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Residents in these medical specialties have the most regrets | American Medical Association
Does anyone of you have regrets?
Does anyone of you have regrets?
Glad to know.If you had asked me a few years ago I would've said undoubtedly yes. I recently got out of training and started practicing and am currently more satisfied, but I was very unhappy during training and this seemed somewhat common throughout my residency mates.
Thanks for the positive response.Well looking at the bright side, that means More people who enter neurology despite all this, are the ones who are actually fascinated by Neuro.
Also I am not complaining about the high demand vs supply of neuro driving our salaries up. Because just based on RVUs, we are many times below most specialties.
P.S. No regrets!
Thanks for the positive response.
Speaking of RVU's, what's the average number of wRVU's a neurologist produces per year? How many patient encounters does it take to achieve that?
Also when you mention that salaries are higher than what they should be (based on RVU's), are you hinting that salaries are artificially (due to subsidies) inflated and that doing self-employment would mean lower income?
Thank you,
Thank you, that's helpful.That is really hard to say- there is a wide range. Also, the RVU- $ conversion is different in every setting. And how much the insurance company finally pays is different too.
Just to give approximate averages (physician work RVUs, total RVUs billed by hospital are higher)- New patient 3.5, f/u 2, routine EEG 1.. etc (see attachment below). So if you see about 5 new and 5 f/u per day, 5 days a week, 46 weeks = Thats about 6000 RVUs. This is the moderate number of patient encounters for neurologists. Obviously there are people who see much less and people who see more than twice of that.
The average conversion is 40-60 per RVUs. So @$50 per RVU you are looking at 300K.
I know many of my GI and Cards friends who are easily doing >1000 RVUs per month and get paid 350-450K in similar settings. By that rate, neurologists shouldn't be making more than 200K, esp neurohospitalists, who work less than 26 weeks. So definitely, our salaries are artificially higher.
Self employment is tricky because you can potentially make more money if you see a lot of patients, but there is a lot of overhead and the worst part- dealing with insurance. In my hospital, insurance denies more than 50% bills (but usually the employer takes that damage). So with anything less than average number of patients, you will earn way less in private. Academics is the worst regarding money/work ratio.
Obviously, the above is a simple analysis and varies a lot. Also, I personally disagree with RVU system and believe we neurologists provide much more than is depicted by mere RVUs, that are biased towards procedures.
Thank you for the generous contributionI am a recent grad and a neurohospitalist. Like I said, during training I was very burned out but coming out to practice has been much more enjoyable than residency for me so far. Regarding compensation it all depends on how you get paid (salaried, per shift + rvus, purely RVU etc).I am personally paid a flat salary that I think is quite generous and I am satisfied with.
I agree with Merchant's point about RVUs not favoring us. If you think of a stroke admitted to the hospital you may only build a comprehensive consult note however assuming TPA is given or thrombectomy is performed there is a lot more revenue that comes downstream from what you do (imaging ordered, EEGs, etc). Also, if it's a somewhat underserved area being able to provide a prompt opinion and outpatient followup may result in fewer days in the hospital which is also favorable from a DRM standpoint.
Make no mistake neurologists are in demand and I believe that will continue to be the case for many years to come, especially if you're good at what you do. While we may get paid higher than our RVU count may suggest it also depends on how good you are at documentation and billing, especially inpatient (I'm still trying to get better at this).
https://www.merritthawkins.com/uplo...ins/Content/Pdf/mhawhitepaperneurology(1).pdf
I found that article from Merritt Hawkins on recruiting neurologists pretty insightful.
Residents in these medical specialties have the most regrets | American Medical Association
Does anyone of you have regrets?
In other words it's a fairly easy specialty to get into and there's no reason why a fresh graduate shouldn't be able to leverage a contract with the hours. location and lifestyle they want.To neutralize some of the negativity in the report of the original post, I’m going to post this one here:
PracticeLink Magazine - FALL 2018
Go to page 44 and see which fields have the highest demand.
Every few months, PracticeLink release a new report. For the past few years, neurology has shown to be most in demand. Moreover, the demand is increasing. Last report the ratio of candidates per jobs was 0.94. This new report the ratio is 0.87. Neurology is the only field where number of jobs outweighs number of candidates.
Pretty much.In other words it's a fairly easy specialty to get into and there's no reason why a fresh graduate shouldn't be able to leverage a contract with the hours. location and lifestyle they want.