Physiatrists are the team players of all the medical specialties.  They work with therapists, case managers, nurses, admissions and more.  PM&R doctors are the team leaders.  They must have great communications and interpersonal skills.

Physical medicine and rehabilitation physicians also are familiar with so many diagnoses like Brain Injury Medicine, Hospice and Palliative Medicine, Neuromuscular Medicine, Pain Medicine, Pediatric Rehabilitation Medicine, Spinal Cord Injury Medicine, and/or Sports Medicine.

PM&R doctors may do many procedures depending on the injury, illness, or disabling condition.  Physical medicine and rehabilitation jobs are available with the focus of these procedures: EMG/Nerve Conduction Studies, Ultrasound guided procedures, Fluoroscopy guided procedures, Injections of spine, Discography, Disc Decompression and Vertebroplasy/Kyphoplasty, nerve Stimulators, Blocks and Ablation procedures—Peripheral and Spinal, Injections of joints, Prolotherapy, Spasticity Treatment (Phenol and Botulinum toxin injections, intrathecal baclofen pump trial and implants), Nerve and Muscle Biopsy, Manual Medicine/Osteopathic Treatment,  Prosthetics and Orthotics,  Complementary-alternative medicine (i.e. acupuncture, etc.),  Disability/impairment assessment, and Medicolegal consulting.

If you’re an experienced physiatrist and looking for a new physical medicine and rehabilitation job, you probably know what to look for in a new position and what’s not of interest to you.  You have the advantage of experience that has informed you of what you truly like and dislike.  Some physiatrists even try locum tenens before their first permanent job to identify what practice type is of most interest to them.  It is a financially-rewarding way see different practice types and learn what works best for them.

With the advantage of experience, there are so many factors that may drive your next physical medicine and rehabilitation job search.  You may be in a situation where the billing system isn’t good so you know to make sure to inquire about it this time around.  Or, maybe the camaraderie in the group you’re with is lacking so now you know to talk with each of the associates carefully in the new groups with whom you’ll be interviewing.  The list goes on and on, e.g., your relationship with administration is not good, you might prefer a hospital employee position instead of being with a private practice, you may not be being paid enough, or you may be working 24/7.

Experienced physiatrists are much savvier therefore about their practice searches.  As is the case whenever you’re doing a physical medicine and rehabilitation job search, it is best to identify your strong likes and dislikes.  These can be used at the tail-end of your search when you can use these to weigh the pro’s and con’s of openings.

Employers often favor experienced physiatrists for the very same reason because they know what they want and don’t want.  For this reason, they are more likely to stay with their second and on physical medicine and rehabilitation jobs.  Job longevity is very important to the hiring entity.  Also, experienced physiatrists can transition into a new entity quickly and efficiently.

Some of the former con’s of physical medicine and rehabilitation jobs have been eliminated over the course of time.  For example, with the inclusion of hospitalists in many settings, physiatrists no longer have to take care of the patients’ medical issues.  Also, hospitalists have lessened the call demands on physiatrists.

Now, many hiring entities employ physiatrists so that you have the security of a salary and benefits.  On the other hand, one physiatrist’s job pro may be another physiatrist’s con.  Some physiatrists prefer an independent contractor affiliation as they favor direct, full reimbursement.

Here are some physiatry jobs exclusively for experienced physiatrists:

AL – Birmingham, Residency Program Director, SCI opening also available

• Golden opportunity in academic leadership
• Growing and successful PM&R program
• Super-collaborative group
• Rated top large employer in the nation
• A known TBI and SCI model system site
• Birmingham has the Lakeshore Foundation which is the home of para-Olympic training
• Recently succeeded from an advanced program to a categorical program
• Level I trauma center
• The SCI Model System has been continuously funded since 1998
• Academics, clinical and research; can just do academics and research if desired

AZ – Phoenix Mostly Inpatient, Similar openings nationwide

• Reap the benefits of well-trained outreach teams to maximize the patient load
• Associate with a national leader in rehab which has a great ability to market and represent rehab on all fronts
• High income potential
• Work with two nationwide companies, experts in hospitals and in rehab
• Salary plus incentive
• Must be Board Certified

CO – Denver Interventional, Similar openings in Atlanta, Las Vegas, Chicago, Nashville, Kansas City

 

• No narcotics or chronic pain
• No Medicare or Medicaid
• This large network gives you the first-choice ability to move to another city
• Lifestyle-friendly practice environment with a rapidly growing, thriving organization
• Procedure suites in the office
• Nurse practitioners in every office
• Equal distribution of new patients
• Monthly incentive bonuses typically range from $5,000 – $15,000

DE– Georgetown & Dover – Mostly inpatient, Similar openings in LA -New Orleans, ND-Fargo, TX-Houston

• 10 minutes to the beach; Dover is the state capitol
• 2019, 2020 Dover Rehab Hospital was the company’s rehab hospital of the year and #1 in quality outcomes ranking for all company rehab hospitals in 2021
• The Dover hospital has a full census so it’s expanding
• The Georgetown, DE rehab hospital is under construction with a Spring, 2022 start date
• 1:4 call and only when admissions
• Internal medicine support and 43 different specialists
• DE has a great rehab need as there are only 125 rehab beds for 1M state residents
• Internists are on call on the weekends

FL – Tallahassee, Medical Director, Rehab – Similar openings in Ocala, Pensacola and Panama City

• Help build a brand-new program
• Strong support system
• In 2019, Southern Living Magazine recognized Tallahassee as “One of the South’s Best Cities”
• 266-bed acute care hospital; named one of America’s 100 Best Hospitals for Orthopaedic Surgery
• $23M, 20-bed rehab center opening in 2022
• State Capitol

 ME – Near Portland – Interventional

• Growing, expanding successful multidisciplinary practice
• In-house injection suite
• PT’s, athletic trainers, personal trainers and more
• Attached to a 10,000 square foot indoor sports performance center
• Work with a NP
• 4 days/week, great benefits
• In-office injection suite
• Partnership potential
• Opportunity to buy into the office building as well; potential ASC affiliation
• Near Portland, the largest city in ME, among the top US cities for restaurants and bars per capita; Arts District, Foods Festivals; 105 miles to Boston

WA – Spokane – Outpatient Spasticity Management Practice Purchase

• One of the area’s leaders in spasticity rehab
• Long-standing reputation with 24 years in operation
• An ideal practice for someone that wants to reduce their hours.  No weekend work, very little over-night call, easy billing, but still have the opportunity to interact with patients.
• This practice is almost all procedures.
• Located in the heart of downtown Spokane, WA near many medical centers

For more openings, visit here

PHYSICAL MEDICINE AND REHABILITATION JOBS

How do you choose a PM&R job?  It’s often geography, family, compensation or a combination of these items and more.   This blog will help you to identify among the myriad of physical medicine and rehabilitation jobs which might be the best for you.  It will include information about geography, compensation and other aspects such as the job responsibilities, call, acute versus chronic pain, etc. so you can best determine what fits your needs.

NEW ENGLAND

INTERVENTIONAL

MA – BOSTON

This physical medicine and rehabilitation job offers the potential for ownership in the ASC and, if interested, practice ownership!  This is a well-established, successful pain practice that has been in operation 20 years.  There is huge growth potential at this 2-person doctor practice with a PA and a NP.  Do interventional procedures 2 – 3 days/week to include cervical epidurals, stimulator trials and implants-temporary and permanent, discography, morphine pumps.  Ideally some knowledge of stem cells would be ideal.  Most procedures are by fluoroscopy.  The surgery center is across the hallway from the office.  Do a few EMG’s and NCV’s.  70% – 80% of the patients are on medications but not long-term and are low dose opioids

 

INPATIENT, CONSULTS AND OUTPATIENT – Permanent or locum tenens

NH – MANCHESTER OR NASHUA

 

This is a very well-regarded rehab hospital system.  Their physician retention rate is high.  They are focused on high quality of care.  Hospitalists provide the primary care.  The system has been operational since 1984, and is Joint Commission- and CARF-accredited with specialty certification in stroke and brain.  The network has 4 rehab hospitals, 20 outpatient centers, 2 interventional pain centers, a home care service and school-based sports medicine programs.  Join a dynamic group of employed physicians that currently include 9 Internists, 6 PAs, and 8 Physiatrists.  There is the potential for an academic appointment with this physical medicine and rehabilitation job.

 

 

THE NORTHEAST

LEADER, RESTORATIVE CARE PROGRAM

PA – YORK

 

This new physical medicine and rehabilitation job is exciting as you will be the lead physician within a newly-developing, world-class multidisciplinary pain team (behavioral health care coordinators, acupuncturists, massage therapists, nutritionists and more).  I often hear of dysfunction, disorganization and lack of continuity from physiatrists about their work.  This opening allows you to be part of the first Transdisciplinary Pain Program within an integrated health system in the nation.  It has comprehensive, trauma-informed, team-delivered care where multiple disciplines provide care at one location based on a single treatment.  It is conveniently situated within a short drive of major cities like Philadelphia, Baltimore and Washington, D.C.

 

INTERVENTIONAL OR GENERAL OUTPATIENT – Permanent or locum tenens

NJ – TEANECK, Similar openings in NYC

 

This physiatry practice is well-connected as it works with a large management services company.  It’s only 19 miles from NYC!  With its flexibility in affiliation type, you can choose to work on a permanent or locum tenens basis.  This position requires a current NJ license.  As an interventionalist, you would provide pain procedures and do your own EMG’s/NCV’s.  There is no medication management. If a general outpatient physiatrist, you will provide EMG/NCV’s and do about 20-25 evals/day at this physical medicine and rehabilitation job.

.

 

THE SOUTH

INPATIENT

FL – OCALA, PENSACOLA AND TALLAHASSEE – Medical Director openings in Jacksonville and St. Augustine and other southern states

                                               

If you enjoy being part of one of the largest national healthcare systems, this position is for you.  Great benefits, great opportunity for career progression, guaranteed referral sources and great system stability all come with this practice opportunity.  The Tallahassee opening offers the opportunity to grow a new rehab hospital program.   Some of these physical medicine and rehabilitation job opportunities are in areas without other rehab competition.

 

INTERVENTIONAL PRACTICE PURCHASE

NC – SOUTH CENTRAL

 

A physiatrist with a long-standing reputation with 21 years in practice plans to retire.  All the physiatrists in town do very well.   The city has received the All-America City Award from the National Civic League three times.  If you so choose, you can also do inpatient.  Beautiful 3,000 square foot office building with a large PT area, 2 doctor’s offices, 3 exam rooms, staff break room, supply storage room and a parking lot.  The building is available for purchase.  It has solar panels which generate income   The physiatrist will introduce you to good referral sources.  When doing inpatient plus outpatient the practice grossed $1.2M a year.  $900,000 OBO

 

THE MIDWEST

 

MEDICAL DIRECTOR, REHAB AND STAFF POSITIONS

IA – IOWA CITY

If you like academics, growing programs and rehab, this is your ideal physical medicine and rehabilitation job!  You’re in good hands because your affiliation is with a rehab leader and a university leader.  Enjoy working with very engaged faculty team.  Play an integral role in the growth and development of PM&R at the university.  Hospitalists serve as the primary care physician and do most of the call.  Enjoy flexibility in services you can provide.  Significant transition payout, commonly known as a sign-on bonus.  Terrific benefits!

 

INPATIENT/OUTPATIENT STAFF

MN – DULUTH

Duluth was named Best Outside City by Outside magazine – Fish, hike, ski, sail, canoe, kayak, bike and mountain bike, golf, tennis ice skate, hockey, rock climb. Enjoy professional collegiality with 6 physiatrists and excellent working relationships with a full continuum of neuromusculoskeletal specialists.  $20,000 sign-on bonus and $270,000 for a new graduate, more if you have experience.

 

MEDICAL DIRECTOR, REHAB

ND – FARGO; Similar openings in DE, LA and TX

 

Outstanding physical medicine and rehabilitation job to make a name for yourself at this 1-year-old rehab hospital.  Help grow and further develop the rehab programs.  Act as the consultant; hospitalists provide primary care days, nights and weekends.  Strong internal medicine and a full array of consulting specialties.  Per a local doctor, it’s a great place with good schools, a good airport, hunting, skiing, college sports and theatre, a low crime rate, and more.

 

GENERAL OUTPATIENT OR INTERVENTIONAL

OH – DAYTON

 

Dayton is close to the metro area of Cincinnati as it’s only an hour away.  If you want the stability of a hospital system which is the largest in the area, this physical medicine and rehabilitation job is for you.  Plus, it’s an area where you can enjoy a good lifestyle as it has a low cost of living.  Dayton is rated as “Top 100 Best Places to Live and Retire”.   The work is approximately 80% outpatient musculoskeletal medicine and 20% inpatient.  The focus is on Spine Pain and non-operative treatment.  The inpatient work is inpatient consults and inpatient coverage when other staff on vacation.  If doing spinal injections, they will be done in the hospital outpatient department.  The physiatry office is connected to the hospital.  No travel.  Enjoy great benefits and a sign-on bonus is negotiable.

 

THE SOUTHWEST

 

ASSOCIATE MEDICAL DIRECTOR, REHAB

AZ – 2 HOURS FROM PHOENIX – Similar opening in Evansville, IN

 

This is a growing hospital next to a Level I trauma hospital.  Enjoy the autonomy and income advantages of being an independent contractor.  Flexibility with days and hours and good work/life balance.  Marketing is done for you and there is help with setting up your practice.

 

TBI, GENERAL OUTPATIENT, INTERVENTIONAL, or EMG

NM – ALBUQUERQUE

These physical medicine and rehabilitation jobs are due to the growth of a fairly new PM&R residency program in beautiful, sunny Albuquerque with sun and snow.  Live in modern downtown, Old Town with shops or the suburbs.  Get in on the ground floor of this opportunity with huge growth potential.  Each of the positions is flexible so that you can include your practice preferences and develop clinics around your areas of interest; do program development and residency education and can be an academic (to include research) or clinical track.

THE WEST

INTERVENTIONAL

CA – SAN FRANCISCO

Join a diversely-talented and excellent team at a world-class practice.  Built-in referral base so your schedule will fill quickly.  There is a great opportunity to further grow this already sizeable practice.

SPASTICITY MANAGEMENT PRACTICE PURCHASE

WA – SPOKANE

 

This is one of the area’s leaders in spasticity rehab.  This practice has a long-standing reputation with 24 years in operation.  It is located in the heart of downtown Spokane, WA near many medical centers.

These are but a few of the available practice opportunities.  For more click here.  There are more physical medicine and rehabilitation jobs than ever before!

 

 

 

 

 

 

 

 

PHYSIATRY JOBS

When it comes to negotiating a contract for a physiatry job, one typical clause is the non-compete clause.  It’s typically something that one would not think is negotiable but it’s worth trying.  Perhaps you can negotiate the distance, the time limit, or the fine.  Compromises are possible.  It may take some skillful negotiation.

Most physiatry jobs have a non-compete clause in the contract.  The monetary penalty associated with a non-compete usually ranges from $10,000 to $250,000. The geographic limitation may range from 5 miles to 100 miles of the practice/hospital.  The larger limit relates to large hospital systems with many satellite offices.  The length of the non-compete is from 1 – 3 years after leaving the entity.  Some options if you leave a practice and have to wait until the non-compete is over are locum tenens work although you may need to get another state license or telemedicine.

Non-compete agreements are frequently challenged in legal cases.  “Many states do not allow non-competes and some states have legislation in the works,” according to Jon Appino, Principal and Founder of Contract Diagnostics, a firm that helps physicians with contract reviews. Yet he still encourages doctors to check all local laws, explaining that even when a doctor hears that a non-compete is unenforceable, the contract may have predetermined damages that are tough to fight against.  https://www.medicaleconomics.com/view/non-compete-clauses-what-physicians-need-know

Physiatry jobs vary based on so many factors.  One of these factors is the compensation model.  If it is your first PM&R job out of residency you probably won’t be able to choose the compensation model nor do you want to unless you are the rare exception that has some prior practice experience.  It usually takes awhile for a new physical medicine and rehabilitation graduate to ramp up their productivity so a guaranteed salary if helpful.  As an experienced physiatrist, even given guarantees from the new practice/hospital, you usually don’t know all the in’s and out’s of the new practice dynamics to ensure your success so a model with some certainty of income is the best.  However, you might be able to negotiate the compensation model so it’s wise to select one that fits you, e.g., your productivity, your practice style, etc.

One form of compensation associated with a physiatry job is when the entity guarantees/loans a physiatrist “X” dollars a year and that these guarantees/loans are forgiven if, for example, you stay at the job for three years. What isn’t considered by some physiatrists is that there are income taxes due on these amounts.  You may not pay tax on those amounts as received, but you will need to report the income and pay taxes on those dollars as they are forgiven.

Imagine if the total of practice support, educational loan repayment, relocation dollars, and signing bonus adds up to $450,000 (plus interest). The loans are to be forgiven over a three-year period following the end of the support period. The physiatrist is making $200,000 at the time forgiveness commences. This means that each year, for three years, the physiatrist’s taxable income will be reported as approximately $350,000 (this is $200,000 salary plus one-third of the $450,000 loan plus interest) and not just $200,000.  https://www.physicianspractice.com/view/physician-recruitment-agreements-4-things-consider

On the flip side, practices should determine the buy-out arrangement as early as when they post a physiatry job and not wait until the associate leaves.  Almost all medical groups have readily demonstrable value. Practices often believe they should vary the payout formula according to whether they have a new physiatry job because a physician’s departure is due to death, retirement, or disability, or if a physician retires “too young.” It is only fair to reward fully a departing PM&R partner who has participated in the group’s growth long enough to deserve a full payout, regardless of the reasons for the departure; after all, the physiciatrist is leaving behind essentially the same tangible and intangible values. An ongoing physical medicine and rehabilitation practice will almost always have the same patient loyalty and forecast for success, regardless of whether the departing physician dies, relocates, or retires. Such variations usually intend to penalize “inappropriate” departures to discourage partners from withdrawing voluntarily. But a practice’s success, to include successfully filling a physiatry job need, is usually tied inherently to the collegial, if not synergistic, interdependence of its physician members. Someone who no longer wishes to be in the group but who stays because of economic coercion will provide a negative influence on the continuing group practice. https://www.seak.com/wp-content/uploads/2014/09/LegalMistakesFinal.pdf

Physiatry groups that obtain life and/or disability insurance for their new PM&R physician when filling a physiatry job in amounts sufficient to fund buyout proceeds usually waste their money. It may be comforting to know that departures may have little economic effect on the remaining physicians, but this emotional comfort is often expensive and misplaced. First, even when the insurance is funded collectively by the group, a departing member will wind up paying for an allocated portion of his or her own insurance, which then benefits the group. The accounts receivable generated by that physician remain with the group. Thus, the doctor subsidizes his or her own insurance and provides a gift back to the remaining colleagues of the receivables and other intangible values he or she generated. Second, the practice’s receipt of insurance proceeds may trigger the alternative minimum tax under federal tax law, making this arrangement far less attractive. If the physicians try to avoid the agreement with a “cross-purchase” arrangement (by which the shareholders individually purchase policies on each other), this is a complicated process at best, and unwieldy when the group has more than two or three physicians. Third, insurance funds a departure only under certain circumstances. A life insurance policy will not fund a payout due to disability, nor will a disability policy fund a death payout. Neither will fund a retirement. The group may have to fund a payout regardless of insurance, so why not just structure the payout to be affordable and eliminate the insurance? On the other hand, sometimes a medical group has a physician whose drawing power, reputation, or influence is so great compared with that of the other physicians that the group is unsure whether it can survive that physician’s death or disability. In that case, insurance may be justified, to provide cash flow that would not necessarily be sustainable otherwise. https://www.seak.com/wp-content/uploads/2014/09/LegalMistakesFinal.pdf

Please visit www.farrhealthcare.com for a list of physiatry jobs.

PHYSIATRY JOBS

There are many physiatry jobs to consider.  Covid dampened the number of PM&R practice opportunities but as the pandemic eases so too has the job market.  Inpatient physiatrists are in particular strong demand.  Farr Healthcare, Inc. tries to make your practice search has worry-free as possible.  We can help direct you to positions that are a good match and guide you through the process.  Farr Healthcare also serves as your cheerleader to employers!

The physiatrist position falls under the broad category of physicians and surgeons, positions with exceptional job prospects. According to the U.S. Bureau of Labor Statistics, the projected employment for doctors and surgeons is expected to grow much faster than average through the year 2024. Board-certified physiatrists, who have an even better job outlook, also command higher salaries. Reference: https://careersinpsychology.org/physiatry-careers/

The PM&R practice search process starts with identifying practice opportunities of interest to you, talking with these entities and to the ultimate end of securing a job.  You can count on it taking 6 months or more usually when one considers the time to meet the practice, get references, get a state license, get on the payor panels, etc.

With experience in physiatry recruitment for over 30 years, Farr Healthcare is able to help doctors to find practice opportunities and employers to find physiatrists.  Not only are we able to find practice opportunities and physiatrists, we make every effort to make connections that are best-suited to both parties.  We use our insight to ask hiring entities information to help discern what candidates are the best fit.  We listen to physiatrists looking for work and ask questions to help identify what practice opportunities are the best for each individual.  We aim to be customer-friendly!

We are always striving to be in front of as many physiatrists and rehab organizations as possible to ensure that each will respectively have enough practice opportunities and physiatrists when their time comes for a search.  For example, we keep in touch with residency and fellowship programs.

According to the Association of Academic Physiatrists, there are over 10,000 board-certified physiatrists in the U.S., yet there is a growing patient base and needs in a variety of environments:

• Older adults are working longer: People are retiring later in life, and may incur on-the-job injuries that require PM&R treatment. By 2022, older males will compromise 27% and older females will make up 20% of the U.S. labor force.
• A number of areas in the U.S. currently have a shortage of rehabilitation services and/or physiatrists. Like other medical specialties, there is a geographic maldistribution of physiatrists. In certain geographic areas, no physiatric services are available.
• According to an article in McKnight’s, a medical industry publication, there is a growing need for physiatrists in sub-acute rehabilitation settings, such as skilled nursing facilities, due to shifts in payer level-of-care preferences. According to Dr. Gnatz: “Rehabilitation in the skilled nursing facility environment is rapidly emerging as the predominant level of inpatient rehabilitation care in the United States.”
• Physiatry’s greatest unmet need is in the number of academic physiatrists. PM&R residency programs continue to experience a shortage of academic talent to fill the growing number of chairperson and faculty positions.

Part of the PM&R practice search process is reference checking.  Given the years of experience that Farr Healthcare has in physiatry recruitment, we have developed relationships with physiatrists that enable us to gain greater insights during our reference-checking process. With a reputation for honesty, we present to the employer thorough information about physiatry candidates.

Typically, an interview follows if the references are good.  Here are some possible questions for the interview process according to https://www.betterteam.com:

1. What process do you follow to locate and diagnose a patient’s source of pain?

Demonstrates broad medical expertise and the ability to diagnose various medical conditions.

2. Describe a time when you collaborated with other medical professionals, such as a physical therapist, to develop a treatment plan for a patient. Was it successful?

Shows the ability to work with others.

3. Describe your most successful medical case to date. What factors contributed to your success?

Proves work experience.

4. How do you stay up to date with new treatments and advancements in physical medicine and rehabilitation?

Shows continuous training and professional development.

5. How do you motivate patients that are feeling despondent? How do you deal with patients who refuse to cooperate with you?

Tests interpersonal skills.

 

Congratulations!  You’ve been offered a physiatry job and received a contract.  Now what?  Most physiatrists pursue professional advice when a contract has been presented.  There’s a reason for that.  The contract is a vehicle to determine the terms of your PM&R work with a hospital or practice.  It also governs what happens when you leave it.

A few legal practices are listed on my website under the Resources tab that I have met while at various conferences.   I can not recommend any of these practices.  You may have local lawyers to assist you.  Of course, you want someone who has experience with physician contracts.

The physiatry contract you receive will no doubt have been crafted by the hiring entity’s attorney to protect their interests so it makes sense that you, too, should consult your attorney to safeguard your interests.  You should consult a lawyer to make sure that their contract is not overreaching in what it requires of you and, if so, you will want to negotiate those points.

One of the key features of the PM&R contract is the compensation section.  It spells out what you’ll receive, the terms of the finances, the calculation of the payment formula, etc.  Hence, it is important that it is as clear as possible and as complete as possible.  I might even suggest that an accountant review the financial part of your PM&R contract.

There are also practice management firms that will review doctor contracts.  Some of them are listed on my website, again under the Resources tab.  These practice management firms specialize in physiatry.  Again, I have never used any of them personally so I can’t recommend any one of them.

Don’t forget to look at the Openings page on my website, www.farrhealthcare.com