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No, not for the same procedure. I could see PMR more frequently nerding out with a U.S. guided procedure that takes 15 min, uses $15 in disposable, and reimburses $60 than anesthesia trained docs. That would be a reason for lower salary.
I have heard that two placed where pay can vary significantly is in VA jobs where PM&R is paid lower and within Kaiser systems (but not sure why). Are there instances where PM&R would be reimbursed differently than an anesthesiologist doing the same procedures?
Last I knew, VA paid PM&R base specialty less than anesthesia. Other than that it's all over the place. AMGA has consistently listed "non-anesthesia pain" as earning more than anesthesia pain. Probably because the PM&R docs work harder and are better looking.I’ve read a lot about anesthesia pain position salaries, I was hoping any PM&R trained pain docs could comment on their salary/region and type of practice their in. Very interested on how the current market looks and what the positions look like.
Where are you located @cowboydoc ?Last I knew, VA paid PM&R base specialty less than anesthesia. Other than that it's all over the place. AMGA has consistently listed "non-anesthesia pain" as earning more than anesthesia pain. Probably because the PM&R docs work harder and are better looking.
Variability between jobs/region etc is probably a far larger spread than any consistent difference in pay between the 2 base specialties. For the most part, your review of local anesthesia pain salaries are a good estimate for PM&R pain in the same region. The anesthesia data is probably a better representation based on the number of responses, as there are far more anesthesiologists than physiatrists.
The market looks great where I am. We could use more good docs. If you want to be in NYC/west coast or decent parts of Florida, you'll probably take a serious hit financially.
My anesthesia friend tried to get me to join his private group, but I didn't think the relative autonomy was worth a 40% pay cut. (This was likely more related to SOS hospital-based employment and a potential low-ball offer than specialty.)
Of course, anesthesia can take call, etc. and make more in their base specialty than most of what PM&R could make peripherally. Work comp/medicolegal can be a headache, but pays me more per hour than everyday "Pain" work.
I often describe my practice as 75% the same as my anesthesia colleagues. I quit doing EMGs a few years ago. I have a few legacy SCI patients (who see a partner for general issues). I still do amputee care because no one else around here will, and those patients end up getting a lot of injections. I was a director at rehab facility (2-4 hrs/week) for several years until it wasn't worth the time away from the office. I probably do more U/S than most, but don't fall into the diagnostic circle jerk described above.
Midwest, suburbs of a city of just under 1 million. Or as @SSdoc33 would call it, BFE.Where are you located @cowboydoc ?
Post in: '2023 Asipp medicare fee schedule'Hello anyone have the RVU clinic and procedure data for pain?
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I have seen pmr pain va jobs in west coast that are closer to 250 starting
No cause I’m the ******* that’s still in network. My cursory understanding is they charge whatever they want and get paid it, because the insurance companies have no way of tracking non contractural agreements so it’s a massive loop holeWould you be able to explain how out of network reimbursement works?
For those of us paid via a K1/1099 the VA is a great resource for an acceptable salary with the rest being distributions.The VA added a table designation of "interventional pain", independent of primary specialty, a few years ago. The max pay is something like 385k. If someone is an anesthesiologist, there would be flexibility in using that title instead, with a max of 400k.
These are MAX pay and it's very rare people get that. The same is true with all specialties at VA. Orthopods and radiologists are in the 350-400k range.
For those of us paid via a K1/1099 the VA is a great resource for an acceptable salary with the rest being distributions.
🤓 I feel attacked 😂No, not for the same procedure. I could see PMR more frequently nerding out with a U.S. guided procedure that takes 15 min, uses $15 in disposable, and reimburses $60 than anesthesia trained docs. That would be a reason for lower salary.
If I was really going to attack, I would have added “requests/demands boss/hospital buys him a $30,000 ultrasound machine”. 😂🤓 I feel attacked 😂
You are giving me PTSD flashbacks of me being forced to watch military PM&R docs doing 60 minute pre-surgical diagnostic ultrasounds for the Ortho Sports docs followed by a comprehensive "gait analysis". Super critical that we visualize and name every ligament in the ankle and foot.No, not for the same procedure. I could see PMR more frequently nerding out with a U.S. guided procedure that takes 15 min, uses $15 in disposable, and reimburses $60 than anesthesia trained docs. That would be a reason for lower salary.
$45k 😅If I was really going to attack, I would have added “requests/demands boss/hospital buys him a $30,000 ultrasound machine”. 😂
yes to all of your concerns.I recently started Pain fellowship and am looking at jobs back home in the NW. I haven't seen too many numbers, but I'm wondering if being a pain doc at the VA right out of fellowship is the right call. PSLF ( and EDRP at the VA would be nice) or loan repayment is a high priority for me, but I'm concerned that the VA won't have the volume/diversity of procedures and the pay won't hold up with a hospital based job.
If anyone could provide their opinion I'd appreciate it
If I’m not mistaken, your loan repayment is valid at a non-profit or government employer.I recently started Pain fellowship and am looking at jobs back home in the NW. I haven't seen too many numbers, but I'm wondering if being a pain doc at the VA right out of fellowship is the right call. PSLF ( and EDRP at the VA would be nice) or loan repayment is a high priority for me, but I'm concerned that the VA won't have the volume/diversity of procedures and the pay won't hold up with a hospital based job.
If anyone could provide their opinion I'd appreciate it
Yeah a hospital based system would be loan eligible, and VA if EDRP eligible would allow me to double dip in the forgiveness category, I just don't know if the pay cut/procedural limitations would be worth it vs community based hospital setting.If I’m not mistaken, your loan repayment is valid at a non-profit or government employer.
https://studentaid.gov/pslf/employer-search/search-tool
Many would pay better than va, and if you still qualify, best of both worlds.
PP or HOPD, and pay your loan off in < 3 yrs while still having a high QoL and job satisfaction.I'm also wouldn't really mind having a relatively easy job compared to non-VA
A "relatively easy" job will not make you a good pain doctor.
It's a real concern, but for some people the trade off may be worth it.This was one of my primary concerns. Thanks for the input.![]()
you don't own asc, that will be a completely different story 🙂It's a real concern, but for some people the trade off may be worth it.
Not everyone wants to do stimulators and kyphos and "cool" procedures, and you'll find out real quick the vast majority of what you'll be doing for a living is ESI/MBB/RFA/joint injections. In fact, the implant I'm doing today at lunch time I really don't want to do...
Those advanced procedures only pencil out financially for you if you're good at them. That's the dirty secret BTW.
If all I did was offer traditional pain procedures (ESI/RFA, etc), I'd make plenty of money and have a line out my door a mile long.
What you mean?you don't own asc, that will be a completely different story 🙂
Facility fee for stim is extremely profitable 😉What you mean?
Not when you're slow and your outcomes aren't very good. You'll get bumped for the hand and wrist guy.Facility fee for stim is extremely profitable 😉
If you're in a busy ASC and your implants are taking forever you'll get bumped by faster doctors.
good point from your practice, however this does not apply to other models, our interventionists here make comparable money to hand surgeons if not more by large. but you are right, my implant time is 1-1.5 hours on average. this morning before intracepts, it was a one-hour in and out of the implant.If you're in a busy ASC and your implants are taking forever you'll get bumped by faster doctors.
Like I said, implants aren't for everyone, neither are trials or kyphos for that matter. MILD isn't for everyone. All the sexy new pain procedures aren't for everyone.
If you have a hand/wrist surgeon or a guy doing totals and you take 3 hrs for an implant you'll get bumped out of the ASC and into a clinic space.
We have several physicians in my group that you simply can't compete with in terms of collections, and they'll get the room before you.
As someone who makes money off the ASC, of you gave me a choice between another pain doctor or an ortho surgeon, I know who I'm picking.
good point from your practice, however this does not apply to other models, our interventionists here make comparable money to hand surgeons if not more by large. but you are right, my implant time is 1-1.5 hours on average. this morning before intracepts, it was a one-hour in and out of the implant.
Don't forget the kit costs 20k
Contracts though.Don't forget the kit costs 20k
Don't forget the kit costs 20k
that is right, you can nail it down quite a bit, the margin for stim implant should be around 8k to 10k for Medicare patientsContracts though.
He may have a great contract, but it's still gonna cost a lot.