National Spine and Pain Centers

[frisbeefreak123]

any new information on this group. National Pain and Spine Centers. Was interested in a job at practice owned by them. Was turned off by 3 weeks of vacation and 1 week of Educational leave. But wanted to know if any one had any new information on this big national group.

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[NJPAIN]

All that I can say is that they are gobbling up many of the larger successful practices around the country. Many of the LinkedIn resident KOLs are now part of this growing group. I believe that the recent "Business of Pain Medicine" conference is essentially their national meeting. Obviously there is strength in numbers in terms of fees, etc. With that your importance as an individual shrinks. I would imagine just like a group being taken over by venture capital guys, it's great to get cash out if you are close to retirement and not so great to be in it for the long haul. I would suggest finding and talking to the low men on the totem pole to get the real story.

 

[willabeast]

That was about the same leave i got at TPMG. Wonder if the benefits are similar.

 

[Sooshi]

Multiple multimillion dollar lawsuits in the last few years. Heard from acquaintances that it's generally ****. One of their bigwigs was on a Zoom presentation for a big seminar telling all the new fellows how they should be thrilled to take a job for $200K starting.

 

[jsaul]

any new information on this group. National Pain and Spine Centers. Was interested in a job at practice owned by them. Was turned off by 3 weeks of vacation and 1 week of Educational leave. But wanted to know if any one had any new information on this big national group.

4 weeks of paid leave is not to your liking? how much paid leave you think you are entitled to as 1st year employee?

 

[Dr. Ice]

Don’t hospital docs get like 6-7 weeks off?

 

[afob100]

hospital docs are usually 4 weeks off + 1 week CME. after 2 years at our practice, you can take however much vacation you want since your salary is all production (wrvus x conversion factor).

 

[Ducttape]

4 weeks + 1 week CME is standard

Don’t hospital docs get like 6-7 weeks off?

no.

 

[medgirl89]

Don’t hospital docs get like 6-7 weeks off?

6 weeks off at my hospital based position and the more senior docs get 7 weeks but maybe that’s not everywhere.

 

[Dr. Ice]

6 weeks off at my hospital based position and the more senior docs get 7 weeks but maybe that’s not everywhere.

6 weeks off at my hospital based position and the more senior docs get 7 weeks but maybe that’s not everywhere.

That’s nice

 

[DOctorJay]

Don’t hospital docs get like 6-7 weeks off?

I get 7 weeks including CME time but I’m basically salaried with small bonus potential for hitting metrics and productivity.

 

[DrSpine]

Private Equity trash. Worked like a dog and get paid low. I hear they present you 400k sometimes, but you're expected to build the practice up, and that's your ceiling essentially. After a year, when practice isn't making enough money because of what they're wanting, expect talks. Save yourself time, avoid this place.

 

[clubdeac]

7 weeks here and another week of CME

 

[Dr. Ice]

7 weeks here and another week of CME

Damn

 

[clubdeac]

Damn

Only used 2 weeks thus far this year as when I don't work I don't get paid

 

[Ferrismonk]

Only used 2 weeks thus far this year as when I don't work I don't get paid

So it's not paid time off. Doesn't count then imo.

 

[paintrain]

Pain Management Organization Pays $5.1 Million to Settle Criminal Medicare Kickback Violations

www.justice.gov

 

[SandmanMD]

Private Equity trash. Worked like a dog and get paid low. I hear they present you 400k sometimes, but you're expected to build the practice up, and that's your ceiling essentially. After a year, when practice isn't making enough money because of what they're wanting, expect talks. Save yourself time, avoid this place.

This is similar to what I heard. I interviewed with them. 400K, 4 weeks paid vacay. Their practice sucked. Low volume, lazy staff. No real upside unless I dramatically grew the practice…which seemed unlikely unless I revamped the office culture. They were replacing a physician who they said was not performing. I never met the physician so I don’t know where the blame should be.

 

[DrSpine]

This is similar to what I heard. I interviewed with them. 400K, 4 weeks paid vacay. Their practice sucked. Low volume, lazy staff. No real upside unless I dramatically grew the practice…which seemed unlikely unless I revamped the office culture. They were replacing a physician who they said was not performing. I never met the physician so I don’t know where the blame should be.

I can assure you, the blame was entirely on them. Here's the issue: You are supposed to work like a dog to build a practice up, for what or whom? You build it up for someone else to reap profits off your license? This deal is already the absolute worst. And the issue is, you have NO control over this practice or what they exactly do in terms of hiring and costs. I know someone who did it and ultimately resigned after he was told, "you're not bringing us in any money, even Physical Therapy is bringing in more money than you." This was told to him by some business guy, so he subsequently resigned the very next day. The practice never grew, and they kept throwing all this high overhead on him. This is the same thing the hospitals do, create a high overhead, constantly tell the Physician, "we're not making any money, you're not bringing in much revenue." If all these set ups are so bad as they claim, why do they even bother to keep opening these up or hiring physicians?

 

[drusso]

I can assure you, the blame was entirely on them. Here's the issue: You are supposed to work like a dog to build a practice up, for what or whom? You build it up for someone else to reap profits off your license? This deal is already the absolute worst. And the issue is, you have NO control over this practice or what they exactly do in terms of hiring and costs. I know someone who did it and ultimately resigned after he was told, "you're not bringing us in any money, even Physical Therapy is bringing in more money than you." This was told to him by some business guy, so he subsequently resigned the very next day. The practice never grew, and they kept throwing all this high overhead on him. This is the same thing the hospitals do, create a high overhead, constantly tell the Physician, "we're not making any money, you're not bringing in much revenue." If all these set ups are so bad as they claim, why do they even bother to keep opening these up or hiring physicians?

"They will never love you back."

 

[DrSpine]

Umm..there are non private equity backed private practices that tell their docs the same thing. Incidentally, as stated hospitals spew the same thing at their employed docs. I feel a song coming on drusso...I like the police, so, “I’m sending out an SOS..”

At my last practice, a fat woman who was then a high up business manager, you know Taus, held meetings with the entire PMR/pain group because as she told upper management, “the F-ing PAs make more for us than these guys.” And we all had to sit there with our advanced degrees and listen to this sloth talk to us about our numbers and how we should be doing more, seeing more, while still padding their bloated physician owned hospital and blah blah. I think the pig finally left for whatever reason, but I digress. This nonsense happens everywhere. Even at my current practice, we are looking to oust our management because they are a bunch of overpaid swine.

Aren’t some KOLs employed by this practice??

Also, I’m curious of peoples interpretation of “working like a dog” actually is in an outpatient pain practice.

If you are seeing 25 patients for a over an 8 hour work day, with a lunch break, time to do dictations, don’t work nights or weekends..are you “working like a dog”

That last line is a straw man argument. I don't think anyone views that as "working like a dog." Most eventually want you seeing consistently 35-40 patients a day, working what appears to be an 8 hour day that quickly seeps into 10+ hour territory otherwise you run the risk of falling behind for "another day to play catch up." If it's your own practice, or you own equity in it, work all you want. It's your baby. You'll even see those 5 patients who can't come in during the week due to work on a Saturday Morning for them. It's ultimately your business, your pride, and your income stream. Reverse that scenario in employment, and you'll definitely be in no mood for that.

At the end of the day, it comes down to what someone wants in life. If you just want to be told what to do, make some money, have no equity, and just come home in your Honda to your house and call it a day, sure, by all means, I respect that. Everyone is different. I always believed in being a business guy, owning a practice, being successful, and running the show. It's just me. Even if it means working a lot of hours for that. Scared money don't make money. They're definitely trying to make it harder for us, and discourage us. But I'm good. If it ever comes down to not being a feasible option, I will just exit medicine without regrets and enter a new business.

 

[DrSpine]

Umm..there are non private equity backed private practices that tell their docs the same thing. Incidentally, as stated hospitals spew the same thing at their employed docs. I feel a song coming on drusso...I like the police, so, “I’m sending out an SOS..”

At my last practice, a fat woman who was then a high up business manager, you know Taus, held meetings with the entire PMR/pain group because as she told upper management, “the F-ing PAs make more for us than these guys.” And we all had to sit there with our advanced degrees and listen to this sloth talk to us about our numbers and how we should be doing more, seeing more, while still padding their bloated physician owned hospital and blah blah. I think the pig finally left for whatever reason, but I digress. This nonsense happens everywhere. Even at my current practice, we are looking to oust our management because they are a bunch of overpaid swine.

Aren’t some KOLs employed by this practice??

Also, I’m curious of peoples interpretation of “working like a dog” actually is in an outpatient pain practice.

If you are seeing 25 patients for a over an 8 hour work day, with a lunch break, time to do dictations, don’t work nights or weekends..are you “working like a dog”

That last line is a straw man argument. I don't think anyone views that as "working like a dog." Most eventually want you seeing consistently 35-40 patients a day, working what appears to be an 8 hour day that quickly seeps into 10+ hour territory otherwise you run the risk of falling behind for "another day to play catch up." If it's your own practice, or you own equity in it, work all you want. It's your baby. You'll even see those 5 patients who can't come in during the week due to work on a Saturday Morning for them. It's ultimately your business, your pride, and your income stream. Reverse that scenario in employment, and you'll definitely be in no mood for that.

At the end of the day, it comes down to what someone wants in life. If you just want to be told what to do, make some money, have no equity, and just come home in your Honda to your house and call it a day, sure, by all means, I respect that. Everyone is different. I always believed in being a business guy, owning a practice, being successful, and running the show. It's just me. Even if it means working a lot of hours for that. Scared money don't make money.

 

[Dr. Ice]

That last line is a straw man argument. I don't think anyone views that as "working like a dog." Most eventually want you seeing consistently 35-40 patients a day, working what appears to be an 8 hour day that quickly seeps into 10+ hour territory otherwise you run the risk of falling behind for "another day to play catch up." If it's your own practice, or you own equity in it, work all you want. It's your baby. You'll even see those 5 patients who can't come in during the week due to work on a Saturday Morning for them. It's ultimately your business, your pride, and your income stream. Reverse that scenario in employment, and you'll definitely be in no mood for that.

At the end of the day, it comes down to what someone wants in life. If you just want to be told what to do, make some money, have no equity, and just come home in your Honda to your house and call it a day, sure, by all means, I respect that. Everyone is different. I always believed in being a business guy, owning a practice, being successful, and running the show. It's just me. Even if it means working a lot of hours for that. Scared money don't make money.

I’m pretty sure the hospital employed docs on here are not seeing 40 patients a day and are not driving Hondas, unless it’s by choice.

 

[DrSpine]

I’m pretty sure the hospital employed docs on here are not seeing 40 patients a day and are not driving Hondas, unless it’s by choice.

Perhaps in the Midwest that may be it. Most hospitals in suburban or urban settings; especially in sunshine areas or NYC want you seeing 35-40 patients a day. I worked at a hospital once, that was what they tried to do. It wasn't the only person that tried it, several friends who worked or are working at a hospital are dealing with the same.

 

[buddababa]

Perhaps in the Midwest that may be it. Most hospitals in suburban or urban settings; especially in sunshine areas or NYC want you seeing 35-40 patients a day. I worked at a hospital once, that was what they tried to do. It wasn't the only person that tried it, several friends who worked or are working at a hospital are dealing with the same.

35-40 in a day is asking too much in a hospital setting with so many inefficiencies ; you'd have to be open 7-5 to accommodate such

 

[DOctorJay]

Hospital employee

Took today off (typical Mondays 16-22 office visits)
19 procedures tomorrow
17 procedures Wednesday
18 office visits Thursday
4 office visits and 7 procedures half day Friday

 

[gaspasser127]

Hospital employee

Took today off (typical Mondays 16-22 office visits)
19 procedures tomorrow
17 procedures Wednesday
18 office visits Thursday
4 office visits and 7 procedures half day Friday

I’m going into a hospital employed gig and it has a similar set up/volume.

Would you mind sharing your ballpark # for compensation?

 

[Nodolor]

I’m going into a hospital employed gig and it has a similar set up/volume.

Would you mind sharing your ballpark # for compensation?

preferably a 1040

 

[nvrsumr]

The hospital seems like the way to go these days.

I like my private practice but… getting a bit harder

 

[DOctorJay]

I’m going into a hospital employed gig and it has a similar set up/volume.

Would you mind sharing your ballpark # for compensation?

PM sent

 

[ateria radicularis magna]

35-40 is not normal at all in my experience

 

[Ducttape]

do what you want.

i see most ppl doing 20-30. definitely not 35-40. i have light schedule today with 19 that i will still end up being behind. tomorrow its heavy at 26.

and its easy to force systems to decrease your volume. just go up to admin and tell them "i wont be getting my charts done today. too many patients. i hope that doesnt affect your billing."

 

[Dr. Ice]

35-40 is not normal at all in my experience

Was seeing this in private pre pandemic

 

[jsaul]

Was seeing this in private pre pandemic

30-40 patients clinic visits is usually what is expected in many private practices around here. I am solo and on my busy day which is tues see about 30-35. that includes new patients, follow ups and procedures. It is exhaustng and have to play catch up on some of the notes that i dont finish that day

 

[DrSpine]

30-40 patients clinic visits is usually what is expected in many private practices around here. I am solo and on my busy day which is tues see about 30-35. that includes new patients, follow ups and procedures. It is exhaustng and have to play catch up on some of the notes that i dont finish that day

Totally fine when it is your own practice. Hence why doing it for a place like National Spine is a joke.

 

[William Sparrow]

PM sent

Could you please PM the same? Thanks!

 

[jonnylingo]

35-40 in a day is asking too much in a hospital setting with so many inefficiencies ; you'd have to be open 7-5 to accommodate such

that's too many in any setting. I find it difficult to have meaningful discourse (education, shared decision making) with patient if I'm slamming patients through that fast.

 

[Iamnew2]

any new information on this group. National Pain and Spine Centers. Was interested in a job at practice owned by them. Was turned off by 3 weeks of vacation and 1 week of Educational leave. But wanted to know if any one had any new information on this big national group.

Based on my experience, the group - which is essentially private equity and recently joined with NPSC (previously Prospira), is not as bad as people make it out to be. It all depends on how much you work. Yes it's true that they were sued, but not really knowledgeable about the specific nature of the lawsuits.
I met both physicians who saw very few patients and didn't make a lot and I met doctor who saw a ton of patients and made a killing ($900->1million). Some walked into already built practices and some had to make their practices from the ground up. It also depends WHERE you are - since they have offices nationwide I'm sure the experience varies.
Generally its a set salary for a year plus benefits, then it goes to productivity model - like with everything it depends on how much you work and how many people you see - but that's not different than anywhere else.
I would say that the people who work diligently do very well. I also saw different levels of staff efficiency - some of the staff was absolutely terrible, some was good. It depends.
But that can be said of anything. I woudln't say that most doctors get 7 weeks off. Maybe long tenure people do. Most people in general don't get that much off unless you are an independent contractor.

 

[macman]

35-40 pts per day for hosp employed is not typical, at all

 

[xvaderx]

any new information on this group. National Pain and Spine Centers. Was interested in a job at practice owned by them. Was turned off by 3 weeks of vacation and 1 week of Educational leave. But wanted to know if any one had any new information on this big national group.

National Pain and Spine Centers is exactly what you think it is.

 

[drusso]

35-40 is not normal at all in my experience

If you work through lunch, you can get your 40 patients done by 1:30 or 2:00 and leave a little early.

 

[nvrsumr]

If I had two c arms and lots of opioid refill follow ups could do 40 a day pretty easy

 

[premed67783]

Multiple multimillion dollar lawsuits in the last few years. Heard from acquaintances that it's generally ****. One of their bigwigs was on a Zoom presentation for a big seminar telling all the new fellows how they should be thrilled to take a job for $200K starting.

I can second this. Saw this guy on a webinar about contract negotiation (lolz). Was trying to tell the fellows not to expect anything more than $250k starting. Seemed kinda sleazy overall.

 

[PainDoc2025]

PM sent

Can you send me a PM too please? Curious about compensation package

 

[bedrock]

The hospital seems like the way to go these days.

I like my private practice but… getting a bit harder

HOPD is definitely the quickest and most consistent route to make mid 6 figures with lots of vacation, due to SOS.

You're still working for the man, and administrators change all the time, so a good job can change and you have to decide whether or not to uproot your family, etc.

HOPD is likely the best first gig for a graduating fellow, for 2-3 years. You pay down your loans, build up some FU money, and learn the business side of medicine. After the first 2-3 years, then it just depends on the person and their priorities.

 

[bedrock]

I can second this. Saw this guy on a webinar about contract negotiation (lolz). Was trying to tell the fellows not to expect anything more than $250k starting. Seemed kinda sleazy overall.

Funny that that some MBA is telling a physician what is appropriate money when the physicians are smarter than him, and all have plenty of friends making the median average pain salary of 400K......or more, so you'd have to be a real idiot physician to buy what this snake oils salesman was selling.

 

[ateria radicularis magna]

New grads with debt and geographic restrictions are cannon fodder for mbas, KOLs and ceos. They salivate when they see your eager faces.

 

[Ducttape]

HOPD is definitely the quickest and most consistent route to make mid 6 figures with lots of vacation, due to SOS.

You're still working for the man, and administrators change all the time, so a good job can change and you have to decide whether or not to uproot your family, etc.

HOPD is likely the best first gig for a graduating fellow, for 2-3 years. You pay down your loans, build up some FU money, and learn the business side of medicine. After the first 2-3 years, then it just depends on the person and their priorities.

remember this about facility fees.

the physician does not get any money directly out of the facility fees. the physician generally speaking gets rvus or gets to bill the professional fees as his/her salary and indirectly gets money from the HOPD fees.

all those hundreds of thousands of dollars goes to the hospital. the hospital then pays the techs, the schedulers, the physician, the nurses, the facility admin, the hospital admin, and the CEO.


typically in reverse order.

 

[drusso]

remember this about facility fees.

the physician does not get any money directly out of the facility fees. the physician generally speaking gets rvus or gets to bill the professional fees as his/her salary and indirectly gets money from the HOPD fees.

all those hundreds of thousands of dollars goes to the hospital. the hospital then pays the techs, the schedulers, the physician, the nurses, the facility admin, the hospital admin, and the CEO.


typically in reverse order.

That's a myth. The truth is that the hospitals transfer cash between accounts and subsidize MD salaries. The more turns of the facility fee crank a doctor makes for his boss, the better. That's how the sausage gets made. That's why hospitals pay bigger salaries to doctors who are "producers" and create "enterprise value."

Ask Admin to show you your Physician Enterprise Value. They know what you're worth and what they're willing to pay. They know how much you're cranking out.

 

[Status Sciaticus]

I’m pretty sure the hospital employed docs on here are not seeing 40 patients a day and are not driving Hondas, unless it’s by choice.

How many patients do I need to see per day to roll up in a lambo?

Hospital employee

Took today off (typical Mondays 16-22 office visits)
19 procedures tomorrow
17 procedures Wednesday
18 office visits Thursday
4 office visits and 7 procedures half day Friday

Could you PM me what youre making with this setup as well? Thanks!

HOPD is definitely the quickest and most consistent route to make mid 6 figures with lots of vacation, due to SOS.

You're still working for the man, and administrators change all the time, so a good job can change and you have to decide whether or not to uproot your family, etc.

HOPD is likely the best first gig for a graduating fellow, for 2-3 years. You pay down your loans, build up some FU money, and learn the business side of medicine. After the first 2-3 years, then it just depends on the person and their priorities.

How will working at a HOPD increase your salary? To my understanding, you dont collect on the facility fee, only the professional fee.