Employed by hospital as interventional pain physician

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NY172

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Hi, I know you all get asked this sort of question often, but I haven't been able to find a lot of posts/data on SDN on compensation for interventional pain docs who are employed by a hospital/health system as opposed to being in private practice. I would assume majority of pain docs are in private practice but would be interested to see what market is for hospital-employed docs. Thanks! Appreciate everyone's time and feedback.

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Hospital employed docs make around $350-425k starting - depends on location (closer to 400 I would say). Starting pay will generally be higher than private practice ($280-330k). The upside in hospital employed wont be as high- probably max around 600-700 while pp can make much higher depending on setup/ancillaries etc.

Usually hospital employed jobs will have a wrvu structure for bonus while pp will have a collections based structure.
 
Hi, I know you all get asked this sort of question often, but I haven't been able to find a lot of posts/data on SDN on compensation for interventional pain docs who are employed by a hospital/health system as opposed to being in private practice. I would assume majority of pain docs are in private practice but would be interested to see what market is for hospital-employed docs. Thanks! Appreciate everyone's time and feedback.

Why do you want to be employed by a hospital?
 
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Why do employees get so much less than private practice

They don't, PP pay has been dwindling for years. Especially considering $$$/hr; you'll make much more as an employed doc. If you are in PP, you are seeing patients during the day and doing business stuff and meetings at night and on weekends. The real difference is whether you are comfortable with an "administrator" calling the shots and having your future determined by press ganey scores or you want to make the rules at your own place.

disclaimer; this refers to non-pill mill practices.
 
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For new grads, I feel that hospital employed jobs seem like a safer bet - higher starting salary, no false promises of partnership, built in referral base from other hospital docs. But yes, you will have an administrator call the shots for sure.
 
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Hi, I know you all get asked this sort of question often, but I haven't been able to find a lot of posts/data on SDN on compensation for interventional pain docs who are employed by a hospital/health system as opposed to being in private practice. I would assume majority of pain docs are in private practice but would be interested to see what market is for hospital-employed docs. Thanks! Appreciate everyone's time and feedback.
MGMA data is theoretically a mix of PP and employed physicians, but in reality, it would seem it's a much more reliable assessment of employed physicians' compensation. I don't think a private doc or a group of private docs is likely to send (accurate) data to MGMA. Systems don't have as much reason not to give accurate data to such an organization.
 
MGMA data is theoretically a mix of PP and employed physicians, but in reality, it would seem it's a much more reliable assessment of employed physicians' compensation. I don't think a private doc or a group of private docs is likely to send (accurate) data to MGMA. Systems don't have as much reason not to give accurate data to such an organization.

So is pp higher than mgma data on avg?
 
Hospital employed docs make around $350-425k starting - depends on location (closer to 400 I would say). Starting pay will generally be higher than private practice ($280-330k). The upside in hospital employed wont be as high- probably max around 600-700 while pp can make much higher depending on setup/ancillaries etc.

Usually hospital employed jobs will have a wrvu structure for bonus while pp will have a collections based structure.

I would agree with above to a T.


They don't, PP pay has been dwindling for years. Especially considering $$$/hr; you'll make much more as an employed doc. If you are in PP, you are seeing patients during the day and doing business stuff and meetings at night and on weekends. The real difference is whether you are comfortable with an "administrator" calling the shots and having your future determined by press ganey scores or you want to make the rules at your own place.

disclaimer; this refers to non-pill mill practices.

I have to disagree with Ligament on some is this. The 10 or so docs that I know personally in hospitals make 400k on avg, two are up around 900k. The 7 colleagues I talk with a lot who are in private practice are all making over 750k with the exception of 2, both make around 500k. The high end of private guys can make 1.5mil and that doesn’t mean they are pill mills or billing out of network or abusing UDS, or any of the other assumptions you hear a lot.

To me the real advantage of private practice is the ability for passive income streams like owning your building or hiring midlevels or junior docs.

Lig is spot on however that a lot of time after working hours is spent on business stuff.
 
To me the real advantage of private practice is the ability for passive income streams like owning your building or hiring mid levels or junior docs.

What's passive about it? Supervising other clinicians is WORK. Picking weeds in front of the office on the weekend, re-striping the parking lot, putting salt out on icy winter days before the clinic opens, running to Home Depot to match the broken tile, etc. It's all work.
 
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For new grads, I feel that hospital employed jobs seem like a safer bet - higher starting salary, no false promises of partnership, built in referral base from other hospital docs. But yes, you will have an administrator call the shots for sure.
I would agree with above to a T.

out of curiosity, what aspects do admins control? number of patients seen per day?


I have to disagree with Ligament on some is this. The 10 or so docs that I know personally in hospitals make 400k on avg, two are up around 900k. The 7 colleagues I talk with a lot who are in private practice are all making over 750k with the exception of 2, both make around 500k. The high end of private guys can make 1.5mil and that doesn’t mean they are pill mills or billing out of network or abusing UDS, or any of the other assumptions you hear a lot.

To me the real advantage of private practice is the ability for passive income streams like owning your building or hiring midlevels or junior docs.

Lig is spot on however that a lot of time after working hours is spent on business stuff.

where are these employed physicians? in metro areas or suburban/rural areas?

What's passive about it? Supervising other clinicians is WORK. Picking weeds in front of the office on the weekend, re-striping the parking lot, putting salt out on icy winter days before the clinic opens, running to Home Depot to match the broken tile, etc. It's all work.

seems like you can hire a kid to do all that work, or just a gardener/custodian for like $100-200.
 
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Day in the life of the HOPD doc:

Roll in at 9:45 for 9:00 clinic in my mid series BMW. See my 3 patients that have been waiting on me, see 7 more by noon. Was hoping for about 5 no shows, but not today. Go to the hospital for lunch. Panini and sushi. Delicious as always. Get a plastic sack and fill it up with bottled drinks, hummus, sushi, and snacks for home. Run that home and play with the dog for an hour. Show up
at the hospital for 1:00 procedures at 1:30. Patient still not ready. Which is understandable since we only have 11 RN’s, 3 scrub techs, and 2 rad techs assigned to this area today. Knock out 6 procedures by 4:30. One was even a CESI! I could tell the staff was nervous since the other doc typically takes an hour on his. Total procedure time: 18 minutes, total web browsing time: a lot. Home by 5. Give hospital VP a ring on the way home and negotiate a nice monthly stipend for myself for medically supervising the PT department. That will cut into my web browsing time .01% but it will be worth it. Say hi to the wife and kids. But get suited up for an important meeting. The wife is so proud of me and she understands I have a lot of things going on. Off to Morton’s to hear about Zilretta. Home by 10. Bring my wife a dessert home that has melted into a puddle and she throws out. She has been doing keto for a year and I knew she wouldn’t eat it anyways but it is all about optics. Did notice 5 empty white claws in the trash outside that weren’t there at lunch, however. Rinse and repeat the next day. Probably take my lifted truck in tomorrow. The new MDT rep is supposed to swing by and I hear she is just out of college.


Now tell me why you wouldn’t want to work for the hospital @drusso ?
 
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Day in the life of the HOPD doc:

Roll in at 9:45 for 9:00 clinic in my mid series BMW. See my 3 patients that have been waiting on me, see 7 more by noon. Was hoping for about 5 no shows, but not today. Go to the hospital for lunch. Panini and sushi. Delicious as always. Get a plastic sack and fill it up with bottled drinks, hummus, sushi, and snacks for home. Run that home and play with the dog for an hour. Show up
at the hospital for 1:00 procedures at 1:30. Patient still not ready. Which is understandable since we only have 11 RN’s, 3 scrub techs, and 2 rad techs assigned to this area today. Knock out 6 procedures by 4:30. One was even a CESI! I could tell the staff was nervous since the other doc typically takes an hour on his. Total procedure time: 18 minutes, total web browsing time: a lot. Home by 5. Give hospital VP a ring on the way home and negotiate a nice monthly stipend for myself for medically supervising the PT department. That will cut into my web browsing time .01% but it will be worth it. Say hi to the wife and kids. But get suited up for an important meeting. The wife is so proud of me and she understands I have a lot of things going on. Off to Morton’s to hear about Zilretta. Home by 10. Bring my wife a dessert home that has melted into a puddle and she throws out. She has been doing keto for a year and I knew she wouldn’t eat it anyways but it is all about optics. Did notice 5 empty white claws in the trash outside that weren’t there at lunch, however. Rinse and repeat the next day. Probably take my lifted truck in tomorrow. The new MDT rep is supposed to swing by and I hear she is just out of college.


Now tell me why you wouldn’t want to work for the hospital @drusso ?

Lol just outta college.

Nice touch.

Also wouldnt it be better to become a partner at a private practice in the long run.
 
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where are these employed physicians? in metro areas or suburban/rural areas?




seems like you can hire a kid to do all that work, or just a gardener/custodian for like $100-200.

Both. It doesn’t seem to matter match in this part of the country. All the hospitals offer about the same deal in terms of base pay and $/RVU. The guys that do well are the ones who make good relationships with the administration and are able to have more control over staffing, scheduling, clinic setup, etc. The name of he game is generating more RVU. None of the guys making 900k are doing so because they get paid a tremendous amount per RVU, they’re getting paid because they’re doing 15000 RVU a year


Exactly, I don’t pull weeds or worry about ice on the sidewalk...if plumbing gets clogged up my office manager handles it, if c arm goes down the backup one is moved in and the service on the broken one is scheduled and handled without me ever being told. My job is to be the doctor, pay other people to do everything else within reason. Good trade off in my opinion, makes me a lot of extra money over being a Hosptial employee.
 
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Day in the life of the HOPD doc:

Roll in at 9:45 for 9:00 clinic in my mid series BMW. See my 3 patients that have been waiting on me, see 7 more by noon. Was hoping for about 5 no shows, but not today. Go to the hospital for lunch. Panini and sushi. Delicious as always. Get a plastic sack and fill it up with bottled drinks, hummus, sushi, and snacks for home. Run that home and play with the dog for an hour. Show up
at the hospital for 1:00 procedures at 1:30. Patient still not ready. Which is understandable since we only have 11 RN’s, 3 scrub techs, and 2 rad techs assigned to this area today. Knock out 6 procedures by 4:30. One was even a CESI! I could tell the staff was nervous since the other doc typically takes an hour on his. Total procedure time: 18 minutes, total web browsing time: a lot. Home by 5. Give hospital VP a ring on the way home and negotiate a nice monthly stipend for myself for medically supervising the PT department. That will cut into my web browsing time .01% but it will be worth it. Say hi to the wife and kids. But get suited up for an important meeting. The wife is so proud of me and she understands I have a lot of things going on. Off to Morton’s to hear about Zilretta. Home by 10. Bring my wife a dessert home that has melted into a puddle and she throws out. She has been doing keto for a year and I knew she wouldn’t eat it anyways but it is all about optics. Did notice 5 empty white claws in the trash outside that weren’t there at lunch, however. Rinse and repeat the next day. Probably take my lifted truck in tomorrow. The new MDT rep is supposed to swing by and I hear she is just out of college.


Now tell me why you wouldn’t want to work for the hospital @drusso ?

That's exactly how I imagine it.
 
Day in the life of the HOPD doc:

Roll in at 9:45 for 9:00 clinic in my mid series BMW. See my 3 patients that have been waiting on me, see 7 more by noon. Was hoping for about 5 no shows, but not today. Go to the hospital for lunch. Panini and sushi. Delicious as always. Get a plastic sack and fill it up with bottled drinks, hummus, sushi, and snacks for home. Run that home and play with the dog for an hour. Show up
at the hospital for 1:00 procedures at 1:30. Patient still not ready. Which is understandable since we only have 11 RN’s, 3 scrub techs, and 2 rad techs assigned to this area today. Knock out 6 procedures by 4:30. One was even a CESI! I could tell the staff was nervous since the other doc typically takes an hour on his. Total procedure time: 18 minutes, total web browsing time: a lot. Home by 5. Give hospital VP a ring on the way home and negotiate a nice monthly stipend for myself for medically supervising the PT department. That will cut into my web browsing time .01% but it will be worth it. Say hi to the wife and kids. But get suited up for an important meeting. The wife is so proud of me and she understands I have a lot of things going on. Off to Morton’s to hear about Zilretta. Home by 10. Bring my wife a dessert home that has melted into a puddle and she throws out. She has been doing keto for a year and I knew she wouldn’t eat it anyways but it is all about optics. Did notice 5 empty white claws in the trash outside that weren’t there at lunch, however. Rinse and repeat the next day. Probably take my lifted truck in tomorrow. The new MDT rep is supposed to swing by and I hear she is just out of college.


Now tell me why you wouldn’t want to work for the hospital @drusso ?

Hahaha
 
Day in the life of the HOPD doc:

Roll in at 9:45 for 9:00 clinic in my mid series BMW. See my 3 patients that have been waiting on me, see 7 more by noon. Was hoping for about 5 no shows, but not today. Go to the hospital for lunch. Panini and sushi. Delicious as always. Get a plastic sack and fill it up with bottled drinks, hummus, sushi, and snacks for home. Run that home and play with the dog for an hour. Show up
at the hospital for 1:00 procedures at 1:30. Patient still not ready. Which is understandable since we only have 11 RN’s, 3 scrub techs, and 2 rad techs assigned to this area today. Knock out 6 procedures by 4:30. One was even a CESI! I could tell the staff was nervous since the other doc typically takes an hour on his. Total procedure time: 18 minutes, total web browsing time: a lot. Home by 5. Give hospital VP a ring on the way home and negotiate a nice monthly stipend for myself for medically supervising the PT department. That will cut into my web browsing time .01% but it will be worth it. Say hi to the wife and kids. But get suited up for an important meeting. The wife is so proud of me and she understands I have a lot of things going on. Off to Morton’s to hear about Zilretta. Home by 10. Bring my wife a dessert home that has melted into a puddle and she throws out. She has been doing keto for a year and I knew she wouldn’t eat it anyways but it is all about optics. Did notice 5 empty white claws in the trash outside that weren’t there at lunch, however. Rinse and repeat the next day. Probably take my lifted truck in tomorrow. The new MDT rep is supposed to swing by and I hear she is just out of college.


Now tell me why you wouldn’t want to work for the hospital @drusso ?
This is actually great writing. You have the makings of a new “house of god” on your hands. Sam Shem junior. I would buy this novel
 
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This is actually great writing. You have the makings of a new “house of god” on your hands. Sam Shem junior. I would buy this novel
Thank you, I have always wanted to write but the pharma dinners and 2 hour lunches only leave time for so much.



I could probably flesh out something jumping from the Russo universe to the real world back and forth that would be pretty good if I worked at it. Thank you for the inspiration.
 
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Thank you, I have always wanted to write but the pharma dinners and 2 hour lunches only leave time for so much.



I could probably flesh out something jumping from the Russo universe to the real world back and forth that would be pretty good if I worked at it. Thank you for the inspiration.

As long as you can find good parts for Joe, Fatima, Karen, Gary and the rest of the neighborhood crew it will be a best seller for sure...
 
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Day in the life of the HOPD doc:

Roll in at 9:45 for 9:00 clinic in my mid series BMW. See my 3 patients that have been waiting on me, see 7 more by noon. Was hoping for about 5 no shows, but not today. Go to the hospital for lunch. Panini and sushi. Delicious as always. Get a plastic sack and fill it up with bottled drinks, hummus, sushi, and snacks for home. Run that home and play with the dog for an hour. Show up
at the hospital for 1:00 procedures at 1:30. Patient still not ready. Which is understandable since we only have 11 RN’s, 3 scrub techs, and 2 rad techs assigned to this area today. Knock out 6 procedures by 4:30. One was even a CESI! I could tell the staff was nervous since the other doc typically takes an hour on his. Total procedure time: 18 minutes, total web browsing time: a lot. Home by 5. Give hospital VP a ring on the way home and negotiate a nice monthly stipend for myself for medically supervising the PT department. That will cut into my web browsing time .01% but it will be worth it. Say hi to the wife and kids. But get suited up for an important meeting. The wife is so proud of me and she understands I have a lot of things going on. Off to Morton’s to hear about Zilretta. Home by 10. Bring my wife a dessert home that has melted into a puddle and she throws out. She has been doing keto for a year and I knew she wouldn’t eat it anyways but it is all about optics. Did notice 5 empty white claws in the trash outside that weren’t there at lunch, however. Rinse and repeat the next day. Probably take my lifted truck in tomorrow. The new MDT rep is supposed to swing by and I hear she is just out of college.


Now tell me why you wouldn’t want to work for the hospital @drusso ?
how about a real day in the life of a HOPD doc (ie last Thursday):

get in office at 7:25. 5 min to gulp down coffee, swear next time, like every time, to remember to put an ice cube in before leaving for work.

meeting with nurses/admin/NP (depending on day of week) until 8. do some chartwork until they show up, admins arrive at 7:30, nurses and APPs usually straggle in at 7:40. 50/50 chance first patient no shows. that's not unexpected. out of the 12 patients scheduled for the morning, typically 2-3 will no show. gives some time to do charts left over from yesterday. or scan SDN.

turns out the 8am is a reliable patient that you have seen for 10 years and shows up on time. so it starts. he arrives early, and is in room by 8. but, usually nurses have to do their part and that wastes 10 min.

while seeing patients, get call from hospitalists. vasculopath that was on triple antibiotics ("but COVID negative!") needs ESI. oh yes, he is on lovenox, got dose 30 min ago, but back pain and need for ESI is stopping him from NH placement. please see him... but you already have TF on a different inpatient scheduled for 12 noon today, so moot point. maybe tomorrow. probably not you mutter to yourself.

finish morning, luckily by 12:20. unfortunately, everyone showed. inpatient has arrived. takes 15 min for nurse and rad tech to get positioned. browse SDN while waiting. uh oh. a lot of posts from SDN members who can be codenamed Fake and Notnews - means a lot of misinformation. 1 min to do injection. time for lunch. answer patient calls, fill scripts, send message to referral docs on patients seen in AM. read another incredulous post on SDN, reply with facts and try as hard as possible to limit opinion.

only 12 patients scheduled for the afternoon. injection day, easy - if only ppl don't want to discuss something else - like why you continue to refuse to give opioids when "a friend of mine" or gramma Florence gets them. and only sees the prescribing doc once a year. what do you mean, cocaine in UDS the last 5 ER visits?

last patient leaves. 4:40 now. time to do paperwork oh darn that inpatient. grab mask and shield, walk to floor. no family members! terrific! this will be qui... what, you want me to talk to your daughter who is power of attorney? sigh okay whats her number? she will be here in 15 min and you don't know her number? ugh.

5:45 now, realize that almost all the charts need work. oh well, gonna see the family. you'll do the charts tonite while the kids are gaming. you can talk to the hospitalist while you are driving home....
 
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Day in the life of the HOPD doc:

Roll in at 9:45 for 9:00 clinic in my mid series BMW. See my 3 patients that have been waiting on me, see 7 more by noon. Was hoping for about 5 no shows, but not today. Go to the hospital for lunch. Panini and sushi. Delicious as always. Get a plastic sack and fill it up with bottled drinks, hummus, sushi, and snacks for home. Run that home and play with the dog for an hour. Show up
at the hospital for 1:00 procedures at 1:30. Patient still not ready. Which is understandable since we only have 11 RN’s, 3 scrub techs, and 2 rad techs assigned to this area today. Knock out 6 procedures by 4:30. One was even a CESI! I could tell the staff was nervous since the other doc typically takes an hour on his. Total procedure time: 18 minutes, total web browsing time: a lot. Home by 5. Give hospital VP a ring on the way home and negotiate a nice monthly stipend for myself for medically supervising the PT department. That will cut into my web browsing time .01% but it will be worth it. Say hi to the wife and kids. But get suited up for an important meeting. The wife is so proud of me and she understands I have a lot of things going on. Off to Morton’s to hear about Zilretta. Home by 10. Bring my wife a dessert home that has melted into a puddle and she throws out. She has been doing keto for a year and I knew she wouldn’t eat it anyways but it is all about optics. Did notice 5 empty white claws in the trash outside that weren’t there at lunch, however. Rinse and repeat the next day. Probably take my lifted truck in tomorrow. The new MDT rep is supposed to swing by and I hear she is just out of college.


Now tell me why you wouldn’t want to work for the hospital @drusso ?

That is hilarious- I know you are kidding.

I only do about 14-15 procedures a day as a hospital employee. I used to do about 24-26 in private practice.

I make about half as much as an employee as I did in private practice, so it is fair.

One thing I find somewhat amusing is the lack of familiarity in the hospital based setting for PR/marketing. I have to arrange it all myself and guide them, as they are not used to it. Also, setting up contracts is alien to them. I don't mind, but just find it peculiar.
 
That is hilarious- I know you are kidding.

I only do about 14-15 procedures a day as a hospital employee. I used to do about 24-26 in private practice.

I make about half as much as an employee as I did in private practice, so it is fair.

One thing I find somewhat amusing is the lack of familiarity in the hospital based setting for PR/marketing. I have to arrange it all myself and guide them, as they are not used to it. Also, setting up contracts is alien to them. I don't mind, but just find it peculiar.

Umm I don’t think he’s kidding..sadly I also don’t think ducttape is kidding either..
 
Capture.JPG

Today's schedule as hospital employed physician with a salary and a salary cap. Lot's of coffee. Lunch can be a walk at the park or a lecture on DM from a pharmD student. 730 to 330 scheduled.
 
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Today's schedule as hospital employed physician with a salary and a salary cap. Lot's of coffee. Lunch can be a walk at the park or a lecture on DM from a pharmD student. 730 to 330 scheduled.

A salary cap seems to provide the wrong incentive.
 
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What's passive about it? Supervising other clinicians is WORK. Picking weeds in front of the office on the weekend, re-striping the parking lot, putting salt out on icy winter days before the clinic opens, running to Home Depot to match the broken tile, etc. It's all work.
This is correct

seems like you can hire a kid to do all that work, or just a gardener/custodian for like $100-200.
This is not. It seems that it would be this easy but it's not.
 
How does your salary cap work out of curiosity? There is a income ceiling? If your wrvu exceeds that does it carry over ?

Salary is X. Bonus measures based on CMS stuff, ability to get RVU from doing physicals for HS and college sports. If I exceed salary plus bonus I get nothing else. No carryover. Like the VAMC but better base pay.
 
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Employed

Generous base salary

+Max ~10% base salary bonus for Access, service, quality metrics

+Another max ~10% of base salary bonus for production up to 80th percentile ($x for each percentile 60th to 80th)

Can do narratives and depositions but otherwise capped

7 weeks vacation including CME time
 
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Private Practice-Owner

I get to keep 1/2 of whatever money is left over after paying for everything (rent, equipment, supplies, employees, taxes, marketing, CME, retirement plan, health insurance, cell phone, IT, Internet, phone, water, electricity, sewer, accountant, malpractice, you name it).

Maybe three weeks vacation/CME/time off per year.
 
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So, generalist OR jobs in location I want to be in post-training pay out at approx 400k. If I do a pain fellowship, I'm giving up a yr of lost earnings as attending. If I come out of fellowship and take hospital pain gig for around 400k, then I dont ever see the financial upside of doing the fellowship. How should this, if at all, be factoring into my calculus of doing a fellowship? Thanks.
Employed

Generous base salary

+Max ~10% base salary bonus for Access, service, quality metrics

+Another max ~10% of base salary bonus for production up to 80th percentile ($x for each percentile 60th to 80th)

Can do narratives and depositions but otherwise capped

7 weeks vacation including CME time

can you be more specific about "general base salary"
 
Do an ACGME fellowship so you can be a competent pain doctor that is well-rounded and provides a service to the community.

If you don't do a fellowship, the odds of your providing high level care are probably low.

Why? You'll either be a pusher of dope or run a block shop.

The fellowship is NOT for reimbursement.
 
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Do an ACGME fellowship so you can be a competent pain doctor that is well-rounded and provides a service to the community.

If you don't do a fellowship, the odds of your providing high level care are probably low.

Why? You'll either be a pusher of dope or run a block shop.

The fellowship is NOT for reimbursement.

Let’s not rehash this argument again and again.

ACGME is always preferred but not all ACGME programs churn out well equipped, trained, ethical pain docs.

I refer you to all those docs doing SI joint fusions, unnecessary stim, pills for pokes, etc.

Until we all realize that cash is king in this market, ACGME versus not just let’s you market better.

Do a fellowship, ACGME is preferred, so there is less of a chance you F**k some one up.

Otherwise just stick to anesthesia general OR. You will never make that 400k back, if that is your primary endpoint. Nothing wrong with that but just be self aware of your motives.
 
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So, generalist OR jobs in location I want to be in post-training pay out at approx 400k. If I do a pain fellowship, I'm giving up a yr of lost earnings as attending. If I come out of fellowship and take hospital pain gig for around 400k, then I dont ever see the financial upside of doing the fellowship. How should this, if at all, be factoring into my calculus of doing a fellowship? Thanks.


can you be more specific about "general base salary"

More lifestyle friendly hours
 
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Anesthesia jobs in my area pay about $380-400k for full time calling taking (roughly once a week of either late or overnight) plus working weekends, nights, holidays.

Versus hospital employed pain could have a base of $380-400k plus production bonus of $50-100k (or more) with no weekends, nights or holidays.

The choice is clear to me- you basically have a derm lifestyle with pain.

The equivalent outpatient anesthesia job without call or weekends usually pays around $250-280k.
 
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I am hospital employee. My salary is the simplest here in many ways. It’s wrvu multiplied by my conversion factor ($/wrvu). That’s it.
 
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Let’s not rehash this argument again and again.

ACGME is always preferred but not all ACGME programs churn out well equipped, trained, ethical pain docs.

I refer you to all those docs doing SI joint fusions, unnecessary stim, pills for pokes, etc.

Until we all realize that cash is king in this market, ACGME versus not just let’s you market better.

Do a fellowship, ACGME is preferred, so there is less of a chance you F**k some one up.

Otherwise just stick to anesthesia general OR. You will never make that 400k back, if that is your primary endpoint. Nothing wrong with that but just be self aware of your motives.

ACGME fellowships have multidisciplinary requirements in their curricula.

That alone is worth the fellowship.

It is MORE likely that an accredited fellowship will properly train someone to provide well-rounded care than a nonaccredited fellowship.
 
So, generalist OR jobs in location I want to be in post-training pay out at approx 400k. If I do a pain fellowship, I'm giving up a yr of lost earnings as attending. If I come out of fellowship and take hospital pain gig for around 400k, then I dont ever see the financial upside of doing the fellowship. How should this, if at all, be factoring into my calculus of doing a fellowship? Thanks.


can you be more specific about "general base salary"

PM sent
 
ACGME fellowships have multidisciplinary requirements in their curricula.

That alone is worth the fellowship.

It is MORE likely that an accredited fellowship will properly train someone to provide well-rounded care than a nonaccredited fellowship.

I can get behind that argument.

Although if you aren’t a pmr trained, did you really get anything out of the time spent following emg clinic? I say this as pmr trained guy who did emgs until recently.

I needed more pain psych time with the psychologists not psychiatrists.
 
I can get behind that argument.

Although if you aren’t a pmr trained, did you really get anything out of the time spent following emg clinic? I say this as pmr trained guy who did emgs until recently.

I needed more pain psych time with the psychologists not psychiatrists.

My fellowship was largely pain psych.

I did zero EMGs as a pain fellow.
 
Do an ACGME fellowship so you can be a competent pain doctor that is well-rounded and provides a service to the community.

If you don't do a fellowship, the odds of your providing high level care are probably low.

Why? You'll either be a pusher of dope or run a block shop.

The fellowship is NOT for reimbursement.

LMAO, that type of brainwashing doesnt work anymore.
And to say that you cant be a competent and well-rounded anesthesiologist and are resigned to being a "dope pusher" or a block jock is ridiculous.
Reimbursement is DEFINITELY a consideration to everyone considering fellowship. No one is happily taking fellow level pay for "the privilege of providing high level care".

I am hospital employee. My salary is the simplest here in many ways. It’s wrvu multiplied by my conversion factor ($/wrvu). That’s it.

So entirely production based? No salary base?
 
He probably has a salary that is like 80% of his typical volume and then they bonus him to catch up.
 
LMAO, that type of brainwashing doesnt work anymore.
And to say that you cant be a competent and well-rounded anesthesiologist and are resigned to being a "dope pusher" or a block jock is ridiculous.


Reimbursement is DEFINITELY a consideration to everyone considering fellowship.


1. As an anesthesiologist, and I trained with anesthesiologists and I have friends that are anesthesiologists...When exactly do you learn the physical exam and the psychosocial aspects of pain management? That stuff matters. You're simply not as prepared as a fellowship graduate. Can you be the greatest pain MD of all time? Of course...
 
Employed

Generous base salary

+Max ~10% base salary bonus for Access, service, quality metrics

+Another max ~10% of base salary bonus for production up to 80th percentile ($x for each percentile 60th to 80th)

Can do narratives and depositions but otherwise capped

7 weeks vacation including CME time

Hey DOctorJay another fellow here—would you be willing to send the PM with further info my way also? Thank you.
 
LMAO, that type of brainwashing doesnt work anymore.
And to say that you cant be a competent and well-rounded anesthesiologist and are resigned to being a "dope pusher" or a block jock is ridiculous.
Reimbursement is DEFINITELY a consideration to everyone considering fellowship. No one is happily taking fellow level pay for "the privilege of providing high level care".



So entirely production based? No salary base?

He's absolutely right. There is a stigma associated with non-ACGME training. It's not right, but it is the way it is.
 
Anesthesia jobs in my area pay about $380-400k for full time calling taking (roughly once a week of either late or overnight) plus working weekends, nights, holidays.

Versus hospital employed pain could have a base of $380-400k plus production bonus of $50-100k (or more) with no weekends, nights or holidays.

The choice is clear to me- you basically have a derm lifestyle with pain.

The equivalent outpatient anesthesia job without call or weekends usually pays around $250-280k.

Yeah but I've heard aneshesia gets 8-12 weeks vacation in my area. Correct me if I'm very wrong.
 
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