If the shortage of neurologists only goes more and more acute, should we expect the salaries to rise exponentially in the next years?

[RA1998]

Yes, we all know the AAMC report, 40.000-130.000 shortage of doctors in US until 2035, even tho the med schools have way more spots, the residency programs don't and here we are. More about that, there is already a big shortage of neurologists especially in the rural and less desirable areas, so I guess this will only get worse and worse, baby-boomers are getting old (a lot of neurological diseases) and all that. So, of course, the classical question, will the neurologist's salary finally catch up the one of a cardiologist, as an example? Yes, even this year, as of Medscape report, there was seen a 7% growth for neurologists, but could that from now go on an exponential growth? I mean, I really like neurology(still in med school), but I'm a honest dude, if there are the circumstances for a nice growth for the neurologists compensation, if the supply is way less than the demand, of course anyone would like bigger compensations, idk, in the end is a very complex field and it's not yet even in the middle on the Medscape compensation report, I don't have the MGMA recent data. Thanks in advance for your opinions!

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[PikminOC]

Yes, we all know the AAMC report, 40.000-130.000 shortage of doctors in US until 2035, even tho the med schools have way more spots, the residency programs don't and here we are. More about that, there is already a big shortage of neurologists especially in the rural and less desirable areas, so I guess this will only get worse and worse, baby-boomers are getting old (a lot of neurological diseases) and all that. So, of course, the classical question, will the neurologist's salary finally catch up the one of a cardiologist, as an example? Yes, even this year, as of Medscape report, there was seen a 7% growth for neurologists, but could that from now go on an exponential growth? I mean, I really like neurology(still in med school), but I'm a honest dude, if there are the circumstances for a nice growth for the neurologists compensation, if the supply is way less than the demand, of course anyone would like bigger compensations, idk, in the end is a very complex field and it's not yet even in the middle on the Medscape compensation report, I don't have the MGMA recent data. Thanks in advance for your opinions!

Doubtful. Proliferation of mid-levels may prevent that.

 

[RA1998]

Doubtful. Proliferation of mid-levels may prevent that.

Hm, I see. I guess this applies to other clinical specialities too.

 

[GuillainMollaret]

Compensation in medicine isn't really based on supply and demand. If it were, neurologists would already be among the highest paid physicians.

It's based on how many work RVUs you produce. Procedural specialties produce more RVUs than cognitive specialties like neuro and thus get paid more.

I suppose there's an argument to be made that high demand could put upward pressure on the dollar amount your employer pays you per wRVU. Haven't seen it happen where I work though.

The best thing high demand does is that it makes it easy to find a job anywhere and you can usually negotiate a nice sign on bonus.

Also, mid-levels are definitely prominent in neurology, which does put downward pressure on our salaries. It may be worse in other specialties though.

 

[bronx43]

Compensation in medicine isn't really based on supply and demand. If it were, neurologists would already be among the highest paid physicians.

It's based on how many work RVUs you produce. Procedural specialties produce more RVUs than cognitive specialties like neuro and thus get paid more.

I suppose there's an argument to be made that high demand could put upward pressure on the dollar amount your employer pays you per wRVU. Haven't seen it happen where I work though.

The best thing high demand does is that it makes it easy to find a job anywhere and you can usually negotiate a nice sign on bonus.

Also, mid-levels are definitely prominent in neurology, which does put downward pressure on our salaries. It may be worse in other specialties though.

The comp/wRVU calculations are based on a lot of factors, several of which are ancillary and downstream revenue streams. I would think that due to the volume of MRIs neurologists order, the comp/wRVU would be fairly high, no?

 

[RA1998]

Compensation in medicine isn't really based on supply and demand. If it were, neurologists would already be among the highest paid physicians.

It's based on how many work RVUs you produce. Procedural specialties produce more RVUs than cognitive specialties like neuro and thus get paid more.

I suppose there's an argument to be made that high demand could put upward pressure on the dollar amount your employer pays you per wRVU. Haven't seen it happen where I work though.

The best thing high demand does is that it makes it easy to find a job anywhere and you can usually negotiate a nice sign on bonus.

Also, mid-levels are definitely prominent in neurology, which does put downward pressure on our salaries. It may be worse in other specialties though.

Yes, I totally see your point. Seems like the ranking on salaries is really made from the most procedural specialities to the less procedural, RVU dictates. Would interventional neurology be seen as a pretty procedural subspeciality?

 

[deathmerchant]

Yes, I totally see your point. Seems like the ranking on salaries is really made from the most procedural specialities to the less procedural, RVU dictates. Would interventional neurology be seen as a pretty procedural subspeciality?

That is correct. Shortage of neurologists won't increase salary by that much, may be a little. Procedures are where the money is.
Yes interventional neurology is procedural and those guys make significantly more - similar to Interventional cards.

 

[Chibucks15]

That is correct. Shortage of neurologists won't increase salary by that much, may be a little. Procedures are where the money is.
Yes interventional neurology is procedural and those guys make significantly more - similar to Interventional cards.

Didn’t I hear they changed some of the billing parameters to take some from proceduralists and a slight amount towards more “cerebral” specialties? Maybe I heard incorrectly but it seems like it’s trending up.

The big perk I’ve noticed at least where I’m at is that there’s such a need of neuro that you can basically pick where you wanna live and won’t lose too much salary unless you go into academic stuff

 

[Thama]

Didn’t I hear they changed some of the billing parameters to take some from proceduralists and a slight amount towards more “cerebral” specialties? Maybe I heard incorrectly but it seems like it’s trending up.

The big perk I’ve noticed at least where I’m at is that there’s such a need of neuro that you can basically pick where you wanna live and won’t lose too much salary unless you go into academic stuff

They took more from proceduralists than they gave to E&M, but yes E&M reimbursement went up a little.

That's likely not what will move the needle. Shortage only helps us when hospital systems become desperate enough for coverage to float compensation that is far above what we directly bill. If you need a neurologist to order MRIs, labs, infusion meds, refer to your neurosurgeons, etc, then at some point if the neurologist is in shortage and that shortage is threatening your other income streams, part of those income streams has to be diverted to the neurologist.

 

[Telamir]

It's our time to be Chads.

 

[deathmerchant]

Didn’t I hear they changed some of the billing parameters to take some from proceduralists and a slight amount towards more “cerebral” specialties? Maybe I heard incorrectly but it seems like it’s trending up.

The big perk I’ve noticed at least where I’m at is that there’s such a need of neuro that you can basically pick where you wanna live and won’t lose too much salary unless you go into academic stuff

Yea it went up just a bit. The biggest gain is in Dementia patients Basically you can bill them a little over New Level 5 every 6 months instead of billing as a Level 3 follow up.
But no doubt the shortage is helping. Inpatient rates are increasing. Most neuro clinics gets busy from first month and you will have more patients than you can see. Basically if you work surgeon hours(with inpatient call), you can potentially make more than them in neuro. (Esp in mid sized towns).

 

[Purkinje223]

It will mean higher starting salaries but so far I haven't seen it translate into overall reimbursement trends.
Inpatient salaries are higher now because tPA reimbursement increased by over 100%, thrombectomy cases bring a lot of revenue, increasing use of continuous EEG and critical care services. The new E/M codes will probably help outpatient practices but not too much.
I think neurologist's relative increase in salary compared to other specailties is due to other factors such as PE takeover and mid-level encroachment that we have so far been immune to.