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TeslaCoil said:
I mean I understand that but what would be reasonable to ask for? The whole 1.3 million? Or some percentage of that?
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13k wrvu. Even if a desirable area is expect 55-60$/wrvu. So 750k is fair. Not what you make. Jesus
 
paindoc007 said:
13k wrvu. Even if a desirable area is expect 55-60$/wrvu. So 750k is fair. Not what you make. Jesus
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I also didnt mention that Im the director for this clinic. So I have directorial duties that Im not paid for. Managing staff, hiring, firing, etc.
 
Ronin1 said:
Apples to oranges. You are in a pp so best case scenario is percentage of collections. Wrvu means nothing in that environment. You may be getting screwed but unless you know your actual amount of collections it’s meaningless
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They told me collections were 1.27 million for the year.... and that their goal was for me to be at ~40% of that number in take-home pay. So essentially they told me to get a lil busier in 2025 to achieve that.
 
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TeslaCoil said:
These are based on a case log that the practice keeps based on cpt codes billed and collected. They're the ones who gave me the numbers. Cases are all done in clinic. The clinic gets paid and then they pay me. They were slick enough not to include wRVU numbers though. I had to figure that out myself based on the conversion factor for each procedure. Like for instance an SIJ injection=1.48 wRVU's times the number of those I did for the year = total number of RVU's I did just with SIJ's for the year. Then I added all those up. 12942 wRVU's just me. I mean, Im busting my ass.
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its not that easy. many places only credit you with 50% of the second side for any bilateral procedure.

also need to know which RVU schedule is being used.

dont let the "keeping up with the jones'" on this forum piss you off.

you may be underpaid, but need all the info before you jump in front of the proverbial train
 
SSdoc33 said:
its not that easy. many places only credit you with 50% of the second side for any bilateral procedure.

also need to know which RVU schedule is being used.

dont let the "keeping up with the jones'" on this forum piss you off.

you may be underpaid, but need all the info before you jump in front of the proverbial train
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Either way im pretty sure im grossly underpaid...
 
It is all relative. I think most of the busy private practice docs have much higher numbers here. The clinic is losing money on the midlevels also. You have two doing the work on one.
 
My collections are over double yours. Work more, make more. Wrvu doesn’t mean anything in private practice. Fire one midlevel and see those patients yourself. There is where all your money went.
 
Looked up our rolling 12m and the physician that works with me out collected you also. He works 4 days a week.
 
General rule in pp around 50% of collections. Anything better is good. I don’t think you’ll ever see 70%for example as that would likely not be financially feasible.
 
BobBarker said:
My collections are over double yours. Work more, make more. Wrvu doesn’t mean anything in private practice. Fire one midlevel and see those patients yourself. There is where all your money went.
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what part of the country is this in? and is this in pp?
 
Yes, private practice. Oklahoma. A normal practice. Nothing weird going on, just seeing more patients. You aren’t working as hard as you perceive. They have added g2211 and increased the e & m wrvu. Anyone with a pulse will hit 10000 wrvu a year.
 
I put in my notice yesterday. Interviewing with a few different places. Can anybody comment on hospital employment? Is it a good work setting for pain mgmt docs?
 
TeslaCoil said:
I put in my notice yesterday. Interviewing with a few different places. Can anybody comment on hospital employment? Is it a good work setting for pain mgmt docs?
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It depends on what you’re looking for.
Typically for most docs, who want lifestyle and pay, hospital is best.
Negotiate wRVU in a strong market (hospital should be feeding you patients).
 
SpineandWine said:
It depends on what you’re looking for.
Typically for most docs, who want lifestyle and pay, hospital is best.
Negotiate wRVU in a strong market (hospital should be feeding you patients).
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Get at least $70/wrvu and you’ll be set
 
you would not like nor do well in HOPD setting in my opinion, and yes i am making assumptions based on the limited information i have on you from your posts...

you would have to give up all control of the workings of the clinic and would be extraordinarily frustrated with how admin determines how the practice is run. you would be perturbed by the inherent inefficiencies of a hospital practice.

you should set up your own practice.
 
Ducttape said:
you would not like nor do well in HOPD setting in my opinion, and yes i am making assumptions based on the limited information i have on you from your posts...

you would have to give up all control of the workings of the clinic and would be extraordinarily frustrated with how admin determines how the practice is run. you would be perturbed by the inherent inefficiencies of a hospital practice.

you should set up your own practice.
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My understanding is that these days, the odds are stacked against private practices, with reimbursement rates being much lower for pp than for hospital. CMS cuts yearly? I mean is that the climate I really want to be starting a practice in?? I just want to be compensated fairly. Thanks all.
 
Seriously, you said you are in charge of the clinic. Fire the worst midlevel. Now you will make $250,000 more. Next add a little DME. The braces cost nothing. Just doing a 3-4 LSO’s a week will really increase your collections and profitability. There is another $50,000. This sounds crazy but I know I do over 25000 wrvu a year. It would be easy if I wasn’t running the business also. It sounds like you are helping manage the clinic but not truly running the business. It is another level when you are doing it all that is difficult to describe. If you go down the path of starting your own practice we will help you. There are things that you can do with the same patient volume to put more money in your pocket than you are seeing now with the same volume. Perhaps, you will be more incentivized to see more if you know that the patient that came late is still $100 in your pocket.
 
I did 150 wrvu Friday at the ASC but my collections were worse than being in the office. Wrvu is not worth worrying about in private practice.
 
BobBarker said:
I would reframe how you think about your current job. No one f’ed you.
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Please do expand on your claim. I see every new patient, I do every procedure, and I step in on every new med mgmt visit, and sign any opiate Rx's which require supervision. The two midlevels are paid 120k per year each. By my math im undercompensated by at least 100k.

Frankly the pay is the least of it. This practice has a slew of other problems Id rather not get into i detail but lets say the owner and his cronies are not ethical in their dealings with anybody here.
 
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TeslaCoil said:
I put in my notice yesterday. Interviewing with a few different places. Can anybody comment on hospital employment? Is it a good work setting for pain mgmt docs?
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devil is in the details with HOPD - they're not all run the same

whatever crazy scheme they come up with for your compensation with salary, production bonus, metric bonus, etc always boil it down to the $/wRVU you're receiving. this means figuring out what that number ends up at 9,000 wrvus, 10,000 wrvus, 11,000 wrvus, etc.

make sure bilateral procedures give you 1.5x the wRVU value. make sure 2 stim leads gives you 2x the wRVU value.
make sure you're doing procedures in an environment that can support at a bare minimum 4 procedures per hour.
 
You are paid around 40% collections. You take her collections and increase it 50% because you do more and are incentivized to increase collections where she is not. Then you take 40% of the new number.


But you seem secure in your decision so you should leave.
 
BobBarker said:
Yes, private practice. Oklahoma. A normal practice. Nothing weird going on, just seeing more patients. You aren’t working as hard as you perceive. They have added g2211 and increased the e & m wrvu. Anyone with a pulse will hit 10000 wrvu a year.
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by the way how exactly are you using this code in your practice?
 
1 Up said:
Nah, median is lower in all regions. More like ~$500-550k.
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actually now that im looking at it closer that is what the mgma numbers say. But the AGMA numbers say the median is $65-70 per rvu…
 
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So my question is- if Im living in the SE, and aiming for a good hospital job, what is a fair dollar/wrvu salary figure to ask for as a seasoned pain mgmt doctor?
 
I’m hitting around 8700 wrvu at the end of my first full calendar year and working four days per week in a rural town in the west. I currently get $66/wrvu as a w2 and will be renegotiating my contract soon. What would be a reasonable ask for the next two years?
 
TeslaCoil said:
My understanding is that these days, the odds are stacked against private practices, with reimbursement rates being much lower for pp than for hospital. CMS cuts yearly? I mean is that the climate I really want to be starting a practice in?? I just want to be compensated fairly. Thanks all.
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Future has never been better for starting a private practice. AI is changing the game. You can run a practice off your phone.
 
Ronin1 said:
Our matrix is 0-3 years experience 450/3-5 years 500/5plus 550

All guaranteed base 2 years. Bonus based at 65wrvu currently.
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Im assuming those are base salaries and then you have a bonus threshold? If so what is the bonus threshold? Thanks so much!
 
PMROralBoards said:
I’m hitting around 8700 wrvu at the end of my first full calendar year and working four days per week in a rural town in the west. I currently get $66/wrvu as a w2 and will be renegotiating my contract soon. What would be a reasonable ask for the next two years?
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Demand at least MGMA median of $71/wRVU
 
TeslaCoil said:
Sounds like a pretty fair structure. So for the first 2 years you have the base plus bonus, and then after the second year you go to a straight $ per wrvu model?
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At any point if you exceed base you get a bonus. If after two years you can’t hit your threshold you go down

They increased my base to about 80% of expected comp at my request so that I don’t have too large a bonus component. I don’t like them holding my money for too long.
I did recently request what they call a fair market value evaluation in regard to wrvu value so we will see what happens.
 
clubdeac said:
So is that based on Marit’s own survey data or most recent MGMA/AMGA?

I’m afraid if it’s just from Marit survey data, hospitals will turn a blind eye
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marit has their own data they collect (you provide your numbers when you sign up) and you get BOTH their data AND the MGMA data for 2025.
 
clubdeac said:
So is that based on Marit’s own survey data or most recent MGMA/AMGA?

I’m afraid if it’s just from Marit survey data, hospitals will turn a blind eye
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​

Hi - Yes, what @DOctorJay said is correct - you can see both the detailed community submitted salaries on Marit, and separately a snapshot of MGMA data for your specialty. Both data-sets are helpful for negotiation and complement each other - since the Marit salaries are individual level, we have seen instances where bringing specific examples that are most relevant to your situation is helpful for negotiation as well.
 
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