Monday, July 17, 2006

Monday July 17, 2006
Intensivists' compensation

We looked into recent surveys' from different sources and found the following:

* All compensations in US dollar annually
* K = 1000

Average base salary compensation for intensivist has been ranged from annual 195K (new graduate) to 240K (3/5 years experienced). Highly experienced intensivist (15-20 years) should have compensation around 255K - 263K annual.

Latest market: all these surveys were published atleast a year ago and in last 12 months advertisements for intensivists' opportunities continue to show rising trend of salaries even upto 225-250K for new graduates.

Academic factor: Intensivist at a university setting make less but have better life style due to house staff availability and protected time for research (average 168 K), while critical care staff physicians employed by a non-university-affiliated hospital gets higher compensation (avaerage 240K) but more burn out.

Total clinical time in university setting is around 26-34 weeks per year but in private groups it all depends on local needs with 40-47 weeks (with 4 weeks vacation and one week for CME). Many groups prefer to work in block scheduling (like '7 days on 7 days off' to wear off burn out).

VA factor: VA system intensivits have good benefits and life style (like their university based colleagues) but salary remained low around 130-140K 3. Recently, there are strong indications that salaries would go up.

eICU factor: Recently eICU physicians have been offered higher than average compensation with heavy investments in this sector from major health systems but still very few intensivists have been found to take it as a full time employment.

Subspeciality factor: Overall critical care anesthesiologists and critical care non-trauma surgeons were under-compensated per one survey 1. Out of all PEDIATRIC intensivists found to be in highest demand due to lowest supply.

Geographical: Region wise east coast (particularly north east) has about 5-10% less compensation in all fields as compared to other regions.

Benefits: Benefits and bonuses upto 15% on top of base salary is a norm. In benfits - continuing medical education (CME) allowance range from 1000 - 5000 per year with average of 3000 US annual. 401 K (retirement), ADD, life insurance are usually part of the package but 3 essential benefits should include

  1. Malpractice with tail coverage
  2. Health/dental benefits for self and family
  3. CME

Mal-practice coverage: As a standard, malpractice with tail should be covered. New graduates often fail to ask for tail coverage and later found themselves in hot water with a condition call 'locked by the tail'. If candidate fail to negotiate but in later years want to relocate or leave the group, tail buying costs around 30K to 80K, depending on region. Tail buying is 200% of annual malpractice premiums.

Non-compete clause: Ideally, there should not be any non-compete or restrictive covenant clause as intensivists are unlikely to carry their own patient base but when private group is contracted or busy in one ICU its natural to have restrictive covenant and should be accepted as standard business practice.


Compensation for Physicians in Critical Care - Compensation of Critical Care Professionals 2005 - Society of Critical Care Medicine
The 2005 AMGA (American Medical Group Association) Medical Group Compensation and Financial Survey -
Testimony of Dr. Stephen P. Rosenthal President National Association of VA Physicians and Dentists
4. Intensive care unit physician staffing: Financial modeling of the Leapfrog standard - Critical Care Medicine. Interface of Public Policy and Critical Care Medicine. 34(3) Suppl:S18-S24, March 2006.