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Has anyone worked for or have any information regarding the laser spine institute? I have a job opportunity with extremely good pay (105k for clinic, plus 5 weeks vacation/cme) and great benefits with great match with 401k.

 

I have read about them and I have heard mixed reviews from patients online. This position would be for their clinic position, M-F, nighttime phone call (paid) 1:4, set hours. The flow of patient care is very streamlined... They have an initial phone consultation to determine if they are a candidate, then, the patient typically flies into town, checks into the hotel they have partnered with for the week, the patient brings their MRI/EMG on day 1 and meets with a mid level provider to go over test results and get their H & P, they then meet the surgeon, have another review of images, schedule surgery for the next day, then have the surgery (all outpatient) then the next day, get a post op visit, and fly home. The facility is brand new, gorgeous, they have a driver for the patients and families, a nurse that stays with the patient overnight in the hotel room, a cafe providing free food and coffee in the office, it sounds like a very efficient and boutique process.....however, My concerns are that it is primarily an all cash business (most insurance companies call it 'experimental'), it is very commercialized and kitschy. As a mid level, you just 'move the meat' and do H and P's all day....but, for the schedule and the money and 5 weeks vacation...it's an attractive offer. Has anyone had any experience with them before? Thanks!!!

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I'm interested to hear, too. It sounds like a nice offer. I recently started in neurosurgery, and we have patients who are also considering the Laser Spine Institute. I'm still very new to the field, but I'll share my two concerns for what they're worth. Firstly, I'd worry that patients are offered a treatment plan before they are examined. This would set some up for disappointment...those who on exam have a far worse clinical picture than the MRI states. Not to mention those who have psychiatric issues making them poor surgical candidates. Secondly, who follows them post-op? We follow surgery patients at least one year post-op. I suppose sending a rhizotomy patient home via plane is better than a two-level lumbar fusion with instrumentation. Like I said, I'm new and this all may be sorted, just my two cents. 

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Interesting.  As a company they have an amazing advertising campaign. Patients who came to see our community spine surgeon would ask if they could just have the laser like the laser spine institute.  We would explain they required a fusion and we did MIS TLIF, like they do. 

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I would not be interested in anyone that hired "midlevels" as I don't practice at a mid level, I practice medicine at the same level as everyone else

 

Does not sound like a good deal

 

You can't say no - they are there with films and cash in hand - so what really is your role?  you are just there to give a legal signature on the eval form.  You will  have  no clinical input - you just are a cog in the physician $$ making machine.  I would think something closer to $150k with 8 weeks PTO would be worth it - other then that no thank you.

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Thanks for the input! That's kind of how I feel....I wouldn't be doing a lot clinically in that type of job. Plus, there is call. I guess I got intrigued by the $$$...

 

Currently, I'm in a very busy hand/upper extremity practice and I feel my doc is under paying a bit for what I do. We are no 'call' but expected to stay in surgery until the day is over...which, sometimes can be 9 or 10pm at night. Office, too, can go late. I sometimes feel like we aren't utilized the way we should be, as my physician prefers to do co-clinics where we basically act as scribes for new patients, etc. We have occasional PA clinics, however, not too often...only when he is oot. I work with another PA (both of us directly paid by my physician) and we just got our first raise in 2yrs this year and then he cut out bonus way back this year stating that our numbers were down. I make 93k now, which is good, but, feel I deserve more. It's just frustrating because we work really hard and it is difficult to see how our numbers are 'down' when I see the lifestyle my physician lives. I work in a a state that isn't too friendly to PAs...choices can be limited in our area.

 

Sometimes it sounds good to make a larger increase in pay, with better hours, and closer to home but compromise my clincal function....

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I'll start by saying that I've only reviewed 4-5 surgical reports from them.  All of them were a minimally invasive surgery paired with either a radiofrequency neurotomy for joint pain (without diagnostic medial branch blocks) or an epidural injection.  I know that most online reviews were not that favorable.  I've seen most of the local neurosurgeons doing minimally invasive procedures anyhow. Disclaimer: I don't work in neurosurgery. I work at an interventional spine pain clinic.

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Former one-time spine PA here. I never once saw a laser.

 

The whole "Laser" thing is mostly a marketing tool. Make no mistake, LSI is first a business and second a practice. From what I understand their actual methods don't differ greatly from most contemporary neuros and ortho spine docs.

 

Be careful with these spine gigs. Many of them look amazing on paper. Big pay, big benefits, and the illusion of sane hours. But like Ventana said you aren't really practicing medicine. You are just a production monkey with a script pad. Think about it, you really have no power to say yes or no or even diagnose; you just streamline their practice for their benefit.

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Thanks for the input! That's kind of how I feel....I wouldn't be doing a lot clinically in that type of job. Plus, there is call. I guess I got intrigued by the $$$...

 

Currently, I'm in a very busy hand/upper extremity practice and I feel my doc is under paying a bit for what I do. We are no 'call' but expected to stay in surgery until the day is over...which, sometimes can be 9 or 10pm at night. Office, too, can go late. I sometimes feel like we aren't utilized the way we should be, as my physician prefers to do co-clinics where we basically act as scribes for new patients, etc. We have occasional PA clinics, however, not too often...only when he is oot. I work with another PA (both of us directly paid by my physician) and we just got our first raise in 2yrs this year and then he cut out bonus way back this year stating that our numbers were down. I make 93k now, which is good, but, feel I deserve more. It's just frustrating because we work really hard and it is difficult to see how our numbers are 'down' when I see the lifestyle my physician lives. I work in a a state that isn't too friendly to PAs...choices can be limited in our area.

 

Sometimes it sounds good to make a larger increase in pay, with better hours, and closer to home but compromise my clincal function....

 

If you want to get paid more you need to start earning it - yes you are putting in huge hours (to many actually - no way I would stay at work till 10pm at night with out overtime) but what the surgeon is looking at is the bottom line to the practice - sit down and figure out how much his running all the clinics is actually costing him - you can pretty much run the clinic - and make $$ for the practice, and then he can do more cases, or work less. 

 

you are close to 100k per year and I suspect you are bringing in no where near that much to the practice in direct income.  Yes you speed him up and make his life easier, but try to start your own clinic, make sure you are set up with the insurance companies, ask for your billing and receipts

 

I think you will be surprised 1) how small they are, 2) how easy it is to drive them up 3) how much you can bring into the practice.

 

This of coarse takes the Doc buying into it..... and that is a hard sell as he has to open up his books a little bit (most don't like that)

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As for a curiosity, how many PAs in neurosurg can say yea or no or formally diagnosed a patient without supervising doctors?

 

Sound though a good opportunity to venture into a different field. Can pick up a part time with that kind of hours.

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Thank you Ventana and everyone who contributed! I do feel like that position, while more predictable in terms of schedule, and a little bit more pay, would kind of be a position that would not really allow me to practice real medicine. Thanks for everyone's input. Now, I need to figure out how to get working on trying to get my own clinic....etc. :)

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As Ortho spine PA for 24 years I can tell you you in no uncertain terms the "Laser Spine" Institute is a total sham.  No insurance, cash only and they are NOT surgeon, they are pain mgt. docs.  Their advertising is amazing for sure, but if you Google Laser Spine lawsuit it is filled with bad press.  I would stay away.  

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As Ortho spine PA for 24 years I can tell you you in no uncertain terms the "Laser Spine" Institute is a total sham. No insurance, cash only and they are NOT surgeon, they are pain mgt. docs. Their advertising is amazing for sure, but if you Google Laser Spine lawsuit it is filled with bad press. I would stay away.

 

Agreed. Very sad how most doc prey on new PA. If you're are taking a position with a doc/surgeon. Must know where they went to school and where they train. If possible check w/ their state board. Make sure they've no dent on their records. Just the way they're screening you for the position; you've got to screen them too.

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