job supply

[Attending1985]

Can anyone comment on the supply of jobs in sleep medicine. After completing a fellowship it is easy to find a job?

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[Shikima]

Jobs are far and few in between. Reimbursement is dropping.

 

[Attending1985]

Jobs are far and few in between. Reimbursement is dropping.

I see a fair amount of job postings online are these attracting so many applicants they’re hard to get?

 

[Shikima]

I couldn't say.

 

[AlbinoHawk DO]

I see a fair amount of job postings online are these attracting so many applicants they’re hard to get?

For disclosure purposes, I'm not even a fellow in this field. However, I have been curious about it. I see most listing being in cities and areas that are undesirable to many people. I think it all comes down do flexibility because a full-time sleep job in sunny San Diego isn't happening without some serious experience under your belt

 

[Sushirolls]

Here is your best place to look: Recent Jobs - American Academy of Sleep Medicine
Here is a runner up website: Physician — Sleep Medicine Jobs at PracticeLink

Sleep departments are starting to shift away from 100% physician to blends of mid level and sleep docs. Much of the salary component of sleep medicine comes from sleep studies and sleep studies come from consults. But when you have a mid level they can't read sleep studies, so they simply generate consults. This model is even being utilized by the private practice docs. When you review those two job boards (much overlap between them) you'll see ample mid level.

Another issue is some jobs have a preference for a base specialty or that they don't want 100% sleep they'll want Neuro/Sleep or Pulm/Sleep. This makes it a little harder for the Psych/IM/FM trained docs. The field is a little saturated, those who have limited or specific geography requirements may be disappointed or will only have the option of opening up their own practice.

Opening one's own practice is time consuming for sleep and costly with overhead. Ideally you want your own sleep lab, and no guarantees another doc will permit your sleep studies to be performed at their lab. Insurance companies may reimburse less for the different levels (or lack of) certification by the AASM. How to get certification is all online with the AASM website (takes years to get it). If/when you get the full lab certification you'll more likely get full reimbursement. Sleep techs are in high demand, not easy to recruit, and if you are rural, even harder. You will need some degree of capital to get your own practice and own lab up and running. Doable, but takes time and effort. You will want to do your homework for an area first to make sure its not already saturated.

Salary offers can frequently be in the 300-350 range.

 

[Needachange15]

so is it impossible to find a gig if you aren’t pulm and want a purely sleep gig? It can even be part-time

 

[Needachange15]

Here is your best place to look: Recent Jobs - American Academy of Sleep Medicine
Here is a runner up website: Physician — Sleep Medicine Jobs at PracticeLink

Sleep departments are starting to shift away from 100% physician to blends of mid level and sleep docs. Much of the salary component of sleep medicine comes from sleep studies and sleep studies come from consults. But when you have a mid level they can't read sleep studies, so they simply generate consults. This model is even being utilized by the private practice docs. When you review those two job boards (much overlap between them) you'll see ample mid level.

Another issue is some jobs have a preference for a base specialty or that they don't want 100% sleep they'll want Neuro/Sleep or Pulm/Sleep. This makes it a little harder for the Psych/IM/FM trained docs. The field is a little saturated, those who have limited or specific geography requirements may be disappointed or will only have the option of opening up their own practice.

Opening one's own practice is time consuming for sleep and costly with overhead. Ideally you want your own sleep lab, and no guarantees another doc will permit your sleep studies to be performed at their lab. Insurance companies may reimburse less for the different levels (or lack of) certification by the AASM. How to get certification is all online with the AASM website (takes years to get it). If/when you get the full lab certification you'll more likely get full reimbursement. Sleep techs are in high demand, not easy to recruit, and if you are rural, even harder. You will need some degree of capital to get your own practice and own lab up and running. Doable, but takes time and effort. You will want to do your homework for an area first to make sure its not already saturated.

Salary offers can frequently be in the 300-350 range.

Do most of these jobs apply to IM residents as I am FM?

 

[Sushirolls]

Not impossible to find a 100% sleep job. Not impossible to find a part time either. Take a look at the postings on both of those job boards and you'll be able to draw your own conclusions.

IM/FM/Psych do get jobs. But you must also understand the history of the field coming mostly from Pulm/CC docs. So some departments ares still set up by them and run by them so they are wary of the outside specialties.

I have seen a posting before where they preferred a psych background (presumably to manage more of the insomnia patients?).

Best I can say, is to just look at the job postings and come to your own conclusions.

 

[braineddetermined]

So basically hypothetically speaking a FM + sleep medicine procedures should easily surpass 330k?

 

[Sushirolls]

So basically hypothetically speaking a FM + sleep medicine procedures should easily surpass 330k?

Need to post more details in this hypothetical. How you currently presented the question currently is: yes, no, maybe, hell no.

 

[braineddetermined]

Need to post more details in this hypothetical. How you currently presented the question currently is: yes, no, maybe, hell no.

Okay so let’s say in this scenario: straight out of fellowship, a FM doctor working in an outpatient only setting (private practice group), location: NE 30 minutes from a big city, gross income: 250k.

Now if they want to add the sleep “procedures” they acquired doing fellowship how much can they possible make to boost their “base” salary?

I am basically wondering what ranges of starting salary one can expect in sleep coming from family medicine.

I’m thinking that one who spends 1/2 of the time doing FM and 1/2 of the time doing sleep could expect to make circa 300k+

 

[Sushirolls]

There are no sleep procedures. Only sleep studies.
Depending on how large this private practice group is, and that there are no other sleep doctors in the group will determine the referral volume from within to get sleep medicine consultations.
I'm Psych, I'm atypical for psych, but I sniff out OSA aggressively and refer 30-80% of my new patients to sleep medicine. Most every patient, you snore ---> go see sleep. Most Psych don't do this, and most FM don't do this.
Sleep Medicine often needs to go to primary care clinics to drum up referrals and educate.

So even if you have 3 other docs, you do FM 4 day a week, you might be able generat a 1/2 day to full day sleep clinic. Doing the follow ups and consults for sleep specific conditions.

The real question is, where or whom has the sleep lab? If your practice has a lab (and how many beds is this lab?) you will be able to 'keep' and generate the facility fees and the sleep studies for yourself to read. If you are referring out for sleep studies, good look being able to be the one who gets to read the studies and there goes the real money.

Simply put, FM, doing Direct Primary Care is more financially lucrative in the long haul with less bureaucratic headache. If you want to make money doing sleep, do 100% sleep.

 

[braineddetermined]

There are no sleep procedures. Only sleep studies.
Depending on how large this private practice group is, and that there are no other sleep doctors in the group will determine the referral volume from within to get sleep medicine consultations.
I'm Psych, I'm atypical for psych, but I sniff out OSA aggressively and refer 30-80% of my new patients to sleep medicine. Most every patient, you snore ---> go see sleep. Most Psych don't do this, and most FM don't do this.
Sleep Medicine often needs to go to primary care clinics to drum up referrals and educate.

So even if you have 3 other docs, you do FM 4 day a week, you might be able generat a 1/2 day to full day sleep clinic. Doing the follow ups and consults for sleep specific conditions.

The real question is, where or whom has the sleep lab? If your practice has a lab (and how many beds is this lab?) you will be able to 'keep' and generate the facility fees and the sleep studies for yourself to read. If you are referring out for sleep studies, good look being able to be the one who gets to read the studies and there goes the real money.

Simply put, FM, doing Direct Primary Care is more financially lucrative in the long haul with less bureaucratic headache. If you want to make money doing sleep, do 100% sleep.

Thank you for your detailed reply, now I have a better understanding.

 

[braineddetermined]

COVID19

Just out of curiosity: how is the actual emergency impacting on sleep physicians and their income?

 

[Bobblehead]

We stopped all in-lab studies a few weeks ago and have moved 100% of our visits to telephone or full audio/video telemedicine. No one's coming in person, but I'm also based out of a large medical center so I don't have to worry about my salary either. About 90% of the visits are by telephone so the reimbursement on those is likely massively down. The full video telehealth visits pay equal to in-person E/M visits I believe but not a lot of patients can do them or are interested in doing them. We're maintaining a full outpatient schedule right now, at least before things explode (we're pulmonary based). We are mailing home sleep test kits and one of our techs made a Youtube video to show patients how to wear the kits. The techs are also calling the patients as a "set-up appointment".

 

[braineddetermined]

We stopped all in-lab studies a few weeks ago and have moved 100% of our visits to telephone or full audio/video telemedicine. No one's coming in person, but I'm also based out of a large medical center so I don't have to worry about my salary either. About 90% of the visits are by telephone so the reimbursement on those is likely massively down. The full video telehealth visits pay equal to in-person E/M visits I believe but not a lot of patients can do them or are interested in doing them. We're maintaining a full outpatient schedule right now, at least before things explode (we're pulmonary based). We are mailing home sleep test kits and one of our techs made a Youtube video to show patients how to wear the kits. The techs are also calling the patients as a "set-up appointment".

Do you do only sleep? Or work in another subspec as well?

 

[Bobblehead]

Do you do only sleep? Or work in another subspec as well?

I do a mix of sleep, pulmonary and critical care.