salary of spinal surgeons

Discussion in 'Orthopaedic Surgery' started by newbie20, Nov 24, 2005.

  1. newbie20

    newbie20 New Member

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    i am a third year medical student and have been deliberating on this for years. Even before that in college i spent numerous time with thoracic and spinal surgeons and i still love them both equally, so the only factor that i have to consider at the moment is the salary? i have tried to find other reasons but i don't have anything significant enough to choose one over the other. I have spoken with a couple of thoracic surgeons and they have told me the job market for thoracic surgeons is becoming difficult because the medical community is trying to minimize the field, because the cardiothoracic surgeon can do the work of the thoracic surgeons and more, so the thoracic surgeons graduating need extra fellowships in order to be more competitive. I have been told that a field as specific as spinal surgery would be ideal in the next 10 - 20 years because of the baby boomers retiring. So i was wondering the salary ranges for spinal surgeons if anyone does know ????
     
  2. ForensicsBound

    ForensicsBound Junior Member
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    Spine surgeons are probably the highest paid specialists in medicine as a group. How much you actually make depends on the area of the country, the group you practice in, and most importantly, HOW BUSY YOU WANT TO BE. In the mid-west, a relatively busy spine surgeon makes anywhere from 600 K to 1.5 million...some make more, some less.
     
  3. HtSht2BoneDoc

    HtSht2BoneDoc Member
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    I second that. I know a lady in So Cal makes 1 mill at a a kaiser permanente. weekends off. nice and cush. you should not go into ortho for the money though. go into ortho because its the best specialty out there.
     
  4. paisano

    paisano New Member

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    i know that you can do the spine fellowship after NS, ortho and plastic. why would people go to an ortho instead of an NS???
    i bet that you can do 2 + millions a year, if you want. (do plastics do more in California???|)
     
  5. NotADocYet

    NotADocYet Should I change my name?
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    So, does this make it incredibly tough to get into?
     
  6. ForensicsBound

    ForensicsBound Junior Member
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    To clarify a few things:

    You can only do spine surgery after ortho or neurosurg training. Someone mentioned plastics...not true.

    Question of why do ortho instead of NS: the bottom line is that it doesn't matter. Orthopods are more adept at stabilization of bones b/c that's what they're trained to do. Neurosurgeons are more adept at decompressions by virtue of their training. But spine surgeons in both fields learn how to do both. The following is a gross generalization but it is my opinion: orthopods in general are better spine surgeons b/c the ones that operate on the spine are subspecialists and spine surgery is pretty much all they do. Neurosurgeons on the other hand tend to do intracranial work in addition to spine surgery. So their practice may be split between brain and spine. In highly subspecialized fields like spine, the more you do, the better you get.

    The question of whether spine is hard to get into: Well both orthopaedics and neurosurgery residencies are. Most neurosurgeons do not do a fellowship in spine. However, almost all orthopods who do spine surgery do a year of spine fellowship. There are some fellowships that are very difficult to match into. But if you finish an orthopaedic residency and want to do spine, you'll get a spine fellowship...there are many of them out there. But the few that are top notch are hard to get.

    The reason many people don't want to do spine is b/c the surgeries tend to be long and demanding and patient population is less than desirable (older, narcotic dependent, chronic pain, low back pain, etc.)
     
  7. paisano

    paisano New Member

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    so, talking about money, what is the best specializatino money wise?? i got the feeling that it is plastic, but I would feel such a waste, if i am a doctor, trying to let people look prettier.
    as for teh spine after plastic. go to the spine fellowship at mass. general, and it says ortho and NS. but if you keep reading you will find them saying plastic. and my father says that spine ops. are 2 hours. he is an ortho(hands and feet)
     
  8. dobonedoc

    dobonedoc Senior Member
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    Follow a spine surgeon for a week. Go to his or her clinic. Stand in the OR during cases. Read some journals about current topics in spine surgery. Then decide.

    Microdiscectomies are in the neighborhood of 2 hours, given the time needed to position the patient, do the procedure, and close up.

    Try doing a revision case for a failed fusion. Perhaps you would like to try to care for the 18 year-old new high-school graduate that just got scooped off the road after a nasty MVC who has a nasty burst fracture and can't feel a thing below her rib-cage. How about the 60 year old that can't walk due to pain in her legs with spinal stenosis from L2-S1. Plan on some type of wide decompression with foraminotomies, with some type of fusion with bone graft and instrumentation. I won't bore you with scoliosis cases. Plan on a bit more than 2 hours.

    These surgeons get paid BUCKS! But money is not the only thing. Spine surgery is time consuming, tedious, and stressful. I've seen many spine surgeons go all night, just to do it again at 0700 the next morning. Their clinic is hell. Finally, the stakes are high. They deserve every dollar they are paid.

    A person does spine because they are not wired correctly. I am greatful we have people like this, however, because a truly bad back is a terrible thing.
     
    OrthoTraumaMD likes this.
  9. HtSht2BoneDoc

    HtSht2BoneDoc Member
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  10. duckhunter25

    duckhunter25 Member
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    i watched a two level spine fusion which is not very complicated at all and it took 5 hrs.
     
  11. Wahoos

    Wahoos Member
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    Spine fellowships can be obtained after either a Neurosurg or Ortho residency. Both N.S. and Orthopods are very good at taking care of the spine, no one is better than the other in general terms, it is surgeon dependant. I have scrubed with both N.S and Ortho Spine and I can say they were both very good. Spine fellowships are not very hard to get, only about 50% of the spine fellowships are filled each year. However, the top academic spine fellowships are tough to get, Case Western with Bohlman, UCSD, Wash U, etc. There is a difference between NS spine and Ortho Spine, Neurosurgeons can go past the dural sack to remove spinal tumors, whereas orthopods do NOT do that or want to go anywhere inside the sack. That is the only difference. About compensation, you can make a lot of money, some of the above figures are correct, academics is lower, 300-400s or so, private practice $600,000 and the sky is the limit.

    The patient popultation is good if you are in a large academic setting which means you will get big/interesting cases (multi level fusion, front + back, Trauma cases, etc), however if you are in a community, you will do many diskectomies, and not much variety. That is why some people make the scarifse to work in academia.

    The clinic can be a pain, and the patients are the hardest of all ortho patients to take care of post op. Most of them will complain of something, pain, hardware irriatation, etc. The surgeries work well, but success/pt satisfaction rate is not as good as elective sport/joint cases.

    Most people in ortho do not go into ortho thinking that they will do spine, our program matched 2 guys to spine surgery fellowship last year, and they both wanted to do sports in the beginning.

    About time per case, depends on the case, diskectomy is about 2 hrs, multilevel fusion w/ant and pos approach 6-8 hours, and I saw part of a case at UVA that was a sacraldectomy, complete sacrum removal for tumor with metal prostesis, that was about 25+ hours long. So the time varies. Taking care of the 16 year old in a MVA who loses sensation below the waist is not something everyone wants to do. Spine surgery has limits, pts like that probably will not get much better no matter what you do. You will not bring back function to the Extremities with spine surgery in the trauma setting, unless in very rare cases. However, you can prevent injuries with spinal surgery in pts with unstable fractures which can be satisfying.

    Hope this clarify things for you guys.
     
  12. aebilling1

    aebilling1 Junior Member
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    I do medical billing for spine surgeons in CA. Incoming receipts out here for a low volume (part time) spine surgeon would be approx $50K/month. Incoming receipts for a high volume spine surgeon could be upwards of approx $150-200K/month. I've seen as high as $250K/month on occasion. Of course, this is based only on cash coming in the door from insurance companies and patients. Overhead and all that would have to be taken into consideration. I've seen practices with extremely high overhead and some solo docs with minimal overhead. Of course, make sure you have a good biller to capture every buck due to you!
     
  13. marcus_aurelius

    marcus_aurelius Membership Revoked
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    If you want money, go into Plastics! Cosmetic surgery can get you a lot of money with a better lifestyle.

    My opinion is you can only be really good at spine surgery if u have a passion for it. Spine Surgery is NO JOKE! Stakes are very high! My father was going to get surgery for a back condition, but VERY risky surgery....he and our family decided against it. Although the stakes are high if you are genuinely interested in it and work hard to get really good, the patients you treat and their families will be eternally grateful to you, which in my opinion would be something great.

    if there is no passion, there are much better and easier ways of making money in medicine.

    i thought of spine but am currently in the bottom third of my class after second year so realistically have no shot...so i'm thinking pmr or pain management or peds.

    if spine is what u want,WORK HARD...and do it for the patients (the bling will follow and is probably less impt than their gratification towards you.)

    remember, ppl suffering from a lot of these problems REALLY SUFFER. back pain can be horrible and chronic. my dad used to be athletic and his pain and arthritis have really taken a chunk out of his lifestyle...when i was a kid i used to play tennis with him and as i got older and he got stiffer, he couldnt play many sports anymore, and he was very disappointed to lose a lot of his mobility to his particular condition.....not only this but the pain many of these patients have is constant, during the day and night.

    be the good doc to spend that extra time with the patient. (ok, enough preaching, good luck!)
     
  14. r7p3

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    I think becoming a CEO will probably give you less lifetime income than getting into ortho spine (unless you're Bill Gates or some other prodigy).
    No, medicine is a slow way to become rich, but it is very secure. A great way to make lots of money, no joke.
     
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  15. doc-oc!

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    how hard is it to become an orthopedic spine surgeon?
     
  16. md-2020

    md-2020 The Immaculate Catch
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    Extremely.
     
  17. pd1112

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    Have to match ortho first, arguably the most competitive specialty to match right now based on numbers.
     
  18. spartywrx

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    "A person does spine because they are not wired correctly. I am greatful we have people like this, however, because a truly bad back is a terrible thing."

    I personally second this. All of our orthopod spine guys are crazy.

    Unless you really love the brain and want to spend an extra year in residency, go ortho spine. You will end up doing very similar things, yet you can also do non spine stuff like take some regular trauma call and do some hip fractures. Neurosurgery call from my limited interaction with it sucks, its a bunch of non op head bleeds then suddenly a 8 hour craniotomy. That sounds awful. At least in ortho our emergencies can get an ex fix and stabilized in about an hour.

    Also no plastics does not do spine.

    If you're after money, remember that Uncle Sam is going to screw us somehow, so pick what you like. Ortho, NS, and Plastics all do quite well. Ortho is probably the shortest path to attending-hood amongst the 3.
     

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