Discussion in 'Sleep Medicine' started by CaymanIslander, Feb 23, 2008.
So, can a sleep guy make 500k - 1M owning his own clinic....a sleep neurologist say?
A busy sleep physician can make $200,000-$300,000 (usually closer to $200,000) from the practice of sleep medicine. A sleep neurologist, I speculate, could make in the higher range of that spectrum if he read frequent EEG's.
If a sleep doc owns a 6-8 bed sleep lab (either as extension of his practice or as an independent diagnostic and testing facility), he could make $500,000 or more per year. However, this involves significant capital investment (it would take 1 million to start such a sleep lab) and I wouldn't call the income from this part of a physician's salary.
To answer your question Cayman Islander, as a sleep neurologist you could reasonably expect to make $250,000, and you would have some investment opportunities available to you that could allow you to double your total income (or drive you to bankruptcy, if the sleep lab failed).
One last thing I should point out- you will pay ordinary income taxes (including the self-employment tax) on all of that "investment income" if you organize the sleep lab as a LLC, chap s, or partnership (because you are a material participant and therefore won't be elgible to have the investment income taxed at the longterm capital gains rate of 15%). If you organize it as a c corp, the corp will be taxed at the corp rate for the income and then you will pay the 15% long term capital gains rate on anything you take home as a dividend. You could also take some salary from the c corp and pay regular ordinary income taxes on that.
So I guess your flirtation with pathology lasted about an hour?
Just wanted to know is this the current average salary or taking into account the March decision?
Also, from many internet sites about salaries for neurologists - I see salaries from 190K to 340K. So, if you're a sleep neurologist, wouldn't you add to the above range (for example 240K to 400K+ --without owning multiple sleep labs)? Just curious on you're thoughts! Thanks.
DoctorSaib and Yaah...I like the new avatar looks
Look, there are about a million variables involved here -- it's not a question of simply giving a number. Location (i.e., supply/demand for services), nature of practice (academic, hospital employed, private practice, group, solo), percentage of job that is actually sleep medicine (unusual to have 100%), number of studies read, how the practice determines salaries, practice ownership of ancillary services (lab, MRI, etc) and so forth.
I can tell you from being on the interview trail that neurologists can make between $100K (if they are not particularly motivated/efficient) and about $350K if they stay busy and all the stars align correctly. A good average would be about $200K. $400K for a neurologist would be pretty darn amazing under any circumstances. Neurologists who do lots of procedures, whether sleep, EMG, interventional pain, or whatever, will make more than neurologists who see headache and stroke patients all day.
In addition to the variables listed by neurologist, there is also the variable of which part of the country you live in. Although the CMS decision comes out in March, some regional Medicare carriers have already made a local coverage decision AGAINSt home testing, and home testing for osa will not be covered in many states.
So this means, sleep studies will probably still be in demand vs. home testing at least for Medicare pts? Also, which regions have local Medicare carriers decided against it (Northeast vs. South, etc.)?
Also, thanks everyone for your posts!
States in which Medicare will not cover home testing for OSA:
American Samoa, California, Connecticut, Delaware, Guam, Hawaii, Kentucky, Illinois, Indiana, Maine, Marina Islands, Massachusetts, Michigan, Nevada New Hampshire, New Jersey, New York (with the exception of Queens County), Ohio, Vermont, Virginia, West Virginia, and Wisconsin.
where are you getting this info from? do you have a link you could provide? I can't seem to find anything this specific . . . Thanks!
One of the readers of my sleepdoctor blog posted the info as a comment to the FEb 12 post. Here is a link to the states in which home testing is not covered (this is not a link to my blog): http://sleepwellandlive.wordpress.com/2008/02/15/initial-determination-on-home-sleep-studies-no/
So in states like Arizona, Texas, New Mexico - sleep reimbursement might fall? Basically, some states will have better compensated sleep neurologists vs others?
Yes, but that's also the case for every other specialty as well. Thanks to our country's byzantine medical system, reimbursement varies from place to place.
Very interesting that Wisconsin is on the list, since the only ENT run sleep fellowship is located in Milwaukee.
what about psychiatry sleep medicine..what do they range??
You can type in various zipcodes to get an idea of how the salary differs from place to place.
You can also type in other specialties to get an idea of how much they pay; however be careful not to type in something that could be misconstrued as a technician's job, e.g. "sleep" or "sleep medicine" is too broad. If a number looks abnormally low (or inflated), look below at 'related jobs' to get a better idea.
For a salaried position, you'd probably start off in the $200-225,000 range.
I practice full time sleep, although my primary residency is psychiatry. However, a few of my friends from psych residency, who did not do any fellowships, are getting paid more than me for doing straight psychiatry. One is child psych and the other two are general adult psych.
I believe Dr. Rack has already explained that doing a sleep fellowship is not going to automatically lead to 500,000 per year....at least without getting a chunk of the technical component. If you were to do only the professional component, the only way to approach making 500,000 would be to spend all day doing PSG interps.
O.K. one more time. Estimated income enhancement for a clinical neurologist who is also boarded in sleep medicine? Without owning your own stand-alone lab.
I would guess that neurologists who are boarded in sleep and spend 1/2 of the time doing general neurology and 1/2 of the time doing sleep could expect to typically make in the range of $200-$300K
Seriously, if you dont like the field, don't waste the extra time.. you can make just as much reading EEGs and doing EMGs. Leave the field to someone who wants to expand it and is interested in it
I'd second that.
If you're looking for maximizing salary, go into rads, subspec surgery, or plastics.
Pretty much anything involving neurology, while it is not totally bottom-of-the-barrel salary-wise, is also not anywhere near the top.
Yes, I think so.
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