What Job offers are current residents getting?

[deleted171991]

Are you sure about that? What's to stop us from billing those same CPT codes that hospitalists do. I don't think that CMS or insurers look into your residency training as long as you're a licensed physician. I could be wrong so someone please educate me on this.

My understanding is that that type of work just pays significantly less than OR time so it's not worth our time, not that we literally can't get paid for doing it???

I don't think you can bill for periop anesthesia-related consults. The preop evaluation and PACU are considered to be included in the anesthesia fee for the procedure. And I wouldn't be surprised if periop management is included in the surgeon's fees.

Once/if hospitals will migrate to bundled payments (one big payment to the ACO for everything, and then the ACO divides the money), the anesthesia team could be reimbursed separately for taking care of the patient preop and/or postop, a la PSH. Today, the preop clinic is generally subsidized, either by the hospital or the group, and the postop management (the part beyond wound care) is done by the surgeon.

@Twiggidy is right when pointing out that anesthesiologists feel that the PSH is just a euphemism for working more for about the same money.

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[IkeBoy18]

academics in columbus OH seems to have a base around 245k and average call adds abt 100k. except for cardiac, d/t longer hours they seem to avg around 390 total

edit: also the call potential is unlimited. a couple of new grads make over 500k from taking more call.

 

[aimedicine]

Maybe the reason you aren't getting the results with this thread that you would like is because you're kind of a dick?

What are u talking about, my question was answered a long time ago...multiple people PM'd me with precise figures and regions they are located....im trying really hard to maintain professional decorum but you need to shut yo face and stop calling people a dick, dick!

 

[IlDestriero]

Academic jobs I know are 290 some call big center. 265 base plus plus for call work late etc. both have good benefits

That may be the average, but there are better offers if you look around.

 

[anbuitachi]

What are u talking about, my question was answered a long time ago...multiple people PM'd me with precise figures and regions they are located....im trying really hard to maintain professional decorum but you need to shut yo face and stop calling people a dick, dick!

can you pm me those figures. you can delete identifiers or w/e

That may be the average, but there are better offers if you look around.

i think it depends on how major of a city we are talking about.. milwaukee (31st largest city) vs NYC is a big difference.

 

[IlDestriero]

A major metro academic job that starts you off at >275k before benefits for a board eligible new grad seems 1-2 SD above average. So while you CAN do so, it certainly isn't likely. Am I way off here?

See above. Just like in private practice jobs, many earn average income and a few earn significantly more. You need to do the legwork and find out which places are 90th percentile academic income and which ones are <50th.
The academic place an hour away or across town, or even next door may have a very different pay scale.
One other thing to consider is what is considered full time clinical work. 3 days a week vs 4.5 days a week. Greater clinical commitment should equal greater income, though not necessarily internally.
There's one notoriously low paying place that tries to con potential faculty into thinking that working only 3 clinical days a week is worth less than 200k, yet expects significant research productivity. I don't know how they recruit anyone. If you are in the research track at my place, your base salary far exceeds their max income.

 

[deleted171991]

can you pm me those figures. you can delete identifiers or w/e

Me too, please.

 

[nimbus]

Are you sure about that? What's to stop us from billing those same CPT codes that hospitalists do. I don't think that CMS or insurers look into your residency training as long as you're a licensed physician. I could be wrong so someone please educate me on this.

My understanding is that that type of work just pays significantly less than OR time so it's not worth our time, not that we literally can't get paid for doing it???

I suppose it's possible. We could bill evaluation and management codes.

I still don't wanna admit the 90yo hip fracture from the ER. I'd rather have the hospitalist do it because at least for now I have better things to do. Things I actually enjoy.

 

[aimedicine]

Some truth....investment banking wharton

 

[deleted50478]

They'll go up for the next 40 years. we'll go down, in all likelihood, for the next 30 of our late-start careers.

 

[Twiggidy]

Some truth....investment banking whartonView attachment 192987

Yes, investment bankers make more than anesthesiologist......something you should have posted to me 1o years ago. I'd rather grind it out than take on more loans and then fight for another job in a shaky economy. (Although a business degrees will give me a better chance to move to Europe)

 

[anbuitachi]

Yes, investment bankers make more than anesthesiologist......something you should have posted to me 1o years ago. I'd rather grind it out than take on more loans and then fight for another job in a shaky economy. (Although a business degrees will give me a better chance to move to Europe)

oO you didn't know IBankers make more than anesthesiologists???

 

[courtnes]

Some truth....investment banking whartonView attachment 192987

*snort* the people who couldn't get into Wharton as undergrads. /snark

I went there. Business isn't all it's cracked up to be. Not all people who can make it in medicine can make it in iBanking. Not all people who can make it in iBanking can make it in medicine. I would bet it's a small subset who can do both. Of my classmates, very few made that jump either way.

 

[pgg]

*snort* the people who couldn't get into Wharton as undergrads. /snark

I went there. Business isn't all it's cracked up to be. Not all people who can make it in medicine can make it in iBanking. Not all people who can make it in iBanking can make it in medicine. I would bet it's a small subset who can do both. Of my classmates, very few made that jump either way.

It wouldn't be SDN without some talk of ibanking.

It's like the Godwin of SDN: "As an online SDN anesthesia forum discussion grows longer, the probability of a comparison involving Nazis or Hitler ibanking approaches 1"

And here we are on page 7.

 

[courtnes]

It wouldn't be SDN without some talk of ibanking.

It's like the Godwin of SDN: "As an online SDN anesthesia forum discussion grows longer, the probability of a comparison involving Nazis or Hitler ibanking approaches 1"

And here we are on page 7.

Too true. I could be a rock star, too.

Not to mention, most of their lives blow - worse hours than ours - and your chances of cocaine addiction are higher.

 

[anbuitachi]

Too true. I could be a rock star, too.

Not to mention, most of their lives blow - worse hours than ours - and your chances of cocaine addiction are higher.

well yea, it makes sense. they are getting paid six figures out at 22, while we are paying 50k a year to be in medical school. by the time we are done with residency, they are getting ready for retirement.

 

[courtnes]

well yea, it makes sense. they are getting paid six figures out at 22, while we are paying 50k a year to be in medical school. by the time we are done with residency, they are getting ready for retirement.

Not really, most of them don't get paid quite that well. They can win big but they can also lose big, too, let us not forget. The grass is always greener.

 

[anbuitachi]

Not really, most of them don't get paid quite that well. They can win big but they can also lose big, too, let us not forget. The grass is always greener.

Ha i was exaggerating a bit, but at least the ones I know of started off w/ base salary in mid 100s, Bonus can push to 200k+ total. But that is still a lot when starting as a 22 year old. Most ppl end up dropping out and going for a more sane business field, settling for a lower salary, but for those who can last til 30... i imagine their salary is quite high.

 

[mja75]

The cardiac anesthesiologists I've worked with give me hope for this field and myself as a future anesthesiologist. That level of expertise, instinct and care is irreplaceable.

 

[anbuitachi]

The cardiac anesthesiologists I've worked with give me hope for this field and myself as a future anesthesiologist. That level of expertise, instinct and care is irreplaceable.

i thought in some places CRNAs are allowed to do cardiac cases unsupervised

 

[gasdoc77]

i thought in some places CRNAs are allowed to do cardiac cases unsupervised

fact

 

[aneftp]

i thought in some places CRNAs are allowed to do cardiac cases unsupervised

Some places WANT the Crna to only do the cardiac cases.

Cause the cardiologist can come in and perform the introp TEE (obviously collects anywhere between $200-800) from TEE.

Easy money in cardiologists pockets.

 

[aka_tigerj]

i thought in some places CRNAs are allowed to do cardiac cases unsupervised

Yes, the hospital in my town... they do it unsupervised. But this is a rural hospital..

 

[deleted162650]

Cause the cardiologist can come in and perform the introp TEE (obviously collects anywhere between $200-800) from TEE.

This happens at many hospitals in my area where there is an MD doing the case solo. In fact, one of our relatively new hires who is cardiac fellowship trained decided to work at my hospital because it was one of the few locations in town where he got to do his own TEE's.

 

[anbuitachi]

This happens at many hospitals in my area where there is an MD doing the case solo. In fact, one of our relatively new hires who is cardiac fellowship trained decided to work at my hospital because it was one of the few locations in town where he got to do his own TEE's.

wow cardiac trained anesthesiologists usuually dont do their own TEEs? That sux

 

[deleted171991]

wow cardiac trained anesthesiologists usuually dont do their own TEEs? That sux

Yeah. It's called Turf Wars. Coming soon in a new 3D version to a hospital near you, the week after Bundled Payments.

 

[deleted162650]

wow cardiac trained anesthesiologists usuually dont do their own TEEs? That sux

I think in my neighborhood it evolved more as a result of the older cardiac guys not being formally cardiac trained and in the pre-echo era to boot so cards did the echoes because they really weren't comfortable calling anything based on their own poor echo skills. Now the new guys are forced to deal with that precedent even though they possess the TEE skills themselves.

 

[Twiggidy]

wow cardiac trained anesthesiologists usuually dont do their own TEEs? That sux

depends on where you are. where i work it was culture the techs did the TEEs while (as quoted by a surgeon) the anesthesiologist got to focus on the patient. we as cardiac trained echo certified anesthesiologists read the images post op

I think in my neighborhood it evolved more as a result of the older cardiac guys not being formally cardiac trained and in the pre-echo era to boot so cards did the echoes because they really weren't comfortable calling anything based on their own poor echo skills. Now the new guys are forced to deal with that precedent even though they possess the TEE skills themselves.

exactly this

 

[chmd]

Yeah. It's called Turf Wars. Coming soon in a new 3D version to a hospital near you, the week after Bundled Payments.

Cardiology reads and reports on our echo exams. But they never come in the room.

 

[deleted171991]

Cardiology reads and reports on our echo exams. But they never come in the room.

Reads and reports = bills. And they don't even have to come in the room for that? How nice.

 

[deleted50478]

Reads and reports = bills. And they don't even have to come in the room for that? How nice.

Beats having some m%+h€rF¥€ker standing in your way while you come off bypass, not knowing or more likely not caring, how in the way they are.

 

[aneftp]

All I know is Mednax (their Pediatrix division) collected $1700 (not billed but collected) just for a 2D office echo for my than 11 month old daughter 2 years ago. That was money out of pocket since we had $6000 deductible. (More of an "innocent murmur" pediatrican heard.

So while most echo can pay the $200-800 I wrote. Mednax also has huge billing advantages in their other speciality divisions. Most small time cardiologists cannot collect $1700 for a 2D office echo.

Wonder what Mednax collects for a TEE???

 

[deleted171991]

Beats having some m%+h€rF¥€ker standing in your way while you come off bypass, not knowing or more likely not caring, how in the way they are.

That just proves that everything in life is relative. One man's junk is another man's gold.

 

[TorMed]

One man's junk is another man's gold.

And the off color jokes begin...

 

[deleted171991]

Junk = trash.

 

[waterbottle10]

All I know is Mednax (their Pediatrix division) collected $1700 (not billed but collected) just for a 2D office echo for my than 11 month old daughter 2 years ago. That was money out of pocket since we had $6000 deductible. (More of an "innocent murmur" pediatrican heard.

So while most echo can pay the $200-800 I wrote. Mednax also has huge billing advantages in their other speciality divisions. Most small time cardiologists cannot collect $1700 for a 2D office echo.

Wonder what Mednax collects for a TEE???

Isn't it only collected because you paid for it.. otherwise i doubt insurance would pay the hospital/group that much.

 

[aneftp]

Isn't it only collected because you paid for it.. otherwise i doubt insurance would pay the hospital/group that much.

That was the bill. If I don't pay for it. I get sent to collections and have my credit dinged.

That's what these mega corporations do. They negotiate higher reimbursement rates from insurers. If you got high deductible like many of us. You are going to be on the hook for the bill.

 

[ArMed]

And the off color jokes begin...

Your junk is off-color?? You should see a doctor!

 

[Carbocation1]

From the US Dept. of Health and Human Services report on the physician workforce, published in 2008:

"Although physicians in surgical specialties earn substantially more than general and family practitioners, surgical specialties require additional years of training and thus a delay in significant earnings. Consequently, taking into account the additional costs of training (such as foregone earnings during residency) and differences in hours worked the returns to training in surgery are approximately 3 to 5 percent. The returns to training for radiologists and anesthesiologists are the highest—ranging from 4 to 7 percent. The returns to OBGYN training declined during the 1990s from 5 percent down to 2 percent. The returns to pathology and internal medicine were in the 1 to 2 percent range, and specialization in psychiatry is associated with a negative rate of return compared to entering general and family practice."

http://bhpr.hrsa.gov/healthworkforce/reports/physwfissues.pdf

 

[deleted171991]

From the US Dept. of Health and Human Services report on the physician workforce, published in 2008:

Current date = 6/22/2015

 

[Carbocation1]

Current date = 6/22/2015

That's the latest report I could find online.

 

[deleted171991]

That's the latest report I could find online.

I am just saying that the times have changed radically since. The Affordable Care Act, for example.

 

[Carbocation1]

I am just saying that the times have changed radically since. The Affordable Care Act, for example.

Right. Part of my point was that perhaps this report lead the government to target Gas and Rads for reimbursement cuts? Anyway, it was interesting to read their perception of physician reimbursement.

 

[aimedicine]

This thread is so ridiculously off topic lol

 

[FollowTheMoney]

I am just saying that the times have changed radically since. The Affordable Care Act, for example.

I think we should blame FFP for selling out the profession

 

[FollowTheMoney]

I would just like to say I love Carbocation1's commitment to go down with the ship. I'm putting you up there with Captain Edward J. Smith.

 

[TorMed]

Your junk is off-color?? You should see a doctor!

If you are a slightly sophomoric gay med student "one man's junk is another man's gold" makes you laugh.