mostly patients in the CCU? Do you see patients with the generic NYHA II and III HF? Do you read nucs, as well as do echos, RHC/LHC/Bx?
How is your total RVU generated? Do you have a lower minimum then other cardiologists?
The current advanced heart failure job market is even stronger than it was when I last posted, because as expected, non academic VAD centers have proliferated. There are probably more non-academic than academic jobs available now.
re: day to day experience, it's different for every HF specialist. I read echos, do RHC/LHC/biopsy, inpatient and outpatient HF service. PM me for details.
re: compensation, it is quite good. for a benchmark, you can look at academic salaries and extrapolate upward. state universities often have to post all salaries for public view. one of the best sites I've seen for this is California's:
All salaries | Transparent California
type in 'Eric Adler,' Teresa De Marco,' and 'Ali Nsair' for examples of academic HF salaries. Those are directors so their underlings make less, but I know that private practice HF makes more than that yearly.
p diddy
At a non-academic LVAD/ecmo center just outside a major US city.
My day differs whether I'm inpatient or outpatient. Our CHF guys rotate through inpatient for a week every 3 weeks. Outpatient is straight forward. I see mainly Nyha III and IV. I get longer for pts given they tend to be more complex than the 27 yo with palpitations.
Inpatient is ICU work (hf runs the CCU) and consults on the floor. I do TEEs and procedures in the ICU if needed but can use Cath Lab if I'm busy. I do rhc but no Lhc. I do little echo reading other than the stuff only CHF should read (lvad turndown or ecmo turndown echos) and read no regular Nucs. I generate 7-8k rvu and am non-rvu based. Unless you read a ton of echos, it is more difficult to generate RVUs so an Rvu model will screw you. However you will generate a **** ton of high paying procedures for everyone else. As others have said, go to a place that values that. My place does and make mid-fives.
I have been several years in practice as an AHF cardiologist. I was hired by a large group which was merging with a large health system at the time.
I practice exclusively advanced heart failure. I am about 1:6 weeks on call for AHF service which includes VAD, transplant, cardiogenic shock, etc. We also have a general heart failure inpatient service. In clinic I see a lot of genetic cardiomyopathies, amyloidosis, sarcoidosis and such in addition to general heart failure.
I do RHC, biopsies and read echos. I have a little time for admin and research. Our institution is a private tertiary center with a direct medical school affiliation, thus a “hybrid” model.
I have been very fortunate that we are on a strict salary basis with only 2 tiers: Intervention/EP and all other cards. I really have no idea what RVUs I generate. We have longer appointment slots in HF because the patients and decisions are more complicated. The system recognizes that a robust AHF/VAD/Tx program brings in a LOT of new referrals who get caths, ICDs, cardiac MRIs, VADs, transplants, etc. which bring a lot of revenue even though us AHF docs don’t bill those RVUs.
The salary is excellent especially being independent of RVUs. This was not a main driver of my decision, although I looked at many jobs including academic positions which seemed to have a similar workload (call burden, limited protected time) for half the salary.
This is an excellent field and job market for those who love it. There does seem to be a lot of movement and turnover but I’ve fortunately avoided that. There do seem to be a lot of private jobs starting new programs which do not seem appealing, either due to workload, uncertainty or not actually in a VAD+/- transplant program.
Thanks.
Is there any scenario where the AHF docs are doing more procedures (other than LHC, RHC, biopsies)? Any AHF docs who put in their own short temp MCS device (ie impellas, IABP etc)? CardioMEMS?
Thanks.
Is there any scenario where the AHF docs are doing more procedures (other than LHC, RHC, biopsies)? Any AHF docs who put in their own short temp MCS device (ie impellas, IABP etc)? CardioMEMS?
Do you read your own cMRI? Is there any benefit to having the skill to read your own cMRI as a AHF doc?
I agree that salary should not be a main driver, but it does play a role in any decision.
At a non-academic LVAD/ecmo center just outside a major US city.
My day differs whether I'm inpatient or outpatient. Our CHF guys rotate through inpatient for a week every 3 weeks. Outpatient is straight forward. I see mainly Nyha III and IV. I get longer for pts given they tend to be more complex than the 27 yo with palpitations.
Inpatient is ICU work (hf runs the CCU) and consults on the floor. I do TEEs and procedures in the ICU if needed but can use Cath Lab if I'm busy. I do rhc but no Lhc. I do little echo reading other than the stuff only CHF should read (lvad turndown or ecmo turndown echos) and read no regular Nucs. I generate 7-8k rvu and am non-rvu based. Unless you read a ton of echos, it is more difficult to generate RVUs so an Rvu model will screw you. However you will generate a **** ton of high paying procedures for everyone else. As others have said, go to a place that values that. My place does and make mid-fives.
In my group AHF and all noninvasive cardiologists are on a salary determined by a blend of multiple national salary benchmarks. There are incentives above that for meeting certain predetermined individual and group goals. These are not RVU goals but things like quality, leadership, teaching, scholarship etc.So how exactly is the salary of an AHF doc determined if it is not based on RVUs?
Yeah there is a steep drop off.
Look at some of the other people at UCSF with Demarco. Google names but one made like < 200k to start. Now making ~250 in San Fransisco. You can barely afford a studio appartment and a hot plate for that in SF...
Obviously I'm kidding but academic salaries rarely reach the names you're posting
In what world are heart transplants/lvad etc happening in non academic centers?Bumped this question up. I'm applying for AHF this cycle. I really like it , in fact is the sub that I like the most but I don't want to be in an academic settings. Is the private practice creating more positions for it now? Is the field generating more wRVU than in the past? How type of salary should I expect? How is the job market?
Thanks.
lots of DT LVAD programs out in the community; handful of private institutions do transplant as well.In what world are heart transplants/lvad etc happening in non academic centers?
Eh I don't think so, I think chf will be a 5-10% premium over general cardiology. The thing is that 95% of what chf does is basically gen cards, eg clinic, echo, nuke, consults. They might have some cath time but honestly cath isn't even a money maker nowadays. I could have applied for lhc/rhc privileges and tried to fight for 0.5 days in the lab. When you do the math, doing clinic in lieu of cath is better financially. So on paper, chf is basically gen cards. It's up to institutions to see if having someone chf trained is worth paying extra for that expertise beyond what their billings would suggest (eg txp/vad referrals). Having the ability to run a vad/txp program can be extremely lucrative and this is where that premium can come in for chf docs.Median pay for 5 cardiology subspecialties
Interventional cardiologists are the top earners among all cardiologist subspecialties, according to a new report from MedAxiom, an American College of Cardiology company.www.beckershospitalreview.com
It's coming up. I predict that in 5 years it'll match IC and 10 years exceed IC.
For an unmatched applicant to Cardiology, are these positions viable or even available for a graduating PGY-3 (not me, just curious as an anxious PGY-2...)62% of the HF fellowship spots went unmatched this cycle, many at big name places. It’s an under appreciated specialty, brings a lot of downstream revenues ( ie ICDs, LHCs, LVAD work ups, millions of CT scans..etc) that’s not directly reflected by itself. It might be simply limited to the exposure I had during my training. But personally, it’s patient population and the constant ego battle that drove me away from HF.
They are if they are desperate and this route can be a viable path to match the following year if you went unmatched. However, keep in mind if you do a AHF fellowship before Gen Card, it’s not ACGME accredited and if you want to be board certified in HF you will have to do a acgme accredited fellowship after general cardiology.For an unmatched applicant to Cardiology, are these positions viable or even available for a graduating PGY-3 (not me, just curious as an anxious PGY-2...)
They are if they are desperate and this route can be a viable path to match the following year if you went unmatched. However, keep in mind if you do a AHF fellowship before Gen Card, it’s not ACGME accredited and if you want to be board certified in HF you will have to do a acgme accredited fellowship after general cardiology.