Love pain but the job market and oversaturation

[Doctodd]

my local hospital bought out some of the GI docs right after they bought out some of the Cancer docs

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[gaseous_clay]

I had an anesthesia offer for 350 with 26weeks vacation. Pain full time for 228? Uhhh no.

I never really practiced anesthesia out of training, so I’m ignorant to its billing and collections. Can someone please explain to me how a group or hospital can give you half a year of paid vacation and still afford to pay you $350K? Does the hospital or facility just take the loss on anesthesia services to make the money on surgical cases?

 

[gaseous_clay]

If you want money, listen to the sage advice in House of God. The best money right now may be in private practice GI, as long as you have an ASC and infusion center, they can clear $2m/yr.

That game changes when facility fees on scopes decline. You can only do so much volume in a day.

 

[gaseous_clay]

Is that the same for OR anesthesiologists in Austin too? Just wondering if doing one or the other makes more sense if I want to live in Austin.

Everyone wants to live there and many are willing to take a pay cut to do so. I lived there for 3 years and all my gas buddies would complain about this.

 

[GandalfTheWhite]

I never really practiced anesthesia out of training, so I’m ignorant to its billing and collections. Can someone please explain to me how a group or hospital can give you half a year of paid vacation and still afford to pay you $350K? Does the hospital or facility just take the loss on anesthesia services to make the money on surgical cases?

Anesthesia bills for its procedures, and 'anesthesia time'. So all the arterial lines, swans, central lines, ultrasound use, etc... gets billed as separate procedures. Pre-op evals are billed. And most importantly intra-op anesthesia time is billed. Its a unit every 15 minutes of anesthesia time. so a 5 hour case is 20 units plus whatever the startup units and procedures/modifiers are.

 

[gaseous_clay]

Anesthesia bills for its procedures, and 'anesthesia time'. So all the arterial lines, swans, central lines, ultrasound use, etc... gets billed as separate procedures. Pre-op evals are billed. And most importantly intra-op anesthesia time is billed. Its a unit every 15 minutes of anesthesia time. so a 5 hour case is 20 units plus whatever the startup units and procedures/modifiers are.

So if you took Medicare as a benchmark, how much would a 2-hour general anesthesia ortho case with U/S guided peripheral nerve block, including preop eval pay out? Or are there too many factors for this question to be answered?

 

[Ronin1]

So if you took Medicare as a benchmark, how much would a 2-hour general anesthesia ortho case with U/S guided peripheral nerve block, including preop eval pay out? Or are there too many factors for this question to be answered?

It’s been a while but likely 3-4 start up units. Plus the block 4 units plus time. 16 units at 20/ unit for Medicare. Only 320. Commercial maybe 1-3k. Depends on contracts etc can’t survive on Medicare in the anesthesia world

 

[gaseous_clay]

It’s been a while but likely 3-4 start up units. Plus the block 4 units plus time. 16 units at 20/ unit for Medicare. Only 320. Commercial maybe 1-3k. Depends on contracts etc can’t survive on Medicare in the anesthesia world

Clearly not, but considering the hospitals take Medicare and Medicaid, it still seems like giving anesthesiologists half the year off for vacation and paying them $350K per year would be a loss leader.

 

[GandalfTheWhite]

Clearly not, but considering the hospitals take Medicare and Medicaid, it still seems like giving anesthesiologists half the year off for vacation and paying them $350K per year would be a loss leader.

Medicare/Medicaid accepting hospitals also tend to be subsidized by CMS for that reason. Hence why you see stipends for heavy medicaid/medicare receiving patients. I think startup units are 6-8 units, 2 hours is 8 units, block is 4 units, ultrasound use is an extra unit. so 20 units for the case. you can add a couple of units for other things like using an ultrasound to place an IV. 20 units. Typically medicaid reimburses 35/unit, not 20. Still chump change at 700 bucks. Now, if youre looking at private insurance that bills 90-120/ unit, youre at 2-3k. Hence why facility fees are helpful to subsidize anesthesia. Good luck trying to do surgery without it.

 

[deleted131481]

Clearly not, but considering the hospitals take Medicare and Medicaid, it still seems like giving anesthesiologists half the year off for vacation and paying them $350K per year would be a loss leader.

If you are a hospital with moderately busy OB with a good chunk private patients, can easily bring in 10k+/day in anesthesia services.

 

[GandalfTheWhite]

If you are a hospital with moderately busy OB with a good chunk private patients, can easily bring in 10k+/day in anesthesia services.

Yep. An epidural placed plus the continuous anesthesia time until delivery is major money.

 

[Ferrismonk]

Also remember that most of these 26-week vacation anesthesia jobs are 7 days on (24 hours) and 7 days off. I don't know about you, but being on call 24/7 gets old pretty fast.

 

[gaseous_clay]

Also remember that most of these 26-week vacation anesthesia jobs are 7 days on (24 hours) and 7 days off. I don't know about you, but being on call 24/7 gets old pretty fast.

That’s the main reason to go into pain lol.

 

[blastoff]

So is MGMA off with the figures? Everyone here is saying 350k if you are lucky.... 2019 MGMA says a median of 460k and a mean of 490k. What am I missing? Is this because MGMA includes bonuses and all?

 

[10KHertz]

As long as our professional salary is higher than the nation physician average and the general population among educated workers, we will be fine. The main issue is that you can’t sit on your Money and need to make it work more efficiently for you ... I realized this after margins continue to diminish and focused more on what I can do with my savings

 

[10KHertz]

So is MGMA off with the figures? Everyone here is saying 350k if you are lucky.... 2019 MGMA says a median of 460k and a mean of 490k. What am I missing? Is this because MGMA includes bonuses and all?

It may be including health benefits, insurance, profit sharing , 3% Match and other benefits you don’t see immediately.

 

[Nodolor]

It may be including health benefits, insurance, profit sharing , 3% Match and other benefits you don’t see immediately.

MGMA is salary only

 

[Ferrismonk]

MGMA is salary only

It's not. It's total compensation.

 

[drnido]

Does anyone have 2020/21 MGMA data for anesthesia/pain 75% and 90% comp?

 

[Agast]

Does anyone have 2020/21 MGMA data for anesthesia/pain 75% and 90% comp?

They reused the 2019 data due to COVID

 

[DOctorJay]

It's not. It's total compensation.

salary plus bonuses

 

[Nodolor]

It's not. It's total compensation.

I just had offer based on MGMA %, number ....it was salary not benefits

 

[Ferrismonk]

I just had offer based on MGMA %, number ....it was salary not benefits

Nice. Sounds like someone doesn't understand MGMA though.

 

[Nodolor]

Nice. Sounds like someone doesn't understand MGMA though.

Maybe you? There are different MGMA numbers, some are compensation, some include other numbers such as benefits.. look on old thread for examples

 

[gazzer]

Maybe you? There are different MGMA numbers, some are compensation, some include other numbers such as benefits.. look on old thread for exa

so what were the mgma salary numbers presented to you?