What jobs are in demand?

[Guest]

How come no one is interested in functional and things like focused ultrasound? I'm going to work in the lab of a functional guy, how come the field is not attracting interest?

[Guest]

Functional is generally not much in demand. Part of the challenge is that it takes more than just a functional neurosurgeon to have a good functional program, and a lot of hospitals aren’t terribly interested in building all that up for a specialty that doesn’t bill particularly well. For example, it’s not just about paying a neurosurgeon who does both general and functional, you also have to pay for a movement neurologist, the necessary clinic staff, physical therapy, develop a referral pipeline for movement disorders, you get the idea. All that requires a sizable investment, and functional honestly doesn’t pay well enough for most hospitals to be interested

[drstrange]

False. Epilepsy can be a revenue driver for a hospital. Device implants are very valuable as most hospitals take a cut of every battery you put in. You are correct that the idea of starting a full program can be a big sell to a hospital system which is why these programs are typically located at university hospitals.

There is a reasonable demand for functional people. Demand is something like spine/endo > functional/tumor > open vascular/skull base. Everyone is going to have to take a chunk of general stuff for a while after finishing. Do not expect to come out and have there be a dozen jobs advertised in desirable locations. Jobs with a sizable epilepsy component are harder to come by.

The advantage of functional over something like endo is that you are not fighting with another specialty for turf. Second, your reimbursement cannot be blown up by a couple of Medicare changes (this has happened before). Spine can be tough in some saturated markets - but that's true of everything.

[Guest]

Just practice in the midwest. That's where the money is at