Thread Rating:
  • 0 Vote(s) - 0 Average
  • 1
  • 2
  • 3
  • 4
  • 5
Starting Pediatric Neurosurgery Salary?
#31
I doubt that staff neurosurgeons at UCSF, e.g. Berger, are running their own private practice on the side, at least in the way the OP is describing. That would imply that they take a salary from UCSF, then pocket all the fees from the awake insular glioma surgery that requires multidisciplinary post op care. That makes no sense. They are probably salaried with potentially some bonus for reaching RVU thresholds. There may be surgeons at UCSF feeder hospitals whose pay scales are mostly RVU based who do probably benefit by the UCSF affiliation, but that is not who anyone is talking about when they say a UCSF surgeon. I haven’t seen Bergers pay stubs, but you certainly take a major pay cut in some academic systems. At Michigan, for example, neurosurgeons make roughly 200K and the chair makes 300; that is public information. It is definitely worth it for some, but it is no doubt a pretty big sacrifice.
Reply
#32
[Image: rW2HfMu.png]
Reply
#33
(04-10-2021, 08:48 PM)Guest Wrote: [Image: rW2HfMu.png]

you forget the 55 percent tax for california..
Reply
#34
(04-10-2021, 08:48 PM)Guest Wrote: [Image: rW2HfMu.png]


Thank you for this reply! Finally something useful on a site dominated by runts. 

As you can see, a huge difference between base salary and realized salary. And lets not forget the consulting fees, which can often be six or even seven figures if you play your cards right. A chair position will attract a lot of such consulting opportunities. And of course you have lots of fringe benefits like free travel, extended stays at conferences with room/food coverage, tickets to cool shows, etc. I am not saying these are worth more than several thousand dollars, but they certainly make life more enjoyable. 

So what the imbecile runts are ranting and raving about is the base salary. THEY ARE ALL MAKING A FOOL OF THEMSELVES. 

(04-10-2021, 08:27 PM)Guest Wrote: I doubt that staff neurosurgeons at UCSF, e.g. Berger, are running their own private practice on the side, at least in the way the OP is describing. That would imply that they take a salary from UCSF, then pocket all the fees from the awake insular glioma surgery that requires multidisciplinary post op care. That makes no sense. They are probably salaried with potentially some bonus for reaching RVU thresholds. There may be surgeons at UCSF feeder hospitals whose pay scales are mostly RVU based who do probably benefit by the UCSF affiliation, but that is not who anyone is talking about when they say a UCSF surgeon. I haven’t seen Bergers pay stubs, but you certainly take a major pay cut in some academic systems. At Michigan, for example, neurosurgeons make roughly 200K and the chair makes 300; that is public information. It is definitely worth it for some, but it is no doubt a pretty big sacrifice.

He earns 1.3 million, and probably works way less than a PP does, considering that most of the grunt work is done by residents and fellows. Add in the consulting fees, research dollars and fringe benefits of being a chair in academic and I would hardly say he is taking a pay cut.

Again, another ignorant comment that confuses base salary with final realizeded salary.
Reply
#35
(04-10-2021, 11:50 PM)Harvard / Yale Neurosurgeon Wrote:
(04-10-2021, 08:48 PM)Guest Wrote: [Image: rW2HfMu.png]
That’s a nice CRNA salary in there too
Reply
#36
Mayo neurosurgeons earn 800K to 1m+. Keep in mind that they have a relatively light load due to excellent PA/NP support. I will agree that a low-tire academic center that gets lots of indigent patients will pay poorly.
Reply
#37
(04-11-2021, 02:18 AM)Harvard / Yale Neurosurgeon Wrote: Mayo neurosurgeons earn 800K to 1m+. Keep in mind that they have a relatively light load due to excellent PA/NP support. I will agree that a low-tire academic center that gets lots of indigent patients will pay poorly.

This thread appears to have gone off the rails with little understanding of how pay is structured or why. 

Neurosurgeons make a lot of money because spine procedures bill very well in relation to time spent operating. Better than all other specialties.  Some cranial procedures, e.g aneurysm surgery, and endovascular procedures also bill well from a time to RVU perspective.  This is not the same for all neurosurgery --> functional and peds. We also take a lot of call and are required for trauma accreditation. The powers that be have limited the number of neurosurgeons by restricting residency spots resulting in increased bargaining power for call coverage.  The addition of stroke coverage for those who specialize in endovascular has provided further money but all of this does come at the cost of working more. The additional value of spine is that basic procedures can be done in an ambulatory care setting (ASCs), meaning you can own shares in a surgery center. This could increase your income by a few hundred thousand or more depending on your stake and the number of surgeries you are doing. 

In general, spine > vascular > tumor > functional > peds in terms of compensation.  Peds does not bill well (in any specialty) and as such you make less. What does bill well is all the downstream effects of having a pediatric neurosurgeon - critical care, radiology, various studies, rehab services and the ability to be designated as a trauma hospital.  So, while you, as a pediatric neurosurgeon, will bill significantly less than an adult neurosurgeon, if you are hospital employed you have the ability to argue that you bring the hospital money in other ways thereby justifying a salary that is beyond your RVU numbers. The NERVEs data provides a good representation what you would expect to make and hospitals do pay for this so that they know what to pay you. Additionally, any system that sees medicare and medicaid patients is limited in terms of what they can pay you per RVU. This further limits your income.

You will often take a pay cut (at least at first) to work in academic neurosurgery. As academic, you are given a stipend for other sorts of activities, e.g. research and/or teaching.  You can also pay yourself through grants although this is limited. The federal government limits this to < $200,000 if you spend all your time doing research and have a number of RO1s (most neurosurgeons don't). These values change if you have private foundation money such HHMI. Again, most neurosurgeons don't have this. If you are skilled researcher and get a K-grant award then you will be very competitive for academic jobs but those awards come with the caveat that at least 50% of your time be spent doing research and you can still only pay yourself so much from the grant. There are only 24 hours in a day so you have to give something up if you are gonna focus this much time on research. While research is a vital part of the field and important for solidifying the future, it does not pay nearly as well as clinical practice. Money really shouldn't be the main driver if you choose to go into academics.

Neurosurgeons who go directly to private practice will make less as they build their practice but have the potential to make significantly more as they progress. As mentioned above, investments in ambulatory care centers and/or private hospitals can put your compensation at levels that hospital employed and academic surgeons could never accomplish.  Hospital employed neurosurgeons generally do the best straight out of residency but these contracts come with stipulations that you must achieve certain thresholds, e.g. and RVU number, to sustain your compensation. If you are hospital employed, you may not have the opportunity to make investments in outside facilities.  Some hospitals have a dual ownership system where they own part of a ASC and you own part.  Ultimately, this is hospital/system specific. There are few privademic groups remaining (Tennessee, Carolinas). These groups staff multiple hospitals and provide continued ability for outside investments but systems around the country have fractured to stop this as they seek increased control and attempt to stop losing patients to outside facilities. 

Neurosurgeons who practice at UCSF main campus do not have private practices. They are employed by the hospital system/university. More of their time goes toward research endeavors and as such their starting salaries are unlikely to be the kinds of numbers being thrown around on this thread. Berger made the most in the department because he was the chair.  Very busy surgeons (Lawton/Mcdermott) in the past made a lot but you are also talking about people who were running two rooms at least two days a week - the type of numbers that are unsustainable at most institutions. These were also world renowned surgeons - most of us won't be. Mayo Clinic may pay at this level as well but I do not have knowledge of their data. The would have advantage of servicing mostly insured and very well-off patients with very little poverty in the surrounding area. The lack of an indigent population would increase their expected revenues as everyone is a payer. However, you generally do make less working at a prestigious institution.

Finally, as a board certified neurosurgeon, you do have ability to consult. Reviewing cases for lawsuits can bring considerable extra income, on the order of 500-1000/hour plus a retainer.  You probably shouldn't do this until you are board certified.  You also wouldn't want to get involved to the point where it was impeding your practice. You can also consult with device and drug companies, all of this is publicly available via the Sunshine act so if you are curious as to what some of the big names are making, you can find this on the web.  This will show you that you don't make much for consulting but make substantial money from royalties if you create something that is widely used.
Reply
#38
Dude you are the GOAT.
Reply
#39
(04-11-2021, 12:07 PM)Guest Wrote:
(04-11-2021, 02:18 AM)Harvard / Yale Neurosurgeon Wrote: Mayo neurosurgeons earn 800K to 1m+. Keep in mind that they have a relatively light load due to excellent PA/NP support. I will agree that a low-tire academic center that gets lots of indigent patients will pay poorly.

This thread appears to have gone off the rails with little understanding of how pay is structured or why. 

Neurosurgeons make a lot of money because spine procedures bill very well in relation to time spent operating. Better than all other specialties.  Some cranial procedures, e.g aneurysm surgery, and endovascular procedures also bill well from a time to RVU perspective.  This is not the same for all neurosurgery --> functional and peds. We also take a lot of call and are required for trauma accreditation. The powers that be have limited the number of neurosurgeons by restricting residency spots resulting in increased bargaining power for call coverage.  The addition of stroke coverage for those who specialize in endovascular has provided further money but all of this does come at the cost of working more. The additional value of spine is that basic procedures can be done in an ambulatory care setting (ASCs), meaning you can own shares in a surgery center. This could increase your income by a few hundred thousand or more depending on your stake and the number of surgeries you are doing. 

In general, spine > vascular > tumor > functional > peds in terms of compensation.  Peds does not bill well (in any specialty) and as such you make less. What does bill well is all the downstream effects of having a pediatric neurosurgeon - critical care, radiology, various studies, rehab services and the ability to be designated as a trauma hospital.  So, while you, as a pediatric neurosurgeon, will bill significantly less than an adult neurosurgeon, if you are hospital employed you have the ability to argue that you bring the hospital money in other ways thereby justifying a salary that is beyond your RVU numbers. The NERVEs data provides a good representation what you would expect to make and hospitals do pay for this so that they know what to pay you. Additionally, any system that sees medicare and medicaid patients is limited in terms of what they can pay you per RVU. This further limits your income.

You will often take a pay cut (at least at first) to work in academic neurosurgery. As academic, you are given a stipend for other sorts of activities, e.g. research and/or teaching.  You can also pay yourself through grants although this is limited. The federal government limits this to < $200,000 if you spend all your time doing research and have a number of RO1s (most neurosurgeons don't). These values change if you have private foundation money such HHMI. Again, most neurosurgeons don't have this. If you are skilled researcher and get a K-grant award then you will be very competitive for academic jobs but those awards come with the caveat that at least 50% of your time be spent doing research and you can still only pay yourself so much from the grant. There are only 24 hours in a day so you have to give something up if you are gonna focus this much time on research. While research is a vital part of the field and important for solidifying the future, it does not pay nearly as well as clinical practice. Money really shouldn't be the main driver if you choose to go into academics.

Neurosurgeons who go directly to private practice will make less as they build their practice but have the potential to make significantly more as they progress. As mentioned above, investments in ambulatory care centers and/or private hospitals can put your compensation at levels that hospital employed and academic surgeons could never accomplish.  Hospital employed neurosurgeons generally do the best straight out of residency but these contracts come with stipulations that you must achieve certain thresholds, e.g. and RVU number, to sustain your compensation. If you are hospital employed, you may not have the opportunity to make investments in outside facilities.  Some hospitals have a dual ownership system where they own part of a ASC and you own part.  Ultimately, this is hospital/system specific. There are few privademic groups remaining (Tennessee, Carolinas). These groups staff multiple hospitals and provide continued ability for outside investments but systems around the country have fractured to stop this as they seek increased control and attempt to stop losing patients to outside facilities. 

Neurosurgeons who practice at UCSF main campus do not have private practices. They are employed by the hospital system/university. More of their time goes toward research endeavors and as such their starting salaries are unlikely to be the kinds of numbers being thrown around on this thread. Berger made the most in the department because he was the chair.  Very busy surgeons (Lawton/Mcdermott) in the past made a lot but you are also talking about people who were running two rooms at least two days a week - the type of numbers that are unsustainable at most institutions. These were also world renowned surgeons - most of us won't be. Mayo Clinic may pay at this level as well but I do not have knowledge of their data. The would have advantage of servicing mostly insured and very well-off patients with very little poverty in the surrounding area. The lack of an indigent population would increase their expected revenues as everyone is a payer. However, you generally do make less working at a prestigious institution.

Finally, as a board certified neurosurgeon, you do have ability to consult. Reviewing cases for lawsuits can bring considerable extra income, on the order of 500-1000/hour plus a retainer.  You probably shouldn't do this until you are board certified.  You also wouldn't want to get involved to the point where it was impeding your practice. You can also consult with device and drug companies, all of this is publicly available via the Sunshine act so if you are curious as to what some of the big names are making, you can find this on the web.  This will show you that you don't make much for consulting but make substantial money from royalties if you create something that is widely used.

We need a "required reading" link on the forum homepage for this and the 5% of other actually valuable posts on here
Reply


[-]
Quick Reply
Message
Type your reply to this message here.

Image Verification
Please enter the text contained within the image into the text box below it. This process is used to prevent automated spam bots.
Image Verification
(case insensitive)

Forum Jump:


Users browsing this thread: 1 Guest(s)