Palliative Care Training

[NPEMTIV]

Anyone know of any good websites to find out statistics on Palliative care docs? I've search through AAHPM and can't find exactly what I'm looking for. I can see this type of question has been tried before, but in an effort to coerce some more details I'm trying again. My goal is two fold, first I'm trying to figure out a lot of this information for myself and secondly, I'm trying to put together a good overview paper on the lifestyle, training, salary, typical day, etc...of a palliative doc for others. Any help would be appreciated.


Here's what I have so far. Please correct any discrepancies:

1) Lifestyle is good. Typical day can vary based on full/part time dedication to hospice. Night call is sometimes arduous, but typically handled via phone. Day activities can vary from driving all over to see patients at other facilities to rounding on in-patients at dedicated hospice facility? (This last part is somewhat of an assumption). Meetings with the hospice team(s) occur regularly and can last for several hours. Topics include patients who have died, current patient's nutrition, well-being, pain levels/management, etc...(any other pertinent topics I'm missing?)

2) Salary can range anywhere from 120,000 to 220,000, but no clear information on an average. (What would be the range if this data were split into two categories: part-time and full-time hopsice?) Here's some figures I have been able to find:
Medicare reimbursement of hospice physicians: If the physician is a consultant for the hospice organization the physician will bill under Medicare Part B, if the physician is directly associated with the hospice (e.g... employed) the physician will bill the Hospice center and the center will bill under Medicare Part A. The physician's compensation as an associate of hospice will then be determined by the appropriate contract(1). It's the contract part that falls off. If the physician is billing under standard Medicare Part B then I would think the salary range above would vary based on patient load just like FP/IM, etc... (no surprise there).

3) Primary specialties typical to enter hospice: IM/FP/EM and to a lesser extend Peds/PM&R/Psychiatry/Onc. There are ten ABMS boards that are eligible to obtain a subspecialty certification in Hospice & Palliative Medicine: IM, Anesthesiology, EM, FP, OB/GYN, Peds, PM&R, Psych/Neuro, Rads, and Surgery. (The AOA offers a certificate of added qualification through FP, IM, Neuo/Psych, PM&R).

4) Training is via a 12 month fellowship following successful completion of a residency in an eligible specialty. (Although it appears its not required as even medicare states the physician may be a PCP)

Primary areas I'm lacking info about: Pediatric Hospice (including education), Pediatric hospice salary (if it varies from traditional).

Sources:
1) Turner R, Rosielle D. Fast Fact and Concept #87. Medicare Hospice Benefit, Part II: Places of Care and Funding. 2nd Edition. November 2007. End-of-Life/Palliative Education Resource Center (www.eperc.mcw.edu).
2) American Academy of Hospice & Palliative Medicine. www.aahpm.org (Varies pages throughout the site)

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[dodoc07]

There are initiatives by the AAHPM to collect and publish physician salary info by looking at MGMA data (which is a clearinghouse for all physician salary info). Unfortunately, this will probably take years and won't be in time for you to make your career decisions.

Not everyone who works in palliative care works for a hospice. That is a common misconception. How you get paid varies and depends mostly on the healthcare environment you work in. Profit or non-profit? Academic vs. private practice? Salary vs. capitation? Medicare, commercial insurance, private pay, or a combination? What insurance will your practice accept, and how much do you collect? All of this affects the bottom line.
This is the part they don't teach you in residency & fellowship but you will need to learn very quickly in the real world.

Pediatric hospice / palliative care data are probably even more scarce, and there are probably only a handful of dedicated university programs in the US. One of the best I know of is Dana Farber up in Boston. Try contacting their office if you have specific questions, they are approachable, I've heard Dr. Joanne Wolf speak, she is very nice.

 

[NPEMTIV]

There are initiatives by the AAHPM to collect and publish physician salary info by looking at MGMA data (which is a clearinghouse for all physician salary info). Unfortunately, this will probably take years and won't be in time for you to make your career decisions.

Not everyone who works in palliative care works for a hospice. That is a common misconception. How you get paid varies and depends mostly on the healthcare environment you work in. Profit or non-profit? Academic vs. private practice? Salary vs. capitation? Medicare, commercial insurance, private pay, or a combination? What insurance will your practice accept, and how much do you collect? All of this affects the bottom line.
This is the part they don't teach you in residency & fellowship but you will need to learn very quickly in the real world.

Pediatric hospice / palliative care data are probably even more scarce, and there are probably only a handful of dedicated university programs in the US. One of the best I know of is Dana Farber up in Boston. Try contacting their office if you have specific questions, they are approachable, I've heard Dr. Joanne Wolf speak, she is very nice.

Thanks for your advice! I greatly appreciate it and will look into Dana Farber more.

 

[Iquitos]

Please post up your results. I have been trying to find answers to some of these questions as well.

 

[signomi]

I can speak, to my experience only, on the salary issue. Full time salaried hospice positions I have seen recently have been offering from $120,000 (not surprisingly, they are having trouble filling that one) up to $180,000. The average I am seeing is $150,000-$160,000.

 

[NPEMTIV]

I can speak, to my experience only, on the salary issue. Full time salaried hospice positions I have seen recently have been offering from $120,000 (not surprisingly, they are having trouble filling that one) up to $180,000. The average I am seeing is $150,000-$160,000.

Excellent! Thanks! That's pretty much what I'd figured.

 

[bunnymd]

For what it is worth:

I am employed by an experienced physician in long term care with years of medical director experience. He is contracted with a hospice and bills my time at $250/hr. Of course, I don't see all of that money. And, this is on average 5 hours per month. Also, he is well known in the community for doing great work and is able to command a high rate.

 

[BuckeyesFan]

I realize that I'm 5 months late responding to this thread, but I just joined today. I was a family physician for 7 years before quitting to complete a 1 year fellowship and now I work for a hospice. Regarding the salary, one rule of thumb I have heard that seems to be accurate (at least from what I've seen in the MidWest) is that a hospice/palliative care salary is roughly equal to what a family medicine or internal medicine salary would be in that area. I have seen some websites where you can either pay for info on salaries in an area or get the info for free, but it's been awhile since I looked so I can't help you with names. It did seem to be the case during my job hunt. So the extra year of fellowship gets you nothing monitarily, but I think for those of us with a real interest in the area, it is definitely worth it.

 

[Doctor4Life1769]

Doing inpatient palliative this month.

NOT my thing. However, you can earn based on how little/large your scope of practice.

The guy I work with, does ALL inpt pain management on certain pt pop, ALL palliative consults, outpt pain clinic for CA pts, and side boutique business (spa, botox). On call 24-7. I'm sure he makes a killing, nonetheless.

Has 2 NP's that do ICU pts.