What is the future prospectus for a Nephrology Career?

[Yanik]

Im a 2nd year fellow, and I'm considering nephrology and non-invasive cardiology and pulmonology. Can someone give me the pros and cons of each and which one seems like the best for the future. I'be heard so many varying opinions on nephrology, some say they work like dogs and make nothing, and some say they have great lifestyles and make very good money? Thank you

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[howelljolly]

Im a 2nd year fellow, and I'm considering nephrology and non-invasive cardiology and pulmonology. Can someone give me the pros and cons of each and which one seems like the best for the future. I'be heard so many varying opinions on nephrology, some say they work like dogs and make nothing, and some say they have great lifestyles and make very good money? Thank you

a 2nd year fellow in what? if you are asking some random person to give you to pros and cons of each and which one seems best for the future, and your basis for choosing a specialty is on how hard you will work, and how much money you make....

you can work like a dog and make very good money in whatever field you want.

 

[EchoMed]

I am also wondering what the outlook on nephrology and non-invasive cardiology is.

 

[howelljolly]

Holy hand grenades.

the prospect for every field of medicine is on the downturn. non-invasive cardio will make good money, interventional will make more, cardiothoracic surgery will make less.

Nephrologists will continue to make money as long as the US government continues to pay to keep their patients on dialysis rather than get their patients a kidney transplant.

 

[RenalFellow3]

I am a second year renal fellow in a big Univ Hosp looking for options next year.
From my own experience almost any specialty in medicine is seeing decreased reimbursement but the situation is more sever for nephrology as the main money making activity is hemodialysis where medicare is almost the only payer.
With the current economic situation and mounting pressure to cut on medicare costs one of the main targets is physician reimbursements and as we have only one payer there is nothing much we can fight; it is very very unlikely that medicare spending in dialysis is going to be increased but he costs of running a practice are increasing above inflation.
Not surprisingly you will see how starting salaries for nephrologist are almost the same as for hospitalist, besides all many practices are recruiting mid level providers to run dialysis facilities which again goes against salaries for nephrologist. Regarding transplantation almost any new patient is medicare so you can see.
Looking for jobs I am getting offers around 150k-170K almost less than a hospitalist and that is in mostly rural middle size cities, in a big city like I am now the best offering is about 130 which is deceptive after so much work.
Sorry to post this large message but somebody has to say the real truth about this specialty; Being an AMG I shold have gone for something ore lucrative like HemOnc, GI or cards

 

[howelljolly]

Thats what I meant to say.

to the previous poster...you might not make a ton of money, but I hope you can keep your spirits up by enjoying the cerebral nature of the field.

 

[RenalFellow3]

Well, that's ok but when you see that the residents in your program going for primary care or hospitalists are getting better job proposals and making more money than you it is kind of frustrating.
Not to mention that nephrologists usually work longer hours in the hospital rounding and making consults with a workload usually heavier than other specialists.
I do not want to be negative I just want to give my personal opinion aiming to those that want to get into the field.

 

[maxpower75]

Hello,
I thought I would weigh in since I am completing my Renal fellowship soon, and have signed a contract for a job, so I think I can offer some perspective. I am currently in the SW region of the US, and have taken a job in this region. I interviewed with several groups, the salaries offered here varied btw 175-195. Most offered partnership after 2 years, the current partners in the groups were making significantly more than the starting salaries.
Dialysis is getting more costly, and the cost of doing dialysis are on the rise, adaptation is important for any physician. Most middle to large size Renal groups (including the one I ended up joining) are attempting to increase revenue by other mechanisms such as access centers.
I am very happy I chose Nephrology, and I am satasfied with the salary, and potential to earn as a partner. My wife is currently interviewing for Hospitalist jobs, and although our initial salary is in the same range, currently the long term earnings are larger.
I hope this was helpful!

 

[draks]

I am a second year renal fellow in a big Univ Hosp looking for options next year.
From my own experience almost any specialty in medicine is seeing decreased reimbursement but the situation is more sever for nephrology as the main money making activity is hemodialysis where medicare is almost the only payer.
With the current economic situation and mounting pressure to cut on medicare costs one of the main targets is physician reimbursements and as we have only one payer there is nothing much we can fight; it is very very unlikely that medicare spending in dialysis is going to be increased but he costs of running a practice are increasing above inflation.
Not surprisingly you will see how starting salaries for nephrologist are almost the same as for hospitalist, besides all many practices are recruiting mid level providers to run dialysis facilities which again goes against salaries for nephrologist. Regarding transplantation almost any new patient is medicare so you can see.
Looking for jobs I am getting offers around 150k-170K almost less than a hospitalist and that is in mostly rural middle size cities, in a big city like I am now the best offering is about 130 which is deceptive after so much work.
Sorry to post this large message but somebody has to say the real truth about this specialty; Being an AMG I shold have gone for something ore lucrative like HemOnc, GI or cards

Thanks for the quote. It seems MAXpower has a totally different view on salaries. where did u get 130 offer from - thats very painful to hear- I mean frm what state. Y is Neph still competitive and is it more competitive than Pul and critical care

 

[howelljolly]

Nephro is probably competetive because it attracts people who like to sit around and think, and appreciate basic sciences and research.

House MD did fellowships in ID and Nephrology, you know.

 

[draks]

Nephro is probably competetive because it attracts people who like to sit around and think, and appreciate basic sciences and research.

House MD did fellowships in ID and Nephrology, you know.

Someone recently told me that one of his friends who recently graduated from a nephro fellowship program is working a Hospitalist in Int Medicine as the salary was better in it compared to nephro jobs. That sucks.

 

[howelljolly]

There might be a way out...
Interventional nephrology certification. Besides placing your own shileys, you can work on AV fistulas yourself... removing clots, maybe transpositioning the fistula. Im pretty sure the actual fistula placement is still up to the vascular guys.
Procedeures always make more money.

 

[haujun]

There might be a way out...
Interventional nephrology certification. Besides placing your own shileys, you can work on AV fistulas yourself... removing clots, maybe transpositioning the fistula. Im pretty sure the actual fistula placement is still up to the vascular guys.
Procedeures always make more money.

True as it in the case for Cards and GI. What I am confused about is Hem/Onc which is non-procedural based speciality pays signficantly better than nephrologist. I imagine reimbursement for chemo is better than dialysis??? Why?

 

[howelljolly]

True as it in the case for Cards and GI. What I am confused about is Hem/Onc which is non-procedural based speciality pays signficantly better than nephrologist. I imagine reimbursement for chemo is better than dialysis??? Why?

Because the oncologist can make a profit off of the chemotherapy drugs, not unlike how dermatologists can make a profit from their drugs.

Besides that, Im pretty sure that R&D for chemotherapy is more costly than for dialysis.

 

[draks]

Because the oncologist can make a profit off of the chemotherapy drugs, not unlike how dermatologists can make a profit from their drugs.

Besides that, Im pretty sure that R&D for chemotherapy is more costly than for dialysis.

Can anyone tell me what the average start salary for Nephrologist and PCCM doc is in big cities like Chicago, NY. Most of the website gives unreal fig. I would appreciate it someone from specialities can tell me. Its hard for me to take a decision as I plan to do research in either one.