How feasible is it to join an established outpatient practice and work exclusively in my subspecialty of choice?

[DrSatan]

I'm a movement fellow looking for work. I want to work primarily in movement disorders. Though I am willing to see some general patients, I'd strongly prefer to exclusively see movement patients. I also want to do botulinum injections, and DBS programming would be a bonus.

There are specific positions (particularly academic) that advertise being able to start a pure movement clinic. I am seeing many more jobs that are interested in general neurologists but would allow for a subspecialty in movement disorders. For my own reasons, I am most often needing to apply to the latter.

What do you think is a fair percentage of focused subspecialty clinic to negotiate for? I imagine it may be unreasonable to expect a pure movement clinic, but was hoping for some suggestions/advice if anyone has experience.

---

Members don't see this ad.

 

[Thama]

Most private practices I'm familiar with directly or with friends working there are at best going to give you a 50/50 split at first, and if the volume isn't there for your subspecialty then you'll have those slots filled in as general no matter what.

People are desperate out there for movement though. So many movement people go to academia that I find that patients drive hundreds of miles to see me because there just isn't anyone that can handle DBS closer to them. Find a desert like that with enough demand and you can probably see pretty much what you want to.

 

[NeuroHopeful1]

My clinical site was at a major tertiary hospital in the south with a several thousand mile catchment area. There is no movement specialist at the hospital. The neurology group refers DBS patients 200 miles away.

 

[neglect]

I'm a movement fellow looking for work. I want to work primarily in movement disorders. Though I am willing to see some general patients, I'd strongly prefer to exclusively see movement patients. I also want to do botulinum injections, and DBS programming would be a bonus.

There are specific positions (particularly academic) that advertise being able to start a pure movement clinic. I am seeing many more jobs that are interested in general neurologists but would allow for a subspecialty in movement disorders. For my own reasons, I am most often needing to apply to the latter.

What do you think is a fair percentage of focused subspecialty clinic to negotiate for? I imagine it may be unreasonable to expect a pure movement clinic, but was hoping for some suggestions/advice if anyone has experience.

I DM'd. For anyone in movement or considering it, this is a really wonderful career. Movement disorders are common and the aging population gives rise to more and more. There are fewer general neurologists taking care of them. So you can basically get what you want: a 99% movement do population. My partner sees only movement in private practice.

We live about 15 miles and between 20-60 min to a huge academic hub. I'm not impressed when they insist that a frail PD patient come down to see them quarterly for their NP to adjust sinemet and pitch DBS.