So I initially was thinking academics cause I want to have a mix of cool cases, but seems like at my residency there is 2-3 big dawg surgeons who suck up all the cranial cases and refuse to do spine and then they hire like 10 spine only surgeons and will steal even a simple meningioma that comes in on general call for any of them. I imagine in private practice it is mostly degen spine, but you occasionally see meningiomas and SDH and chiaris etc you can do without having a cranial only chairmen taking the case while trading you 3 IV drug use osteo cases from their general call. Am I wrong in this viewpoint? That academics sort of sucks unless you are one of the big dawg guys at a place and if you are a grunt taking the cases the big dawgs don’t want to do then you should just go to private practice?
this is a semi-accurate take
Yes. Academics blows. Avoid at all costs.
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06-04-2023, 11:20 AM
(This post was last modified: 06-04-2023, 11:26 AM by Focus.)
After care becomes the issue in a lot of private practice situations. Not a great feeling when you are told you can't do a case because someone else doesn't feel comfortable with it either from an anesthesia or critical care standpoint.. I've moonlighted at smaller hospitals that wouldn't let me revise fractured hardware because it was from a fall and they aren't equipped to manage trauma. Same place transferred out a juicy SM grade 1 unruptured AVM that was so small and superficial that you could have just bovied it out of the frontal lobe.
I would add that this is a place with full time neurosurgeons.
In my experience, private practices and non-academic hospitals are quite interested in holding on to patients and facilitating their surgeries, as that’s how they make money. They tend to be vastly more efficient, with faster turnovers, and better support. They also tend to appreciate and treat their physicians better. Private practice anesthesia also is way more efficient than the clowns in academics.
Based on my personal experiences in both academic and non-academic medical practices, I can confirm that the traditional notion that everything must be referred to academic centers is gradually fading. Unfortunately, it often falls to uninsured or underinsured individuals to be transferred or for cases that are bound to have a poor outcome regardless of the medical setting. In my experience, non-academic practices tend to handle a greater number of elective cases across various specialties. I've seen colleagues in non-academic practices, especially in skull base and vascular, staying incredibly busy because of their efficiency and dedication to patient care. One of the most notable differences I've observed is that non-academic hospitals generally treat physicians better, providing a more favorable work environment. Additionally, they prioritize the patient experience, which contributes to patient loyalty towards the hospital. Personally, I have found my life to be more satisfying in a non-academic practice, with fewer political challenges, better compensation, and even when I'm the one handling overnight cases/calls it's often easier than dealing with resident-related complexities.
How do salaries compare between academic and non-academic in terms of starting salary?
What about comparing the support your residents give vs an APP in private practice or non-academic hospitals. They don’t have the same work ethic.
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Definitely don't dispute that PP oriented hospitals still treat physicians like the breadwinners we are. Reserved parking and a physicians lounge with free meals, snacks, and coffee don't actually cost the hospital much but employee loyalty is purchased in small installments like that.
