Physiaty Salary

[PainMaster]

Many people have quoted numbers and there is a link posted with average salaries for PM&R. However many of those figures are not updated for 2007 and they don't include any information on current compensation for the sub-specialties out of PM&R i.e. Interventional spine, Pain Mngt. Can someone shed some light on this issue? I've googled the hell out of this already

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[PainMaster]

Sorry for the typo, physiatry

 

[TRAMD]

I used multiple resources including 6 internet sites and 1 book to record recent median salary values for multiple specialties. I then averaged the values found for each specialty (as long as I had at least 3 values) and ranked them 1 to 46.

Physiatry had 5 values for median salary that ranged from $171,000 to $244,000 with an average of $202,000 ranking it 34/46.

Interventional Pain Management by way of Anesthesia or PM&R had 4 values for median salary ranging from $280,000 to $400,000 with an average of $342,000 ranking it 9/46.

For reference Spine Surgery (neuro or ortho) was first with an average of $522,000 and Family Medicine was last with an average of $147,000.

A very rough estimate for 10th and 90th percentile is 70% of the median and 200% of the median.

So for Physiatry percentiles would be similar to:
10th: 141k 50th: 202k 90th: 404k

For Interventional Pain:
10th: 239k 50th: 342k 90th: 684k

I will say that these median salaries often seem low as I always seem to know someone in X specialty making twice what the supposed median is. It is possible that you just hear about the 90th percentile or that salaries for private physicians are higher while employed physicians receive better benefits (health insurance, 401k contributions, etc.) not counted in salary.

I hope that is informative.

 

[PainMaster]

Thanks a lot TRAMD. That was indeed very helpful. Im still tormented between Anesthesia/PM&R, damn it!!! Any tips?

 

[njdevil]

Let us start with simple, do you want to talk with patients and do long thorough physicals or do you want to put them asleep and make sure they don't die.

 

[TRAMD]

Thanks a lot TRAMD. That was indeed very helpful. Im still tormented between Anesthesia/PM&R, damn it!!! Any tips?

I am doing PM&R so I would say that is the way to go, but the above poster put it pretty nicely. You probably have a slightly better chance of landing a pain fellowship out of anesthesia if that is what you have your heart set on. However, many PM&R residencies will give you adequate training in basic interventional pain procedures such as trigger point injections, joint injections and flouroscopically guided lumbar epidurals and facet injections. If you want to do all the other stuff like cervical facets, rhizos and stims you will probably need to do a fellowship.

 

[bgnj]

does anybody know how readily available a career in physiatry is? meaning all the pay stats are there but the day i graduate is it easy, or should i ask...am i in demand for a position somewhere, in a group practice, hospital, etc.?

 

[axm397]

does anybody know how readily available a career in physiatry is? meaning all the pay stats are there but the day i graduate is it easy, or should i ask...am i in demand for a position somewhere, in a group practice, hospital, etc.?

depends on where you go for residency, where you want to work, what you want to do, and who you want to work for. You're asking a really general question.

 

[Nikiforos]

does anybody know how readily available a career in physiatry is? meaning all the pay stats are there but the day i graduate is it easy, or should i ask...am i in demand for a position somewhere, in a group practice, hospital, etc.?

Despite what many posters on this forum may say, PM&R is not as in demand as many other specialties. You may not be able to practice what you want where you want. For example, some posters on this forum will say you can specialize in TBI (brain injury), SCI (spinal cord injury), etc. While technically that's true, the reality is that there are relatively few positions in TBI or SCI available in the entire country, let alone in a specific region or city. Even remaining as a general physiatrist does not ensure that you will be able to practice where you want to. Contrast this with other fields such as anesthesiology, neurology, cardiology, psychiatry, etc. where you can pretty much practice anywhere in the country. There is far more demand for these speciaties. Some major metropolitan areas may be at or near saturation, but you can usually find a spot in those specialties very near to a desired area.

Beware of PM&R jobs that mention that you are expected to play a leading role in "program development." This is code and usually means that there is little or no established demand for PM&R in the area and that you will need to beat the bushes and create demand for your services. Most other specialties don't have that issue--there already is genuine demand for their services.

Inpatient PM&R (which is mostly the reason why the specialty was given specialty status in the first place) is slowly dying. The inpatients are sicker than ever. Over the last several years, Jefferson and Mount Sinai ran ads recruiting for inpatient attendings. Their stated preference was for doctors dually trained in internal medicine. It's pretty clear that this is an admission that the high medical acuity of the patients requires internal medicine training beyond that of an internship year.

If not for the creative work of many physiatrists to recast the specialty as one of outpatient/musculoskeletal/pain, PM&R would probably be contracting right now.

While there is no guarantee in any specialty, it will likely continue to remain more challenging for physiatrists to practice what they want where they want. And by no means should you allow pay stats to guide your selection of specialty or subspecialty. That can change quickly.

 

[axm397]

Again, I think it depends on where you want to go and what you want to do and unfortunately, it also depends on where you did your residency. sdn is a forum - which means it's a place where people post their opinions - so you're going to get a lot of different perspectives. Probably the better thing to do is to get data on the region you are trying to go - or even the city you are trying to go - and see if there are physiatrists in that area (really easy to do - can look up on aapmr.org) and get info from physiatrists and PM&R residents in that area.

None of my co-residents this year had any problems finding jobs or landing fellowships. 3 of us are doing ACGME accredited pain fellowships, 1 is doing a TBI fellowship, another a research fellowship, 1 is doing private practice outpatient MSK, and the rest are all doing inpatient academic rehab at various academic rehab programs in the country. (Ann Arbor - doing women's MSK stuff and some inpatient, Dallas trying to start women's MSK but inpt TBI for now, Charlotte, LA, Baltimore, etc.) Most PM&R jobs are not advertised - it's a lot of word of mouth and alum/networking type information flow. On our bulletin board, there are pages and pages of job opportunites from all over the country representing almost all the states.

thus my original point - it depends on where you want to go, what you want to do, where you did your residency, and probably who you know and who the people you know know.

nikiforos switched to anesthesia from PM&R and there are other sdn posters who are disgruntled about the current state of the field of PM&R. I think those opinions are valuable - but as a reader of this forum, you have to take everything with a grain of salt. The more objective data you can collect, the better. Maybe others can post how their senior class did with job placement and fellowships??

 

[tchoupdoc]

Maybe others can post how their senior class did with job placement and fellowships??

My graduating class (2002), from Umich: 3 into academics (me, ortho dept, new orleans; 2 pmr dept's, michigan and NC), 1 VA in Kentucky, 1 Kaiser permanente, outpt msk/occ med in northern cali. One person did a fellowship.

Things have changed a lot just since I graduated. There is a much better sense of what we do. But it is still true that you will be in demand as much as you create that demand.

 

[PMR 4 MSK]

does anybody know how readily available a career in physiatry is? meaning all the pay stats are there but the day i graduate is it easy, or should i ask...am i in demand for a position somewhere, in a group practice, hospital, etc.?

4 years ago I decided to get out of my former practice. I posted a CV online to a physicians-only job board. Within 24 hours I had at least 20 head-hunters contacting me with multiple opportunities each. I quickly narrowed it down to where I wanted to live (midwest) and what kind of practice I was looking for (multi-specialty group). Sometimes multiple head-hunters have the same opportunities. I found my current position this way.

Is this my absolute ideal place to live? No, but the cost of living is low, traffic is minimal and the place is fairly safe. Is this my absolute ideal practice to work in? No, but I traded automomy for less administrative hassels, smaller overhead and a chance to build a new practice from scratch. It has worked out very well for me and I am very happy here.

I hold these truths to be self evident:

1) You will not get a job in the 90th % for salary right out of residency. You gotta pay your dues in real-world experience.

2) You will not get your ideal job right out of residency, because you don't know what you really want until you've practiced a while. The real world is a real eye-opener.

3) Most docs will leave their 1st position/job within a few years of graduation, likely due to #2.

4) Residents and students worry too much about what their salary will be. Don't worry about it. It's likely more money than you've ever seen before, but you are going to spend it faster than you've ever done before. Worry more about getting the medical skills you need to be marketable and the personal skills to be a good physician in your chosen field. More money will not make you happier, it just buys more toys.

5) Pick a career based on what you want to do, not how much you can make. You have been blessed with the brains and ability to make it through College, Medical School and Residency to one of the highest callings on earth. Do things the way you were taught with your ethics and you will be very happy no matter how much money you make. As someone else said here recently, if you can't live on $150 - $200K/year, you need to get your priorities (or head) examined.

6) If you spend all your time in a clinic examining people and writing them prescriptions, you will make less money than if you poke them with sharp objects. For some reason needles are very valuable, depending on where you poke them.

7) Diagnostics pays more than examining the patient in many cases (i.e. EMG, MRI). It's a warped situation, but you can't change it.

8) We live in a capatalist society, and everyone is going to try to:
a) make money off you
b) get money from you
c) keep you from making money

9) Medicine is a very high risk/high reward career, but there are many careers out there, both within and outside of medicine that have much better ratios.

10) Opinions are like @$$holes - everyone has one, and they all stink...

 

[Finally M3]

Maybe others can post how their senior class did with job placement and fellowships??

My graduating class (2002), from Umich: 3 into academics (me, ortho dept, new orleans; 2 pmr dept's, michigan and NC), 1 VA in Kentucky, 1 Kaiser permanente, outpt msk/occ med in northern cali. One person did a fellowship.

Things have changed a lot just since I graduated. There is a much better sense of what we do. But it is still true that you will be in demand as much as you create that demand.

UMich 2008; 6 residents, 2 private practice, 2 ACGME pain, 1 non-ACGME spine, 1 SCI fellowship.

 

[OMMFellow06]

UT Houston/Baylor
12 graduates this year - 2 ACGME pain fellowships, 1 cancer fellowship, 1 TBI, 1 SCI, 7 private practice throughout the US.