Reimbursement for ENTs

[Moola]

Just wondering how well ENT docs do for themselves. I really found out that I like the field but no one really wants to talk about salary, lifestyle, etc. How much do ENT docs make compared to other surgeons? How is the lifestyle in terms of hours, call? Is there a lot of litigation?

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[TheThroat]

Salary: anywhere from high 100's and up. I know guys that have made over a mil in a year (I am not kidding) and know guys making 160K (pretty low if you ask me). The "Bulletin" is a publication sent out by the AAOHNS and ever year or so it gives averages of salaries. They vary by region, but are usually around 250K. Salary depends on numerous factors: academic vs private practice, subspecialization, big or small city, etc. Probably the biggest factor for private guys is how good of a businessman you are.

As far as lifestyle, you have to take call, but that varies widely as well. Academic guys in the dept I'm in take call about q 14. Guys in a small town might be on q2. Your lifestyle will also vary based on the surgeries that you do. Head and neck surgeons prob work harder (hours-wise) than the others because their surgeries last longer and their patients stay in the hospital longer.

 

[HiddenTruth]

Salary: anywhere from high 100's and up. I know guys that have made over a mil in a year (I am not kidding) and know guys making 160K (pretty low if you ask me). The "Bulletin" is a publication sent out by the AAOHNS and ever year or so it gives averages of salaries. They vary by region, but are usually around 250K. Salary depends on numerous factors: academic vs private practice, subspecialization, big or small city, etc. Probably the biggest factor for private guys is how good of a businessman you are.

As far as lifestyle, you have to take call, but that varies widely as well. Academic guys in the dept I'm in take call about q 14. Guys in a small town might be on q2. Your lifestyle will also vary based on the surgeries that you do. Head and neck surgeons prob work harder (hours-wise) than the others because their surgeries last longer and their patients stay in the hospital longer.

Not to sound greedy or materialistic, but simply looking at it objectively, most surgeons with 7 years of training (assuming you would do a fellowship) make more than 250K. Usually the competitiveness of the specialty is correlated with lifestyle and salary, so it is a bit surprising that they are not making more than that on an average. I could be totally wrong though. Out of curiousity, which subspecialties of Oto are in the upper range of the salaries? I am assuming cosmetic plastics may be one of them. What about those of us that are not interested in cosmetics?

 

[TheThroat]

Not to sound greedy or materialistic, but simply looking at it objectively, most surgeons with 7 years of training (assuming you would do a fellowship) make more than 250K. Usually the competitiveness of the specialty is correlated with lifestyle and salary, so it is a bit surprising that they are not making more than that on an average. I could be totally wrong though. Out of curiousity, which subspecialties of Oto are in the upper range of the salaries? I am assuming cosmetic plastics may be one of them. What about those of us that are not interested in cosmetics?

People do what they want to do. The fact is that fellowship trained academic otos, other than for highly respected faculty or chairmen, do not make much more than 250K. In private practice, there is much more variation. In private practice, cosmetic facial plastics, rhinologists, and otologists all can make a lot. That said, how much you make in private practice has much more to do with you business skills rather than your medical skills.

 

[1SwtWrld]

I know 5 ENT's all in private practices. It is evident from there lifestyle that they all make well over $250,000 a year. But they do work a ton. Im sure the more you put into a private practice the more you will get out of it. 3 of them are in a group with 8 regional offices and travel over a 3 county span to do surguries.

 

[nrut88]

Where im from, I know an Oto that makes around 1 mill. a year... Everywhere I go people know his name... He does surgeries from 7 till 12 on mon., tues. and thur. and doesnt work on fri. sat. or sun... he does clinic on wed and half a day clinic on mon. and tues... he plays golf more than he works... seriously... it seems like he owns this area...

 

[TheThroat]

Where im from, I know an Oto that makes around 1 mill. a year... Everywhere I go people know his name... He does surgeries from 7 till 12 on mon., tues. and thur. and doesnt work on fri. sat. or sun... he does clinic on wed and half a day clinic on mon. and tues... he plays golf more than he works... seriously... it seems like he owns this area...

It is a uncommon occurence that otos that don't do alot of facial plastics can make around seven figures, but it still can happen. Several factors come into play:
1. The payer demographic. If you have a very low percentage of Medicare and esp. Medicaid in your practice and a high percentage of non-HMO insurance, you will be reimbursed higher.
2. Your practice make-up. If you do a lot of sinus surgery and high turnover pedi oto, you can generate higher cash flow. Head and neck surgery takes longer and pays less, for the amount of time it takes to do it.
3. Your speed. The more patients you see and the more surgeries that you can do will lead to high cash flow. Having an OR/clinic with an efficient staff is a key part of this.

Honestly, I think that these factors have permanently damaged the ethics of private practice ENT, as many otos look to do too-fast sinus surgery on rich patients, neglecting the poor and those who truly need our help (those with cancer), while thinking first of the cash flow and not so much of how they can be a good physician.