Typical hours for PM&R

[Louisville04]

I was reading the 20 questions with Dr. Zafonte, Chair of PM&R at Harvard. I was surprised at the number of hours he works a week. I am usually at around 45 hours.

"I work between 80 and 100 hours per week and sleep around four hours per night. I typically take two weeks of vacation a year."

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[colourmebadd]

Lolz.

 

[Baritonebass]

Are the hours so high because of clinical practice or bring chair of a clinical department at Harvard???

 

[bedrock]

Bit of both. The residency director before Zafonte arrived as chair, supposedly slept 4-5 hrs a night, and "only" worked 60-70 hrs a week.

Zafonte is a driven guy, course you don't get 250 publications and a Harvard chair if you're not.

 

[SSdoc33]

"I work between 80 and 100 hours per week and sleep around four hours per night. I typically take two weeks of vacation a year."

bullsh$t

 

[lobelsteve]

45 hrs for my day job, 10 hrs for "other" work.

 

[Xardas]

Chairmen don't represent the typical clinicians in that they are really functioning more like CEO of a small or even mid size company. There is a ton of administrative and financial info to go through. In addition to at least some semblance of clinical practice and research. Plus other stuff like fund raising etc.

Most chairmen of successful depts work a ton.

 

[Silent Cool]

"Plenty of Money and Relaxation."

'nuff said.

 

[jonnylingo]

for me: 45-50 hours, sometimes feels like 80. Depends on procedure/chronic pain patient ratio.

 

[anbuitachi]

"Plenty of Money and Relaxation."

'nuff said.

PMR is one of the lowest paid fields of medicine... im not sure where the money part came from..

 

[Silent Cool]

PMR is one of the lowest paid fields of medicine... im not sure where the money part came from..

anbu,

Do have any salary anecdotes? I've heard widely varying income reports for PMR, depending on fellowship, ownership, etc..

thanx

 

[anbuitachi]

anbu,

Do have any salary anecdotes? I've heard widely varying income reports for PMR, depending on fellowship, ownership, etc..

thanx

On aamc.org's specialty page it lists the salaries as 1-2 yr salary is 221k, and all PMR doc median as 250k.. which is on the low end [it's only like a bit more than IM]
(the source according to the website, is MGMA 2013)

 

[Silent Cool]

On aamc.org's specialty page it lists the salaries as 1-2 yr salary is 221k, and all PMR doc median as 250k.. which is on the low end [it's only like a bit more than IM]
(the source according to the website, is MGMA 2013)

Does that include the value of benefits? I have read that the MGMA numbers include the value of benefits (health care, disability, etc...)

 

[anbuitachi]

Does that include the value of benefits? I have read that the MGMA numbers include the value of benefits (health care, disability, etc...)

"
Based on the description provided by MGMA, the total compensation numbers include a physician’s salary,
contracted medical compensation, and partnership distributions"

 

[lobelsteve]

PMR is one of the lowest paid fields of medicine... im not sure where the money part came from..

Depends on what you do in PMR.

As a member of the membership committee for the AAPMR, one of the pain docs at our recent meeting said he can walk in the hospital elevator and when comparing salary to all other docs in the building, he says "Suck Me".

Might be atypical, but potential is there for all of us.

 

[anbuitachi]

Depends on what you do in PMR.

As a member of the membership committee for the AAPMR, one of the pain docs at our recent meeting said he can walk in the hospital elevator and when comparing salary to all other docs in the building, he says "Suck Me".

Might be atypical, but potential is there for all of us.

Ehh I know pain docs make a lot (though not sure after their huge cuts), but I mean just for PMR, not pain, since you can go into Pain from several different fields. [Just like when you say IM doesn't make much, you aren't including GI]

 

[Disciple]

Ehh I know pain docs make a lot (though not sure after their huge cuts), but I mean just for PMR, not pain, since you can go into Pain from several different fields. [Just like when you say IM doesn't make much, you aren't including GI]

Back in the day, interventional spine/MSK, ultrasound, EMG, sports med. Outpatient only.

Couldn't beat it.

 

[anbuitachi]

Back in the day, interventional spine/MSK, ultrasound, EMG, sports med. Outpatient only.

Couldn't beat it.

man looks like the good days are over =(

 

[lejeunesage]

man looks like the good days are over =(

We'll be fine.
The landscape will change, we'll adapt with it.
I do think the biggest change is going to be a switch from fee for service, which is volume-driven to something where you don't get paid for doing more, but you get paid for results.

Most people seem to think of this as necessarily detrimental to income potential. Might be or might not be. Only time will tell.

 

[anbuitachi]

We'll be fine.
The landscape will change, we'll adapt with it.
I do think the biggest change is going to be a switch from fee for service, which is volume-driven to something where you don't get paid for doing more, but you get paid for results.

Most people seem to think of this as necessarily detrimental to income potential. Might be or might not be. Only time will tell.

Results? when are pain patients ever satisfied?

 

[lobelsteve]

Results? when are pain patients ever satisfied?

You have serial negative posts. I see the opposite of most everything you say on a daily basis and wonder if you won't mind sharing some of your background for training and job history. I have a busy practice and need more staff. My income has gone up every year since graduating from a pain fellowship in 2005. I get calls every month for new work opportunities.

 

[SSdoc33]

Depends on what you do in PMR.

As a member of the membership committee for the AAPMR, one of the pain docs at our recent meeting said he can walk in the hospital elevator and when comparing salary to all other docs in the building, he says "Suck Me".

Might be atypical, but potential is there for all of us.

steve, in the future, please let me speak for myself. thanks.

 

[lejeunesage]

You have serial negative posts. I see the opposite of most everything you say on a daily basis and wonder if you won't mind sharing some of your background for training and job history. I have a busy practice and need more staff. My income has gone up every year since graduating from a pain fellowship in 2005. I get calls every month for new work opportunities.

So, there's been a lot of talk and freaking out about how pain is about to die any day now, any day, I tell you, since the recent CMS cuts.

What's the view like from your standpoint? Should people run away from pain? Is a pain fellowship worth pursuing?

Thanks.

 

[lejeunesage]

Results? when are pain patients ever satisfied?

Dude, chill.

Your insinuation is that pain patients are not ever satisfied? Really.

Sometimes, in medicine, especially with people without much experience, there is a tendency to equate cynicism with wisdom.

It's true that you need to remain vigilant for people trying to take advantage of you, but most patient's I've seen in pain clinic, Ortho clinic, Sports Medicine clinic, Outpatient MSK clinic get significant pain relief for months before they need to return.

And as far as I know, no one is saying that you'll only get paid if you cure someone of pain forever. I think (just guessing, admittedly) that chronic pain will be classified as a chronic condition. I'm not sure what the metrics for quality or success of treatment will be after the end of fee-for-service, but most things are quantifiable if you give it a try. Maybe it will be number of months of pain relief, or a functional capacity scale where pain per se is not what is measured, but the ability of patients to perform whatever task the pain was preventing them from performing.

Also, there will always be a cash market for injections and Botox and PRP, etc.

So, again, not sure what exactly things will look like, but my guess is that it won't be the end of the world, that kinks will be worked out over time, and that we'll adapt.

 

[lobelsteve]

So, there's been a lot of talk and freaking out about how pain is about to die any day now, any day, I tell you, since the recent CMS cuts.

What's the view like from your standpoint? Should people run away from pain? Is a pain fellowship worth pursuing?

Thanks.

Provide good care to your patients and treat them like you would your mother. The rest works itself out. I think pain will weed out the bad apples thrrough insurance panels dropping the overutilizers and the DEA and medical boards weeding out the pill mills.

 

[anbuitachi]

You have serial negative posts. I see the opposite of most everything you say on a daily basis and wonder if you won't mind sharing some of your background for training and job history. I have a busy practice and need more staff. My income has gone up every year since graduating from a pain fellowship in 2005. I get calls every month for new work opportunities.

Dude, chill.

Your insinuation is that pain patients are not ever satisfied? Really.

Sometimes, in medicine, especially with people without much experience, there is a tendency to equate cynicism with wisdom.

It's true that you need to remain vigilant for people trying to take advantage of you, but most patient's I've seen in pain clinic, Ortho clinic, Sports Medicine clinic, Outpatient MSK clinic get significant pain relief for months before they need to return.

And as far as I know, no one is saying that you'll only get paid if you cure someone of pain forever. I think (just guessing, admittedly) that chronic pain will be classified as a chronic condition. I'm not sure what the metrics for quality or success of treatment will be after the end of fee-for-service, but most things are quantifiable if you give it a try. Maybe it will be number of months of pain relief, or a functional capacity scale where pain per se is not what is measured, but the ability of patients to perform whatever task the pain was preventing them from performing.

Also, there will always be a cash market for injections and Botox and PRP, etc.

So, again, not sure what exactly things will look like, but my guess is that it won't be the end of the world, that kinks will be worked out over time, and that we'll adapt.

That was more of a joke guys lol...

But obviously it depends on many factors. I don't doubt there are many who are doing just as well as before, but the trend is that more are doing worse. It also depends on where you practice. Personally, I'm in NYC, so all the attendings I meet are in NYC and I try to talk to attendings of different fields to get an idea, and they've all been fairly negative. My finance friends and law friends in Manhattan who graduated college with me dont help w/ the process either lol. I know you can say like.. stop being picky, you can work in the middle of no where too, but if you think about it, most of the other successful fields today [law, engineering, finance] are all centered around major cities [silicon valley, manhattan, seattle, etc], where as for medicine, it's the opposite.

In the end, there'll always be ppl doing well, but we all come from different backgrounds. For some medical students today with massive loans, things are looking more and more negative recently.

 

[SSdoc33]

That was more of a joke guys lol...

But obviously it depends on many factors. I don't doubt there are many who are doing just as well as before, but the trend is that more are doing worse. It also depends on where you practice. Personally, I'm in NYC, so all the attendings I meet are in NYC and I try to talk to attendings of different fields to get an idea, and they've all been fairly negative. My finance friends and law friends in Manhattan who graduated college with me dont help w/ the process either lol. I know you can say like.. stop being picky, you can work in the middle of no where too, but if you think about it, most of the other successful fields today [law, engineering, finance] are all centered around major cities [silicon valley, manhattan, seattle, etc], where as for medicine, it's the opposite.

In the end, there'll always be ppl doing well, but we all come from different backgrounds. For some medical students today with massive loans, things are looking more and more negative recently.

plenty of jobs in finance. go for it.

medicine IS centered around major cities. remuneration isnt. i think you gotta take a long hard look in the mirror. if your goal in medicine is to make a lot of money, you will be a very unhappy person. you might still be able to do that, but you will never be satisfied.

 

[anbuitachi]

plenty of jobs in finance. go for it.

medicine IS centered around major cities. remuneration isnt. i think you gotta take a long hard look in the mirror. if your goal in medicine is to make a lot of money, you will be a very unhappy person. you might still be able to do that, but you will never be satisfied.

I mean in those fields, the high paying jobs are in big cities, because their work location is in big cities. Where as medicine is more spread out, w/ the high paying ones in rural areas.

And seriously, what is wrong with wanting to help ppl and make big bucks? I believe making a decent amount of money is always a plus. Besides, look at the satisfaction surveys, we went from ~60-70% just 3 years ago, to mostly 40-50% today. The majority are NOT satisfied today. [does that mean most ppl went into medicine for the wrong reasons?].

 

[SSdoc33]

I mean in those fields, the high paying jobs are in big cities, because their work location is in big cities. Where as medicine is more spread out, w/ the high paying ones in rural areas.

And seriously, what is wrong with wanting to help ppl and make big bucks? I believe making a decent amount of money is always a plus. Besides, look at the satisfaction surveys, we went from ~60-70% just 3 years ago, to mostly 40-50% today. The majority are NOT satisfied today. [does that mean most ppl went into medicine for the wrong reasons?].

i know what you meant. you equated "success" with salary. i was pointing out your poor word choice.

look, you will still make a crapload of money and provide a service to people. your finance friends are clicking buttons all day, trying to figure out how to screw the little guy, so their CEO can make 100mil a year, and they get a small piece of that pie.

just realize that if money is your ultimate goal: go into something else. its not too late

 

[lejeunesage]

I will never blame a man for wanting to make more money. Money is good.

No doubt, medicine is not as good a deal as it was 20-30 years ago, if you look at total tuition vs income potential; the former has increased much more than the latter.

I just think we ought to keep things in perspective. You can reasonably expect to make $180k straight out of residency. That's not bad at all. Depending on where you live, that's about $4.5k in cash every 2 weeks. That's really good!

You can always work more and make more or do a pain fellowship and make even more, but let's not forget that medicine is the only field where the floor on incomes is that high. You can make a lot more in business/finance, but you can also make a lot less.