PM&R Pain Salaries

[Dr. Ice]

Things have changed in certain respects since you have been there. Some for the better. Some not. You know we have largely had very different experiences from our prior conversations.

Like anything else, there are pros and cons, benefits, and trade offs.
It is not all good. It is not all bad. Pros have outweighed cons, hence Im still there after a decade.
I’m not going to go point by point and comment on everything you have said in this thread, some are true, some are not.

I think, however, you have crossed the line with putting the level of specific detail in a public forum. True or not, I don’t think you would take kindly to someone airing your dirty laundry.

Haha ok man..except I have no dirty laundry that cant be shared on an open forum. My life is an open book. So is my practice. We are struggling, mismanaged. Lost yet another ceo. Lost many clinical staff, looking to merge with other corporate entities. We have a surgical center that has failed miserably and we are looking for a bail out.

One of our former ceo stole 900k from the practice and was arrested. And yet we continue to make similar mistakes with other CEO’s like children that cannot learn from past mistakes.

There’s my dirty laundry bro. And as much as my life and job hangs on the balance everyday, I wouldn’t have traded the last 8 years working in an environment where even if they hate my guts they at least know how to fake it well enough. No restrictions, practice as you wish just do right by the patients in whatever way you see fit.

Here’s the thing, no one from my group is claiming to be the savior of orthopedics or world class or whatever marketing ploy there is to offer. Perhaps that’s why the dirty laundry stings so badly.

Btw the only reason it likely got a little better is because of your former chief of service that recently left. I hope for all of your sakes that MF doesn’t take over again.

You can’t go point by point because much of what I say is in fact true. And it’s not like I made it up, must be coming from a reliable source no?

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[MitchLevi]

Your CEO shared the books with you? Where do you practice? Happy land?!

I have all of our information open and available to me.

End July I've seen 3650 patients, and I can tell you the number of pts of every other doctor or midlevel has seen. I know your billing and collecting numbers at the ASC, clinic and ancillary numbers. Procedure numbers. Surgery numbers. Total money the practice brings in, and total money broken up into ancillary, ASC and clinic.

I think you've got an opinion that only pertains to your experiences, and your experiences alone.

You're not describing every ortho practice, and given your last post it sounds like you've been around some BS and probably have a good reason to feel the way you do.



"Here’s the thing, no one from my group is claiming to be the savior of orthopedics or world class or whatever marketing ploy there is to offer"

Dude, marketing and creating buzz is part of the gig. You want business or no? You have to do it. I've driven around to a ton of local doctors and shook hands. Calling yourself world class is just marketing. No harm in that assuming you're ethical in your medicine.

Edit - Tomorrow I'm lecturing to our hospital about CRPS. We have 97 people that have RSVP'd. That's nearly 100 people that will get to hear my voice and know I'm not FoS and I'm trustworthy. You can send your mother to me, and I may not get her feeling better but I'll try my best and I'm not gonna pull snake oil out of my ass.

I really do NOT want to do it.

My son is a freshman in HS and is on the varsity Cross Country team. First HS meet is tomorrow AM, and I'm going to miss it. My wife is out of town, and my daughter is spending the night with a friend tonight because no one can watch her in the AM.

...but I have to do this lecture. That's 97 people that my practice needs me to educate.

 

[Dr. Ice]

I have all of our information open and available to me.

End July I've seen 3650 patients, and I can tell you the number of pts of every other doctor or midlevel has seen. I know your billing and collecting numbers at the ASC, clinic and ancillary numbers. Procedure numbers. Surgery numbers. Total money the practice brings in, and total money broken up into ancillary, ASC and clinic.

I think you've got an opinion that only pertains to your experiences, and your experiences alone.

You're not describing every ortho practice, and given your last post it sounds like you've been around some BS and probably have a good reason to feel the way you do.



"Here’s the thing, no one from my group is claiming to be the savior of orthopedics or world class or whatever marketing ploy there is to offer"

Dude, marketing and creating buzz is part of the gig. You want business or no? You have to do it. I've driven around to a ton of local doctors and shook hands. Calling yourself world class is just marketing. No harm in that.

Seriously thinking of making a big geographic move. I know it’s not the same everywhere. If I had to give any new grad advice, I would say, if you wanna do private practice and you want to join ortho, stay far far far away from the northeast.

I have colleagues at the illustrious hss looking to jump ship. It is what it is..

 

[MitchLevi]

Seriously thinking of making a big geographic move. I know it’s not the same everywhere. If I had to give any new grad advice, I would say, if you wanna do private practice and you want to join ortho, stay far far far away from the northeast.

I have colleagues at the illustrious hss looking to jump ship. It is what it is..

That's probably the issue dude. I've heard the NE is brutal.

Find an old ortho group that doesn't have a pain doctor.

My practice was founded in 1966, and we've had a couple of (worthless) pain doctors in the past. They'd stay and leave. Slow, not good at their job. I come in and show them what a good PMR doctor can offer (no EMGs) and I'm very well taken care of here...No complaints.

Edit -

We have a guy in my practice who has been here a long time, and end of June I've more than doubled his procedure numbers. Our billing isn't comparable in any way. He is what our group was used to before I came here. BTW, I'm no one special. Let's get that BS straight...I'm just a younger, modern trained pain doctor.


I'm telling you nothing you don't already know...

 

[MD87]

That's probably the issue dude. I've heard the NE is brutal.

Find an old ortho group that doesn't have a pain doctor.

My practice was founded in 1966, and we've had a couple of (worthless) pain doctors in the past. They'd stay and leave. Slow, not good at their job. I come in and show them what a good PMR doctor can offer (no EMGs) and I'm very well taken care of here...No complaints.

Edit -

We have a guy in my practice who has been here a long time, and end of June I've more than doubled his procedure numbers. Our billing isn't comparable in any way. He is what our group was used to before I came here. BTW, I'm no one special. Let's get that BS straight...I'm just a younger, modern trained pain doctor.


I'm telling you nothing you don't already know...

What region/state are you in? City or rural?

 

[MitchLevi]

Ga. Rural and city.

 

[sdnuser001]

Bob is correct. In an eat what you kill model, the anesthesia pain doc gets paid the same for an epidural as a PMR/Pain doc.

Some pain docs are more procedure focused than others. PMR docs tend to do more peripheral joint work, including the accurate example bob gave of spending all day on a MSK US guided procedure that pays peanuts. Anesthesia tends to be more spine focused which pays better. But there are plenty of spine focused PMR/Pain docs as well.

Only in the military and Kaiser, is PMR specifically paid lower for doing the same work. Otherwise, you get paid the same for the work, same CPT codes, etc.

And even Kaiser this is only certain cities, not all

 

[po_boy]

The tide may have turned from office based to asc for procedures with declining physician fees and increasing facility fees. I don’t have enough stim cases to pencil out asc ownership personally

Are you saying that it’s better to have ownership in an ASC and collect a facility fee vs. doing procedures in office?

 

[MitchLevi]

Are you saying that it’s better to have ownership in an ASC and collect a facility fee vs. doing procedures in office?

If you have a sizeable amount of ownership in a busy ASC, yes...

 

[Agast]

Are you saying that it’s better to have ownership in an ASC and collect a facility fee vs. doing procedures in office?

Keep in mind you have to purchase those shares. I’m coming out to the end of my 5 year loan where I will finally be making pure
profit from my shares.

 

[po_boy]

If you have a sizeable amount of ownership in a busy ASC, yes

Keep in mind you have to purchase those shares. I’m coming out to the end of my 5 year loan where I will finally be making pure
profit from my shares.

I guess this doesn’t apply to every situation though. I’m sure there are some situations where docs are collecting more from office based procedures. Just depends on how much you own and how profitable the ASC is correct ?

 

[Dr. Ice]

I guess this doesn’t apply to every situation though. I’m sure there are some situations where docs are collecting more from office based procedures. Just depends on how much you own and how profitable the ASC is correct ?

Yes

 

[po_boy]

Is it a fact that reimbursement is increasing for facility fees and decreasing for office-based procedures? Why aren't facility fee reimbursements declining as well?

 

[DOctorJay]

Is it a fact that reimbursement is increasing for facility fees and decreasing for office-based procedures? Why aren't facility fee reimbursements declining as well?

Think about who’s lobbying for facility fees (massive hospital orgs) vs who is lobbying for physician fees (essentially you and me).

 

[DoYouEvenLiftBro]

In regards to the original post, and some stating PMR higher earners. I could only imagine it would be from having more orthobiologics integrated into your practice (not to say gas can’t learn it obviously, you’re just changing the medium injected). Epidural with prp cash ~ $1200 instead of $200 csi. Facets same. Change that to bmac and you’re looking at $3-5k. Change that to disc and even more. Prp joint $500-750. Wildly different pricing depending on area of practice but that’s our cost.

 

[lobelsteve]

In regards to the original post, and some stating PMR higher earners. I could only imagine it would be from having more orthobiologics integrated into your practice (not to say gas can’t learn it obviously, you’re just changing the medium injected). Epidural with prp cash ~ $1200 instead of $200 csi. Facets same. Change that to bmac and you’re looking at $3-5k. Change that to disc and even more. Prp joint $500-750. Wildly different pricing depending on area of practice but that’s our cost.

Sucker born every minute. Get the cash while you can.

 

[drusso]

Think about who’s lobbying for facility fees (massive hospital orgs) vs who is lobbying for physician fees (essentially you and me).

#theywillneverloveyouback