The salary question is always a tough one. I agree with Drusso on the numbers. However, I think, as in any specialty, there are significant variables in how one does financially in private practice. I emphasize private practice, not academic.
As a physician, you can decide to practice medicine in any way you wish. Of course you want to help your patients and get compensated well for doing it. However, you can definitely get paid more for doing procedures than to counsel and educate because our health care system always rewards those who think with their hands more than the ones who think with their heads. Here's some examples-
A patient comes to you with a history of questionable radicular back pain with an MRI with evidence of a herniated disk at L5S1. He also has a history of DJD of his lumbar spine. You can take many different approaches with this patient. You can teach the patient about the myths and the truths about MRI findings and its clinical correlations and try concervative treatments for a month or two with physical therapy and exercises to see if the patient improves at all. Another approach is to get the patient to the fluoroscopy table as quickly as possible to try some diagnostic facet joint injections or tri-level discograms to diagnose lumbar disk disease versus DJD causing the pain. Neither of the approaches that I have described would be considered malpractice. However, first approach may cost $300-500 while the latter may cost the insurance company or the patient up to $3000. And to the physician, the reimbursement may be considerably more - probably up in the thousands with the procedures that I have described above.
I have another example. Let's say you have a large volume of Electrodiagnostic practice. You may only make a few hundred of dollars if you do a particular EMG for a Medicaid patient. The same EMG may get you a thousand dollars more if you were an insurance company advocate (versus a patient advocate) were in middle of a heavy workman's compensation case.
I'm neither a saint or an insurance company advocate. And also I'm a big proponent of interventional physiatry. And, I believe as a physiatrist, I can do quite well.....I mean very well ( probably in the 300 to 500Gs/ year). However, I believe that all of us has the responsibility to keep the cost of health care as low as possible.
