Critical Care Salary

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TrailRun said:
To me this sounds incredible! I'm matching into general surgery but really wish I explored this further before applying... Would it be possible to do a critical care fellowship (1 year from gen surg) and then work exclusively in critical care (1 wk on, 1 off)? I'm not motivated by money, just motivated by missing my family and wanting to take my future kids to Disney.

I think I made a mistake in picking surg (thought it was a good way to get to do procedural and medical things everyday). I did several sub-Is but how can you really know until you're the one actually doing it.
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You shouldn't have a problem getting a job, demand is high and is expected to stay this way for a while. I think it's important to get multidisciplinary ICU training if you can. If your exposure in residency and fellowship is limited only to SICU patients, you may not feel comfortable managing many MICU/CVICU type patients which will make up a majority of the patients you will be caring for as an intensivist.
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TrailRun said:
To me this sounds incredible! I'm matching into general surgery but really wish I explored this further before applying... Would it be possible to do a critical care fellowship (1 year from gen surg) and then work exclusively in critical care (1 wk on, 1 off)? I'm not motivated by money, just motivated by missing my family and wanting to take my future kids to Disney.

I think I made a mistake in picking surg (thought it was a good way to get to do procedural and medical things everyday). I did several sub-Is but how can you really know until you're the one actually doing it.
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I think it is pretty common to find jobs like you are describing. i'm starting to look for jobs and talk to people and 1 week on, 1 week off is a pretty common arrangement for community jobs. The on week can be covering the SICU, trauma, or emergency general surgery.

Also, I think its kind of a waste to do a 5 year surgery residency only to not operate anymore, but thats just me
 
kemper6036 said:
I think it is pretty common to find jobs like you are describing. i'm starting to look for jobs and talk to people and 1 week on, 1 week off is a pretty common arrangement for community jobs. The on week can be covering the SICU, trauma, or emergency general surgery.

Also, I think its kind of a waste to do a 5 year surgery residency only to not operate anymore, but thats just me
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You're definitely not wrong about it being a waste to do a surgical residency if one isn't going to operate anymore... I'd like to operate, I'm just fearful about future lifestyle as a surgeon, but it sounds like you're saying the week on/week off arrangement is possible as a surgeon as well, which is reassuring :) I went agains the tide in picking surgery (the OR is not my "favorite place in the world," I don't miss the OR when I'm not there, and I could actually see myself happy in multiple specialties). So I just hope I picked the right thing.
 
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How's CC compensation in Chicago area. Can someone share 2016 MGMA report. Btw total compensation doesn't include benefits. MGMA site has given definitions of their terminology on their website
 
adempsey22 said:
I am anesthesia trained CCM. I have been out of fellowship for two years. Currently I am working in a private practice MICU. Our group is a mix of medical trained and anesthesia trained intensivists. Everyone is pretty much 100% ICU, including me. A couple of the pulmonary docs at the hospital cover the ICU a week here and there. We are a 300-350 bed hospital in what most would consider the middle of no where. We have a 7 on 7 off model, 7a-7p or 7p-7a. 2 weeks of paid time off. 3 intensivists on during the day, and 2 on at night. I usually see between 10 and 18 patients per day, do procedures and notes, answer pages, talk to families etc. We do have an NP who helps out with procedures and sees patients transferring out of the unit. At night each intensivist usually admits between 3-5 patients and does procedures as needed. (tonight for example, I have admitted 3 patients, done 3 central lines, one a line, and 3 intubations...and answered a bunch of bs pages)
The base pay is 460K (222/hr for 168 hours per month which is 14 twelve hour shifts), they are paying my student loans over ten years. This adds about 45K per year. It doesn't have to be paid back if I leave before ten years. We get paid 1.5x our hourly rate for hours worked above 168 hours per month, or 333/hr. I usually work 1-4 extra per month on a voluntary basis (average an extra 2/month). We also get 9K matching for retirement and have a 403b and 457 plan.
I expect to make about 600-650 this year. the work is hard but I have a good amount of time off. Its a pretty good gig. I live in a city about 2.5 hours away so I travel back and forth and stay for the week when I'm working. When I am at home, though, there are no pages, no phone calls, no meetings, just time with the wife and kids.
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Sounds like a great gig. I would think this is 90-95 percentile job as I have heard 350k is much more the norm. Are you a partner?
 
anbuitachi said:
Does it matter if pulm crit fellowship or cc after anesthesia?
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just wondering general location for this kind of rate? In vegas a lot of job offers come down to about 180-200/hr at the high end with many being 150-175.
 
Soccer171983 said:
just wondering general location for this kind of rate? In vegas a lot of job offers come down to about 180-200/hr at the high end with many being 150-175.
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I just heard of a job that's 2 hours away from a large size midwestern city that pays similar/slightly higher than the previously mentioned job. Comes out to like 230/H for a day shift and 275/H for evening shift which goes till midnight. Hospitalist covers rest of the night. It would be appropriate to describe it as "middle of nowhere".
 
CCM2017 said:
I just heard of a job that's 2 hours away from a large size midwestern city that pays similar/slightly higher than the previously mentioned job. Comes out to like 230/H for a day shift and 275/H for evening shift which goes till midnight. Hospitalist covers rest of the night. It would be appropriate to describe it as "middle of nowhere".
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Thats really really good. I know of a locums cc posted on doximity for 240 hr in reno but i think thats the highest I have seen.
 
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spacegun said:
It says for pulm/crit, but the job sounds like it's only crit?

But either way, it sounds like an amazing job: $270 x 12 hours/day x 7 days/week x 26 weeks/year = almost $590k! Is this common?
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I wouldn't say its "common" but these numbers are out there. Looks like this is a locum position so it may not be possible to sustain this for a whole year.
 
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no its totally good. super model turned lawyer = super hot but super crazy.

if you need a further explanation or if constipated because you with s$%& yourself laughing.
 
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Sorry if this is a dumb med student question, I'm curious if there are differences in salaries in working in the MICU (IM/CCM) vs. other units like the SICU or the neurocritical care unit (I assume through neurology/NCC)? Or would salaries be similar? (All things equal, assuming similar practice settings, etc. though I know there are a lot of variables, but if it's possible to speak very generally?)
 
spacegun said:
Sorry if this is a dumb med student question, I'm curious if there are differences in salaries in working in the MICU (IM/CCM) vs. other units like the SICU or the neurocritical care unit (I assume through neurology/NCC)? Or would salaries be similar? (All things equal, assuming similar practice settings, etc. though I know there are a lot of variables, but if it's possible to speak very generally?)
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Very variable. Every place has things set up differently. Most small to medium size places that have intensivists will have one group that sees patients in all the units. A lot of places won't even have divided medical and surgical units. Few places outside academic centers have neuro ICUs, and even those that do are often times run by non neurologists. Surgical patients often times are "post op monitoring" patients or "can't extubate" or "don't want to extubate tonight" type patients - sometimes they don't qualify for billing critical care time, which can be reduced billing.

Surgeons generally want to operate rather than be in the unit, so depending on how much operating and how much ICU you are doing will affect $. Very variable from hospital to hospital and position to position.
 
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CCM2017 said:
Very variable. Every place has things set up differently. Most small to medium size places that have intensivists will have one group that sees patients in all the units. A lot of places won't even have divided medical and surgical units. Few places outside academic centers have neuro ICUs, and even those that do are often times run by non neurologists. Surgical patients often times are "post op monitoring" patients or "can't extubate" or "don't want to extubate tonight" type patients - sometimes they don't qualify for billing critical care time, which can be reduced billing.

Surgeons generally want to operate rather than be in the unit, so depending on how much operating and how much ICU you are doing will affect $. Very variable from hospital to hospital and position to position.
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Thanks CCM2017! Interesting that often neuro ICU's aren't run by neurologists/NCC, but by non-neurologists. I'm wondering now if there is a salary advantage for working in the neuro ICU if someone is a neurologist/NCC (vs. something else like IM/CCM or anesthesia/CCM)? Because it sounds like there's a lack of neurologists/neurointensivists in neuro ICU's, thus maybe they will be in greater demand for a group/hospital that wants to staff a neuro ICU? (Reason I'm asking is I love critical care and recently fell in love the neuro ICU too and have been considering IM vs. neurology, like both, neuro seems to have less social work etc. which I like. If salary is different enough in IM/CCM vs. neuro/NCC however, then that might be the deciding factor for me.).
 
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spacegun said:
Thanks CCM2017! Interesting that often neuro ICU's aren't run by neurologists/NCC, but by non-neurologists. I'm wondering now if there is a salary advantage for working in the neuro ICU if someone is a neurologist/NCC (vs. something else like IM/CCM or anesthesia/CCM)? Because it sounds like there's a lack of neurologists/neurointensivists in neuro ICU's, thus maybe they will be in greater demand for a group/hospital that wants to staff a neuro ICU? (Reason I'm asking is I love critical care and recently fell in love the neuro ICU too and have been considering IM vs. neurology, like both, neuro seems to have less social work etc. which I like. If salary is different enough in IM/CCM vs. neuro/NCC however, then that might be the deciding factor for me.).
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Many other factors involved. There's a lot of IM/Pulm/CCM who are boarded in neurocritical care who are not neurologists. There's more of a lack of neuro ICUs than a lack of neuroCC physicians. Probably won't be a compensation advantage, maybe disadvantage if you're in a place that has a neuro ICU to admit all post elective neurosurgical and post spinal surgery cases that aren't sick enough to bill CCM time. Most real neuro ICUs are in large academic centers. Academics and money don't generally go hand in hand.

You need to figure out whether you want to be a neurologist or an internist. Don't go by money, things will be probably be very different by the time you are done. Probably not much difference in compensation between neuroCC and other intensivists but none of the large surveys MGMA/AMGA report it so who knows.
 
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spacegun said:
Thanks CCM2017! Interesting that often neuro ICU's aren't run by neurologists/NCC, but by non-neurologists. I'm wondering now if there is a salary advantage for working in the neuro ICU if someone is a neurologist/NCC (vs. something else like IM/CCM or anesthesia/CCM)? Because it sounds like there's a lack of neurologists/neurointensivists in neuro ICU's, thus maybe they will be in greater demand for a group/hospital that wants to staff a neuro ICU? (Reason I'm asking is I love critical care and recently fell in love the neuro ICU too and have been considering IM vs. neurology, like both, neuro seems to have less social work etc. which I like. If salary is different enough in IM/CCM vs. neuro/NCC however, then that might be the deciding factor for me.).
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What would you rather be doing when not in the unit? Outpatient IM/urgent care/hospitalist, neurology/stroke team, pulmonary or even anesthesiology? There aren’t tons of people who do only 100% CCM - that’s a highway to burnout-town for many.

Don’t go chasing money, you’ll probably end up disappointed. Regional salary differences are vast in medicine, so assuming you’d make 50th or 80th percentile salary as an intensivist may not be realistic depending on your practice environment, patient population and overall competition.
 
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spacegun said:
Sorry if this is a dumb med student question, I'm curious if there are differences in salaries in working in the MICU (IM/CCM) vs. other units like the SICU or the neurocritical care unit (I assume through neurology/NCC)?
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If you want to be a CCM doc, don't do neurology.

You will limit your options.

And if you want to be a good CCM doc trained initially in neurology, you will have a lot more to learn in CCM fellowship...which takes time that you could be pursuing subspecialty or other skills/knowledge.

HH
 
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AdmiralChz said:
What would you rather be doing when not in the unit? Outpatient IM/urgent care/hospitalist, neurology/stroke team, pulmonary or even anesthesiology? There aren’t tons of people who do only 100% CCM - that’s a highway to burnout-town for many.

Don’t go chasing money, you’ll probably end up disappointed. Regional salary differences are vast in medicine, so assuming you’d make 50th or 80th percentile salary as an intensivist may not be realistic depending on your practice environment, patient population and overall competition.
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Don’t forget EM!
 
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AdmiralChz said:
What would you rather be doing when not in the unit? Outpatient IM/urgent care/hospitalist, neurology/stroke team, pulmonary or even anesthesiology? There aren’t tons of people who do only 100% CCM - that’s a highway to burnout-town for many.

Don’t go chasing money, you’ll probably end up disappointed. Regional salary differences are vast in medicine, so assuming you’d make 50th or 80th percentile salary as an intensivist may not be realistic depending on your practice environment, patient population and overall competition.
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Good amount of 100% CCM physicians in my area (large midwest city)
 
Is 2 on 2 off a viable option for CC? I love to travel so that has always sounded like a killer schedule for me.
 
CCM2017 said:
Never seen that
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My understanding is that it is very common among hospitalists and neurohospitalists (I'm actually mainly interested in neuro/NICU). Is ICU work just too intense for 14 straight days? Why would that be an option for wards but not the unit?
 
ChrisMack390 said:
My understanding is that it is very common among hospitalists and neurohospitalists (I'm actually mainly interested in neuro/NICU). Is ICU work just too intense for 14 straight days? Why would that be an option for wards but not the unit?
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Maybe is an option. But it's probably very rare. I have never heard of a place specifically set up like that. But I'm sure there's some individuals who do this. I think it's probably a recipe for disaster.
 
ChrisMack390 said:
Is 2 on 2 off a viable option for CC? I love to travel so that has always sounded like a killer schedule for me.
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Usually schedules are 7 on 7 off, but in the right practice, you could likely work out that schedule...but having worked multiple shifts in a row at times, I would not recommend it. 7 straight seems like the perfect balance of getting to know your patients and not working too many so that you are not missing things. In our practice, we try to keep a 7 on 7 off model as much as possible. there is also a benefit to having a new doc come in with a fresh set of eyes and ideas after 7 days or so. We will all occasionally block some shifts together before a vacation in order to maximize days off, but it would be torture in my mind to do that every month.
 
Out of curiosity, where do you guys go to look for critical care jobs, just to get an idea of what's out there (besides word of mouth)? I've heard of places like Merritt Hawkins and Practice Link, also Indeed, but I don't know how reliable they are (and I think only Merritt Hawkins actually gives salary figures, sometimes Indeed).
 
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spacegun said:
Out of curiosity, where do you guys go to look for critical care jobs, just to get an idea of what's out there (besides word of mouth)? I've heard of places like Merritt Hawkins and Practice Link, also Indeed, but I don't know how reliable they are (and I think only Merritt Hawkins actually gives salary figures, sometimes Indeed).
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Job advertisements are the most unreliable way to obtain accurate compensation figures. The AMGA medians are available for for free with some smart Google use.
 
CCM2017 said:
Job advertisements are the most unreliable way to obtain accurate compensation figures. The AMGA medians are available for for free with some smart Google use.
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I found this, but not sure it's complete:

amga.jpg
 

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ChrisMack390 said:
@CCM2017 and @adempsey22 could you comment on why the two week schedule is reasonable for a hospitalist but not for an intensivist?
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I don't think a 2 week on/off schedule is reasonable for anyone unless you have an extremely light patient load and very low acuity. It's for crazy people. My view of the world is that there is a certain percentage of crazy people. There's an immense number of hospitalists in comparison to critical care physicians... hence more crazy people which is probably why there's more crazy opportunities out there.
 
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ChrisMack390 said:
@CCM2017 and @adempsey22 could you comment on why the two week schedule is reasonable for a hospitalist but not for an intensivist?
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I cannot comment on why a two week schedule would be reasonable for a hospitalist. I am not a hospitalist. I can comment on why I think I two week on/two week off schedule is not reasonable for an intensivist. There are a few key aspects to being an intensivist. Staying calm under pressure, multitasking/staying organized, facility/safety with procedures, talking with families, and attention to detail. All of these must be at almost 100% every moment of every day for 12 hours in the ICU. Loose any of those and patients will literally die. I and most intensivists find that after 7 days or nights, some or all of those start to get lost. This is a disservice to our patients. Also, while we all put up defense mechanisms and barriers to deal with the emotional drain of dying patients/end of life discussions/crying families/unreasonable expectations...if you are still a human, it gets to you. Day in day out for 14 days, I think the defense mechanisms become center stage and we loose something that our patient families need. More importantly, though, its hard on all of us to deal with so much sadness, and a person needs a break away. An occasional long stretch is reasonable to accommodate vacations and/or moonlighting, but every month...too much.
 
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So many of my Pulm/CCM seniors who got job offers have it in the range of 350-400. Includes 1 weeks of icu, a 3-4 nights and 2 weeks mix of clinics and consults. They work around one weekend a month.
 
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