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This interview was conducted with a prominent Neurosurgeon in the Northeast.  We did the interview anonymously because he fully disclosed how much money he was making.  

What do you do for a living? Neurosurgeon

I’m a neurosurgeon.

How would you describe what you do?

Neurosurgery is a specialty that involves the diagnosis and treatment of conditions affecting the brain, spinal cord, peripheral nerves, and their supporting and surrounding structures.

What does your work entail as a neurosurgeon?

Three days a week I operate on the brain, the spine, or peripheral nerves. Two days a week I’m in the office seeing patients. I also teach medical students and I give lectures to residents.

How did you get started?

I became interested in medicine because I had a brain tumor when I was nine months old, so I was around a lot of doctors. I also watched the Donna Reed Show where Donna Reed’s husband was a pediatrician and I thought he had a nice life. And that’s the truth.

What do you like about what you do?

I help a lot of people. They come back to me and they say, “Thank you for helping me. I feel much better.” “Thank you for helping me. My pain is gone.” “Thank you for taking out my brain tumor.”

[The misconception is]That you have to be really smart to be a brain surgeon. I know a lot of people who are not smart, who are just hard workers and got through their residency. So, I think the joke, Well, hey, it’s not brain surgery isn’t necessarily accurate. I think it’s something that takes years to learn and it takes a lot of studying…But I don’t think that you have to be really smart.

I have four partners in my group who get along great. I can make my own schedule. I don’t have to work as hard if I don’t want to. One of my partners is much younger and has four younger kids, and he’s able to work less. We’re able to, in a sense, set our own schedules.

What do you dislike?

I dislike dealing with insurance companies who either deny payment for legitimate claims or delay payment for legitimate claims. In Pennsylvania they pay less for certain procedures than the same Blue Cross/Blue Shield company would pay for another city three hours away, like Cleveland or Columbus, which are comparable sized cities to Pittsburgh. The pay is between 50% and 100% higher in Columbus or Cleveland than it is in Pittsburgh. And that’s because Blue Cross/Blue Shield has the overwhelming majority of contracts in Pennsylvania, or at least in Western Pennsylvania, whereas in Ohio, there are lots of competing insurance companies.

How do you make money or how are you compensated?

I get paid for surgery. Of course, different people’s insurance pay different amounts. Medical assistance pays less. Medicare pays a little bit more. Private commercial insurance like Blue Cross/Blue Shield, Health America, United, Aetna pays a little bit more, but pretty much everything is based on Medicare.

I would recommend neurosurgery. Nationally there is a big shortage of neurosurgeons now and there will continue to be a shortage of neurosurgeons for at least the next 20 years. The number of training programs has not increased in the last 15 years and more and more neurosurgeons are retiring earlier because of high medical malpractice costs and because of the stress of the profession. So, the number of neurosurgeons now, in the year 2007, is the same as the number of neurosurgeons in 1991, yet the population of the United States has obviously grown by a third since 1991. So, neurosurgeons are busier than ever…

One insurance company will be 116% of Medicare, another insurance company will be 111% of Medicare, so everything is a multiplier of Medicare. So, it makes you a little uncomfortable that the federal government, which sets Medicare reimbursement rates, really is setting the reimbursement rates for everybody else.

How much does a neurosurgeon make?

It depends.  Neurosurgeon salary can be anywhere from $400,000 to over a million.  It’s really a function of how hard you work and how your practice is set up.

How much money do you make as a neurosurgeon?

About $600,000.

What education or skills are needed to become a neurosurgeon?

Four years of medical school, a year of internship, and then neurosurgical residency is an additional six years. So, my training was seven years after medical school.

What is most challenging about what you do?

Micro-brain surgery done under the microscope for aneurysms or certain deep tumors. Uses of computers for a lot of surgery is standard now, so I think using a computer for brain surgery and using a microscope for brain surgery are the most challenging aspects of the job.

What is most rewarding?

Personally, I think just having the patients come back and say, Thank you for helping me. I have a wall full of thank you notes. A lot of people thank me, but when somebody actually sends me a thank you card, I put it up on my wall. And after 20 years, my wall is pretty much full with thank you cards.

What advice would you offer someone considering this career?

The entry into medical school is pretty much now the same as it was 20 years ago. You need about a 3.6 GPA and you need to have reasonably good medical MCATs, Medical College Admission Test scores. And then once you get into medical school, then you can decide on any medical or surgical specialty. And you rotate through the different specialties and you see what you like or which professor inspires you. But you have to want to work hard because residency is hard, but even when you go into practice, a normal work day is 10 to 12 hours a day, and there’s always some night and weekend call. I have four partners, so I’m on call every fifth night and every fifth weekend, which doesn’t mean I operate at all those times. It means I have to handle phone calls and emergencies. So, a lot of hard work and good grades in college and to get into medical school.

How much time off do you get/take?

Well, we have requirements for continuing medical education. So, we have to go to approximately two meetings a year and those are usually in nice places. I’m going to San Diego in three weeks. I just came back from Washington D.C. in the spring. So, you get sort of a chance to go on a nice vacation to a nice place for a meeting. And then usually the amount of time you take off, other than the meetings, is about four weeks a year.

What is a common misconception people have about what you do?

That you have to be really smart to be a brain surgeon. I know a lot of people who are not smart, who are just hard workers and got through their residency. So, I think the joke, “Well, hey, it’s not brain surgery” is an understatement. I think it’s something that takes a lot of years to learn and it takes a lot of studying, and you have to keep up with your field, you know, read two or three journals a month, take your courses, go to the meetings go to continuing medical education things. But I don’t really think that you have to be really smart. I mean, I know a lot really smart neurosurgeons but I also know a lot of neurosurgeons who are not real smart. I mean they’re not geniuses.

What are your goals/dreams for the future?

I’d like to, at some point, stop operating and just teach residents full-time. I’d like to be able to do more laboratory research, which is hard to do unless you’re doing it full-time. I did laboratory research for a year and a half during my residency and if you’re doing it full-time, you can do it. But to do research in a laboratory when you’re actually practicing neurosurgery is essentially impossible. So, I’d like to be able to teach residents full-time because I think that’s very satisfying and do some clinical research.

What else would you like people to know about what you do?

I would recommend neurosurgery. Nationally there is a big shortage of neurosurgeons now and there will continue to be a shortage of neurosurgeons for at least the next 20 years. The number of training programs has not increased in the last 15 years and more and more neurosurgeons are retiring earlier because of high medical malpractice costs and because of the stress of the profession. It’s a stressful profession. So, you have 98 residency programs graduating 136 residents a year and there are about 150 neurosurgeons leaving practice each year because of health or retirement or what-have-you. So, the number of neurosurgeons now, in the year 2007, is the same as the number of neurosurgeons in 1991, yet the population of the United States has obviously grown by a third since 1991. So, neurosurgeons are busier than ever because the population is growing and the number of neurosurgeons has remained just about the same as it was almost 15 years ago.

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