Current MGMA for anesthesia pain?

[Paindude11]

Can someone please link the recent data?

Salary or %ile estimate for southeast for my scenario?

PP anesthesia IPM practice with sole ASC on site, lab on site, pt/rehab on site. Partnering in ASC is not an option at this time, but just looking for comps.
2 days clinic/2 days ASC per week.
I average about 160 ASC cases per month
and 60-80 NE, OV, in office (non fluoro) procedures on clinic days. Several midlevels billing under me as well.

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[Bostonspine]

Probably want to post that on the private forum so you can give more details and get more answers

 

[drusso]

Can someone please link the recent data?

Salary or %ile estimate for southeast for my scenario?

PP anesthesia IPM practice with sole ASC on site, lab on site, pt/rehab on site. Partnering in ASC is not an option at this time, but just looking for comps.
2 days clinic/2 days ASC per week.
I average about 160 ASC cases per month
and 60-80 NE, OV, in office (non fluoro) procedures on clinic days. Several midlevels billing under me as well.

This looks like 90%tile+. You should be very prosperous.

 

[Paindude11]

Probably want to post that on the private forum so you can give more details and get more answers

Thanks.

 

[paindoc007]

50th Percentile should be around 400-420k/year range

 

[Aether2000]

Every Medicare and Anthem patient you do in an ASC (where you are not a partner/owner) will lower your income significantly- by about 60% for those patients due to site of service differentials.

 

[Paindude11]

Probably want to post that on the private forum so you can give more details and get more answers

I will apply for membership, but I haven'

Probably want to post that on the private forum so you can give more details and get more answers

thanks. i can not get on the forum yet according to the criteria on that thread. i could not remember the email i used to open my account in residency and had to sign on as a new member. i will get on it when i can.

 

[Disciple]

Every Medicare and Anthem patient you do in an ASC (where you are not a partner/owner) will lower your income significantly- by about 60% for those patients due to site of service differentials.

That’s a 60% decrease, after taking into account the overhead associated with the in-office procedure room, vs. no overhead at the surgery center?

 

[Paindude11]

I don't think the medicare anthem situation applies in this situation, as the other 2 physicians are the full owners of the ASC and all of our procedures are done there? I am an employee and I would think I would be reimbursed at the same rate as the owners based on their insurer contracts with their ASC. Maybe I am not following...?

 

[DODOCSS]

I don't think the medicare anthem situation applies in this situation, as the other 2 physicians are the full owners of the ASC and all of our procedures are done there? I am an employee and I would think I would be reimbursed at the same rate as the owners based on their insurer contracts with their ASC. Maybe I am not following...?

No, you’re not

 

[bronchospasm]

Here it is

 

[sniderwes]

I'm an MS4 going into anesthesiology considering pain. A published study shows general anestheiaa working 58 hours a week avg, what is that figure like for pain?

 

[Biohazard685]

I'm an MS4 going into anesthesiology considering pain. A published study shows general anestheiaa working 58 hours a week avg, what is that figure like for pain?

Don't go into a subspecialty based on average hours a week.

Workload is so location and practice dependent.

I know friends that average 45 hours a week getting paid handsomely doing general anesthesia locums at amazing places.

Same for pain. Some ppl are in low volume practices averaging 40-50. Some ppl are killing it at mature practices averaging 60+.

Do not let some BuzzFeed/Medscape clickbait BS article influence your decision on choosing a subspecialty. Make sure you like chronic pain management first.

 

[willabeast]

I'm an MS4 going into anesthesiology considering pain. A published study shows general anestheiaa working 58 hours a week avg, what is that figure like for pain?

I did pain for 20+ years. also did only "general anesthesia" for 9 years. Hours were about the same but there is a big difference. when you do anesthesia you usually (but not always) have night and weekend call. IMHO it is the nights and weekends that are by far the worst hours. I would gladly work more hours per week in exchange for no nights and weekends. BTW IMHO the best lifestyle specialty for the money is dermatology with a path fellowship. It is so much better than anything else there is really no comparison. If you have to do anesthesia, aim for a full time job in a surgi center. In the right setup 90% collection rate, no nights or weekends. Also remember that if a job is really good, there will be a lot of people wanting to steal your job, and will happily do whatever it takes to obtain it. The really great jobs seldom go to applicants fresh out of training.

 

[sniderwes]

Don't go into a subspecialty based on average hours a week.

Workload is so location and practice dependent.

I know friends that average 45 hours a week getting paid handsomely doing general anesthesia locums at amazing places.

Same for pain. Some ppl are in low volume practices averaging 40-50. Some ppl are killing it at mature practices averaging 60+.

Do not let some BuzzFeed/Medscape clickbait BS article influence your decision on choosing a subspecialty. Make sure you like chronic pain management first.

I don't mean to imply I would go into a subspecialty solely for good hours. I didn't choose to go into radiology because I wouldn't enjoy it as much as anesthesiology despite anesthesiology having worse hours. But I also didn't end up choosing urology because I knew working 80-100 hours a week during residency would destroy the other parts of my life.

It's another factor towards making an informed decision for something I will be doing for the next few decades, and averages/median are a pretty good figure to know. If I enjoy the work of anesthesiology and pain similarly, and one is 50 hours no call/weekends vs. 58 hours with call, I know which one I would choose. I suspect that's a reason half the CA-3's at my institution applied for pain last year.

 

[Aether2000]

Pain without any call obligations is sometimes considered patient abandonment. For instance: you do a discogram on a patient on Friday morning. The patient attempts to call your office about increasing back pain Friday afternoon but does not have their message returned. The weekend finds the patient with severe pain and tells the ER doc they had a back injection but does not know the type of injection or what was injected. The ER doc tries to call you to get details but is unable to reach you. The ER gives the patient a few pills of Percocet and tells the patient to call the pain doctor on Monday. But by Sunday night, the patient has overt disciitis with neuro findings. An emergent CT shows nothing. The patient is admitted to the neurology service who tries to call the pain doc who is unavailable. By Monday morning the patient has developed weakness in both lower extremities, a low grade fever, and the pain is being kept in check with IV dilaudid. A MRI is performed demonstrating disciitis with epidural abscess. Pain doc still not reachable since their office does not open until 9am. By 9am the patient is in surgery having an emergency laminectomy.

Take care in Pain Medicine that you (or another pain physician designee) remain available (i.e. taking call) by telephone and have EMR available at all times so you can assist in consultation. Sometimes it is necessary to operate on the weekends in case of emergencies. The worst case is those doctors that simply have a message on their answering machines after hours "call 911 in case of a medical emergency" without leaving any way for hospitals and other doctors to contact the pain physician.

 

[nvrsumr]

If you are getting phone calls on the weekend as a pain doc you are doing something wrong. That being said of course you have to pay for an on call service that will be used twice a year.

 

[Aether2000]

It is not often you actually receive calls on weekends or nights, but if there is no way for other physicians taking care of your complications (and you will have some, even if you are doing nothing wrong) to reach you or whoever is covering for you, then you are opening yourself to viable malpractice litigation.

 

[willabeast]

Pain without any call obligations is sometimes considered patient abandonment. For instance: you do a discogram on a patient on Friday morning. The patient attempts to call your office about increasing back pain Friday afternoon but does not have their message returned. The weekend finds the patient with severe pain and tells the ER doc they had a back injection but does not know the type of injection or what was injected. The ER doc tries to call you to get details but is unable to reach you. The ER gives the patient a few pills of Percocet and tells the patient to call the pain doctor on Monday. But by Sunday night, the patient has overt disciitis with neuro findings. An emergent CT shows nothing. The patient is admitted to the neurology service who tries to call the pain doc who is unavailable. By Monday morning the patient has developed weakness in both lower extremities, a low grade fever, and the pain is being kept in check with IV dilaudid. A MRI is performed demonstrating disciitis with epidural abscess. Pain doc still not reachable since their office does not open until 9am. By 9am the patient is in surgery having an emergency laminectomy.

Take care in Pain Medicine that you (or another pain physician designee) remain available (i.e. taking call) by telephone and have EMR available at all times so you can assist in consultation. Sometimes it is necessary to operate on the weekends in case of emergencies. The worst case is those doctors that simply have a message on their answering machines after hours "call 911 in case of a medical emergency" without leaving any way for hospitals and other doctors to contact the pain physician.

There are some advantages to working at a vertically integrated HMO. Call might be one of them. If you are in private practice, you are on call 24/7 unless you have partners. Strangely enough I had the following scenario for a patient with problems. 1. advice line or ER 2. a whole bunch of PMR docs to advise the E.R. (they took call in rotation). They also could read MRI images at home, and on their employer issued i phones all with unlimited data plans. 3. ortho spine (above average bunch of spine docs) took care of admissions. Finally, patients could always reach me if they were unhappy. As i recall, that happened once in the last ten years. Not as good as Dermatology however...

 

[pastafan]

Patients can reach me 24/7. I doubt I get called once a year. Before procedures I spend time explaining what to expect and thus head off worried patient calls. The last call I remember happened a few years ago. An elderly patient of mine called me at 6:30 a.m. on a Sunday saying that she had her cataract operation a day or two before and her eye was all red. I explained that I was not her surgeon, asked who did the operation, and looked up his number for her to call. Not worth paying for an answering service IMO.

 

[drusso]

Answering service with scripting for "I ran out of my meds, etc." Then, PA's/NP take first call for issues that can't be resolved by answering service algorithm. Then, 4 MD's rotate in call rotation for issues that can't be resolved at lower levels of intervention. I get 1-2 calls per year...although the last time I was called was for a rheum patient on chronic steroids that I did an injection on who was having bright red blood per rectum, tachycardic, diaphoretic, SOB, etc.

Sometimes you have to be real doctor to this job...

 

[Biohazard685]

I don't mean to imply I would go into a subspecialty solely for good hours. I didn't choose to go into radiology because I wouldn't enjoy it as much as anesthesiology despite anesthesiology having worse hours. But I also didn't end up choosing urology because I knew working 80-100 hours a week during residency would destroy the other parts of my life.

It's another factor towards making an informed decision for something I will be doing for the next few decades, and averages/median are a pretty good figure to know. If I enjoy the work of anesthesiology and pain similarly, and one is 50 hours no call/weekends vs. 58 hours with call, I know which one I would choose. I suspect that's a reason half the CA-3's at my institution applied for pain last year.

My bad. In that case, it's easier to be more flexible with your schedule in pain than compared to anesthesia. Most anesthesia groups in my state are owned by mega corps.

 

[Ducttape]

if you enjoy pain and anesthesiology equally, then do both.

of course, that does mean sacrificing a year to do the pain fellowship, but over time you might find yourself gravitating towards one or the other.

 

[jimmy johnson123]

Here it is

How accurate are these MGMA surveys?

It seems like the median dropped by 25K since last year.

Also when they give the "compensation", does that include 401K benefits?

 

[Fpg1245]

How accurate are these MGMA surveys?

It seems like the median dropped by 25K since last year.

Also when they give the "compensation", does that include 401K benefits?

If you look at the prior thread on this from 2014 the decline is even more stark. Median is down much more. 90th percentile even a few years ago was over well 800K and now it’s coming down to mid 700s. Even on the low end it’s barely budged.

 

[Frogger27]

If you look at the prior thread on this from 2014 the decline is even more stark. Median is down much more. 90th percentile even a few years ago was over well 800K and now it’s coming down to mid 700s. Even on the low end it’s barely budged.

What's the reason for this? Expecting this trend to continue?

 

[Fpg1245]

What's the reason for this? Expecting this trend to continue?

Not really in a position to say but it is happening.

My shoot from the hip analysis is that CMS cuts and reduced networks with smaller network coverage for the private payors. Loss of existing patient population referral base. Big hospital takeovers with loss of ownership. More providers fighting over a shrinking patient populations. I mean it’s probably all the standard structural stuff that’s destroying all of medicine. Plus the new govt craze with treating all opioid prescribers as a criminal class probably doesn’t help either.

 

[SeniorWrangler]

Insurance companies cracking down on overutilization and making life more difficult for everybody.