Urology earnings???

[docmd]

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I am currently doing a rotation in urology.
I observed that besides the major surgeries there are a no. of procedures that urologists perform but the average earnings of a urologist when compared to other competitive specialities are a little on the lower side.Am I wrong or Can anybody figure out why?(Lower- 200k-400k
higher-600k-800k)

 

[cdql]

Maybe there are fewer patients? (I dunno...I'm guessing)

Most people won't have a problem going to get a skin problem fixed by a dermatologist or lipo from a plastic surgeon.

Going to the urologist because something is growing on your peepers is probably very embarassing.

 

[docmd]

well I dont think that explains it well. I think those days are over when people used to get embarassed. Today they want to get away with these problems asap before they turn grave.

 

[cytoskelement]

Maybe there are fewer patients? (I dunno...I'm guessing)

Most people won't have a problem going to get a skin problem fixed by a dermatologist or lipo from a plastic surgeon.

Going to the urologist because something is growing on your peepers is probably very embarassing.

You know what else is embarassing. Pulling down your pants to reveal said growth on your "peepers" to your partner.

Let's try not to propagate that urological disorders are "dirtier", "more embarassing", or "different" from any other medical disorder.

To the OP. Most private practice urologists have the potential to make money comparable to your "higher" figures. Most just decide that those earnings aren't nearly as important as doing what they love while maintaining outside interests, family, and sanity.

 

[former military]

I am currently doing a rotation in urology.
I observed that besides the major surgeries there are a no. of procedures that urologists perform but the average earnings of a urologist when compared to other competitive specialities are a little on the lower side.Am I wrong or Can anybody figure out why?(Lower- 200k-400k
higher-600k-800k)

In California,
a newly graduated resident should start around 245-270K at a major HMO... if you want to work at the VA or the university you are going to make less... joining a private practice group depends on location--- rural hard to recruit places often more than a major city.....if you were stupid enough to join the military you can make about 135K. I make around 315K 5 yrs out.

 

[cdql]

You know what else is embarassing. Pulling down your pants to reveal said growth on your "peepers" to your partner.

Let's try not to propagate that urological disorders are "dirtier", "more embarassing", or "different" from any other medical disorder.

To the OP. Most private practice urologists have the potential to make money comparable to your "higher" figures. Most just decide that those earnings aren't nearly as important as doing what they love while maintaining outside interests, family, and sanity.

I didn't say it was dirtier, more embarassing, or different to me.

In other people's eyes though, there is a huge difference between going to the dentist or going to your GP and going to the urologist.

 

[bobbyseal]

In California,
a newly graduated resident should start around 245-270K at a major HMO... if you want to work at the VA or the university you are going to make less... joining a private practice group depends on location--- rural hard to recruit places often more than a major city.....if you were stupid enough to join the military you can make about 135K. I make around 315K 5 yrs out.

So, I guess it's going to be a while until I get to make the big bucks. Maybe they'll decide to increase the specialty pay scale. I mean it's been more than a decade and they haven't increased it yet. Maybe in the next 3-4 years it'll get moved up! 🙂

Can you tell us what locale of the US you are practicing? East coast, West coast, midwest, rural, etc? How many people are in your call pool?

 

[former military]

I practice near Sacramento CA... I have 5 urologists who share m-th call and 11 urologists share weekend call... hence I am on every 11th weekend... luckily I have a resident below me.

When I was in the military I took over 200 days of call per year. I lost so much money with that decision even factoring the med school payment, stipend, etc. interest. I also could have done a five year residency rather than a 6 and incurred an extra year of commitment because of the extra year of training...

I was very very stupid.

 

[bobbyseal]

I practice near Sacramento CA... I have 5 urologists who share m-th call and 11 urologists share weekend call... hence I am on every 11th weekend... luckily I have a resident below me.

When I was in the military I took over 200 days of call per year. I lost so much money with that decision even factoring the med school payment, stipend, etc. interest. I also could have done a five year residency rather than a 6 and incurred an extra year of commitment because of the extra year of training...

I was very very stupid.

Well, my rosy picture of my future life in the military has just tarnished... Just kidding, I knew it wasn't going to be great for awhile now.

Besides your low earnings and lack of support which seems to be rampant in the military, how were the cases that you did? Were you mostly doing endourology things? Or did you find yourself the occasional cystectomy? Also, what about ped's urology? Did you do hypospadias?

Thanks for the info. And it sounds like you'll be buying a house in lake tahoe pretty soon!

 

[henson]

Urologists make more money than internists, and marginally more than general surgeons.

That doesn't sound so great, but they don't have to work quite as hard as the general surgeons do to make the same amount of money.

 

[bobbyseal]

bump for former military

 

[former military]

Well, my rosy picture of my future life in the military has just tarnished... Just kidding, I knew it wasn't going to be great for awhile now.

Besides your low earnings and lack of support which seems to be rampant in the military, how were the cases that you did? Were you mostly doing endourology things? Or did you find yourself the occasional cystectomy? Also, what about ped's urology? Did you do hypospadias?

Thanks for the info. And it sounds like you'll be buying a house in lake tahoe pretty soon!

Obviously it depends where you are. I had to stop doing cystectomies a couple years in. The general surgeons wouldn't support me with ICU care. "Why should I come in on the weekend and put in a central line on an urology patient when I am not getting paid for it?" Is the exact quote. We didn't have the Ligasure for 4 1/2 years, we didn't have a lithotripter and we couldn't do brachytherapy due to start up expense. There was not a lot of pediatric urology to do but there is also no PICU, peds anesthesia specialty and an average pediatric hospital census is 1-2 patients. Obviously, this makes you nervous on doing any big pediatric cases like diversions or augments which I could do. The peds residency closed while I was there a couple years ago. I was the only interested peds person so I did a lot of ped circs, hydroceles and undescended testicles. After I left the guys just shipped those out. I did a lot of prostatectomies, turps, ureteroscopies, some penile implants, hydroceles, pubovaginal slings, TVTs, varicoceles, circs, some lap kidneys and pyeloplasties. Overall my operative experience was pretty good. I worked with a couple good guys over the years. We did all our own admin and didn't have a secretery and were short on female techs.
Outside of operating and seeing clinic there was a lot of unnecessary training, military meetings, and BS that made it difficult to take care of patients and wasted lots of time. The people who ran the hospital were real ******s and they obviously had a non patient care agenda. It was a very very frustrating time and a miserable life. Hope it works out better for you

 

[-Goose-]

BUMP.

A resident at my home program said he is getting offers for $400k guaranteed starting salary. Boonies, though and only guaranteed for 1 year.

Just curious if this is par for the course.

EDIT!

I ran into this guy again and he said it was much less than I remembered. It was also in the middle of nowhere (30 minutes out of jackson, tn). Salary was only promised for one year and then you eat what you kill (work a lot).

 

[Dr JPH]

BUMP.

A resident at my home program said he is getting offers for $600k guaranteed starting salary. Moderate sized city, too.

Just curious if this is par for the course.

😱

I think you need to find out more about the offer.

Is that guaranteed or quota based?

Is it a short term "teaser" salary?

What is factored in to that $600K?

Is that base salary or including benefits and incentives.

Ive heard all sorts of numbers in Gen Surg, Ortho, Trauma.

Many sound great until you read the fine print or find out all the details.

With that said, I DO know of some great offers that seem to not have all that funny business to worry about.

Not saying the money isnt out there, but dont take these high salary stories at face value until you investigate them a bit more.

 

[Richie Truxillo]

Those 600k figures do exist but I believe the average starting salary is closer to the 250-300k range coming out. This is from the AUA meetings I used to attend before going to medical school.

 

[-Goose-]

Those 600k figures do exist but I believe the average starting salary is closer to the 250-300k range coming out. This is from the AUA meetings I used to attend before going to medical school.

I was wrong about the 600k figures. see above edited post.

 

[Wallachia]

higher salaries quite possible with radiation therapy integrated practices
http://www.nytimes.com/2006/12/01/business/01beam.html?_r=1&oref=slogin&pagewanted=all

 

[mdjobexchange]

$310,000 is about right for an average urology private practice job. Urology used to make quite a bit more, but took a big hit when Medicare reduced reimbursement for in-office medication adminstration, such as Lupron and zoladex. One of the urologists I know said that ruling cost him over $100,000/year. Medicare is in the process of screwing the heme/onc guys the same way. You can make much more than that in a well run practice that does some cash pay vas reversals and penile implants.

What is most important is how a urology group runs their practice. If you interview with a group, ask them how many RVUs per year they are billing and what their overhead percentage is. If it is over 50%, they are too fat. Ask them what their malpractice rates are and when they last negotiated them. Ask them when they last negotiated their managed care contracts. $10,000 here and $20,000 there adds up fast.

It is unfortunate that medicine has become such a business, but it is reality. If you don't keep up with those things, you will lose a bunch of money. One other urologist I know did not watch the books at all (until it was too late) and it turns out that his office manager had been pocketing the co-payments (average $15 per pt) for over seven years. He saw about 150 pts/week, so that was maybe $500,000-$700,000 he and his partner lost. Not to mention, that as she was quitting, she stopped billing Medicare in July. They both retired in January, so that was another 6 months of Medicare billing that just went "poof."

 

[-Goose-]

$310,000 is about right for an average urology private practice job. Urology used to make quite a bit more, but took a big hit when Medicare reduced reimbursement for in-office medication adminstration, such as Lupron and zoladex. One of the urologists I know said that ruling cost him over $100,000/year. Medicare is in the process of screwing the heme/onc guys the same way. You can make much more than that in a well run practice that does some cash pay vas reversals and penile implants.

What is most important is how a urology group runs their practice. If you interview with a group, ask them how many RVUs per year they are billing and what their overhead percentage is. If it is over 50%, they are too fat. Ask them what their malpractice rates are and when they last negotiated them. Ask them when they last negotiated their managed care contracts. $10,000 here and $20,000 there adds up fast.

It is unfortunate that medicine has become such a business, but it is reality. If you don't keep up with those things, you will lose a bunch of money. One other urologist I know did not watch the books at all (until it was too late) and it turns out that his office manager had been pocketing the co-payments (average $15 per pt) for over seven years. He saw about 150 pts/week, so that was maybe $500,000-$700,000 he and his partner lost. Not to mention, that as she was quitting, she stopped billing Medicare in July. They both retired in January, so that was another 6 months of Medicare billing that just went "poof."

Spent some time with a urologist in my home town recently. He told me that uro is going to take a bigger hit than other surg subspecialties due to the simple fact that so many of uro pts are medicare age. Said that he's seen his practice slowly dwindle over the past 10+ years and he's sick of it. He was pretty discouraging... basically told me to go into ENT for facial plastics or PRS because of the immunity to healthcare overhaul.

 

[CouchPotato]

Demand is always greater than supply in this field . Also, people will always pay to make sure their penis' work and to be able to urinate. I have heard of urologists who refuse to take call at hospitals and still get hired at great salaries. I think the future is only looking better...

 

[viagradoc]

Starting salary means very little after several years of practice. You really have to look at the town/city you're living in, and your personal life situation and try to make predications from that. The starting salary isn't going to make you happy, no matter what it is. The practice is a big part of your life, and impacts on your life substantially, though. You must realize that a large percentage of newly trained Urologists will relocate at some point in the future, many times when "buy-in" time comes 1-3 years into the practice, if you have a good contract. Hire a good attorney to review your contract before you sign it. You truly have an adventure ahead of you.
As for the market/supply of patients: plenty and counting, as the years go by. An academic steering committee about 9 years ago came up with the grand idea that there were too many Urologists, so they decreased the number of residency spots by 50 or 55. Given the aging population and increasing urological problems in older people, I (We) will be overwhelmed in our careers, in my humble opinion. The backlash from this decision will be felt for decades. I could already work 7 days per week instead of 5 and increase my income by 20-30%, but I wouldn't live to tell about it.😛

 

[ShrinkJamie]

..

 

[asmallchild]

I am currently doing a rotation in urology.
I observed that besides the major surgeries there are a no. of procedures that urologists perform but the average earnings of a urologist when compared to other competitive specialities are a little on the lower side.Am I wrong or Can anybody figure out why?(Lower- 200k-400k
higher-600k-800k)

400K is pretty sweet if that's your lower side. 👍