Where would you go to earn the most?

[Aheadbyacentury]

Yes as I mentioned the NHS pays garbage. Germany and France are about 300k USD for by American standards cush jobs with strong job security. None would be tempted by 300k USD in America, let alone 150k.

How much does say a police officer make in germany?

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[dhb]

How much does say a police officer make in germany?

Probably between 25 and 40k after taxes

 

[Aheadbyacentury]

Probably between 25 and 40k after taxes

so about the same

 

[Mman]

Yes as I mentioned the NHS pays garbage. Germany and France are about 300k USD for by American standards cush jobs with strong job security. None would be tempted by 300k USD in America, let alone 150k.

well sure, nevermind the fact they wouldn't have a medical license in the US and may have to repeat residency training. Not exactly free market forces impacting a temporary locums pay.

 

[deleted941485]

The salaries of European doctors on the whole are WIDELY understated and people are easily misled trying to look up averages. If you were in Switzerland trying to look up anesthesiologist pay in the US you might think the BLS figure of 270k is accurate for example: Anesthesiologists

If you google anesthesiology salary Switzerland you’ll see things like ~357k CHF (1 CHF = 1.08 USD). In reality the median in 2014 was 518k CHF, or 560k USD. Doctors’ salaries exceed expectations and that was 7 years ago.

In general these figures are kept hush hush where possible. If you thought earning a lot of money put a target on your back it’s way worse in Europe so take any “googled” figures with a massive grain of salt.

The one exception is NHS docs in UK truly are paid crap by most 1st world country standards. Private is much better, but not everyone can be private and even private pay isn’t comparable to US/Canada/AUS/many other countries in Western Europe.

I always loved the salary debates especially when t comes to comparing Euro/US. It’s been used by agenda pushers who think they can shame docs and prompt policy makers to lowball US docs. The reality is you probably should consider the Euro docs salary in the context of their own national income distributions and not just plugging it into a currency calc and then saying LOOK HOW LITTLE THEY MAKE!

 

[deleted941485]

Also and I don’t know why this doesn’t have its own thread now with balanced billing measures in place that are clearly unfavorable to Anesthesia

Anesthesiologists are prohibited in all circumstances to be OON when’s facility is also IN. They cannot even consent a patient for OON charges. What a joke.

Going somewhere to make more just sounds more and more like chasing your own shadow.

 

[Aheadbyacentury]

Also and I don’t know why this doesn’t have its own thread now with balanced billing measures in place that are clearly unfavorable to Anesthesia

Anesthesiologists are prohibited in all circumstances to be OON when’s facility is also IN. They cannot even consent a patient for OON charges. What a joke.

Going somewhere to make more just sounds more and more like chasing your own shadow.

I guess its good if it will finally put the Anesthesia Managment Companies in a coffin.

 

[deleted941485]

I guess its good if it will finally put the Anesthesia Managment Companies in a coffin.

Um no it wont...but your small time group whose been at the hospital for 30 years will be.

 

[Mman]

Anesthesiologists are prohibited in all circumstances to be OON when’s facility is also IN.

we have been out of network with different insurers several times over the years at facilities that were in network. It was painful, but we got through it.

 

[nimbus]

we have been out of network with different insurers several times over the years at facilities that were in network. It was painful, but we got through it.

While going OON may have been an effective strategy in the past, it is unclear if going OON will have a similar effect when we are prohibited from balance billing OON patients and/or OON rates are limited to a multiple of medicare rates. The insurance companies will no longer have an incentive to negotiate in network rates in good faith because they will know that OON rates won’t hurt them. In many instances the insurance companies will save money if anesthesia groups go OON because of OON rate caps.

 

[deleted941485]

While going OON may have been an effective strategy in the past, it is unclear if going OON will a similar effect when we are prohibited from balance billing OON patients and/or OON rates are limited to a multiple of medicare rates. The insurance companies will no longer have an incentive to negotiate in network rates in good faith because they will know that OON rates won’t hurt them. In many instances the insurance companies will save money if anesthesia groups go OON because of OON rate caps.

They have no incentive to even put you in network anymore. So your options are suck it up, go OON and still get screwed, or work for the hospital. Either way you wont have any control. This is all being cloaked in protecting the patient but all its really doing is screwing you. Its free work at rates you did not agree to.

 

[Mman]

While going OON may have been an effective strategy in the past, it is unclear if going OON will a similar effect when we are prohibited from balance billing OON patients and/or OON rates are limited to a multiple of medicare rates. The insurance companies will no longer have an incentive to negotiate in network rates in good faith because they will know that OON rates won’t hurt them. In many instances the insurance companies will save money if anesthesia groups go OON because of OON rate caps.

that is a very state dependent issue right now and you can get very different scenarios in different states. For example, New York has a nice surprise billing out of network process that does not give the insurance company massive leverage over the physician.

 

[deleted941485]

that is a very state dependent issue right now and you can get very different scenarios in different states. For example, New York has a nice surprise billing out of network process that does not give the insurance company massive leverage over the physician.

Only 12 states actually have something for BB at the state level. The rest do not.

If you are an ancillary service forget it you aren't even allowed to let the patient know you'll be OON and that you'll be charged at a higher rate.

 

[Mman]

Only 12 states actually have something for BB at the state level. The rest do not.

If you are an ancillary service forget it you aren't even allowed to let the patient know you'll be OON and that you'll be charged at a higher rate.

which 12 states?

 

[deleted941485]

which 12 states?

Dont remember.

 

[nimbus]

They have no incentive to even put you in network anymore. So your options are suck it up, go OON and still get screwed, or work for the hospital. Either way you wont have any control. This is all being cloaked in protecting the patient but all its really doing is screwing you. Its free work at rates you did not agree to.

Yeah that’s the worst case and very possible.

 

[deleted941485]

Yeah that’s the worst case and very possible.

Everyone wanted baseball style arbitration but what they failed to understand it imagine having to do this for every patient thats OON. Its too costly and time intensive so you end up in a situation where its just not possible. Any remaining groups will be forced to consolidate or become employed. AMCs arent going to go away theyll just stary firing anesthesiologists and replacing them with more and more CRNAs.

 

[Mman]

Everyone wanted baseball style arbitration but what they failed to understand it imagine having to do this for every patient thats OON. Its too costly and time intensive so you end up in a situation where its just not possible. Any remaining groups will be forced to consolidate or become employed. AMCs arent going to go away theyll just stary firing anesthesiologists and replacing them with more and more CRNAs.

I heard somewhere Joe Biden is going to direct the FTC to try to eliminate or greatly limit non compete clauses nationwide.

 

[anbuitachi]

If location, family and other factors were not an issue where would you move to in the US for the highest salary for 2-3 years? I am trying to pin down a location, so far Alaska seems to be the highest salaries I've seen advertised. Do $700k + jobs exist out there? I am contemplating doing this for a few years to jump start savings and then take a more chill job when I start a family.

one of my colleague in NYC made 700k a few yrs ago. He quit though because he says he was working 120 hrs a week... and it just wasnt worth it

forget comparing salaries to EUROPE. even comparing salaries here in same profession is often difficult. look at MGMA averages and how useful that is to each specific job? It doesnt tell you how many calls you are taking, how busy you are during calls, how busy the days are, etc, all of which would have a huge impact on QOL. also 300k in NYC is worth like 100k in Kansas.

 

[deleted941485]

I heard somewhere Joe Biden is going to direct the FTC to try to eliminate or greatly limit non compete clauses nationwide.

Yeah thats almost meaningless because corps will find another way to screw you. Plus its completely nullified by legislation that essentially is the closest thing to price controls. Sure you can go out on your own but you wont be materially better off for doing so.

 

[Status Sciaticus]

Yeah thats almost meaningless because corps will find another way to screw you. Plus its completely nullified by legislation that essentially is the closest thing to price controls. Sure you can go out on your own but you wont be materially better off for doing so.

The benefit of voiding non-competes nationally is that youre clipping the corps ability to bargain with hospitals/insurance companies because they cant threaten them with "pay up or GTFO". You can leave and go to their competitor in the same city. In a free-market, that will increase competition for your employment rather than one large AMC in a city telling you to accept their offer or look elsewhere.

 

[deleted941485]

The benefit of voiding non-competes nationally is that youre clipping the corps ability to bargain with hospitals/insurance companies because they cant threaten them with "pay up or GTFO". You can leave and go to their competitor in the same city. In a free-market, that will increase competition for your employment rather than one large AMC in a city telling you to accept their offer or look elsewhere.

True and I support that measure but if that same federal govt already puts caps on what you can charge and they already are. The economic advantage of this practice is diminished significantly. Also the chances of that happening at this point are low. The chances of AMCs letting giant swaths of their staff just walk out the door because of this is also a fantasy. If anything it will just make it easier for hospitals to cancel AMC contracts and then employ the docs.

Also in other industries like Big Tech, they have tacit no poach agreements. No need for a non compete as the big players in the game already have agreed upon terms. You wanna leave fine but our competitor has agreed not to hire you.

 

[Status Sciaticus]

True and I support that measure but if that same federal govt already puts caps on what you can charge and they already are. The economic advantage of this practice is diminished significantly. Also the chances of that happening at this point are low. The chances of AMCs letting giant swaths of their staff just walk out the door because of this is also a fantasy. If anything it will just make it easier for hospitals to cancel AMC contracts and then employ the docs.

Also in other industries like Big Tech, they have tacit no poach agreements. No need for a non compete as the big players in the game already have agreed upon terms. You wanna leave fine but our competitor has agreed not to hire you.

Right. Thus best not to worry about "corps finding a way to screw you" if the chances of it happening are low.

 

[<(^_^)>]

True and I support that measure but if that same federal govt already puts caps on what you can charge and they already are. The economic advantage of this practice is diminished significantly. Also the chances of that happening at this point are low. The chances of AMCs letting giant swaths of their staff just walk out the door because of this is also a fantasy. If anything it will just make it easier for hospitals to cancel AMC contracts and then employ the docs.

Also in other industries like Big Tech, they have tacit no poach agreements. No need for a non compete as the big players in the game already have agreed upon terms. You wanna leave fine but our competitor has agreed not to hire you.

They had, for a bit (and were caught). That ended. Salaries are pretty phenomenal right now: Levels.fyi | Salaries & Tools to Level Up Your Career

 

[anbuitachi]

They had, for a bit (and were caught). That ended. Salaries are pretty phenomenal right now: Levels.fyi | Salaries & Tools to Level Up Your Career

Salaries only going higher for tech. There is a huge focus on recruiting talent . And USA is super lacking in talent in CS compared to number of jobs available

 

[Mman]

Yeah thats almost meaningless because corps will find another way to screw you. Plus its completely nullified by legislation that essentially is the closest thing to price controls. Sure you can go out on your own but you wont be materially better off for doing so.

if there were no non competes, I know of multiple large hospitals with AMCs that would currently be private practice models. It would almost end AMCs overnight in many places.

 

[deleted941485]

if there were no non competes, I know of multiple large hospitals with AMCs that would currently be private practice models. It would almost end AMCs overnight in many places.

I wanna believe...so bad.

 

[Aheadbyacentury]

if there were no non competes, I know of multiple large hospitals with AMCs that would currently be private practice models. It would almost end AMCs overnight in many places.

Dont think the pvt practice model is all roses.. That model was rife with top heavy groups that churned through new grads. Case law is plentiful since the lawsuits can show this.
In my opinion, the only pvt practice model that works(fairly) is credential anyone who wants to be on staff and let it be a meritocracy on who the surgeons consult.

 

[Arch Guillotti]

In my opinion, the only pvt practice model that works(fairly) is credential anyone who wants to be on staff and let it be a meritocracy on who the surgeons consult.

Not sure that would work most places.

 

[Mman]

Not sure that would work most places.

everybody is on call 24/7 and the surgeons will just call whoever won't cancel their case

 

[GassYous]

Dont think the pvt practice model is all roses.. That model was rife with top heavy groups that churned through new grads. Case law is plentiful since the lawsuits can show this.
In my opinion, the only pvt practice model that works(fairly) is credential anyone who wants to be on staff and let it be a meritocracy on who the surgeons consult.

Then some people will burn out from being called too much and others will leave from having no business. Makes no sense.

 

[Arch Guillotti]

everybody is on call 24/7

lol

 

[Aheadbyacentury]

In the pvt practice group model especially the larger one gets is that a few people subsidizes a lot of people which is ridiculous. It should be eat what you kill all around

 

[Mman]

In the pvt practice group model especially the larger one gets is that a few people subsidizes a lot of people which is ridiculous. It should be eat what you kill all around

the problem in anesthesia is that the physical/mental labor is often not related to the compensation from the case. The acceptable choices are that the workload gets assigned evenly and the money is split evenly, or that the pay is correlated to the work in some fair fashion. Eat what you kill accomplishes neither, unless everybody has equal opportunity to pick the richer assignments.

 

[Aheadbyacentury]

the problem in anesthesia is that the physical/mental labor is often not related to the compensation from the case. The acceptable choices are that the workload gets assigned evenly and the money is split evenly, or that the pay is correlated to the work in some fair fashion. Eat what you kill accomplishes neither, unless everybody has equal opportunity to pick the richer assignments.

Splitting the money evenly regardless of how much you work or how little you work does not accomplish anything except incentivize cherry picking assignments.. In my method, if you dont wanna work it will be reflected on the score card every two weeks.. (your pay).

 

[GassYous]

the problem in anesthesia is that the physical/mental labor is often not related to the compensation from the case. The acceptable choices are that the workload gets assigned evenly and the money is split evenly, or that the pay is correlated to the work in some fair fashion. Eat what you kill accomplishes neither, unless everybody has equal opportunity to pick the richer assignments.

Best way is to let the call person choose their room imo

 

[Mman]

Splitting the money evenly regardless of how much you work or how little you work does not accomplish anything except incentivize cherry picking assignments.. In my method, if you dont wanna work it will be reflected on the score card every two weeks.. (your pay).

that's why you split the work evenly to split the money evenly, everybody gets an even number of good days and bad days

 

[Aheadbyacentury]

that's why you split the work evenly to split the money evenly, everybody gets an even number of good days and bad days

But thats the thing, some people know how to simply not be available and do far less work than anyone else or conveniently have less bad days and more good days and are bad conveniently at whatever the task to be completed is.. It is a reality. Dividing the money evenly makes for corrupt system. The only way to do it fairly is to pay for RVU and divide the money. If that is not fair, then at the next FED RVU meeting they will change it to make it fair.

 

[Mman]

But thats the thing, some people know how to simply not be available and do far less work than anyone else or conveniently have less bad days and more good days and are bad conveniently at whatever the task to be completed is.. It is a reality.

That is only reality in a dysfunctional group, of which you have apparently been a part of. I can assure you that is not the case in all groups.

 

[deleted697535]

that's why you split the work evenly to split the money evenly, everybody gets an even number of good days and bad days

money should never be even.
communism failed.
if money is equal then ppl will game the system to do **** all

i work harder & faster than 90% of my colleagues, basically never cancel a case or ask for breaks. I get all the **** cases while other people are manning the lounge - or doing the eye list 5 days in a row.. so yeah no, screw that. nothing should be equal ever

i respect your opinion but its very hard to find the right path
if you make the work equal, the work will never be done or the patients will be dead because most of these idiots cant do **** cases

 

[Aheadbyacentury]

That is only reality in a dysfunctional group,

Any group over 2 is dysfunctional.

 

[Mman]

Any group over 2 is dysfunctional.

and yet some have been going strong for decades

 

[deleted697535]

Yes as I mentioned the NHS pays garbage. Germany and France are about 300k USD for by American standards cush jobs with strong job security. None would be tempted by 300k USD in America, let alone 150k.

Where are you getting that from? I did a stint in a big euro heart hospital and they told me they were making about 120 and working fairly hard. They did admit that most do that for 5-10 years then peace out to a cushy number but idk what that is

A belgian guy i trust a lot told me about 100k, a french immunologist told me the same and worked like dogs. So i dont know

 

[ZzzPlz]

and yet some have been going strong for decades

my group been around since ‘83. Four docs for 95+% of that time. Equal call rotation. Equal ambition to work hard. It all works out. Shareholders split the overhead and accounts receivable evenly.

 

[Aheadbyacentury]

and yet some have been going strong for decades

Lots of things have longevity yet are completely FUBARd. Doesn't mean anything!

 

[Aheadbyacentury]

since ‘83. Four docs

The same FOUR?..... That is some longevity for you.

 

[ZzzPlz]

Lol four at a time… not the same four. Although in that time frame there there has been very low turnover

 

[nimbus]

or doing the eye list 5 days in a row..

Hey I know that guy!

 

[Mman]

Lots of things have longevity yet are completely FUBARd. Doesn't mean anything!

it means a lot when nobody ever leaves. Crappy jobs have high turnover. Great jobs have almost no turnover.

 

[pgg]

or doing the eye list 5 days in a row

I think if I had to do eyes four days in a row, I'd be booked as a patient on the fifth day, after I desperately stabbed myself in my own eyeball just to get away.