Rheumatology job prospects

[TaroBubbleTea]

I saw in another thread that someone commented that rheumatology is starting to become saturated.

I was hoping to hear from some fellows or new attendings who have recently gone through the job search for rheumatology positions to get a better sense if this is indeed the case. How easy/difficult was it to find a job in a location you wanted to be in? What is the range of salaries you saw during your search? When during fellowship did you start your job search?

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[holaho]

Very saturated job market in my neck of woods. No openings for the past year within an hour radius. All I would say is be careful. The people I know got jobs were give offers comparable to primary care. I am guessing markets recover post COVID but this may be permanent.

 

[TaroBubbleTea]

Very saturated job market in my neck of woods. No openings for the past year within an hour radius. All I would say is be careful. The people I know got jobs were give offers comparable to primary care. I am guessing markets recover post COVID but this may be permanent.

That’s what I was afraid of. Which geographic region are you in?

 

[RheumDoc112]

Very saturated job market in my neck of woods. No openings for the past year within an hour radius. All I would say is be careful. The people I know got jobs were give offers comparable to primary care. I am guessing markets recover post COVID but this may be permanent.

I have to disagree.
If you're hoping for New York, Los Angeles, Chicago, etc then yes it is an unpleasant job market.
Anywhere else in the country you will find the exact opposite. I had multiple offers prior to completing fellowship and with salaries ranging from 260-310.
Browse the ACR career connection site and I imagine you'll be giddy for days from the reassurance it provides. Good luck!

 

[bronx43]

I have to disagree.
If you're hoping for New York, Los Angeles, Chicago, etc then yes it is an unpleasant job market.
Anywhere else in the country you will find the exact opposite. I had multiple offers prior to completing fellowship and with salaries ranging from 260-310.
Browse the ARC career connection site and I imagine you'll be giddy for days from the reassurance it provides. Good luck!

310? Sorry, but the only jobs that you'll see 300k base is 1.5 hours away from any metropolitan.

Anything in a desirable location is under 260, with the exception of the south.

OP, look at the ACR career site and search your desired geographic location. More likely than not, there will not be any good jobs.

 

[TaroBubbleTea]

310? Sorry, but the only jobs that you'll see 300k base is 1.5 hours away from any metropolitan.

Anything in a desirable location is under 260, with the exception of the south.

OP, look at the ACR career site and search your desired geographic location. More likely than not, there will not be any good jobs.

I’m guessing I’m headed south then lol.

I have been browsing, but I’m not sure what entails a good job. A lot of these listings don’t even clarify the base salary.

 

[bronx43]

I’m guessing I’m headed south then lol.

I have been browsing, but I’m not sure what entails a good job. A lot of these listings don’t even clarify the base salary.

If you're geographically flexible and don't mind 4th tier cities, then you won't have a problem.

Cheers.

 

[blue.jay]

If you're geographically flexible and don't mind 4th tier cities, then you won't have a problem.

Cheers.

How is the job market in Phoenix, Tucson? Is it considered under south or west ?

 

[bronx43]

How is the job market in Phoenix, Tucson? Is it considered under south or west ?

I'm not terribly familiar with that area, but the south I was referring to is the southeast - think Alabama, Carolinas, Georgia, FL, etc.

 

[RheumDoc112]

If you're geographically flexible and don't mind 4th tier cities, then you won't have a problem.

Cheers.

Do you consider Minneapolis a 4th tier city? Why the snobbery anyway?

 

[bronx43]

Do you consider Minneapolis a 4th tier city? Why the snobbery anyway?

Minneapolis is great. Would love to live there. I don’t see high paying openings there though. You work there?

not trying to be snobby, just bearish on rheumatology market. If someone asks if I recommend the field, my answer is a resounding no. Our fellows this year have had a tough time finding good jobs near metros (except the south). I don’t expect much improvement next year tbh

 

[TaroBubbleTea]

Minneapolis is great. Would love to live there. I don’t see high paying openings there though. You work there?

not trying to be snobby, just bearish on rheumatology market. If someone asks if I recommend the field, my answer is a resounding no. Our fellows this year have had a tough time finding good jobs near metros (except the south). I don’t expect much improvement next year tbh

What factors do you think contributed to this? Was it covid? Midlevel encroachment? Too many graduates?

I feel like over the past several years, I’ve been reading about a shortage of rheumatologists from the ACR, is this no longer the case?

 

[bronx43]

What factors do you think contributed to this? Was it covid? Midlevel encroachment? Too many graduates?

I feel like over the past several years, I’ve been reading about a shortage of rheumatologists from the ACR, is this no longer the case?

ACR put out a workforce study in 2015 that stated there would be an impending shortage. It was quite misleading of a report IMHO, due to the fact that it didn't account for the sheer speed of rise in midlevels, and overestimated the number of OA and MSK pts treated by rheumatology. You will find that OA/MSK and even fibromyalgia are now increasingly treated by PCPs and other musculoskeletal specialties like ortho, sports med, PMR, pain medicine. I recall at my previous private practice gig that 3/4 patients that came to me for joint pain/ANA+ had already been given injections by the local ortho or pain doc. My job was to simply tell the patient that they didn't have a rheumatic disease.

Further pressures are placed on rheumatology by the displacement of health care cost onto the patient by insurers. Before, when copays were minimal and your insurance covered all of the visit cost, why not just make a trip to the rheumatologist for some counseling on fibro treatment? Now, you're paying a huge copay at the door, and are responsible for the full clinic bill until you hit your deductible. Is hearing the same schpiel about exercise and small changes in gabapentin dose worth $160? This has lead to a tighter market across the board for outpatient docs (not just rheum). However, in heme/onc for example, patients will always pay to see the oncologist. For aches and pains? Less likely.

COVID didn't start these trends, but I do believe that it accelerated them. Hospital employers are now more cautious with their budget, and my fellows have told me they have seen fewer hospital employed positions out there. A lot of private groups are hiring midlevels to pad their bottom line, which likely has expedited post-COVID. And all this is occurring on the backdrop of a modest uptick in fellowship spots, which in a specialty like rheumatology, can lead to rapid saturation if one is not careful.

 

[Prehealth1011]

@bronx43 would you recommend Allergy over Rheum?

 

[bronx43]

@bronx43 would you recommend Allergy over Rheum?

Rheum used to have a better job market but honestly not sure anymore. It may still, but I doubt either is robust.

 

[TaroBubbleTea]

ACR put out a workforce study in 2015 that stated there would be an impending shortage. It was quite misleading of a report IMHO, due to the fact that it didn't account for the sheer speed of rise in midlevels, and overestimated the number of OA and MSK pts treated by rheumatology. You will find that OA/MSK and even fibromyalgia are now increasingly treated by PCPs and other musculoskeletal specialties like ortho, sports med, PMR, pain medicine. I recall at my previous private practice gig that 3/4 patients that came to me for joint pain/ANA+ had already been given injections by the local ortho or pain doc. My job was to simply tell the patient that they didn't have a rheumatic disease.

Further pressures are placed on rheumatology by the displacement of health care cost onto the patient by insurers. Before, when copays were minimal and your insurance covered all of the visit cost, why not just make a trip to the rheumatologist for some counseling on fibro treatment? Now, you're paying a huge copay at the door, and are responsible for the full clinic bill until you hit your deductible. Is hearing the same schpiel about exercise and small changes in gabapentin dose worth $160? This has lead to a tighter market across the board for outpatient docs (not just rheum). However, in heme/onc for example, patients will always pay to see the oncologist. For aches and pains? Less likely.

COVID didn't start these trends, but I do believe that it accelerated them. Hospital employers are now more cautious with their budget, and my fellows have told me they have seen fewer hospital employed positions out there. A lot of private groups are hiring midlevels to pad their bottom line, which likely has expedited post-COVID. And all this is occurring on the backdrop of a modest uptick in fellowship spots, which in a specialty like rheumatology, can lead to rapid saturation if one is not careful.

Very informative post.

Most of medicine is bound for the same trajectory in a race for the bottom. It seems primary care makes more financial sense, but I’m already on this train anyway so I’ll opt to pursue something I’d enjoy. Hopefully I don’t regret it in the end.

 

[bronx43]

Very informative post.

Most of medicine is bound for the same trajectory in a race for the bottom. It seems primary care makes more financial sense, but I’m already on this train anyway so I’ll opt to pursue something I’d enjoy. Hopefully I don’t regret it in the end.

I mean don’t get me wrong. If someone really wants rheum, it’s not the end of the world. Simply that people need to adjust their expectations. I rather go into this knowing potential drawbacks instead of going in thinking it’s a buyers market.

 

[CaliPCCSM]

I don’t know. My medical group in Southern California needs 2 rheumatologists soon.

 

[Sushirolls]

Big Box shop near me has 2 postings.

 

[bronx43]

Big Box shop near me has 2 postings.

Strike while the iron is hot! Won’t last.

 

[TaroBubbleTea]

Big Box shop near me has 2 postings.

What is a big box shop in this context? Like a large health system?

 

[Sushirolls]

VA, very large multispecialty groups, Health systems, multistate single specialty groups, regional hospital multispecialty medical group, etc

 

[sloh]

My job was to simply tell the patient that they didn't have a rheumatic disease.

Before, when copays were minimal and your insurance covered all of the visit cost, why not just make a trip to the rheumatologist for some counseling on fibro treatment? Now, you're paying a huge copay at the door, and are responsible for the full clinic bill until you hit your deductible. Is hearing the same schpiel about exercise and small changes in gabapentin dose worth $160? This has lead to a tighter market across the board for outpatient docs (not just rheum).

This is such a good post. As PM&R, in my previous job that held patient (customer) satisfaction scores on a pedestal, I pretty much had my hand forced to perform procedures, prescribe medications, and make recommendations that were not even in the least bit supported by the evidence because the patients had to fork out a significant amount of money for that clinic visit and they wanted "something" out of it. Patient education on lifestyle change, which is what and all they needed, was often met with anger.

 

[mszzeta]

I heard that the rheum job market were affected significantly during the pandemic, so did many other specialties.

I have heard that some place in big cities are about to open positions and recruit people as pandemic is getting better. But I am based on very small samples so please take my words as a grain of salt. But the only way to see what the market will be like is time.

 

[FohBay]

I just graduated from fellowship and had a good experience with job search. I applied at the very beginning of 2nd year (7/2020) during COVID. There were multiple openings in the SF Bay Area. I interviewed with one of them in 8/2020 and got a same day offer. The salaries I've seen has been in the 240-290k range.

 

[rumitology]

New rheumatology attending here.


The state of the job market is a complicated question - you will get answers from people who are relaying their personal perspectives and considering how many factors go into the job search this will ultimately be narrow so my first bit of advice to you is to make sure you gather many perspectives as you will gain a more accurate sense of things.

I was training in the northeast looking for jobs primarily in big cities - I wasn't in NYC and so I found the job search there challenging. For starters the better known healthcare systems did not advertise their positions much - I imagine because they could rely on word of mouth. It would save them from going through tons of applications from websites. That's what happens in desirable locations, recruiters do not need to advertise so unless you are already a fellow in the program or have a connections based on relationships (ACR, research, mentors) it is hard to break in. This is why networking in a hard but important. Also start early as mentioned in different post. Of course as you slowly move outside of Manhattan jobs become more and more available - by the time you are 30-45 minutes away in New Jersey you have more flexibility and range. Even further out you will certainly see postings of large academic centers looking for rheumatologists. Ultimately there are jobs but if you are looking for something specific then it will become harder based on what I said. That is essentially the job search in a nut shell. When people say "there are rheumatology jobs everywhere" technically they are not lying because certainly there are but like most people you probably had something specific in mind and thats what makes it harder.


Having said all that I ended up with a teaching position at an academic community hospital in a major city - I was lucky in that it checked a lot of boxes. My salary is mid 200s and I like my schedule. Getting this job required a bit of tenacity on my part - so don't be discouraged. Finding a good fit somewhere takes determination and all of us start somewhere only to realize we want to be somewhere else. At the end of the day if you picked rheumatology out of interest then you'll always be doing something that provides you satisfaction and meaning. Good luck!

 

[Renal_Prometheus]

ACR put out a workforce study in 2015 that stated there would be an impending shortage. It was quite misleading of a report IMHO, due to the fact that it didn't account for the sheer speed of rise in midlevels, and overestimated the number of OA and MSK pts treated by rheumatology. You will find that OA/MSK and even fibromyalgia are now increasingly treated by PCPs and other musculoskeletal specialties like ortho, sports med, PMR, pain medicine. I recall at my previous private practice gig that 3/4 patients that came to me for joint pain/ANA+ had already been given injections by the local ortho or pain doc. My job was to simply tell the patient that they didn't have a rheumatic disease.

Further pressures are placed on rheumatology by the displacement of health care cost onto the patient by insurers. Before, when copays were minimal and your insurance covered all of the visit cost, why not just make a trip to the rheumatologist for some counseling on fibro treatment? Now, you're paying a huge copay at the door, and are responsible for the full clinic bill until you hit your deductible. Is hearing the same schpiel about exercise and small changes in gabapentin dose worth $160? This has lead to a tighter market across the board for outpatient docs (not just rheum). However, in heme/onc for example, patients will always pay to see the oncologist. For aches and pains? Less likely.

COVID didn't start these trends, but I do believe that it accelerated them. Hospital employers are now more cautious with their budget, and my fellows have told me they have seen fewer hospital employed positions out there. A lot of private groups are hiring midlevels to pad their bottom line, which likely has expedited post-COVID. And all this is occurring on the backdrop of a modest uptick in fellowship spots, which in a specialty like rheumatology, can lead to rapid saturation if one is not careful.

This is the story of nephrology and what lead to its decline. Expansion of fellowship positions followed by oversaturation in the market place. It’s a race to the bottom for volume based specialties. Academics can care less about the problems in private practice as long as they get bodies for the scut machine.

 

[bronx43]

Having said all that I ended up with a teaching position at an academic community hospital in a major city - I was lucky in that it checked a lot of boxes. My salary is mid 200s and I like my schedule. Getting this job required a bit of tenacity on my part - so don't be discouraged. Finding a good fit somewhere takes determination and all of us start somewhere only to realize we want to be somewhere else. At the end of the day if you picked rheumatology out of interest then you'll always be doing something that provides you satisfaction and meaning. Good luck!

By academic community hospital, do you mean community hospital with a residency and fellowship program? Or do you mean the community satellite of a university based institution?

Mid-200s for a teaching position is a solid job, though. My local academic institution isn't coming close to that, unfortunately. They have the private hospital volume for research pay mentality, and my suspicion is this will blow up in their face in the near future. You can only push docs so far before they wake up to the scam.

 

[FohBay]

Is this the range you saw in California?

Super late reply. This is the range that I have seen in California and Seattle when I applied last year.

 

[bronx43]

Looking on various job boards, I have noticed a significant increase in "academic" jobs. Anyone biting at these FAKEdemia jobs where you do PP volume but get paid like you're doing 3 half days of clinic?

 

[Prehealth1011]

Super late reply. This is the range that I have seen in California and Seattle when I applied last year.

Thanks!

 

[rokshana]

Do you consider Minneapolis a 4th tier city? Why the snobbery anyway?

Because some people think life only exists in nyc…

 

[TaroBubbleTea]

Because some people think life only exists in nyc…

Those people can stay in those saturated markets on the coasts then.

 

[mszzeta]

Looking on various job boards, I have noticed a significant increase in "academic" jobs. Anyone biting at these FAKEdemia jobs where you do PP volume but get paid like you're doing 3 half days of clinic?

Haha, I like the way you are so straightforward......

The true academic, that people get funding and do serious research continuously, is pretty hard and rare overall. There is a wide spectrum from university hospitals who hires a big-name chief who is the only person doing serious research, to community hospitals with an IM residency......

technically, all residents and fellows are required to have some research experience per ACGME, so people just play the game and pretend that they are being academic.....

Big pharm also have clinical trial opportunity for clinician to participate. This is also an kind of "academic", being a part of something big.....

Everything is about personal choices. And there are people who would be willing to take a pay cut to see more interesting pathology, being a colleague with prestigious experts and teaching students and trainees. And I believe there are many jobs who is not actually what they pretend to be......

 

[Residentdoc86]

Haha, I like the way you are so straightforward......

The true academic, that people get funding and do serious research continuously, is pretty hard and rare overall. There is a wide spectrum from university hospitals who hires a big-name chief who is the only person doing serious research, to community hospitals with an IM residency......

technically, all residents and fellows are required to have some research experience per ACGME, so people just play the game and pretend that they are being academic.....

Big pharm also have clinical trial opportunity for clinician to participate. This is also an kind of "academic", being a part of something big.....

Everything is about personal choices. And there are people who would be willing to take a pay cut to see more interesting pathology, being a colleague with prestigious experts and teaching students and trainees. And I believe there are many jobs who is not actually what they pretend to be......

Truth Bomb!!!!

 

[DrCanez]

Current fellow here. When does this group recommend starting to apply for positions (personally looking for community hospital employed vs private/multi-specialty practice)? Wait start of the 2nd year of fellowship? Is an earlier the better approach appreciated or not, especially since I have known geographic preferences?

Thanks!

 

[dfib slim]

Current fellow here. When does this group recommend starting to apply for positions (personally looking for community hospital employed vs private/multi-specialty practice)? Wait start of the 2nd year of fellowship? Is an earlier the better approach appreciated or not, especially since I have known geographic preferences?

Thanks!

I just signed a contract 2 months into 2nd year but I was an outlier. I had started applying and interviewing May of 1st year. Most fellows in my program signed anywhere from January to May of 2nd year.

 

[Kakoy]

I need to move to where @bronx43 is located! We are at a hiring freeze but we have tons of referrals and book out for months for new patients!

For us, it's not legitament rheumatology patients in these referrals. With the rise of midlevels and some PCPs, our referrals consists of ANA pos, OA, any Msk pain, fibromyalgia, neuropathy, "can't figure out what this is, go to rheum and they will figure it out", venous insufficiency, erythema of the face, etc. We see them twice ( once for initial visit, 2nd time to review/labs/xray for recommendations), then TRY to send them back to pop. Some OA and Msk patient insist on staying with us.

So, I agree that there are a low number of ACTUAL rheumatology patients! However, as long as some PCP act as referring machines, we will always have too many referrals!

 

[bronx43]

I need to move to where @bronx43 is located! We are at a hiring freeze but we have tons of referrals and book out for months for new patients!

For us, it's not legitament rheumatology patients in these referrals. With the rise of midlevels and some PCPs, our referrals consists of ANA pos, OA, any Msk pain, fibromyalgia, neuropathy, "can't figure out what this is, go to rheum and they will figure it out", venous insufficiency, erythema of the face, etc. We see them twice ( once for initial visit, 2nd time to review/labs/xray for recommendations), then TRY to send them back to pop. Some OA and Msk patient insist on staying with us.

So, I agree that there are a low number of ACTUAL rheumatology patients! However, as long as some PCP act as referring machines, we will always have too many referrals!

This is a bad thing... very bad thing, especially with the way the current medical system is constructed where the "customer is always right" mentality runs amok. Why? Because a good portion of these patients referred for nonsense indications are just suffering from the human condition, but will be angry at the rheumatologist for not making a right diagnosis and "blowing them off."

The percentage of this type of referral just increases with the number of rheumatologists in a particular geographic catchment area.

 

[bronx43]

Current fellow here. When does this group recommend starting to apply for positions (personally looking for community hospital employed vs private/multi-specialty practice)? Wait start of the 2nd year of fellowship? Is an earlier the better approach appreciated or not, especially since I have known geographic preferences?

Thanks!

Good decision on looking for community hospital employed or PP. These are honestly the only jobs that are financially feasible nowadays.
Given the current landscape, I would not accept any base salary that's not at least mid-200s. If you're 30+ minutes out from a major metro, then that number goes up to high 200s or even 300k. If they offer low, then counter HARD. A lot of times, employers will buckle. If they don't budge, then tell them "thanks but no thanks."

I would reach out to internal recruiters as soon as you can for openings. Even if they are not listed, hospitals would often consider you to keep some of their business in-house. The whole process does take a bit so you want to have a job secured by early 2022 at the latest.

 

[mszzeta]

Current fellow here. When does this group recommend starting to apply for positions (personally looking for community hospital employed vs private/multi-specialty practice)? Wait start of the 2nd year of fellowship? Is an earlier the better approach appreciated or not, especially since I have known geographic preferences?

Thanks!

I am currently into the process of hunting jobs....And I asked the same question to many people

For the majority of the job (particularly non-academic)., it is purely a market economy. Whether you will get a job depends primarily on whether there is an opening from the employer due to supply/demand imbalance. The market is often fluid, with new good jobs can pop up "randomly" at any time point.

If you look early and sign a place you really like, you are the lucky one. The difficult question becomes if there is a job that is so-so but acceptable, would you accept it, or waiting for a better job? If you wait, there is a chance that the previous job will be taken by another person and the position would be no longer available.

In big cities, due to market saturation, it could take some time to find a very good job, especially for those who need visa sponsorship. Also note that in big cities, some positions for new grads could open late, as some employers would initially prefer candidates who can work right away rather than next year.

For academics, particularly the major centers, things can differ a little bit and I do think internal connections play some role

 

[Kakoy]

This is a bad thing... very bad thing, especially with the way the current medical system is constructed where the "customer is always right" mentality runs amok. Why? Because a good portion of these patients referred for nonsense indications are just suffering from the human condition, but will be angry at the rheumatologist for not making a right diagnosis and "blowing them off."

The percentage of this type of referral just increases with the number of rheumatologists in a particular geographic catchment area.

Agreed! I use to have patients call patient advocate on me being dismissing for the concerns for a random symptom I don’t treat!

At this time, we review the referrals! If it’s an indication that we don’t treat ( itchiness referral just came in 10 minutes ago), my front desk warn the patient that I can see them for evaluation of ana or rule out rheumatologist diseases but I do not treat ___ ( does she still want an appt?), I don’t use pain meds, and book these pts at next available appt! We don’t reject referrals except for oldest doc! Us, youngin’s, get reported to him for refusing referrals!

After setting boundaries, it is a lot better but these referrals are absolutely frustrating at times! Someone told me last wk that life is a not a painfree experience and should not expect it to be so! Lol, maybe I should steal that!

Oh, a medscape survey ( so take with grain of salt) reported rheum has 2nd highest reported burnout rate reported after critical care! A few friends and I discussed it ( 2 rheum and 1 psych), the psych doctor made a very good point: In rheumatology, we have tons of patients with somatic symptoms and psychiatric issues sent to us but we are not trained in psych and is not equip to handle it! So, the mental gymnastics of handling chronic rheum diseases with immunosuppressants, life threatening- organ damaging conditions, “the mysteries that no one can figure out”, random referrals and all the somatic/centralization conditions in an area we are not trained in… I can see why we have high burnout after the pandemic end is #2 after CC ( who treated Covid patients)! We are now getting long haul Covid … which I don’t know what to do with either!

I have a friend who left clinical practice after a year!

2.5 years out! I set clear boundaries in my practice and feel pretty good about my job! I am not saying rheumatology is not a great field, it is if you do the hard work up front ( setting boundaries) or else, the burnout is very real! I still love my field and mg job, but I also had the hard conversations and established very clear boundaries!

I am rarely on any more with a busu practice but will try and pop on!

On to my next new patient ( cardio crp elevated, inflammatory crp neg on repeat, want to talk about inflammation)!

Edit: posted on phone, please excuse typos and other errors!

 

[bronx43]

Agreed! I use to have patients call patient advocate on me being dismissing for the concerns for a random symptom I don’t treat!

At this time, we review the referrals! If it’s an indication that we don’t treat ( itchiness referral just came in 10 minutes ago), my front desk warn the patient that I can see them for evaluation of ana or rule out rheumatologist diseases but I do not treat ___ ( does she still want an appt?), I don’t use pain meds, and book these pts at next available appt! We don’t reject referrals except for oldest doc! Us, youngin’s, get reported to him for refusing referrals!

What’s your practice situation? Private practice, hospital employed or academia?

 

[Kakoy]

What’s your practice situation? Private practice, hospital employed or academia?

It’s a mixed model! I am base in RVU with salary (so private practice like) but associated with a large group with a stable referral base!

Interesting that we are having this conversation today; our group of rheumatologist had a lunch meeting to decide how to decrease the number of referrals!

@bronx43 I have followed your post for a long time from when I was a resident and as a fellow! In one of your very very distant posts, you mention a lesson that shaped my practice! I think you mention that when you first started, you took on a lot of patients that may not need rheum care and that you had wish you had been more judicious! I took that to heart and has been very clear on my boundaries and my patients! So, thank you for that! I am grateful for my job and is happy with it since I am VERY focus on building a practice that I can work for the rest of my life!

Luckily, I am at a practice with supportive partners who allow me to do so!

 

[RheumDoc112]

Good decision on looking for community hospital employed or PP. These are honestly the only jobs that are financially feasible nowadays.
Given the current landscape, I would not accept any base salary that's not at least mid-200s. If you're 30+ minutes out from a major metro, then that number goes up to high 200s or even 300k. If they offer low, then counter HARD. A lot of times, employers will buckle. If they don't budge, then tell them "thanks but no thanks."

I would reach out to internal recruiters as soon as you can for openings. Even if they are not listed, hospitals would often consider you to keep some of their business in-house. The whole process does take a bit so you want to have a job secured by early 2022 at the latest.

Weren't you previously saying the only way to make those numbers was to go to a 4th tier city or 90 minutes outside of a desirable area? What changed?

 

[bronx43]

Weren't you previously saying the only way to make those numbers was to go to a 4th tier city or 90 minutes outside of a desirable area? What changed?

The job market in this post-covid (kinda?) landscape is much better than pre-covid. Maybe the Great Resignation is diffusing into older physicians, and the market for our specialty is definitely opening up.

But for the most part, you're still not going to see 300k+ in a major metro, and will have to drive at least 30 minutes out. I say 30 min now, because one of our fellows got this offer about 30-45 minutes from a suburb of our metro area. If you want to measure from downtown, it's still 60+ minutes. But no reason to nitpick... the point here is that rural rheum = 300k and city rheum = 250-275k. And perhaps more importantly, more openings in more cities.

 

[Prehealth1011]

The job market in this post-covid (kinda?) landscape is much better than pre-covid. Maybe the Great Resignation is diffusing into older physicians, and the market for our specialty is definitely opening up.

But for the most part, you're still not going to see 300k+ in a major metro, and will have to drive at least 30 minutes out. I say 30 min now, because one of our fellows got this offer about 30-45 minutes from a suburb of our metro area. If you want to measure from downtown, it's still 60+ minutes. But no reason to nitpick... the point here is that rural rheum = 300k and city rheum = 250-275k. And perhaps more importantly, more openings in more cities.

What are the typical patient loads for these jobs?

If i recall correctly from the other veteran poster here, 300k+ in something like primary care is 20+ patients a day. Curious how that compares to outpatient subspecialties like Rheum

 

[RheumDoc112]

What are the typical patient loads for these jobs?

If i recall correctly from the other veteran poster here, 300k+ in something like primary care is 20+ patients a day. Curious how that compares to outpatient subspecialties like Rheum

I typically see 14 a day, but I have colleagues that see 20-22 which just sounds exhausting.

 

[bronx43]

What are the typical patient loads for these jobs?

If i recall correctly from the other veteran poster here, 300k+ in something like primary care is 20+ patients a day. Curious how that compares to outpatient subspecialties like Rheum

Alot of variables. Most employed jobs will be either completely productivity or base salary with productivity bonus.

In a metro, the RVU conversion will be low to mid 50s. But that number can change after you hit your RVU target.

All in all, I think if you bill correctly, 300k should be somewhere between 18-20 per day. It also depends if you do alot of injections or ultrasounds.

 

[TaroBubbleTea]

Alot of variables. Most employed jobs will be either completely productivity or base salary with productivity bonus.

In a metro, the RVU conversion will be low to mid 50s. But that number can change after you hit your RVU target.

All in all, I think if you bill correctly, 300k should be somewhere between 18-20 per day. It also depends if you do alot of injections or ultrasounds.

Are injections or ultrasound efficient for increasing RVUs or are you better off just seeing more patients?