Salaries for Endovascular/general ?

[p76]

What offers are you seeing for hospital employed or group practice for endovascular with X% general neurosurgery component? Looking at academic affiliated 600k base/productivity bonus with higher proportion of open/endo vs. 750k base/productivity bonus for hospital employed but about 50% or more spine and general

[Guest]

That sounds more like a standard PP/academic salary gap than anything to do with your case distribution. Same choice most of us have to make.

[Guest]

Why does academic pay less? Also, how come people look up to academics but PP NS's are seen as lesser/relatively unsuccessful?

[Guest]

Academics pays less for a couple of reasons. One - they get to pay less because there’s the prestiges of working at XYZ university. I mean when your friends, family, neighbors etc ask you where you work, you can say,”oh, I’m professor of neurosurgery at Johns Hopkins, Massachusetts General Hospital, Harvard, University of California San Francisco, etc”. However, even if you work at a super good private practice like Goodman Campbell, your neighbors will say,”Huh? Where is that?” They’ll know you’re a neurosurgeon but they won’t know enough of the context to know Goodman Campbell Brain and Spine is a practice that gets to pick elite surgeons. The only people who will know are basically local to the area or are within the neurosurgical community already. People dont understand that working at Harvard doesn’t make you the worlds best neurosurgeon because culture has trained us to believe all the best are in the ivy league and therefore if you work there or at some big research university, you must be great. So in a sense you are paying for that prestige with a lower salary. Another reason is if you’re interested in a research career, there’s the machinery to connect with NIH, and extramural funding at these larger, academic institutions; that’s not something is just not available through private practice. You can get deals with medical device companies to try their equipment or maybe join an investigation trial for a device. Maybe if you’re really valuable to them you could potentially get on the design team from private practice, but you’re not gonna be doing basic science in private practice. The two lifestyles are just incompatible. And the third is that private practice surgeons oftentimes get reimbursed by work rvu or by collections, and often have better payor mixes than academic institutions, which are often found in the most indigent portions of their respective cities, and have poor payors as a result, such as Medicaid, and the uninsured.

[Focus]

Some other thoughts are that when you are affiliated with a big academic center you are almost certainly going to get fed. I mean that both in terms of getting referrals and consults on cases just by the virtue of existing in that space but also, if for whatever reason you don't, you are going to still walk home with a paycheck that you can potentially justify despite poor clinical productivity (committees, research, teaching etc). PP you have to potentially pound the pavement a bit more but, if you are successful, you will see a larger percentage of the rewards of your work.

[Guest]

In academic you have to produce original research, which requires significant intelligence. In PP, all you do are surgeries, and no one cares if you mess up.

[Guest]

In academics your only job is to drink coffee and yell at residents. In pp you have to earn your keep and demonstrate why patients should come to you above others