Tox Reimbursement

[DocEspana]

I know I'm asking the taboo question as people tend to keep exact income figures on the DL for a myriad of reasons.... But I'm asking it anyway.

PGY1 at a pretty well connected program, but no tox fellowship (though we get time on tox at a major nearby center with fellowship.) I've always considered it, but I have a lot of options open to me including a different fellowship at the home hospital which would provide a good "exit plan from the ER" if I pursued it.

I have some concept of the practice environment and schedule differences from pure ED only practice. But, what is the reimbursement environemtn like. Is it a significant boon to the income (assuming supportive administration allowing an ideal situation)? Is reimbursement a pain? Is it like ID, where the income won't really change, but you'll be doing what you enjoy more?

Of course I care about the money, but I'd rather do something I enjoy. But to me, I can get a "better than average" grasp of tox if I simply seek it out in my own academic pursuits and wonder if formal training is worth pursuing head-first if I could go after administration which is a massive pay increase in most situations.

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[Daiphon]

The quick & dirty: you're reimbursed less than you get paid for ED patients.

Inpatient consults pay more, but outpatient consults pay less... provided the insurer will actually pay it.

However, there are 3 things to consider about this:
1) you're doing what you love, on a more normal schedule.
2) typically reimbursement is enough to not be a big loss to the department; if your chair/director believes in it then ok. There's also the non-financial benefits from having a toxicologist on staff - decreased utilization that can result, committee work, etc - that look good for your department.
3) consulting/medicolegal work.

Hope this helps.
-d

 

[BADMD]

I collect on average, around $36 per consult. That includes the uninsured patients where my actual collections for all them, in aggregate is $0.00 over the last 3 years.

I do a little legal work, but I can't live off of it. One of my colleagues does quite a bit, but still keeps his day job.