Since this is for attendings, as people are going into practice, please, please, please open your eyes. There are plenty of places to work as an attending neurosurgeon. Major alarm signs are :
People that “lost” 2-3 neurosurgeons in the last year. That’s NOT normal. No matter what they tell you. That’s NOT the neurosurgeon’s fault it’s the place. For example, if you’re seeing a strong ortho spine, and neurosurgeons taking call, they tell you well, you know we had two other guys but they did not like it here and they left, please RUN don’t walk. The reason is this ortho spine is taking all the cases and neurosurgery is left with covering call q3 and unable to make the work RVUs, so their salaries are getting cut.
Try to identify who was there and ask them what happened. Sometimes they can’t tell you the story because they have a non disclosure agreement. sometimes people will tell you.
Hospitals will use you - they make money off of you.
Don’t be afraid to ask MGMA and higher, if a place is asking you to make 8000 RVUs please be convinced that you’re bringing the hospital anywhere from 5-8 million dollars and your collections alone, from clinic charges will be around 2 million depending on the payor mix. Don’t forget your value.
Others in practice please feel free to share! neurosurgery is a small community, if we stick together and are united we will all succeed. Don’t allow the hospital to take advantage of you.
as someone looking for a job, see this waaaaay too often
what is a reasonable ## of RVUs to be given as an expectation for 1st year out of practice? i've seen as high as 9500 RVU before bonus kicks in, which to me is just ridiculous
(01-29-2020, 07:41 PM)Guest Wrote: as someone looking for a job, see this waaaaay too often
what is a reasonable ## of RVUs to be given as an expectation for 1st year out of practice? i've seen as high as 9500 RVU before bonus kicks in, which to me is just ridiculous
Most places will make sure you never hit bonus! Or you work until you die to make them money. Every penny you ask for hits their bottom line, but at the end of the day it will be your back that hurts cause you did 5 cases that day to meet your RVU quota and you’re the one that starts having health issues due to the onerous q 2 call. Level 2 trauma center should not be q2 call, if there is no other hospital for 100 miles you for sure you will be up all night with trauma, don’t let them fool you.
Some neurosurgeons became semi administrators and they are trying to sweet talk you into going there, because they make their cush medical director stipend and they don’t do call or cases. Their stipend for being an administrator comes from YOUR work, and usually their salary is just as much as yours.
Thanks for sharing. Very helpful thread for those on the job hunt.
Very helpful thread.
Seems like pure private is best opportunity to get what you're worth...any other tips folks?
I think we should start a thread about which employers to avoid. You see the same positions advertised over and over and over, like Colorado Springs, Nebraska, North Dakota, Farmington NM. Anyone know anything about these places?
(02-12-2020, 06:59 PM)Guest Wrote: I think we should start a thread about which employers to avoid. You see the same positions advertised over and over and over, like Colorado Springs, Nebraska, North Dakota, Farmington NM. Anyone know anything about these places?
Avoid lower tier "academic" departments in the northeast.
If you are inclined to “take a job” in “rural” anything, or small town anything, do your homework thoroughly, talk to all the people there and the previous people there.
The issue with taking a job in a small market like that, if you have a family, is this: they hire you with a salary guarantee for one or two years. Come year 3 you have to make your salary but there are no cases, because the population is sparse. So your salary gets cut in half. And the only way to know the patient volumes is to talk to people around who either have been there or people in the neighboring cities. You really should do the same amount of work for your job search that you did for selecting your residency program, if not more work. This is super important.
You can connect with people online and really in this day and age, most neurosurgeons would be more than happy to talk to you and stir you clear of disasters.
Just talk to the predecessor for the job you are looking at. They will tell you everything you need to know. If you take a job without talking to someone who was there and left, you will be in for many potentially unpleasant surprises. The current faculty will not tell you anything close to the truth and will do whatever it takes to sign you so you can take their call.
And make sure that stuff like how many days of call, pay for call, vacation days, CMEs, etc gets written into the contract. If not you will definitely find yourself with lots of crappy call and no ability to go to any conferences and taking the call for all the holidays.
Also, how do you get reimbursed for calls at night? Let’s say that you are in a hospital that gets many calls at night from other hospitals to look at scans, and see if the patient needs surgery. You can’t bill for that, but you still get called. So 3-4 calls every night you’re on call, do you think you’ll be good for clinic or surgery in the AM? You need to make sure those calls ARE somehow reimbursed or paid for by the hospital. Remember that it is the responsibility of the hospital to find people to cover call and pay for call.
If the hospital wants level 1/level 2/level 3 trauma center, the hospital has to pay for call coverage. Think about the fact that when one does locums the hospital pays the following ( the locums company 60%, the physician 40% and transportation for the physician, hotel and meals and reimbursement for other meal related expenses) - yes locums company takes 60% and you take 40%, and don’t let them fool you, malpractice insurance is not that much!
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