anonperson

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There isn't a lot of transparency regarding salary/benefits for those on the job search.

Anyone on the job search or currently working, please post salary info and job setup.

Here's my situation (FPMRS trained)
Base $300,000
5 weeks off
Productivity bonuses can be worth $100,000. Realistically though $25,000 to $50,000 is more likely achievable.
$4000 CME
4% 401k match (worth $12000)

Currently do a mix of GYN/Urogyn/OB for now.
 
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Jecave

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Apr 14, 2013
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This thread would be very informative. I’ll be interviewing soon and will make sure to come back and post.
 
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Nov 20, 2018
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There isn't a lot of transparency regarding salary/benefits for those on the job search.

Anyone on the job search or currently working, please post salary info and job setup.

Here's my situation (FPMRS trained)
Base $300,000
5 weeks off
Productivity bonuses can be worth $100,000. Realistically though $25,000 to $50,000 is more likely achievable.
$4000 CME
4% 401k match (worth $12000)

Currently do a mix of GYN/Urogyn/OB for now.
what does FPMRS trained mean?
 
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newby000

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Sep 30, 2010
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I like the idea of salary transparency as it will allow new residents what to expect and hopefully negotiate good deals.
Post residency with no fellowship was offered 250 starting as a laborist at an east coast hospital, in a large city with driving distance to large metropolitans. Roughly 13-15 shifts a month.
Would be interested to know if people who start as a laborists stay as one or move one to more office based jobs.
Also what is the general financial structure of office based jobs? Are there financial incentives based on the number of patients you see, in addition to your base? What does that entail ( how much more than your base should you bring in to be able to pull in the incentive) Are there any partnership positions? How long would it take to become a partner? how much would it cost to buy in into a partnership?
Your responses would be much appreciated.
 
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Nov 20, 2018
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I like the idea of salary transparency as it will allow new residents what to expect and hopefully negotiate good deals.
Post residency with no fellowship was offered 250 starting as a laborist at an east coast hospital, in a large city with driving distance to large metropolitans. Roughly 13-15 shifts a month.
Would be interested to know if people who start as a laborists stay as one or move one to more office based jobs.
Also what is the general financial structure of office based jobs? Are there financial incentives based on the number of patients you see, in addition to your base? What does that entail ( how much more than your base should you bring in to be able to pull in the incentive) Are there any partnership positions? How long would it take to become a partner? how much would it cost to buy in into a partnership?
Your responses would be much appreciated.
What do you meail 13-15 shifts? how many hours of work each shift? days or nights? weekend or weekdays?
 

newby000

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Sep 30, 2010
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Technically it is 15x12 hours shifts in a month, mix of days and nights, occasional 24 hour shifts which counts for two shifts. Anyone care to comment on this deal?
 

Dr G Oogle

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Mar 8, 2017
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Is this a base salary with ability to get incentives once you hit a certain RVU target? Or is a flat rate? Is the city you’re in a desirable place to live and competitive market?
Your deal is about $110/hr which is lower end for a laborist unless the answer to the RVU question and desirability of location is yes
 
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anonperson

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Jun 26, 2008
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Technically it is 15x12 hours shifts in a month, mix of days and nights, occasional 24 hour shifts which counts for two shifts. Anyone care to comment on this deal?
Does not seem like that great of a deal to be honest.
The base salary is $250,000. That comes to ~115 an hour. (15 x 12=180 hours a month, x 12 months).
The problem is the fact that you are in house for 13-15 days a month covering labor and delivery. That can be a busy/stress circumstance and you could set yourself up for burnout.
PTO?
Retirement package/401k?
CME?

Are you collecting/billing? If you deliver a patient, do you get paid more?etc

Typical laborist rates are at least $125 an hour.

A hospital I know of only pays $1500 for a 24 hour shift but the laborist can bill for any deliveries/C section assists/ Gyn cases etc. Some laborists have pulled in $6000-$7000 a shift on a busier night.
 
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anonperson

10+ Year Member
Jun 26, 2008
678
615
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Attending Physician
I like the idea of salary transparency as it will allow new residents what to expect and hopefully negotiate good deals.
Post residency with no fellowship was offered 250 starting as a laborist at an east coast hospital, in a large city with driving distance to large metropolitans. Roughly 13-15 shifts a month.
Would be interested to know if people who start as a laborists stay as one or move one to more office based jobs.
Also what is the general financial structure of office based jobs? Are there financial incentives based on the number of patients you see, in addition to your base? What does that entail ( how much more than your base should you bring in to be able to pull in the incentive) Are there any partnership positions? How long would it take to become a partner? how much would it cost to buy in into a partnership?
Your responses would be much appreciated.
This is all practice dependent.

I have interviewed at places that had a 2-3 year partnership track where you were working for a reduced salary as a type of buy in.

Unless the group is stable and large, this is a gamble. The one group I interviewed at delivered out of 2 or 3 hospitals, but there office was located by the main hospital they delivered out of. About a year after I interviewed, the hospital they mainly functioned out of closed down. Now they are seeing patients, delivering, etc at 2 further hospitals which is disruptive etc.

Some places will compensate based on an RVU structure. Others will have different benchmarks to reach a bonus etc.

Places like Kaiser have an entirely different set up as well along with a "partnership" track.
 

paradoxofchoice

5+ Year Member
Jan 12, 2015
27
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Suburb of major city in southeast. Private practice generalist. $250,000 guarantee for yr 1. Next two years 200k with an rvu based incentive for >450k generated. 3 weeks vacation. $1500cme. 1 wk off for come stuff.
Need privileges at three community hospitals. Honestly, I would rather work for a practice that works at a single hospital for less money. The commuting is terrible. I received offers between 200-230k at other places. One place said 50% of what I generate is mine, 50% is theirs. I think I would have the most salary there after a few years, but I didn't want to live in that suburb.
Sadly no 401k. I didn't have any in residency either so my retire planning is terribly behind.

My classmates received offers between 200-250k depending on size of city, all are practicing in >200k-1M population. Small town people got as high as 325k for at least first year, don't know after that
 
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Dr G Oogle

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Mar 8, 2017
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Urogynecologist in academic urology practice base 370K at asst prof rank and am 75% clinical. Promotion to associate increases to 425K base. Most benefits through wife’s job which are generous. 403b , $5000 annual CME but in reality chair will pay for any meeting where faculty are senior or presenting authors.
Take backup call for generalists obgyn mostly when they find their way into bladder or have complicated lac repair or peripartum hyst but this is a trade off so they send me all their referrals. Do have to take general urology call at satellite but it’s mostly stents or catheters and anything more complex than that gets shipped to the big house. Most stuff handled by PA who is in house. Did a lot of this kind of stuff including cysto and stents in guys in felowship because it was a urology based fellowship so feel very comfortable and the group needed an FPMRS so kind of lucked into this job.
 
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anonperson

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Jun 26, 2008
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Attending Physician
Suburb of major city in southeast. Private practice generalist. $250,000 guarantee for yr 1. Next two years 200k with an rvu based incentive for >450k generated. 3 weeks vacation. $1500cme. 1 wk off for come stuff.
Need privileges at three community hospitals. Honestly, I would rather work for a practice that works at a single hospital for less money. The commuting is terrible. I received offers between 200-230k at other places. One place said 50% of what I generate is mine, 50% is theirs. I think I would have the most salary there after a few years, but I didn't want to live in that suburb.
Sadly no 401k. I didn't have any in residency either so my retire planning is terribly behind.

My classmates received offers between 200-250k depending on size of city, all are practicing in >200k-1M population. Small town people got as high as 325k for at least first year, don't know after that
Seems pretty typical. I'm surprised by lack of 401k. Are you delivering out of 3 hospitals or mainly one and operating out of the others?

That is a big issue in my opinion. Covering multiple hospitals gets old and the drive/ stress is not worth it.

How big is the group?

Is the bonus on rvu generated or on collections? That is a big deal.

Will they cover tail if you leave (that will run $50k at least).
 
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anonperson

10+ Year Member
Jun 26, 2008
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Attending Physician
Urogynecologist in academic urology practice base 370K at asst prof rank and am 75% clinical. Promotion to associate increases to 425K base. Most benefits through wife’s job which are generous. 403b , $5000 annual CME but in reality chair will pay for any meeting where faculty are senior or presenting authors.
Take backup call for generalists obgyn mostly when they find their way into bladder or have complicated lac repair or peripartum hyst but this is a trade off so they send me all their referrals. Do have to take general urology call at satellite but it’s mostly stents or catheters and anything more complex than that gets shipped to the big house. Most stuff handled by PA who is in house. Did a lot of this kind of stuff including cysto and stents in guys in felowship because it was a urology based fellowship so feel very comfortable and the group needed an FPMRS so kind of lucked into this job.
Interesting set up. So you are taking general urology call then? That would explain higher base salary.

What general region (if not comfortable, can PM).

Strong work getting a nice gig.
 

Dr G Oogle

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Mar 8, 2017
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Interesting set up. So you are taking general urology call then? That would explain higher base salary.

What general region (if not comfortable, can PM).

Strong work getting a nice gig.
yes I take general Uro call but honestly hardly ever come in, share it with a general Uro and a male recon urologist so 1 in 3
 

Jecave

5+ Year Member
Apr 14, 2013
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FQHC in major southeast city. 250,000 base salary + percentage on collections from gyn surgeries + production based on billable encounters. 20 days PTO + 10 holidays + 1 week CME. 2% continuation into retirement. Downside is 7 call days a month which are in house. Thoughts?
 

Dr G Oogle

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Mar 8, 2017
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Hey
FQHC in major southeast city. 250,000 base salary + percentage on collections from gyn surgeries + production based on billable encounters. 20 days PTO + 10 holidays + 1 week CME. 2% continuation into retirement. Downside is 7 call days a month which are in house. Thoughts?
Is this gyn only or OB too? If OB too seems a bit low;? If gyn only seems like good deal especially if can make 300+ with extras
 
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Dr G Oogle

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I’d say if you can make up to 325 with the incentive end and OB call is benign with deliveries few and far between then it’s decent if OB is brutal and your doing 5+ deliveries a day then not enough in my mind. General OBgyns around me in PP/hospital employed are pulling in 350-370
 
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anonperson

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Jun 26, 2008
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FQHC in major southeast city. 250,000 base salary + percentage on collections from gyn surgeries + production based on billable encounters. 20 days PTO + 10 holidays + 1 week CME. 2% continuation into retirement. Downside is 7 call days a month which are in house. Thoughts?
You're on call every 4th day. How many deliveries a month are they expecting you to do?

What percentage on gyn surgery? Is it based on actual amount collected? This can be an issue.

When you say billable encounters , what does that entail. A colposcopy or new pelvic pain consult takes a lot more time than a routine OB visit. Are they differentiating this?
 

Jecave

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Apr 14, 2013
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You're on call every 4th day. How many deliveries a month are they expecting you to do?

What percentage on gyn surgery? Is it based on actual amount collected? This can be an issue.

When you say billable encounters , what does that entail. A colposcopy or new pelvic pain consult takes a lot more time than a routine OB visit. Are they differentiating this?
Deliveries are only done on call days and was told to expect around 3-4/call. The percentage on surgeries is 65% but it is based on whats collected. I didnt think about what actually went into the billable encounters. I’d have to look into this. My impression was that this was a relaxed position however I might be a little naive.
 

Dr G Oogle

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3-4 deliveries a shift doesn’t seem relaxed to me ‍♂ but maybe that’s why I did FPMRS. If it seems like an easyish job and you don’t have a lot productivity pressure and plenty of free time/time to sleep on call and you can break 300 then pretty good offering. Are you getting percentage of deliveries because majority of gyn surgery doesn’t pay that well unless you’re doing pelvic recon/urologic procedures
 
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anonperson

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Deliveries are only done on call days and was told to expect around 3-4/call. The percentage on surgeries is 65% but it is based on whats collected. I didnt think about what actually went into the billable encounters. I’d have to look into this. My impression was that this was a relaxed position however I might be a little naive.
That's ~250+ deliveries a year. The average OB GYN is doing 150 a year. Plus the patient population will be more non compliant etc.(due to being a FQHC).

I think you are working on the cheap and they are getting a deal. 7 in house calls a month is worth 300K easy.

I would try to negotiate a higher base.

Plus your patients are more likely to no show etc. This can effect you.

Who is covering malpractice and the tail?
 

DocWinter

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I received an offer in the southeast. 300k for yr 1-2; 3rd yr 245k base and rvu with expectation to hit 400k if I meet the average of rvus being made by current docs. Signing bonus/student loan repay/resident stipend of 95k altogether plus moving expenses.
General ob with call 1-5, smaller town 50k pop, stable practice taking over for retiring doc. Thoughts?
 

Dr G Oogle

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I received an offer in the southeast. 300k for yr 1-2; 3rd yr 245k base and rvu with expectation to hit 400k if I meet the average of rvus being made by current docs. Signing bonus/student loan repay/resident stipend of 95k altogether plus moving expenses.
General ob with call 1-5, smaller town 50k pop, stable practice taking over for retiring doc. Thoughts?
Sounds like a pretty legit offer, are you on the hook for the loan repayment if you don’t stay for a certain period. For instance if you leave within 5 years do you have to repay the signing bonus etc ?
 

DocWinter

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Sounds like a pretty legit offer, are you on the hook for the loan repayment if you don’t stay for a certain period. For instance if you leave within 5 years do you have to repay the signing bonus etc ?
If I leave before the 3 years are up, yes. Of course I have intentions to stay and hopefully long term
 
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anonperson

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Jun 26, 2008
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I received an offer in the southeast. 300k for yr 1-2; 3rd yr 245k base and rvu with expectation to hit 400k if I meet the average of rvus being made by current docs. Signing bonus/student loan repay/resident stipend of 95k altogether plus moving expenses.
General ob with call 1-5, smaller town 50k pop, stable practice taking over for retiring doc. Thoughts?
What is the RVUs they are expecting? Do you have to meet a threshold or is it a certain dollar amount per RVU.

If you leave the practice, who pays your tail? You or them? That can cost $50k to $100k.

How many deliveries per month for the group?

Are you going to be an actual partner with access to the books or an employee.

Is the retiring doc actually retiring or staying on in some admin position and collecting a paycheck?

In house call or at home? Are you seeing patients when on call. Post call day off?
 
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DocWinter

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What is the RVUs they are expecting? Do you have to meet a threshold or is it a certain dollar amount per RVU.

If you leave the practice, who pays your tail? You or them? That can cost $50k to $100k.

How many deliveries per month for the group?

Are you going to be an actual partner with access to the books or an employee.

Is the retiring doc actually retiring or staying on in some admin position and collecting a paycheck?

In house call or at home? Are you seeing patients when on call. Post call day off?
Average of 10k rvu/ur produced by current providers. There is no expectations for yr 1-2. For yr 3 it is based on $$ per rvu after threshold of 6k

With tail coverage

75/month deliveries.

Employed position


Retiring doc leaving OB, will maintain some gyn. Is private practice.

At home call. Not seeing pts when off. Not off postcall.
About to discuss contract details so trying to figure out these important details. Appreciate input.
 

Dr G Oogle

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Average of 10k rvu/ur produced by current providers. There is no expectations for yr 1-2. For yr 3 it is based on $$ per rvu after threshold of 6k

With tail coverage

75/month deliveries.

Employed position


Retiring doc leaving OB, will maintain some gyn. Is private practice.

At home call. Not seeing pts when off. Not off postcall.
About to discuss contract details so trying to figure out these important details. Appreciate input.
75 deliveries per doc or for entire group; if the former sounds like a lot
 
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anonperson

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Jun 26, 2008
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Average of 10k rvu/ur produced by current providers. There is no expectations for yr 1-2. For yr 3 it is based on $$ per rvu after threshold of 6k

With tail coverage

75/month deliveries.

Employed position


Retiring doc leaving OB, will maintain some gyn. Is private practice.

At home call. Not seeing pts when off. Not off postcall.
About to discuss contract details so trying to figure out these important details. Appreciate input.
The average OBGYN generates about 6500 RVU per year based on some of the more recent MGMA data.

Doing 10,000 is possible but a lot. You may end up making less in year 3 and going forward.

How long will this retired doc going to be around. They are going to siphon GYN patients off of you. They could keep up a GYN only practice for years theoretically while leaving only OB for you. If you don't mind, that is fine but there needs to be parity how new GYN patients are going to be distributed. Plus you need GYN cases for your boards.

In general I am wary of longer term contracts. I am assuming there is an exit clause. Should be 90 days or less.
 

DocWinter

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The average OBGYN generates about 6500 RVU per year based on some of the more recent MGMA data.

Doing 10,000 is possible but a lot. You may end up making less in year 3 and going forward.

How long will this retired doc going to be around. They are going to siphon GYN patients off of you. They could keep up a GYN only practice for years theoretically while leaving only OB for you. If you don't mind, that is fine but there needs to be parity how new GYN patients are going to be distributed. Plus you need GYN cases for your boards.

In general I am wary of longer term contracts. I am assuming there is an exit clause. Should be 90 days or less.
Is 3 years a longer term contract by standards? I’ll look for exit clause in e contract once we get there

I will ask about how those cases will be distributed. It seems from the past that providers come in and build their practice starting OB heavy and gyn follows.

Yes the data has average at 6500-7k. It seems I could financially do about the same as years 1-2 if at national average according to data, or close to 400k if average by their historic standards.

And it is 75/mo for the hospital as a whole, not per provider.
 

Dr G Oogle

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@anonperson is right about the gyn thing, the whole “gyn follows” was fine 15-20 maybe even 10 years ago, but unless you’re doing majors at least biweekly you’re skills are going to atrophy quickly. If you’re fine with OB mostly then no big deal but if not try to negotiate block time or something like that. I’ve seen a bunch of young generalists come in to our tertiary care center gung ho about surgery and 2-3 years later are doing minors, office and L&D, but this is in academics and in my hospital system they are very much about fellowship people doing the surgeries so it’s hard to break in; may be different in PP.
 

Dr. Death

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@anonperson is right about the gyn thing, the whole “gyn follows” was fine 15-20 maybe even 10 years ago, but unless you’re doing majors at least biweekly you’re skills are going to atrophy quickly. If you’re fine with OB mostly then no big deal but if not try to negotiate block time or something like that. I’ve seen a bunch of young generalists come in to our tertiary care center gung ho about surgery and 2-3 years later are doing minors, office and L&D, but this is in academics and in my hospital system they are very much about fellowship people doing the surgeries so it’s hard to break in; may be different in PP.
Sorry to jump in, but I was wondering if it is much harder to rack up a lot of RVU without doing majors? It seems like a lot of the country is going away from generalists doing hysterectomies except for rural areas and I'm wondering how much earning power generalists could stand to lose if they aren't doing many hysterectomies in a year.
 

Dr G Oogle

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Sorry to jump in, but I was wondering if it is much harder to rack up a lot of RVU without doing majors? It seems like a lot of the country is going away from generalists doing hysterectomies except for rural areas and I'm wondering how much earning power generalists could stand to lose if they aren't doing many hysterectomies in a year.
actually low volume surgeons stand to money by doing the occasional major. A TLH reimburses about 20 RVUs, if you’re doing that for 3-4 hours you can only do 2 a day and you’re not seeing patients in the office and doing office procedures, which in that time could net you a lot more just seeing 30-40 patients in the office or an afternoon on L&D and triage. We have generalists who were averaging 6 hours per hyst and they were asked to stop doing them because they are losing money. For a generalist the money is in obstetrics not gynecology and it’s always been that way. The reason urogyn generates RVUs is not because of the gyn part of the surgery but the reconstructive procedures, UDS and urologic procedures and onc makes money from chemo and concomitant procedures not the hysterectomy. In my practice I started with partnering with the generalists If they referred a patient with a concomitant hysterectomy and would only do the urogyn part, doing 2 or 3 of those types of cases a day. I Don’t bill for the hyst even when I assist them but just for the urogyn part and still end up generating more RVUs then they for the case, most of them have realized it’s now in their best interest to just have me do the whole case and they can spend their time doing something more lucrative like ultrasound or office hysteroscopy which can be a cash cow. If you look at academic mgma data generalists make more or as much as many gyn onc and urogyn and MFM makes a lot more than everyone: this is because OB===$$$ and most gyn does not.

TLDR: not doing majors will at worst not have an affect on generalist finances and at best improve them. And perhaps more importantly patient outcomes will improve
 
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Dr G Oogle

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Sorry to jump in, but I was wondering if it is much harder to rack up a lot of RVU without doing majors? It seems like a lot of the country is going away from generalists doing hysterectomies except for rural areas and I'm wondering how much earning power generalists could stand to lose if they aren't doing many hysterectomies in a year.
here's an editorial from the most recent green journal Hysterectomy in Residency Training: The New Numbers Game? : Obstetrics & Gynecology

This most likely will be the generation that will see drastic shifts in OBGyn training and practice, particularly with regard to surgery
 
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anonperson

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actually low volume surgeons stand to money by doing the occasional major. A TLH reimburses about 20 RVUs, if you’re doing that for 3-4 hours you can only do 2 a day and you’re not seeing patients in the office and doing office procedures, which in that time could net you a lot more just seeing 30-40 patients in the office or an afternoon on L&D and triage. We have generalists who were averaging 6 hours per hyst and they were asked to stop doing them because they are losing money. For a generalist the money is in obstetrics not gynecology and it’s always been that way. The reason urogyn generates RVUs is not because of the gyn part of the surgery but the reconstructive procedures, UDS and urologic procedures and onc makes money from chemo and concomitant procedures not the hysterectomy. In my practice I started with partnering with the generalists If they referred a patient with a concomitant hysterectomy and would only do the urogyn part, doing 2 or 3 of those types of cases a day. I Don’t bill for the hyst even when I assist them but just for the urogyn part and still end up generating more RVUs then they for the case, most of them have realized it’s now in their best interest to just have me do the whole case and they can spend their time doing something more lucrative like ultrasound or office hysteroscopy which can be a cash cow. If you look at academic mgma data generalists make more or as much as many gyn onc and urogyn and MFM makes a lot more than everyone: this is because OB===$$$ and most gyn does not.

TLDR: not doing majors will at worst not have an affect on generalist finances and at best improve them. And perhaps more importantly patient outcomes will improve
TLH is only around 13 to 17 Wrvu.

Abdominal hysterectomy is around 21.
 
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anonperson

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Sorry to jump in, but I was wondering if it is much harder to rack up a lot of RVU without doing majors? It seems like a lot of the country is going away from generalists doing hysterectomies except for rural areas and I'm wondering how much earning power generalists could stand to lose if they aren't doing many hysterectomies in a year.
A TLH only gives you 13 wrvu.

A delivery (only the delivery, not visits) gets you ~14 rvu.

If you are low volume gynecological surgeon, it is more financially viable to do deliveries, office visits, and minor procedures.

I make a better amount doing urodynamics on a proportional basis. No significant complications and no real global to worry about.
 
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Campanella

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May 23, 2013
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I just want to say this is great information for those of us gearing up for the job search. Thank you for getting this information out there!
 
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