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What can you expect to make?

One question on everyone’s mind when they are looking at a neurology opportunity is, what will I make? There is rarely a simple answer to that question! Lots of factors go into determining both a starting salary and what someone will make at 5 years out, 10 years out and beyond. Below is information regarding compensation ranges and what you can expect. If you have questions or ever want to talk about the market, please send us an email at, call us at 216-906-8188 or complete the form below and we’ll contact you!

The factors that influence an offer

Many factors make up the compensation portion of an offer you may receive. Typically, practices start with the most recent national neurology compensation benchmarking data such as Sullivan-Cotter and MGMA and then go up or down from there depending on:
  • Type of Practice: Academic, Hospital-Employed Community Practice or Independent Private Practice
  • Geography
  • Subspecialty
  • Need of the practice
  • Experience of the Candidate
  • Other components such as call responsibilities, leadership elements of the position, research and/or teaching responsibilities
The type of practice (i.e. academic, hospital-employed community practice or independent private practice) all make a difference when thinking about what offer you might receive. In addition, there are differences among different locations that impact supply and demand of candidates, which in turn impacts the price employers need to pay to attract a neurologist. There are a lot of neurologists who want to be in big cities, so the hospitals don’t need to pay as much in order to attract candidates. Those hospitals and practices in less popular locations, such as rural hospitals or those in smaller or mid-sized cities, may need to offer higher salaries, RVU-based bonuses, student loan forgiveness and training stipends in order to attract quality candidates. Differences in subspecialties will also influence the amount of an offer you may receive. For example, in recent years, MS neurologists were in particularly high demand, and were therefore able to ask for (and get!) higher offers.

Compensation Benchmarking Data

Academic medical centers, hospitals, and private practices all rely on compensation benchmarking data that is updated annually. Different surveys will show different data and it is important to understand what surveys the hospital or practice may be using. Some stick with one survey, and some use a blend of several surveys. We believe that the Medical Group Management Association (MGMA) data is the most accurate reflection of what we are seeing in the market. We are always happy to talk with you about the different surveys and their relevance with respect to the particular job you are considering!

The survey data is a great place to start and provides a good overview. It does not, however, help with a lot of data regarding how your subspecialty in neurology is likely to impact your compensation. For example, if you want to know what an MS neurologist can earn, you may have to rely on anecdotal data or talk about the market with people who have seen recent offers in that subspecialty.  There is some national benchmarking data available for some subspecialties, but such data has not been consistently provided by the major compensation benchmarking companies.  We are always happy to let you know if recent surveys have reported benchmarking data in your subspecialty area.

Type of Practice  

The type of practice you are interested in will impact your starting and sustainable income. Academic neurology tends to pay lower than other types of practices (although there are always exceptions!) due to the fact that your research time may take away from clinical productivity, and also due to simple supply and demand—there are often more candidates interested in academic jobs. Hospital employment will generally offer the highest starting salaries (hospitals have deeper pockets than independent private practices) and conversely, private practices usually offer lower offer salaries (particularly if the doctors are paying for the new hire out of their own pockets).   However, private practice neurologists often think their autonomy is worth the tradeoff, and neurologists in private practice have the ability to supplement their income with income from testing, real estate, or other ancillary sources, and sometimes end up with higher earning potential over-all.

Understanding not only the starting salary but how subsequent years’ compensation is likely to be set is incredibly important not only to avoid an unexpected drop in income, but also to understand what is possible at a particular practice. 

Compensation Ranges  

Typical neurology compensation falls into 3 bands:

$200,000 - $250,000 
Academic and some starting salaries at private practices (where they may start you lower and provide you with the opportunity to earn more as you get busier)

$250,000 - $300,000 
Typical starting salary for most community practices, with private practices generally offering lower salaries than hospitals

We are seeing offers above $300,000 as starting salaries for inpatient neurologists, neurocritical care neurologists and interventionalists, as well as outpatient neurologists in some locations where it is hard to attract qualified candidates. 

Compensation Models
The most common ways to compensate neurologists are:

Base Salary plus RVU Production Bonus: Hospitals and most academic centers use this model.  The hiring practice understands that a new neurologist will need time to build a practice and ramp up. They will give you time to do this by guaranteeing you a base salary for a period of time (most common is 1-3 years). They will also pay you a bonus based on how productive you are. The bonus will have two components: the RVU threshold (i.e. the amount of RVUs you need to produce before you start earning a bonus) and the per dollar amount they will pay per RVU once the threshold is reached. It is good to make sure that everyone is on the same page and for you to ask what the threshold and dollar/RVU numbers are based on, so you know what the expectations are. Many practices will provide a pro-forma that will include number of cases they expect you to do in order to be able to start earning a productivity bonus.  In most hospital-employed positions, a new base salary is set at the end of the contract term using a formula set by the institution.

Straight Salary: some types of positions, such as research-focused positions or purely inpatient positions, as those involving research or those that are purely inpatient, are often compensated using a straight salary plus other types of bonuses for things like quality, citizenship, leadership, or academic productivity.  This is common when the primary value for the role is not determined by the volume of patients seen.

Productivity: After the guaranteed salary period ends, many practices will move you to a pure production model in which you are paid based on the RVUs produced or revenue collected minus expenses.  A “collections minus expenses” model is common in private practice, but very uncommon in hospital-employed arrangements where the neurologists do not control the collections nor the expenses of the practice and have less control over which patients they see.  

Fair Market Value (FMV) and why it matters

Even if a hospital really, really wants to hire you, they can’t just pay you anything they think you are worth because of federal regulations regarding healthcare institutions.  Whether a hospital is for-profit or not-for profit, they must keep physician compensation within “Fair Market Value” if they take payments from government programs, including Medicaid or Medicare.   If a hospital pays its physicians more than “Fair Market Value,” the hospitals can face very serious consequences with respect to these federal programs, and be charged with violating the Anti-Kickback Statute (42 U.S.C. 1320a-7b) and the False Claims Act (31 U.S.C. 3729).  Not-for-profit hospitals can even lose their tax-exempt status.   So, no matter how badly a hospital wants to hire you, it is important to understand that they aren’t free to pay you whatever they would like.  It may be helpful to their legal compliance team if you are able to share evidence that the compensation you are asking for is justified in your particular situation, such as if you have competing job offers, a W-2 reflecting that you are earning at or close to what you are asking, and productivity information.

Questions? Thoughts? We would love to help! Please fill out the form below and we’ll contact you or call 216-906-8188 or email bdery@rosmansearch.

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