wouldn't be nice to have these sorts of income streams....

[vistaril]

Fiance is about to take a position where she is guaranteed 85,000/year............from pathology alone.

That's like free money. Just a trivial "oh, and here is a check for 85k for something you don't even do we found lying around" type of money.

She will make more off this next year alone than I will in 4+ months.

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[Dkr]

Fiance is about to take a position where she is guaranteed 85,000/year............from pathology alone.

That's like free money. Just a trivial "oh, and here is a check for 85k for something you don't even do we found lying around" type of money.

She will make more off this next year alone than I will in 4+ months.

I've been reading your posts about your fiance's income potential for a while now. You should really seal the deal on this engagement soon, she might get away

 

[vistaril]

I've been reading your posts about your fiance's income potential for a while now. You should really seal the deal on this engagement soon, she might get away

oh a date is scheduled....worry not.

 

[BS81]

So if you will be making "paltry change" compared to her, why even bother busting your ass doing 4-5+ med-checks per hour? It's not like the extra 50k or so will be making a dent if she will be making 400k straight out of residency like you were claiming before. (I'm surprised that that's still happening because reimbursement for scopes has been getting cut left and right)

 

[vistaril]

So if you will be making "paltry change" compared to her, why even bother busting your ass doing 4-5+ med-checks per hour? It's not like the extra 50k or so will be making a dent if she will be making 400k straight out of residency like you were claiming before. (I'm surprised that that's still happening because reimbursement for scopes has been getting cut left and right)

dude, you aren't listening...she is making around 85k next year. From *pathology* alone. To put it in perspective, that would be like you or me finding out we are going to make big money collecting the change in our office chairs after they dropped out of patient pockets. Literally money that is free and requires nothing on their part.......

And that's not even considering the facility fee component. Which is a *lot* more obviously. And obviously there is a gradual buy in for that.

What a GI is reimbursed for a scope is just a sliver of their revenue stream.

Why will I bust my add doing 4-5+(and the plus is relevant...haha) med checks an hour(if I do that kind of practice)? Because why wouldn't I.....

 

[BS81]

So how do your offers compare to hers in your neck of the woods? On a per year, and a per hour basis, how much more will she be making than you? I'm guessing 250k vs 400k, and about $125/hr vs. $160/hr, since she will probably have to take more frequent calls...? I can live with the procedural specialties making 30% or so more per hour worked, but if it's more like double...

 

[kindasorta]

According to research, if you want to preserve your happiness, you should dump her now...


http://pss.sagepub.com/content/21/4/471.short

 

[BS81]

dude, you aren't listening...she is making around 85k next year. From *pathology* alone. To put it in perspective, that would be like you or me finding out we are going to make big money collecting the change in our office chairs after they dropped out of patient pockets. Literally money that is free and requires nothing on their part.......

And that's not even considering the facility fee component. Which is a *lot* more obviously. And obviously there is a gradual buy in for that.

What a GI is reimbursed for a scope is just a sliver of their revenue stream.

Why will I bust my add doing 4-5+(and the plus is relevant...haha) med checks an hour(if I do that kind of practice)? Because why wouldn't I.....

And doing scopes in your own facility (an ASC) barely lets you break even unless you are very very efficient and cut corners and are in a CRNA opt-out state, so they must be getting some of that money from these other sources

Money gets cut in one place, you game the system to make it up somewhere else

 

[tartesos]

I say you keep that woman happy and start Making plans for valentines day.
I would elope right now if I were you!
Lol

 

[vistaril]

So how do your offers compare to hers in your neck of the woods? On a per year, and a per hour basis, how much more will she be making than you? I'm guessing 250k vs 400k, and about $125/hr vs. $160/hr, since she will probably have to take more frequent calls...? I can live with the procedural specialties making 30% or so more per hour worked, but if it's more like double...

lol....dude....85k...for the pathology!!!! Just with that extra wrinkle, if we were both making the same thing after that(which obviously isnt going to be the case), she's going to be making already that much more than me. And that's just an 85k money grab that was an afterthought....sort of a "oh yeah, why are we letting the pathologists take this money again from us" moment of clarity.

I can't give you a definite % rate because in procedural specialties the arrangements are more complicated initially. I don't understand it all yet myself. You have slow buy ins, then equipment depreciation, multiple revenue streams, etc....for example she's going to have to put up a lot of money of her guaranteed salary the first couple years to gain equity in the outpatient surgery center the group owns. The point is that there is a heckuva lot money involved(going in and out), and when that sort of money is involved it is mucho easier to 'hide' money.....

I don't think the people on this forum have any idea how much enterprising GI, IR, intcards, uro, etc make....with different revenue streams, it's a lot.

Go find someone who had a non-screening colonoscopy done and then look at their insurance statements. ALL of the different lines....the pathology, the anesthesia, the facility fee, the technical fee, professional component, etc.....the movement in the more enterprising GI(and uro and a few others...same thing applies there) practices is to take it *all* and subcontract out the rest. The facility, the path, the gas, heck if there was a strong imaging component they'd find a way to

So it's hard to say(after her buy in costs) what the % difference will be.....depending on whether they open up another branch office or not I may actually have more 'net' than her(but she'll have much more net + equity)......I suspect in 4 years the % differenc is going to be 300% or more.

 

[BS81]

lol....dude....85k...for the pathology!!!! Just with that extra wrinkle, if we were both making the same thing after that(which obviously isnt going to be the case), she's going to be making already that much more than me. And that's just an 85k money grab that was an afterthought....sort of a "oh yeah, why are we letting the pathologists take this money again from us" moment of clarity.

I can't give you a definite % rate because in procedural specialties the arrangements are more complicated initially. I don't understand it all yet myself. You have slow buy ins, then equipment depreciation, multiple revenue streams, etc....for example she's going to have to put up a lot of money of her guaranteed salary the first couple years to gain equity in the outpatient surgery center the group owns. The point is that there is a heckuva lot money involved(going in and out), and when that sort of money is involved it is mucho easier to 'hide' money.....

I don't think the people on this forum have any idea how much enterprising GI, IR, intcards, uro, etc make....with different revenue streams, it's a lot.

Go find someone who had a non-screening colonoscopy done and then look at their insurance statements. ALL of the different lines....the pathology, the anesthesia, the facility fee, the technical fee, professional component, etc.....the movement in the more enterprising GI(and uro and a few others...same thing applies there) practices is to take it *all* and subcontract out the rest. The facility, the path, the gas, heck if there was a strong imaging component they'd find a way to

So it's hard to say(after her buy in costs) what the % difference will be.....depending on whether they open up another branch office or not I may actually have more 'net' than her(but she'll have much more net + equity)......I suspect in 4 years the % differenc is going to be 300% or more.

Oh... so she is on some sort of partner track and her salary is not nearly as impressive. Have you looked at some of the anesthesia and cardiology boards and read about some of these predatory groups that just use up new attendings with the carrot of future partnership and dump them before any of that happens? I hope you guys are having someone in the know look over her contract

 

[vistaril]

Oh... so she is on some sort of partner track and her salary is not nearly as impressive. Have you looked at some of the anesthesia and cardiology boards and read about some of these predatory groups that just use up new attendings with the carrot of future partnership and dump them before any of that happens? I hope you guys are having someone in the know look over her contract

every board has it's own flavor on the pessimism/optimism scale....that's not entirely a bad thing, but it isn't always representative. If you go over on the path board, all pathologists are either unemployed or working for peanuts in pod mills(oh wait...maybe based on my fiance's position that is true haha).

My fiance is an exceptional candidate. She is from a very highly ranked fellowship(and med school and undergrad, although that's of little significance), has excellent communication skills, but more importantly(from the standpoint of what pp groups are looking for) sees herself as equal part physician and equal part entrepeneur. I don't know much about practices with lots of overhead/procedures though....that's what lawyers are for I think. She's got a lawyer who will go over everything before she signs.

 

[surftheiop]

. To put it in perspective, that would be like you or me finding out we are going to make big money collecting the change in our office chairs after they dropped out of patient pockets.

To be fair its more analogous to looking for spare change in the patients rectums

 

[BS81]

every board has it's own flavor on the pessimism/optimism scale....that's not entirely a bad thing, but it isn't always representative. If you go over on the path board, all pathologists are either unemployed or working for peanuts in pod mills(oh wait...maybe based on my fiance's position that is true haha).

Case in point this board. I don't think there is a more "positive" board than the psych board, with near 100% rainbows and sunshine minus you and michaelrack. I'm sure it's not nearly this rosy in the real world.

My fiance is an exceptional candidate. She is from a very highly ranked fellowship(and med school and undergrad, although that's of little significance), has excellent communication skills, but more importantly(from the standpoint of what pp groups are looking for) sees herself as equal part physician and equal part entrepeneur. I don't know much about practices with lots of overhead/procedures though....that's what lawyers are for I think. She's got a lawyer who will go over everything before she signs.

That's probably the key. Although once the ACOs kick in who knows what will happen. Who knows how much power the PCPs will have and if they'll start skimming off the top once they "control" all the patients. Although people with this "entrepreneurial" spirit always find ways to make bank and they'll just adjust to the times. Hopefully you guys can make bank while you still can. Cause the ACOs will kick in 2014, and the landscape will change.


interesting article about GI and ACOs

Edit: I'd also want to find out what happens if the group sells out before she makes partner. Where does all that "work equity" go?

 

[BS81]

To be fair its more analogous to looking for spare change in the patients rectums

It'd be more analogous to have someone else (pathologist) look for spare change in the patients rectum and you taking 50% off the top for a finders fee.

 

[surftheiop]

It'd be more analogous to have someone else (pathologist) look for spare change in the patients rectum and you taking 50% off the top.

man, tough crowd tonight


This is just a pointless thread, obviously procedural specialties are going to have higher income and obviously if your in a partner position of a procedural based practice your going to have numerous sources of income.

Not sure why any of this is thread worthy?

 

[BS81]

man, tough crowd tonight


This is just a pointless thread, obviously procedural specialties are going to have higher income and obviously if your in a partner position of a procedural based practice your going to have numerous sources of income.

Not sure why any of this is thread worthy?

Fair enough. If you are in the 15% or so that is a partner in a procedure heavy specialty you'll make bank. Otherwise, you'll make closer to what us mere mortals make

And yes it would be nice to have those...

 

[vistaril]

Edit: I'd also want to find out what happens if the group sells out before she makes partner. Where does all that "work equity" go?

Well I think that's all stuff for her lawyer to work out. I don't know if the practice just has to pay it back to her, or if there are penalties for the one who opts out on top of that(like if my fiance decided to join another practice before would she pay penalties or vice versa)

Partnership track in GI practices(at least the ones she's interviewed at) aren't all that difficult. There is nothing superduper special about being a partner..from what I understand it's simply pooling money together together to get the capital and financing to obtain the ambulatory surgery centers and fund all that goes into that and keep it going. If for some reason there was a bottleneck in GI where young GI docs after a few years were being held off from this, they would simply band together and form their own groups. The advantage in being a group is to share access to the facilities of course.

It will be interesting to see how this all shakes out with health care changes. If cost savings are the prime concern, seems like the govt would want to bundle things like GI and cards procedures to the outpatient surgery centers themselves who can run leaner and more efficiently than bloated hospitals....

 

[michaelrack]

If cost savings are the prime concern, seems like the govt would want to bundle things like GI and cards procedures to the outpatient surgery centers themselves who can run leaner and more efficiently than bloated hospitals....

Cost savings aren't the prime concern. Control is the prime concern. Hospitals will control doctors (and the government will control hospitals)

 

[sickofit]

Here's a surprise: Vistaril is making friends over in pathology too
http://forums.studentdoctor.net/showthread.php?t=978699

 

[wholeheartedly]

Here's a surprise: Vistaril is making friends over in pathology too
http://forums.studentdoctor.net/showthread.php?t=978699

 

[vistaril]

Cost savings aren't the prime concern. Control is the prime concern. Hospitals will control doctors (and the government will control hospitals)

I am still somewhat more optimistic than others with respect to this. I do believe Obama and his policies are overall very damaging to this country, but I don't think this is his main concern.