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Neurology Salary?


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Hi guys,

 

I was told a couple weeks ago that in Ontario, the mean gross billings for neurologists is actually lower than that of family doctors.

 

 I was quite surprised by this, and since I'm very interested in neurology as a profession I just wanted to see if I could get some clarification about how much they actually make.

 

Thanks so much,

scared

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Hi guys,

 

I was told a couple weeks ago that in Ontario, the mean gross billings for neurologists is actually lower than that of family doctors.

 

 I was quite surprised by this, and since I'm very interested in neurology as a profession I just wanted to see if I could get some clarification about how much they actually make.

 

Thanks so much,

scared

 

The CMA profiles is a good place to start - here's Neurology's. Overall a Neurologist's income is similar if not better than the typical FM doc. 

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I am not an neurologist - but the overhead is quite a bit less I thought as well(?)

 

no doubt neurologist earn a lower amount compared to other similar specialties. I have been told some reasons why that is the case but it still doesn't make a lot of sense to me on a system's level. 

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I am not an neurologist - but the overhead is quite a bit less I thought as well(?)

 

no doubt neurologist earn a lower amount compared to other similar specialties. I have been told some reasons why that is the case but it still doesn't make a lot of sense to me on a system's level. 

 

If neurologists could actually treat stuff maybe their incomes would improve...  ;)

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If neurologists could actually treat stuff maybe their incomes would improve...  ;)

 

(ooooooooooooooo......)

 

but in seriousness that is exactly the problem - the government doesn't like to pay for things that don't somehow END the problem or lead to it ending. Chronic management of things is not their style. Not logical in all cases, not logical at all.  

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(ooooooooooooooo......)

 

but in seriousness that is exactly the problem - the government doesn't like to pay for things that don't somehow END the problem or lead to it ending. Chronic management of things is not their style. Not logical in all cases, not logical at all.

 

Instead of putting more and more money into specialized treatment, they would reach their goal of "ending problems" by focusing on prevention and firts line treatment aka making fm more attracting for med students!

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The pay is not great for general outpatient Neurology. That is, in large part due to the length of the neuro physical exam and the patient population they deal with. Often times, those patients are presenting with issues that cannot be addressed in 10 minutes. On top of that, they have loads of elderly patients, who tend to have social issues such as failure to cope, caregiver fatigue, dementia, etc. going on. 

 

That said, certain sub specialties and procedures within Neurology can pay decently from what I hear. 

 

Botox for dystonias, Parkinsons patients, and headaches, EMGs, NCS, neurocritical care,  and sleep medicine all pay well. Beware, however, that you may find it difficult to establish the required patient population to appreciably boost your income via botox. Unfortunately, I don't believe that OHIP covers botox injections for headaches. There is a private market for this however. The neurocritical care and sleep medicine job markets are saturated. Not sure about EMG/NCS.  

 

In the states, there are Neurologists who practice interventional pain, although that is dominated by Anaesthesia in Canada. I don't imagine it would be impossible to land a fellowship for that in Canada.

 

Interventional neuroradiology is ~20-25% completed by Neurologists in the states. The remaining 70-75% of the field is split between Neurosurgery and Radiology, with Neurosurgery taking the larger portion of that pie. That, too, pays quite well. I think there are a couple of Neurologists practicing this in Canada now. 

 

That said, these will all require 2 year fellowships AFAIK. There are better paths to money out there. 

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The pay is not great for general outpatient Neurology. That is, in large part due to the length of the neuro physical exam and the patient population they deal with. Often times, those patients are presenting with issues that cannot be addressed in 10 minutes. On top of that, they have loads of elderly patients, who tend to have social issues such as failure to cope, caregiver fatigue, dementia, etc. going on. 

 

That said, certain sub specialties and procedures within Neurology can pay decently from what I hear. 

 

Botox for dystonias, Parkinsons patients, and headaches, EMGs, NCS, neurocritical care,  and sleep medicine all pay well. Beware, however, that you may find it difficult to establish the required patient population to appreciably boost your income via botox. Unfortunately, I don't believe that OHIP covers botox injections for headaches. There is a private market for this however. The neurocritical care and sleep medicine job markets are saturated. Not sure about EMG/NCS.  

 

In the states, there are Neurologists who practice interventional pain, although that is dominated by Anaesthesia in Canada. I don't imagine it would be impossible to land a fellowship for that in Canada.

 

Interventional neuroradiology is ~20-25% completed by Neurologists in the states. The remaining 70-75% of the field is split between Neurosurgery and Radiology, with Neurosurgery taking the larger portion of that pie. That, too, pays quite well. I think there are a couple of Neurologists practicing this in Canada now. 

 

That said, these will all require 2 year fellowships AFAIK. There are better paths to money out there. 

 

there are 2 neurologist practicing neurointerventional in Canada last time I looked. Not very popular in canada as it doesn't pay particularly well and of course the hours are terrible. Still interesting work :) 

 

In Canada at least most of that is still done by radiologists. 

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The pay is not great for general outpatient Neurology. That is, in large part due to the length of the neuro physical exam and the patient population they deal with. Often times, those patients are presenting with issues that cannot be addressed in 10 minutes. On top of that, they have loads of elderly patients, who tend to have social issues such as failure to cope, caregiver fatigue, dementia, etc. going on.

 

That said, certain sub specialties and procedures within Neurology can pay decently from what I hear.

 

Botox for dystonias, Parkinsons patients, and headaches, EMGs, NCS, neurocritical care, and sleep medicine all pay well. Beware, however, that you may find it difficult to establish the required patient population to appreciably boost your income via botox. Unfortunately, I don't believe that OHIP covers botox injections for headaches. There is a private market for this however. The neurocritical care and sleep medicine job markets are saturated. Not sure about EMG/NCS.

 

In the states, there are Neurologists who practice interventional pain, although that is dominated by Anaesthesia in Canada. I don't imagine it would be impossible to land a fellowship for that in Canada.

 

Interventional neuroradiology is ~20-25% completed by Neurologists in the states. The remaining 70-75% of the field is split between Neurosurgery and Radiology, with Neurosurgery taking the larger portion of that pie. That, too, pays quite well. I think there are a couple of Neurologists practicing this in Canada now.

 

That said, these will all require 2 year fellowships AFAIK. There are better paths to money out there.

Neurosurg is smart. They're avoiding the mistakes Cardiac Surgery made.

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  • 3 weeks later...
  • 2 weeks later...

I don't know how common medicolegal work is in Neurology, but it's possible AFAIK. I have heard of one neurologist who makes a killing doing medicolegal stuff. That individual has largely abandoned clinical practice. I don't know the details, just something I heard word of mouth. 

 

Neurology is a very academic and research oriented specialty. I think ~50 percent of all neurologists in canada work in academic centres. Given that, I don't think the type of person who would become a neurologist is likely to be interested in stuff like medicolegal work, which is why you don't hear about it often. 

 

But it seems like the opportunities exist.  

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there are 2 neurologist practicing neurointerventional in Canada last time I looked. Not very popular in canada as it doesn't pay particularly well and of course the hours are terrible. Still interesting work :)

 

In Canada at least most of that is still done by radiologists. 

 

I did not know that. I incorrectly assumed that because neurointerventional procedures pay well in the states, they must pay well in Canada. I stand corrected. :P

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  • 2 weeks later...

I don't know how common medicolegal work is in Neurology, but it's possible AFAIK. I have heard of one neurologist who makes a killing doing medicolegal stuff. That individual has largely abandoned clinical practice. I don't know the details, just something I heard word of mouth. 

 

Neurology is a very academic and research oriented specialty. I think ~50 percent of all neurologists in canada work in academic centres. Given that, I don't think the type of person who would become a neurologist is likely to be interested in stuff like medicolegal work, which is why you don't hear about it often. 

 

But it seems like the opportunities exist.  

A family member does this. Runs a consult clinic a couple times a month, the rest is doing medicolegal work. Lets just say their garage is amazing. 

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A family member does this. Runs a consult clinic a couple times a month, the rest is doing medicolegal work. Lets just say their garage is amazing. 

Anyone know if he's 1 in 1000, or if it's a readily accessible to the average neurologist who wants to do it for only a few days a month?

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I did not know that. I incorrectly assumed that because neurointerventional procedures pay well in the states, they must pay well in Canada. I stand corrected. :P

 

Yeah ha, you would think it would pay well - I mean it is a kind of brain surgery effectively to reverse under hi stress and short time constraints a stroke - often at 3am. Cannot think of any reason that should be paid so much less than me slurping a tea while reading a CT (the visceral organs and GI system are unremarkable....slurp.....the osseous structures and body wall soft tissues are within normal limits.....slurp.....Impression: No acute abdominal/pelvic pathology.....powerscribe NEXT......)

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  • 3 months later...
  • 2 months later...
On 10/21/2017 at 2:26 PM, PhD2MD said:

For anyone still interested, the 2017 numbers came out a few weeks ago.
Ontario
FP: 230,016
Neurology: 295,569
Medical specialties: 343,175
Surgical specialties: 457,110

Canada
FP: 253,683
Neurology: 310,797
Medical specialties: 350,629
Surgical specialties: 473,448

Data: https://www.cihi.ca/en/physicians-in-canada

Good find, thanks for posting this! One thing to point out with these numbers, however, is that this only represents billings to the government and does not account for part-time work. Both those factors would probably bring FP income up closer to the other specialties. Hard to find decent apples-to-apples comparisons for income between specialties, unfortunately, and this comes about as close as it gets.

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  • 2 weeks later...

What part time work are you talking about? Un-insured services in FP account for less than 10% of income. If anything else, the non-FM incomes are severely under reported thereas a lot of them either pay no overhead as they're poaching hospital resources and/or they often have a significant ARP component that isn't appreciated in these FFS numbers.

The discrepancy between FP and others has really gotten out of hand in the last 30 years and while I'm not sure of what other provinces are doing, Alberta is actively looking at the issue and looking at things to bring it back in line.

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