Neurology compensation

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HueySmith

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Hi, does anyone have any insight about compensation for each neurology subspecialties?

I know this will depend on practice set up, and location, but I am just asking to see if there are any actual numbers that can be shared from doctors who are currently practicing. From what I have researched, being a neurologist pays about ~249k (from MedScape). I was wondering if there are any chances for neurologists to reach over >300k or >350k without moving out to the boonies/rural? What are income in cities like (Phoenix,Chicago, Los Angeles, Seattle, etc)?

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Have you tried a search? Many of these questions have been addressed before. Inflation and supply/demand and reimbursement hasn't changed enough in the past several years to make prior threads on the topic obsolete.
 
Actually if you look at Merritt Hawkins website avg 2017 Neuro salary was $305k up from $285k in 2016. That is a 7 % increase so I would argue that it does change from year to year. I'm still early on in training but I have heard of a wide range of salaries from $170K in an academic setting to >$450k in pp setting in decent cities. I have also read that based on AAN literature the shortfall of neurologists to treat the population was 11% back in 2012. This number will increase to 19% in 2025. In addition 70% of current practicing neurologists are greater than 55 yo. Based on simple supply-demand economics, it is likely the number of available jobs will increase significantly and salaries will continue to creep up.
 
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Of the like 10 attendings who post here, how do you think that 7% salary increase fits into the standard error?
 
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Huey,

Yes. I am an Academic Neurointensivist in a top 15 MSA population city. 50% of my time is completely protected research time and I am a medical director, so I do 1.1 FTE right now. In my non clinical weeks I do tele Stroke a few days a week. I will make 500 K this year. A chunk of that is from tele work, which does not interfere with my research. I am on a critical care, not neurology, salary line.

Know your value and you will max your earnings. Most MDs are risk averse and have no knowledge of the business of medicine right out of training. You should educate yourself on this if salary is a priority for you.

Hi, does anyone have any insight about compensation for each neurology subspecialties?

I know this will depend on practice set up, and location, but I am just asking to see if there are any actual numbers that can be shared from doctors who are currently practicing. From what I have researched, being a neurologist pays about ~249k (from MedScape). I was wondering if there are any chances for neurologists to reach over >300k or >350k without moving out to the boonies/rural? What are income in cities like (Phoenix,Chicago, Los Angeles, Seattle, etc)?
 
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Huey,

Yes. I am an Academic Neurointensivist in a top 15 MSA population city. 50% of my time is completely protected research time and I am a medical director, so I do 1.1 FTE right now. In my non clinical weeks I do tele Stroke a few days a week. I will make 500 K this year. A chunk of that is from tele work, which does not interfere with my research. I am on a critical care, not neurology, salary line.

Know your value and you will max your earnings. Most MDs are risk averse and have no knowledge of the business of medicine right out of training. You should educate yourself on this if salary is a priority for you.
Huey,

Yes. I am an Academic Neurointensivist in a top 15 MSA population city. 50% of my time is completely protected research time and I am a medical director, so I do 1.1 FTE right now. In my non clinical weeks I do tele Stroke a few days a week. I will make 500 K this year. A chunk of that is from tele work, which does not interfere with my research. I am on a critical care, not neurology, salary line.

Know your value and you will max your earnings. Most MDs are risk averse and have no knowledge of the business of medicine right out of training. You should educate yourself on this if salary is a priority for you.
Wow that is a high salary! I am glad that there are stories out there like yours. It seems like no one comes on to this site anymore.
 
Wow that is a high salary! I am glad that there are stories out there like yours. It seems like no one comes on to this site anymore.
My preceptor made more than that in PP. it's all about the volume.

Also remember that there's a huge gap between academic and PP salaries. I also noticed that this gap is even wider in neurology than other specialties.
 
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Actually if you look at Merritt Hawkins website avg 2017 Neuro salary was $305k up from $285k in 2016. That is a 7 % increase so I would argue that it does change from year to year. I'm still early on in training but I have heard of a wide range of salaries from $170K in an academic setting to >$450k in pp setting in decent cities. I have also read that based on AAN literature the shortfall of neurologists to treat the population was 11% back in 2012. This number will increase to 19% in 2025. In addition 70% of current practicing neurologists are greater than 55 yo. Based on simple supply-demand economics, it is likely the number of available jobs will increase significantly and salaries will continue to creep up.
Another thing that is going on for neuro is that it's protected from midlevel providers encroachment since the subject is not easy to learn... Not something you can shadow a doc for 3 months and claim you can treat patients as well as docs...
 
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My preceptor made more than that in PP. it's all about the volume.

Also remember that there's a huge gap between academic and PP salaries. I also noticed that this gap is even wider in neurology than other specialties.
Does he/she work 70+ hrs wk?
 
Woow....I thought neurologists earn around primary care income levels. I gues it is about volume. Does he work in rural regions or metropolitan regions?
Nope. In one of the largest 3 cities in the US. He sees 40-50 pts a day in his clinic. He also cover calls q3. Plus he cover few patients at a nearby rehab.

He works surgeon hours, but he also makes surgeon salary
 
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Ditto. I am projected to earn over $500k working only 22 weeks as a locum. Setting up contracts for next year it seems it will be over $600k.
 
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What kind of locums do you do? That's an impressive rate.
 
Inpatient, outpatient or mix. I don't care. I have a business model that I follow- as long as I get my daily rate, I'll do the work. I have done Clinic 8-5 for $3000 a day or neurohospitalist work 12 hour shifts at $325/hour. I have a set of weeks that I work and the rest of the time I spend with my family. I end my gig on the end of the month. I am not working until the end of nov, for a week. Living the vita locum.
 
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Inpatient, outpatient or mix. I don't care. I have a business model that I follow- as long as I get my daily rate, I'll do the work. I have done Clinic 8-5 for $3000 a day or neurohospitalist work 12 hour shifts at $325/hour. I have a set of weeks that I work and the rest of the time I spend with my family. I end my gig on the end of the month. I am not working until the end of nov, for a week. Living the vita locum.

Are you a general neurologist? or do you have a fellowship? I feel like your success is only reserved for those living out in the middle of nowhere/specialized neurologists.
 
Are you a general neurologist? or do you have a fellowship? I feel like your success is only reserved for those living out in the middle of nowhere/specialized neurologists.

Yes, I am a general neurologist with an interest in inpatient/stroke. Success has nothing to do with where I choose to live or work and more to do with implementing a good business model and negotiating skills. Physicians are smart and medicine is a business- It seems that everyone is getting rich but the doctors, and they are the one performing all the work.

For those of you who like baseball or football, there is no way the general manager should be making more than the players, and there are some hospital administrators that are killing it.

Don't get me wrong, I came into medicine as altruistic and compassionate as they come. In fact, I never leave a stone unturned for the fear of failing the patient. But again, medicine is a ruthless business with insurance companies and hospitals making billions of dollars-I choose to also be ruthless when dealing with the business in medicine.

For the record, as I am setting up my 22 weeks for next year, 15 of those weeks will be done in a city of more than 1.5 million population and a MSA of more than 4.5 million. While I prefer to live in the Ann Arbors' or Austins' of the world, instead of the filth infested cities of LA, NYC, or CHI, there is no saying that I can work 3 months as a locum in a small city earning $350k and live in a bigger city the remaining 9 months

Cheers,
 
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Woow....I thought neurologists earn around primary care income levels. I gues it is about volume. Does he work in rural regions or metropolitan regions?

Volume is true for all field, there are psychiatrists making 700k working around 70-80 hours a week.
 
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Yes, I am a general neurologist with an interest in inpatient/stroke. Success has nothing to do with where I choose to live or work and more to do with implementing a good business model and negotiating skills. Physicians are smart and medicine is a business- It seems that everyone is getting rich but the doctors, and they are the one performing all the work.

For those of you who like baseball or football, there is no way the general manager should be making more than the players, and there are some hospital administrators that are killing it.

Don't get me wrong, I came into medicine as altruistic and compassionate as they come. In fact, I never leave a stone unturned for the fear of failing the patient. But again, medicine is a ruthless business with insurance companies and hospitals making billions of dollars-I choose to also be ruthless when dealing with the business in medicine.

For the record, as I am setting up my 22 weeks for next year, 15 of those weeks will be done in a city of more than 1.5 million population and a MSA of more than 4.5 million. While I prefer to live in the Ann Arbors' or Austins' of the world, instead of the filth infested cities of LA, NYC, or CHI, there is no saying that I can work 3 months as a locum in a small city earning $350k and live in a bigger city the remaining 9 months

Cheers,

Hey,

In regards to benefits are they provided by the locums staffing agency?




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No. I pay for my own benefits. However, under my s -corp, I pay less taxes than when I was employed and I am able to save more.
 
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Technically, with the rate that I getting now, I can earn $1.17mil if I work 300
Days. But I can't or won't because I have a very young family. I am Extremely happy working 20-22 weeks a year and earn what I am earning.
 
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Technically, with the rate that I getting now, I can earn $1.17mil if I work 300
Days. But I can't or won't because I have a very young family. I am Extremely happy working 20-22 weeks a year and earn what I am earning.
I've been intrigued by the concept of being a contracted physician with a locums company for a while now it seems too good to be true ha. Is there anything you DON"T like about it if at all? Also, do the inpatient shifts require in-house call?
 
I've been intrigued by the concept of being a contracted physician with a locums company for a while now it seems too good to be true ha. Is there anything you DON"T like about it if at all? Also, do the inpatient shifts require in-house call?

Please note that I do not use an agency to contract with hospitals.

Right now it is my perfect setting. Every hospital is different but you just need to adapt, adjust and overcome. I have little ones and this settings allows me to spend the most time with them.

Inpatient settings depends on location. Right now I have a very "interesting job" as I am establishing an inpatient setting from scratch. I work around 2-4 hours and then go home and wait to be call- hasn't happened in 3 months.
Other locations I work until 5 pm and come in if needed. Weekends i may round and go home.

It all depends.
 
Technically, with the rate that I getting now, I can earn $1.17mil if I work 300
Days. But I can't or won't because I have a very young family. I am Extremely happy working 20-22 weeks a year and earn what I am earning.
@neurochica , I have an academic/professional interest in work/life balance. A few questions, if you would be so kind:

- how do you handle childcare during your 22 weeks of work?
- do you have a partner who is home with the kids during these work weeks or do they have a job outside the home too?
- do they kids and partner move with you to locums at places that are not nearby to your primary residence? If so will this change when the kids are of school age if they aren't already?
 
@neurochica , I have an academic/professional interest in work/life balance. A few questions, if you would be so kind:

- how do you handle childcare during your 22 weeks of work?
- do you have a partner who is home with the kids during these work weeks or do they have a job outside the home too?
- do they kids and partner move with you to locums at places that are not nearby to your primary residence? If so will this change when the kids are of school age if they aren't already?

1. My husband and family travels with me. Remember, 75% of the time I work is in the summer when kids are off from school. The remaining 5 weeks are done when kids are out from school ie spring break, xmas break etc.
2. Husband stays at home/travels with me. He has a doctoral degree and had a high power/paying job. We decided that this type of setting would give us the most time together and with the kids. For example, after next week, I am off 3 months, work for 1 week and then off for 6 weeks again. Also, we have breakfast, lunch and dinner and sleep in the same bed every night, which is important to me. He has no ego. We do what is best for our family.

3. Yes. I have young kids and both go to school. They never miss school because of the set up that I have. This summer we spent 3 months in a city with one of the biggest amusements and water parks in the country. We truly had a blast- felt like a 3 month vacation as my patient load was extremely low all summer and thus spent a lot of time with them.

I do want emphasize that I love neurology and what I do everyday.
Good luck!
 
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I'm really impressed, sounds like you have an incredible set up going for you!
 
1. My husband and family travels with me. Remember, 75% of the time I work is in the summer when kids are off from school. The remaining 5 weeks are done when kids are out from school ie spring break, xmas break etc.
2. Husband stays at home/travels with me. He has a doctoral degree and had a high power/paying job. We decided that this type of setting would give us the most time together and with the kids. For example, after next week, I am off 3 months, work for 1 week and then off for 6 weeks again. Also, we have breakfast, lunch and dinner and sleep in the same bed every night, which is important to me. He has no ego. We do what is best for our family.

3. Yes. I have young kids and both go to school. They never miss school because of the set up that I have. This summer we spent 3 months in a city with one of the biggest amusements and water parks in the country. We truly had a blast- felt like a 3 month vacation as my patient load was extremely low all summer and thus spent a lot of time with them.

I do want emphasize that I love neurology and what I do everyday.
Good luck!

That sounds like a great set up!

Based on what you've seen available out there, do you think working locums would be impossible (in the distant future for me) if my significant other is a full time physician in a more traditional practice set up and we have kids at home? I'd consider working locums as I see it as opportunity to NOT work during summer so I can spend time with/provide childcare for kids out of school...

I'm assuming answer is No, but based on what you've seen out there, is it possible to work locums jobs that remain within a 1 hour commute area in the midwest (2 hour drive diameter)? Or are opportunities typically more spread out/sporadic? Thanks for your input and sharing your experience!
 
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That sounds like a great set up!

Based on what you've seen available out there, do you think working locums would be impossible (in the distant future for me) if my significant other is a full time physician in a more traditional practice set up and we have kids at home? I'd consider working locums as I see it as opportunity to NOT work during summer so I can spend time with/provide childcare for kids out of school...

I'm assuming answer is No, but based on what you've seen out there, is it possible to work locums jobs that remain within a 1 hour commute area in the midwest (2 hour drive diameter)? Or are opportunities typically more spread out/sporadic? Thanks for your input and sharing your experience!
 
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There is a misconception that the only locum available jobs are through an agency or posted online. The reality is that most of my locums jobs have been through me reaching out.

You create your own destinity- if you are aggressive, you should have no problem getting what you want, especially in the Midwest and shortage of neurologist. I have done that with great success.
 
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There is a misconception that the only locum available jobs are through an agency or posted online. The reality is that most of my locums jobs have been through me reaching out.

You create your own destinity- if you are aggressive, you should have no problem getting what you want, especially in the Midwest and shortage of neurologist. I have done that with great success.
Great to hear, thanks!
 
No. I pay for my own benefits. However, under my s -corp, I pay less taxes than when I was employed and I am able to save more.

Is this because you are paying yourself via dividends from your practice? Just want to understand how this works.
 
Do you give up a significant financial advantage by choosing a vascular neurology over CNL (therefor losing EEG/EMG reimbursement)? I have TONS of debt (including helping my Mother after my father died suddenly) and I hope to work by butt off post-residency/fellowship. I am having trouble deciding between stroke verse CNL, my heart says stroke but my head says CNL..
 
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Thanks for taking the time to reply.

1. My husband and family travels with me. Remember, 75% of the time I work is in the summer when kids are off from school. The remaining 5 weeks are done when kids are out from school ie spring break, xmas break etc.
2. Husband stays at home/travels with me. He has a doctoral degree and had a high power/paying job. We decided that this type of setting would give us the most time together and with the kids. For example, after next week, I am off 3 months, work for 1 week and then off for 6 weeks again. Also, we have breakfast, lunch and dinner and sleep in the same bed every night, which is important to me. He has no ego. We do what is best for our family.

3. Yes. I have young kids and both go to school. They never miss school because of the set up that I have. This summer we spent 3 months in a city with one of the biggest amusements and water parks in the country. We truly had a blast- felt like a 3 month vacation as my patient load was extremely low all summer and thus spent a lot of time with them.

I do want emphasize that I love neurology and what I do everyday.
Good luck!
 
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Do you give up a significant financial advantage by choosing a vascular neurology over CNL (therefor losing EEG/EMG reimbursement)? I have TONS of debt (including helping my Mother after my father died suddenly) and I hope to work by butt off post-residency/fellowship. I am having trouble deciding between stroke verse CNL, my heart says stroke but my head says CNL..

Don't know if you are asking me, but I was acepted into a really well respected vascular fellowship and ended up not going. It hasn't affected me whatsoever. I have ran an icu and consider myself a vascular expert. 75 percent of my professional career has been as a stroke doc.
If you want to into academics, I would say you will probably need a fellowship. In the real would, you don't need one if you know How to practice vascular medicine.
 
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How is the job market in rural, suburbs, and cities?
 
Hello, Neurochica

I have some questions for you in regards to neurology as well as practicing in medicine in general. I hope you can help me out.

1. Would you say it's more profitable to work for a hospital or for an outpatient center contracted through a hospital in order to make more money as a general neurologist?

2. What are the differences in working hours (what are the actual hours) for an inpatient facility vs an outpatient facility? Based on my experiences volunteering, I've seen that at a hospital, physicians generally start at 7 am and outpatient physicians start at 8 am. Is this true based on your experiences?

3. Do you ever feel burned out from being a specialist in strokes? I've heard the call for that is bad and difficult due to the random hours (strokes don't care about your schedule)?

4. You think it's possible to make 300k as a neurologist who sub-specializes in sleep in a saturated city such as Los Angeles? I ask because I don't plan on opening up my own practice.

Thanks and if I think of anything else, I'll post it.
 
Interesting. I work as a hospitalist but want to cut my hours way back. Do some of these locum jobs wreck you? Ive heard horror stories.
 
Interesting. I work as a hospitalist but want to cut my hours way back. Do some of these locum jobs wreck you? Ive heard horror stories.

I been lucky-none of these gigs have burned me out. In fact, as I told a few people who PM asking personal questions...in my current gig which ends this week (I been on "24/7" for 15 straight weeks, i been working a total of 4 hours a day! I am starting an inpatient neurology service line and thus I don't have a lot of business....which means more time with my family. Other gigs are no different that working at regular medical centers...in by 8-out by 5, with call etc....I can count maybe with two hands, in over 2 years, the times I had to go in after 5pm, even tough I am 24/7...my locum hospitalist friends feel the same way...but the beauty of this is that if you feel wrecked, you can take more time off....

Nevertheless, I am prepare to go in at anytime, anyplace, anywhere as this is how I set up my contracts.
 
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I agree with neurochica as I am currently looking around for jobs and not surprisingly there is an extreme shortage of neurologists throughout the country and hundreds of hospitals just outside of big cities don't have coverage. I have been offered 325k- 350k for 7 on and 7 off with sign on and PTO and benefits from several places. And the workload is easily manageable. You can work extra shifts in your offtimes and make more.
 
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I agree with neurochica as I am currently looking around for jobs and not surprisingly there is an extreme shortage of neurologists throughout the country and hundreds of hospitals just outside of big cities don't have coverage. I have been offered 325k- 350k for 7 on and 7 off with sign on and PTO and benefits from several places. And the workload is easily manageable. You can work extra shifts in your offtimes and make more.

What about the demand for neurologists in California? Would you say that there is a shortage there as well, or is it saturated there which means you would get a lower offer to start?
 
This is just a thought but how busy can a neurohospitalist at a smaller hospital outside a big city really be? Its not like in residency where Neurology was an admitting service. Also, you can usually just do stroke over the phone and give the OK for TPA and follow up with the patient the next day.

@neurochica do your gigs also request that you read EEG's and/or EMG's ?
 
Huey,

Yes. I am an Academic Neurointensivist in a top 15 MSA population city. 50% of my time is completely protected research time and I am a medical director, so I do 1.1 FTE right now. In my non clinical weeks I do tele Stroke a few days a week. I will make 500 K this year. A chunk of that is from tele work, which does not interfere with my research. I am on a critical care, not neurology, salary line.

Know your value and you will max your earnings. Most MDs are risk averse and have no knowledge of the business of medicine right out of training. You should educate yourself on this if salary is a priority for you.

Where do you suggest we start?
 
What about the demand for neurologists in California? Would you say that there is a shortage there as well, or is it saturated there which means you would get a lower offer to start?
I was not looking on west coast, but you are right in California it might be 10% less . But it mostly depends on how far the place is from a big city. In SF or LA you might get as much as NYC or chicago, but 1-2 hours away it should be similar
 
This is just a thought but how busy can a neurohospitalist at a smaller hospital outside a big city really be? Its not like in residency where Neurology was an admitting service. Also, you can usually just do stroke over the phone and give the OK for TPA and follow up with the patient the next day.

@neurochica do your gigs also request that you read EEG's and/or EMG's ?
You will be surprised. I just went to a place in midwest, that is a town with 18000 people only, but they have a catchment of 250k people. Their small hospital get 45k ER admits per year and Neurology inpatient is usually 12-20 patients a day(new+ f/u). And yes most places are currently run by telestroke from nearby big universities.
 
No. I pay for my own benefits. However, under my s -corp, I pay less taxes than when I was employed and I am able to save more.

Do you have to pay for your own malpractice insurance? If so, how much does it cost you per year?

Thanks
 
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